To receive apologies for absence.

Apologies for absence were received from Neil Bolton-Heaton and Tracy Hendren.

To receive any declarations of interest.

The Chairman declared a personal interest as he was an independent healthcare consultant, infectious disease specialist and vaccines expert and he had formerly worked for Sanofi Pasteur. He was currently working as an adviser for the Vaccines Taskforce and Antiviral and Therapeutics Taskforce. Councillor Carroll declared this in the interests of full transparency and to highlight that should for any reason during the meeting, or indeed during future meetings, the Health and Wellbeing Board discussed anything directly related to Sanofi Pastuer’s business he would abstain from the discussion and leave the room as required.

To confirm the minutes of the meeting held on 2^nd November 2021.

RESOLVED UNANIMOUSLY: That the minutes of the meeting held on 2^nd November 2021 were agreed as a true and accurate record.

To consider the report.

Becky Campbell explained that the Pharmaceutical Needs Assessment (PNA) was a statutory responsibility of the Health and Wellbeing Board. It considered the pharmaceutical needs of the population on a 3 yearly basis, with the last one being carried out in 2018. Due to a delay with Covid, the next PNA had been pushed back but it was now planned to be refreshed by October 2022. In 2018, the PNA was done across Berkshire with each Health and Wellbeing Board having added into this collective piece of work. An external provider called Healthy Dialogues had been brought in to carry out the PNA and it would provide each local authority with their own statement of needs. The assessment would link in with work being done by the East Berkshire Public Health Hub which would be the check and balance to ensure that the process was carried out correctly.

A steering group had been created and had met twice already, the group consisted of a number of people and was scheduled to meet every six weeks. The first task for the group was to gather feedback, a survey had been created and the questions to be asked had been agreed. The survey would go out to pharmacies, while the public would also be asked the questions. It was planned that the survey would be launched at the end of the month. Healthy Dialogues were also undertaking some work on targeted groups, for example older generations, those whose first language was not English, those in care, sheltered housing and younger generations were all examples. It was proposed that the first draft of the PNA would be ready for April 2022, after this there would be a 60-day consultation. The PNA could then be signed off by the Board in September 2022, ready for publication in October 2022.

The Chairman asked how the steering group planned to publicise and communicate with residents about the consultation period.

Becky Campbell said that Healthy Dialogues had put together a plan, working in partnership with the public health hub and the local authority communications leads. Each local authority would advertise the consultation using their own channels and Healthwatch were also going to help. A wide range of communication methods were planned to push the consultation out once it was ready.

Kevin McDaniel, Executive Director of Children’s Services, asked how young people could get involved with the consultation.

Becky Campbell explained that Healthy Dialogues were keen to use current channels to engage with this age group, for example by using youth ambassadors.

Kevin McDaniel said that he was happy to be involved and investigate ways to help ensure that young people were aware and participated in the consultation.

ACTION – Becky Campbell to contact Kevin McDaniel to discuss how young people could be more involved in the consultation on the PNA.

Councillor Werner joined the meeting.

Anna Richards, Consultant in Public Health, suggested that the Board could be used to help reach the targeted groups that had been mentioned,  ...  view the full minutes text for item 284/15

To receive the presentation.

Kevin McDaniel gave a presentation and spoke about the third priority, which was to target prevention and early intervention to improve wellbeing. People were good at reacting to things that had happened because the impact could be seen, but less good at investing in preventing things from happening in the first place. There were three types of prevention; primary, secondary and tertiary. For every £1 invested in prevention, the return could be around £14 saved across the rest of the healthcare system. Research showed that prevention was a long-term game, some benefits came through in a year or two, but it could be as long as 15-20 years before some benefits of prevention were seen after the initial investment had been made. Considering the RBWM Corporate Plan, two of the main objectives in the plan linked to prevention:

·         Investing in prevention and intervene early to address problems before they escalated.

·         Promoting health and wellbeing and focus on reducing inequalities across all areas.

Kevin McDaniel outlined the gap in expected progress at school between those children living with financial deprivation, compared to the rest of the cohort. There was early help available to young people, for example there was a ‘starting well ambition’ across the Integrated Care System which had funded community led projects for young people. Family Hub services had been refocused on hard to reach groups, while edge of care services provided help to families to allow them to deal with the pressures experienced in everyday life.

Prash Patel said that when looking to make patients lives better, it often started at the reactionary level. He felt that RBWM was ahead of the curve when it came to ensuring that prevention was a focus, the idea of getting prevention into communities would allow it to be more prosperous in the long term. It was clear where the problems were but it could often be difficult to achieve changes in these areas. Prash Patel considered the film Jaws, where the impact of the shark attacks on the community could have been prevented if a preventive approach had been taken, but this would not have been easy to do. Prevention was a leap of faith, long term goals meant that the outcome would not be known for a significant number of years. Broad stroke targeting had its place but Prash Patel felt that there needed to be innovation to discover the inequalities in communities and understand exactly what they needed. The council had the tools to look at these inequalities at a ward level and this would allow prevention to be implemented in the right areas. One particular issue in RBWM was the ageing population, who could be using resources in both primary and secondary care. If frail members of the community could be identified, interventions could be offered. This was currently being trialled in primary care. Other innovations included using opportunistic screening at vaccination centres across the borough. Prash Patel concluded by explaining that it was important for health leaders,  ...  view the full minutes text for item 285/15

To consider and sign off the strategy.

Anna Richards explained that this agenda item continued the theme of prevention, the Suicide Prevention Strategy was a Berkshire wide plan covering the period from 2021-2026. Councils had a responsibility to develop a plan and appropriate action plan.

Charlotte Littlemore, Public Health Programme Officer, explained that she had been representing RBWM at the steering group. There were a number of national strategy themes and principles, with the new strategy being a refresh of the previous strategy. A working group had been established within the steering group who had worked together to identify the key principles. The data underpinning the strategy had come from a variety of sources, including the Berkshire suicide prevention 2018 audit along with the impact of Covid on mental health. Suicide rates in RBWM had been significantly below the national average, however since 2019 this rate has risen to be similar to the national average. The vision of the strategy was to reduce deaths by suicide in Berkshire and ensure better knowledge and actions around self-harm.

Charlotte Littlemore explained that suicide represented the extreme end point of mental ill-health, there were a number of people who experienced suicidal thoughts, self-harmed and attempted suicide that were not recorded in the figures. Self-harm was an area that the steering group wanted to explore, it was considered the strongest predictor of suicide and made up a number of hospital admissions. There had been a growing increase in female suicides, with a decrease in the rate of male suicide. Three key areas of concern were linked to female suicide; perinatal mental health, domestic abuse and parent or carer stress. Economic factors also needed to be considered and that those suffering were able to receive support. The final focus in the strategy was around those who had been bereaved by suicide. People who had been bereaved by suicide were at greater risk of suicide themselves and there was also an increase in self-harming. Charlotte Littlemore concluded by outlining some of the overall recommendations within the strategy.

The Chairman said it was vital that suicide was talked about openly and the strategy was in place to provide support to those who were at risk of taking their own life. Prevention was again a key focus which linked in with the previous agenda item.

Hilary Hall, Executive Director of Adults, Health and Housing, asked if there were any particular local issues and what was the RBWM response, as some things could be missed at the Berkshire wide level.

Anne Richards explained that the strategy was overarching and was a collaborative approach across Berkshire in terms of resources. The next steps for the steering group were to develop action plans for specific areas and consider the next steps for each local authority.

Charlotte Littlemore said that the strategy covered the period 2021-26 and there were therefore a significant number of recommendations included. The steering group agreed that there would be a reactive nature to the data as there was a time lag. A separate working  ...  view the full minutes text for item 286/15

To receive an update on the work of the Outbreak Engagement Board.

Link to the minutes and Q/As of the LOEB - COVID19 : Outbreak control plan | Royal Borough of Windsor and Maidenhead (rbwm.gov.uk)

Browse meetings - Outbreak Engagement Board (moderngov.co.uk)

Hilary Hall said that the Outbreak Engagement Board had continued to meet monthly in public, with every meeting streamed live on the RBWM YouTube channel. There was a focus on communications and engagement, it had been proving difficult to promote messages that still had an impact. With the Omicron variant, cases had increased and there had been a subsequent push around vaccinations. There was an opportunity for public questions to be submitted in advance of meetings which would be answered by Board Members. Looking forward, there would be a standing item around long Covid and its impact.

Anna Richards said that the Local Outbreak Management Plan had been updated as a lot had changed since the plan was created. Up to date information was shared on the Public Health Berkshire website. The plan worked to deal with outbreaks and stop them from happening. A shortened version of the plan was publicly available on the RBWM website, with the update being done collaboratively with all relevant stakeholders.

Huw Thomas encouraged the public to come forward to get vaccinations, no one would be judged if they were receiving their first dose.

The Chairman said it was important that there was no judgement and that RBWM wanted people to come forward to receive their vaccinations. He passed on his thanks to Huw Thomas and his colleagues for their continued hard work.

To hear from Councillor Stimson.

Councillor Stimson had spent two weeks in Glasgow for the COP26 event. She was a trustee of a rewilding charity which looked at re-healing land, where land could be purchased in each county around the UK. It was important that the borough was careful on funding around climate change and sustainability in order to effectively finance initiatives. Councillor Stimson had spoken and networked with a number of colleagues at the conference. There had been a significant number of young people present, those from island communities and more diverse communities had been well represented too. There were four key aims from COP26:

·         Net zero by 2050 at the latest

·         Keeping the limit of 1.5 degrees alive

·         Protecting the most vulnerable communities

·         Mobilise finance

Councillor Stimson said that over 100 countries had signed up to reverse deforestation by 2030 and there were almost 90 countries who had agreed to methane commitments. Councillor Stimson concluded by saying that she felt positive for the future.

The Chairman thanked Councillor Stimson for her commitment and work in this area. He had been pleased to see an increase in the number of residents in his ward using their food recycling bins.

Anna Richards said that she would be interested in knowing what school children felt about sustainability, she asked how this could be fed back to the council.

Councillor Stimson said that her next engagement with schools was in early March 2022, she was aiming to deliver a presentation on sustainable development goals.

Kevin McDaniel said that the RBWM Youth Council were keen for their voices to be heard, they would be interested in having a conversation with the Public Health team on a range of topics.

To consider the report.

*Update 11/01/21 – this item will be considered at the next meeting due to pressures on the service area.*

The Chairman said that Tracy Hendren had been unable to attend the meeting due to pressures in the service area. A briefing note had been produced which was circulated to Board Members after the meeting.

Board Members to consider items for future meetings:

·       Library transformation strategy update - Angela Huisman

·       LEDER report

·       Implications of COP26 for health and wellbeing at Place

·       Flu report

·       CAMHS - pre and post diagnosis

·       JSNA following soft launch at the end of Jan 2022

The Board noted the items which would be considered at future meetings.

·       Tuesday 29^th March 2022 – 3pm

·       Tuesday 12^th July 2022 – 3pm

·       Tuesday 18^th October 2022 – 3pm

The next Health and Wellbeing Board would be held on Tuesday 29^th March 2022, starting at 3pm.