Agenda and minutes

There were no declarations of interest received on this occasion. </AI1>

Resolved – That the minutes of the previous meeting be agreed and signed as an accurate record.

None received.

The quarterly data had been included with the agenda pack for information.

Resolved – That the quarterly data be noted.

The Board received a presentation from Karen Coker, (Staffordshire County Council Children and Families Lead Commissioner) and Nicola Bromage (Integrated Care Board Associate Director Mental Health, Learning Disability, Autism and Children and Young People) on the good mental health priority and the progress made to date in this area, supported by Louise Andrews-Gee (Staffordshire County Council) and Jan Cartman-Frost (Staffordshire County Council).

The Board were reminded of the eleven strands identified in the Health and Wellbeing Board Strategy in relation to engendering Good Mental Health in Staffordshire and the presentation was structured to provide an update on the work being undertaken in each of these areas:

-      More social interaction and physical activity

-      Reduced unsafe social media use

-      Using the Five Ways to Wellbeing and other evidence-based approaches

-      Improved maternal and parental mental health

-      Early identification of mental health issues in children and young people

-      Mental health and wellbeing support for children and young people

-      A stronger focus on workplace mental wellbeing

-      A system-wide approach to preventing and reducing suicide and self-harm

-      More initiatives that tackle loneliness and social isolation

-      Public sector organisations as exemplars-creating employment, training and volunteering opportunities for local people

-      Encouraging and enabling communities to support each other.

The Good Mental Health in Staffordshire Strategy had been approved in March 2023 followed by a supporting action plan in September 2023. It primarily focussed on adults but also covered the transition into adulthood and incorporated the Health and Wellbeing Board good mental health priorities as part of the strategy’s 6 priority outcomes. The Board were provided with an update on the progress made during the first year of delivery, which had included the expansion of crisis provision, a strategy for in-patient services, increased physical health checks and interventions, a housing strategy developed with district/ borough councils, Shared Lives placements and baselining data for future comparisons.

As it related to mental health, Lisa Cope was asked to provide an update on the Right Care Right Person, a project being led by Staffordshire Police aimed at ensuring people with mental health issues received the right support from the right emergency services. A project evaluation report had been completed for Phases 1 and 2 which had focussed on calls relating to concern for welfare and walkouts and people missing from health facilities. It was reported that the primary objectives had been achieved and minor issues were being addressed to work towards long-term operational stability. The Board heard that the project and the Integrated Care Framework had strengthened working arrangements between all three emergency services, health providers and local authorities, and the phased approach had been found helpful. Phases 3 and 4, which related to the transportation of Section 136 patients and voluntary mental health activity, were currently being implemented. A final project closure report was due in February and would document lessons learned, outcomes realised and provide a status update on wider partner activity. NHS guidance on the implementation of Right  ...  view the full minutes text for item 19.

The Board received the Staffordshire and Stoke-on-Trent Adult Safeguarding Partnership Board (SSASPB) Annual Report for 2023/24 for consideration and feedback.

The annual report covered the period for 1^st April 2023 to 31^st March 2023. Mr John Wood had been Independent Chair of the Board during this time but had since retired and the role had been taken over by Adrian Green, who joined the meeting virtually to provide an overview of the report. The Vice Chair, Ruth Martin (Principal Social Worker, Staffordshire County Council), was also in attendance to support the presentation.

It was reported that the SSASPB had received a total of seven referrals of incidents. Only one of these had met the criteria for a Safeguarding Adult Review (SAR) (‘Gillian’) but three different single agency reviews had been initiated. The report also provided updates on previous SAR Reviews and how learning from these had been applied, such as hosting an event on mental capacity and sexual safety during the 2023 National Safeguarding Adults Week.

During the year the SSASPB had received presentations covering a range of subjects including police public protection units, MASH arrangements, safeguarding information sharing, prisons, Right Care Right Person and Pit Stop. Adrian highlighted the Right Care Right Person initiative as a future area to watch as incidents would be channel shifted away from the police to other agencies.

Adrian summarised the progress towards SSASPB’s strategic priorities, which included Making Safeguarding Personal, reviews of mental capacity and Deprivation of Liberties Safeguards (DoLs), improving response to self-neglect and understanding the safeguarding risks during transitional periods. It was reported that there was a backlog with DoLs and mental capacity assessment had become a priority for 2025-27. The SSASPB’s audits had identified key themes including self-neglect, and nationally 70% of SARS had a self-neglect element. These were becoming more complex and review of self-neglect pathways was underway. Staffordshire had implemented updated pathways for transition between services, and these were providing better supervision and oversight.

Headlines for the reporting period were highlighted to the Board. During 2023/24, 15,810 safeguarding concerns had been received by local authorities in Staffordshire, with repeats of around 17%. Over half of the safeguarding enquiries were regarding adults aged over 75 years old, the most prevalent types of abuse were neglect and acts of omission (30%), 67% of abuse occurred in their own home and the main type of care required was for physical support, followed by memory and cognition.

In Staffordshire, 2950 (19%) of the concerns had progressed to a formal ‘Section 42’ enquiry. The report included a breakdown of the equalities data for these cases and referrals seemed to be proportionate with the county’s population. Councillor Leung asked whether it would be possible to provide more detailed ethnicity categories to reflect the diversity of the population and to show the breakdown by district. Adrian explained that this had been set as one of the new priorities for 2025-27 as the SSASPB wanted to better understand the demographics of local communities and  ...  view the full minutes text for item 20.

The Board received the Staffordshire Safeguarding Children Partnership Board Annual Report for 2023/24 for consideration and feedback.

Lynne Milligan, the Business Manager for the Safeguarding Children Partnership (Staffordshire County Council) was joined by Ian Vinall, the outgoing Independent Chair and Scrutineer, who joined the meeting virtually to provide a presentation summarising the annual report for 2023/24. The incoming Chair, Vicky Lee (Chief Superintendent for Staffordshire Police) and Sharon Conlon (Assistant Director for All Age Safeguarding and CYP Quality Lead at the Integrated Care Board and member of the partnership) were also in attendance. Bernie Brown (Director of Children and Families, Staffordshire County Council) was also a member of the partnership.

Ian Vinall explained that following the publication of the statutory guidance ‘Working Together’ in December 2023, the child safeguarding arrangements had been updated, with the board transitioning to a partnership in June 2024. Details of these new arrangements would be published in December 2024 and placed responsibility and accountability on the Chief Constable of Staffordshire Police, the Chief Executives of the Local Authority and the Integrated Care Board. These responsibilities had been delegated to Vicky Lee (Police), Bernie Brown (Local Authority) and Heather Johnstone (Integrated Care Board). Work to develop the new partnership’s vision and priorities was ongoing and would involve engagement with colleagues from the early years, education and further education sectors. As part of the new arrangements the timescales for reporting the Child Safeguarding Partnership annual report and Child Death Overview Panel report had changed and were now required to be published by September.

Lynne Milligan provided an overview of the report. The main priority of the partnership for 2023/24 had been ‘the neglect of the under ones’ and the annual report summarised the activity and outcomes undertaken by the partners to improve the collective response to neglect. Historically the category used to record neglect on the system had been overused in Staffordshire and work had begun to recode the category so that issues such as child exploitation would be recorded as ‘harm outside the home’ rather than neglect.

The Child Safeguarding Board had worked with partners to reduce parental risk factors and influence delivery plans. This had resulted in an increase in the number of women accessing community perinatal mental health services and the implementation an e-learning package to improve the confidence of the workforce working with non-verbal children.

The Health and Wellbeing Board were informed that the rate of serious incident notifications in Staffordshire during 2023/24 remained similar to the national average. Six rapid reviews had been conducted during the year. Four Child Safeguarding Practice Reviews (CSPRs) had been published and two were pending criminal proceedings. The independent scrutineer had identified recurring themes from these reviews which were listed in the report and presentation.

The Board were informed that progress had been made on improvements since recent inspections, there had been an improvement in the recruitment and retention of staff, particularly in children’s social care, and there had been an increased understanding of the child’s experience  ...  view the full minutes text for item 21.

The Board had been provided with presentation slides which provided an overview of the annual report, summarising the content requirements prescribed by the Department of Health and Social Care, and the highlights for 2023/24. A summary document and the full annual report had been published on the Integrated Care Board (ICB) website following external audit, sign off by NHS England in July and the ICB’s AGM in September.

Paul Winter, the ICB’s Associate Director for Corporate Governance explained that, as the organisation had only been established part way through the previous financial year, when it had taken on the statutory duties and powers previously held by Clinical Commissioning Groups, this was the ICB’s first full annual report. It included information about the ICB’s work programmes and key risks and challenges faced from 1^st April 2023- 31^st March 2024, with three main sections covering performance, accountability and the annual accounts. Achievements highlighted in the presentation included the creation of seven portfolios to concentrate on specific areas, 230 beds opened in ‘virtual wards’, two community diagnostic centres opened, a pilot scheme of increased support for severely frail patients, exceeding the dementia diagnosis rate target and completing annual health checks for over 5000 people with a learning disability.

The ICB was required to work with the Health and Wellbeing Board (HWBB) to undertake a statutory review on improving population health and inequalities, the work of the Integrated Care Partnership and the progression of the NHS’s Joint Forward Plan.

The timescales for the production of the 2024/25 annual report were outlined. A new template and guidance for annual reports was due to be published in January 2025 and a first full draft of the report for 2024/25 needed to be submitted to NHS England by April, providing a potential opportunity for engagement with Health and Wellbeing Board partners in January/ early February and around three months to work together on the mandatory sections before being brought formally to the Board in March for sign off. Paul Winter was keen to hear ideas about how to make the engagement process more meaningful and invited suggestions for areas where the ICB and HWBB could work better together during the following year.

Dr Harling acknowledged the prescribed content requirements of the annual report and expressed an interest in exploring how the Staffordshire narrative could be drawn out.

Elizabeth Disney, the new Chief Transformation Officer for Staffordshire and Stoke-on-Trent ICB, commented on the opportunity to consider how the ICB and HWBB work together as part of the proposed review of the health and wellbeing board, which was due to be discussed later on the agenda. With this in mind the Chair brought forward the Health and Wellbeing Board Review item on the agenda.

Resolved – (a) That the Board note the Integrated Care Board Annual Report 2023/24; and

(b) That the Board note the timescales for the production of the 2024/25 ICB annual report and the opportunity to consider how the HWBB could contribute to this.  ...  view the full minutes text for item 22.

Claire McIver, the County Council’s Assistant Director for Public Health and Prevention, and Miriam Hussain, the new Lead Officer for the Health and Wellbeing Board, had put together a proposal to conduct a review to identify potential improvements to the way that the Staffordshire Health and Wellbeing Board operates.

It was proposed that the review would involve interviews with Health and Wellbeing Board members to identify strengths and areas for improvement and would also research insights from other health and wellbeing boards, with findings shared at the next meeting in March.

Claire McIver acknowledged there had been improved partnership arrangements across the system but felt there was potential for further improvement in areas such as health inequalities, and with the integration of programmes of work and the health and wellbeing board and strategy. The review would provide an opportunity for members to provide feedback on whether the Board was meeting the needs of their individual organisations.

Councillor Sutton endorsed the proposal and commented on the potential for the review to help develop the Board and consider the potential to reduce the need for people to present updates to multiple committees or organisations.

Councillor Pert highlighted the importance of partners using the Joint Strategic Needs Assessment to align their priorities and suggested seeking insights from the Local Government Association if the review timescales allowed.

Councillor Leung welcomed the review and commented on the value of having breakdowns of activities and ethnicities by district to enable borough and district councils to help with engagement. Allied to this Cllr Sutton emphasised the importance of the district and borough councillor members on the Board acting as representatives of all the second-tier authorities.

Resolved – (a) That the Board authorised the review of the Health and Wellbeing Board and approved the objectives, methodology and timescales presented in the report; and

(b) That the Health and Wellbeing Board continued to use the existing Terms of Reference approved in December 2023 until the review was concluded.

Elizabeth Disney, the Staffordshire and Stoke-on-Trent ICB Chief Transformation Officer, provided the Board with a verbal update on the Better Care Fund.

The Board heard that a joint review of the Better Care Fund was underway to consider the services provided by the fund and the outcomes delivered, with the Integrated Care Board and local authority commissioning teams from Staffordshire and Stoke-on-Trent and other partners all involved. Current investments were being reviewed line by line to see what may need to change in the future to ensure the fund provided the best outcome from services and best value for the population. A formal report detailing the first part of the review would be considered at the next Health and Wellbeing Board meeting in March.

Resolved – That the Board note the update on the Better Care Fund.

Miriam Hussain informed the Board that the following items had been listed on the Forward Plan for consideration at the March meeting, but the agenda would need to be refined to allow adequate time for consideration of each item:

• ‘Healthy Aging’ priority progress update, linked to the Health and Wellbeing Board Strategy
• Staffordshire and Stoke-on-Trent Alcohol Strategy
• Integrated Care System and Joint Local Health and Wellbeing Strategy
• Healthwatch Public Engagement update
• Disability and Neurodiversity Partnership Board update
• Child Death Overview Annual Report
• Better Care Fund Review
• Health and Wellbeing Board Review Conclusion
• Right Care, Right Person

Councillor Sutton agreed that the agenda would need to be subject to review, but highlighted that the Child Death Overview Report had already been deferred until the next meeting and emphasised the importance of considering the Health and Wellbeing Board Review conclusions at the next meeting.

Resolved – That the Board note the items for the March meeting, acknowledging they may be subject to change.