To consider the main theme of the meeting, including:

·         JSNA

·         Introduction to the Inequalities programme and emerging themes

·         Berkshire Public Health Annual Report 2021/22

·         Young Carer support in RBWM

Joint Strategic Needs Assessment

Marc Connor, Intelligence and Strategy Officer (Covid-19), gave a presentation on the work of the Joint Strategic Needs Assessment (JSNA). The website had recently been launched and Marc Connor gave the Board a detailed overview of the website, how it worked and what information was available to residents on the JSNA. National inequality trends included:

·         Emergency admissions to hospital for under 5s increased as affluency decreased.

·         Children from minority ethnic backgrounds underachieved at school.

·         Manual workers were twice as likely to smoke.

·         People residing in less affluent areas died younger.

·         Vaccine uptake was lower in the Polish community.

From Hub data, the white European population was not fairly represented in RBWM. Approximately 3,600 were not vaccinated and of this, two thirds were likely to be Polish. The JSNA contained the tools to identify which areas Polish speakers lived and how the Public Health team could start to consider targeted intervention. The website launch had been communicated to all stakeholders and a general introduction, training and demonstration webinar had been delivered. A public demonstration was also planned for later in the year.

Kevin McDaniel commented that the data which was provided on the website was historical, the pandemic had a big impact. He asked what could be done looking forward and understanding how trends had changed over the past few years.

Marc Connor said that the Public Health team was led by the national data, this research would then inform local thinking. The response from RBWM could be tailored using the JSNA data.

Kevin McDaniel suggested that the Public Health team could influence the future research programme on a national basis to allow RBWM to make strategic decisions going forward.

Councillor Coppinger said that when the first JSNA had been created, he was surprised about the areas of inequality in the borough. The JSNA allowed this information to be shown to the council and parish councils, Councillor Coppinger felt that it was important that Councillors worked closely with GPs.

The Vice Chairman said that the JSNA data had been particularly useful to allow the health service to understand the hidden areas of deprivation.

Councillor Stimson suggested that communication with targeted communities could be more cost effective as a result of the JSNA.

Steve Dunn asked if it was possible to influence the focus of the data in the JSNA. The 2021 census data would be available shortly and could provide some actionable insights, Steve Dunn asked if this was planned.

Marc Connor said that the national data was useful and could be used on different projects at a local level. There were a number of projects that were reliant on the census data, once it had been made available.

Anna Richards, Deputy Director of Public Health for East Berkshire, said the JSNA was a great resource and helped inform commissioning and understanding of the needs of the local population. The JSNA should be used by colleagues, if the Board had any suggestions on how the JSNA could be developed they would be considered.

Introduction to the inequalities programme and emerging themes

Anna Richards outlined the inequalities project to the Board. RBWM was one of the most affluent areas of the country, but there were pockets of deprivation. Over half of neighbourhoods were in the least deprived deciles, no neighbourhoods were in the most deprived deciles but there were some neighbourhoods in some lower deciles. The cost of living crisis meant that the number of families who would be living in deprivation would increase. The main aim of the project was to support all residents and communities to achieve their ambitions and fulfil their potential, with a focus on those who were at risk of poor outcomes. This would therefore reduce demand for high cost services. This aim would be supplemented by three objectives:

·         To improve the council’s collective understanding of inequalities and disadvantage in the borough.

·         To reduce inequalities in the borough, through developing a shared approach, based on evidence.

·         To reduce demand on high cost services, through improved prevention and early intervention.

Rebecca Hatch, Head of Strategy, explained that the scope of the project was to consider inequalities in the broadest term and outcomes could be seen across a number of areas. A two phase approach was planned; phase 1 was about understanding the issues and developing an evidence base, phase 2 was focused on developing a shared approach of reducing inequalities. Phase 1 was close to being complete, with most of the data having been collected in an evidence pack. Outputs from the first phase would include the refresh of the Corporate Plan, the development of equality objectives, an evidence base of equality impact assessments and the design of a shared approach to reducing inequalities. This shared approach could include new policies or approaches and the design of more effective strength-based support for communities and families experiencing inequalities. There was also some alignment with other work, for example the Frimley ICS Place and health inequalities work, the JSNA and the Health and Wellbeing Strategy. The methodology for the project would consist of three sources: data analysis, frontline engagement and insights, and community engagement.

Councillor Luxton said that she had been pushing for community engagement to come to the south of the borough but she was not aware of any engagement with the local community that she represented.

Rebecca Hatch said that the world cafes were moving between wards across the borough, she would check with Jesal Dhokia, who was leading the world cafes, and confirm with Councillor Luxton after the meeting.

ACTION – Rebecca Hatch to confirm the engagement work which was planned for residents in Ascot, Sunningdale and Cheapside.

Kevin McDaniel was interested to see what barriers to health and access to services there were for some families in the borough, he asked if there was any early feedback on clustering.

Rebecca Hatch outlined one key cluster being around financial stress, impact on mental health, impact on relationships and impact on parenting. Another cluster was social isolation, particularly with the elderly age group. Social isolation was also coming through in younger ages groups too.

Kevin McDaniel highlighted that these people were needing support from the public and community sector, the work could be used to see how the council could work better with groups to avoid some of the stresses which many families currently faced.

Councillor Coppinger was pleased to see the progress of the project, he felt that it was long overdue. He appealed to officers to make sure that they involved local Councillors in the project.

Anna Richards confirmed that Councillors had been included in the conversations that had taken place with frontline staff.

Councillor Stimson said that she had attended the world café held in her ward, there had been a huge attendance from local residents. It was a health and wellbeing exercise, understanding how people were coping was key and the engagement was pleasing to see. Councillor Stimson felt that there had been good representation attending the world cafes.

Steve Dunn said that this was an exciting project and had the full support of NHS Frimley. It was well known that residents from the poorer wards of the borough were higher users of health and public services, this underlined the importance of the piece of work and the need for intervention.

Rebecca Hatch said that world cafes had been successful in attracting a wide range of people but there would always be a slight selection basis. There had been focus groups and targeted interviews to ensure that specific groups of people were reached.

Young Carer support in RBWM

Sarah Collin, Family Action Young Carers Project Manager, gave the Board a presentation on the work of Family Action. A young carer was someone under the age of 18 who helped to look after someone in their family who was ill, disabled or misused drugs or alcohol. Research showed that 1 in 5 young people had taken on some form of caring responsibility at home. The UK was rated as advanced internationally, when considering the rights of young carers. It was important to step away from the number of young carers and instead look to understand the prevalence of caring by young people in society and to make sure that they were identified. The pandemic had made unpaid care more visible than before. Emerging research was considering the health and wellbeing of young carers but there was limited research on the long term impact. There needed to be a shift from caring responsibilities to emotional burden of caring and the long term implications. In the UK, approximately 40% of young carers self-reported mental health issues of their own.

Family Action received referrals through a number of different routes and undertook a young carers assessment to understand the situation. It was important that the tasks a young carer was doing were both age and gender appropriate. The impact of caring was also considered as part of the assessment. Sarah Collin outlined some data on the impact of caring from the past three years in RBWM. Family Action was committed to making sure that caring was a positive experience, they provided a 4-6 month intervention. Families were able to re-refer to the service at any point if there continued to be a support need for a caring role within the family. Considering next steps, it was important that as a society there was a collective responsibility to identify gaps in the service provision. It was also recommended that professionals were educated about the long term impact of care on young carers future mental health.

Sarah Collin concluded by appealing to Members of the Board to identify young carer champions within staff teams, while also identifying suitable referral pathways for young carers.

Berkshire Public Health Annual Report 2021/22

Anna Richards said that each year, the Director of Public Health put together an annual report which could cover a range of topics. This year, the Director of Public Health for East Berkshire had worked in collaboration with the Director of Public Health for West Berkshire to produce a joint annual report. The report had a focus on food: its production, distribution and consumption and what could be done at each stage to reduce its environmental impact.