Apologies were received from Diane Jones MBE, Ian Stead and Councillor EJ Swinglehurst.

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

Christine Price attended for Ian Stead.

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

None.

To approve and sign the minutes of the meeting held on 13 February 2018.

It was requested that additional text be include in minute no. 150 at the first sentence of paragraph two, to read:

Responding to a question from the vice-chair about the functioning of the system in the context of reductions to the public health budget, it was explained that this was about the wider approach across the system where wellbeing was everyone’s business.

RESOLVED

That subject to the additional wording as noted, the minutes of the meeting held on 13 February 2018 be approved as a correct record and signed by the chairman.

To receive questions from members of the public.

Questions must be submitted by 5pm two clear working days before the day of the meeting, in this case by 5pm on Thursday 10 May 2018. 

Please submit questions to: councillorservices@herefordshire.gov.uk

Guidance on submitting public questions can be seen here: https://www.herefordshire.gov.uk/info/200148/your_council/61/get_involved/3

Accepted questions will be published as a supplement prior to the meeting.

None.

To receive questions from councillors.

Questions must be submitted by 5pm two clear working days before the day of the meeting, in this case by 5pm Thursday 10 May 2018.

Please submit questions to: councillorservices@herefordshire.gov.uk

Accepted questions will be published as a supplement prior to the meeting.

None.

To approve Understanding Herefordshire 2018, the annual summary of Herefordshire’s Joint Strategic Needs Assessment (JSNA).

The Director of public health introduced officers from the intelligence team who had produced the joint strategic needs assessment (JSNA).

The Intelligence team leader presented the report and explained that Understanding Herefordshire was an annual high level summary, and that this year was a light touch exercise, and more information would be published on the Understanding Herefordshire website.

She highlighted the key findings with focus on the priority areas for the health and wellbeing board which were identified from the 2017 JSNA:

·         Fuel poverty – a high proportion of older people were living in the county’s rural areas, putting them at risk of fuel poverty, and the consequences of this, including increased susceptibility to poor health and winter deaths

·         Childhood dental health and obesity – there had been little change in the data since last year, and more information would following on this priority in the autumn to draw out some information on inequalities

·         Dementia – the number of people with dementia who had a formal diagnosis was lower than the national target

More generally in terms of the population:

·         there was little change from 2017 regarding low average earnings in the county

·         There were high levels of digital exclusion which was a consideration when looking at how people were able to get access to services and information

·         An integrated learning disability needs assessment found inequalities around heath checks and cancer screening

·         Stroke, heart disease and hypertension rates were higher than the national level.  An integrated needs assessment for cerebrovascular disease, linked to risk of strokes, was part of the core offer and found that there was high prevalence but low mortality leading to the development of a pathway.

The Director of public health added that stroke and diabetes prevention work were priorities for the sustainability and transformation partnership and there was work in progress with Worcestershire, which involved clinicians and CCG colleagues.

The Director of public health explained that future JSNAs would take a more themed approach with plans to take a more in-depth look into particular neighbourhoods to explore issues around inequalities.

The Chair noted the important role of the JSNA and its role in identifying priorities.

In response to a comment about identifying communities, the Interim director of adults and wellbeing commented that it was important to be clear on language used in the reports and what particular terms meant, such as intermediate care.  Commenting also on rates of lower earnings being prevalent for some time, affecting peoples’ ability to afford housing, he added that there were people with low earnings and who were self-employed, who relied on their parents for support to buy houses or act as guarantors. This highlighted the challenge that people who were needed to fill gaps in the workforce would struggle to afford to live the county. The challenge was not limited to buying homes as the rental market was costly and limited, so a key element would be to consider how the system could help solve the problem and attract recently  ...  view the full minutes text for item 157.

To approve the Pharmaceutical Needs Assessment (PNA) 2018-2021.

The Director of public health explained that it was a function of the health and wellbeing board to publish the pharmaceutical needs assessment (PNA), which was intended to inform the strategic planning for pharmaceutic services. She reported that there were no significant changes from the previous needs assessment published in 2015 but it was important to ensure the information was up to date, and as highlighted by the JSNA, it was important to consider the issue of digital exclusion when looking at developing digital services.  

The Director of public health summarised the main points that:

·         Both the 2015 and the 2018 PNAs had found that there was adequate provision of pharmaceutical services including adequate provision of a ‘flu vaccination service and no reduction in provision of emergency contraception, stop smoking and needle exchange services

·          Adequate provision of pharmaceutical services would need to take into account the future housing supply

·         The role of pharmacist was key in terms of what could be offered around responding to the health and wellbeing board’s priorities, minor illnesses and reducing demand on other services, and so there was work underway with the CCG on how to take this forward.

RESOLVED

That the2018-2021 Pharmaceutical Needs Assessment be approved for NHS and public health commissioners to implement.