To approve as a correct record the minutes of the meeting held on 24 January 2024.

Decision

To approve the minutes of the meeting held on 24 January 2024 as a correct record.

To receive an update following the most recent meeting of the Manchester Partnership Board.

The Board was advised that at their public meeting of 29 February 2024 the Manchester Partnership Board (MPB) had discussed in detail progress on the delivery of the North Manchester Strategy.

The Board were informed that at their public meeting of 26 March 2024 the MPB had considered a deep dive on the subject of cancer and the measures being taken to tackle the disease within the city. At this meeting consideration was also given to an update on progress that had been made to identify priorities for 2024/25 in relation to the ICB Operational Plan for 2024/25, noting that these were to improve physical and mental health and wellbeing, prevent ill-health and address health inequalities; and

improve access to health and care services, so that people could access the right care, at the right time, in the right place, in the right way.

The Board were informed that the next meeting of the Manchester Partnership Board was scheduled for 30 July 2024.

Decision

To note the update.

The report of the Director of Public Health and Executive Director of Adult Social Care is enclosed.

The Board considered the report of the Director of Public Health that introduced the city’s new age friendly strategy Manchester: A City for Life 2023–28. It further provided a summary of progress and update on arrangements that had been put in place to support delivery of the strategy.  

Manchester’s new Age Friendly Strategy Manchester: A City for Life 2023–28 was launched in November 2023 and followed extensive engagement with the Age Friendly Manchester (AFM) Older People’s Board (the Board), with people aged over 50 at the Age Friendly Assembly (the Assembly) and direct collaboration with key strategic partners, services, frontline workers and key complimentary strategy teams, for example Making Manchester Fairer.

The new strategy builds on previous progress, provided a series of responses to the ongoing impact felt by some older people to the pandemic and the struggles faced by the cost-of-living crisis for many people aged over 50. It outlined a series of priorities and commitments to drive better outcomes so that more people could age well in place with increased financial security.

The Board welcomed Elaine Unegbu, Chair of Age Friendly Manchester Older People's Board who presented the report and discussed the significant and important work that this represented. A suggestion was made that this report be submitted to the Local Care Organisation Executive so that consideration could be given as to how the MLCO could best support this work.

The Chair thanked Elaine for attending the meeting and presenting to the Board. He reiterated the comments of support from the Board for Manchester: A City for Life 2023–28. He said that the report was transparent and clearly articulated the aims and objectives of the strategy. He referenced the section of the report that discussed the immediate responses required to address the impact of the pandemic and the cost-of-living emergency in the here and now, which was something older people had told us was a priority.

Decisions

The Board note the report and agree to receiving future progress update reports on an annual basis.

The report of the Director of Public Health is enclosed.

The Board considered the report of the Director of Public Health that described Manchester Health and Wellbeing Board (HWB) was responsible for producing a local Pharmaceutical Needs Assessment under the National Health Service (Pharmaceutical and Local Pharmaceutical services) Regulations 2013.

Since 5 December 2016 pharmacies had been able to apply to NHS England and NHS Improvement to consolidate the provision of pharmaceutical services at two pharmacies onto one site.  Health and Wellbeing Boards had a statutory duty to make representations in relation to these applications.  

The representations must indicate whether, if the consolidation application were granted, in the opinion of HWB, the proposed removal of premises from the pharmaceutical list would or would not create a gap in pharmaceutical services provision that could be met by a routine application.

This case was an appeal against the decision taken by NHS Greater Manchester Integrated Care Pharmaceutical Services Regulations Committee (PSRC) on 16^th February 2024 to reject an application from Everest Healthcare Limited to consolidate two existing premises into one.

The NHS GM Manchester Locality Medicines Optimisation Team had reviewed the application and found the following:

·       There was a significant reduction in hours as the proposed closing site is a 100-hour contractor operating 76 hours per week Monday to Sunday whilst the remaining site would be maintaining 49 hours per week Monday to Saturday following consolidation.

·       There was a significant distance to the two remaining nearby 100-hour pharmacies (now operating reduced hours) that provide coverage Monday to Sunday.

·       That there were no significant issues identified that presented any barriers in terms of physical access to either sites; consolidation would therefore not adversely affect patients.

·       Consolidating the two sites would not have an adverse impact on the range of pharmaceutical services as all services currently delivered on either site would be offered on the existing premises.

·       Based upon this assessment, and subsequent reduction in opening hours, it was considered that a gap in provision would be created in terms of access to pharmaceutical services on a Saturday or Sunday evenings for patients accustomed to accessing services from the closing site. It was therefore concluded that granting the consolidation would lead to a gap which could be met by an application to secure improvements, or better access, to pharmaceutical services.

The report also described the responsibilities of the Board to make representations in future cases and asked for guidance on the approach to their management.

Decisions

1.   The Board agree that the consolidation application described in the report would create a gap in pharmaceutical services provision which could be met from a routine application.

2.   The Board agree that future decisions relating to consolidation applications should be delegated to the Director of Public Health, in consultation with the Chair of the Health and Wellbeing Board.

The report of the Director of Public Health is enclosed

The Board considered the report of the Director of Public Health that provided information about the recent national measles incident. It described the governance arrangements and actions that had been put in place to prevent the spread of measles in Manchester and to contain any cases as they arose to minimise the risk of an outbreak. The report also described plans for ongoing work to increase the uptake of the measles, mumps and rubella (MMR) vaccination and prepare for future increases in cases. 

The Deputy Director of Public Health stated that since the report had been produced the number of identified cases in older teenagers and people in their early twenties had increased in the North West, adding that this was a concern for Manchester due to the high number of students who resided here.

The Deputy Director of Public Health stated that communications, engagement and awareness raising on this issue of measles and the importance of vaccination was very important. Noting the previous comment from the Director of Public Health she commented that the Public Health team, in conjunction with local health partners and the Universities had undertaken scenario planning for the event of an outbreak, adding that planning for a measles outbreak had been ongoing for over two years and this had included scenario planning with both early years settings and care homes.

The Assistant Director of Population Health said that the vaccination rates in Manchester remained a challenge and therefore presented a significant risk. She commented that the lessons from a recent targeted vaccination programme with primary schools would be reflected upon. She further commented that a vaccination service that had been delivered at the University had been very positive, particularly with overseas students and that the learning from this pilot would be rolled out from September as students arrived in the city. She commented that the source of relevant communications and key messaging on vaccinations had been very important to promote and encourage take up. She also added that the learning from the Community Pharmacy Offer would be reflected upon as this had proven to be less successful.

The Board discussed the barriers to vaccination take up and encouraged all learning to be utilised to maximise the take up of all vaccinations. The Board noted that all established relationships in Neighbourhood Team should be used to support this activity.

The Chair in concluding this item of business paid tribute to all the staff working in the Public Health Team for their continued work to protect all residents in the city. He commented that the report clearly demonstrated that Manchester was not complacent about this issue and was prepared for the event of an outbreak of measles.

Decision

The Board note the report.

The report of the Strategic Director of Children and Education Services is enclosed.

The Chair informed the Board that he had agreed to defer consideration of this report until the next meeting, scheduled for 18 September 2024.

Decision

To defer consideration of this report to the meeting of the Health and Wellbeing Board scheduled for 18 September 2024.

The report of the Director of Public Health is enclosed.

The Board considered the report of the Director of Public Health that provided an overview of the new Mental Wellbeing Strategic Framework for Manchester 2024-2029. The framework had been developed to provide a focus on mental health and wellbeing as an essential component of overall health, and efforts to prevent ill-health and reduce health inequalities. It was intended to support the work of Making Manchester Fairer in reducing health inequalities. The framework reflected activity that was already underway across the Council and other organisations and identified opportunities for further developing activities for improving mental health and wellbeing and preventing mental ill-health. Development of the framework had been guided by a multi-agency Mental Wellbeing Steering Group along with insights from trusted organisations that represented or worked with people with lived experience of the impact of health inequalities who tended to be marginalised or seldom heard. Continual engagement of the workforce and services across the social determinants of health, and ongoing community and resident involvement would be critical to developing the detail and successful delivery of the framework.

The Board welcomed the report and supported the adoption of a Framework approach rather than a strategy. They supported the importance placed on the preventive work, early intervention and consideration of the wider determinants of mental health and wellbeing. The Board discussed the importance of staff training and awareness on this activity. The Board further said that all available capacity within the VCSE and Primary Care should be utilised to support this work. A Board member said that the report would be presented to the Greater Manchester Mental Health NHS Foundation Trust Board. The Director of Public Health welcomed this suggestion and stated that she would be happy to support this if required.

Decisions

The Board note the report and support the further development and delivery of the action plans that will follow the framework with the involvement and engagement of local communities and partners across the population health system.

The report of the Director of Public Health is enclosed.

The Board considered the report of the Director of Public Health that provided an update on two key elements of the Making Manchester Fairer (MMF) Action Plan, noting that MMF was Manchester City Council’s five-year action plan to address health inequalities in the city focusing on the social determinants of health. The two key elements contained in report considered were:

(i) The implementation and delivery of the Making Manchester Fairer Kickstarter Scheme - Improving Health Equity for Children and Young People - Young People’s Element

(ii) Making Manchester Fairer Theme 6 Update – Places, Transport and Climate Change:  Improving our surroundings, the environment where we live, transport and tackling climate change

The Board welcomed consideration of theme 6, noting the importance of quality, accessible green space and the dual benefits of active travel, in terms of reducing carbon emissions and contributing to a healthier lifestyle.

The Board then heard from guests from 42^nd Street who had been invited to address the Board on the Improving Health Equity for Children and Young People element of the report. The spoke of their work to address health inequalities and supporting access to mental health support for young people up to the age of 25 years. They noted the importance of the Framework as it acknowledged the complexity and intersectionality of young people’s experiences with mental health. Reference was also made to the importance and relationship between identity-based workers and recovery rates amongst young people.

The three Young Practitioners, 42^nd Street spoke of the importance of recognising and meaningfully addressing the relationship between social media and young people’s mental health, noting that this was a significant issue for young people, and this needed to be recognised and included in conversations with young people. They further made reference to the work undertaken to map provision and identify gaps and barriers that young people experienced when attempting to access services and relevant support, adding that appropriate promotion and awareness raising of available services was important. They also made reference to the importance of ensuring services were inclusive and accessible to all with due consideration given to cultural sensitivity when developing communication strategies, with consideration given to the preferred and trusted channels of communication to reach young people. 

The Board welcomed the contributions from the young people and commented that the lived experience and voice of young people needed to be heard and captured so as to inform all responses. An assurance was given that all the comments had been noted and would be reflected upon. The Chair reiterated this and thanked all those present for attending and contributing to the discussion.

Decision

The Board note the report.

The report of the Director of Public Health is enclosed.

The Board considered the report of the Director of Public Health that provided a summary of the content of the recently produced Joint Strategic Needs Assessment (JSNA), on Tuberculosis (TB) in Manchester. The JSNA described what we know about TB, the impact of this disease on high-risk populations and what Manchester City Council and other organisations working in the city were doing to address these needs. The JSNA ended with several key actions to be endorsed, signed off and acted upon.

Decisions

The Board note the content of the JSNA and support the opportunities for further action described in the JSNA.