PEOPLE'S BOARD

At a meeting of the People's Board held on Wednesday, 6 June 2018

(Present)

Geoffrey Appleton (Deputy Chair) Chair, St Helens CCG Rachel Cleal Deputy Director People’s Services Michael Ejuoneatse Deputy Chair/Deputy Clinical Lead, St Helens CCG Louise Harrison Local Police Commander, Merseyside Police Sue Hill Director of Finance, Bridgewater Community Healthcare Tom Hughes Chair, Healthwatch Tom Knight Head of Primary Care, NHS England Councillor Long Council Leader, St Helens Council Michelle Loughlin Assistant Director Public Health Ann Marr Chief Executive, St Helens and Knowsley Teaching Hospitals Councillor Neal Cabinet Member, Better Health and Building Arts and Culture Sarah O’Brien Strategic Director People's Services / Clinical Accountable Officer Sandra Oluonye Assistant Chief Officer, National Probation Service Councillor Pearson Cabinet Member, Developing Young People John Quick Assistant Chief Executive, Community Rehabilitation Co. Councillor Quinn Cabinet Member, Adult Social Care and Health Dr David Reade GP Principal Mark Thomas Prevention Manager, Merseyside Fire and Rescue Tina Wilkins Clinical Network Director, North West Boroughs Healthcare NHS Foundation Trust Michelle Wood Head of Health and Housing, Torus Sally Yeoman CEO, Halton & St Helens VCA

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1 APOLOGIES FOR ABSENCE

Apologies were received from Councillor Burns, Phil Garrigan, Stephen Tracey and Rob Young.

2 MINUTES

* Resolved that the minutes of the meeting held on 14 March 2018, be approved and signed subject to the following amendment:

Minute 47 : Operation Sector to read ‘Sceptre’.

3 DECLARATIONS OF INTEREST

No Declarations of Interest from Members were made.

4 JOINT LOCAL AREA SEND INSPECTION ST HELENS

The Strategic Director People's Services / Clinical Accountable Officer presented the report on the Joint Local Area SEND Inspection St Helens. PEOPLE'S BOARD

The report updated the Board on the outcomes and findings from the inspection undertaken by Ofsted and Care Quality Commission (CQC), between 29 January 2018 and 2 February 2018, on the local area’s arrangements for children and young people with special educational needs (SEND) and/or disability.

The inspection was undertaken by one of Her Majesty’s Inspector from Ofsted, with a team of Inspectors including an Ofsted Inspector and a Children’s Services Inspector from the Care Quality Commission (CQC).The purpose of the inspection was to evaluate how local areas were discharging their duties under the Children and Families Act 2014.

The three broad areas of focus for the inspection were:

 The effectiveness of the local area in identifying children and young people who have special educational needs and/or disabilities;  The effectiveness of the local area in assessing and meeting the needs of children and young people who have special educational needs and/or disabilities; and  The effectiveness of the local area in improving outcomes for children and young people who have special educational needs and/or disabilities.

It was reported to the Board that the St Helens Inspection report highlighted a significant number of positives and areas of strength, and relatively few areas identified for improvement. It was noted that where the report did identify areas for improvement, it was acknowledged that the local area was already taking action to address these areas.

The full letter from Her Majesty’s Inspector dated 21 March 2018, outlining the findings of the inspection, was attached to the report at appendix 1

The Board was informed that the intention was to work with the Parent/Carer Forum and the Children and Young People’s Engagement Forum to develop underpinning workstreams in order to address the areas identified.

* Resolved that:

(1) the report be noted; and

(2) a vote of thanks be given to all staff involved in the SEND Inspection.

5 ST HELENS CARES CLINICAL AND SUPPORT STRATEGY

The Strategic Director People's Services / Clinical Accountable Officer presented the report on the St Helens Cares Clinical and Support Strategy.

The strategy had been produced to build on the positive progress made by Partners in St Helens in integrating services through genuine collaboration and outlined how clinical and other social, community and wellbeing services would operate across the four St Helens localities of St Helens South, North, Central and Newton and Haydock.

A presentation was made to the Board which detailed the following:

 Aim of Presentation;  Main Additions to the strategy;  Locality model; PEOPLE'S BOARD

 What will it mean for Residents?  What will it mean for Staff? and  What will it mean for the Borough?

The Board was informed that the Strategy was a progression of the work that Partners in St Helens had achieved together over the previous 18 Months and gave a framework for the implementation and delivery of localised and effective services that would deliver both the strategic outcomes and the vision of reducing cost and demand whilst improving the quality of services.

The report detailed the vision for the borough including; agreed strategic outcomes and shared principals, The St Helens Circle, Locality Model, underpinning enablers of locality approach, performance indicators and measuring success of the locality approach and priorities and conclusion.

The I Statements, Explaining the Inner Rings of St Helens Circle, Draft Urgent Care Strategy, St Helens Cares Locality Handbook and Financial Modelling were appended to the report at Appendices 1 to 5 respectively.

The Board discussed the report and comments were made regarding reviewing if Pharmacy and Dentistry were in the correct tier of the ‘Inner Rings’ of the St Helens Circle with a proposal that they should be in the first rung of the circle not second.

Questions were raised regarding measuring success and outcomes as a result of the strategy and if there was scope for evolving the model. Assurance was given that audit and assessment had been built in and that there was flexibility to develop the strategy. The Board was also informed of the formation of a Delivery and Learning Group to continue the development of the system over all localities.

The Board acknowledged the impact the third sector had on enabling social prescribing and the role it had in supporting the system, alongside the need to ensure that local school links continued to be established.

* Resolved that the report be noted.

6 DISCUSSION PAPER ON NEW ARRANGEMENT FOR CHILD DEATH OVERVIEW PANELS

The Assistant Director of Public Health presented the Discussion Paper on new arrangements for Child Death Overview Panels (CDOP).

The current child death review processes were contained within Working Together, and formed an integral part of the Children’s safeguarding arrangements, with Merseyside CDOP being responsible to each of the five existing Local Safeguarding Children’s Boards (LSCB).

The Board was informed that current national arrangements were being changed; with a transfer of responsibility for Child Death Reviews from the Department for Education to the Department of Health; with Local Authorities and CCG’s becoming the new accountable bodies. PEOPLE'S BOARD

The paper informed the Board on the changes to the Child Death Review process, outlined the key issues that needed addressing, highlighted the implications for stakeholders and recommended next steps.

The Board was informed that a workshop with stakeholders was proposed to be undertaken on 9 October 2018.

* Resolved that:

(1) the report be noted;

(2) endorsement be given from this Board for the Merseyside Child Death Overview Panel to continue to operate on the existing five Local Authority area footprints;

(3) it be noted that the accountability for Child Death Overview Panels be moved from the Local Safeguarding Children’s Board to the People’s Board;

(4) a review of the current budget and contributions be undertaken to determine how future funding should be arranged to fund the future Child Death Review process in a fair and equitable way;

(5) current chairing arrangements be reviewed to determine whether there is a need for change;

(6) the proposed date of 9 October 2018 for a stakeholders workshop be noted; and

(7) a report on the outcomes from the workshop and proposals on future arrangements be received by this Board.

7 TACKLING DOMESTIC ABUSE - ST HELENS STRATEGY 2018-19

The Strategic Director People's Services / Clinical Accountable Officer presented the report on Tackling Domestic Abuse – St Helens Strategy 2018-2023, as approved at a meeting of the Cabinet held on 21 February 2018.

The Tackling Domestic Abuse St Helens Strategy 2018-2023 had been developed specifically for St Helens to reflect local needs and was intended to be the framework for all agencies to respond effectively to domestic abuse.

The Strategy was a partnership document and responsibility for its delivery required the Council and other agencies to take responsibility for specific priority areas. Four priority areas had been identified, together with the outcomes that we are looking to achieve with each of the priority areas.

The four priorities areas were identified as:

 Prevention;  Partnership;  Provision; and PEOPLE'S BOARD

 Protection.

To support the delivery of the Strategy it was proposed that new governance arrangements be implemented and a Domestic Abuse Strategy Group be established with overall strategic oversight for the strategy and to report regularly to the Board.

The Board was informed that the Domestic Abuse Strategy Group would be supported by a Domestic Abuse Operational Group, which would lead on the delivery of the Action Plan, and a High Risk Steering Group which would monitor the performance of the Multi- Agency Risk Assessment Conference (MARAC) and the Domestic Violence Disclosure Scheme (DVDS).

The Tackling Domestic Abuse St Helens Strategy 2018-23 (February 2018) and Community Impact Assessment were attached to the report at Appendices 1 and 2 respectively.

The Board discussed the strategy and agreed the importance in capturing the victims and survivors voice to help underpin and continue to inform the strategy.

* Resolved that:

(1) the report be noted;

(2) an update on the implementation of the strategy be brought to a future meeting of this Board; and

(3) the Board to receive 6 monthly updates following implementation of the strategy.

8 ST HELENS PEOPLE AND PLACE: MAXIMISING OPPORTUNITIES FOR GOOD HEALTH AND WELLBEING

The Assistant Director of Public Health presented the report on St Helens People and Place: Maximising Opportunities for Good Health and Wellbeing which detailed the joint work being completed by People’s and Place and outlined further integrated work to improve health and wellbeing in the borough.

The report detailed the interconnected key determinant of health which all played a part in health and wellbeing for an individual and a neighbourhood. These key determinants were; socio-economic status, economic factors, physical environment and social environment.

It was reported that there were three particular aspects of health and wellbeing that were having a significant negative impact on our local population and remained key public health priorities for work going forward. These were; alcohol, obesity and mental health and wellbeing.

The report recommended the following areas for inclusion in future work plan; public health input to planning, licensing and health, promotion of active travel and sustainable transport, development of policies for engaging with commercial organisations with a potential to impact on health and wellbeing and Liverpool City Region. PEOPLE'S BOARD

The Action Plan for 2018/19 and Guidance and Key Frameworks were attached to the report at Appendices A and B respectively.

* Resolved that:

(1) the report and action plan for 2018/19 be noted;

(2) a joint work programme be developed to maximise future opportunities for integrated working and improvement of health and wellbeing; and

(3) the recommended areas for future work plans as detailed in the Action Plan 2018/19 be noted and agreed.

9 JOINT STRATEGIC NEEDS ASSESSMENT – SECTION 2 LIFE EXPECTANCY, MORTALITY, AND MAJOR AND LONG TERM CONDITIONS AND SECTION 4: ADULT LIFESTYLES

The Assistant Director of Public Health presented a report which informed the Board on the 2018 update to the Joint Strategic Needs Assessment (JSNA) reports, Life Expectancy, Mortality and Major and Long Term Conditions and Adult Lifestyles.

The key findings of the reports were:

Life Expectancy, Mortality  In St Helens between 2014 and 2016, the life expectancy at birth was 77.5 years for men and 81.0 years for women. While the long-term trends in life expectancy at birth in St Helens are upward, it has decreased by 0.4 years for men and 0.6 years for women since 2011-13;  Rates of early mortality due to cancer decreased in both males and females in 2017 compared with the previous year; and  Early deaths due to respiratory disease have increased over recent years and are now close to double the national rate.

Major and Long Term Conditions  Between 2009/10 and 2014/16 the cancer incidence rate increased by 15% in St Helens CCG, 11% regionally and 8% nationally;  17.6% of the St Helens GP registered population were recorded as having high blood pressure (2016/17), which is the highest prevalence amongst all CCGs in Cheshire and Merseyside. (It was noted that this may in part reflect the significant efforts undertaken locally to identity and treat previously undiagnosed hypertension); and  The rate of one year survival after a cancer diagnosis has increased significantly in St Helens from 55.7% in 2000 to 72.3% in 2015. This rate is now equal to the national average.

Adult Lifestyles  Alcohol harm in the Borough remained significant. St Helens had the tenth highest rate for mortality from alcohol-related conditions of 152 upper tier and local authorities in 2016.  Smoking attributable mortality in St Helens was significantly higher than the national average (359.8 and 272.0 respectively). However, smoking rates were PEOPLE'S BOARD

falling and the St Helens rate of smokers who successfully quit was the highest rate in the North West region and the 6th highest rate nationally in 2016/17.  72.1% of adults in St Helens were estimated to have excess weight (overweight or obesity). This corresponds to more than 100,000 adults within the Borough; and  In 2016, the rate of sexually transmitted infections diagnosed in St Helens (including chlamydia) was 645 diagnoses per 100,000, (1,146 cases) which was significantly lower than the England rate of 750 per 100,000.

There is a legal duty under the Health and Social Care Act 2012 for Local Authorities and Clinical Commissioning Group (CCG) to jointly undertake the JSNA and that duty was discharged through the Health and Wellbeing Boards. The process for development should be decided locally and take note of national guidance and that states the JSNA’s should support health and social care commissioning decisions and the development of Joint Health and Wellbeing Strategies, (People’s Plan in St Helens).

The Board discussed the contents of the report, in particular the heath inequalities presented within differing wards of the borough. It was proposed that a piece of work be undertaken looking at way in which health inequalities within the borough may be tackled.

* Resolved that:

(1) the report be noted; and

(2) a strategy/approach for tackling health inequalities within the borough be developed and brought to a future meeting of the Board for consideration.

10 DATE OF NEXT MEETING

Wednesday, 25 July 2018 at 2.30pm at Room 10, Town Hall

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