Agenda item - Chair's Communications

The Chair of the Board will start the meeting with a short update on recent developments on health and wellbeing.

49.1      The Chair stated the following:

“Better Care Fund clarification

At the last Health & Wellbeing Board a query was raised about the large variance in community equipment spending and could the Board have clarification as to why this was.

The Community Equipment service budget was increased by 5% from 2017/18 to 2018/19 and the Council increased their permanent funding to replace the loss of £0.241m temporary funding in 2018/19. This is in recognition of the increasing demand and cost pressures within this service. I think the Board may remember the conversations we had here some time ago about was the original historic budget too low.

Due to additional funding received in the Autumn budget statement, there is now no expected variance on the Community Equipment service. A further detailed paper on the Better Care Fund will be coming to the June Board including the financial update and I have asked officers to ensure that this area is covered in the text not just in the financial tables.

NHS Long Term Plan

NHS Long Term Plan has been published.  We are aware that over the next few months there will be a range of activities to assist with developing the delivery plan which I believe needs to project actions over the next 5 years for the local area and to which I anticipate there will be a close read across with Brighton and Hove’s joint Health and Wellbeing Strategy which is being presented to this meeting for formal consideration.

Much of the information will be found on the CCG website as this this becomes available. https://www.brightonandhoveccg.nhs.uk/

Public Health funding

Councillor Yates as Leader of the Council recently signed a letter that went to senior cabinet ministers highlighting the issue of Public Health reduced funding and the impact on services such as cancer screening.  The letter to Mr Hammond, Mr Hancock and Mr Brokenshire will be attached to the minutes (Appendix 1).

Carers

Between now and the next Board in June there is a range of activity covering Carers. I will touch on key elements now but this will be reported fully in the minutes of the meeting.

Young Carers Health Champions is a national programme run by NHS England, to encourage young carers aged between 16 and 24 years old, to have their say in how health services develop.  The programme was established to support improved health literacy, promote health and wellbeing and develop the capacity of young carers to participate in planning and development of young carer friendly services.  The Health Champions are recruited annually and we have three young carers from Brighton and Hove on the programme.  The Commissioning Manager for Carers (joint BHCC/CCG post) will be meeting with them after their final residential this March, to discuss how they can be supported to improve the experience of young carers across the City. Rob Persey (Executive Director of Health and Adult Social Care) has also agreed to meeting with them to explore how their expertise can be best utilised within the development of our services.

National Carers Week 2019 is from the 10^th June to 16^th June – the theme this year is Getting Carers Connected in their Communities – the aim of Carers Week is to increase the awareness of carers, and to raise awareness with carers of the support available for them. Brighton and Hove’s Carers Strategy has a commitment to building a stronger Carer Friendly City, and Carers Week is a key vehicle to support this.  We will be involved in a range of events and activities across the City, and are pleased to announce a new addition this year - the Carers Festival, to both raise awareness and to celebrate the vital (often unrecognised) contribution unpaid carers make to our City – the festival will both provide information for carers, and have a diverse range of entertainment and opportunities aimed at increasing the wellbeing of all carers (young, parent and adult carers), including ‘taster’ sessions from some of our local Carers Card offer providers.  The timing of the event will enable young carers to attend after school, and we are hoping to foster an intergenerational approach by celebrating all carers.   Additionally we will have specific activities aimed at engaging young carers, including potentially a performance from some of our local young carers.     

The date for the Carers Festival is 12^th June 2019 between 2pm to 6pm at the Open Market – more details will follow and will be widely publicised.

Update on Ardingly Court

At the last HWB the Board asked for further information about the changes in the development of Ardingly Court. I am grateful for the CCG for providing this update:

‘During discussions the CCG has had with the Sussex Community Foundation Trust (SCFT) and Ardingly Court Surgery (ACS) practice partners, it became apparent that since the original proposal for the Palace Place development was discussed, the primary care landscape has changed.  Available primary care capacity has increased with a number of neighbouring practices seeking to increase their registered patient list sizes, making it easier for residents to register and see a local GP, compounding ACS concerns that they may be unable to recruit enough patients for them to remain a financially sustainable practice in the new building.

Every effort is being made by the CCG to support GPs in the city so that they can provide services for local people, in the face of workforce pressures, and rises in demand for their services, that are being reported across the country. This includes financial and educational support to help them run their surgeries more effectively and efficiently to free up doctors to provide more care for patients. 

A key area of CCG plans to improve health and social care across the city, is to make sure general practice is more sustainable, more resilient and works efficiently and effectively for many years ahead. This will include integrating some services, with other clinical specialists like pharmacists better supporting GPs, and helping GPs work more collaboratively together.  There are also a number of specific schemes such as GP retention packages, as well as oversees recruitment, that the CCG is implementing as part of its workforce strategy.

The CCG is continuing to work closely with ACS to improve their premises and to support the development of plans for the practice team to continue to provide high quality care for their patients.’

Recommissioning sexual health services

As the Board is aware there was a report due to come concerning the recommissioning in sexual health services. This report has been delayed due to the potential changes in how these services are funded and commissioned which could impact on a longer terms contract. We are waiting for clarity about these matters and will update the Board as soon as possible with the outcomes and way forward.

Food and nutrition

The Board has highlighted access to food and nutrition as a concern. We have agreed the Brighton & Hove Food Partnership Food Strategy and also and several reports on nutrition for key groups in the city.  A further deputation on the city becoming part of the Milan Urban Food Policy Pact will be going to Full Council. There is one area that is outstanding and that is access to food and cooking for homeless and vulnerably housed. We are waiting for the final work on Kendal Court and will report in the summer.

Arch Health

Arch Health Community Interest Company is the specialist GP surgery in Morley Street Brighton and provides GP and other services for our homeless and vulnerably housed residents.

Like all GP surgeries they have to be inspected by CQC. Their inspection took place in January 2019 and the inspection covered all the 5 areas of care: safe, effective, caring, responsive, and well led.

I am delighted to be able to report that Arch were rated as outstanding in all 5 areas.  And I am sure that the Board would like to send our congratulations to all the team there.”

49.2      Councillor Page asked for more information on the Update on Ardingly Court, whether the CCG could provide a more specific statement regarding the capacity for care in the city centre, and Recommissioning sexual health services, that the budget uncertainty was alarming.

49.3      Dr David Supple responded that the capacity was in a context of building space available, particularly for the Oxford Street Surgery.

49.4      Alistair Hill responded that the changes should not be of alarm because they were based on general landscape of service provision and not the level of funding. He stated that the national suggestions have come forward from the NHS Long Term Plan and the Secretary of State for Health and Social Care and the services to review the future of commissioning and stability of services.

49.5      The Chair stated that it was widely accepted Public Health had performed well by making good use of council funding and it was too early to comment on the future commissioning. She added that Alistair Hill would provide an update prior to the June HWB.

Public Health Investment

As council leaders, we are writing to you on behalf of the millions of citizens that we represent, urging you to provide increased and sustainable funding for public health in the forthcoming spending review. This is vital if we are to work together to prevent ill health, reduce health inequalities and support a sustainable health and social care system. Community health engagement is also vital to the delivery of the NHS Long Term Plan as it is these interventions which will help keep people out of hospital and save the statemoney.

In 2018/19 and 2019/20 every local authority will have less to spend on public health than the year before. Councils are now responsible for delivering most public health services, but our ability to do so is increasingly compromised by ongoing public health grant reductions and the broader funding climate for local government.

Given that we know around four in ten cancers are preventable - largely through reducing avoidable risk factors, such as stopping smoking, keeping a healthy weight and cutting back on alcohol - reducing public health funding is a false economy. Smoking, obesity and alcohol account for 80,000, 30,000 and 7,000 early deaths each year respectively. Smoking remains the single biggest cause of preventable cancer in the world. Furthermore, smoking-related ill health costs our local authorities £760 million every year in social care costs. On average, for every £1 spent on smoking cessation, £10 is saved in future health costs.

Reducing investment in public health puts undue demand on local health services and our economy suffers too. Poor public health costs local businesses heavily through sick days and lost productivity. Unless we restore public health funding, our health and care system will remain locked in a ‘treatment’ approach, which is neither economically viable nor protects the health of our residents.

While we welcome the Government’s recent commitment to preventing ill health through the NHS Long Term Plan, we know a sustainable NHS cannot be achieved if undermined by these local cuts. Public health must be seen as an essential component of a healthy society – it therefore deserves parity of funding and of esteem. That’s why we are coming together and calling on you to deliver a sustainable funding solution, for the health, wealth and wellbeing of our communities

We look forward to hearing from you soon. [Undersigned council leaders]