To consider any items which the Chair has agreed to have submitted as urgent.

The Chair agreed to an item of urgent business to provide the Board with an update on the work of the Manchester Partnership Board following its most recent meeting.

The Deputy Place Base Lead addressed the meeting and referred to the meeting of the Partnership Board, held on 15 September 2023 which considered proposals for the winter plan for Manchester and the Manchester Board priorities for ensuring the health and wellbeing of residents and the accessing of services.

Hospital at Home programme

Reference was made to the development of the Hospital at Home programme in place to avoid the need for hospital admission, using virtual wards or other technology-enabled care within a patient’s home. The pilot scheme has in six months seen a reduction of over two thousand hospital bed days. A further information sharing event is planned for 28 September 2023, for the next stage of the rollout of the programme. It is planned that the ‘Hospital at Home’ team will be in place to support the Central Manchester area by the end of 2023, and it is expected that this will be extended to the north and south areas of the city by the first quarter of 2024.        

Integrated Care Board

An update was also provided on the Integrated Care Board (ICB) and the financial position. It was reported that a turnaround director has been appointed to look examine the finances across the integrated care system to work to towards improving the current financial position. The current deficit stands at £606 million across the integrated system for 2023/24 financial year. Work continues to ensure financial sustainability for Manchester and a financial stability programme is in place and to integrate services for best value.

Carnall Farrar Leadership and Governance Review

It was reported that following the review, work has proceeded and there is now a revised model for the Integrated Care Board that will be considered by the Board of the ICB, today. The proposed model will set up more clearly the division of responsibility held at a Greater Manchester level. Work is continuing to embed and operationalise the new system, in particular the commissioning of services at a Greater Manchester level.

The Chair reported that he with the Chair of the Health Scrutiny Committee (Councillor Green) had written to the Secretary of State (Health) to highlight concerns regarding the transition of Integrated Care, in view of the financial deficit (£606 million) so late into the financial year. The Secretary of State has been requested lobby the Treasury to highlight the situation, ahead of the Government’s Autumn Statement. The Chair made the point was made that, as the winter period approaches there are clear indications of increasing numbers of seasonal illness and health service partners have implemented changes to accommodate additional pressure on existing services.              

Decision

To note the update.

The chair made a correction to the title of members present at the previous meeting.

Decision

To approve the minutes of the meeting held on 7 June 2023 as a correct record.

Report of Director of Public Health attached

The Board considered the report of the Director of Public Health that provided background information about the refresh of the Operational Local Health Economy Management Plan for Manchester and includes the draft plan for approval. It also provided a detailed focus on current epidemiology and issues relating to tuberculosis (TB).

The Board was informed that the Health Protection Board had focussed on covid during the covid pandemic, however other diseases such as TB remain a serious public health concern and present a challenge to public health funding. Reference was also made the Outbreak Management Plan (appendix 1, of the report), concerning the operational arrangements in place specific to Manchester. The operational arrangements in place address several diseases specific to the complexity and diversity of city. It was reported that the covid pandemic had highlighted the lack of public health protection capacity and work had been ongoing to address this. The report also addressed the incidence of TB in Manchester which had risen in the latest reporting period. It was reported that there are current funding and capacity challenges regarding levels of latent TB and screening.

The Assistant Director of Public Health reported on the good working relationship with health service partners to help identify and treat TB cases through MFT. It was reported that current funding levels have limited preventative screening work to identify latent TB and this has been highlighted from outbreaks of TB across the city in different settings such as care homes and schools. Health partners were requested to consider the provision of services to ensure health equity for all the city’s population.

The Chair thanked officers for their ongoing important work in tackling TB within the city and noted that current funding allows screening for 26% for latent TB, and highlighted the necessity for anyone newly arriving in Manchester to be provided with health screening checks to identify illnesses at the earliest stage.

Members welcomed the report and noted the difficulties of detecting and treating latent TB across communities. The importance of developing a joined-up communications strategy to raise public awareness and provide information to a range of communities on recognising TB symptoms must continue as well as encouraging attendance for screening appointments. The approach taken to engage with communities, in particular migrants, is important to ensure health screening and the take up of vaccination at the earliest opportunity before individuals were resettled to other areas.

The Board was informed that a business plan is in place to address funding issues for services across the city and the help of the Health and Wellbeing Board is welcomed in progressing that work.

Reference was made to those individuals with no recourse to funds, in particular homeless people leaving hospital and requiring accommodation to help sustain their recovery. A recovery pathway has been produced to help homeless people recovering from TB, where accommodation will be provided and located close to hospital to ensure treatment is continued. The system has been recognised nationally as unique to Manchester and will  ...  view the full minutes text for item 15.

Report of Director of Public Health attached

The Board considered the report of the Director of Public Health that described that in November 2022, the Department of Health and Social Care confirmed that local Health and Wellbeing Boards would continue to be responsible for assessing the health and wellbeing needs of their local population through the publication of a Joint Strategic Needs Assessment (JSNA) and a Joint Local Health and Wellbeing Strategy (JLHWS). The report focused specifically on the statutory guidance and the November 2022 update and what it meant for Manchester.

Reference was made to section 3 of the report regarding the Manchester Joint Health and Wellbeing Strategy and the proposal to not write another new strategy but use Our Healthier Manchester Strategy which was refreshed in 2021 alongside Making Manchester Fairer to constitute the Joint Local Health and Wellbeing Strategy. The Our Healthier Manchester Strategy will reflect both the Greater Manchester Strategy and the five year forward view.

The Chair referred to the number of changes to health arrangements, outlined between paragraphs 3.4. and 3.6 and asked how these may be scrutinised or assessed between the Manchester Partnership Board and the Health and Wellbeing Board.

The Board welcomed the proposal to bring the strategies together and refresh them to produce a strategy that aligns with the Greater Manchester framework and that is specific and works for the city, noting also the need to include greater focus on the needs of children and young people and the measurement of outcomes delivered.

Decisions

The Health and Wellbeing Board;

1.    Note the report and its statutory duties and powers in relation to the Joint Local Health and Wellbeing Strategy.

2.    Agree to delegate the co-ordination of the approach to comply the statutory duty to the Director of Public Health and the Deputy Place Based Lead.

Report of Strategic Director of Children and Education Services attached

The Board considered the report of the Strategic Director of Children and Education Services that provided a summary of the evidence and data regarding the health of the armed forces community. It described some of the health issues that may affect members of the armed forces community and what the data from the 2021 Census told us about UK armed forces veterans living in Manchester. 

The report also described what Manchester City Council and other organisations working in the city are doing to support members of the armed forces community and their families as well as some of the opportunities for action that existed.    

The Chair welcomed the report and referred to the provision of support at a national level to ex-service personnel returning to civilian life, suffering from mental health issues and/or physical injuries or other illnesses. The production of a Joint Strategic Needs Assessment will help to bridge the gap of the national strategy and better focus services for veterans and serving members of the armed forces and their families living within Manchester, to help them to settle and access help with medical issues and employment opportunities.

Members of the Board welcomed the report and acknowledged the work of those to help ex-service personnel and there their families to settle within communities and help with employment. Also, the work to help those who are employed and who are members of the TA and serve and return to work. It is important for those employers who have employees serving in the armed forces to allow them time to return and readjust to civilian life. Reference was made to the importance of raising of awareness of local GPs on the process to access the mental health support pathway. There are currently twenty-two GP surgeries involved under the OP Courage and Transition intervention and liaison service operated by MFT. Recognising skills that can be transferred to the civilian workplace is a major factor in helping ex-service personnel, and employers are asked to look further than the individual’s academic achievement to include other important skills that have been developed in the armed services, when considering an offer of employment.

The Director of Public Health reported that the new style to the production of Joint Strategic Needs Assessments will be a briefer concise document that will include a structure to include the nature of challenges involved in an area of service and provide opportunities for action. This model will be developed to allow contributors to take ownership of the document. The proposal to include consultation with GPs to raise awareness of OP Courage and Transition intervention and liaison service will be included in the JSNA to move the matter forward in promoting the service to veterans and armed forces personnel.  

Decisions

The Health and Wellbeing Board;

1.  Note the content of the Joint Strategic Needs Assessment.   

2.  Support the opportunities for further action described in the JSNA.

To endorse the inclusion within the JSNA of GP surgery liaison and consultation to raise awareness  ...  view the full minutes text for item 17.

Report of Deputy Director of Public Health attached

The Board considered the report of the Deputy Director of Public Health that provided an overview of progress made during June to August on the Making Manchester Fairer Action Plan and a case study on Manchester Housing Provider Partnership’s approach to Making Manchester Fairer and tackling health inequalities.

The Board welcomed the report and acknowledged the role of housing providers in communities by providing more than just good quality homes and working to empower local people and helping maintain the health and wellbeing of residents through maintaining communication and involvement of service provider partners.

The Chair welcomed the report and looked to use the subject matter for inclusion in future meetings of the Making Manchester Fairer Board. The chair requested the amendment to the first bullet of paragraph 4.1 of the report to replace the word ‘launch’ with ‘development’.

Decision

The Health and Wellbeing Board note progress made in implementing the Making Manchester Fairer Action Plan. As well as noting the work that is taking place across partner organisations to integrate the Making Manchester approach and principles system wide. 

Report of Deputy Director of Public Health attached

The Board considered the report of the Deputy Director of Public Health that described that the Children and Young People’s Health Summit brought system leaders together to develop, drive and own the future direction and delivery of Manchester Locality’s priorities for the health of our children and young people. The report summarised the event and next steps.

Decision

The Health and Wellbeing Board note the key outputs from the event and proposed next steps.