Agenda item

Dr Katherine Packham, Consultant in Public He Dr Katherine Packham, Consultant in Public Health, Leicester City Council will present the report.

Dr Katherine Packham, Consultant in Public Health presented the report on the production of a Joint Health and Wellbeing Strategy (JH+WBS), a statutory duty of Leicester City Council and Leicester City Clinical Commissioning Group.  The current JH+WBS was published in 2019 before the Covid pandemic. The draft revised JH+WBS has been updated in light of the pandemic and other changes that have occurred in policy.  The report also outlined a recommended timeline for the 2022-2027 JH+WBS.

As part of the development of the Integrated Care System, each ‘place’ needed to have a place-led plan.  The Leicester draft place-led plan consisted of the draft JH+WBS and the draft priorities for the Leicester City Health, Care and Wellbeing Delivery Plan.  A more detailed delivery plan would follow once the priorities had been through an engagement process and the final version approved by Health and Wellbeing Board in January 2022.

The draft revised JH+WBS and the draft priorities had been developed through partnership working centred on a core working group, with members of this group collaborating with others.

During discussion on the report, it was noted that:-

·         Members of the Board comment on the draft priorities during the meeting or submit their views through the engagement process.

·         The timescale of plan was considered to be the middle ground approach to give 5 years to deliver and achieve priorities and provide for a review not too far in the future as there had been many challenges through the impacts of Covid-19 which were not fully understood at the present and these can be assessed in timely manner to review any new challenges.

·         The Delivery Plan -Framework approach had been built upon the 5 strategic strands of the Joint Health and Wellbeing Strategy.

·         In identifying the priorities, priorities that could have a significant impact through multi- agency/partnership working were selected.  It was aimed to get a balance of health, care and wellbeing priorities.  Some of the priorities required city wide action whilst others required more delivery at a neighbourhood level and sone required act at both levels.

·         Health and wellbeing equity was at the forefront and this included an approach of ‘proportionate universalism’ in which interventions were targeted to enable a ‘levelling up’ of the gradient in health outcomes.

·         The priorities were built on existing engagement insights of what people thought was important in the way services should be delivered and took a strengths based approach building on existing community services and assets.

·         Every opportunity for collaborative delivery of priorities with VCSE and community organisations at either a city wide or neighbourhood level had been considered and they were supported by clear measures of progress ( i.e. SMART).

·         Since the agenda pack had been published, other priorities had come to light including a number of education related themes to young children affected by the pandemic and play development and others linked to deprivation.  Also, healthy minds and other initiatives to be a zero suicide City had been identified.  It would be helpful to have these extra priorities added to the summary of priorities and send to Board Members.

Members of the Board commented that:-

·         More data was needed on outliers such as mental health in the city compared to the county.  There were 20% more people with mental health diagnosis in the in the city, a third were on care programmes and twice as many were in hospitals and 4 times the number of patients with Section 8 Notices.  The City was a real outlier and this needed to be addressed through synergy and collaboration.

·         The 5-year length of the Plan was supported and the 19 priorities could be standing priorities but with a focus this year on 3-4 priorities.  There should be real community empowerment input into the priorities and the zero suicides ambition was supported as an ambitious and progressive aim to make improvements.

·         The ability of staff in all organisations to develop should be recognised.  UHL currently had 650 nurse vacancies and maybe there should be a reflection of how staff could be channelled from social care to nursing care etc.  The biggest risk to the NHS was staff.

·         Crime and Knife Crime were important and leisure centres and libraires could provide opportunities for healthy exercise through leisure facilities and GP referrals so people could stay fitter and not need to go to hospital.

·         The focus on the whole city to make bigger impact on all people was supported.  More information may be needed on  racism and discrimination which impacted upon people.  The strategy should support people to get the best impact for themselves with some support from services provided by organisations.  The inclusion of people from a wider remit was needed to make a difference to what happens in the City.  How the strategy connected with other strategies and schools and how opportunities were signposted would make a difference to the outcomes.

·         Given the introduction of the ICS a possible challenge could be the proportion of funds spent on prevention services and how the Board’s priorities could influence and be integrated with those of the ICS.  The leverage provided by the whole system and its budgets could play a key role in maximising benefits for improvements in health and wellbeing.

·         The working group was multi-disciplinary across the anchor institutions which should help to align priorities.

·         There was support for the priorities to be bold and clearly indicate that they did not tolerate or support the inverse care law where less goes to where it most needed.  Leicester was a deprived multi-cultural city with complex needs that needed to be changed and to achieve improvements.  It was important to focus on societal level changes and the priorities should hone in on genuine transformational issues.

The Chair thanked everyone for their supportive contributions and encouragement for the porposals.

RESOLVED:-

1)    Officers were thanked for the presentation and update in the work carried out and endorsed the duration of the draft revised JH+WBS to be 2022-2027.

2)    Officers were asked to take into account the comments made by Board Members and in preparing the draft priorities to be released for engagement.