Agenda item

Purpose: For Health Scrutiny Committee to review the draft Joint Health and Wellbeing Strategy and associated Delivery Plan, and the initial findings from the formal public consultation exercise.

Sarah Rayfield, Acting Consultant in Public Heath, gave a presentation on the Joint Health and Wellbeing Strategy (Agenda Item 6). The presentation went through the process of how the Strategy was developed.

In April 2019, the Health and Wellbeing Board Chairmen from West Berkshire, Reading and Wokingham had agreed to develop a Joint Health and Wellbeing Strategy. Work started in March 2020 by evaluating the current strategies and looking at their impacts. Identification of residents’ needs was informed by data and discussion with stakeholders, partners and organisations working in the area. An initial long-list of 30 priorities had been developed, which was refined to a list of 11 through a series of workshops. In November 2020, a public engagement exercise was used to further refine the priorities to a total of five.

The presentation included a number of key Statistics relating to the population, demographics and health needs of West Berkshire residents.

It was explained that the Strategy had been co-produced and delivered through a Consultation and Engagement Task and Finish Group. An online survey had attracted 3,967 responses, 1,201 of which were from West Berkshire. In addition, 18 focus groups had been held with under-represented groups.

Comments from West Berkshire residents were around the following themes:

·         Better communication and support for parents of children with mental health difficulties.

·         Bring together the educational needs and long-term wellbeing of young people.

·         More financial support for people and families who work but still struggle to pay household bills.

·         Better coordination between Social Services and the NHS for elderly / vulnerable people.

·         Minority groups were less likely to use and trust public services.

·         The impact of dementia on people, and their families, required input from many agencies.

The final agreed priorities were:

1.    Reduce the differences in health between different groups of people.

2.    Support individuals at high risk of bad health outcomes to live healthy lives.

3.    Help families and children in early years.

4.    Promote good mental health and wellbeing for all children and young people.

5.    Promote good mental health and wellbeing for all adults.

The Strategy was underpinned by the following eight principles:

1.    Recovery from Covid-19

2.    Engagement

3.    Prevention and Early Intervention

4.    Empowerment and Self Care

5.    Digital Enablement

6.    Social Cohesion

7.    Integration

8.    Continuous learning

It was confirmed that the Strategy would be in place for the next 10 years, but it would be adjusted as needed to reflect new learning and data.

An online public consultation on the draft strategy had taken place in West Berkshire and Reading from 24 June to 4 August 2021. Of the 162 responses received, 67% were from West Berkshire, 26% from Reading and 7% from other areas. 80% of responses were from individuals and 12% were on behalf of organisations. The responses showed strong support for each of the priorities and supporting strategic objectives.

Themes in the ‘free text’ comments included:

·         A general acknowledgement that the priorities were sensible and important issues.

·         Interlinking / overlapping nature of the priorities.

·         Accessibility of the Strategy.

·         The need for ongoing listening and engagement.

·         The need for more emphasis on social determinants of health.

·         Self-empowerment, self-management and people taking responsibility for their own health.

·         The wording of the strategy needed to be more specific in parts.

·         The need for funding.

·         The need for a delivery plan and measurable targets.

Each of the three local authorities was developing their own delivery plan. West Berkshire Health and Wellbeing Board (HWB) held a workshop on 24 June to look at what needed to be done to achieve the strategy’s objectives. Actions at both the West Berkshire and Berkshire West levels were being considered.  The Integrated Care Partnership (ICP) was already using the priorities to help frame their future work, and work was progressing with the CCG on delivery of the priorities. It was confirmed that the delivery plan would be for the first three years of the strategy and would be regularly updated. Indicators would be developed to measure progress towards targets. A draft delivery plan would be taken to the HWB in September 2021 with the final version signed-off in December 2021.

Councillor Alan Macro asked how the long-list of 11 priorities had been arrived at and noted that there were no priorities for older people, particularly in relation to dementia. Sarah Rayfield explained that current strategies had been reviewed to identify where a difference had been made and where there were gaps. This was followed by engagement with community groups and stakeholders. Public Health data had been examined to understand local needs. A “what’s missing” exercise had also been carried out. Data for the three local authorities had been reviewed and if an indicator was red for at least one authorities or amber for all three, this was added to the list. This process gave an initial long list of 30 priorities. A series of stakeholder workshops were held, during which questions were asked in relation to each priority, such as: ‘was this work being done elsewhere?’; ‘would it be duplication if it was included within the strategy?’; and ‘was there a way in which we could work together as a system to address this?’. This led to the reduced long-list of 11 priorities, which were put out to public consultation. The consultation feedback was used to refine them down to the final five priorities. It was acknowledged that a significant number of people had felt there were things missing from the priorities, but these had mostly already been considered and some were included, but not explicitly. For example, dementia came under the second priority – ‘support individuals at high risk of bad health outcomes to live healthy lives’ – where those living with dementia were explicitly mentioned. She noted that over the course of the 10 year strategy, the groups who were at higher risk may change, but this would be kept under regular review.

Councillor Andy Moore asked how contention between the plans of the three local authorities would be resolved. It was explained that although there was a shared vision, how each local authority chose to implement this would be different. Sarah Rayfield confirmed that she would lead that process for each of the three areas and was looking at which actions could better be delivered jointly. Councillor Graham Bridgman commented that the delivery plan was the most important part of the Strategy. He agreed that there may be aspects that would be better delivered at ‘place’ rather than ‘locality’ level, which would need a separate delivery plan. 

Andrew Sharp acknowledged the challenge of having to engage people remotely during the pandemic. He felt that all partners, especially Public Health, should be proud to have put together a good engagement programme and capture meaningful feedback to ensure that the public's concerns had been identified and addressed in this strategy. He felt it was incumbent on the Committee to ensure the strategy produced the desired outcomes in terms of delivering change and action in relation to health inequalities.

The Chairman thanked Sarah Rayfield for her role in developing the Strategy in difficult circumstances and indicated that she felt the voices of local residents had come across and she was pleased to see the level of feedback that had been received.

There was discussion around the Strategy’s principle of ‘digital enablement’. Councillor Moore noted that some people were unable to engage digitally, while Councillor Linden noted that would be circumstances where people wanted to engage with a health professional on the phone or face-to-face. Councillor Macro recalled a GP's testimony in a national newspaper in which he recounted that in about 30% of cases, he was able to determine a patient’s status just from the way in which they presented themselves upon entering his surgery. Also, he suggested that in face-to-face consultations it was easier to establish whether information had been understood by the recipient. The Chairman questioned whether digital engagement took account of the needs of those who were hearing impaired and suggested ongoing training was implemented to enable people to become skilled and comfortable with digital engagement. Assurances were given that these issues were recognised and that the goal  was to support people who are able to engage digitally, but not to exclude anyone either, and appropriate provisions would be made.