Agenda Item No
The Vale of Glamorgan Council
Scrutiny Committee (Social Care and Health): 12th March 2012
Report of the Director of Social Services
The Vale of Glamorgan Public Health and Wellbeing Board
Purpose of the Report
1. To summarise progress made in establishing a Public Health and Wellbeing Board in the Vale of Glamorgan.
1. That Scrutiny Committee notes the content of this report.
2. That Scrutiny Committee continues to receive reports every six months on the work of the Public Health and Wellbeing Board.
Reasons for the Recommendations
1. To increase awareness of this area of work.
2. To ensure effective scrutiny of key developments in the delivery of the Health, Social Care and Wellbeing Strategy.
2. Section 40 of the National Health Service Wales Act 2006 places a statutory duty on each local authority and each Local Health Board (LHB) to prepare a health, social care and wellbeing strategy (HSCWBS) for that local authority’s area.
3. The HSCWBS provides a framework within which the local authority and LHB set out how together they will:
drive forward improvements in the health and well-being of the local population;
strengthen the planning and management of health and social services; and
improve outcomes for those who use them.
4. The strategy must be agreed at the highest level within both organisations and the third sector is recognised as having a crucial role.
5. The HSCWBS has to comply with Welsh Government guidance but the detailed content and format and the way in which outcomes will be achieved are a matter for local discretion. The latest guidance required that the strategy for the three years 2011/12 - 2013/14 should focus more narrowly on two important areas:
improving the provision, quality, integration, and sustainability of ‘overlapping services’;
improving health and well-being and reducing inequities, that is inequalities in health that are unfair and avoidable.
6. To meet these new requirements, the structure of the Health, Social Care and Wellbeing Partnership was reformed to incorporate two new Boards: the Integrating Health and Social Care Services Board and the Public Health and Wellbeing Board.
7. In its role as community leader and given the range of services it provides, the Council as a whole has a central role to play in improving the overall health of the population. There is strong evidence that employment, education and lifelong learning, housing, planning the physical environment, keeping people connected, sustainable development, community safety and access to services are extremely important for improving health. The creation of a new Public Health Wales organisation and the developing locality model within the UHB (which is better linked to local networks) has provided opportunities for a more collaborative, more corporate and more planned approach to promoting healthy living and healthy communities in the Vale.
8. To take forward this work, the Vale of Glamorgan Local Service Board (LSB) agreed to sponsor the creation of a Public Health and Wellbeing Board (PHWB). The work of the PHWB will be guided by two key strategic documents. These are the Vale of Glamorgan Community Strategy and the Local Public Health Strategic Framework (LPHSF). Additionally, the Healthy Vale Communities Framework has identified improvement of public health as a key function within the Council and Cardiff and the Vale University Health Board (UHB). The Framework has identified as a priority three themes and related actions, with a focus on food and physical activity:
building capacity and skills for public health, both with staff and with individuals and groups in the community;
supporting those in the most disadvantaged areas; and
incorporating a public health dimension in planning, design and development of new communities.
9. The PHWB will be expected to provide strong leadership, set a strategic direction and provide a focus for work to prevent avoidable ill health or injury, lifestyle diseases and their determinants. Use of the evidence base and population needs assessment will underpin its work. The Board will provide a collaborative and integrated approach to the development and implementation of partnership and joint plans and ensure that resources are used effectively in improving the health and wellbeing of the local population. Terms of Reference for the Board (Appendix 1) and an organisation chart of the structures (Appendix 2) are attached to this report.
10. The PHWB reports directly to the Business Management Group for the Health, Social Care and Wellbeing Strategic Partnership and then to the Implementation Group of the LSB, with issues needing resolution at a more senior level being escalated to the LSB itself. The sub-groups and workstreams which report to the PWHB include the Food and Physical Activity Sub-Group, Smoke Free Vale and Heart Borough Vale.
11. The PHWB has delivery responsibility for relevant sections of the Community Strategy and the LPHSF (as it applies to the Vale of Glamorgan).
12. Membership of the Board is at a senior management and professional level from across the statutory agencies, partners and the third sector with the ability to:
scrutinise and challenge;
monitor outcomes via a clear performance management framework; and
transcend organisational boundaries and breaks down barriers where they are encountered.
Relevant Issues and Options
13. The PHWB held its first meeting in November 2011, with representation from Heads of Service in the Council, the UHB, the third sector and Public Health Wales. The Chairman of the Board is Dr Siân Griffiths, Consultant in Public Health. The following summarises the discussion at that first meeting.
14. The Board considered its role in the short, medium and long term. The priority for the Board will be improving population health in the Vale of Glamorgan, with a focus on delivering current plans. However, ensuring appropriate linkages with neighbouring local authority areas must be considered. Much is already in place and the Board will need to align its work with that of other partnerships, in order to minimise duplication.
15. The Board has a key role in overcoming obstacles and addressing gaps. Discussion identified that there are many potential areas for linking existing services to help the health prevention and promotion agenda in the short term. It was felt to be important to adopt the priorities of existing strategies and action plans and play a key role in facilitating their delivery. Therefore, food, fitness, tobacco and alcohol will be a key focus initially. The individuals who lead on these areas will be invited to present to forthcoming Board meetings. This will allow the Board to begin to identify any obstacles and gaps and consider how these can be addressed.
16. The Board is seen as a forum to facilitate change and deliver health improvement on the ground. It also has a role in providing oversight of the relevant strategies, plans and groups. It is proposed that a Results Based Accountability Framework will be utilised to develop exception reports.
17. All partners have staff members who interface with communities, often visiting people in their own homes. Through these contacts, each organisation has a significant potential to influence health and wellbeing, either via intervention or advice. It was suggested that a limited number of key messages could be developed which all partners could adopt and encourage staff to deliver. Suggestions included checking for the presence of smoke alarms or trip hazards or asking about smoking. These would need to be identified and developed by the partnership. Safeguarding was also identified as an important skill in these settings. Empowering staff and imparting skills and confidence was seen as key. All partners deliver a range of staff training. Sharing access to this training across the partnership may be a way of developing the skills of the combined workforce and developing their understanding of their public health role (as proposed in Healthy Vale Communities).
18. The Board is initially meeting on a monthly basis. It has considered already planned actions in respect of tobacco and food and physical activity. An additional sub-group has been created to consider alcohol misuse in more detail. The Board has directly improved the sharing of information and the development of links between services. For example, it has:
assisted the Vale Community Safety team by providing additional data on the prevalence of alcohol misuse and by ensuring better linkages with Primary Care services;
prompted a more detailed proposal with respect to the development of smoke free playgrounds in the Vale.
Resource Implications (Financial and Employment and Climate Change, if appropriate)
19. There are no direct financial, staffing issues or climate change issues for the Council anticipated as a result of this report. The work of the Board may influence these in due course.
Legal Implications (to Include Human Rights Implications)
20. There are no legal implications arising directly from this report. The Board will exercise management control of the overall public health programme without affecting current executive and scrutiny arrangements for Council services in the Vale of Glamorgan.
Crime and Disorder Implications
21. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
22. There are no equal opportunities implications arising out of this report. However, the Council will need to take these issues into account when considering any future changes in services as a result of recommendations from the Board.
23. The key objective of the Council addressed by this report is "To make the Vale a safe and healthy place in which individuals, children and families can live their lives to the full".
Consultation (including Ward Member Consultation)
Relevant Scrutiny Committee
25. Social Care and Health.
Lance Carver, Head of Adult Services / Locality Manager
Philip J. Evans, Director of Social Services