All committee members were present. 

Apologies were noted from Councillor David Hitchiner (Leader of the Council) and Dr Ian Tait (Chair of NHS Herefordshire and Worcestershire Clinical Commissioning Group).

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

There were no substitutes.

To receive any declarations of interests in respect of schedule 1, schedule 2 or other interests from members of the committee in respect of items on the agenda.

No declarations of interest were made.

To approve the minutes of the meeting held on 2 March 2020.

The minutes of the last meeting were received.

Resolved:  That the minutes of the meeting held on 2 March 2020 be approved 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 for this meeting.

To receive any written questions from councillors.

A question received from Councillor Tillett and the response provided by the consultant in public health, and a supplementary question asked by Councillor Tillett under this item and the response provided by the director of public health (during the following agenda item), are provided in an appendix to these minutes.

To consider a presentation on suicide prevention from the Adults and Communities Directorate and to determine any recommendations the committee wishes to make.

The committee received a presentation from the head of community commissioning and resources (HCCR) on suicide prevention, as included in the appendix to the report.  The principal points included:

i.           Suicide prevention had been a national priority for a number of years and, whilst local authorities led on this, it involved a whole system / multi-agency approach.

ii.         The national policy position, that all suicides are potentially preventable, was embraced locally.

iii.        The most recent official data (2018) showed significant increases in completed suicides nationally, particularly for people under 25, but this was not replicated locally, where there was a slight downward trend overall, with the same number of deaths in 2017 and 2018.

iv.        Demographically, nationally and locally, men aged 35-64 were at greatest risk of suicide.  There was high representation of farming / construction sectors.  There was also higher incidence in areas of greater deprivation.

v.         Hanging was the most commonly used method in completed suicides.

vi.        There was a significant change evolving in the way in which coroners recorded suicide, moving away from the traditional criminal standard of proof (beyond reasonable doubt) and towards the civil standard (the balance of probabilities).

vii.       Interpreting and understanding suicide data was complicated by the relatively low numbers locally and the time that could elapse before confirmation of death by suicide was received.

viii.      The ‘Herefordshire Suicide Prevention Strategy 2019-2023’ had been approved by cabinet in July 2019 and included the key priorities of: communities; media; bereavement information and support; reducing the means of access to suicide; reducing the risk of suicide for high risk groups; mental health services; and self-harm.  These reflected national priorities, apart from the inclusion of ‘communities’ which reflected the local approach to working with communities on prevention.

ix.        An action plan had been developed in conjunction with a number of organisations and groups.  Although the process had been affected by the Covid-19 emergency, good progress had been made in some areas.  It was commented that, anecdotally, there could be an increasing risk of suicides occurring in Herefordshire but this could not be verified without further intelligence.

x.         There was good work emerging with a number of voluntary groups, including national groups such as Survivors of Bereavement by Suicide and PAPYRUS, and local groups such as the CLD Trust.  There was a great deal of potential for multi-agency effort, with interest from the Primary Care Networks and the emergency services.

xi.        Real time data (RTD) was a key issue that had been made a national priority.  It was anticipated that an RTD capture arrangement, in collaboration with the emergency services, would be established before the end of the year.  There were compelling reasons to take this approach, such as directing bereavement support quickly and appropriately; people bereaved by suicide were more likely to feel suicidal themselves, with around 9% making a suicide attempt.  This would also enable patterns and emerging trends to be identified.  The sensitivities to be managed, including the potential for suicide not to be  ...  view the full minutes text for item 7.

To consider the committee’s work programme.

The chairperson noted that members had identified various potential items for future consideration and these now needed to be prioritised based on their impact, significance, timeliness and potential to lead to effective outcomes.  It was reported that a work programming session was being arranged for scrutiny committee members during October 2020.

The chairperson drew attention to the schedule of recommendations and responses, made by the committee at the January and March 2020 meetings, and requested an update on the position with NHS Continuing Healthcare (CHC).  On behalf of the assistant director all ages commissioning who had to leave earlier in the meeting, it was reported that the work on CHC had ceased during the past few months, as CHC itself as a funding stream was suspended between March and August.  It was expected that the issue would be progressed now that the relevant teams were back in operation and an update would be provided to a future meeting.

Resolved:      That consideration of the work programme be deferred to the work programming session for scrutiny committee members.

The next scheduled meeting is Monday 23 November 2020 at 2.30 pm.

It was noted that the next scheduled meeting was Monday 23 November 2020.