A meeting of the OVERVIEW AND SCRUTINY PANEL (SOCIAL WELL-BEING) will be held in CIVIC SUITE 0.1A, PATHFINDER HOUSE , ST MARY'S STREET, HUNTINGDON, CAMBS, PE29 3TN on TUESDAY, 3 JULY 2012 at 7:00 PM and you are requested to attend for the transaction of the following business:-

Contact (01480)

APOLOGIES

1. MINUTES (Pages 1 - 4)

To approve as a correct record the Minutes of the meeting of the Miss H Ali Partnership held on 12th June 2012. 388006

2 Minutes.

2. MEMBERS' INTERESTS

To receive from Members declarations as to personal and/or prejudicial interests and the nature of those interests in relation to any Agenda Item. Please see Notes 1 and 2 overleaf.

2 Minutes.

3. LOCAL GOVERNMENT ACT 2000: FORWARD PLAN (Pages 5 - 8)

A copy of the current Forward Plan, which was published on 13th Mrs H Taylor June 2012 is attached. Members are invited to note the Plan and to 388008 comment as appropriate on any items contained therein.

10 Minutes.

4. UPDATE ON REDESIGN OF MENTAL HEALTH SERVICES

To receive an update on NHS Cambridgeshire’s redesign of mental health services across Cambridgeshire and Peterborough.

Mr John Ellis, Head of Mental Health, Learning Disability and Substance Misuse Commissioning for NHS Cambridgeshire, Mr K Spencer, Director of People and Business Development and Mr C Denman, Medical Director for Cambridgeshire and Peterborough Foundation Trust will be in attendance for this item.

20 Minutes.

5. VOLUNTARY SECTOR FUNDING 2013/14 ONWARDS

To receive a report from the Head of Environmental and Community D Smith Health Services on voluntary sector funding from 2013/14 onwards – 388377 “TO FOLLOW” .

20 Minutes.

6. JOINT STRATEGIC NEEDS ASSESSMENT - AWARENESS RAISING (Pages 9 - 28)

To receive a presentation on the Joint Strategic Needs Assessment. The presentation will inform the Panel’s discussions on the Cambridgeshire Health and Wellbeing Strategy 2012 – 17 which is the next item on the Agenda.

15 Minutes.

7. DRAFT CAMBRIDGESHIRE HEALTH AND WELLBEING STRATEGY 2012 - 17 (Pages 29 - 62)

To receive a report from the Head of Environmental and Community Health Services on the draft Cambridgeshire Health and Wellbeing Strategy 2012-17.

20 Minutes.

8. LEADERSHIP DIRECTION

To receive a report from the Corporate Office proposing the adoption H Thackray of a new Leadership Direction for the Council – “TO FOLLOW” . 388035

20 Minutes.

9. NEIGHBOURHOOD FORUMS - PROPOSALS TO ESTABLISH LOCAL JOINT COMMITTEES IN HUNTINGDONSHIRE - CONSULTATION RESPONSES (Pages 63 - 108)

To receive a report from the Head of Legal and Democratic Services Miss H Ali detailing the outcome of the consultation on the proposals to 388006 establish Local Joint Committees in Huntingdonshire.

20 Minutes.

10. CAMBRIDGESHIRE ADULTS, WELLBEING AND HEALTH OVERVIEW AND SCRUTINY COMMITTEE

To receive an update from Councillor R J West on the outcome of recent meetings of the Cambridgeshire Adults, Well-Being and Health Overview and Scrutiny Committee.

5 Minutes.

11. WORK PLAN STUDIES (Pages 109 - 114)

To consider, with the aid of a report by the Head of Legal and Miss H Ali Democratic Services, the current programme of Overview and 388006 Scrutiny studies.

15 Minutes.

12. OVERVIEW AND SCRUTINY PANEL (SOCIAL WELL-BEING) - PROGRESS (Pages 115 - 124)

To consider a report by the Head of Legal and Democratic Services Miss H Ali on the Panel’s programme of studies. 388006

15 Minutes.

13. SCRUTINY

To scrutinise decisions as set out in the Decision Digest and to raise any other matters for scrutiny that fall within the remit of the Panel – “TO FOLLOW” .

5 Minutes.

Dated this 25 day of June 2012

Head of Paid Service

Notes

1. A personal interest exists where a decision on a matter would affect to a greater extent than other people in the District –

(a) the well-being, financial position, employment or business of the Councillor, their family or any person with whom they had a close association;

(b) a body employing those persons, any firm in which they are a partner and any company of which they are directors;

(c) any corporate body in which those persons have a beneficial interest in a class of securities exceeding the nominal value of £25,000; or

(d) the Councillor’s registerable financial and other interests.

2. A personal interest becomes a prejudicial interest where a member of the public (who has knowledge of the circumstances) would reasonably regard the Member’s personal interest as being so significant that it is likely to prejudice the Councillor’s judgement of the public interest.

Please contact Miss H Ali, Democratic Services Officer, Tel No: (01480) 388006 / email: [email protected] if you have a general query on any Agenda Item, wish to tender your apologies for absence from the meeting, or would like information on any decision taken by the Panel.

Specific enquiries with regard to items on the Agenda should be directed towards the Contact Officer. Members of the public are welcome to attend this meeting as observers except during consideration of confidential or exempt items of business.

Agenda and enclosures can be viewed on the District Council’s website – www.huntingdonshire.gov.uk (under Councils and Democracy).

If you would like a translation of Agenda/Minutes/Reports or would like a large text version or an audio version please contact the Democratic Services Manager and we will try to accommodate your needs.

Emergency Procedure

In the event of the fire alarm being sounded and on the instruction of the Meeting Administrator, all attendees are requested to vacate the building via the closest emergency exit.

Agenda Item 1

HUNTINGDONSHIRE DISTRICT COUNCIL

MINUTES of the meeting of the OVERVIEW AND SCRUTINY PANEL (SOCIAL WELL-BEING) held in Civic Suite 0.1A, Pathfinder House, St Mary's Street, Huntingdon, PE29 3TN on Tuesday, 12 June 2012.

PRESENT: Councillor S J Criswell – Chairman.

Councillors S Akthar, Mrs P A Jordan, P Kadewere, Ms L Kadic, M C Oliver, J W G Pethard and R J West.

Mr R Coxhead and Mrs M Nicholas – Coopted Members.

APOLOGY: An Apology for absence from the meeting was submitted on behalf of Councillor K M Baker.

6. MINUTES

The Minutes of the meetings of the Panel held on 3rd April and 16th May 2012 were approved as a correct record and signed by the Chairman.

7. MEMBERS' INTERESTS

No declarations were received.

8. LOCAL GOVERNMENT ACT 2000: FORWARD PLAN

The Panel considered and noted the current Forward Plan of Key Decisions (a copy of which is appended in the Minute Book) which had been prepared by the Executive Leader of the Council for the period 1st June to 30th September 2012. The item entitled “Housing Strategy 2012-15 – to include Tenancy Strategy” would be submitted to the September meeting of the Panel.

The Chairman reported that the item entitled “Voluntary Sector Funding 2013 Onwards” had been deferred for consideration by the Panel at its July 2012 meeting.

9. EQUALITY FRAMEWORK FOR LOCAL GOVERNMENT EQUALITY PEER CHALLENGE - ACHIEVING ACCREDITATION

With the aid of a report by the Corporate Project Officer Policy and Performance (a copy of which is appended in the Minute Book) the Panel was apprised of the Council’s recent achievement of accreditation as an “Achieving” authority under the Equality Framework for Local Government. Members’ attention was drawn to the findings arising from the assessment, and in particular, they noted the areas which had been identified for future consideration. In response to a question on how the Council compared to other local authorities, it was noted that national data was currently being awaited but that South Cambridgeshire District Council was the only

1 other Cambridgeshire authority to have attained the “Achieving” status.

The Panel was informed that an action plan had been produced to address the areas which had been identified for future consideration. Having discussed the way forward, the Panel agreed to establish a Working Group to review the content of the action plan. Members would be appointed during discussion on the Panel’s remit and work programme, which would be considered later on in the meeting (Minute No. 12/11 refers).

RESOLVED

that the content of the report now submitted be noted.

10. CAMBRIDGESHIRE ADULTS, WELLBEING AND HEALTH SCRUTINY COMMITTEE

The Panel received and noted the Minutes of the meeting of the Cambridgeshire Adults, Wellbeing and Health Overview and Scrutiny Committee held on 21st March 2012 (a copy of which is appended in the Minute Book). Councillor R J West then delivered a brief update on the meeting of the Committee held on 29th May 2012 when discussion had taken place on the development of clinical commissioning in Cambridgeshire and Peterborough, progress against the Adult Social Care Integrated Plan, redesign of the sexual health service, developing Healthwatch Cambridgeshire and an update on the redesign of mental health services across Cambridgeshire and Peterborough.

11. REMIT AND WORK PROGRAMME

Consideration was given to a report by the Head of Legal and Democratic Services (a copy of which is appended in the Minute Book) reviewing the Panel’s programme of studies and providing an opportunity for Members to plan their work programme for the year. The Panel reviewed and approved the membership of its Working Groups relating to the Council’s Consultation Processes and One Leisure Performance (Social Well-Being). Further to the earlier discussions on the Equality Peer Challenge, the Panel established a further Working Group to consider the action plan arising from the peer assessment.

Members received updates on the redesign of mental health services across Cambridgeshire and Peterborough, the Corporate Plan and the ongoing review of the Neighbourhood Forums in Huntingdonshire. Having regard to the latter, the Chairman delivered a brief update on a meeting of the Working Group which had been held earlier that day. The Panel then reaffirmed its wish to undertake scrutiny of the Council’s budgets that fell within its remit. In noting that the Corporate Plan would be presented to the Panel at its July 2012 meeting, the Scrutiny and Review Manager reported that consideration would be given thereafter to the re-establishment of quarterly performance reports.

Members were acquainted with details of studies being undertaken by the other Overview and Scrutiny Panels and reminded of the

2 opportunity they had to participate in the investigations should they wish. Whereupon, it was

RESOLVED

(a) that the contents of the report now submitted, including the existing programme of studies, be noted;

(b) that Councillors Mrs P A Jordan, P Kadewere, J W G Pethard and R J West be appointed to the Consultation Processes Working Group; and

(c) that a Working Group be established comprising Councillors Mrs P A Jordan, P Kadewere and R J West to review the action plan arising from the Equality Framework for Local Government peer assessment.

12. HOUSING BENEFIT CHANGES AND THE POTENTIAL IMPACT ON HUNTINGDONSHIRE

(Councillor B S Chapman, Executive Councillor for Customer Services was in attendance for consideration of this item).

(Councillors T V Rogers and M F Shellens were present for the discussion on this item).

Consideration was given to a report by the Head of Customer Services (a copy of which is appended in the Minute Book) outlining the effect of Government changes to the Housing Benefits system arising from the Welfare Reform Bill. The Executive Councillor for Customer Services reported that the changes would result in a reduction of £370,000 per annum being paid to Housing Benefit claimants renting in the private sector. Of particular concern to Members were the larger households residing in 4 bedroom properties which would experience a significant reduction in their entitlement. Given that there also was a shortage in the availability of social rented housing, it is likely that there would be an increase in the number of households facing homelessness. This trend was already starting to emerge, as there had been an increase in the number of homeless households in 2011/12 when compared to the previous year. Members were informed by the Head of Customer Services that efforts were being made to approach these households with a view to discussing with them the available housing options. This was, however, resource intensive and depended on households accepting the Council’s offer for assistance.

The Panel discussed a number of ways in which the changes could have an impact. These included landlords potentially selling their properties because the returns on their investments were insufficient thereby reducing the number of homes available for rent in the private sector, the relocation of households into the District from other local authority areas, in particular London Boroughs, in their search for more affordable housing, whether certain areas within the District would be affected more than others, utilising empty properties in the District to assist with meeting the shortfall in housing and other ways of increasing the stock of social rented housing.

3 The Panel’s attention was drawn to the financial implications of the requirement for the Council to introduce a localised Council Tax Support scheme by April 2013. Preliminary investigations had established that the Council would have a substantial shortfall in funding. For this purpose, consultations with precepting and neighbouring authorities would take place over the summer, the findings of which would be presented to the Overview and Scrutiny Panel (Economic Well-Being) and the Cabinet in September 2012. Members were advised that if agreement on a local scheme was not reached by January 2013, then the Government would impose its own scheme upon the Council.

A number of ways to mitigate the impact of the reforms upon the Council were currently being explored by Officers. These included a review of the Council’s Housing Strategy, which incorporated the Lettings Policy, and discussions with the Head of Planning and Housing Strategy on the use of planning policy to assist with meeting the need for social housing. Members commented on the challenges the Panel faced in meeting claimants’ needs whilst not introducing a scheme that attracted claimants from different areas because it was less draconian than others. It would also be necessary to balance this against the Council’s other budget priorities.

Having suggested that work should be undertaken on non-nominable social housing the Panel placed on record their grave concerns over the impact of the Government’s Welfare Reform programme and reiterated their wish to receive quarterly updates on the matter.

RESOLVED

that the content of the report now submitted be noted.

13. SCRUTINY

The 124th Edition of the Decision Digest was received and noted.

Chairman

4

FORWARD PLAN OF KEY DECISIONS Prepared by Councillor J D Ablewhite Date of Publication: 13 June 2012 For Period: 1 July 2012 to 31 October 2012

Membership of the Cabinet is as follows:-

Councillor J D Ablewhite - Leader of the Council, with responsibility for 3 Pettis Road Strategic Economic Development St. Ives Huntingdon PE27 6SR

Tel: 01480 466941 E-mail: [email protected] Councillor N J Guyatt - Deputy Leader of the Council with responsibility for 6 Church Lane Strategic Planning and Housing Stibbington 5 Cambs PE8 6LP

Tel: 01780 782827 E-mail: [email protected] Councillor B S Chapman - Executive Councillor for Customer Services 6 Kipling Place St. Neots Huntingdon PE19 7RG

Tel: 01480 212540 E-mail: [email protected] Councillor J A Gray - Executive Councillor for Resources Shufflewick Cottage Station Row Tilbrook PE28 OJY Agenda Item3

Tel: 01480 861941 E-mail: [email protected] Councillor D M Tysoe - Executive Councillor for Environment Grove Cottage Maltings Lane Ellington Huntingdon PE28 0AA

Tel: 01480 388310 E-mail: [email protected] Councillor T D Sanderson - Executive Councillor for Healthy and Active 29 Burmoor Close Communities Stukeley Meadows Huntingdon PE29 6GE

Tel: (01480) 412135 E-mail: [email protected]

Any person who wishes to make representations to the decision maker about a decision which is to be made may do so by contacting Mrs Helen Taylor, Senior Democratic Services Officer on 01480 388008 or E-mail: [email protected] not less than 14 days prior to the date when the decision is to be made.

The documents available may be obtained by contacting the relevant officer shown in this plan who will be responsible for preparing the final report to be submitted to the decision maker on the matter in relation to which the decision is to be made. Similarly any enquiries as to the subject or matter to be tabled for decision or on the availability of supporting information or documentation should be directed to the relevant officer.

Colin Meadowcroft Head of Legal and Democratic Services

Notes:- (i) Additions/significant changes from the previous Forward are annotated *** (ii) For information about how representations about the above decisions may be made please see the Council’s Petitions Procedure at http://www.huntsdc.gov.uk/NR/rdonlyres/3F6CFE28-C5F0-4BA0-9BF2-76EBAE06C89D/0/Petitionsleaflet.pdf or telephone 01480 388006

Subject/Matter Decision/ Date Documents How relevant Officer Consultation Relevant Relevant for Decision recommendation decision to Available can be contacted Executive Overview & to be made by be taken Councillor Scrutiny Panel

Corporate Plan*** Cabinet 19 Jul 2012 None Helen Donnellan, Corporate Team Manager Overview & J D Ablewhite/ All O&S Panels

6 Tel No 01480 388263 or email Scrutiny Panels and N J Guyatt [email protected] Corporate Plan Working Group

Neighbourhood Cabinet 19 Jul 2012 None Miss H Ali, Democratic Services Officer Tel None N J Guyatt Social Sell- Forums Outcome of No 01480 388006 or email Being Consultation*** [email protected]

Charging for Second Cabinet 19 Jul 2012 None Eric Kendall, Head of Operations Tel No. None D M Tysoe Environmental Recycling Bin 01480 388635 or email Well-Being [email protected]

Voluntary Sector Cabinet 19 Jul 2012 None Dan Smith, Community Health Manager Tel None T D Sanderson / Social Well- Funding 2013/2014 No. 01480 388377 or email J A Gray Being onwards [email protected]

Subject/Matter Decision/ Date Documents How relevant Officer Consultation Relevant Relevant for Decision recommendation decision to Available can be contacted Executive Overview & to be made by be taken Councillor Scrutiny Panel

Waste Collection Cabinet 19 Jul 2012 None. Eric Kendall, Head of Operations Tel No. None D M Tysoe Environmental Policies 01480 388635 or email Well-Being [email protected]

Bearscroft Farm Cabinet 19 Jul 2012 None. Paul Bland, Planning Service Manager Adopt as Council N J Guyatt Environmental Urban Design (Policy) Tel No. 01480 388430 or email policy. Well-Being Framework [email protected]

Technical Reforms of Cabinet 13 Sep 2012 None Julia Barber, Head of Customer Services Tel None B S Chapman Economic Well- Council Tax*** No 01480 388105 or email Being [email protected]

7 Financial Strategy*** Cabinet 13 Sep 2012 None Steve Couper, Head of Financial Services Overview & J A Gray Economic (Well- Tel No 01480 388103 or email Scrutiny (Economic Being) [email protected] Well-Being)

CIL Governance Cabinet 13 Sep 2012 None. Steve Ingram, Head of Planning Services Tel Endorse N J Guyatt Economic Well- Principles No. 01480 388400 or email Governance Being [email protected] Principles.

Houghton & Wyton Cabinet 13 Sep 2012 Consultation Paul Bland, Planning Service Manager Approve new N J Guyatt Environmental Conservation Area Outcomes (Policy) Tel No. 01480 388430 or email Conservation Area Well-Being Boundary Review [email protected] Boundary

Housing Strategy Cabinet 13 Sep 2012 Previous Housing Jo Emmerton, Housing Strategy Manager Tel Housing N J Guyatt Social Well- 2012-2015 - to Strategy 2006-2012 No. 01480 388203 or email Associations and Being include Tenancy and Strategic [email protected] Partners Strategy Housing Market Assessment (SHMA)

Subject/Matter Decision/ Date Documents How relevant Officer Consultation Relevant Relevant for Decision recommendation decision to Available can be contacted Executive Overview & to be made by be taken Councillor Scrutiny Panel

Planning for Cabinet 13 Sep 2012 Consultation Paul Bland, Planning Service Manager Approve new N J Guyatt Environmental Sustainable Drainage Outcomes (Policy) Tel No. 01480 388430 or email Conservation Area Well-Being Systems (SuDs) [email protected] Boundary.

Gambling Act - Cabinet 23 Oct 2012 None Christine Allison, Licensing Manager Tel No None T D Sanderson Social Well- Revised Statement of 01480 388010 or email Being Principles*** [email protected]

8 Agenda Item 6

Annex A

Cambridgeshire Joint Strategic Needs Assessment

Phase 5 Summary Report

2011

• Prevention of Ill Health in Adults of Working Age • Health profiles for Local Commissioning Groups

9

TABLE OF CONTENTS

1. Introduction ...... 3 2. Cambridgeshire’s Population...... 4 3. Prevention of ill health in adults of working age...... 6 4. Health Profiles for GP led Local Commissioning Groups...... 13 5. Action Plans Resulting from the Previous JSNA Recommendations ...... 16

102 1. Introduction

We are now in the fifth year of Joint Strategic Needs Assessment (JSNA) for Cambridgeshire – and have collected a wealth of information on local health and wellbeing over these years, available on website www.cambridgeshirejsna.org.uk .

JSNA is becoming increasingly important as a shared resource, through which different organisations can understand the health and wellbeing needs of communities in Cambridgeshire. It will provide an information base for the shadow Cambridgeshire Health and Wellbeing Board and Network to develop a local Health and Wellbeing Strategy.

In the past we have produced quite detailed hard copy JSNA summaries, but following the launch of the JSNA website in 2010, we have decided to produce this much briefer summary, with web links through to more detailed documents and data tables.

This summary starts with a brief outline of Cambridgeshire’s main population characteristics, and recent trends in mortality rates from different causes.

This is followed by the main focus of this year’s ‘Phase 5’ JSNA - which was to collect data and evidence on promoting health and preventing disease amongst adults of working age. The work has included supply of data and information by many different local organisations, together with wide ranging consultation with community groups and via an on-line survey, to find out what local people’s priorities for ‘prevention’ are.

Because GPs are taking on new roles in Cambridgeshire, leading on the clinical commissioning of NHS services, another focus of JSNA this year has been to provide information in the most useful form to support his. GP practices in Cambridgeshire are organised into Local Commissioning Groups (LCGs), which work together to commission services for a local population of patients. We present data on the health needs of LCG patient populations.

Finally - last year’s ‘phase 4’ JSNA focussed on the health and wellbeing needs of older people; children and young people; working age adults with mental health problems; and Gypsies and Travellers. Recommendations were made to support improvements in health and wellbeing for each of these groups, and this summary provides a link to updates on progress against these recommendations.

I would like to thank the wide range of local stakeholders and organisations who have contributed to JSNA this year; with particular thanks to Wendy Quarry who managed the overall programme, Val Thomas who led the work on prevention; David Lea who leads the public health analyst team, and Sue Hall as lead administrator.

Dr Liz Robin Director of Public Health

113 2. Cambridgeshire’s population

More detailed information from the Cambridgeshire Core JSNA Dataset is available on: www.cambridgeshirejsna.org.uk/webfm_send/182

It is estimated that there are 605,400 people living in Cambridgeshire. About1 one in six are children under 15 years of age and another one in six are aged over 65 . The majority of the population are working age adults. Table 1: Total population : population estimates, mid 2010 (CCCR&PT) Local Authority Population Cambridge 119,800 East Cambridgeshire 80,800 Fenland 94,200 Huntingdonshire 165,300 South Cambridgeshire 145,300 Cambridgeshire 605,400 Source: Cambridgeshire County Council Research & Performance Team (CCCR&PT). Definition: Mid 2010 population estimates (Note: Figures are rounded to the nearest 100).

Population growth The population of Cambridgeshire is forecast to increase by 13% between 2011 and 2021

(78,900 people in2 total), with the majority of the increase seen in Cambridge City and South Cambridgeshire . The forecast increase for people aged 65+ years is 40% (40,700 people), for people of working age is 6% (25,100 people) and for children aged under 15 years is 12% (12,700 people). The increase in older people is particularly important for health and social care service planning, as service use increases with age.

Ethnicity

Cambridgeshire has a predominantly white population.3 Cambridge City has a higher proportion of people from non-white ethnic groups , when compared to the national average, many of whom are students or professionals. Ethnicity is important to health because disease rates vary across ethnic groups, as well as language and access issues.

Socio-economic deprivation There is variation in socio-economic deprivation across Cambridgeshire although all geographical areas include some disadvantaged residents. The Index of multiple deprivation as outlined in the table below is one way of measuring this. South Cambridgeshire is one of the least socio-economically deprived local authorities nationally, while Fenland has higher levels of deprivation than the England average.

Table 2: Indices of Deprivation: Average IMD rank of Local Authorities in 2007 and 2010 Local Authority Average IMD Average IMD % rank % rank Rank 2007 rank 2010 2007 2010 Cambridge 234 188 66% 58% East Cambridgeshire 278 269 79% 83% Fenland 125 94 35% 29% Huntingdonshire 311 276 88% 85% South Cambridgeshire 350 321 99% 99% Definition: The English Indices of Deprivation 2010 include domains at lower super output area (LSOA) for income deprivation, employment deprivation, health deprivation and disability, education, skills and training deprivation, barriers to housing and services housing, living environment deprivation and crime. Source: Dept for Communities and Local Government Note: LA rank (England): Direct comparisons of local authority ranks between 2007 and 2010 are not possible as there are 28 fewer local authorities in 2010 (326 in total) than 2007 (354 in total), however using the percentage rank may give an indication.

1 Cambridgeshire County Council Research Group, Mid-2010 single year population estimates. 2 Cambridgeshire County Council Research Group, Mid-2010 population forecasts. 3 2001 Census.

124 Mortality

4 5 There are about 4,800 deaths a year in Cambridgeshire6 . Circulatory disease (1,600 deaths a year) and cancer (1,350 deaths a year) are the most common causes.

Figure 1: Main causes of death in Cambridgeshire, total population, 2007-2009

Cambridgeshire: Main causes of death (2007-2009)

Cancer 28% Other 34%

Self-harm and injury undetermined Circulatory disease 1% 34%

Accidents 3%

Source: ONS, Vital Statistics.

9 There are an average of 40 child deaths (aged under 15 years) per year . For children, deaths from conditions present at birth and road traffic accidents are the commonest causes of death.

Trends in mortality

The table below summarises the main mortality rates for 2007 to 2009 by district, and determines whether the change in trend is faster or slower than the change seen nationally. Trends for the most common causes of death are positive across the county. It is important to note that the trends for suicide and undetermined injury, accidents and land based transport accidents are based on relatively small numbers.

Table 3: Mortality rates per 100,000 population - trends and 2007/09 rates Disease area Cambridge City East Fenland Huntingdonshire South Cambridgeshire England Cambridgeshire Cambridgeshire

2007/09 Trend 2007/09 Trend 2007/09 Trend 2007/09 Trend 2007/09 Trend 2007/09 Trend 2007/09 Trend rate rate rate rate rate rate rate All Cause Mortality, all ages 549.5
476.0
589.9
501.2
445.0
505.1
567.1
All Cause Mortality, under 75 years 274.1
223.6
294.1
234.2
202.4
238.7
287.8
All Circulatory diseases, under 75 years 61.4
53.6
67.5
57.0
47.3
56.6
70.5
All Cancers, under 75 years 102.7
90.2
108.5
97.3
92.5
97.2
112.1
Suicide and Undetermined Injury, all ages 11.1  8.1  13.9  5.7
7.1
8.3
7.9
Accidents, all ages 17.0
13.6
23.7  18.2  13.5
16.3
15.7
Land based transport accidents, all ages 3.1  4.4
12.9
5.6
6.4
5.9
4.3
Source : Compendium of Clinical and Health Indicators, NCHOD, March 2011 Note : the trend is based on the annual change in rates between 1998 and 2009 (except for Land based transport accidents which are based on 1996 to 2098) Key 2007/09 rate Trend (Exponential Trendline)

Statistically significantly higher than England Increasing trend
Higher than England Decreasing trend  Lower than England Faster rate of change than England Statistically significantly lower than England Slower rate of change than England Opposite trend to England

4 5 East of England Public Health Observatory, 2011. Mainly heart disease and stroke 6 Compendium of Clinical and Health Indicators (2007-2009)

135 3. Prevention of ill health in adults of working age

The full JSNA for Prevention of Ill Health in Adults of Working Age including data tables which contains a wealth of detailed information and data is available on:, http://www.cambridgeshirejsna.org.uk/cambridgeshire-joint-strategic-needs-assessment- jsna/jsna-phase-5-prevention

The JSNA ‘Prevention of Ill Health in Adults of Working Age’ is based on a model where health is determined by a wide range of factors. These include the “upstream” wider determinants of health such as socio-economic factors, the health behaviours that individuals adopt, and protective actions such as screening.

The JSNA captures information on local needs for prevention through a wide range of health and well being indicators, known local views, and local examples of good practice, along with identifying gaps and areas for development. It also includes some of the substantial evidence that prevention works, that it can provide cost benefits and importantly that it can make substantial improvements to the health of the population, decrease health inequalities and effectively address health and social problems.

The development and production of the JSNA has been overseen by a very active committed Steering Group with membership from a wide range of organisations. For the first time a bespoke community consultation process was developed and implemented for this JSNA. This involved the use of social media, an online survey and focus groups. A Stakeholder Event that was well attended by representatives from the statutory and voluntary sectors reviewed the JSNA and highlighted key issues and prevention priorities.

What do we know? - The wider determinants of health

Employment and Income

• People on lower incomes and in unskilled occupations generally experience poorer health and life expectancy. On a geographical basis, there is a close link between the level of socio-economic deprivation in an area and the overall health of people living there. On average, people living in areas of deprivation become ill with long term conditions at a younger age (which may result in them leaving the workforce early) and have a shorter life expectancy. • Overall Cambridgeshire residents experience greater prosperity and less socio- economic deprivation than other parts of England. But deprivation varies significantly across the county, with Fenland, north-east Cambridge and parts of North Huntingdon having the highest levels of relative deprivation. The same pattern exists for children living in poverty, but income deprivation for older people is more widely dispersed around the county. All parts of the county will have some residents who experience disadvantage. • There is currently a clear negative trend across the socio-economic determinants of health related to the economic downturn, and although Cambridgeshire as whole is relatively affluent; the patterns of inequality are mostly unchanged or worsened in some cases from previous years. • Unemployment has a negative effect on people’s mental and physical health. The estimated unemployment rate in Cambridgeshire increased from 3.7% in September

2008 to 5.1% in 2010 – about one in twenty adults. The highest level of unemployment7 is seen in Fenland at 7.6%, which is at a similar level to the national rate at 7.7% . Between August 2008 and 2010, the percentage of population receiving benefits

7 ONS, NOMIS Model-Based Estimates of Unemployment (for districts), Annual Population Survey, ONS, NOMIS.

146 increased across all the districts with the highest being in Fenland. In 2005-2009, the highest median household income was in South Cambridgeshire and the lowest was in Fenland. • There is limited local data on employee health, occupational health services and prevention activities or opportunities in Cambridgeshire’s workplaces. The available information gives an insight into the marked differences in reported workplace injury rates by district council area with higher rates in East Cambridgeshire and Fenland.

Housing

• Both nationally and locally, demand for both affordable and market housing significantly outstrips supply. More detailed information is provided in the Strategic Housing Market Assessment (SHMA). www.cambridgeshirehorizons.co.uk/shma . Private housing is particularly expensive in Cambridge City both to purchase and to rent. This has resulted in an increasing affordability gap between incomes and rents and house prices. In the past eight years, some 5,910 new affordable homes have been built across Cambridgeshire but the housing needs register for social rented properties has increased by around 10,000. Of concern are the planned changes to the Local Housing Allowance (LHA) which risk making rents unaffordable to some population groups. This in turn may impact on health through increased rates of overcrowding and/or homelessness, together with the broader impact on mental health of stressful life events. The Supporting People Service helped around 2000 people in 2009/10 of working age to live independently in housing across the county, but there is some inequity of provision. • It is estimated that 35,000 households in Cambridgeshire experience fuel poverty (more than 10% of income required to heat the home). Cold homes during severe winter weather increase the risk of illness and hospital admission for infants and older people, particularly from chest infections, heart attacks and strokes. Rates of fuel poverty are rising - it was estimated that in 2008 there were 11.5% fuel poor households in Cambridgeshire compared to 6% in 2003. In addition there are Lower Super Output Areas where the proportion of the fuel poor households is above 20%. Most of those areas are in Fenland and East Cambridgeshire. • Local data from the Citizen’s Advice Bureau has shown a steady and large increase in demand for advice on housing related and other debt arrears especially in relation to fuel poverty, mortgage arrears and credit cards.

Transport

• Although there has been a reduction in deaths between 1998 and 2010 all the Cambridgeshire districts with the exception of Cambridge City have significantly worse rates of road deaths than England as a whole. The greatest number of road traffic casualties occurs in the working age population with 17 to 25 year olds having the highest casualty rate per head of population. The highest mortality rate is in Fenland followed by Huntingdonshire. The evidence for prevention is strongest for area-wide traffic calming measures such as speed bumps and safety cameras. • Air pollution can have short term health effects through triggering respiratory conditions such as asthma, and longer term effects on both respiratory and circulatory disease. Cambridgeshire has a number of Air Quality Management Areas (AQMAs), in which levels of pollutants are subject to additional monitoring and management. Some of these AQMAs are related to heavy concentrations of road traffic. Issues of concern include the housing growth in the south of the county adjacent to existing AQMAs and the proximity of AQMAs related to industrial pollutants to more deprived communities in the north of the county.

157 • Ability to access transport, particularly in rural areas, can affect access to health services, and may also affect people’s ability to access their social networks, which are

important to maintaining mental and physical health. Nearly one8 in five of Cambridgeshire’s population do not have access to a car or van . This goes down to less than one in ten for children living in households with no access to a car or van but up to four in ten pensioners. The full JSNA contains links to detailed maps that demonstrate the patterns and inequalities for transport and access that are present in Cambridgeshire.

Education and skills

• Educational attainment is closely linked with health later in life. The expected standard of performance at the end of Key Stage 4 is five or more GCSEs including English and Maths at grades A*-C. In Fenland in 2010 less than half (45%) of candidates attained

five or more GCSE9 grades A*-C, compared to over two thirds (68%) in South Cambridgeshire . By age 19, educational achievement for pupils who were entitled to free school meals is 35% worse than for pupils who were not. • In March 2011 4.8% of the total population cohort aged 16-18 was Not in Education or Training (NEET). Localities with the highest proportion of young people in the NEET group were in Wisbech (7.8%), Cambridge North (6.7%) and Cambridge South (6.5%). In 2009/10, more than 6,500 people (25-64 age groups) were attending courses in Adult Learning in Cambridgeshire at an average 1.8% of people in the 19 - 64 age group, which was less than in the previous years. The proportion was smallest in Cambridge City and Fenland. Identified concerns for the future are the need to increase apprenticeship starts, the decline in other funded employee qualification routes, and unmet needs for skilled workers and workers with sufficient employability skills.

What do we know? – Lifestyles

There is good evidence of the links between lifestyle behaviours and health. Long term smoking causes a range of cancers and circulatory disease and reduces life expectancy by an average of ten years, while sedentary behaviour, poor diet and obesity are closely linked to development of diabetes, heart disease, joint and back problems and depression. Use of alcohol above recommended limits leads to a range of longer term health problems including high blood pressure, liver disease and mental health issues.

Smoking and tobacco

• Tobacco use remains the leading cause of preventable morbidity and mortality worldwide. In Cambridgeshire nearly 20% adults smoke, though Cambridgeshire has relatively low smoking prevalence in comparison to national and regional figures. This masks the range in smoking rates within Cambridgeshire. In Fenland the prevalence is 26.7% compared to the national figure of 21%. There are smaller areas that have rates higher than the national figure. Smoking prevalence is higher in more deprived populations and amongst the routine and manual group of workers.

Obesity

• Nationally the prevalence of obesity among adults has increased over recent years. The estimated levels of obesity in Cambridgeshire (22.1%) are significantly lower than in England (24.2%). Fenland, with estimated obesity at 25.8%, is significantly higher than the county level (22.1%) but is not in comparison to the national levels (24.2%).

8 2001 Census. 9 Cambridgeshire County Council and NHS Cambridgeshire, Children & Young People Data Profile July 2011.

168 • Key factors for prevention of obesity are a healthy diet and physical activity. In Cambridgeshire 67.4% population is eating less than the recommended five portions of fruit and vegetables a day. • Surveys indicate that participation in physical activity decreases with age and that there has been an overall downward trend in rates of participation in sport locally, with the exception of Huntingdonshire and South Cambridgeshire. Fenland has the lowest levels of participation in sport but scores highly on general physical activity rates, attributable to a high number of people in manual occupations. Sports participation in all age groups is relatively low in Fenland and is generally lowest in the more deprived areas in each district, with the exception of East Cambridgeshire.

Sexual health

• Overall the rate of Sexually Transmitted Infections (STIs) in Cambridgeshire has remained consistent between 2008 and 2010 with about 5-6 cases per 1000 population. Rates are highest in the 15-24 age group. The numbers of people living with HIV in Cambridgeshire has increased since 2004 reflecting to a large degree better treatment methods. A third of HIV infected residents live in Cambridge City. Nationally there is concern about late HIV diagnoses which compromises treatment and potentially could increase the spread of the disease. • The Cambridgeshire teenage conception rate has been consistently and significantly lower than the national and East of England with an overall downward trend over the past ten years. The rates vary across the county with Fenland having the highest rate and East Cambridgeshire the lowest in 2007-2009. Within districts there is variation in teenage conception rates. • There were 740 sexual offences recorded in Cambridgeshire during 2008-2009 with 755 recorded sexual offences in Cambridgeshire in 2009-2010, representing a 2% increase year on year. The Cambridgeshire and Peterborough Sexual Assault Referral Centre opened in 2010 provided services to 330 people in its first year of which, 112 of those clients were from Cambridgeshire. This new Service is anticipated to identify unmet demand through increased reporting.

Substance misuse

• Consumption of alcohol above the recommended limits (21 units per week for males and 14 units per week for females) is known to be harmful to health. A local telephone survey in 2009 found that about 30% of men drank more than the recommended limit. Overall, Cambridgeshire as a county compares well to the national average on statistics for alcohol misuse and harm, but Cambridge City is above the national average for a number of indicators including hospital admissions specifically caused by alcohol, aspects of alcohol related crime, and binge drinking. • Although there are primary prevention interventions for drug misuse, most of these target young people and not those of working age. Prevention for the working age population is mostly secondary and occurs when individuals access the treatment service. A concern for Cambridgeshire is that an estimated one third of the drug using population does not access any services.

Mental health

• In 2004-06, 13% of the England population had a possible psychiatric disorder. The percentage was higher in Cambridgeshire (15%) but not significantly so. The most recent figures on suicide rates show that these are higher than the national average in Cambridge City and Fenland, and high amongst homeless people in Cambridge City. Current service provision is more focused on mental illness and further opportunities

179 exist to invest in ‘preventive’ interventions in a range of settings. Further information is provided in the JSNA for mental health of adults http://www.cambridgeshirejsna.org.uk/mental-health-adults-working-age/mh-adults

Domestic violence

• There has been a substantial increase in reported domestic violence in recent years. In the period 2005 – 2009, the number of incidents reported to the police in Cambridgeshire has risen by more than 41.9%. The Independent Domestic Violence Advocacy Service received 324 high-risk referrals from the Constabulary in 2005. In 2008/09 that figure was1536 – this change is likely to reflect changes in referral behaviour as well as needs. Data indicate that there is a higher level of domestic abuse in Fenland, amongst women from A8 accession countries, teenage mothers, and families of Looked After Children and children subject to a Child Protection Plan. Concerns include under reporting, and the availability of services to support victims and where possible prevent further incidences.

Dental health

• Information about dental and oral health is collected at a Regional level. The most recent Adult data for the East of England indicates that oral health is improving in adults of working age particularly among the younger age group up to 45 years. However for those who do have decay or gum problems, disease can be very extensive and for many people in older middle age, dental needs can be very complex. The vulnerable and socio-economically disadvantaged groups are more likely to be at risk of poor dental and oral health. Adults who smoke, use alcohol, are binge drinkers, are obese are more likely to suffer from periodontal disease and mouth cancer.

What do we know? Prevention for people with existing health conditions

Screening

• The purpose of screening is to identify disease at an early stage, with the result that early treatment leads to better health outcomes. Local NHS screening programmes are well established and generally meet national targets for the numbers of people screened. There is insufficient information about access to screening for people in vulnerable and hard to reach groups.

Long term conditions

• Nationally there are estimated to be 15 million people living with one or more long term health conditions (LTCs) with prevalence and severity increasing with older age. These conditions are often lifestyle related and rates are generally greater amongst populations experiencing higher levels of deprivation. Examples of common LTCs include diabetes, heart disease, long term respiratory disease and stroke. Improving the health of people suffering from a long term conditions through lifestyle interventions such as stopping smoking, increased physical activity, and healthier diet can help stabilise conditions, reduce the need for health and social care, and enhance the quality of life. There are opportunities to further incorporate preventive services into patient pathways for people with LTCs.

Long term impairments such as visual impairment, with an estimated 14,000 sufferers in Cambridgeshire, can also have their impact mitigated by preventive interventions.

1810 Key findings from the community consultation

In the Survey responses and Focus Groups it was clear that prevention of ill health is valued by local people and that there is support for preventive activities. There was an understanding that health is a complex concept that is a consequence of the inter- relationship between the wider determinants of health, lifestyle choice and the support that is available through different services.

Improving lifestyle was seen as challenge that demanded individuals taking responsibility for their health but that it would not be achieved without supportive services. But the most common theme from the consultation was how the current economic climate is perceived as affecting people’s health. Job loss, economic hardship, lack of housing and loss of motivation were seen as having a negative effect upon health.

There was acknowledgement that there are preventive services that can be accessed across the county. But there are gaps in these that to large degree reflect personal financial constraints and inability of some services to meet demand. In terms of lifestyle services the main gaps were services for promoting and protecting mental health, and workplace health schemes.

General practice was found to be inaccessible to some groups and not fully effective in terms of prevention services. Services that target socio-economic issues were seen to be experiencing stress in the current situation, particularly the Citizens’ Advice Bureau.

Overall there was shared expectation that the NHS and government had responsibility to work with individuals and communities on the prevention agenda.

What is this telling us?

The persistent theme from both the data trends and the community consultation in the JSNA is that despite the generally positive wellbeing and health statistics for Cambridgeshire as a whole, the current economic climate has created trends that risk having a negative effect upon health. Unemployment rates, benefits claims, and debt have all increased in Cambridgeshire in recent years. There is a particular concern with the availability and affordability of housing, which is accompanied by concern about increasing levels of fuel poverty.

In Cambridgeshire there are long standing pockets of deprivation in geographical areas and amongst vulnerable population groups across the county. Poorer health is experienced where the impact of the negative socio-economic factors is greatest. Earlier JSNA work for specific vulnerable population groups such as Travellers and homeless people highlights specific opportunities for prevention.

Alongside the wider determinants of health are the lifestyle issues that affect health, such as levels of physical activity, smoking, healthy diet, and alcohol consumption. In some cases there are associations between these lifestyle factors and negative socio-economic indicators, but some lifestyle behaviours which impact adversely on health are present across all social groups.

The JSNA also looks at programmes that protect the population from ill health, and identified some inequalities across the county, together with opportunities to develop client/patient pathways between organisations that would help people access preventive interventions more easily.

1911 Taking forward prevention for adults of working age in Cambridgeshire

The Steering Group and a wider Stakeholder event identified the following priorities for prevention of ill health amongst adults of working age in Cambridgeshire.

• Socio-economic factors especially housing • Lifestyle Issues • Workplace Health • Prevention for people with Long Term Conditions • Domestic Violence

The Steering Group expressed a wish to continue to work together to address prevention across Cambridgeshire and to facilitate further partnership working. It thought that the lessons learnt from the JSNA could inform the overall further development of the Prevention Agenda. These include adopting a life-course approach to prevention as so many of the determinants cut across age groups and settings.

Organisations represented in the Steering Group include:

NHS Cambridgeshire Cambridgeshire County Council Cambridge City Council East Cambridgeshire District Council Fenland District Council Huntingdonshire District Council South Cambridgeshire District Council Cambridgeshire Community Services Cambridgeshire Voluntary Services Infrastructure Consortium Citizens Advice Bureau Job Centre Plus

2012 4. Health profiles for GP led Local Commissioning Groups

Introduction

One of the aims of this year’s JSNA programme was to introduce the JSNA to GP commissioners and make it relevant to their patient populations. In Cambridgeshire, GP practices have organised themselves into Local Commissioning Groups (LCGs), which work together to commission services for a local population of patients.

As at the time of writing there are seven GP led Local Commissioning Groups in Cambridgeshire, all of which have been recognised by the county-wide GP Clinical Senate, and have agreements in place with NHS Cambridgeshire about their commissioning responsibilities.

These Local Commissioning Groups are:

Cambridge Association to Commission Health (CATCH) : The majority of GP practices in Cambridge City and South Cambridgeshire, together with a small number from North

East Hertfordshire. It includes a sub-grouping of practices10 – CAMHealth, which consists of eight GP practices in or close to Cambridge City.

Hunts Care Partnership : GP practices in Huntingdonshire and a small number in mid- Fenland

Hunts Health : GP practices in or on the border of Huntingdonshire

Isle of Ely Health : GP practices in East Cambridgeshire with a small number in South Fenland

Wisbech : GP practices in North Fenland

Borderline : GP practices in Peterborough, Fenland and Huntingdonshire

The Cambridgeshire public health team have been working with Local Commissioning Groups to develop health profiles for their population and to investigate potential commissioning priorities for health and wellbeing. Tables A1 and A2 overleaf provide a summary of population health indicators by LCG and shows the variation between them, which reflect geographical differences in age structure and socio-economic circumstances described earlier in this report.

The proposed LCGs in Cambridgeshire cross existing administrative and organisational boundaries and in some cases data for areas outside Cambridgeshire and Peterborough local authority boundaries were not available. The tables overleaf are grouped according to themes, but are also grouped according to data availability.

10 For the purposes of health needs analysis, CATCH is broken down into small localities, which demonstrate different age profiles and health needs - for example between rural South Cambridgeshire populations and populations with a high proportion of students in Cambridge City.

2113 Table A1: Summary of key population health indicators for Cambridgeshire’s Local Commissioning Groups (excluding Hertfordshire and Northamptonshire practices)

Source Indicator/practice Borderline CATCH Hunts Care Hunts Health Isle of Ely Wisbech Cambridgeshire North South City Cambridge Granta Cam Health CATCH Partnership Villages Villages City

Population - number 1 77,029 21,469 53,483 30,377 63,460 29,090 73,538 271,417 110,555 73,750 87,041 45,611 629,674

Population aged under 5 (%) 1 6.6% 6.8% 5.2% 6.2% 4.2% 8.1% 5.7% 5.6% 5.7% 6.1% 6.2% 5.8% 5.8%

Population aged >= 75 (%) 1 7.2% 6.4% 8.8% 8.9% 4.8% 4.1% 7.8% 6.9% 7.9% 6.8% 7.7% 9.1% 7.4%

Population dependency (0-14 yrs and 65+ years) (lower ratio = 1 1.9 2.0 1.8 1.9 4.0 2.6 2.3 2.4 1.9 2.0 1.9 1.8 2.1 more dependency)

Deprivation (IMD 2010) (higher score = more deprived) 2 17.3 6.7 6.2 10.3 12.8 12.3 14.9 11.1 11.4 12.6 11.8 30.0 12.5

Adult Obesity - estimated prevalence (%) 3 25.8% 21.5% 20.5% 16.3% 13.3% 16.3% 17.2% 17.1% 22.7% 22.3% 24.2% 25.7% 22.1%

Adult smoking - estimated prevalence (%) 3 23.1% 17.2% 16.1% 17.7% 20.5% 20.6% 21.7% 19.4% 20.2% 23.0% 21.1% 30.7% 18.7%

Smoking cessation (quitter rate per 10,000 population aged 15+) 4 25.3 18.9 9.0 11.5 9.1 15.7 17.0 15.9 22.1 17.6 15.4 35.4 18.2

Binge drinking - estimated prevalence (%) 3 17.9% 20.6% 17.8% 19.6% 26.1% 23.4% 22.6% 22.0% 18.5% 19.6% 17.6% 15.0% 18.3%

Fruit and vegeable consumption - estimated prevalence (%) 3 27.9% 34.2% 35.8% 36.7% 39.3% 36.4% 34.8% 36.4% 30.3% 30.2% 30.1% 23.4% 32.6% 22 Birth rate (per 1,000 women aged 15-44) 5 63.9 72.6 54.8 62.0 31.7 62.6 50.3 49.6 58.1 61.7 63.1 61.6 55.3

Low birth weight (%under 2,500g) 5 5.9% 5.8% 5.3% 6.2% 4.7% 5.7% 6.7% 5.7% 6.5% 5.8% 7.1% - 7.6%

Life expectancy at birth (persons) 6 81.2 82.4 84.6 81.4 84.0 81.1 80.6 82.5 82.6 80.8 81.4 79.6 81.8

Deaths from all causes (all ages/100,000) 7 513.2 456.2 379.3 512.0 382.7 534.9 549.4 464.8 452.3 541.1 491.5 576.2 489.3

Deaths from all causes (< 75 years/100,000) 7 241.8 217.8 176.9 233.9 158.8 290.1 242.6 209.6 209.3 280.1 235.2 295.9 225.9

Note : excludes Northamptonshire and Hertfordshire practices Data for CATCH LCG are also broken down into smaller localities

Sources : 1. Quarterly age sex breakdown of registered patients, July 2011,NHS Cambridgeshire 2. Index of Multiple Deprivation 2010, OPDM and Exeter quarterly download April 2010, Anglia Support Partnership 3. Synthetic estimates, The National Centre for Social Research and the NHS Information Centre for Health and Social Care 2006/8 and Exeter quarterly download 2010, Anglia Support Partnership 4. Smoking cessation – quitter rate per 10,000 population aged 15+ years, July 2011/12 submission, CAMQUIT 5. Public Health Births File (PHBF), National Statistics, Quarterly Exeter Downloads (April 09 and April 10), NHS Cambridgeshire, April 2008 - March 2010 6. Life expectancy (years), Public Health Mortality File (PHMF), National Statistics, Quarterly Exeter Downloads (April 09 and April 10), and ERPHO life expectancy calculator April 2008 – March 2010 7. Directly age-standardised rate per 100,000 population. Public Health Mortality File (PHMF), National Statistics, Quarterly Exeter Downloads (April 09 and April 10), NHS Cambridgeshire, April 2008 - March 2010

14 Table A2: Summary of the percentage of patients diagnosed with specific health conditions for Cambridgeshire’s Local Commissioning Groups (includes Northamptonshire and Hertfordshire practices)

Source Indicator/practice Borderline CATCH Hunts Care Hunts Health Isle of Ely Wisbech Cambridgeshire North South City Cambridge Granta Cam Health Herts CATCH Partnership Villages Villages City

Coronary Heart Disease Prevalence (%) 8 3.2% 2.7% 3.4% 3.1% 1.6% 1.7% 2.7% 2.8% 2.5% 3.6% 3.2% 3.4% 4.1% 3.1%

Hypertension Prevalence (%) 8 14.7% 11.9% 13.5% 12.2% 7.2% 7.3% 11.7% 12.8% 10.8% 14.6% 14.3% 12.8% 15.2% 12.8%

Stroke or Transient Ischaemic Attacks (TIA) Prevalence (%) 8 1.6% 1.3% 1.6% 1.6% 0.9% 0.9% 1.5% 1.4% 1.3% 1.6% 1.6% 1.5% 2.0% 1.5%

Atrial Fibrillation Prevalence (%) 8 1.3% 1.3% 1.6% 1.7% 0.8% 0.8% 1.5% 1.3% 1.3% 1.6% 1.5% 1.5% 1.6% 1.4%

Cardiovascular Disease Primary Prevention Prevalence (%) 8 0.6% 0.3% 0.7% 0.6% 0.3% 0.8% 0.5% 0.6% 0.5% 0.9% 0.9% 0.5% 1.0% 0.7%

Diabetes Mellitus (Diabetes) Prevalence 17+ (%) 8 5.5% 4.0% 4.8% 4.3% 2.3% 2.9% 4.3% 4.3% 3.8% 5.7% 5.2% 5.7% 6.6% 4.9%

Obesity Prevalence 16+ (%) 8 10.7% 9.2% 7.1% 6.0% 4.5% 6.9% 8.9% 10.1% 7.2% 10.6% 11.3% 12.2% 12.6% 9.5%

Depression Prevalence 18+ (%) 8 13.4% 6.8% 10.2% 9.5% 9.0% 11.7% 11.4% 13.1% 10.3% 13.4% 15.8% 13.4% 16.8% 12.5%

Mental Health Prevalence (%) 8 0.6% 0.6% 0.6% 0.9% 1.0% 1.2% 1.0% 0.4% 0.9% 0.6% 0.6% 0.5% 0.5% 0.7%

Dementia Prevalence (%) 8 0.4% 0.3% 0.4% 0.5% 0.3% 0.2% 0.7% 0.3% 0.4% 0.4% 0.5% 0.4% 0.5% 0.4%

Cancer Prevalence (%) 8 1.5% 1.7% 1.7% 2.0% 1.0% 1.2% 1.4% 1.7% 1.5% 1.7% 1.6% 1.8% 1.8% 1.6% 23

Chronic Obstructive Pulmonary Disease Prevalence (%) 8 1.6% 1.2% 1.2% 1.1% 0.7% 1.0% 1.3% 1.2% 1.1% 1.5% 1.5% 1.5% 2.2% 1.4%

Asthma (%) 8 6.3% 6.3% 7.5% 6.0% 4.9% 6.1% 6.5% 7.3% 6.3% 7.5% 6.8% 6.9% 6.2% 6.6%

Chronic Kidney Disease Prevalence 18+ (%) 8 4.4% 2.2% 2.9% 2.9% 1.5% 2.5% 3.3% 2.2% 2.5% 4.8% 4.4% 4.5% 3.4% 3.7%

Note : includes Northamptonshire and Hertfordshire practices Data for CATCH LCG are also broken down into smaller localities

Sources :

8. Recorded prevalence from Quality and Outcomes Framework (QOF) 2009/10, Information Centre for Health and Social Care. Note: these are not age standardised and therefore will depend on the age structure of the locality population, as well as other factors such as deprivation. For most diseases, localities with an older age structure will have a higher prevalence.

15 5. Action plans resulting from the previous JSNA recommendations

Action plans have been put in place for all of the recommendations raised in the JSNA phase 4 Summary Report.

The action plans examine each of these recommendations in more detail outlining specific objectives, how they will be measured and the leads responsible for ensuring their progression.

These action plans should be read in conjunction with the JSNA reports which are also available as executive summary reports. The JSNA reports can be found at: www.cambridgeshirejsna.org.uk

Children and Young People Action Plan | JSNA Phase 4, 2010 http://www.cambridgeshirejsna.org.uk/webfm_send/173

Older People's JSNA Action Plan | JSNA Phase 4, 2010 http://www.cambridgeshirejsna.org.uk/webfm_send/176

Mental Health JSNA Action Plan | JSNA Phase 4, 2010 http://www.cambridgeshirejsna.org.uk/webfm_send/175

Travellers JSNA Action Plan | JSNA Phase 4, 2010 http://www.cambridgeshirejsna.org.uk/webfm_send/174

Homelessness Action Plan | JSNA Phase 4, October 2011 http://www.cambridgeshirejsna.org.uk/webfm_send/181

16

24 Health Profile 2011 Huntingdonshire

ThisThis profile profile gives gives a picture a snapshot of health of in this area. It is designed to help local government and health services understand their community’s needs, so

that they can work to improve people’s health and reduce health inequalities.

Visit the Health Pro files website for:  Profiles of all local authorities in England  Interactive maps – see how health varies between areas  More health indicator information  Links to more community health profiles Huntingdonshire at a glance and tools  The health of people in Huntingdonshire is generally

Health Profiles are produced by the English Public H ealth better than the England average. Deprivation is lower Observatories working in partnership. than average, however 3,990 children live in poverty.

Life expectancy for both men and women is higher www.healthprofiles.info than the England average.

 Life expectancy is 6.3 years lower for men in the most

A43 A47(T) deprived areas of Huntingdonshire than in the least A1139 A605

A141 A1179 deprived areas (based on the Slope Index of Inequality A6118 Stibbington A1260 PETERBOROUGH Water Newton March published on 5th January 2011). Chesterton Farcet Elton Haddon  Over the last 10 years, all cause mortality rates have Morborne . A427 Folksworth fallen. Early death rates from cancer and from heart Ramsey Mereside Holme Ramsey Forty Foot A142 disease and stroke have fallen and are better than the Image found and displayed.Conington Ramsey A1(M) England average. Great Gidding . Bury

Winwick Woodwalton Wistow  About 14.6% of Year 6 children are classified as Warboys Hamerton Upton A6116 Abbots Ripton Pidley obese. A lower percentage than average of pupils A14(T) Old Weston Somersham Alconbury. Weston Kings Ripton Brington Alconbury Woodhurst #Name?Keyston Barham Bluntisham spend at least three hours each week on school sport. Great Stukeley A1421 Catworth Spaldwick Hartford A1123 79.7% of mothers initiate breast feeding and 11.4% of Easton Huntingdon St Ives A6 Stow Longa Godmanchester Tilbrook Grafham expectant mothers smoke during pregnancy. Kimbolton Fenstanton Buckden A45(T) West Perry  A6(T) Rushden Hilton An estimated 19.4% of adults smoke and 22.6% are Diddington Great Staughton Great Paxton obese. The rate of road injuries and deaths is higher Yelling Hail Weston A1198 . St Neots A1303 than average. Eynesbury . A428(T) CAMBRIDGE  Priorities in Huntingdonshire include addressing local Abbotsley . A1134

A421(T) Waresley A1307 inequalities in health, partnership to meet the needs of A1309 . A428 an ageing population and focusing on long term

A1301 A5141 BEDFORD A603 Sandy prevention of ill health across all age ranges. For more © Crown Copyright and database rights 2011, Ordnance Survey 100020290 A10 Other map data © Collins Bartholomew. information see www.cambridgeshire.nhs.uk or Population 166,000 www.cambridgeshirejsna.org.uk Mid-2009 population estimate Source: National Statistics website: www.statistics.gov.uk

25 Copyright Crown ©2011 Huntingdonshire - 10 June 2011 Deprivation: a national view

This map shows differences in deprivation levels in this area This chart shows the percentage of the population in based on national quintiles (of the Index of Multiple Deprivation England, this region, and this area who live in each of 2007 by Lower Super Output Area). The darkest coloured these quintiles. areas are some of the most deprived areas in England. 100 N

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70 Survey 100020290 Survey 60

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0 England East of England Huntingdonshire © Crown Copyright and database rights 2011, Ordnance 2011, rights database Copyright and Crown © 0 2 4 Miles

1 - least 2 3 4 5 - most deprived quintile deprived quintile

Health inequalities: a local view

This map shows differences in deprivation levels in this area This chart shows the life expectancy at birth for males based on local quintiles (of the Index of Multiple Deprivation and females (2005-2009) for each of the quintiles in this 2007 by Lower Super Output Area). The darkest coloured area. areas are the most deprived in this area. 95 N

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© Crown Copyright and database rights 2011, Ordnance 2011, rights database Copyright and Crown © 95% confidence interval. These indicate the level of uncertainty about each 0 2 4 Miles value on the graph. Longer/wider intervals mean more uncertainty.

1 - least 2 3 4 5 - most deprived quintile 26 deprived quintile Huntingdonshire - 10 June 2011 www.healthprofiles.info © Crown Copyright 2011 Health inequalities: changes over time Trend 1: These graphs show how changes in death rates for this All age, all cause mortality area compare with changes for the whole of England.

Data points on the graph are mid-points of 3-year 1250 averages of yearly rates. For example the dot labelled 1150 2003 represents the 3-year period 2002 to 2004. 1050 950 Trend 1 compares rates of death, at all ages and from all causes, in this area with those for England. 850 750 650

Trend 2 compares rates of early death from heart population 550 disease and stroke (in people under 75) in this area 450 with those for England. 350

Age-standardised rate/100,000 250 Trend 3 compares rates of early death from cancer (in 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 people under 75) in this area with those for England. Years Males: England Huntingdonshire Females: England Huntingdonshire Trend 2: Trend 3: Early death rates from heart disease and stroke Early death rates from cancer

215 215

195 195

175 175

155 155

135 135

115 115

95 95 population population 75 75

55 55

Age-standardised rate/100,000 35 Age-standardised rate/100,000 35 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Years Years England Huntingdonshire England Huntingdonshire Health inequalities: ethnicity

This chart shows the percentage of pupils by ethnic group in this area who achieved five GCSEs in 2009/10 (A* to C grades including English and Maths). Comparing results may help find possible inequalities between ethnic groups.

80 75 England 70 Huntingdonshire 65 60 % pupils No. of pupils 55 Ethnic achieved achieved 50 Groups grades grades 45 White 57.4 966 40 35 Mixed 60.5 26 Percentage 30 Asian 56.8 21 25 Black 20 Chinese/other 15 10 If there are any empty cells in the table this is 5 because data has not been presented where the 0 calculation involved pupil numbers of 0, 1 or 2. Some further groups may not have data presented White Mixed Asian Black Chinese & in order to prevent counts of small numbers being other ethnic calculated from values for other ethnic groups or groups 95% confidence intervals are shown for this local authority area 27 areas. © Crown Copyright 2011 www.healthprofiles.info Huntingdonshire - 10 June 2011 Health summary for 12UE Huntingdonshire The chart below shows how the health of people in this area compares with the rest of England. This area's result for each indicator is shown as a circle. The average rate for England is shown by the black line, which is always at the centre of the chart. The range of results for all local areas in England is shown as a grey bar. A red circle means that this area is significantly worse than England for that indicator; however, a green circle may still indicate an important public health problem.

Significantly worse than England average Regional average + England Average Not significantly different from England average England England Worst Best Significantly better than England average 25th 75th Percentile Percentile + In the South East Region this represents the Strategic Health Authority average

Local No. Local Eng Eng Eng Domain Indicator England Range Per Year Value Avg Worst Best 1 Deprivation 0 0.0 19.9 89.2 0.0 2 Proportion of children in poverty 3990 11.0 20.9 57.0 5.7 3 Statutory homelessness 137 1.99 1.86 8.28 0.08 4 GCSE achieved (5A*-C inc. Eng & Maths) 1048 57.5 55.3 38.0 78.6

Ourcommunities 5 Violent crime 1527 9.2 15.8 35.9 4.6 6 Long term unemployment 447 4.2 6.2 19.6 1.0 7 Smoking in pregnancy 213 11.4 14.0 31.4 4.5 8 Breast feeding initiation 1494 79.7 73.6 39.9 95.2 9 Physically active children 9898 45.8 55.1 26.7 80.3

health 10 Obese children (Year 6) 238 14.6 18.7 28.6 10.7 Children's and Children's youngpeople's 11 Children's tooth decay (at age 12) n/a 0.5 0.7 1.6 0.2 12 Teenage pregnancy (under 18) 84 26.2 40.2 69.4 14.6 13 Adults smoking n/a 19.4 21.2 34.7 11.1 14 Increasing and higher risk drinking n/a 21.1 23.6 39.4 11.5 15 Healthy eating adults n/a 30.8 28.7 19.3 47.8 lifestyle 16 Physically active adults n/a 13.9 11.5 5.8 19.5 Adults' health and health Adults' 17 Obese adults n/a 22.6 24.2 30.7 13.9 18 Incidence of malignant melanoma 26 15.4 13.1 27.2 3.1 19 Hospital stays for self-harm 250 161.6 198.3 497.5 48.0 20 Hospital stays for alcohol related harm 3482 1736 1743 3114 849 21 Drug misuse 471 4.3 9.4 23.8 1.8 poor health poor Diseaseand 22 People diagnosed with diabetes 6848 5.20 5.40 7.87 3.28 23 New cases of tuberculosis 9 5 15 120 0 24 Hip fracture in 65s and over 142 429.3 457.6 631.3 310.9 25 Excess winter deaths 73 18.9 18.1 32.1 5.4 26 Life expectancy - male n/a 79.7 78.3 73.7 84.4 27 Life expectancy - female n/a 83.7 82.3 79.1 89.0 28 Infant deaths 7 3.75 4.71 10.63 0.68 29 Smoking related deaths 208 175.9 216.0 361.5 131.9

causesdeath of 30 Early deaths: heart disease & stroke 105 57.0 70.5 122.1 37.9 Life expectancy Life and 31 Early deaths: cancer 178 97.3 112.1 159.1 76.1 32 Road injuries and deaths 111 67.2 48.1 155.2 13.7

Indicator Notes 1 % of people in this area living in 20% most deprived areas in England 2007 2 % children in families receiving means-tested benefits & low income 2008 3 Crude rate per 1,000 households 2009/10 4 % at Key Stage 4 2009/10 5 Recorded violence against the person crimes crude rate per 1,000 population 2009/10 6 Crude rate per 1,000 population aged16 -64, 2010 7 % of mothers smoking in pregnancy where status is known 2009/10 8 % of mothers initiating breastfeeding where status is known 2009/10 9 % of year 1-13 pupils who spend at least 3 hours per week on high quality PE and school sport 2009/10 10 % of school children in Year 6, 2009/10 11 Weighted mean number of decayed, missing or filled teeth in 12-year-olds, 2008/09 12 Under-18 conception rate per 1,000 females aged 15-17 (crude rate) 2007 -2009 (provisional) 13 % adults aged 18+, 2009/10 14 % aged 16+ in the resident population, 2008 15 % adults, modelled estimate using Health Survey for England 2006 -2008 (revised) 16 % aged 16+ 2009/10 17 % adults, modelled estimate using Health Survey for England 2006-2008 (revised) 18 Directly age standardised rate per 100,000 population under 75, 2005 -2007 19 Directly age and sex standardised rate per 100,000 population 2009/10 20 Directly age and sex standardised rate per 100,000 population, 2009/10 21 Estimated problem drug users using crack and/or opiates aged 15-64 per 1,000 resident population, 2008/09 22 % of people on GP registers with a recorded diagnosis of diabetes 2009/10 23 Crude rate per 100,000 population 2007-2009 24 Directly age and sex standardised rate for emergency admission 65+, 2009/10 25 Ratio of excess winter deaths (observed winter deaths minus expected deaths based on non-winter deaths) to average non -winter deaths 1.08.06-31.07.09 26 At birth, 2007-2009 27 At birth, 2007-2009 28 Rate per 1,000 live births 2007-2009 29 Per 100,000 population aged 35 +, directly age standardised rate 2007 -2009 30 Directly age standardised rate per 100,000 population under 75, 2007-2009 31 Directly age standardised rate per 100,000 population under 75, 2007 -2009 32 Rate per 100,000 population 2007-2009

For links to health intelligence support in your area see www.healthprofiles.info More indicator information is available online in The Indicator Guide.

You may use this profile for non -commercial purposes as long as you acknowledge where the information came from by printing ‘Source: Department o f Health. © Crown Copyright 2011 ’. 28 Huntingdonshire - 10 June 2011 www.healthprofiles.info © Crown Copyright 2011 a consultation on the Draft Cambridgeshire Health & Wellbeing Strategy 2012–17 29 Agenda Item7

www.cambridgeshire.gov.uk Table of Contents

Foreword from Councillor Nick Clarke, Chair, 5 Our proposed priorities – Cambridgeshire Shadow Health & Wellbeing Board ...... 3 why we think they are important ...... 12

5.1 Proposed priority 1: Ensure a positive start to life 1 Introduction ...... 4 for children and families ...... 12

5.2 Proposed priority 2: Support older people to be 2 How is the Health & Wellbeing Strategy being developed? ... 5 independent, safe and well ...... 14

2.1 Developing the draft strategy: what we have done so far ...... 5 5.3 Proposed priority 3: Encourage healthy lifestyles and behaviours in all actions and activities while respecting 2.2 The Public Consultation: people's personal choices...... 16 how your views will inform the strategy ...... 5 5.4 Proposed priority 4: Create a safe environment and help 30 2.3 Community Impact Assessment ...... 5 to build strong communities, wellbeing and mental health...... 18

5.5 Proposed priority 5: Create a sustainable environment 3 Information about Cambridgeshire ...... 6 in which communities can flourish...... 20 3.1 Who lives in Cambridgeshire? ...... 6

3.2 How healthy are the people of Cambridgeshire?...... 6 6 Working Together ...... 22

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 3.3 How do we currently spend public money on health and social care in Cambridgeshire?...... 6 7 Strategies related to Health & Wellbeing in Cambridgeshire ...... 23

4 Our Approach to improve Health and Wellbeing in Cambridgeshire ...... 8 8 A summary of the consultation questions ...... 24

4.1 Our Principles...... 8

4.2 Our Model of Health and Wellbeing...... 9 Appendix: Consultation questionnaire 2 4.3 A Summary of our Priorities ...... 10 Foreword 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

Good health and wellbeing is With this in mind, we have produced a fundamental to enable us to live an draft Health & Wellbeing Strategy for active and fulfilled life and play a consultation which identifies the role in our local communities. In priority issues we believe are Cambridgeshire, we are fortunate to important for local people and live in a part of the country where outlines how we will work together the health of local people is effectively to tackle them. The generally better than the England consultation will be held between 18th average. Whilst this is encouraging, June and 17th September 2012 and, it can mask some real challenges. We know later in this document, we have set out how that some local people experience significant you can get in touch with us. disadvantage and inequalities in health, which is

31 Your views are important to us and we something we must improve. welcome your comments on this draft strategy. The Cambridgeshire Health & Wellbeing Board and Network will work hard to achieve better Councillor Nick Clarke outcomes for our communities. We now need Chair, Cambridgeshire Shadow Health & your help in shaping a bold vision and strategy Wellbeing Board that will guide our work.

3 1 Introduction

All aspects of our everyday life have an impact We recognise that there are variations across guide our actions and shape both clinical and on our health and wellbeing: from health Cambridgeshire and that different parts of the non-clinical commissioning decisions. services through to our environment, housing, county will have different needs and priorities. An important objective of the Health & Wellbeing employment, education, transport and our This means that the best solutions will often be Board is to communicate, listen and engage with involvement in local communities. This means derived through partnership working at a local the communities we serve. This consultation is that working to improve community health and level. This strategy aims to identify priorities being conducted to seek genuine, open wellbeing, whilst respecting people’s personal which are shared across the county and across feedback and views from across lifestyle choices, is everybody’s business organisations, for which working as a Health Cambridgeshire. We expect that the views of and in everybody’s interest. Throughout and Wellbeing Board and Network can add local residents and organisations will significantly Cambridgeshire each of our partner most value. influence the priorities in this draft – the Board organisations have strategies or action plans to The shared priorities identified in this draft seeks and welcomes this input to improve our address specific health and wellbeing needs. strategy will help us to go outside organisational strategy. We aim to develop a final strategy 32 We believe that the value of our role as a boundaries and work in creative and innovative which is responsive to local needs, views and Health and Wellbeing Board and Network is in ways to improve outcomes. The priorities will gains shared commitment by all partners. identifying which issues we can influence the most as a partnership , for example: • how we can address the most important local needs, now and in the future;

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 • how can we build on the strengths in our communities and what is working well; • how we can best protect or include the most vulnerable people in our communities; • how we can work together at a time of public sector financial restraint to use our resources most efficiently; • how working together can bring the most benefit to outcomes for Cambridgeshire 4 residents. 2 How is the Health & Wellbeing Strategy being developed? 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

2.1 Developing the draft strategy: c) Stakeholder event to identify the The priorities we have identified in this strategy what we have done so far current priorities of local partnerships will be reviewed and re-evaluated in light of the and organisations comments and feedback we receive from the We have developed this draft strategy using: We asked people from a range of different public consultation. This will enable us to a) National and local evidence of health organisations and groups to use their local confidently produce a shared strategy which needs as measured, analysed and knowledge and expertise to identify key reflects what matters most to organisations and reported in the Cambridgeshire Joint areas which are most important for health communities in Cambridgeshire. It will be Strategic Needs Assessment and wellbeing locally, and to think about reviewed and refreshed periodically to reflect (http://www .cambridgeshir ejsna.or g.uk ) what principles should guide decisions about progress. The Health and Wellbeing Strategy will We used the Joint Strategic Needs priorities. help to inform the strategic and annual plans of Assessment (JSNA), which is an analysis of the Cambridgeshire and Peterborough Clinical data, information, and intelligence from local Commissioning Group. In this way, we can ensure 33 and national sources, jointly produced by 2.2 The Public Consultation: how your that clinical commissioning in the NHS reflects Cambridgeshire County Council and views will inform the strategy the wider health needs of our community. The final strategy will be agreed and published in Cambridgeshire Primary Care Trust (NHS The consultation will run from 18th June to October 2012 and will be supported by more Cambridgeshire). The JSNA includes 17th September 2012. This gives you an detailed outcome measures and action plans for information about a wide range of health and opportunity to tell us what you think about the confirmed priorities over the next five years. wellbeing indicators, the views of the local whether we have identified the right priorities, people, and examples of effective practice how we should tackle these and where we along with identifying gaps and areas for should focus our resources. Throughout the 2.3 Community Impact Assessment development. consultation period residents will be able to A Community Impact Assessment of the draft b) Existing local strategies and plans submit their opinions via an online questionnaire strategy has been conducted. This is a process (see Section 7) or completing and posting a paper designed to evaluate the potential impacts on We compiled a list of the strategies which questionnaire. The consultation questionnaire all individuals in Cambridgeshire and ensure are most relevant to health and wellbeing can be found in the appendix. Presentations will that the strategy and associated actions do not from county-wide or local partnerships, NHS be given at a number of events throughout the discriminate against any disadvantaged or organisations, and County and District county to engage local residents and vulnerable people. This will be reassessed for stakeholders. councils. the revised final strategy. 5 3 Information about Cambridgeshire

3.1 Who lives in Cambridgeshire? also has a considerable number of Travellers levels of skills, income and greater health and migrant workers within the county. inequalities than the rest of Cambridgeshire are Approximately 605,000 people live in experienced. People in the more socio- Cambridgeshire. Of these, approximately Some groups of people across the county are economically deprived areas of Cambridgeshire 105,000 people are under 15 years of age, particularly vulnerable both to suffering from have a life expectancy which is 6.5 years lower and 99,000 people are over the age of 65. socio-economic deprivation and to the for men and 4.9 years lower for women Within the next five years, the population of consequences of this deprivation. For example compared to people in the least deprived Cambridgeshire is expected to grow further older people, people with disabilities, people who areas. Improving the health of the worst off and by 2016 there are forecast to be another are on low incomes or unemployed, Travellers, fastest is a theme throughout this strategy. 37,000 people living in the county, with the homeless people and rural migrant workers. largest increases expected in Cambridge City More information about health in Cambridgeshire and South Cambridgeshire. We are expecting 3.2 How healthy are the people of is available at www.cambridgeshirejsna.org.uk to see a significant rise in the population of

34 Cambridgeshire? 3.3 How do we currently spend older people across the whole county. Between In Cambridgeshire, overall health and life 2010 and 2021 the number of people aged 65 expectancy are well above the national average. public money on health and and over in Cambridgeshire is predicted to Life expectancy at birth for men is 80.1 years social care in Cambridgeshire? increase by 44%. and for women is 83.9 years. Death rates from This Health and Wellbeing Strategy is being Cambridgeshire County as a whole is among the all causes and early death rates from cancer, developed at a time of significant public sector 20% least socio-economically deprived top tier heart disease and stroke have fallen and are financial restraint. A key aim of this strategy is to A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 local authorities in England. At District Council better than the England average. But these support public sector organisations to work and level, there is variation; South Cambridgeshire major diseases still have a considerable impact commission together so that their combined and Huntingdonshire are both within the 20% on health and wellbeing which could be reduced resources can be used to best effect to achieve least deprived second tier authorities nationally, through healthier lifestyles and choices. outcomes for Cambridgeshire residents. while Fenland is in the 40% most deprived. Within this picture, there are health inequalities During the financial year 2010/11, NHS Most local authority areas in Cambridgeshire across the county. These are closely linked with Cambridgeshire spent £872 million on health have a mainly white population. Cambridge City socio-economic circumstances and are more services for Cambridgeshire patients. Nearly has higher proportions of minority ethnic groups concentrated in Fenland, the north and east of half of this spend was on hospital services than the England average, many of whom are Cambridge City, North Huntingdon and the including specialist services (£432m, 49%), 6 students and professionals. Cambridgeshire north of East Cambridgeshire, where lower followed by primary care (£192m, 22%) which A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A £20m

Cambridge City South Cambridgeshire Huntingdonshire

Fenland East Cambridgeshire includes GP practice services and the drugs prescribed by GPs. A tenth of spend (£84m, £15m 10%) was on community health services and another tenth (£83.5m,10%) on mental health and learning disability services.

The total adult social care budget for £10m Cambridgeshire County Council for the financial year 2011/12 was £182 million. Of this, over two fifths (£78.8m, 43%) was for social care for older people aged 65+ and over a quarter £5m (£49m, 28%) was for social care for people with

35 learning disabilities. The budget allocation for Cambridgeshire County Council Children and Young People’s 0 Services for 2011/12 was £133 million, 85+ 01-04 05-09 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 excluding direct spend on schools. Nearly a Under 1 quarter (£29.9m, 22%) was for looked after Age band children, over a sixth (£22.9m, 17%) for other Figure 1: Unplanned (emergency) hospital admissions – total resource use by age group, 2010/11 social care for children, including services for (Note: PBR spend tariff only) disabled children, and an eighth (£16.8m, 13%) was for locality teams, including children's from NHS services, adult social care, district 60-74, resources used for unplanned hospital centres and youth services, which provide councils and the voluntary sector. This showed admissions (see Figure 1) and for placements in preventive interventions for children, young that nearly half (45%) of resources used for NHS nursing and residential home care were highest people and their families. hospital care were for people aged 65+, which is for the very oldest age groups. This analysis In order to better understand how resources are to be expected as people are more likely to raises the question of whether the needs of our currently used across different agencies and develop health problems and long term most elderly and frail residents would be better services to meet the needs of older people in conditions with increased age. Further analysis met by shifting resources into more responsive Cambridgeshire, we carried out a JSNA Ser vice showed that while resources used for planned and integrated health and social care services, 7 and Financial Review , which gathered information hospital admissions were highest for people aged based within communities. 4 Our Approach to improve Health and Wellbeing in Cambridgeshire

4.1 Our principles Stakeholders from health and social care 3. Developing cost-effective solutions and 5. Emphasising local action and organisations, County and District Councils and improving efficiency responsibility local voluntary organisations agreed a number We will aim to use solutions which have the Different age groups and communities will have of principles which helped us to decide on the greatest impact for the most people, at the different needs for information, prevention of five priorities we will focus on in the next three appropriate cost, taking account of the poor health, and health and social care for the years, and will inform how we work together available resources and the constraints on most vulnerable. This strategy recognises the and develop actions to achieve these priorities. public finances. We will try new approaches or importance of using local solutions. We will These principles are: ideas where there is a limited evidence base encourage individuals and communities to take and support robust evaluation of services and responsibility for making healthy choices and 1. Reducing inequalities and improving the programmes. identifying the services they need, and to build

36 health of the worst off fastest on existing strengths and resources in the Whilst working to improve everyone’s health, we community including local voluntary 4. Focusing on prevention will strive to reduce inequalities in healthy life organisations. We will offer our residents expectancy between communities by improving Wherever possible we will take actions which choice, control and encourage their the health of the worst off fastest. support the prevention of poor health and participation. wellbeing outcomes – this may be by encouraging healthy communities and lifestyles

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 2. Using evidence-based practice and in general while respecting people’s personal 6. Sustainability responding to local information choices, or by supporting people with long We will ensure that our services are sustainable We will use public health evidence and local term conditions, to prevent their health to protect our environment and resources, information and views to make sure that we problems worsening. ensuring that changes are made which will focus on significant health and wellbeing needs create long term positive change, taking into in Cambridgeshire to provide the best possible account long term challenges services and support, building on what works and stopping what isn’t working.

8 A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

4.2 Our Model of Health and When people are experiencing problems with available to support people when they are Wellbeing their health or with caring for themselves, we needed. We will aim to ensure that these are will work together to ensure that appropriate integrated, and focussed on the needs of the Maintaining health and wellbeing is important local health and social care services are individual person. for individuals to maximise their potential, enable them to lead active, fulfilled lives and Y AN Figure 2: Model of wider ONOM D ENVIR participate fully in their local community. L EC ON determinants of health CA ME Physical and mental health are closely linked LO NT & wellbeing Housing and both are important for wellbeing. Employment Streets Figure 2 illustrates how lots of different aspects AL COMMUN LOC ITY of our environment and community have a Community Business safety significant impact on our health and wellbeing Cohesion

37 Social inclusion and influence our behaviour. These include Transport Social networks links Parks and employment, education, housing, local ACTIVITIES green community space or green areas, and spaces Living Volunteers transport. The health and behaviours of an Playing Moving individual are influenced more widely by the Assets Learning LIFESTYLE communities in which they live: their social Shopping Diet Alcohol networks, perception of safety and ability to Working Smoking contribute to the local neighbourhood. Our Physical VID Sexual activity DI UA approach to health and wellbeing includes health IN L recognising that the best way to ensure Age, sex & participation, sustainability, and ownership of genetics local initiatives is to work directly with local H ea re communities to enable them to develop local lth and Social Ca services and activities that are important to them and their community. Source: Modified from Dahlgren & Whitehead’s rainbow of determinants of health (G Dahlgren and M Whitehead, Policies and strategies to promote social equity in health, Institute of Futures Studies, Stockholm, 1991) and the LGA circle of social determinants (Available at: http://www.local.gov.uk/web/guest/health/-/journal_content/56/10171/3511260/ARTICLE-TEMPLATE) 9

10 A consultation on the draft38 Cambridgeshire Health & Wellbeing Strategy 2012–17 4.3 groups. marginalisedand communities disadvantaged morein improvementsgreaterthrough fastest, off worst the of health the improve towork will we priorities, these of each particular,withinIn residents.Cambridgeshire ofwellbeing and health mental and physical theimprove to priorities five these on focus willNetwork and BoardWellbeing & Health The A Summary of our Prioritiesour of Summary A • on:focus particular a includes This 1. • • • emotional and social skills for children.for skills social and emotional developto situations, challenging infamilies for particularly parenting, resilientand positive Supporting and raise their self-esteem.their raise and communitythe to contribute to people youngfor opportunities positive Creating needs.complex mostthe with children of numbers growingfor as well community,as thein child the of needs the on focus whichcare social and health education, acrossservices integrated Developing children.and families support toaction appropriate taking and problems healthmental or physical experiencing arewho parents with or needs complexpoverty,with in children identify toapproach multi-agency a Encouraging children. forlife to start positive a Ensure • • • on:focus particular a includes This 2. people with dementia and their carers.their and dementia with people olderof support and care the for services inter-agencyand diagnosis Timely care.institutional otheror homes care hospitals, in stays longfor need the minimise which people, olderof needs individual the to tailored servicescare and health community stronghave we that ensuring and peopleolder frail for services Integrating rehabilitation. cardiacand strokeprevention, fallsthrough e.g. outcomes improve andconditions term long with people foradmissions hospital unnecessary reducewhich interventions Preventative independent and well. and independent safe,be to people older Support A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

3. Encourage healthy lifestyles and 4. Create a safe environment and 5. Create a sustainable environment in behaviours in all actions and helping to build strong communities, which communities can flourish. activities whilst respecting people’s wellbeing and mental health. personal choices.

This includes a particular focus on: This includes a particular focus on: This includes a particular focus on: • Increasing the number of adults and • Implementing early interventions and • Encouraging and informing consideration children with a healthy weight, using a accessible and appropriate services for of health needs associated with housing range of interventions to encourage mental health. when strategies and plans are being healthy eating and physical activity. • Reducing homelessness and addressing developed and refreshed. • Reducing the numbers of people who the effect of changes in housing benefit • Encouraging the use of green, open

39 smoke – by discouraging young people on vulnerable groups. spaces and activities such as walking and from starting and supporting existing • Minimising the negative impacts of cycling. smokers to quit. alcohol, illegal drugs and associated anti- • Maintaining effective public transport and • Promoting sexual health, reducing social behaviour on health and wellbeing. transport networks which ensure access teenage pregnancy rates and improving • Reducing abuse and neglect – particularly to services and activities and reduce road outcomes for teenage parents and their domestic abuse. traffic accidents. children. • Building on the strengths of local • Ensuring that people with long term communities, including the existing local conditions receive appropriate healthy voluntary sector, and promoting inclusion lifestyle support services. of marginalised groups and individuals. • Increasing the engagement of individuals and communities in taking responsibility for their health and wellbeing.

11 5 Our proposed priorities – why we think they are important

5.1 Proposed priority 1 are pockets of real deprivation as well as children growing up in poverty are two and a disadvantaged families living within prosperous half times more likely to suffer chronic illness Ensure a positive start to life for areas. Based on 2009 figures, 16,455 children and almost four times more likely to suffer children and families (13.3% of the total) live in relative poverty mental health problems 2. The Joint Strategic Needs Assessment (JSNA) (families whose income is at or below 60% of Action to tackle poverty is a key strand within 1 for Childr en & Y oung People provides an the national average) in Cambridgeshire . This the Children’s Trust programme and there are overview of key issues and needs for children represents an increase which is 1,365 children specific opportunities where the Health & and young people currently living in from 12.5% in 2008. Children living in areas of Wellbeing Board and Network can encourage all Cambridgeshire. We know that the first few deprivation are exposed to multiple social partners to identify and reach families years of life have a significant impact on the factors which adversely affect their health, vulnerable to poverty or with high or complex health and wellbeing of children for the rest of educational attainment and life chances. needs. This includes both a concerted effort to their lives. It is therefore vitally important that we Children from poorer families living in more identify children who are at risk of poverty or in 40 help to support the early development of healthy prosperous areas are also at risk of poorer challenging situations, tackling the challenges behaviours and foster a supportive community outcomes. National evidence shows that of worklessness, work poverty and poor for parents and families, to give children the best housing, and working together to ensure these opportunities in life. An essential component of families can access effective, high-quality this is positive and supportive parenting. This is services and support. This also links closely to particularly important for parents experiencing the importance of creating a safe and poor physical or mental health or in poverty.

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 supportive environment (Proposed priority 4) There is now a range of effective ways to and the positive effect on families of tackling support parents – from low-cost interventions for drug and alcohol abuse and preventing abuse all parents, through to intensive programmes to and neglect, particularly domestic abuse. support those families most in need. In Cambridgeshire, there are key inequalities in In Cambridgeshire, there are children growing outcomes for children and young people, and up in poverty in every town and village. Despite these are demonstrated in a number of the affluence of much of the population, there indicators, including attainment rates across all

1 Cambridgeshire’s Child Poverty Needs Assessment 2011. Available at: http://www.cambridgeshire.gov.uk/childrenandfamilies/providingchildrensservices/children/strategiesandplansforchildren/default.htm 2 D.Hirsch and N. Spencer (2008), Unhealthy Lives: intergenerational links between child poverty and poor health in the UK 12 3 JSNA Children & Young People. Available at: http://www.cambridgeshirejsna.org.uk/webfm_send/121 A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

Our focus will be to:

• Support positive and resilient parenting, particularly for families in challenging situations, to develop emotional and social skills for children; • Encourage a multi-agency approach to identifying children in poverty, with complex needs or with parents who are experiencing physical or mental health problems and taking appropriate action

41 to support families and children; • Developing integrated services across education, health and social care which focus on the needs of the child, in the community as well as for growing key stages of education, rates of unhealthy Tackling youth unemployment is important if we numbers of children with the most weight, childhood deaths and injuries 3, and are to grow the local economy, and increasing complex needs; rates of young people becoming NEET (not in the participation of 16-18 year olds in education, employment or training). education, work and training improves their life • Create positive opportunities for young Cambridgeshire is experiencing rapid chances and makes a lasting difference. people to contribute to the community demographic growth and in parts of the county Around 5% of 16-18 year olds in and raise their self esteem. numbers of children are rising rapidly. The Cambridgeshire are not in education, number of children with Special Educational employment or training (NEET). For young Needs is also rising. It is not only an economic people with learning difficulties and/or necessity, but critical to the best outcomes for disabilities (LDD), this percentage rises to these children that education, health and social 8.4%. Tackling this problem also requires care services work together to assess, plan interventions during the school years to ensure and support these children and their families. all children achieve their potential. 13 5.2 Proposed priority 2 Support older people to be independent, safe and well People in Cambridgeshire are living longer and the number of people over 65 is set to grow by approximately 44% in the next 10 years and 80% in the next 20 years. We know from the Joint Strategic Needs Assessment (JSNA) for Older People that most older people in Cambridgeshire are in good health, but over a lifetime can expect to spend longer in poor 42 health and with disability then previous generations. The JSNA on Physical and Sensor y Impair ment and Long-T er m Conditions also integrated health and social care services, • Prevention of ill health and promotion of provides local information on a variety of long based in communities for our most elderly and good health (see Proposed priority 3); term conditions, a large proportion of which frail residents. affect people over 65 years. Although 40% of • Reconfiguration and integration of services We want to support older people in to support people to live in a community A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 older people do not have a long term condition such as diabetes, hypertension, coronary heart Cambridgeshire to live healthy lives, engaged setting as long as possible, avoid admission disease or asthma, many people live with a long and empowered to make decisions about their to hospital, and return to a community term condition that limits their ability to cope own health and wellbeing and play active roles setting after discharge from hospital. within their local communities. In addition we with day to day activities. Recent JSNA work We need to employ a whole system approach want to continue providing services for older which analyses how different agencies use to prevention, early intervention and cost- people that are effective, cost-effective and resources to meet the needs of our oldest effective services to enable any individual valued by service users and carers as the residents is described in section 3.3. This requiring help to stay independent for as long number of older people living in the county indicates that resources may need to be used as possible. One particular example is the increases. This aim for the older population in differently to provide more responsive and prevention of falls. In the very elderly 14 Cambridgeshire drives two main themes: A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

population (aged 85+), falls leading to hip inclusion, access to information on services Our focus will be: fractures is the most common diagnosis for and activities, housing and help in the home. emergency admission to hospital. Compared Fewer than 30% of people felt that residents • Preventative interventions which reduce to the East of England, Cambridgeshire has a are given the support they need to live at home unnecessary hospital admissions for 4 higher number of falls amongst older people: as long as they want . The role of communities people with long term conditions and around one third of people aged 65 and older, is important. 85% of older people do not improve outcomes e.g. through falls and one half of people aged 85 and older will access social care services and most care and prevention, stroke and cardiac fall once a year. For frail older people with support provided to older people is unpaid and rehabilitation. health and social care needs, we aim to informal. The number of older people • Integrating services for frail older people integrate services across organisations to experiencing difficulty in managing alone at and ensuring that we have strong focus on the needs of the individual, ensuring least one domestic task (for example shopping, community health and care services that we have strong community health and jobs involving climbing, floor-cleaning) is 43 tailored to the individual needs of older social care services, which minimise the need expected to almost double from 40,800 to people, which minimise the need for long for long stays in hospital or other institutional 74,500 in the next 20 years. If current patterns stays in hospitals, care homes or other care. of need and care are applied to the increasing institutional care; Local integrated services and support for older numbers of older people, the provision of 5 • Timely diagnosis and inter-agency people with long term conditions, including services will be unsustainable . services for the care and support of mental health issues can also be improved. For Older people make a valuable contribution to older people with dementia and their example, to facilitate timely recognition and their local community. It is important that we carers. support for individuals with dementia which capture contributions of older people and affects 20% of people over 85, and 5% over identify ways we can support, expand and utilise 65. In Cambridgeshire the number of people these assets in Cambridgeshire. This also links who have dementia is expected to double from closely to ensuring a safe and accessible 7,000 to 14,000 over the next 20 years. environment where older people can play an Older people in Cambridgeshire are most active role in community and local activities concerned about income, transport and social (linked to Proposed priorities 4 and 5).

4 JSNA Older People. Available at: http://cambridge.newcastlejsna.org.uk/webfm_send/143 5 JSNA Older People. Available at: http://cambridge.newcastlejsna.org.uk/webfm_send/143 15 5.3 Proposed priority 3 both for children and adults, smoking rates, lack as people become more affluent they are more of physical activity and harm due to alcohol are likely to adopt healthy behaviours. Preventing ill Encourage healthy lifestyles and all key areas where current levels are likely to health requires integrated approaches that bring behaviours in all actions and have long term health consequences. In together these wider determinants of health and activities while respecting Cambridgeshire about 20% of local adults are how people choose to live their lives when people’s personal choices smokers 6: Fenland has the highest rates where healthy or when suffering from ill health. 26.7% of the population is estimated to smoke. There is good evidence of the links between There are a number of ways in which we can Nearly 30% of men drink more than the lifestyle behaviours and health. Long term encourage individuals towards positive lifestyle recommended limits, with the highest rates being smoking causes a range of cancers and change. Encouraging healthy lifestyles and found in Cambridge City and Fenland 7. Estimates circulatory disease and reduces life expectancy behaviours in children can have a big impact, as suggest that less than half of local adults eat by an average of ten years. Sedentary it is likely that these habits and activities will last more than five portions of fruit and vegetables a lifetime. Childhood obesity and teenage

44 behaviour, poor diet and obesity are closely per day and only 50% of men and 43% of women linked to the development of diabetes, heart smoking are considerable challenges that can have high levels of physical activity 8. disease, joint and back problems and be met by schools, health services, social care Most of us know some of the everyday things depression. Use of alcohol above recommended services, environment teams and local we can do to improve our own health and life limits leads to a range of longer term health communities working closely together, expectancy. Yet not everyone is able to make problems including high blood pressure, liver encouraging peer support and leadership from healthy decisions or adopt healthy behaviours. disease and mental health issues, as well as children and young people themselves. We can A number of factors can influence this from also encourage and support older people to A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 often contributing to antisocial behaviour and individual experiences to wider environmental crime in local communities. make healthy lifestyle choices, such as factors which influence our behaviour such as remaining physically active. We know from the Joint Strategic Needs the housing in which we live, transport that we Raising awareness of risks and early signs of Assessment (JSNA) on the Pr evention of Ill Health can access, or community support we enjoy. disease so that early treatment can be given, in Adults of W orking Age that a large number of These wider determinants of health are also can help to improve both physical and mental people in Cambridgeshire have lifestyle factors closely linked to the gap in health between the health. For people who already have health which will adversely affect their health. Obesity rich and the poor. We know, for example, that problems, there are lifestyle changes which can

6 Source: Integrated Household Survey (April 2011) (In JSNA Older People) 7 Source: NWPHO LAPE http://www.lape.org.uk/. (In JSNA Older People) 16 8 JSNA Prevention of Ill Health in Adults of Working Age. Available at: http://www.cambridgeshirejsna.org.uk/webfm_send/142 A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

slow or halt the rate at which these problems for action, associated with health inequalities and Our focus will be to: worsen. We want to make sure that the way we poor social, economic and health outcomes for provide treatment or care increases people’s both mother and child. Despite the fact that • Increase the number of adults and control over their own health and enables them teenage pregnancy rates in Cambridgeshire children with a healthy weight, using a to minimise the impact of ill health on their lives. remain below the national average, there is still range of interventions to encourage We can also do much to promote sexual health room to reduce them and opportunities to better healthy eating and physical activity; support teenage parents and their children. where there is a clear link with poverty and social • Reduce the numbers of people who exclusion. Teenage pregnancy remains a priority smoke – by discouraging young people from starting, and supporting existing smokers to quit; • Ensure that people with long term 45 conditions receive appropriate healthy lifestyle support services; • Promote sexual health, reduce teenage pregnancy rates and improve outcomes for teenage parents and their children; • Increase the engagement of individuals and communities in taking responsibility for their health and wellbeing.

17 5.4 Proposed priority 4 may have difficulty accessing services and health promotion 9. Migrant workers and black Create a safe environment and and minority ethnic communities are also help to build strong communities, vulnerable and may have barriers to accessing wellbeing and mental health mental health services. Many of the risk factors for mental health and illness are linked to socio- As described in the Mental Health Joint economic circumstances. There is more work Strategic Needs Assessment (JSNA) , to be done in mapping areas of deprivation and supporting good mental health and emotional ensuring that mental health service provision is wellbeing are fundamental to achieving good targeted appropriately. We also know that health, wellbeing and quality of life. Mental chronically excluded homeless people often wellbeing impacts on how we think, feel, have poor outcomes, poor physical and mental 46 communicate and understand. It enables us to health, and drug, alcohol and social problems 10 . manage our lives successfully and live to our Making the transition out of homelessness can full potential. Mental health and physical health be an intensely difficult process and their are strongly linked. Coping with a physical complex needs require well co-ordinated problem such as a long term condition can services and support from a variety of different contribute significantly to mental health and organisations. wellbeing. Conversely, over two thirds of people

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 As well as stressing the importance of with a persistent mental health problem also addressing wellbeing needs for the whole problems include those which reduce have a long-term physical complaint. population, it is important to give attention to inequalities, prevent violence, reduce It is well recognised that social and health the wellbeing of people with serious mental homelessness, improve housing conditions, inequalities can both result in and be caused by health problems. Many interventions can have a support debt management, and promote mental ill health. Travellers, migrant workers, positive impact throughout the spectrum of employment. A persistent theme from both the prisoners, people with substance misuse mental health and wellbeing needs. data trends and the community consultation is problems and people with learning disabilities Interventions to increase individual, family and that despite the generally positive wellbeing are at increased risk of mental ill health and community resilience against mental health and health statistics for Cambridgeshire as a

9 JSNA Mental health. Available at: http://cambridge.newcastlejsna.org.uk/webfm_send/58 18 10 JSNA for people who are homelessness or at risk of becoming homeless. Available at: http://www.cambridgeshirejsna.org.uk/webfm_send/110 A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

whole, the current economic climate has linked to mental health. They may have similar Our focus will be to: created some new areas of concern. determinants such as drugs, alcohol and Unemployment rates, benefits claims, and debt deprivation and victims of crime are more likely • Implement prevention, early interventions have increased in Cambridgeshire in recent to suffer mental health problems such as and accessible, appropriate services for years, all of which may impact on people’s depression. In addition to the impact alcohol mental health, particularly for people in mental health and longer term physical health. can have on the health of an individual, alcohol deprived areas; There is early evidence of an increase in rising misuse increases the risk of an individual • Reduce homelessness and address the levels of poor mental health amongst vulnerable becoming involved in crime, either as a victim effect of changes in housing benefit on parents for example. There is also a particular or offender. Antisocial behaviour has also been vulnerable groups; concern with the availability and affordability of identified as an area of concern for local housing, increasing levels of fuel poverty, and communities and can force some individuals or • Minimise the negative impacts of alcohol changes to the benefits system. communities to live in fear and social isolation. and illegal drugs and associated anti- 47 social behaviour on health and wellbeing; There is evidence that strong social networks Tackling this involves understanding why people help to protect people against physical and (especially young people) commit crime or act • Reduce abuse and neglect – particularly mental health stressors. Actions to develop antisocially and engaging with communities to domestic abuse. sustainable, cohesive and connected encourage social responsibility. There are many communities have an important role in types of abuse or neglect, but domestic abuse promoting good mental health and wellbeing. continues to be a particular problem. 7,718 individual reports of domestic violence were Therefore it is clear that part of maintaining made to the police in 2010/2011. Domestic resilience involves creating a safe environment violence is the most common form of violence for residents to participate in community in rural areas and is the most frequently activities and particularly for children to have reported reason for referrals to Children’s safe places to play and access to positive services in Cambridgeshire. activities 11 . Crime, particularly violent crime, is

11 The Big Plan 2: www.thebigplan2.co.uk 19 5.5 Proposed priority 5 Create a sustainable environment in which communities can flourish It is recognised that transport, green spaces and the built environment play a key role in determining our health and wellbeing. The importance of the wider local economy, and the health benefits to individuals of being in employment are also well known. The New Communities Joint Strategic Needs Assessment (JSNA) describes how that quality of our 48 communities’ health and wellbeing is linked to the quality of their environment. For example: • Good quality, affordable and accessible housing is important to people’s health and wellbeing including housing adapted to meet the needs of people as they age or when A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 they develop a disability; • Exposure to green spaces is good for health, can improve mental wellbeing and food and other amenities and services that • It is critical to provide good community may stimulate more social contact; promote health and wellbeing; facilities for young families moving into new • Transport planning can enhance health by • Building structures and transport systems communities with lots of open play space, promoting active transport (such as cycling that reduce or minimise air and noise as this minimises the chances of isolation and walking), reducing road traffic pollution have clear health benefits in terms and depression. accidents, facilitating social interaction, and of respiratory illness and stress related • The provision of safe, continuous cycling and 20 improving access to green spaces, fresh conditions; walking networks can also help to improve A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

quality of life and wellbeing of vulnerable one in the county is unable to access the Our focus will be to: groups in the community such as young services and facilities they need to participate people and help them to access key services in community life, take advantage of life • Ensure that housing and development such as health care, leisure and recreational choices and to lead a healthy lifestyle because strategies for new and existing facilities. they do not have access to a car. The Health communities identify the health and We will continue to work with District Councils and Wellbeing Board and Network recognises wellbeing impacts for residents in the and with housing providers including registered that partners need to work together to ensure short and long term; services are provided in such a way that social landlords to consider the short and long • Promote the use of green, open spaces transport is not considered a barrier to term impacts of housing on the physical and and activities such as walking and accessing them. mental health and wellbeing of residents. We cycling; will ensure that health and wellbeing is an We recognise that new communities do not • Maintain effective public transport and

49 integral part of our planning process for new develop in isolation from existing communities transport networks which ensure access communities or new environmental spaces, and the character of new communities is to services and activities and reduce road considering the benefits: of lifetime homes so determined by much more than the physical traffic accidents; that people are not excluded by design when infrastructure. Community development they become older or frailer; of ensuring approaches enable those in similar need to • Build on the strengths of local access to green spaces; and of support to work together to seek changes and solutions in communities, including the local voluntary develop community networks at an early stage. their environment as part of a bottom up rather sector, to enhance social cohesion, and promote social inclusion of marginalised Ability to access transport, particularly in rural than top down approach to improvement. groups and individuals. areas, can affect access to health services, Sharing community resources and supporting local amenities and green spaces and may also systems that promote mutual support are affect people’s ability to access their social crucial in developing this social capital. Stronger networks, which are important for maintaining community networks play an essential role in mental and physical health. Nearly one in five of supporting vulnerable families and individuals. Cambridgeshire’s population do not have Good communications using existing networks access to a car or van. The County Council’s and routes are central in promoting this type of Local T ranspor t Plan sets out the vision that no community-based prevention. 21 6 Working Together

In many ways, these five priorities are not new. Joined up commissioning Using resources differently Health and social care organisations have been To improve health and wellbeing and improve This strategy is being developed during a striving to achieve these changes for a long the health of the worst off fastest we will need period of public sector resource constraint. To time. What is new, is the ambition of the Health to think about the whole picture and how we make a difference we will need to change the and Wellbeing Board and Network to tackle can shape the services and support we provide way we use resources and re-think how we some of these priorities through organisations to meet the needs of different communities. commission and deliver services across health working together in new ways or with fresh and social care and other relevant services, in approaches. It is important that we continue to The County Council and local NHS will aim to order to achieve better outcomes and challenge our ways of working and understand work closely with our partners in District effectively meet increasing levels of need. We whether we are using the right approach and Councils and Local Health Partnerships, the aim to find new ways of working with aligned or how we can more effectively link together. Police Service and Criminal Justice System, the Voluntary sector and local community groups. shared budgets and using our combined resources more effectively together, to get 50 When considering commissioning of services best value across the local public sector. from the community sector, where possible we will enter into joint funding arrangements with those statutory agencies already providing Local and collaborative effort funding to add value and avoid duplication of We will continue to engage and involve all monitoring and reporting. partners and the local community in decision-

A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 making and strive for open, honest conversations. We aim to maximise effective health networks across Cambridgeshire to ensure effective communication.

22 7 Strategies related to Health & Wellbeing in Cambridgeshire 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A

This is a list of strategies and plans in Cambridgeshire that impact on health and wellbeing. They have all contributed to the development of this strategy and will inform the actions we will take to deliver the strategy. We are aware that we may have missed some strategies from this list. Please do let us know of any other strategies that should be included.

County-wide strategies • Early Years Strategy • East Cambridgeshire Homelessness Strategy 2008- • Special Educational Need and Disability Strategy 2011 (under review) • Cambridgeshire County Council Integrated Plan • Child and Adolescent Mental Health Strategy • East Cambridgeshire Housing Strategy 2008-10 (Strategic Framework) • Shaping Places, Shaping Services – Cambridgeshire (under review) • NHS Cambridgeshire: A Strategic Plan for County Council’s approach to community engagement • Parks & Green Spaces Strategy 2006 (Refresh due Cambridgeshire • 21st Century Library Vision & Programme Sept 2012) • Cambridgeshire Policing Plan • Cambridgeshire Alcohol Harm Prevention Strategy • Fenland Strategic Partnership – Priority Areas for Action. • Shaping our Future – Adult Social Care Strategy • Cambridgeshire Obesity Prevention & Management • Fenland Active Leisure Strategy 2010 (refresh due by • Transformation Strategic Plans Strategy 2008-2011 Sept 2012) • Prevention & Early Intervention Strategic Plan • Cambridgeshire County Council Road Safety Strategy • Fenland Sports Facilities demand analysis 2010 • Universal Information & Advice (revised 2011) • Fenland Community Safety Partnership Action Plan • Participation • Cambridgeshire Green Infrastructure Strategy 2011 2012-13 51 • Promoting Direct Payments • Cambridgeshire Domestic Abuse and Sexual Violence • Fenland Homelessness Strategy Action Plan 2011-14 • Quality Assurance Framework (Draft) Strategy 2012-2015 • Fenland Housing Strategy 2009-12 • Workforce Development Strategy • Cambridgeshire Tobacco Control Alliance Action Plan • Fenland Community Cohesion Action Plan 2011-14 • Quality for Adults Programme (Project Trinity) 2010 – 2011 • Huntingdonshire Community Safety Plan 2008-2011 • Re-ablement • Cambridgeshire Gypsy & Traveller Strategy (2012 update in draft) • Commissioning Strategies • Health Inequalities Strategy Plan • Sports Facilities Strategy for Huntingdonshire 2009 – • Joint Commissioning Strategy for Older Peoples • NHS Cambridgeshire Mental Health Promotion 2014 Mental Health Services Strategic Action Plan • Huntingdonshire Housing Strategy 2006-11 • Physical Disability & Sensory Service • NHS Cambridgeshire Sexual Health Strategy • Learning Disability Strategic Plan • Huntingdonshire Local Economy Strategy (Medium Term Plan 2008-15) (update draft by June 2012) • Older People • South Cambridgeshire Community Safety Plan 2012 • Community Engagement Programme District-level strategies (in draft) • Adult Safeguarding Strategy • Cambridge City and South Cambridgeshire Improving • South Cambridgeshire Housing Strategy 2012-2016 • Assistive Technology Strategy Health Plan 2008-2011 • South Cambridgeshire Corporate Plan 2012-2013 • Carer’s Strategy • Cambridge City Home Energy Strategy & Cambridge • South Cambridgeshire community Transport Strategy • Extra Care Strategy City Affordable Warmth Policy 2010-2012 • Supporting People Commissioning Strategy • Cambridge City Housing Strategies • South Cambridgeshire Empty Homes Strategy 2012- • Looked After Children placements Strategy: 'Keeping • Cambridge City Open Space and Recreation Strategy 2016 families together' • Cambridge Sustainable Community Strategy 2011- • Child Poverty Strategy: Breaking the Cycle 2014 • South Cambridgeshire Safeguarding Children Policy 2009 • Narrowing the Gap: Cambridgeshire’s Strategy to raise • East Cambridgeshire Community Safety Strategy Plan • South Cambridgeshire Safeguarding Vulnerable Adults the attainment of vulnerable groups 2011-2014 Policy 23

24 A consultation on the draft52 Cambridgeshire Health & Wellbeing Strategy 2012–17 questionnaire which you can find on our webpage: http://www.cambridgeshire.gov.uk/council/partnerships/Health%20and%20Wellbeing%20Board.htmwebpage: our on find can you which questionnaire onlinethe using views your submitting below,or box the in address FREEPOST the at us to it sending and questionnaire printed a in filling by either this Youdo can 2012. September 17th by views your us tell Please June. 18th on begin will Consultation Public The county? the suit to adapted better be couldit which in ways example, For add? to likewould you further anything have you Do Cambridgeshire? forappropriate is out setvision the that feel you do far howoverall, strategy the at Looking questions:5 key the of summary a is This document. this to appendix an as found be can questionnaire Consultation 8-page An 8 Question 1Question All information you provide will be treated in confidence and not shared with any third parties.third any with shared not and confidence in treated be will provide you information All 0BRCB3 Cambridge CB176, FREEPOST Council, County Cambridgeshire CC1318, Box please contact us by calling by us contact please cassetteaudio on or languages other in largeprint, Braille, in format, read easy in document this of copy a like would you If A summary of the consultation questionsconsultation the of summary A 01223 70324001223 priorities for Cambridgeshire? for priorities correctthe identified we have area,priority proposed each For Cambridgeshire inwellbeing and health for priorityappropriate an is each that agreeyou do far how areas priority proposedfive the Considering to add?to like would you else anything there Is Question 2Question Question 3Question , or by email by or , [email protected] this Strategy?this regardstowith add to like would you further anything have you Do community?your for prioritieswellbeing and health the meetingin achievement of markers keybe to consider you would What Question 5Question 4Question , or by post to post by or , a consultation on the Draft Cambridgeshire Health & Wellbeing Strategy 2012–17 53

Appendix: Consultation questionnaire

Please fill in this questionnaire to tell us your views on the priorities we have outlined in the Draft Cambridgeshire Health & Wellbeing Strategy by 17th September 2012. You can do this either by filling in this printed questionnaire and sending it to us at Box CC1318, Cambridgeshire County Council, FREEPOST CB176, Cambridge CB3 0BR or submitting your views using the online questionnaire which you can find on our webpage: http://www.cambridgeshire.gov.uk/council/partnerships/Health%20and%20Wellbeing%20Board.htm

www.cambridgeshire.gov.uk Consultation questions

Good health and wellbeing is fundamental to You can find a copy of the Draft Cambridgeshire Your thoughts on the overall strategy enable us to live an active and fulfilled life and Health & Wellbeing Strategy on our webpage play a role in our local communities. In and fill in the questionnaire online: Q1a Are you completing this questionnaire Cambridgeshire, we are fortunate to live in a http://www .cambridgeshir e.gov .uk/council/par t as an individual or on behalf of a group? part of the country where the health of the local nerships/Health%20and%20W ellbeing%20Boar d. Individual Group people is generally better than the England htm average. Whilst this is encouraging, it only If you prefer to send us a paper copy you can Q1b Which of the following best describes paints part of the wider picture. We also know either print this questionnaire to fill in or your involvement in your local community? that some local people experience significant request a copy of the questionnaire using the disadvantage and inequalities in health and well- contact details below. Member of the public being. If you would like a copy of the strategy or this Councillor With this in mind, we have produced a draft 54 document in easy read format, in Braille, large County Council officer Health & Wellbeing Strategy for consultation print, in other languages or on audio cassette District Council officer which identifies the priority issues we believe please contact us: are important for local people and outlines how NHS: Commissioner Tel: 01223 703240 we will work together effectively to tackle NHS: Provider them. E-mail: hwbconsultation@ Health Protection Agency cambridgeshire.gov.uk We are keen to get your views on the strategy Other Public Sector organisation A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 to help improve our services, and would be Address: Box CC1318 grateful if you could spare a few minutes to Cambridgeshire County Council Business organisation complete this short questionnaire. Your insight Freepost CB176 Voluntary/ Third Sector and opinions are important and will help us to Cambridge Service Provider ensure that we are providing the most useful CB3 0BR University information and support to the people that All information you provide will be treated in need it. confidence and not shared with any third Other, please state: The consultation will begin on the 18th June. parties. Please take some time to fill in this ii questionnaire by 17th September 2012 . Q2a Looking at the strategy overall, how Q2b Do you have anything further you would like to add? For example, ways in which it 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A far do you feel that the vision set out is could be better adapted to suit the county? appropriate for Cambridgeshire?

Very appropriate Inappropriate Appropriate Very inappropriate Neither appropriate or inappropriate

Your thoughts on our proposed priorities Five proposed priorities have been developed within the Cambridgeshire Health and Wellbeing Strategy. For a summary of these please see pages 10-11. Q3 Considering these five proposed priorities, how far do you agree that each is an appropriate priority for health and wellbeing in Cambridgeshire? Very Appropriate Neither Inappropriate Very Don't know 55 appropriate appropriate nor inappropriate / Undecided inappropriate Proposed priority 1: Ensure a positive start to life for children

Proposed priority 2: Support older people to be safe, independent and well

Proposed priority 3: Encourage healthy lifestyles and behaviours in all actions and activities while respecting people’s personal choices

Proposed priority 4: Create a safe environment and help to build strong communities, wellbeing and mental health

Proposed priority 5: Create a sustainable environment in which communities can flourish iii What should we focus on? Is there anything else you would like to add • Integrating services for frail older people and about this? ensuring that we have strong community Proposed priority 1 health and care services tailored to the individual needs of older people, which Ensure a positive start to life for minimise the need for long stays in hospitals, children care homes or other institutional care. Our focus areas are: • Timely diagnosis and inter-agency services • Supporting positive and resilient parenting, for the care and support of older people with particularly for families in challenging dementia and their carers. situations, to develop emotional and social Q4b Have we identified the correct areas skills for children. to focus on for Cambridgeshire within this • Encouraging a multi-agency approach to theme? identifying children in poverty, with complex needs or with parents who are experiencing Yes No

56 physical or mental health problems and Is there anything else you would like to add taking appropriate action to support families about this? and children. • Developing integrated services across education, health and social care which focus on the needs of the child in the community, as well as for growing numbers A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 of children with the most complex needs. Proposed priority 2 • Creating positive opportunities for young Support older people to be safe, people to contribute to the local economy independent and well and community and raise their self-esteem. Our focus areas are:

Q4a Have we identified the correct areas • Preventative interventions which reduce to focus on for Cambridgeshire within this unnecessary hospital admissions for people theme? with long term conditions and improve outcomes e.g. through falls prevention, iv Yes No stroke and cardiac rehabilitation. A consultation on the draft Cambridgeshire Health & Wellbeing Strategy 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A Proposed priority 3 Is there anything else you would like to add • Minimising the negative impacts of alcohol, about this? illegal drugs and associated anti-social Encourage healthy lifestyles and behaviour, on health and wellbeing. behaviours in all actions and • Reducing abuse and neglect – particularly activities while respecting people’s domestic abuse. personal choices Our focus areas are: Q4d Have we identified the correct areas • Increasing the number of adults and children to focus on for Cambridgeshire within this with a healthy weight, using a range of theme? interventions to encourage healthy eating and physical activity. Yes No • Reducing the numbers of people who smoke Is there anything else you would like to add – by discouraging young people from starting about this? and supporting existing smokers to quit. 57 • Promoting sexual health for teenagers, reducing teenage pregnancy rates and improving outcomes for teenage parents and their children. • Ensuring that people with long term Proposed priority 4 conditions receive appropriate healthy Create a safe environment and help lifestyle support services. to build community resilience, • Increasing the engagement of individuals and wellbeing and mental health communities in taking responsibility for their health and wellbeing. Our focus areas are: • Implementing early interventions and accessible and appropriate services for Q4c Have we identified the correct areas mental health. to focus on for Cambridgeshire within this theme? • Reducing homelessness and addressing the effect of changes in housing benefit on Yes No vulnerable groups. v Proposed priority 5 Is there anything else you would like to add about this? Proposed priority 5: Create a sustainable environment in which communities can flourish Our focus areas are: • Encouraging and informing consideration of health needs associated with housing when strategies and plans are being developed and refreshed. • Encouraging the use of green, open spaces and of activities such as walking and cycling. • Maintaining effective public transport and transport networks which ensure access to 58 services and activities and reduce road traffic accidents. • Building on the strengths of local communities, including the existing local voluntary sector, and promoting inclusion of marginalised groups and individuals. A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17

Q4e Have we identified the correct areas to focus on for Cambridgeshire within this theme?

Yes No

vi Looking forward Q6 Do you have anything further you About you 2012–17WellbeingStrategy & Health Cambridgeshire draft the on consultation A would like to add with regards to this In tackling the health and wellbeing priorities Finally, it would be helpful if you could answer a Strategy? outlined, it is important that we continue to few questions about yourself. challenge our ways of working, identify if we Completion of these questions is however are using the right approach and explore how entirely optional. we can work more effectively. Your continued engagement is important to us. Q7 What is your age?

Q5 What would you consider to be key Under 16 markers of achievement in meeting the health and wellbeing priorities for your 16 to 24 community? 25 to 44

45 to 64 59

65+

Prefer not to say

Q8 Are you male or female?

Male

Female

Prefer not to say

vii Q9 How would you describe your Q10 Please enter your postcode if you Q12 Which of these best describes what ethnicity? are a UK resident. you are doing at present?

White – British Employee in full time job (30 hours plus

White – Irish per week) This enables us to ensure we are reaching all Any Other White background areas of the County with this consultation. It will Employee in part-time job (under 30 hours not be used to identify you in any way. per week) Mixed – White and Black Caribbean Self employed (full or part-time) Mixed – White and Black African Q11 Do you have any of the following long-standing conditions? Full-time education at college or university Mixed – White and Asian Blindness or partially sighted Unemployed and available for work Any Other Mixed background Deafness or severe hearing impairment Permanently sick / disabled Asian or Asian British – Indian 60 Mobility difficulties Retired Asian or Asian British – Pakistani Cognitive or learning disabilities Looking after the home Asian or Asian British – Bangladeshi A long-standing physical condition Other (please specify below) Any Other Asian backgound A mental health condition Black or British Black – Caribbean A consultation on the draft Cambridgeshire Health & Strategy Wellbeing 2012–17 A long-standing illness such as cancer, Black or British Black – African diabetes or epilepsy Any Other African background Thank you for taking part in the No, I do not have a long-standing condition Chinese Cambridgeshire Health and Prefer not to say Wellbeing Strategy Consultation. Gypsy/Roma/Traveller Your feedback will be invaluable Other in shaping the final strategy for viii Prefer not to say the county. a consultation on the Draft Cambridgeshire Health & Wellbeing Strategy 2012–17

ood health and wellbeing is to enable them to develop local is encouraging, it can mask lead to higher levels of need for c) Stakeholder event to identify G fundamental to enable us to services and activities that are some real challenges. We know some health and care services. the current priorities of local live an active and fulfilled life important to them and their that some local people partnerships and This strategy aims to identify and play a role in our local community. experience significant organisations. priorities which are shared communities. This diagram disadvantage and inequalities in In Cambridgeshire, we are across the county and across An important objective of the illustrates how lots of different health, which is something we fortunate to live in a part of the organisations, where working as Health & Wellbeing Board is to aspects of our environment and must improve. We also know country where the health of local a Health and Wellbeing Board communicate, listen and community have a significant that the population of older people is generally better than and Network can add most engage with the communities impact on our health and people is set to increase rapidly

61 the England average. Whilst this value. The priorities will guide our we serve. This consultation is wellbeing and influence our in the next decade, which will actions and shape both clinical being conducted to seek behaviour. These include and non-clinical commissioning genuine, open feedback and employment, education, NOMY AND ENV ECO IRON decisions. The shared priorities views from across CAL ME housing, local community space LO NT Housing identified in this draft strategy Cambridgeshire. or green areas, and transport, Employment Streets will help us to go outside AL COMMUN as well as the health and social LOC ITY The consultation will run from Community organisational boundaries and care services which support us Business safety 18th June to 17th September. Cohesion work in creative and innovative when we are ill. The health and Social inclusion This gives you an opportunity to Transport Social networks ways to improve outcomes. links Parks and behaviours of an individual are ACTIVITIES green tell us what you think about spaces influenced more widely by the Volunteers We have developed this draft whether we have identified the Playing Living communities in which they live: Assets Moving strategy using: right priorities, how we should Learning LIFESTYLE Shopping their social networks, perception Diet tackle these priorities and where Alcohol a) National and local evidence of of safety and ability to Working Smoking we should focus our resources. Physical health needs as measured, activity IVIDU Sexual contribute to the local D A You can do this through N L health I analysed and reported in the neighbourhood. Our approach to submitting a paper feedback Age, sex & Cambridgeshire Joint health and wellbeing includes genetics form or submitting an online H Strategic Needs Assessment recognising that the best way to ea re response, available at: lth and cial Ca (http://www.cambridgeshirejs ensure participation, So http://www.cambridgeshire.gov. na.org.uk/) sustainability, and ownership of Source:Modified from Dahlgren & Whitehead’s rainbow of determinants of health (G Dahlgren and M Whitehead, uk/council/partnerships/Health% EXECUTIVE SUMMARY Policies and strategies to promote social equity in health, Institute of Futures Studies, Stockholm, 1991) and the local initiatives is to work LGA circle of social determinants(Available at: http://www.local.gov.uk/web/guest/health/- b) Existing local strategies and 20and%20Wellbeing%20Board.h directly with local communities /journal_content/56/10171/3511260/ARTICLE-TEMPLATE) plans (see Section 7) tm

www.cambridgeshire.gov.uk A consultation on the draft62 Cambridgeshire Health & Wellbeing Strategy 2012–17 fastest, through greater improvements in more disad more in improvementsgreaterthrough fastest, particula In residents.Cambridgeshire of wellbeing Cross cutting principles: principles: cutting Cross Network Wellbeingand Board& Health Cambridgeshire • • • • on:focus particulara includes This 1. supportfamilies and children. takingappropriate action to mentalhealth problems and experiencingphysical or parentswho are complexneeds or with childrenin poverty, with approachto identifying Encouraginga multi-agency children.for skills social andemotional develop tosituations, challenging infamilies for particularly parenting,resilient andpositive Supporting self-esteem. theirraise and community andeconomy local theto contribute to people youngfor opportunities positiveCreating mostcomplextheneeds. numberschildrenof with growingforwellas community,thechildin as theneedstheoffocuson healthsocialandcare which servicesacross education, Developingintegrated to life for children. for life to startpositive a Ensure 2. • • • on:focus particulara includes This Equitable Equitable their carers.their anddementia with people olderof support and care thefor services agency inter-and diagnosis Timely care.institutional other orhomes care hospitals, instays long for need theminimise which people, olderof needs individual theto tailored services careand health community stronghave we that ensuringand people older frailfor services Integrating rehabilitation.cardiac andstrokeprevention, fallsthrough e.g. outcomes improveand conditions termlong with people foradmissions hospital unnecessaryreduce which interventionsPreventative and well. and independentsafe, be topeople older Support • • Evidence-based r, within each of these priorities, we will work to work will we priorities, these r,of each within vantaged communities and marginalised groups.marginalised and communities vantaged will focus on these priorities to improve the phys the improve to priorities these on focus will • on:focus particulara includes This 3. • • • • and physical activity.physical and eatinghealthy encourage tointerventions of range ausing weight, healthy awith children and adults ofnumber the Increasing health and wellbeing.and health theirfor responsibility takingin communities andindividuals of engagementthe Increasing services. support lifestyle healthyappropriatereceive conditionsterm long withpeople that Ensuring children. theirand parents teenage foroutcomes improving andrates pregnancy teenagereducing health,sexual Promoting quit.to smokers existing supporting and starting from peopleyoung discouraging by– smoke who people ofnumbers the Reducing and activities.and actionsall in behaviours andlifestyles healthyEncourage • • Cost-effective Cost-effective • • • • • • on:focus particulara includes This 4. Preventative domestic abuse.domestic particularly– neglect andabuse Reducing wellbeing. and healthbehaviour,on social anti-associated and drugs illegalalcohol, of impacts negativethe Minimising groups. vulnerableon benefit housingin changes of effectthe addressing and homelessnessReducing health.mental for services appropriateand accessible andinterventions earlyImplementing and mental health.mental and wellbeingcommunities, strongbuild to helping andenvironment safea Create improve the health of the poorestthe of health the improve • • Empowering ical and mental health and health mental and ical • • • • on:focus particulara includes This 5. individuals. marginalisedandgroups ofinclusion promoting sector,andvoluntary localexisting the including communities,local ofstrengths the on Building accidents. traffic roadreduce and activities andservices to access ensurewhich networks transportand transport public effective Maintaining cycling.and walkingas such activities ofand spaces open green, ofuse the Encouraging refreshed.and developed beingare plans and strategieswhen housing withassociated needs healthof consideration informingand Encouraging flourish. cancommunities whichenvironmentin sustainablea Create • • Sustainable Sustainable Agenda Item 9

OVERVIEW AND SCRUTINY PANEL (SOCIAL WELL-BEING) 3RD JULY 2012

CABINET 19TH JULY 2012

NEIGHBOURHOOD FORUMS – PROPOSED ESTABLISHMENT OF LOCAL JOINT COMMITTEES IN HUNTINGDONSHIRE – CONSULTATION RESPONSES (Report of the Working Group)

1. INTRODUCTION

1.1 At its meeting on 6th March 2012, the Overview and Scrutiny Panel (Social Well- Being) considered a report from the Neighbourhood Forums Working Group on the proposed boundaries, composition, voting and constitution for new Local Joint Committees (LJCs) in Huntingdonshire. These were endorsed for submission to the Corporate Governance Panel and Executive Members with a view to launching a consultation with Town and Parish Councils, District and relevant County Members, Partners and various other interested parties. The proposals were subsequently noted by the Corporate Governance Panel at their meeting on 28th March 2012 and the Cabinet asked that they be subject to public consultation at their meeting on 19th April 2012.

2. BACKGROUND

2.1 A consultation was therefore launched on 30th April 2012, running for a six week period up to 8th June 2012. Letters were sent out to the following:-

Town and Parish Councils; District and relevant County Members; Partners of the existing Neighbourhood Forums; and Members of the public with an interest in the existing Neighbourhood Forums.

2.2 Details were also posted on the Neighbourhood Forums page and the Get Involved section of the Council’s website.

3. BENEFITS OF THE PROPOSALS

3.1 The LJCs will promote the localism agenda by:-

building on the ways of working already established and the achievements of the Neighbourhood Forums; extending the remit and responsibilities of the Neighbourhood Forums; providing a mechanism for all tiers of local government to work together; allowing the LJCs to engage with their communities in the most appropriate way; allowing the LJCs to develop in a way that suits them; enabling there to be greater flexibility to operate in a way that suits local need; and providing an opportunity for local democratic decision making to take place on a range of possible matters where appropriate.

3.2 The proposals are not intended to usurp the roles of Town and Parish Councils nor are they intended to add another layer of bureaucracy within local government. They

63 seek to provide a forum whereby the three tiers of local government can meet to discuss issues of local concern for the benefit of their communities and take decisions on local matters.

4. KEY PRINCIPLES OF THE LOCAL JOINT COMMITTEES (LJCS)

4.1 The proposals are intended to build upon the existing Neighbourhood Forums and introduce smaller more localised areas than at present. Members are mindful of localism and the opportunities that this presents and are therefore proposing nine new areas as attached at Appendix A . Of the 34 consultation responses received, four of the Town and Parish responses propose changes to the boundaries for their respective areas. Members will recall that an initial consultation was undertaken in September/October 2011 to elicit the views of stakeholders on the Neighbourhood Forums, at which point views were sought from Town and Parish Councils on whom they considered to be part of their local communities. The boundaries proposed in Appendix A were devised according to the comments received at that time. Having reviewed the Parish responses received during the recent consultation, Members have concurred that it will not be necessary to make any changes to the boundaries in light of the comments received. In reaching this view account has been taken of elected Member representation for each proposed area – a breakdown for which appears at Appendix B , the boundaries of the Shape Your Place initiative and the views of other Parishes.

4.2 The LJCs are intended to operate in a flexible way, to enable each area to develop in accordance with local need, whilst also encouraging public engagement and participation at meetings. It may appear that the functions listed in Section 3 of the constitution are exhaustive but it is stressed that the LJCs do not have to undertake all of the functions proposed. A number of comments were received on the constitutional terms of the LJCs, which have been taken in to account by Members. This has resulted in revisions to the draft which had been subject to consultation. An amended version appears at Appendix C .

4.3 Localism has been the main driver for the proposals. A significant change to the Neighbourhood Forums is the possibility for decision making responsibilities to be devolved from the District or County Councils to the LJCs. This will enable communities to have greater say and take decisions on local matters. Members who sit on the LJCs are reminded that they are there to represent the whole community, not specifically their Ward or the local authority that appointed them.

5. CONSULTATION RESPONSES

5.1 As had been said before, 35 responses to the consultation have been received, a breakdown for which is as follows:-

Town and Parish Councils – 21 District and Relevant County Members – 2 Partners of the existing Neighbourhood Forums – 4 Members of the public - 8

5.2 All responses received have been subject to review by the Neighbourhood Forums Working Group which met on 12 th June 2012.

5.3 A summary of the responses received are attached as Appendix D. A number of comments and points of clarification were raised in the responses that were received.

64 The Appendix also outlines the Working Group’s response to each of the points raised.

6. COMMON ISSUES RAISED

(a) Budgets and Accountability

6.1 Some respondents have commented on the delegation of budgets to the LJCs. The LJCs will not hold funds and there will not be a requirement for the LJCs to have their own separate accounts or for them to be subject to audit. It is the intention that the decision making responsibility relating to a particular budget might be delegated from the District or County Councils in the future. The relevant authority will continue to hold that budget and they have their own audit procedures (Section 4 of the constitution refers). Whilst these delegated decisions have not yet been determined by either of the two authorities, there needs to be a mechanism in place to enable this to happen. Furthermore, the devolution of decision making responsibilities embraces the localism concept by enabling communities to take decisions on local matters. The constitution has been updated to make this clearer.

(c) Public Speaking at LJC Meetings and Delegated Decision Making

6.2 The question of public speaking at LJC meetings has been raised by a number of respondents. As had been said before, the proposals seek to build on the Neighbourhood Forums and enhance their effectiveness. Public attendance and public speaking will always be encouraged at the LJC meetings as they have always been with the Neighbourhood Forums. To be clear on one particular point, Local Joint Committees established under Section 101 of the Local Government Act 1972 do not permit members of the public to speak during formal decision-making deliberations. Only those from amongst the membership would be entitled to speak at formally constituted meetings. There will be a separate open public session on the Agenda for meetings. Members of the public will not be entitled to speak during the LJCs deliberations on such matters, but can continue to observe the meeting.

(d) Voting Arrangements

6.3 Having reviewed the consultation responses, Members have taken on board the points about “Twin -hatters” (i.e. Members who are both the relevant District Councillor and County Councillor) having two votes each. This would have permitted two votes on some issues and not others. Members are keen to create a voting system that promotes equality whilst at the same time not being too complex in nature. Members are therefore proposing to amend the voting arrangements so that all Members have one vote each. This would ensure consistency in voting arrangements. Section 7 of the constitution has been updated to reflect this change.

(e) Elected Member Representation

6.4 The relative levels of Member representation between the three tiers of local government are neither equal nor constant across all the LJCs. The view has been taken that localism and the geographical identities of settlements should be the overriding factor in determining the boundaries of the LJCs. The boundaries take into account the views of those Town and Parish Councils who responded to the earlier consultation undertaken in September/October 2011 and the Shape Your Place initiative.

65 6.5 Some concern has been expressed by respondents with regard to the representation proposed for Town Councils. It has been suggested that there should be one Member per Parish Ward within a Town on LJCs. This matter was discussed at length by Members who expressed the view that representatives are appointed to represent the views of their communities and not just their respective Wards.

(f) Secretarial Functions

6.6 Clarification was required on the secretarial functions outlined with 10.1 of the Constitution. It should have been made clearer prior to the consultation that these functions were being proposed to be undertaken by Town and Parish Clerks/Officers of Councils in the LJC area. Respondents have enquired whether this function should be carried out by elected Members but this is not what was intended.

6.7 Additionally, a number of concerns have arisen around the role of the Secretary. Views have been expressed that Parishes do not have sufficient resources for their Clerks to service LJC meetings and that the function should be centrally co-ordinated to avoid any confusion with a view to ensuring continuity and efficiency. This is not, however, a universal view and there may be a need for further negotiation on this point. The intention is to promote local ownership of the scheme, not a top-down approach. It is hoped that as the whole purpose is to increase local benefit, local Councils would want to be involved.

(g) Police Representation at LJC Meetings

6.8 There has been a perception that the Police would not be present at LJC meetings and this has caused some concern. A review of their Engagement Strategy was already underway and Cambridgeshire Constabulary have submitted a response and have indicated that there no longer is a legal requirement for the Police to set local priorities as they have done previously. Members of the public are therefore encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until meetings. Furthermore, they have given an undertaking that they will re- establish contact with Town and Parish Councils directly as one of their methods of engagement. Police representatives will however be in attendance at LJC meetings if there is a significant matter of local concern.

6.9 Within their response, the Constabulary outlined the numerous ways that they will seek to engage with the public, which is a requirement under Section 34 of the Police Reform and Social Responsibility Act 2011. These are as follows (as extracted from their response dated 1st June 2012):-

The local PCSO or Constable will attend local Parish and Town Council meetings. There will be a commitment to attend once a year and then outside of this where there is a significant issue requiring further attendance that cannot be resolved via telephone or email, with regular and timely updates given to the issues that are raised.

To inform the meetings, monthly crime data will be available at the end of every month via the force website, enabling residents and councils to view the crime in their area. This will then be supported later in the month via the website www.police.co.uk which will allow more detailed street by street crime data, broken down in offence types. This will enable parish and town councils to get a timely view of crime in the area and raise any issues of significant concern.

66

A re-invigoration of Neighbourhood Watch, with more timely disclosure of crime and suspicious activity seeking more timely feedback. This will also provide a communication route in and out for issues to be highlighted.

Improved use of Parish newsletters and continuation of ecops service.

Rolling programme of mobile station visits/ surgeries at key locations with opportunities to pop into local meetings and group encouraged e.g. coffee mornings, community groups etc.

Single email point of contact into local police – [email protected] which will be checked 365 days per year.

Participation in the new Induction meetings run by Luminus Housing for all prospective Luminus tenants.

Regular problem solving team meetings where police can be made aware of issues by partner agencies.

Police Enquiry Offices at Huntingdon, St Neots and St Ives remain open to the public, with a phone system available when the offices are closed.

National 101 non-emergency number with speech dial facility.

Voicemail system to local officers that will be checked regularly.

Cambridgeshire Constabulary website providing details of local policing within the area and informing the public on ways to contact the local police.

Sign up to “Shape your Place”, providing timely responses to the issues raised via the website. (Due July 2012)

New Constabulary Facebook and Twitter accounts to facilitate engagement and improved communication.

7. OTHER MATTERS

7.1.1 Members have considered the feasibility of undertaking a pilot LJC meeting within the District. In light of the fact that the meetings are proposed to be held at least twice a year and in noting that a review of the Constitution will be undertaken after 12 months, the Working Group recommend that all LJCs are seen as a 12 month trial.

8. CONCLUSION AND RECOMMENDATIONS

8.1 The Working Group has reviewed and responded to each of the points raised by respondents to the consultation on the proposed establishment of LJCs in Huntingdonshire. The consultation was open for comment between 30th April and 8th June 2012. A number of comments and points of clarification have been received. As a consequence some changes have been made to the constitutional terms of the LJCs.

67

8.2 Members will recall that the Panel was tasked by the Cabinet to undertake a review of the Neighbourhood Forums in Huntingdonshire. This work has now been completed by the Working Group. If the LJCs are to be introduced the Cabinet are recommended to:

(a) approve the Constitution for Local Joint Committees in Huntingdonshire as appended in Appendix C of the report now submitted;

(b) request each individual Ward Member of the Council to attend their respective LJC as outlined in Appendix B of the report now submitted; and

(c) request the Overview and Scrutiny Panel (Social Well-Being) to undertake a review of the Local Joint Committees after 12 months operation.

8.3 Given that a range of views have been received, Members are requested to consider whether any further work is required before the proposals are finalised such as undertaking negotiations on detailed points with the County Council.

Contact Officer: Miss H Ali, Democratic Services Officer ( 01480 388006 * [email protected]

BACKGROUND INFORMATION

Minutes and Reports of the Overview and Scrutiny Panel (Social Well-Being) held on 6th September, 1st November and 6th December 2011 and 3rd January, 7th February, 6th March and 12th June 2012.

Neighbourhood Forums Working File held by Democratic Services Section.

68 Proposed Local Joint Committee Huntingdonshire D I S T R I C T C O U N C I L March 2012

Sibson cum Stibbington

Water Newton Alwalton

Chesterton Elton ELTON & FOLKSWORTH Farcet Haddon YAXLEY & FARCET Yaxley Morborne

Folksworth & Washingley Stilton STILTON Holme Denton & Caldecote RAMSEY

Glatton Conington

Great Gidding Bury Woodwalton Warboys Little SAWTRY Upwood Gidding Sawtry & WARBOYS & BURY The Raveleys Wistow UPWOOD Winwick Upton & Hamerton & & Pidley Steeple Gidding THE RAVELEYS Coppingford cum Old Abbots Fenton Somersham Weston Ripton Broughton Alconbury Buckworth Old SOMERSHAM Brington Weston hurst Colne & Kings Molesworth Leighton ALCONBURY Ripton Bythorn Woodhurst Earith & Alconbury & Wyton on ELLINGTON Barham Keyston & THE STUKELEYS the Hill Bluntisham Woolley The Stukeleys Catworth Houghton EARITH Huntingdon & Wyton St Ives Holywell Spaldwick cum Needingworth Covington Stow Ellington Brampton Longa Easton BRAMPTON Hemingford Grey Tilbrook GODMANCHESTER THE KIMBOLTON HEMINGFORDS Grafham & Kimbolton Hemingford FENSTANTON Buckden Abbots STAUGHTON Perry Fenstanton

BUCKDEN Offord Cluny Diddington & Hilton Offord Darcy Great Southoe & Midloe Staughton Great LITTLE Paxton Hail Weston PAXTON Toseland Yelling

St Neots Abbotsley GRANSDEN & THE OFFORDS Great Gransden Key Waresley-cum-Tetworth County Ward

District Ward

69

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70 APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES

AREA PARISHES DISTRICT WARDS COUNTY WARD(S) 1 Sibson-cum Stibbington Elton and Folksworth (1) Norman Cross (2) Water Newton Yaxley and Farcet (3) Alwalton Stilton (1) Chesterton Elton Haddon Morborne Folksworth and Washingley Stilton 20 Seats Denton and Caldecote Holme % Split Yaxley Parish - 65% Farcet

71 District - 25% County - 10% 13 PARISHES 5 DISTRICT MEMBERS 2 COUNTY MEMBERS

19 Votes Guyatt Guyatt Banerjee, Butler and Oliver McGuire, M Mitchell

2 Sawtry Sawtry (2) Sawtry and Ellington (1) Glatton Conington Little Gidding Great Gidding 11 Seats Winwick Hamerton and Steeple Gidding % Split Upton and Coppingford Parish - 73% District - 18% County - 9% 8 PARISHES 2 DISTRICT MEMBERS 1 COUNTY MEMBER APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES

11 Votes Tuplin and Tysoe McGuire, V

3 Bythorn and Keyston Ellington (1) Brampton and Kimbolton (1) Brington and Molesworth Brampton (2) Sawtry and Ellington (1) Old Weston Kimbolton and Staughton (1) Leighton Catworth Buckworth Barham and Woolley Spaldwick Stow Longa Easton Ellington Grafham 72 Perry 23 Seats Covington Kimbolton and Stonely % Split Great Staughton Parish - 74% Tilbrook District - 17% County - 9% 17 PARISHES 4 DISTRICT MEMBERS 2 COUNTY MEMBERS

Baker, M Downes 22 Votes Downes and Jordan McGuire, V Gray APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES 4 Godmanchester Godmanchester (2) Huntingdon (2) Brampton Brampton (2) Godmanchester and Huntingdon East (2) 23 Seats Huntingdon Huntingdon East (3) Brampton and Kimbolton (1) Alconbury Huntingdon North (2) % Split Alconbury Weston Huntingdon West (2) Parish - 26% The Stukeleys Alconbury and The Stukeleys (1) District - 52% County - 22% 6 PARISHES 12 DISTRICT MEMBERS 5 COUNTY MEMBERS

21 Votes Hyams and Kadic Downes and Jordan Brown and Kadic Akthar, Greenall and Shellens Dutton and Wilson Kadewere and Mackender-Lawrence Downes Cawley and Sanderson Baker, K 73 5 Little Paxton Little Paxton (1) Little Paxton and St Neots North (2) St Neots Kimbolton and Staughton (1) Brampton and Kimbolton (1) 20 Seats Hail Weston St Neots Eaton Ford (2) St Neots Eaton Socon and Eynesbury (2) St Neots Eaton Socon (2) Buckden, Gransden and The Offords (1) % Split St Neots Priory Park (2) Parish - 15% St Neots Eynesbury (3) District - 55% County - 30% 3 PARISHES 11 DISTRICT MEMBERS 6 COUNTY MEMBERS

17 Votes Churchill Harty and Churchill Gray Downes Farrer and Harty Hutton and Farrer Giles and Harrison West Chapman and Longford Hansard, Ursell and Van De Kerkhove APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES 6 Buckden Gransden and The Offords (2) Buckden, Gransden and The Offords (1) Diddington Buckden (1) Southoe and Midloe Offord Cluny Offord Darcy Great Paxton Toseland 15 Seats Yelling Abbotsley % Split Great Gransden Parish - 73% Waresley-cum-Tetworth District - 20% County - 7% 11 PARISHES 3 DISTRICT MEMBERS 1 COUNTY MEMBER

14 Votes Boddington and West West Clough 74

7 Ramsey Ramsey (3) Warboys and Upwood (1) Warboys Warboys and Bury (2) Ramsey (1) Bury Upwood and The Raveleys (1) Wistow 16 Seats Upwood and The Raveleys Abbots Ripton % Split Kings Ripton Parish - 50% Woodwalton District - 37% County - 13% 8 PARISHES 6 DISTRICT MEMBERS 2 COUNTY MEMBERS

15 Votes Curtis, Duffy and Reeve Lucas Bucknell and Pethard Reeve Howe APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES 8 Fenstanton The Hemingfords (2) The Hemingfords and Fenstanton (1) Hilton St Ives West (1) St Ives (2) Hemingford Abbots St Ives South (2) Warboys and Upwood (1) Hemingford Grey St Ives East (2) 23 Seats Houghton and Wyton Fenstanton (1) St Ives Upwood and The Raveleys (1) % Split Holywell-cum-Needingworth Earith (2) Parish - 35% Wyton-on-the-Hill District - 48% County - 17% 8 PARISHES 11 DISTRICT MEMBERS 4 COUNTY MEMBERS

22 Votes Bates and Williams Bates Fuller Pegram and Reynolds, K Davies and Dew, D Lucas Ablewhite and Reynolds, D

75 Harlock Howe Rogers (+ 1 vacancy)

9 Old Hurst Somersham (2) Somersham and Earith (1) Woodhurst Earith (2) Pidley-cum-Fenton 13 Seats Somersham Colne % Split Earith Parish - 61% Bluntisham District - 31% Broughton County - 8% 8 PARISHES 4 DISTRICT MEMBERS 1 COUNTY MEMBER 12 Votes Criswell and Bull Criswell Rogers (+ 1 vacancy) APPENDIX B DIVISION, WARD AND PARISH BREAKDOWN FOR PROPOSED LOCAL JOINT COMMITTEES

NB - Those in red denote "twin-hatters" - to receive one vote each

Upwood and The Raveleys x 2 Sawtry and Ellington x 2 District Wards Brampton x 2 County Wards Warboys and Upwood x 2 Covering Duplicate Covering Kimbolton and Staughton x 2 Brampton and Kimbolton x 3 Areas: Duplicate Areas: Earith x 2 Buckden, Gransden and The Offords x 2 76 APPENDIX C

HUNTINGDONSHIRE LOCAL JOINT COMMITTEES

CONSTITUTION

1. Composition

1.1 The Local Joint Committees (LJCs) will be constituted in accordance with Sections 101 and 102 of the Local Government Act 1972 and will be Joint Committees for decision making.

1.2 Committees will be established across the District on the boundaries delineated in Appendix 1. The boundaries will be kept under regular review.

2. Membership

2.1 Membership will comprise Cambridgeshire County Council (CCC) and Huntingdonshire District Council (HDC) Members for the LJC area. Town and Parish Councils within the LJC area will appoint one representative each. Membership will cease if, for whatever reason, Membership of the nominating authority ceases.

2.2 Town and Parish Councils will appoint a representative on an annual basis prior to the LJCs first meeting in each Municipal Year. A Town and Parish Council shall not appoint, as a voting Member or substitute, a person who is not a Member of that authority.

2.3 Each representative will have equal voting rights.

2.4 Town and Parish Council substitutes at meetings will be allowed provided the Secretary is informed at least 3 working days prior to a meeting.

2.5 Substitutes should be nominated at the same time as the Town and Parish Council representatives and will have the same voting rights as the Member that they replace and will count towards the establishment of a quorum.

3. Functions

3.1 The purpose of the LJCs is to enable transparent strategic decision making at a localised level but not to detract from public engagement with Town and Parish Councils who should be the normal point of engagement. In doing so, it will also:

(a) engage the public at a more strategic level than Town or Parish Councils;

(b) promote and enhance local democracy;

(c) facilitate closer working between the three tiers of local government and other public and community services within the LJC area;

(d) enable Town and Parish Councils, the County Council, the District Council and the Police and public sector and voluntary sector Partners (including interested Community Groups), where appropriate, to discuss and address issues of current or future concern to the LJC area;

77 APPENDIX C

(e) make plans and related decisions for the LJC area (or constituent parts of the LJC area) based on need/evidence, including community views represented and captured through existing or additional work and virtual social mediums such as ‘Shape Your Place’;

(f) undertake or enable consultations (outside of the LJC meeting) to ensure the community is consulted as widely as possible, including organising special public meetings where these are indicated/agreed as being needed in the LJC area (or constituent parts of the LJC area);

(g) determine expenditure of any delegated decision making responsibilities relating to a budget by CCC or HDC. This must be spent within policy to improve service standards and in accordance with any conditions set by that authority on how funding should be spent. It could also be used to support the delivery of service improvements identified in Parish plans or to provide grants to local voluntary organisations;

(h) provide a reporting mechanism to the Town and Parish Councils in paragraph 2.1 above by requesting them to attend local meetings and scrutinise service delivery within the LJC area - i.e. the LJCs will have a strong role in the performance management of services in local communities;

(i) act as a decision maker with regard to the local delivery of a range of services and to prioritise resource allocation in their area within existing standards and policy;

(j) where they cannot be resolved by the LJC, refer matters of concern regarding service to the relevant Committee/Panel or of policy to Cabinet and for the LJC Chairman to have the right to speak at those bodies of CCC and HDC in order to represent the views of the LJC;

(k) act as a formal consultation mechanism for CCC, HDC and other public and community services over and above that undertaken with individual Town and Parish Councils;

(l) facilitate partnership working between the County, District, Town and Parish Councils within an LJC area;

(m) assist with neighbourhood planning/preparation of community plans/liaison on Parish plans;

(n) liaise with the Police, Fire, NHS, other public bodies and community groups;

(o) provide a mechanism to enable Councils to pursue the localism agenda – in the wider sense of organising communities into action as well as acting as a conduit for the upward transmission of views;

(p) consult on and prioritise any devolved decision making responsibility relating to funds relating to the Community Infrastructure Levy and the New Homes Bonus; and

78 APPENDIX C

(q) undertake any decision making functions that may have been delegated by CCC and HDC.

In addition to this framework, each LJC will have the freedom to customise or develop their activities according to local need.

4. Budgets

4.1 Where the LJC has a delegated decision on a budget, its administration will be subject to local authority audit procedures.

5. Meetings and Chairing of Meetings

5.1 Each LJC will meet at least two times each year with other meetings being called as necessary with the prior agreement of the LJC Chairman or if more than half the Members of the Committee are in favour. Requests for other meetings can only be initiated from amongst the membership of the LJC.

5.2 The Chairman and Vice-Chairman of an LJC will be appointed annually. The Chairman and Vice-Chairman will be from amongst the membership of the LJC – preferably from a Town and Parish Council.

5.3 Ordinary meetings will take place in the local area.

5.4 An invitation to attend together with the Agenda for each meeting and the Minutes of the previous meeting will be sent to each Member, interested parties and members of the public no less than five working days before each meeting.

5.5 At least ten working days notice will also be given to the public of the time and place of each meeting by posting details at HDC’s offices and on its website. Copies of such notice will also be sent to CCC and each Town and Parish Council in the area and will be widely publicised.

5.6 All meetings of the LJC will normally be open to the press and public where they will be provided with an opportunity to contribute to business transacted at the meeting. An exception to this is when decision making responsibilities have been devolved from CCC or HDC to the LJC. The public will not be permitted to partake in discussions in this respect.

5.7 Members of the public are encouraged to attend LJC meetings, to contribute to discussions and raise issues of local concern. There will be a separate item on the Agenda for each meeting for this purpose. Members of the public who are speaking will be encouraged to be concise and avoid repetition, thereby ensuring sufficient opportunity for others to contribute.

5.8 The Chairman of the LJC may invite any person to attend a meeting for the purpose of making a presentation or participating in discussion on any item relevant to that bo dy’s functions.

5.9 Town and Parish Councils are encouraged to receive reports on the work of the LJC.

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6. Public Participation

6.1 So as to encourage public participation and engagement in the business of the LJC, Members and Officers shall ensure local people are informed, involved and consulted about any issues relevant to the LJC (excluding regulatory matters).

6.2 Each LJC meeting will decide how best to achieve this objective.

7. Voting

7.1 Any matter will be decided by a simple majority of all voting members of the LJC present at the time the question is put. All Members (or their substitutes) are entitled to vote at LJC meetings.

7.2 In the event of an equality of votes for and against, the Chairman will have a casting vote, but there will be no restriction on how he/she chooses to exercise this right.

7.3 Members who are both the relevant District Councillor and County Councillor will have one vote each.

7.4 Some decisions will be delegated to an Executive Member of CCC or HDC. In these instances the delegation will remain with that Member but he/she will take into account the views expressed by the LJC.

8. Quorum

8.1 The quorum for all meetings will be at least one third of voting Members to include representatives from all three tiers of local government.

9. Minutes

9.1 The Minutes of all meetings will take the form of a decision list. This will be presented to the Chairman to sign at the next scheduled meeting.

9.2 The Chairman will move that the Minutes of the previous meeting be signed as a correct record and no discussion shall take place on their content except with regard to their accuracy.

10. Secretary

10.1 Secretarial functions will be shared between the Clerks/Officers from amongst the membership of the LJC.

10.2 The responsibilities of the Secretary in respect of the business of the LJCs will be to ensure meetings are serviced and also specifically:

(a) to provide advice and support to Members in relation to the conduct of meetings;

80 APPENDIX C

(b) to liaise with the Chairman, other Members and District and County support Officers to identify the matters to be included on the Agenda for each meeting; and

(c) to produce a decision list following the deliberations of each meeting and circulate this to all participants within ten working days of the meeting.

11. Officer Support

11.1 CCC and HDC will both provide Officer support for each LJC.

11.2 The duties of the Officers in respect of the business of LJCs will be:

(a) to assist the Chairman to set the Agenda for each meeting;

(b) to collate and dispatch all relevant papers and publicise the date, time and venue for each meeting;

(c) to ensure that, where appropriate, reports are produced and that all Members, Officers and Partners who are invited to meetings are aware of the purpose of their attendance;

(d) to provide general advice and support to Members;

(e) to support the Chairman and Members in engaging and consulting local residents;

(f) to ensure that all necessary actions are taken promptly to implement decisions;

(g) to monitor the implementation of decisions and report back to the community and, where appropriate, refer any decision to CCC, HDC, Partner or Town and Parish Council bodies for further consideration;

(h) to circulate details of actions taken in advance of the next meeting; and

(i) to produce a schedule of dates and venues for meetings.

12. Conduct at Meetings

12.1 High standards of conduct are expected from the representatives of public sector and voluntary sector organisations at LJC meetings. Elected Members must abide by the Members Code of Conduct of their respective authority when engaged in the business of the LJCs. They should apply the rules concerning the declaration of interests at LJC meetings.

12.2 Where it is clear that a decision in which a Town or Parish representative has such an interest in a matter likely to arise at a particular meeting, the substitute Member (with no interest to declare) may attend that LJC meeting or a part of the meeting in his/her place.

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12.3 Members of the public speaking at LJC meetings should not engage in personal criticism or slanderous comment or use the LJC as a means of pursuing personal objectives.

13. Expenses

13.1 Voting Members and substitutes shall be entitled to recover from the nominating authority by which they are appointed any expenses they incur in connection with the discharge of the LJCs functions (for example travel expenses) according to their authority’s own policy.

14. Review

14.1 This Constitution will be reviewed after 12 months at a meeting to which all Members of all LJCs in Huntingdonshire will be invited.

15. Interpretation

15.1 The decision of the LJC Chairman, after consultation with the HDC Officer on the interpretation of this Constitution, shall be final.

82 APPENDIX D SUMMARY OF RESPONSES RECEIVED

TOWN AND PARISH COUNCIL RESPONSES

COMMENTS WORKING GROUP’S RESPONSE

The Stukeleys Supportive of the proposals, in particular the suggestion Noted. to enable the LJCs to have decision making responsibilities.

Slight concerns expressed over the co mposition of the The respective levels of representation between proposed areas in terms of the proportion of voting the tiers of local government vary across the LJCs. power given to Parish Councils. For e.g. the Parishes in The view has been taken that localism and the

83 Area 1 (Norman Cross) have 65%, in Area 2 (Sawtry geographical identities of settlements should be and Ellington) it is 73% while for Area 4 w hich includes the overriding factor in determining the boundaries The Stukeleys it is only at 26% as it is dominated by the for the LJC areas. Boundaries that are proposed urban areas with the larger number of County and have taken into account the views of those Town District Members. Parish Council is proposing that their and Parish Cou ncils who responded to the earlier area should be more rurally focused comprising The consultation undertaken in September/October Stukeleys, The Alconburys, The Riptons, Woodwalton 2011. All Members represent the community and The Raveleys given that there is a greater regardless of who appointed them. commonality of interest.

Great and Little Suggest that their respective area should further be Boundaries that are proposed have taken into Gidding broken down (Area 2) account the views of those Town and Parish Councils who responded to the earlier consultation undertaken in Septembe r/October 2011.

Propose that an annual meeting should be held with the The proposals are intended to be flexible to enable power to call for more if required. each area to develop their own LJC in accordance with local need. An annual meeting could be held if agreement from amongst the membership of the LJC area has been reached. Section 5 of the Constitution (para 5.1) contains a provision to call for more meetings if necessary.

Holywell-cum- Welcomed the end of the old Neighbourhood Forums Noted. Needingworth and hope that the changes will lead to a less expensive and more productive way forward.

Ramsey Expressed concerns over the size of their respective The new areas are smaller than the previous area (Area 7) which is regarded to be too large and Neighbourhood Forums. A scheme has been have suggested that their area should comprise the devised that enables all tiers of local government Parishes of Ramsey, Bury and Upwood . Comments to be represented without creating meetings that has been made that no account seems to have been are unwieldy. Boundaries that are proposed have given to proportional representation across each area taken into account the views of those Town and and the number of proposed seats on the LJC. Parish Councils who responded to the earlier consultation undertaken in September/October 2011. The number of seats for each LJC ensures 84 that each tier of local government is represented through a model which c an be adopted Districtwide.

Concerns have been expressed over what funding will The LJCs will not have a budget. It is the decision be devolved and the Parish have questioned to whom making responsibility that will be devolved to the the proposed LJCs will be accountable. LJC. The authority that delegates the decision will hold that budget and it will be up to that authority to condition how funding is spent. Section 4 of the Constitution has been amended to make this clearer. Local authorities are yet to determine what decision making responsibilities are to be devolved, however there must be a mechanism in place, such as the LJCs, to enable this to happen.

Buckden Object to the proposals which are portrayed as creating Noted. an additional level of deci sion making which is regarded as being expensive, time consuming and unnecessary.

Are concerned that decision making powers will be No decision making powers will be taken away taken away from the Parishes but retained by the upper from Town or Parish Councils. tier authorities.

The areas proposed are not based on communities of The boundaries that are proposed have taken into interest but on Electoral Wards and Divisions. account the views of those Town and Parish Councils who responded to the earlier consultation undertaken in September/October 2011. They also reflect Shape My Place areas.

The proposal for twin-hatters to have 2 votes each is It has been agreed that twin-hatters will now opposed. receive one vote. The Constitution has been updated to reflect this change.

The absence of the Police from these meetings is Please refer to Police (Cambridgeshire

85 regrettable. Constabulary) response below. There no longer is a legal requirement for the Police to hold formal public engagement meetings. Public are encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until these meetings arise. They have given an undertaking that they will re-establish formal contact with Town and Parish Councils directly.

Hail Weston Content with the area proposed (Area 5) but would wish Boundaries that are proposed have taken into for Great Staughton to be included. Parish have account the views of those Town and Parish indicated that they would wish to receive the Minutes of Councils who responded to the earlier consultation neighbouring LJCs (Kimbolton and Staughton) as there undertaken in September/October 2011. Noted the may be matters d iscussed at these meetings which request for Minutes of neighbouring LJCs to be might affect the Parish. received.

Spaldwick and Content with the areas proposed for their respective Noted. Stow Longa Parishes.

Who will administer the proposed LJC budget ? This will Budgets will be administered by the delegating be subject to audit and there will need to be some authority. accounts.

3.1 of the Constitution should be amended so that Agreed – Constitution amended. “Overview and Scrutiny” is deleted as another Committee/Panel may be relevant. “LJC” should be inserted before the word “Chairman” to avoid doubt.

5.1 of the Constitution should state who should initiate Agreed – Constitution amended. a request and to whom it should be sent. Perhaps it should state that any Member wishing to call an extra meeting must obtain the prior agreement of the Chairman or more than half the membership and then inform the Officer identified in 11.2 of the Constitution to make the arrangements.

86 Second sentence of 7.1 of the Constitution should be Agreed – Constitution amended. amended to read “All Members (or their substitutes) are entitled to vote at LJC meetings”.

7.4 of the Constitution re decisions that are delegated Agreed – Constitution amended. to an Executive Member of CCC and HDC – this needs to be made clearer.

8.1 of the Constitution re quorum for meetings. Suggest For clarity and to comply with the requirement to replacing the words “voting Members” with “the take delegated decisions, this is not agreed. membership”.

10.1 of the Constitution re secretarial functions being This should have been made clearer. It was shared between the Members of the LJC. Does this intended that the Clerks/Officers of participating mean that for each meeting a different Member (i.e authorities should provide these functions. Councillor) will be invited as Secretary, or that a Constitution has been amended. different Council will be invited to provide secretarial services (e.g. the Clerk)?

The functions of the Secretary in 10.2 (a) and (b) of the The Secretary and the Officer providing support Constitution appear to duplicate those of Officer are encouraged to liaise with one another. There support in 11.2. may be instances when requests for advice and support and discussion around the Agenda setting for the meeting are considered by both the Secretary and the Officer outside of meetings. It is important therefore that dialogue is maintained during these times to avoid duplication.

12.3 of the Constitution re failure of a Member or their No longer in Constitution – see elsewhere. substitute to attend 2 consecutive meetings and the seat being declared vacant thereafter – Who will be responsible for declaring the vacancy and notifying the Town or Parish Council of the need to appoint a replacement?

87 Warboys Not in favour of the proposals. Creating a formally There are already Neighbourhood Forums. constituted body under local government administrative Decisions will only be taken where the LJCs are legislation would add a further tier of local government the most appropriate forum. The principle of decision making which would confuse the public and delegating matters to the lo west appropriate will add complexity. apply.

If formally constituted, only local authority Memb ers Members of the public can speak at meetings. should be entitled to speak at meetings. An Open Members of the public cannot legally speak when Forum session could act as a mechanism to enable the deliberations on delegated decisions have Police and public and voluntary sector Partners to commenced. speak during this part of the meeting, with contributions from the public being sought at this stage.

Budgets would also require separate accounts to be Decisions can be delegated . The authority that maintained whilst also being subject to external audit. delegates the decision will hold the budget. There This will incur additional audit fees at a time when local will not be a need for separate accounts. authorities are facing budgetary cuts.

The Parish Counci l is opposed to the dissemination of It is for the delegating authority to determine the Community Infrastructure Levy and New Homes whether it is appropriate to delegate a particular Bonus as it is felt that this should be targeted to the matter to the LJC. Parish Council and not be subject to competition from neighbouring Parishes. There will always be a danger that money will be spent in the largest community within an LJC area.

Twin hatters having two votes each is not permissible It had been intended to allow twin-hatters to have under local government law. two votes to try to equalise voting imbalances between the tiers of local government during discussion on matters that are not formally delegated decisions. Legally individual Members can only have one vote in respect of delegated decisions. Rather than having this voting system it is suggested that all Members should have one vote at all times (except the LJC Chairman’s 88 casting vote).

Clarification is needed on 10.1 of the Constitution re This should have been made clearer but it was secretarial functions being shared between the intended that the Clerks/Officers of participating Members of the LJC. Does this mean Elected authorities should provide these functions and not Councillors or Officers of the local authorities that form the Elected Members. Constitution has been each LJC? If the former, Members are not best suited amended. Concerns with regard to the capacity of to carry out these functions. If the latter, none bar a Parish Clerks has been noted. handful of Town and Parish Councils in Huntingdonshire employ more than a part time Clerk, most of whom do not have spare capacity to share the secretarial role. Town and Parish Councils will be relu ctant for their Clerk’s limited time to be diverted to servicing the LJC meetings.

The County and District Councils struggle to support Please refer to the Police (Cambridgeshire the existing 5 Neighbourhood Forums and the Police Constabulary) and Cambridgeshire County Council were opposed to a sixth Forum when the latter were response below. established. Ther e will be little inclination to support 9 LJCs.

Section 11 of the Constitution makes provision for only These comments have been noted and reviewed. the County and District Councils to provide Officer It is intended that Officers/Clerks of participating support. Some of the duties listed in this section are authorities should provide secretarial functions. administrative tasks which should be the responsibility There may be instances where an individual of the Secretary. The section excludes any reference to Officer/Clerk may be able to carry out both Officers of Parish Councils and there is no mention of functions. The LJCs will not have a budget and financial accounting, budgetary control etc which will be separate accounts will not be required. required if budgets are delegated.

12.3 of the Constitution states that if a Town or Parish Agreed that this reference should be deleted from Councillor fails to attend consecutive meetings, the seat the Constitution which has been amended will be declared vacant with a replacement being accordingly. sought. There is not such restriction on a County or

89 District Member who may miss several meetings.

The existing Neighbourhood Forums have provided a It will still be possible for LJCs to discuss matters satisfactory mechanism for the public to raise issues of public interest. It will be for the LJC to determine with their elected representatives. The proposed LJCs how best to do this. will not encourage public participation, will be more costly and time consuming and would generate even greater confusion in the minds of the public about who does what in local government within Huntingdonshire.

Bury Concerned that the size of the proposed areas are too Boundaries that are proposed have taken into unwieldy. account the views of those Town and Parish Councils who responded to the earlier consultation undertaken in September/October 2011. The LJC areas are considerably smaller than the previous Neighbourhood Forum areas.

The frequency of meetings is too infrequent and that 5.1 of the Constitution enables LJCs to call more they should be held quarterly. meetings if required. The Constitution states that “Each LJC should meet at least two times a year”.

That regular Police attendance should be provided at Please refer to Police (Cambridgeshire the LJC meetings. Constabulary) response below. There no longer is a legal requirement for the Police to hold formal public engagement meetings. Public are encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until these meetings arise. They have given an undertaking that they will re-establish formal contact with Town and Parish Councils directly.

Houghton and Houghton and Wyton borders on to the two towns of Formal membership of LJCs shall be restricted to Wyton Huntingdon and St Ives. Is it possible for the Parish to the Parishes within its boundaries. LJC meetings sit on both proposed areas? are public meetings so interested parties can attend if desired.

90 Earith Happy to accept the group of Parishes that we have Noted. been allocated to and feel that the new LJCs will help each parish to work together.

Catworth Concerned that the proposals would add another layer The bureaucracy will be less than under the of bureaucracy. existing system of Neighbourhood Forums.

Concerned over the loss of police involvement with Please refer to Police (Cambridgeshire local communities. Constabulary) response below. There no longer is a legal requirement for the Police to hold formal public engagement meetings. Public are encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until these meetings arise. They have given an undertaking that they will re-establish formal contact with Town and Parish Councils directly.

Clarification has been sought on what budgetary and It will be for the delegating authorities to determine financial decisions will be devolved down, together with which decisions will be delegated. the level of budget held.

Furthermore, clarification has been sought on what Clerks/Officers of participating authorities should secretarial services would be shared and made provide these functions. Agree with the central co- comment that the Agenda should be co-ordinated ordination of the Agenda. centrally.

It is however accepted that the proposed area for Noted. Catworth would be more suitable than at present, given the commonalities with other Parishes proposed for their respective area.

Chesterton A general consensus on the proposals has been Noted. reached by the Parish , particularly to have smaller, more localised areas. The Parish Meeting also favour

91 the “bottom up” approach proposed and welcome the existence of a comprehensive Constitution at this stage in time.

Waresley-cum- Broadly welcomed by the Parish. Proposals will make it Noted. Tetworth much easier for Parish Councillors to attend and to contribute to discussion on more localised issues.

Hemingford Parish Council has expressed concerns over the Decisions will be delegated to the lowest possible Abbots membership. Localism intends to pass greater level. The tier w ith the voting majority varies responsibility to communities as represented by the across the District. lowest tier of local government. This will not be the case if an LJC has been established with voting majority o f higher tier District and County Members. District Councillors are required by their own Constitution to “effectively represent the interest of their Ward and individual constituents”. A perception will exist that District and County Members have divided loyalty when casting their votes.

Reference to 3.1 (k) of the Constitution – LJCs acting All Members will represent the views of their as a formal consultation mechanism for various bodies, communities. There are only two LJCs which given the arrangement of voting rights, in those LJCs District Members have more than 50% of votes. having a large number of District Members, effectively leads to HDC consulting with itself.

Questions have arisen about matters delegated to the This can be done by formal resolution. proposed LJCs. Given that decisions often have a cost implication, there should be powers for the LJCs to reject the delegation in the absence of agreed sufficient funding.

Comment has been made about claiming travel Noted. The proposals are intended to embrace the expenses. Whilst these may be minor, it is in fact a localism concept and encourage greater levels of further call upon electors to fund local government partnership working between the three tiers of expenditure. local government for the benefit of the local 92 community.

Little Paxton Clarification sought on the term “Partner” referred to in Membership of the LJC is outlined in 2.1 of the para 2 of the covering letter to Town and Parish Constitution – CCC, HDC and Town and Parish Councils. Does this include all Members of the LJC? Councils. The term “Partner” refers to other public, voluntary and community organisations such as the Police, Fire and Rescue Service, NHS Cambridgeshire, local Community Groups, etc.

The proposed LJC area for Little Paxton (Area 5) All Members will represent the whole of the LJC proposes 3 Parishes, 11 District Members and 5 area. The number of seats for each area ensures County Members. Basically, Little Paxton will have one that each tier of local government is represented vote to give us a maximum of two votes, if the Ward through a model which can be adopted Councillor supports us, against 17 other voters. Districtwide. Little Paxton is in fact represented by 4 Members – 1 Parish, 1 Distri ct Member and 2 County Members.

The proposed area has the lowest Parish Please refer to the response above. representation at 16% compared to all other areas and should therefore be based upon the population residing within the area. This would enable greater representation as the present proposals mean that Little Paxton would have very little say in decisions passed by the LJCs.

Budgetary and financial decisions – are these at District The LJCs will not be taking decisions that affect level affecting our precept? the precept.

Frequency of meetings – the Parish Councils only need Noted - all three tiers of local government should to assist once every two or three years. This implies the embrace partnership working and work effectively LJC are utilising Parish resources for which they have and efficiently together for the good of local no control. communities to whom they are accountable. It is not just the Parishes that will be providing resources, but the District and County as well.

93 Voting rights – not proportionally represented and Please refer to the response at the second bullet closer working will not be facilitated when the proposed point above. Those appointed to sit on the LJC are LJC is dominated by the District and County Members. there to represent their communities and are encouraged to work together to achieve this aim.

Does “determine expenditure of any delegated budget” The LJCs will not be taking decisions on the mean the Parish precept and how this is spent? precept. The LJCs will not hold funding. It is the decision making responsibility that will be devolved to the LJC. The authority that delegates the decision will hold that budget and it will be up to that authority to condition how funding is spent. Section 4 of the Constitution has been amended to make this clearer. Local authorities are yet to determine what decisions they would wish to delegate, however there is a need to ensure that there is a mechanism in place to enable this to happen.

CIL and New Homes Bonus should be determined by The delegating authority will determine which the Parish Council and not the LJC. decisions should be taken by LJCs. Local authorities are yet to determine what decisions could be devolved down.

CCC and HDC will be able to delegate functions for the Decision making responsibilities will be devolved Parish Council to carry out – the Parish Council will to the most appropriate level. This will be made have no say in this. This may have serious financial clearer in the Constitution. The proposals will not implications and affect how the Parish can utilise its affect Parish Council responsibilities/precept. precept.

Clarification is required – is there an additional budget Delegations will be determined by delegating delegated to the whole LJC by CCC and HDC or does authorities. There are no implications for Parish this refer to the Parish Councils’ individual precepts. precepts.

Parish Councils are stretched for resources already – Concerns have been noted. Membership of the they would be unable to satisfactorily share secretarial LJC comprises not only Town and Parish Councils 94 functions between members of the LJC. but the District and County as well. Officers/Clerks of all authorities are all encouraged to provide this support.

Officer support – does this refer to Ward Councillors? 11.1 of the Constitution states clearly who Officer Support is – CCC and HDC Officers.

Chairman has the final say in the interpretation of the The Constitution will be amended to include the Constitution – no matter what all other views Members words “after consultation with the HDC/CCC may have. This appears not to be very democratic. Officer providing support to the LJC”.

The proposals appear not to allow members of the There will be an opportunity for members of the public an opportunity to speak. public to speak at these meetings. Please refer to 3.1 (a) and Section 6 of the Constitution.

Many Parish Councils are non-political. District and Members of the LJC are there to represent the County Members will not be entirely non-political and interests of their communities, not just a Parish. this will subsequently impact upon decision making and The LJCs are not intended to be utilised as a its relevance and benefit to a Parish. political platform for any elected Members.

Is the Working Group aware of the Parish Charter Yes – both are District Council initiatives. Working Group? They should work more closely together.

Abbots Ripton The proposals add another layer of bureaucracy and There will be less bureaucracy than the costs. Why should costs be borne by Town and Pa rish Neighbourhood Forums. The only addition cost to Councils during these “tight” economic times? Towns and Parishes would be through attendance by an Officer at meetings say once every three years to take Minutes. This is still under negotiation.

Police are not involved in the proposed LJCs which is Please refer to Police (Cambridgeshire what the Neighbourhood Forums were originally set up Constabulary) response below. There no longer is for. We understand the Police will not be attending a legal r equirement for the Police to hold formal

95 these meetings. public engagement meetings. Public are encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until these meetings arise. They have given an undertaking that they will re-establis h formal contact with Town and Parish Councils directly.

Will meaningful budgets be set and where will the This will be for the delegating authorities to money come from? What functions will be delegated? If determine. functions are delegated there needs to be a monetary saving of County/Distric t budgets which can be quantified.

There are already adequate channels of The principle behind the LJCs is to embrace the communication fo r Parishioners. The functions localism concept and to provide a forum that identified for LJCs are concocted and duplicate the enables all three tiers of local government to vote existing roles of Town and Parish Councils. Overall, the together. Parish oppose the LJC proposals.

Somersham Supportive of the proposals however there is concern Noted Parish’s concerns. Section 10.1 of the over the secretarial provision. View expressed that this Constitution has been amended to make it clear should be provided by HDC to ensure continuity and that it will be Officers/Clerks of the LJC that will efficiency especially as there will not be a great number provide these functions – this includes HDC. of meetings through the year.

Upwood and The The current system works well so why should it be The proposals are intended to introduce smaller Raveleys change d. The Parish Council considered that if more localised areas whilst being mindful of changes were to be made to the current system then localism and the opportunities that this would the mapped out area on your proposed local joint present. The proposals will allow the existing committee plan would be more preferable. Neighbourhood Forums to evolve , one of the mechanisms for which will be to devolve decision making responsibilities, thereby giving repre sented communities more power.

St Ives What is the purpose of the LJC and its remit? It Purpose and remit is set out in the Constitution. appears we are introducing another level of local The proposals build upon the existing 96 government. Will this body have decision making Neighbourhood Forums and will be able to take powers? If so what on? What powers are the District decisions. HDC and CCC will decide whether to and County Council divesting themselves of? delegate decisions.

The make-up of the Committee is top heavy with The respective levels of representation between District Councillors. There should be one appointed to the tiers of local government vary across the LJCs. vote for each Ward. Under the current model, both The overriding principle is that LJC boundaries Councillors could vote if there are two in a Ward. This is reflect communities and are of a more manageable disproportionate in comparison to the voting rights of size than the Neighbourhood Forums. All Members Town and Parish representatives. represent the community regardless of who appointed them.

Each Parish and Each Town has one representative. Please refer to the response above. All Members This means that the representative of St Neots will be will represent the whole of the LJC area. The representing 27,000 people and the representative of number of seats for each area ensures that each Houghton will be representing some 2,000. This is tier of local government is represented through a problematic and certainly is weighted against the model which can be adopted Districtwide. St Ives Market Towns. is in fact represented by 8 Members – 1 Town, 5 Di strict and 2 County Members.

Town and Parish Councils are corporate bodies. Noted. Council’s must receive the Agenda with enough advance notice that they are able to discuss their issues to enable their representative to reach a decision. This could be difficult to organise, but is not insurmountable.

Members of the LJC who sit on two bodies will be given It has been agreed that twin-hatters will now two votes. This is profoundly undemocratic. It should be receive one vote. The Constitution has been stipulation that one Member should represent one updated to reflect this change. Given that all body, that being the most senior. That being, if a District and County Members for an LJC area will Member is a County Councillor and a District form part of the membership for an area, it will not Councillor, then someone else should represent the be acceptable to have a Member representing the District Council. interests of a local community that he/she may not

97 serve.

It is envisaged that Town and Parish should keep the This should have been made clearer but it was Minutes and act in a secretarial capacity. Such a role intended that the Clerks/Officers of participating prevents them from taking part in the meeting properly. authorities should provide these functions and not The representative from St Ives Town Council would the Elected Members. Constitution has been not be in a position to do this. Officers are present at amended to make this clearer. the meeting and that should be their role.

It is envisaged to drop the meetings from quarterly to There will be matters that progress outside of LJC twice yearly. This is certainly a retrograde step or is the meetings. 5.1 of the Constitution enables LJCs to Agenda going to be so minimalist that further meetings call as many meetings as they require. CCC are are not deemed necessary? If this is the case, then already reviewing the role of the AJCs. once again we must question the role of the AJC.

Whilst some aspects are welcomed, we would welcome Noted. the Overview and Scrutiny Panel to revisit the consultation document in light of the localism act and maybe join us at a Town Council meeting to explain it. Kimbolton Parish considers the establishment of LJCs to be an Noted. excellent idea and would be interested to learn more in due course.

DISTRICT MEMBER RESPONSES

COMMENTS WORKING GROUP’S RESPONSE

Cllr B S Concerned that there is no proportionality of The number of seats for each LJC ensures that Chapman representation for Parishes, that there isn’t any each tier of local government is represented adequacy of representation and that there is no through a model wh ich can be adopted distinction between Town and Parish Councils. It is felt Districtwide, which is not of a complex na ture. that the proposals disenfranchise the population of St Area 5, which includes St Neots, proposes 1 Neots by limiting to a minimum, representation by Town Parish representative, 9 District representatives Council Members who deal with far more complex and 5 County representatives. This means that out 98 issues than those managed by other Parishes. It is of the 20 seats proposed (albeit there being 3 twin- suggested that 1 Member per Parish Ward would be a hatted Members) St Neots is represented by 15 fair comprise. Many of the Pari sh Councils are even (out of 20) Members – 12 in real terms when smaller than Hail Weston and yet are proposed to each taking into account twin-hatted Members. have the same representation as St Neots. The voice of St Neots is often not heard at District and County and the LJC proposals forego a golden opportunity to engage locally.

The current proposals omit the County Division of Noted – schedule updated accordingly. Buckden, Gransden and The Offords.

Cllr Mrs P Unsure how Hail Weston fits in with the identities of St Please refer to the response to Councillor B S Longford Neots and Little Paxton (Area 5). A larger number of Chapman above re representation. Please also representatives at Parish level would be more refer to Hail Weston’s comments outlined above – appropriate and it is suggested that each of the Parish the Parish have expressed their contentment at Wards of St Neots be represented along with a Parish being included within Area 5. representative from Little Paxton. Hail Weston should be transferred across to Area 3. In general, the current proposals for Area 5 would result in a “top heavy” representation on a Committee designed to promote localism.

PARTNER RESPONSES

COMMENTS WORKING GROUP’S RESPONSE

Cambridgeshire Proposals are a positive opportunity for local people to Noted. Constabulary engage with their elected representatives, other agencies and service providers, including the Police. Frequency of meetings is appropriate and realistic. This also risks usurping the role of the Town and Parish

99 Councils. Nine areas meeting twice yearly is acceptable – any more will present agencies some challenges to attend.

There is no longer a legal requirement for the Police to Noted. set local priorities as they have done p reviously. Public are encouraged to contact the Police as soon as an issue arises and are not encouraged to wait until these meetings arise. The new ethos of local policing is to ensure that there are as many ways as possible for the public to engage with the Police, raise issues of concern and find out about local policing in their area. The LJCs could be utilised to review progress against issues that haven’t been resolved to peoples satisfaction or to link together on cross boundary issues.

It would be good to see a broader range of agencies Noted. represented at the LJC meetings. In more recent times some of the meetings had become Police and Luminus (outside of Elected Members). Encouraging other Partners to attend would be a benefit to the LJCs.

The Polic e will support community engagement within Noted. Huntingdonshire as much as possible and as much as is reasonable with the available resources. HDC’s new venture is certainly supported.

Cambridgeshire The existing Neighbourhood Forums worked extremely Noted. Police Authority well, with issues being dealt with appropriately when they occurred and in partnership with other agencies.

The proposed number of areas are acceptable however Noted. concerns do arise with regard to the frequency of meetings which are regarded as being insufficient to

100 adequately address any concerns that arise between meetings. However, having seen the Constabulary’s response to the proposals the Authority is satisfied with the measures that will be in place to resolve such issues as and when they arise.

It is proposed that the notice for calling meetings should The expectation is that longer than 10 days’ notice be extended to three months notice, with one month as of a meeting will be given. Please refer to 11.2 (i) an absolute minimum. The current proposal is for ten of the Constitution which states that a schedule of days. dates and venues for meetings will be produced. This in turn will be circulated to the LJC membership as soon as it is avai lable, thereby giving longer notice period. The Agenda for the meeting will be circulated at least five days before the meeting.

The Authority is su pportive of the proposal to Noted. encourage a broader range of agencies and community group representation at LJC meetings. Whilst the Police Authority will cease to exist on 22nd November, the Authority will continue to work positively with HDC, CCC and other a gencies to see the joint Constabulary/Authority Engagement Strategy embed prior to the arrival of th e Police and Crime Commissioner, who will have overall responsibility for crime and community safety.

Cambridgeshire Cambridgeshire Fire and Rescue Service will continue Noted. Fire and Rescue to serve the communities we serve by working with Service whatever structures exists where possible.

Cambridgeshire Supportive of the aim and intention to promote the Noted. A meeting between HDC and CCC is County Council localism agenda and concur there is a greater need for currently being arranged. flexibility to suit local need. Keen to meet with HDC representatives to discuss further and believe that 101 effective working between the three tiers of local government would be the best way to service local communities in a simple and effective manner. Specific comments are as follows:-

5 We are unsure as to whether extending the remit Meeting being arranged between CCC and HDC to of Panels is a good thing. It would be fair to say discuss this further. that in their current configuration we do not believe Panels to be working particularly well. We therefore applaud the intention to review Panels, but if they are to remain, we need clarity as to their purpose. We therefore welcome the attention paid to the potential functions of Local Joint Committees, and inevitably some of the functions we would see as legitimate aspirations, but some require more definition.

5 We would agree that the LJCs could indeed Noted. It is up to each LJC a rea to develop their facilitate closer working relationships between own Agenda. the three tiers of Local Government; something that we believe would be a welcome development. We also agree that the LJC, because of this tri-partite approach, could act as the appropriate point to commission and receive local Parish Plans, and monitor progress against targets set. (3.1.c,d,e)

5 We would however be concerned if the LJC were Agreed – see earlier response. to operate in a “semi scrutiny” function, or indeed acted as a referral point to the existing democratic scrutiny functions. We are not aware of any experience currently sitting with Parish Councils that might make this a wise option. (3.1.h)

5 We would be concerned about LJCs being given 102 The delegating authority will condition how funding responsibility for determining expenditure on is spent. delegated budget without much greater clarity about the remit of the budget concerned. Whist we do believe in greater delegation, the decision making process has to be fit for purpose, and until we have decided what budgets will be delegated and by whom, it is problematic to put the structure in place first. (3.1.g)

5 This is compounded by the proposed make up of The proposed LJCs seek to promote localism. the LJCs. If the County Council were to delegate Members that sit on the LJCs are there to decision making responsibilities to the LJCs, represent the interest of their communities. Voting their proposed make up would mean that the arrangements have been discussed above. If this local County Councillor would be in a clear is a genuine concern then CCC would delegate a minority, despite the fact that the Councillor decision to an Executive Councillor after concerned would have the responsibility for that consultation with the LJC. Matter to be reviewed at service. We believe that we would need to find the meeting between CCC and HDC. some way of balancing this inequity, particular at the early stages of implementation. (7.1,2)

5 The concerns outlined above would be echoed in Agreed – this is already in the Constitution. concerns over the proposals over quoracy. We would argue all tiers of Local Government have to be there to achieve quoracy (8.1)

5 We share your desire to make local Councillors Noted. The proposals allow such practical matters the “champions” of their communities. We to be implemented if required. believe in strengthening local democracy. However your proposals raise questions over the democratic mandate of some Parish Councillors, and significantly over the training and development opportunities available to Councillors at all levels of Local Government.

103 We would argue that we have to enable local Councillors to be seen to be more representative of the communities they serve, an issue facing us all. We therefore believe it might be helpful to make reference to other engagement techniques, as recently evidenced at the recent Somersham NESTA pilot, to enable LJCs to develop.

5 The County Council would argue that rather than The new LJCs build on the Neighbourhood having standing local Committees, the key is to Forums. Most of the intent has been in the provide the structure to enable formal contact introduction of the ability to take delegated between the community and its publically elected decisions; however, this is only one of the ways in servants. It is having the facility available should which they will be able to operate. The Constitution an issue arise that exercises the concerns of provides a flexible framework that will permit LJCs local people. Whilst it is problematic to have this to operate in the way they see fit and to develop flexibility in formal structures, we would worry their way of working. that the LJCs structured as proposed, do not learn sufficiently from our shared experiences of Neighbourhood Panels.

5 We are not sure we understand why the Chair of It is intended to encourage greater Town and the LJC should preferably come from the Parish Parish involvement and promotes the localism or Town Council (5.2) concept.

5 We would argue that a nominated person Concerns noted. becomes Secretary for the LJC, potentially for a designated period, although this does raise issues over capacity. To do otherwise would, we believe, lead to confusion (10.1)

5 We would wish to have a more detailed Matter to be discussed at meeting between CCC discussion over the Officer support available for and HDC. each LJC, and this might be linked to the discussion over Secretarial duties above (11.1)

104 5 Who will be party to the Annual Review of the Noted. LJCs? If this is to occur we would argue that all Huntingdonshire County Councillors should also be present (14.1)

5 We do not understand who the Chairman 15.1 refers to the Chairman of the LJC. The referred to in 15.1 is. Constitution has been updated for clarification purposes.

PUBLIC RESPONSES

COMMENTS WORKING GROUP RESPONSE

Public No 1 The District Council needs to make up its mind whether Other responses do not reflect this view. All they want Town and Parish Councils or Neighbourhood Members of LJCs would be elected Councillors Forums. Many Parish Councillors believe they are and would be accountable to the taxpayer for their being compromised by these “quangoes”. They have decisions. no responsibilities to tax payers whatsoever.

Public No 2 The existing Neighbourhood Forums work so why The proposals are intended to introduce smaller reinvent the wheel? Improved advertising and videoing more localised areas whilst being mindful of sessions could possibly improve knowledge and localism and the opportunities that this would participation. present. The proposals seek to build on the existing Neighbourhood Forums, one of the mechanisms for which will be to devolve decision making responsibilities, thereby giving represented communities more power and flexibility . The proposals are designed to provide more efficient use local authority resources.

Public No 3 There is a fear that some isolation of community groups Noted. such as Neighbourhood Watch may occur. I will 105 however give the proposals time to be d in before my fears are recognised over time.

Public No 4 The existing Neighbourhood Forums do not work as Noted. they are only attended by Town and District Councillors, the Police and a few very dedicated Neighbourhood Watch members.

Public No 5 A separate Hartford Forum should be established as a Noted. precursor to a formal Hartford Parish Council. Hartford should be given a real voice.

Public No 6 The existing Forums provide a great opportunity to LJCs can engage with the public in the way they discuss, with Partners, areas of local concern. The see fit. There will be less bureaucracy then the proposals appear to be very bureaucratic with almost Neighbourhood Forums required. no opportunity for public comment.

Is there any place for the public and community groups Please refer to the response above. to have an input? If so, what is the route by which this closer working/consultation will be facilitated? Will there be a reporting mechanism to these groups and if so who will be responsible for them?

Twice yearly meetings appear to be insufficient. The proposals are intended to be flexible to enable each area to develop their own LJC in accordance with local need. Section 5 of the Constitution (para 5.1) contains a provision for LJCs to call more meetings if necessary.

Agendas and Minutes will only be sent to Members five 5.4 of the Constitution will be amended to include working days before each meeting. How are members reference to interested parties and members of the of the public and other groups expected to raise issues public. if they have not had the opportunity to read these beforehand?

106 How will public participation be achieved? Will there be Please refer to the first bullet point and the a time limit on how long members of the public can immediate response above. There will not be a contribute to discussion on various issues? How can time limit on the length of time members of the public participation be decided at each LJC in advance public can speak – it will be at the LJC Chairman’s when the Agenda is not known? discretion as to how long he/she will permit them to speak.

Public No 7 Support of the proposals however view has been The LJCs can still operate as the Neighbourhood expressed that both a Neighbourhood Forum and a Forums did if they want. There is, therefore, no Local Joint Committees is needed for each area. The need for both. LJCs can engage with the public as proposals appear to reduce public participation which they see fit. should be encouraged.

Public No 8 The existing Forums work well so why change them? A The proposals seek to build on and enhance the review of them was undertaken last year where it was existing Neighbourhood Forums. agreed that they would remain the same. There is no pur pose to changing to a new structure and is an attempt to engage with more Councillors and Parish Councillors who already are in attendance at these meetings.

Presently, the Forums are very informal which The LJCs will engage with the public in the way encourages public participation. they see fit.

Waiting 6 months in between meetings loses some The proposals are intended to be flexible to enable momentum – it is suggested that 4 monthly meetings each area to develop their own LJC in accordance should be held. This would also help to balance the with local need. Section 5 of the Constitution (para costs of Partner and Officer time at meetings and 5.1) contains a provision for LJCs to call more thereby generate some form of saving. meetings if necessary.

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108 Agenda Item 11

OVERVIEW AND SCRUTINY PANELS RD (SOCIAL WELL-BEING) 3 TH JULY 2012 (ENVIRONMENTAL WELL-BEING) 10 TH JULY 2012 (ECONOMIC WELL-BEING) 12 JULY 2012

WORK PLAN STUDIES (Report by the Head of Legal and Democratic Services)

1. INTRODUCTION

1.1 The purpose of this report is to inform Members of studies being undertaken by the other Overview and Scrutiny Panels.

2. STUDIES

2.1 The Council has a duty to improve the social, environmental and economic well- being of the District. This gives the Overview and Scrutiny Panels a wide remit to examine any issues that affect the District by conducting in-depth studies.

2.2 Studies are allocated according to the Overview and Scrutiny remits. Details of ongoing studies being undertaken by the two other Panels are set out in the attached Appendix.

2.3 Members are reminded that if they have a specific interest in any study area which is not being considered by their Panel there are opportunities for involvement in all the studies being undertaken.

3. RECOMMENDATION

3.1 The Panel is requested to note the progress of the studies selected.

BACKGROUND DOCUMENTS

Minutes and Reports from previous meetings of the Overview and Scrutiny Panels.

Contact Officers: Miss H Ali, Democratic Services Officer 01480 388006

Mrs J Walker, Trainee Democratic Services Officer 01480 387049

Mrs C Bulman, Democratic Services Officer 01480 388234

109 ONGOING STUDIES

STUDY OBJECTIVES PANEL STATUS TYPE

th Leisure Centre Financial To consider the future Economic Well-Being Working Group met on 28 Joint Working Group Performance and business model for “One and Social Well-Being February 2012. Agreed to Employment Structure Leisure” and the split into two sub groups to development of a investigate each area. methodology for the quantification of Social Sub-Group looking at the Value. ‘Social Methodology’ will meet once desktop research has been undertaken by Officers.

The Sub-Group looking at the business model have met with the Managing

110 Director, Resources. The

Group has recommended that the Council should not draft a Business Plan for One Leisure until the Services’ Strategic objectives have been identified. A14 improvements. To review the implications Economic Well-Being Panel has requested a Whole Panel Study. to the local economy of presentation on the decision not to developments relating to proceed with the A14 the A14 for all Members of improvements. the Council at an appropriate time.

Updates on recent developments to continue to be provided by email. Tree Strategy To form a strategy in Environmental Well- The draft tree strategy is Working Group. conjunction with the Tree Being being prepared for the Officers for the retention Working Group to view. and planting of trees.

Land Use for Agricultural To review the lack of Environmental Well- Various meetings held and Working Group. Purposes in the Context of promotion and protection Being a site visit to a local farm Planning Policies and its of land for this purpose. has been conducted. A Contribution to the Local report of the Working’s Economy. findings to date is being drafted.

Rural Transport To review the provision of Environmental Well- Transport for To be determined. transportation in rural Being Cambridgeshire report areas. received in July 2011. Comments conveyed to Cabinet. Final report

111 expected in due course.

Maintenance of Water To receive a presentation Environmental Well- The County Council’s Flood Working Group Courses on the maintenance Being and Water Manager arrangements in place for attended the February Water Courses within the meeting to present on flood District. risk management activities.

Following the consideration in June 2012 of the St Neots Surface Water Management Plan and subsequent discussions on widespread drainage problems within the District, a working group has been convened to engage with Anglian Water in order to establish their general powers, responsibilities and the limitations on its ability to prevent flooding.

District Council Support To review the services Economic Well-Being Working Group has formed Working Group Services provided by the District two sub groups to Councils Document consider:- Centre to form a view on a) the financial cost of its efficiency and cost the service; and effectiveness. b) the operation of the service

th Last meeting held on 25 April 2012. Final Report is currently being prepared.

Design Principles for To examine issues that Environmental Well- Various meetings held and Working Group. Future Developments have arisen at Loves Being a site visit has been 112 Farm, St Neots and to conducted. A meeting with make recommendations to the Urban Design, Trees

inform future and Landscape st Team developments. Leader was held on 1 June to summarise the Group’s findings. The working group is drafting its final report.

Business Rates To consider the Economic Well-Being Report to be presented to To be determined. implications to the July meeting on the ‘pooling Authority from changes to proposals’. Business Rates.

Economic Development To be determined. Economic Well-Being The Economy Strategy is To be determined. scheduled for completion at the end of the year. Work is currently taking place to develop a robust evidence base for the new Strategy. As part of this process all members will be given the opportunity to participate in the consultation on the initial report and the Economic Development Manager will attend the September meeting.

Fraud Prevention To consider the Economic Well-Being Report to be submitted to a To be determined. implications from future meeting. It will forthcoming changes to address resources, the the Housing Benefits effect that the Housing system. Benefit single fraud investigation service will have on the current fraud team and the Council’s 113 future approach.

Supporting People Back to To be determined. Economic Well-Being Economic Development To be determined. Work Manager to prepare a briefing paper for the Panel’s September meeting.

Community Infrastructure To consider the Economic Well-Being Managing Director To be determined. Levy (CIL) implications of planning (Communities, Partnerships social housing & Projects) to indicate an requirements on appropriate time to Community Infrastructure undertake this review. Levy income and the housing waiting list.

Waste Collection To identify options for Environmental Well- This study was postponed Working Group improving the Council’s Being in light of the work of the waste collection and Advanced Waste recycling arrangements Partnership and the and for enhancing public upcoming Waste Collection satisfaction with the Policies report from the service. Head of Operations. However a Member has emphasised the immediate need for the Council to educate residents as to what can be placed in recycling bins.

114 Panel Date Decision Action Response Date for Future Action

Management of Hinchingbrooke Hospital

5/04/11 With effect from 1st February 2012, Circle took over TBC the management of Hinchingbrooke Hospital. Representatives of Circle and Hinchingbrooke attended the Panel’s meeting to deliver the Hospital’s Business Plan. Agreed to come back to report on progress against the Business Plan in the future.

Redesign of Mental Health Services Across Cambridgeshire and Peterborough

6/12/11 At these meetings, the Panel considered the content Invitation extended This item appears elsewhere on the 03/07/12

115 3/01/12 of NHS Cambridgeshire’s consultation on the to representatives of Agenda. Mr J Ellis, NHS 7/02/12 Redesign of Mental Health Services Across NHS Cambridgeshire and Mr K Spencer Cambridgeshire and Peterborough and submitted a Cambridgeshire to and Mr C Denman, Cambridgeshire response accordingly. Representatives of NHS provide an update and Peterborough Foundation Trust Cambridgeshire have been in attendance at on transportation. will be in attendance for this item. meetings to respond to the concerns raised. Panel wishes to monitor service redesign developments, in particular those which relate to the actions agreed in respect of transportation arrangements for

Huntingdonshire patients and visitors. Agenda Item12

Leadership Direction

16/05/12 Councillors S J Criswell and R J West appointed to Process of Corporate Plan Working Group. monitoring yet to be determined.

Panel Date Decision Action Response Date for Future Action

7/06/11 The Panel expressed their wish for continued involvement by overview and scrutiny in monitoring the performance of the new Council Plan.

07/02/12 Panel has requested the Corporate Plan Working Meeting of the This item appears elsewhere on the 3/07/12 Group to have sight of an early draft of the Corporate Plan Agenda. performance framework before it is adopted. Working Group held on 28th June 2012.

Consultation Processes

6/7/10 Panel requested a scoping report on the Council’s current consultation processes to be submitted to a future meeting. Members questioned whether the 116 Council’s approach to consultation was consistent across the authority and wished to be informed of what the current process was, what methods were used and how materials were prepared for this purpose.

7/12/10 Councillor B S Chapman, Mr R Coxhead and Workingth Group met Final report submitted to Cabinet in Councillors Mrs P A Jordan, P G Mitchell, P D on 15 th December June. Managing Director Reeve and R J West have been appointed onto a 2010,th 18 January, (Resources) to undertake Working Group to pursue investigations further. The 16 Februaryst 2011 investigations as to how the current Working Group has been tasked with reviewing the and 1 April 2011. process can be improved and to

Council’s guidance on consultation methodology Further st meetings report to the Overview and Scrutiny and to evaluate examples of previous consultations. heldnd on 21 April and Panel (Social Well-Being) and 2 June 2011. Executive Councillors on the outcomes.

6/03/12 Update received. Panel to partake in the review of Panel to appoint Panel Date Decision Action Response Date for Future Action

the Consultation and Engagement Strategy in the Members to new Municipal Year. undertake this work.

12/06/12 Councillors Mrs P A Jordan, P Kadewere, J W G Meeting of the Pethard and R J West appointed on to the Woking Group to be Consultation Processes Working Group. arranged.

One Leisure Performance

4/01/11 Panel received a presentation on the performance of One Leisure. This presentation was also delivered to the January meeting of the Economic Well-Being Panel.

117 rd 1/02/11 Advised that the Economic Well-Being Panel Meetings held th on 3 Interim report submitted to the Panel established a joint working group to review the March and 28 April and Cabinet at their meetings in information presented to both Panels in greater 2011. June 2011. depth. Councillors B S Chapman and J J Dutton and Mr R Coxhead were subsequently appointed on to the Working Group.

07/06/11 Councillor Mrs D C Reynolds appointed to the Meetingsrd held onst Working Group. 23 June, 1 th September, 7 th November and 8 December 2011.

th 03/01/12 & Report of the Working Group considered by Panel Working Group met on 28 February 07/02/12 and submitted to the Cabinet in January 2012. The 2012 to discuss their further Cabinet has endorsed the Working Group’s investigations into the future recommendations. business model for “One Leisure” Panel Date Decision Action Response Date for Future Action

and the development of a methodology for the quantification of Social Value.

6/03/12 Report of the Working Group considered. Two sub- groups established. Appointed Members of the Social Well-Being Panel to undertake investigations in the quantification of social value, after desktop research has been undertaken.

12/06/12 Membership of the Social Sub-Group reviewed. Mr R Coxhead is the only member of the Working Group to date.

118 Gypsy and Traveller Welfare

6/7/10 Agreed that gypsy and traveller welfare should be Report requested for TBC included within the Panel’s work programme, with a submission to a view to informing any future Council policy on the future meeting. identification of sites. Following consultation with the Chairman, agreed that the study would proceed once Government guidance has been issued on future provision requirements.

Panel Date Decision Action Response Date for Future Action

Grant Aid

05/07/11 Annual Report on organisations supported by grants Next Annual Report expected 4/09/12 through Service Level Agreements received by September 2012. Panel.

Future of the CCTV Service

1/11/11 Update received on the options for the future operation of the CCTV service. Efforts made to reduce the cost of the service to the Council was noted by the Panel.

119 7/02/12 Further update delivered to the Panel following Request submitted Report anticipated at the Panel’s 6/11/12 discussions with Town Councils. Panel requested for to the Head of November 2012 meeting. a further report on service changes in 2012/13 to be Operations. submitted to a future meeting.

Review of Neighbourhood Forums In Huntingdonshire

th 7/06/11 The Cabinet, at its meeting on 19 May 2011, requested the Panel to undertake a review of the Neighbourhood Forums in Huntingdonshire.

6/09/11 Background report considered. Councillors S J Working Groupth Criswell, J J Dutton and R J West appointed onto a meeting held on 19 Working Group to initiate the Panel’s investigations. September 2011. County and District Council Members and Town and Letter sent to all Parish Councils views on the Neighbourhood those with an Panel Date Decision Action Response Date for Future Action

Forums will initially be sought and reported back to interestst in the Forum the Panel in November. on 21 September 2011.

1/11/11 Views of interested parties reported at meeting. Meetings of Workingrd Chairmen of the Neighbourhood Forums for Group held on 23 th Huntingdon and Ramsey were in attendance for this November, 12 item. Working Group established comprising December 2011 and Councillors S J Criswell, J J Dutton, S M Van De 19th January and Kerkhove and R J West, together with Mr R Coxhead 27th February 2012. to pursue investigations.

6/03/12 Draft proposals presented to Panel for comment prior Proposals Consultation launched on 30th April 03/07/12 to consultation commencing with the Town and considered by to 8th June 2012 inclusive. Parish Councils and Partners. Executive Leaders Responses to be considered by 120 Strategy Group and Panel in July. Meeting of the Corporate Working Group held on 12th June. Governance Panel This item appears elsewhere on the on 12th and 28th Agenda. March 2012 respectively. Also by Cabinet on 19th April 2012.

Equality Framework for Local Government – Peer Assessment

12/06/12 Noted the recent accreditation achieved by the Meeting of the Council as an “Achieving” authority under the Working Group to be Equality Framework for Local Government. arranged. Councillors Mrs P A Jordan, P Kadewere and R J Panel Date Decision Action Response Date for Future Action

West appointed on to a Working Group to review the action plan arising from the assessment.

Housing Benefit Changes and the Potential Impact on Huntingdonshire

7/06/11 Requested a background report to be provided on the emerging issue of homelessness arising as a result of changes to the Housing Benefit system.

6/12/11 Report considered by the Panel. Further report on Request submitted Members of the Economic Well- 4/09/12 and the wider housing policy implications arising from the to the Head of Being Panel will be invited to attend

121 12/06/12 Government’s Welfare Reform Bill submitted to the Customer Services. for this item. Next quarterly report Panel in June 2012. Quarterly updates will continue expected September 2012. to be provided.

Scrutiny of Council Budgets within the Panel’s Remit

4/10/11 & Panel agreed to scrutinise the budgets associated Report expected November 2012. 6/11/12 3/01/12 with the Council functions that fall within the remit of the Panel on an annual basis. Agreed that this work would be undertaken as part of the existing budget setting process.

Panel Date Decision Action Response Date for Future Action

Cambridgeshire Safer and Stronger Overview and Scrutiny Committee Study – Domestic Abuse

7/06/11 Councillor Mrs D C Reynolds appointed as the Study shortly due to Final report presented to the County Panel’s representative on the study being conclude. Council’s Overview and Scrutiny undertaken by the County Council. Following Committee on 14th June 2012. membership changes in May 2012, Councillor R J West undertook to update the Panel on the study’s developments.

The Council’s Relationship With The Voluntary Sector

6/03/12 Panel considered a request from the Economic Well- Members of the Economic Well- 03/07/12 122 Being Panel to examine the proposed future Being Panel will be invited to attend relationship between the Council and the Voluntary for this item. This item appears Sector. A report by the Head of Environmental and elsewhere on the Agenda. Community Health Services on Voluntary Sector Funding for 2013/14 onwards will be submitted to the Panel and the Cabinet in July. Panel agreed to determine how they would proceed with their investigations at this meeting.

Huntingdonshire Strategic Partnership (HSP)

The Panel has a legal duty to scrutinise the work of the HSP, with three thematic groups of the HSP falling within its remit.

Panel Date Decision Action Response Date for Future Action

03/04/11 Huntingdonshire Community Safety Partnership

Annual review of the work of the Partnership Due for consideration by the Panel in 2/04/13 undertaken. Members have expressed their April 2013. satisfaction that appropriate accountability and reporting mechanisms are in place.

05/10/10 Children and Young People

Details of the thematic group’s outcomes and Invitation extended Due to be considered by the Panel in 04/09/12 objectives have been received together with the to the Lead Officer September 2012 – awaiting latest report of the group, outlining its terms of of the thematic confirmation. reference, membership and current matters being group. discussed.

123 7/02/12 Health and Well-Being

Background information received on the thematic Request submitted The Draft Joint Health and Well- 3/07/12 group’s outcomes, terms of reference, membership to Head of Being Strategy will be submitted to and Action Plan. Panel has requested sight of the Environmental and the Panel in July 2012 where the Draft Joint Health and Well-Being Strategy as soon Health Services. Panel will have an opportunity to as it was available. The Panel has also confirmed comment prior to its formal adoption. their wish to review the Group’s Action Plan at future This item appears elsewhere on the meetings. Agenda.

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124