To receive apologies for absence.

Apologies for absence had been received from Kevin Crompton (Herefordshire Safeguarding Adults Board), Susan Harris (Herefordshire and Worcestershire Health and Care NHS Trust), Dr Mike Hearne (Herefordshire General Practice), Tina Russell (Herefordshire Council), Simon Trickett (NHS Herefordshire and Worcestershire Integrated Care Board) and Superintendent Helen Wain (West Mercia Police).

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

Dr Lauren Parry attended in person for Dr Mike Hearne, and Chief Inspector Gregory Tudge attended remotely for Superintendent Helen Wain.

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

No declarations of interest were identified at the start of the meeting.

During the agenda item ‘Update to the board on the implementation of the Physical Activity Strategy’ and due to the participation of representatives of Halo Leisure, Stephen Brewster declared an other interest as a member of the Board of Trustees of Halo Leisure.

To approve and sign the minutes of the meeting held on 9 December 2024.

The minutes of the previous meeting were received.

Resolved:  That the minutes of the meeting held on 9 December 2024 be confirmed as a correct record and be signed by the Chairperson.

To receive any accepted written questions from members of the public.

No questions had been received from members of the public.

To receive any accepted written questions from councillors.

No questions had been received from councillors.

To provide an update on the progress of the implementation plan for the Health and Wellbeing Board’s strategic priority of giving our children the ‘Best Start in Life’ focusing on 0-5 years.

The report was introduced by the Public Health Principal, highlighting progress recorded in the Best Start in Life (BSiL) Implementation Plan 2023-2025 (Appendix 1 to the report) and in the Outcome Indicators Dashboard (Appendix 2).

Attention was drawn to the following red, amber, green (RAG) ratings:-

i.             Red indicators: dental decay in 5-year-olds; MMR (measles, mumps and rubella) vaccination at 5 years; DTaP and IPV (diphtheria, tetanus, acellular pertussis and inactivated poliomyelitis vaccine) booster vaccinations at 5 years; vaccination coverage of children in care; and premature births (less than 37 weeks).  The board was advised about the work being undertaken in relation to oral health and vaccinations.

ii.            Amber indicators: mother’s smoking status at time of delivery; overweight children including obesity at reception and year 6; children achieving a good level of development at age 2.5 years; and Free School Meals children reaching a good level of development at the end of reception year.  It was reported that local data suggested that ‘smoking status at time of delivery’ had reduced from 8.3% to 6.7%.  It was commented that the time lag in some national data sources highlighted the need to explore the use of uptake data and other proxy indicators at a local level to identify trends more quickly.

iii.          Green indicators included: the launch of the Healthy Schools programme, with work coming along on the Healthy Tots programme, and for further education settings; and SEND (special educational needs and disabilities) champions had been implemented within the 0-5 service and were represented in each PCN (Primary Care Network) area.  It was commented that progress had been made in terms of partnership working and in utilising data from early years settings to inform policy development.

The Public Health Lead (Children and Families) provided further details about BSiL projects and initiatives.  The key points included: over 45 schools had signed up to the Health Schools programme; the Healthy Tots programme aimed to enhance standards in early years settings, including addressing issues around unhealthy baby and toddler food products; a large proportion of schools had signed up to the supervised toothbrushing scheme; through the recommissioning of the 0-19 years Public Health Nursing Service, additional health checks had been introduced and were receiving good uptake; and work with the local maternity services included the roll-out of ‘challenging conversations’ training to midwives around healthy lifestyles.

The Chairperson emphasised the corporate parenting principles for children in care and sought further clarification on the position with vaccination coverage.  The Public Health Principal commented on the efforts to identify which vaccinations were missing, noting that a significant proportion of the children concerned were in out of county settings, and the Public Health Programme Officer (Strategy and Partnerships) outlined the work with partners and other local authorities to administer vaccinations and to improve the recording process.  The Vice-Chairperson noted that the position had improved, with coverage increasing from a baseline of 80% to 87% currently; this compared favourably to the region (83%) and England (85%).

The Chairperson questioned why  ...  view the full minutes text for item 43.

The purpose of this report is to update the Health and Wellbeing Board on the actions taken to work towards achieving a Smoke Free Generation (SFG) in Herefordshire, including the new Tobacco Control Alliance, and request sign-off from the board on the new Tobacco Control Plan.

The Consultant in Public Health introduced the item and explained that the purpose of the Tobacco Control Plan was to reduce smoking prevalence and create a ‘smokefree generation’ in Herefordshire by 2030.

The Public Health Lead – Healthy Behaviours delivered the presentation ‘Tobacco Control Report’, including slides on: Background; Expected Impact; Tobacco Control Plan (including the four workstreams of prevention, supporting smokers to quit, eliminating variations in smoking rates, and effective enforcement); Measuring Progress (including reducing the number of adult smokers, reducing smoking rates among individuals with a long-term mental health condition, increasing the number of quit dates set, and reducing the number of children and young people who vape); and Recommendations. 

The Public Health Officer (Tobacco Control) drew attention to Appendix 1 to the report, ‘Planned Actions 2025 – 2030’, and explained that the next quarterly Tobacco Control Alliance meeting would consider indicators/measurements that were currently identified as ‘to be confirmed’ and would work with partners to assign the responsible service(s).

The Chairperson commented on the ‘Smokefree Sidelines’ initiative which encouraged people not to smoke at local youth football matches.

In response to questions from board members, the Public Health Officer (Tobacco Control) reported that:

1.           Work had been undertaken through the Healthy Schools programme to engage with students about vaping, but it was recognised that there was more to be done.  The Chairperson commented on the number of children and young people who vape and expressed concern about potential long-term implications.

2.           The Tobacco Control Alliance included representation from the Trading Standards department, reflecting ongoing efforts to stop underage sales.  It was noted that the Tobacco and Vapes Bill intended to place additional controls in connection with tobacco, vapes and other products.

Resolved:  That

a)      the new Tobacco Control Plan for Herefordshire and the roadmap to achieve a Smokefree Herefordshire by 2030 be supported;

b)      actions to deliver on the Smokefree Herefordshire 2030 strategic priorities, including building strong place-based partnerships to achieve our Smokefree ambition, be supported; and

c)      an annual report from the Tobacco Control Alliance, on progress against the planned actions of the Tobacco Control Plan, be added to the work programme for the board.

To provide an update on the progress and the actions taken to work towards delivering the Physical Activity Strategy and next steps.

The item was introduced by the Consultant in Public Health.  The presentation ‘Herefordshire's Physical Activity Strategy’, was delivered as follows:

i.             The Public Health Lead – Health Behaviours presented the slides: Physical Activity in Herefordshire; Sport and Physical Activity Levels (Children and Young People in school years 1-11); and Highlights of the Action Plan Deliverables. 

Halo Leisure

ii.            Aneka Rao, Evaluation Specialist, presented the slides: Halo – Feel Good For Life; Programme Overview; Project Goals; Training and Support; Accessible Leisure Environment; Key Performance Indicators – Highlights; Wellbeing; and Partners and Signposting.  Mark Farrell, Active Communities Coordinator, presented the slides: Rika and Colin; and Session Information.  Ryan Stratton, Active Communities Manager, also contributed.

In response to a question from a board member, it was confirmed that work was to be undertaken to qualify and quantify the social return on investment.

Stride Active

iii.          Beky Williams, Managing Director, presented the slides: Stride Active – Community Interest Company; An Overview of Stride Active; Areas of Focus; Supporting Healthy Schools; Here Girls Can, including the video Here Girls Can - Be part of the Change; and Climbing and Resilience Interventions.  Sarah Volpe, Active Families Co-ordinator, presented the slides: Active Families; Active Families Physical Activity Impact; Active Families Outcomes; and A Family’s Physical Activity Journey.

The Chairperson commented on a visit to the Here Girls Can Festival in 2024, including witnessing positive changes in the levels of confidence and engagement in several participants.  Board members briefly discussed opportunities to raise the awareness of primary care practitioners to such campaigns.  A comment was made about the potential of physical activity projects to address specific inequalities within the system.

iv.          The Talk Community Health and Wellbeing Manager, responsible for the Healthy Lifestyle Service, presented slides on: Ramblers’ Wellbeing Walks.

v.           The Public Health Lead - Mental Health presented the slide: Next Steps.

Noting reference to the next step ‘Broaden the existing strategy to focus on the development of a Healthy Weight Strategy…’, a board member commented on the need to consider the linkages to new weight loss medications for obesity to be prescribed in primary care settings.

The board thanked the presenters and noted the merit of hearing from people involved in the schemes.  The Chairperson commented that the board would welcome the participation of relevant parties in appropriate agenda items at future meetings.

Resolved:  That

a)      the progress to date be noted; and

b)      the board encourages all partnership organisations to be clearly sighted on the Herefordshire Physical Activity Strategy and reference it across their own strategies and plans.

To consider the work programme for the board.  The board is also invited to consider topics for the next board workshop / development session to be held in (date to be arranged) July 2025.

The updated work programme for the board was considered and additions were identified.

Resolved:  That the work programme be agreed, with the following additions:-

a)           an annual report to be received from the Tobacco Control Alliance; and

b)          consideration be given to a future agenda item on work and health (with reference made to the WorkWell project) for September 2025 or December 2025.

The note the date of the next scheduled meeting, Monday 9 June 2025, 2.00 pm.

The date of the next scheduled meeting in public was confirmed as Monday 9 June 2025, 2.00 pm.