Joint Health and Wellbeing Board Minutes

Joint Health and Wellbeing Board Minutes

Wednesday 6 December 2017
10:00 a.m.
Mandela Room, Town Hall, Middlesbrough

Attendance Details

Ms A Baxter,Mr D Budd, Mr M Braithwaite, Councillor M Carr, Ms C Elliott, E Kunonga, Ms V Nanda, T Parkinson, Councillor C M Rooney, Councillor J Rostron, E Scollay, Mr A Simpson, Ms C Smith, Councillor M Thompson, Councillor N J Walker, Ms K Warnock, Ms H Watson
J McNally, M Quinn
Apologies for absence:
Dr P Crawshaw, Mr M Davis, Mr B Clark,Mr D Gardner, Ms A Hullick, Ms A Hume, Mr C Irvine, B Kilmurray, Ms S McArdle, Ms S Picknett, P Stephens,
Declarations of interest:

There were no declarations of interest

Item Number Item/Resolution

The minutes of the Health and Wellbeing Board held on 6 September 2017 were agreed as a true and accurate record.

Tony Parkinson - Chief Executive - Middlesbrough Council

Edward Kunonga, Director of Public Health presented the Chief Executive Assurance Report.


The purpose of the report is to provide the Middlesbrough Health and Wellbeing Board with assurance that the Board is fulfilling its statutory obligations, and a summary of progress in implementing the Joint Health and Wellbeing Strategy.


The Health & Wellbeing Board were asked to consider the following items in the Chief Executive Assurance Report:


Joint Strategic Needs Assessment

  • The Board was asked to agree that the CYP JSNA goes out for further consultation and engagement with children and young people, to allow them to challenge and shape findings and conclusions, and notes the proposed next steps.


Health Protection

  • Notes that adequate multi-agency arrangements are in place to protect the health and wellbeing of the local population, and the progress made in addressing priority issues.

Pharmaceutical Needs Assessment

  • Notes the draft PNA summary of recommendations and the summary of changes.
  • Approves the DPH to proceed to take the PNA through the statutory 60-day consultation.
  • Receives the final report and a summary of the consultation findings at its March 2018 meeting.

Better Care Fund

  • Notes progress against the Better Care Fund at Quarter Two 2017/18.

South Tees Integration

  • Notes progress to date on Integration in Action initiatives.

Joint Health and Wellbeing Board arrangements

  • Notes progress made in developing joint H&WBB arrangements with Redcar and Cleveland Borough Council, and the proposed next steps.

Agreed as follows: -

  • The Health and Wellbeing Board noted the content of the report and agreed to the recommendations made

Tony Parkinson, Chief Executive of Middlesbrough Council presented a report to advise Middlesbrough Health and Wellbeing Board of the Council’s proposed strategic priorities for the period 201--21 and of its proposed approach to 'social regeneration'.


The report outlined the Council’s proposed strategic priorities for the period 2018-21, and its approach to social regeneration, one of three key thematic areas of future activity.


The Health and Wellbeing Board were advised that on 6 December 2017, Full Council will be asked to approve for stakeholder consultation a set of proposed strategic objectives and associated savings initiatives for the period 2018-21. Once finalised, the strategic priorities will form the basis of the Council’s Strategic Plan for the period, to be considered by Council on 28 March 2018. The savings initiatives will form part of the Mayor’s Budget for 2018/19 and those of future years.


The Chief Executive stated that in the past year the Council's approach to delivering the Mayor's Vision for Middlesbrough had featured around three strategic themes:


  • Business Imperatives - Ensuring that the Council operates efficiently and effectively, so that Physical and Social Regeneration outcomes are maximised.
  • Physical Regeneration - Investing in Middlesbrough to provide and improve facilities which act to increase the town’s reputation, create social opportunity, and improve the Council’s finances.
  • Social Regeneration - Working with our communities and other public service organisations to improve the lives of Middlesbrough’s residents.

The Board were advised that the proposed priorities in respect of Social Regeneration originate from a report presented to the Council Executive on 6 September 2017.  At this meeting the Executive:


  • Endorsed the principles of addressing the social regeneration agenda, including the working definition of social regeneration and its component parts.
  • Endorsed the methodology for developing a strategy to address social regeneration issues to be presented to Executive in March 2018 and
  • Endorsed the proposed commitment to the Council taking a lead role around public service reform, using fundamentally different approaches to engage our communities.

The Board were advised that community conversations would be taking place in the new year, to gain a wider and deeper understanding of residents needs and build on existing community assets.


The Health and Wellbeing Board were asked to:


  • Note the Council’s proposed strategic priorities for the period 2018-21 and provides feedback as requested.
  • Endorse the approach proposed to social regeneration, and commits to working with the Council and local communities in the manner described in the report to address this key issue.

Agreed as follows:-


  • The Health & Wellbeing Board noted the content of the report and endorsed the approach proposed to social regeneration.



Michael Quinn, Principal Housing Policy Officer

The Middlesbrough Housing Strategy was provided to the Health and Wellbeing Board for information.


The strategy aims to deliver investment in new and existing homes and neighbourhoods in order to meet the diverse needs and aspirations of Middlesbrough's communities, help people live healthier and happier lives, drive and support economic growth and mitigate public service challenges and costs.


The strategy has three key objectives:

  • meet the housing needs and aspirations of a growing population;
  • improve the life opportunities of residents in areas of poor quality housing and deprivation; and,
  • address the pressures of an ageing population and support vulnerable people to live independent lives for as long as possible

A Member commented that it was more of a statement than a strategy and that the strategy should be far more aspirational and talk more widely about regeneration.


The Board were informed that having taken into account comments received during a public consultation, the strategy was adopted by the Council’s Executive 22 November 2017.


Agreed as follows:-


  • The Health and Wellbeing Board noted the content of the report.
Alex Sinclair - Director of Programmes and Primary Care Development

Alex Sinclair, Director of Programmes and Primary Care Development presented the CCG update to Health and Wellbeing Board members.


The Board were informed that following the joint inspection of special educational needs and disability (SEND) services in Middlesbrough by the Care Quality Council and Ofsted a joint written statement of action had been developed in conjunction with stakeholders and had been approved by Ofsted.  The CCG are continuing to work in partnership with colleagues in Middlesbrough Local Authority to implement the actions to address education, health and social care actions and timelines.  The written statement of action is accessible to view on the South Tees CCG website and Middlesbrough Council Local Offer webpage.


The Board were also informed that the Resolution Health Centre will be closing.


The Chief Executive of Middlesbrough Council asked if it would be possible to have oversight of the CCG financial plan and recovery process.  It was agreed that an update would be provided at the next meeting of the Health and Wellbeing Board.


A discussion ensued on non-statutory services that were currently being reviewed and how this could impact on other services.  Members felt that it would be helpful for the Health and Wellbeing Board to have an oversight of the CCG plans.  It was felt by members that commissioners should work together to understand each other's commissioning plan and the potential adverse impact on organisations services.


Agreed as follows:-


The Health and Wellbeing Board noted the content of the report.

Edward Kunonga - Director of Public Health

Edward Kunonga, Director of Public Health presented the Middlesbrough Director of Public Health Annual Report 2016/17 - Dying Before Our Time?


The report highlighted the key issues regarding length and quality of life.  The following issues were highlighted as a great cause for concern:


  • The downward trend in year on year improvements in life expectancy at birth
  • The fact that people in the deprived wards have lower life expectancy at birth and lower healthy life expectancy
  • The growing gap between the borough average and England and the widening inequalities within the town

The following are the key recommendations to address the gaps and issues identified within the report:


Improving life expectancy at birth and healthy life expectancy

  • Inclusive growth - ensure the opportunities from economic development and regeneration are fairly distributed across all segments of the population
  • Ensure longer and healthier lives is a critical component of the social regeneration plans for the town
  • Implement the prevention strategy for adults and older people, Live Well Middlesbrough with a focus on prevention and early intervention for long term conditions and cancer
  • Develop and implement a prevention strategy for children, young people and families to address underlying causes of infant and child deaths

Reducing suicide deaths

  • Implement the Tees Suicide Prevention Strategy 2017-2020 with a focus on tackling the social determinants, building emotional resilience, mental health promotion and targeted work to reduce the risk of suicide in key high-risk groups

Reducing alcohol and drug related deaths

  • Develop and implement a multi-agency comprehensive plan to reduce drug and alcohol related deaths

Reducing deaths from accidents

  • Develop a multi-agency integrated approach to falls prevention
  • Review the road safety approaches to ensure awareness raising programmes and targeted action to address the rising casualties and fatalities

Preventing excess winter deaths

  • Refresh the approach to tackling fuel poverty and affordable warmth across the town

Agreed as follows:-


  • The Health and Wellbeing Board noted the content of the report
  • The Health and Wellbeing Board agreed to receive further updates on the implementation of the report
Helen Watson, Executive Director of Children's Services

Helen Watson, Executive Director of Children's Services provided the Health and Wellbeing Board with an update on the work being undertaken following the joint Care Quality Commission and Ofsted inspection of special educational needs and disability (SEND) in March 2017.  Helen stated that areas of concern raised following the inspection included:

  • Governance of the implementation of the reforms
  • Leadership
  • Commissioning

Helen informed Members that a Written Statement of Action has been produced following the inspection and that a significant amount of improvement will need to be shown by June 2018.  It was advised that a Dfe Advisor and colleagues from NHS England are supporting the local authority and CCG to ensure that significant improvement is made, support is also being provided from the London Leadership Challenge.  It was agreed that further updates will be provided to the Health and Wellbeing Board.


Helen provided an update to Members on the Children's Trust.  Members were informed that a workshop had been held in November 2017 with partners and had been well attended.  Helen provided Members with a draft of the Children and Young People's Plan.  Helen stated that the plan is in the early consultation stages and will have strong connectivity to other strategic documents and groups.


The key priorities of the Children and Young People's Plan are:

  • To safely reduce the number of children and young people who are looked after
  • Increase the number of families we work with at an Early Intervention threshold, for which the Toxic Trio features in the household.

A discussion ensued and Members felt it was important to consider the following:

  • How do we make the best use of information we hold
  • Define who the households are
  • Identify who these children are and which point to intervene

It was felt by all Members that adverse experiences such as physical abuse, sexual abuse, domestic violence, loss of a key adult in childhood can impact on adulthood.  It was stated that if a child experienced 4 or more their life chances diminish which can have an effect on Public Health, Mental Health and Social Care outcomes.


The Board were informed that the next meeting of the Children's Trust Board will be held on 8 January 2018.


The draft Early Help Strategy 2018-2022 was tabled at the meeting.  Helen informed Members that the strategy is a cross agency strategy and partnership challenge was welcomed.  Helen stated that the Early Help Strategy and Children's Trust Plan would work together and link with the Health and Wellbeing Strategy.  The Early Help Strategy will be presented at the next Children's Trust Board meeting on 8 January 2018.  Helen stressed that the strategy needs to be seen as a multi-agency response and not just a council strategy.


Agreed as follows:-

  • The Health and Wellbeing Board noted the information provided
  • Further updates will be provided to the Health and Wellbeing Board


Mark Braithwaite - Independent Chair - Middlesbrough Safeguarding Children Board

Mark Braithwaite, Independent Chair of the Middlesbrough Safeguarding Children's Board (MSCB) attended the meeting to present the MSCB Annual Report 2016/17 and to also provide an update on The Children and Social Care Act 2017.


Mark stated that safeguarding and child protection matters continue to hit the headlines and are a key priority for the local authority and partner agencies.


The Health and Wellbeing Board were informed that the following priorities had been agreed by the MSCB:



  • The MSCB will promote the safety and wellbeing of children and young people with a particular focus on those suspected of being at risk.


  • The MSCB will work with partner agencies to promote early help and recognise and respond to the neglect of children and young people.


  • The MSCB will develop and implement effective communication strategies with a focus on the participation of children and young people.


  • The MSCB will work with partner agencies to improve the link with adult services in particular those services working with domestic abuse, parental mental health and substance misuse.

Mark provided the Health and Wellbeing Board with an update on The Children and Social Work Act 2017.  Mark stated that this new piece of Government legislation proposed the biggest shake up of Social Work practice and Child Protection oversight for many years. The main provisions include:

  • Replacing LSCBs with new arrangements led by three safeguarding partners (Local Authorities, Chief Officers of Police and Clinical Commissioning Groups) with a duty to work together for the purpose of safeguarding and promoting the welfare of children in their area.
  • Requiring safeguarding partners to identify and arrange for the review of serious cases pertaining to their local area.
  • Providing for the establishment of a national practice review panel to commission and publish reviews that are complex and/or considered of national importance.
  • Providing clinical commissioning groups and local authorities joint responsibility for child death review work enabling for a wider geographic footprint aiming to gain a better understanding of emerging themes.

Mark informed the Health and Wellbeing Board that the provisions of the Act commence in April 2018 and safeguarding partners are required to publish details of what their future arrangements are to be by April 2019. DfE intend final implementation of the new arrangements by July 2019.


Mark stated as Independent Chair to the LSCB in Middlesbrough, it would be a dereliction of his responsibilities if he did not raise concerns and challenge the complexity of unpicking current LSCB arrangements in favour of new Multi-Agency Safeguarding Arrangements (MASAs) it was pointed out that this will not be straightforward and that the new arrangements must aim to be better than they are currently to justify the potential disruption that transition will inevitably cause.


Agreed as follows:-


  • The Health and Wellbeing Board noted the content of the report





Ann Baxter - Independent Chair - Teeswide Safeguarding Adults Board

Ann Baxter, Independent Chair of the Teeswide Safeguarding Adults Board (TSAB) provided an update to the Health and Wellbeing Board.  Ann informed the Members that the TSAB had, had a positive year and continued to work with partner organisations and share information.  Members were informed that that the TSAB had held over 60 events/forums over the past year.  Methods of communication used to promote the work of the TSAB had included Twitter, Facebook, e bulletins and a regional radio campaign to highlight self-neglect, modern day slavery and hoarding.


Ann reported that the TSAB had undertaken one serious case review this year and the learning from this review would be shared across all agencies.


Ann stated that future challenges for the TSAB included substance misuse, mental health, modern day slavery and the growing population and limited resources.


Agreed as follows:-

  • The Health and Wellbeing Board noted the update provided.
Mark Davis, Chief Executive, MVDA

Mark Davis, Chief Executive of MVDA was unable to attend the meeting.  An update report will be circulated electronically to Members of the Health & Wellbeing Board.

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