Agenda and minutes

All Members who believe they have a Disclosable Pecuniary or other Interest in any matter to be considered at the meeting must declare that interest and, having regard to the circumstances described in Section 4 paragraph 4.6 of the Councillors’ Code of Conduct, leave the meeting while the matter is discussed.

Councillor Pantelic declared a non-pecuniary interest by virtue of being a Stakeholder Governor on Frimley Health NHS Foundation Trust.

To elect a Chair for the 2019-20 municipal year from amongst the voting members of the Board.

The Board was invited to make nominations for the position of Chair for the 2019-20 municipal year.

Councillor Pantelic was proposed by Councillor Nazir and seconded by Dr Jim O’Donnell.

Resolved – That Councillor Pantelic be elected Chair of the Slough Wellbeing Board for the ensuing year.

(Councillor Pantelic in the Chair for the remainder of the meeting)

To elect a Vice-Chair for the 2019-20 municipal year from amongst voting members of the Board.

The Board was invited to make nominations for the position of Vice-Chair for the 2019-20 municipal year.

Dr Jim O’Donnell was proposed by Ramesh Kukar and seconded by Councillor Nazir.

Resolved – That Dr Jim O’Donnell be elected as Vice-Chair of the Slough Wellbeing Board for the 2019-20 municipal year.

Resolved - That the minutes of the meeting held on 8^th May 2019 be approved as a correct record.

Dr Liz Brutus introduced a report that provided an update on sexual and reproductive health in Slough.

The Board received a presentation outlining key indicators and trends relating to sexual health, compared Slough with other South East England areas and benchmarked Slough against other local authorities matching its demographic and socioeconomic profile.

It was noted that the key challenges for Slough were: HIV, abortion, LARC (Long-Acting Reversible Contraception) and Chlamydia.  New HIV diagnoses in Slough were higher than average but had been falling most recently.  There was increasingly good HIV testing coverage and it was believed that this was contributing to reducing late diagnoses.  Abortion rates in Slough remained high, especially amongst over 25 year olds.  The use of LARC was far below the England and regional average; evidence suggested that this was a significant factor contributing to the higher abortion rate.  Chlamydia screening was a challenge and lower rates of screening were likely to be contributing to the rising rates of pelvic inflammatory disease.

The underlying causes of the key challenges were discussed.  The Board was advised that the majority of people were accessing sexual health services through The Garden Clinic.  There had been a significant reduction in the use of General Practice surgeries for everyday contraceptive advice.  It was explained that discussions would be undertaken with Primary Health Care leads to establish ways of encouraging people to access these services through primary care.

In relation to the use of contraception, the Board was advised that amongst the population of Slough there was a general resistance to using LARC.  In an effort to improve uptake it was suggested that pharmacists or healthcare assistants might be best placed to communicate the benefits of LARC.  Discussions with Clinical Commissioning Groups would be initiated to consider co-commissioning opportunities.  However, it was recognised that the current offer to General Practitioners was not financially attractive, so consideration of how this could be improved was required.

(Tessa Lindfield joined the meeting)

The Board noted that Milton Keynes was facing similar challenges to Slough and Members felt it would be beneficial to contact practitioners there to see what learning could be garnered.  There was some discussion about undertaking a visit; however it was agreed that it would be a better use of time to make initial telephone calls to ask if representatives from Milton Keynes would be available to attend a future Board meeting; if this was not possible, further consideration could be given to visiting Milton Keynes.

Resolved –

(a)  Dr Jim O’Donnell, the Director of Public Health and Superintendent Sarah Grahame to contact their counterparts in Milton Keynes to discuss the approach partner organisations adopted to address sexual health challenges.

(b)  The Director of Public Health to discuss with Primary Health Care lead members ways of encouraging people to access sexual health services through primary care.  

(c)  An update report be provided to a future Slough Wellbeing Board meeting.

Consideration was given to the recent work undertaken by Slough’s Safeguarding Executive Board (SSEB) to align priorities and governance.  The Board had agreed at its last meeting to ask the recently established SSEB to consider ways in which the Wellbeing Board could add further value as part of its work to review and strengthen partnership working.  The SSEB brought together senior managers from core agencies, including Slough Borough Council, Thames Valley Police and the Clinical Commissioning Group to ensure common and coordinated approaches. 

The Service Lead Strategy and Performance Service provided a Powerpoint presentation to the Board setting out the recommendations of the SSEB and how the governance arrangements would assist partnership working.

New legislation dictated that the Local Safeguarding Children Boards (LSCBs), set up by local authorities, were to be replaced.  Under the new legislation, the three safeguarding partners (local authorities, police, and Clinical Commissioning Groups) were required to make arrangements to work together with relevant agencies to safeguard and protect the welfare of children in their area.  The requirement for local authorities to begin the transition from LSCBs to safeguarding partners began in June 2018. The arrangements had to be published by 29 June 2019 and implemented by 29 September 2019.  LSCBs were required to continue to carry out all of their statutory functions until safeguarding partner arrangements were operative within a local area.

The Board was advised that the proposed priorities of the SSEB for the next two years were: serious youth violence, neglect, exploitation, and domestic violence.  Each priority area would have a range of subset focus areas and deliverables.  These would be reviewed every six months to ensure that these priorities remained the correct focus.  Superintendent Sarah Grahame reported that further work would be undertaken to establish a robust evidence base for these priorities.

A discussion took place about how the Board approached the issue of health.  In particular, how the strategic priorities for Slough were developed and how preventative strategies could be established amongst partner organisations to encourage residents to better look after themselves.

Dr Jim O’ Donnell suggested that a ‘scorecard’ for professionals could be established to help them to spot safeguarding issues, similar to the way GPs had scorecards to spot people at risk of vascular disease, stroke and heart attacks.  Whilst the Board accepted that this type of tool would be useful, it was recognised that this approach was fallible and could lead to pre-determination.  It was noted that there could be circumstances in which all risk factors were present, without any safeguarding instances occurring.  The Director of Children, Learning and Skills explained that ‘indicating factors’ were considered on a strategic level and informed the development of preventative strategies.  However, identifying an individual as being vulnerable to safeguarding issues could have a detrimental impact, and this could inadvertently become self-fulfilling.  It was agreed that providing a ‘universal offer’ to communities was the most effective approach of building resilience.

Resolved – That an update report be provided to the Slough Wellbeing Board meeting on 13th November 2019.

The Board received an update on the Council’s Transformation Programme.  The Programme would deliver a new Operating Model for the Council, including building on the importance of partnerships and developing a ‘One Slough’ approach.

The Council recognised the need to change to meet a number of challenges, whilst also keeping a focus on its statutory responsibilities.  The vision and case for change was summarised.  The Transformation Programme was necessary as the Council needed to respond to continued financial pressures and rising demand for key services, specifically in Social Care and an increase in resident expectations around customer services in a digital age.  The ambition was for the Council to be a world class organisation, delivering seamless services to customers with the agility to respond to future changes and demand.

Nick Kennell, Client Director, Gateone, was introduced to the Board.  He explained that Gateone would be working with the Council to deliver the Transformation Programme.  A key driver of the transformation would be collaborating with partners to develop a joined up integration agenda.  It was recognised that partnership working was essential to tackle the broad range of issues in Slough. It was explained that the Council’s role would be as ‘place shaper, facilitator and enabler, closely collaborating with residents, businesses, communities and partners’. 

Mr Kennell said the Wellbeing Board provided partners with a forum to maximise efforts by identifying where the ‘multiplier effect’ could be adopted to enable an organisation to have an impact beyond its formal remit.  He expressed a wish to meet with each representative of the Board to discuss how the Board could support the Council’s Transformation Programme.

Resolved –

(a)  That the report and presentation regarding the Council’s Transformation Programme be noted.

(b)  Mr Kennell to contact each Board Member to arrange one-to-one discussions regarding the Transformation Programme.

Consideration was given to the arrangements for the 2019 Annual Partnership Conference due to be held in October 2019.  In particular, the Board was asked to discuss how to increase attendance at the Conference.

Following on from the discussion under the previous agenda item regarding the ‘multiplier effect’ it was noted that health and in particular obesity, was an example of an issue that required a multi-agency ‘whole system’ approach to be tackled effectively. 

It was suggested that the Conference could be used as a forum to engage with residents and host a ‘listening session’.  Each resident could be provided with five minutes to raise issues and concerns.  Dr Jim O’Donnell supported the suggestion and highlighted that under the Integrated Care System model up to 80% of health funding spend would be determined locally.  Therefore, it was important to gather the views of residents to establish an evidence base.

There was some discussion about the timing of the Conference.  It was noted that the Wellbeing Strategy was due to be renewed next year and it was felt that it was important for the priorities and purpose of the Slough Wellbeing Board to be determined before the Conference was held.  The Board felt an October Conference was too early and therefore agreed that it be postponed to a later date.  The arrangements for the Conference would be discussed at the next Board meeting.

Resolved – That the Partnership Conference be deferred until to a later date and further discussion about the arrangements be held at the next Board meeting on 25^th September 2019.

Consideration was given to a report that detailed the Pause Programme and the positive outcomes it had achieved.

The Chief Executive, Slough Children’s Trust explained that the Programme had exceeded expectations in the level of successful engagement with women who had had one or more children removed in legal proceedings.  The Programme was currently funded jointly through the Department for Education Innovation Funds and the Slough Children’s Trust.  It was highlighted that the Programme accrued savings for partner agencies such as the police and Adult Social Care due to the reduced need for assessments, emergency interventions and the costs associated with substance misuse and domestic violence.

The Board was asked to note the demonstrable practice and budgetary benefits of the Pause Programme, with a view to contributing funding to enable it to continue for a further 18 months.  The current funding ran to the end of the financial year (2019-20) and a decision would be required by December 2019.

Dr Jim O’Donnell agreed to invite the Chief Executive, Slough Children’s Trust and the Director of Operations to the next Health and Care Partnership Board meeting to present the Pause Programme report.

Resolved –

(a)  That the report be noted.

(b)  Dr Jim O’Donnell and the Director of Adults and Communities be asked to invite the Chief Executive, Slough Children’s Trust and the Director of Operations to the next Health and Care Partnership Board meeting to present the Pause Programme report.

Consideration was given to the Forward Work Programme.

The following amendments were raised:

25 September 2019

Immunisation and Screening Action Plan be deferred to the 13 November 2019 meeting.

The Director of Public Health Annual Report be removed and presented at a future meeting.

Resolved – That the Forward Work Programme be agreed subject to the amendments detailed above.

The date of the next meeting was confirmed as 25th September 2019.