To receive apologies for absence.

Apologies for absence had been received from Councillor Carole Gandy.

To receive details of members nominated to attend the meeting in place of a member of the committee.

Councillor Helen I’Anson participated via remote attendance on behalf of Councillor Carole Gandy.

To receive any declarations of interest in respect items on the agenda.

Councillor Peter Jinman declared an ‘other interest’ in the agenda item ‘The Impact of the Intensive Poultry Industry on Human Health and Wellbeing Scrutiny Report’ due to connections to farming related bodies, as disclosed previously in the Register of Interests.

To receive the minutes of the meeting held on 23 September 2022.

The minutes of the previous meeting were received.

RESOLVED:

That the minutes of the meeting held on 23 September 2022 be confirmed as a correct record and be signed by the Chairperson.

To receive any written questions from members of the public.

No questions had been received from members of the public.

To receive any written questions from members of the council.

No questions had been received from councillors.

This report provides a brief summary update on issues previously considered by the Health, Care and Wellbeing Scrutiny Committee, including responses to information requests made by the committee, updates on resolutions made by the committee, including reports and recommendations to the executive and the executive response and executive decision made in respect of scrutiny reports and recommendations.

The Interim Statutory Scrutiny Officer reported that the recommendations made at the last meeting on ‘Obesity in Herefordshire’ (minute 16 of 2022/23 refers) had been reported to Cabinet on 24 November 2022, and the executive response was expected within two months.

RESOLVED:

That the progress report on scrutiny information requests, scrutiny reports and recommendations, and other matters raised by the committee be noted.

To note the work plan for the committee.

The Interim Statutory Scrutiny Officer introduced the work plan for the committee.

The Chairperson noted that matters relating to Herefordshire Minor Injury Units (MIUs) had been considered by the former Adults and Wellbeing Scrutiny Committee and a briefing note on the current position was requested from the Managing Director of Wye Valley NHS Trust.  The committee briefly discussed the role of cabinet members and how information was disseminated to other councillors.

The Chairperson noted that a briefing note had been requested at the last meeting on dementia provisioning, aligned to the agenda item on ‘Domiciliary and Residential Care in Herefordshire’ to be considered at the 6 March 2023 meeting.

In response to a question from the Vice-Chairperson, the Managing Director of Wye Valley NHS Trust provided an update on the situation in terms of strike action to be taken by the members of the Royal College of Nursing (RCN).  It was noted that the required thresholds had not been reached at Wye Valley NHS Trust but RCN members at Herefordshire and Worcestershire Health and Care NHS Trust would be taking action, and the Herefordshire and Worcestershire Integrated Care System was planning accordingly.

RESOLVED:

That the work plan for the committee be noted.

To present to the committee a review of the development of the Herefordshire Health and Wellbeing Strategy, with firstly, an assessment of the overall impact and any learning points from the existing strategy and then secondly, inform the committee of the progress and timelines of the new draft Herefordshire Health and Wellbeing Strategy.

The Director of Public Health introduced the item with the following comments: the report included an assessment of the existing strategy and limitations in terms of being able to understand its impact and the governance for the delivery of the strategy were acknowledged; the report set out the process for developing the new strategy, in accordance with the requirements of the Health and Social Care Act 2012; an online survey was being undertaken, closing on 11 December 2022; and, with input from the Executive Director of Strategy and Integration, an overview was provided of the interface between the Health and Wellbeing Strategy, the new Integrated Care Strategy for Herefordshire and Worcestershire, and the new Joint Forward Plan.

The committee discussed the report, the principal points included:

1.           The Chairperson noted the difficulties with the existing Health and Wellbeing Strategy and the need for robust monitoring and analysis of the effectiveness of the new strategy going forward.

2.           The Director of Public Health said that the existing strategy was relatively good but there had been challenges around organisational memory and ownership.  The new strategy would identify high level priorities which would be allocated to partnership / governance groups for oversight of the delivery plans, with reporting to the Health and Wellbeing Board; the intention was to co-produce the delivery plans with the community.

3.           The Director of Public Health said that it was recognised that many determinants of health lay outside the National Health Service and there was an opportunity to utilise system leadership through the Health and Wellbeing Board to influence the wider socioeconomic, cultural and environmental conditions; this may involve focus on a smaller number of priorities over a certain period.

4.           The Director of Public Health considered that the Health and Wellbeing Board was fulfilling its functions in accordance with the provisions of the Health and Social Care Act 2012 but the development of the strategy provided an opportunity to consider how the board could be more effective in addressing existing and emerging challenges and inequalities.

5.           In response to a comment from a member in attendance about the dissemination of information in relation to the ‘Roll out of the Solihull Parenting Programme’, as referred to in Table 1- ‘Summary of achievement against priorities’ (agenda page 45), the Chairperson suggested that the matter be raised through the Children and Young People Scrutiny Committee.

6.           The Vice-Chairperson commented on the need for measurable and meaningful Key Performance Indicators (KPIs), with appropriate monitoring and reporting, to ensure that outcomes were being achieved. 

The Executive Director of Strategy and Integration concurred and said that the Joint Forward Plan would set out specific, measurable indicators with clear trajectories and actions to address the identified priorities.

For purposes of clarity, the Director of Public Health advised that the KPIs referenced in Table 1 related to the Fingertips Public Health Outcomes Framework (link to the website) which involved longer term and national issues.

The Director of Public Health emphasised that there were  ...  view the full minutes text for item 28.

To report the outcomes and recommendations of the Task and Finish Group on ‘The Impact of the Intensive Poultry Industry on Human Health and Wellbeing'.  The committee is invited to consider the outcomes from the task and finish group and to decide if the report and recommendations adopted and submitted to the Cabinet.

Further to the draft report debated in detail by the committee at its meeting on 22 July 2022 (minute 8 of 2022/23 refers), the committee considered a further iteration of the task and finish group report.

Councillor Felicity Norman, chairperson of the task and finish group, advised that the report had been updated to reflect comments made during the previous discussion and to tighten some of the wording used in the document.  Members, officers and stakeholders involved in the preparation of the report were thanked for their input.  Councillor Norman reported that the task and finish group had not found evidence of harmful impact from the intensive poultry industry on human health, commented on the importance of ‘One Health’ (i.e. the interlinking of the health of people, animals and the environment), noted that anecdotal evidence indicated that some people had anxieties and concerns, and emphasised the need for more research and evidence.

The committee discussed the document, the principal points included:

i.             With reference made to a recent report by the Alliance to Save Our Antibiotics and World Animal Protection (link to the report) and a related response by the Responsible Use of Medicines in Agriculture (RUMA) Alliance (link to the response), the Chairperson noted that this was a live topic and there was a need for more data and better understanding.

ii.            Attention was drawn to Recommendation 5 (Pollution Monitoring and Abatement Equipment and Techniques) and the Chairperson commented that local testing in terms of modelling would be beneficial to the planning application process.

The Head of Public Protection advised that no monitoring of dust levels was required by the Environment Agency currently and it was understood that the purpose of the recommendation was to invite government to consider best available techniques now available.

The Chairperson suggested that the council should work with the industry on a voluntary basis on the use of monitoring equipment to sense-check modelling reports.

iii.          With reference made to paragraphs 30-32, a committee member welcomed the suggestions about the involvement of local public health bodies in the development of a ‘Health Impact in Planning’ Supplementary Planning Document and for all planning applications to be screened for suitability for health impact assessments.

The Public Health Consultant welcomed the report and advised that preliminary work was being undertaken on a toolkit for conducting a health impact assessment.

iv.          A committee member commented on the need to encourage the upgrading / retrofitting of existing intensive poultry units to the best available techniques.  The Chairperson suggested that an adjustment to Recommendation 5 to reference both existing and new intensive poultry units explicitly.

v.           In response to a query from the Head of Public Protection about Recommendation 8 (Intensive Poultry Farming Myth Busting), the Chairperson considered that the recommendation anticipated the preparation of a brief summary of current knowledge, with links to further resources, and suggested adjustments to the recommendation.

The Vice-Chairperson acknowledged the importance of addressing common misconceptions and offered to assist  ...  view the full minutes text for item 29.