To receive and if so determined, to approve as a correct record the Minutes of the meeting held on 17 November, 2023.

RESOLVED: That the minutes of the meeting held on 17 November 2023, were approved as an accurate record.

Members to give notice of any interest and the nature of that interest relating to any item on the agenda in accordance with the adopted Code of Conduct.

Councillor Brophy declared an interest regarding employment by Manchester Foundation Trust.

To update the Board on progress made against the identified physical activity priorities.

Jamie Lees, Head of Leisure, Trafford Council, gave a power point presentation which is attached to the agenda, in respect of Physical Activity in Trafford. He wanted to draw attention to the progress in physical activity since the deep dive in July 2022. He reminded the Board of the three key priorities which have been agreed and are as follows –

(1) Produce a dataset that enables strategic conversations around physical activity benefits, challenges and drivers, and reflects differences within and between neighbourhoods.

(2). Ensure that physical activity and healthy weight data and insights are fed into the neighbourhood plans and enable production of place-based physical activity plans.

(3). Develop neighbourhood active travel plans that include key evidence-based actions, and are completed alongside neighbourhood plans.

With regard to (1) above he drew attention to the Active Lives Survey shown on page 13 which gives a platform and a rich dataset. This year the sample size is 1000 people which allows more detail in the trends to draw upon. He referred to the following percentages from the survey (page 13 refers) –

• Active 68 %
• Fairly Active 8%
• Inactive 24%

Details of the above are set out in the report including the numbers of residents aligned to the above criteria. He informed the Board that adult activity in Trafford is at an all-time high. In terms of inactive adults this had not decreased since the Pandemic.

The ‘Be Well’ Survey is also utilised to understand activity levels of children and young people, and is carried out by Manchester University which the Council supports and that survey is broken down into localities and neighbourhoods.

He drew Members attention to the demographics of those inactive adults (page 14 of the report refers) which show that the black and Asian community have increased against the white, white other and mixed communities. Inactivity for men has reduced but women’s inactivity has remained static throughout the year (page 15 of the report refers). The pandemic disrupted the reduction in inactivity for adults, with those adults with a limiting illness showing a higher inactivity rate against those without a limiting illness which has fallen. Inactivity in deprived households remains high (pages 16 and 17 of the report refers). To emphasize this those adults in lower social economic groups are more inactive than those in the higher groups and that gap is growing.

Members were informed that the report also draws upon other datasets to give a more detailed picture. These are

• Trafford Leisure Operating agreement
• Holidays Activity and Food Programme
• Travel Dataset

With regard to Priority 2 and the place-based physical activity plans he emphasised that there is not one plan for this priority but that it is a collection of approaches and programmes that support what we are trying to achieve. These approaches and programmes are set out on pages 19 – 23 in the report. It was emphasised that the place-based approach dovetails with the Neighbourhood programme: both of these work with local communities and  ...  view the full minutes text for item 32.

To consider a report sets out the draft approach for the curation of the Locality Plan refresh, incorporating the Trafford Health and Wellbeing Strategy and outlines the parallel process of curating the Trafford Delivery priorities for 2024/25.

Thomas Maloney, Programme Director Health and Care, Trafford Council/NHS GM presented a report  which sets out the draft approach for the curation of the Locality Plan refresh, incorporating the Trafford Health and Wellbeing Strategy and outlines the parallel process of curating the Trafford Delivery priorities for 2024/25. The report covers the rationale, programme governance, ways of working, stakeholder management and outline content creation.

Thomas Maloney advised that there may be repetition of information from previous presentations but there is new detail within this presentation which will encourage a deep discussion on the refresh of the Locality Plan. He reminded Members that the aim is to create one plan for health, care and wellbeing in Trafford by integrating the existing Locality Plan aspirations and the Health and Wellbeing Strategy. He made reference to the aim and rationale of the refresh as detailed on page 4 of the presentation. He emphasised that there are a number of key drivers for change and referred to the missions of the ICP Strategy regarding stronger communities and helping people to stay well and detecting illness earlier, which are fundamental to the existing aspirations of the Locality Plan. He informed the Board that the Social Model of Health and Care is a long standing commitment in Greater Manchester and that the system is built based on a preventative model for health and care. Working in parallel to the Model is the GM Joint Forward Plan which includes a comprehensive Prevention and Early Intervention Framework The GM JFP contains over 160 actions phased over the 5 year life course of the GM ICP Strategy. More detail on these actions are shown on page 10 of the presentation. There are a large number of strategies and page 6 of the presentation shows a number of these and importantly they drive the work going forward. He referred to the Greater Manchester Operating Plan and Local Delegated Responsibilities which are set out on page 7. There is an Agreed comprehensive Prevention and Early Intervention Framework as part of the Joint Forward Plan and some of the detail is set out on page 8 of the presentation. He emphasized the need to do the best we possibly can and the need to strengthen our approaches and indeed identifying areas for improvement this being one of the key drivers in the refresh. In distilling all the information he has drawn together and distilled a number of areas showing key ‘Drivers for Change’ that will impact and what the Board decides on a set of priorities for 2024-25 and provide a basis for the longer term aspirations of the Trafford Integrated Care Partnership as shown on page 11 of the presentation.

The Greater Manchester ICP approach to planning has started earlier than usual and the aim is to complete the 2024-25 plan by the end of March. Key dates are set out on page 13 and more detailed timetables will be shared with localities. Details of the approach to planning are set out  ...  view the full minutes text for item 33.

(a)  Quarter 3 Report Submission (Verbal)

To seek approval from the Board to submit the Quarter 3 BCF Report to the Better Care Fund Central Team and Better Care Fund Manager by the deadline of 9^th February 24.

a)    Changeology Support Proposal

To ask the Board to support the proposal outlined in the paper which focuses on a review of demand and capacity bed requirements following the introduction of IMC at Home, and our current contracting and delivery model.

The Chair has agreed that these items be taken as urgent matters.

Nathan Atkinson, Corporate Director Adult and Wellbeing, presented a report regarding the Better Care Fund – Changeology Support Proposal.

In July 2023, Trafford resubmitted its Better Care Fund Plan for 2023/24, and supporting narrative to NHS England, following a required set of revisions from an earlier submission in June 2023. This was shared and retrospectively approved by Trafford’s Health and Wellbeing Board on 14th August, 2023 and Trafford received formal approval letter from NHSE. Trafford’s Q2 submission was accepted by the national BCF team and retrospectively signed off by the Health and Wellbeing Board in October 2023.

As part of this process, an offer of support from BCF Changeology Team was made, in the form of a deep dive into a challenging service or system issue, which is funded via the Better Care Fund. This is a time limited offer, with a maximum of 5 sessions (full days).

As the funding of Ascot House represents a significant proportion of Better Care Programme, and in light of the ongoing financial, contracting and delivery challenges it is proposed that this offer of support forms part of our ongoing Intermediate Care Review.

This report outlines the aims of this proposal which includes a review of our demand and capacity bed requirements following the introduction of IMC at Home (Pathway 1 D2A team within Trafford Community Response Service), and our current contracting and delivery model. This will provide external expertise to inform future decision making, in a politically and financially challenging service area.

RESOLVED: that the Board

(i)             notes the content of the report.

(ii)            provides system support and approval for this proposal.

(iii)          provides commitment by each partner organisation to engage with the project. Provide commitment by each partner organisation to engage with the project; and

(iv)          approves the submission of the Quarter 3 BCF Report to the Better Care Fund Central Team by the deadline of 9 February 2024.

The report supports the Health and Wellbeing Board in understanding their statutory obligations around Joint Strategic Needs Assessment. In doing so to discuss the benefits, challenges and methodological considerations of needs assessments and to highlight existing and ongoing needs assessments and elicit feedback from the Health and Wellbeing Board around potential future priority topics.

The Board considered a report submitted by Helen Gollins, Director of Public Health, and Kate McAllistair, Principal Public Health Intelligence Analyst, regarding the Health and Wellbeing Board’s role in understanding and responding to our population’s needs regarding Joint Strategic Needs Assessment.

The report set out each of the following (detail on pages 39 to 49) –

·       Assessing and Understanding our population needs.

·       A Joint Strategic Needs Assessment (JNSA) is a Statutory requirement that local authorities must meet.

·       Definition of a JNSA.

·       The need for a JSNA.

·       How a Needs Assessment is carried out (further detail will be brought to a future Health and Wellbeing Board meeting).

·       Categorising the population into the levels of need.

·       How the population is identified.

·       Considerations when carrying out a Needs Assessment.

·       Opportunities and Benefits.

·       Challenges.

·       Existing / Forthcoming Needs Assessments in Public Health 2024-25

In terms of Forward Planning the aim is to develop a work plan for Needs Assessment activity for the next 12 months, with quarterly progress reviews.

Richard Sterling, Managing Director of Trafford LCO, was of the view that the neighbourhood networks would be a good place to take information from and to cross check that with what the community sector is saying which will show the areas that need help in terms of the Plan.

Nathan Atkinson, Corporate Director of Adults and Wellbeing, echoed the points made by Richard Sterling and drew attention to the various types of neighbourhoods within neighbourhoods and recognising inequalities and taking on board that communities have changed, and that Trafford is more diverse than it has ever been in terms of communities.

Sara Todd, Place Based Lead, Trafford, reinforced the previous points made that they now have some fantastic data place wise in terms of communities identities for example ethnic diversity and disabilities.

In response to a question around population needs unmet such as long term needs such chronic fatigue form covid, in other words invisible groups so how do we find out data about these groups, Helen Gollins advised that we would start by looking at national produced evidence at what we would expect to see in the population and taking account of organisations who support people in the communities and this data would support the needs assessment.

Thomas Maloney echoed the previous points raised and emphasised that the organisations and data resources that are available are phenomenal. It is about having the staff to use those resources to be fundamental to help strengthen and update our needs assessments.

Richard Sterling drew attention to the challenge for our partner organisations as to how we put this into our organisational plans and it would be a challenge for the Board.

RESOLVED: That

(i)       the report be noted; and

(ii)       the methods of travel in terms of progressing Needs Assessments for the population of Trafford as set out in the report and presentation together the points put forward by Board Members be endorsed.

Note: The Chair made reference to the fact that this would  ...  view the full minutes text for item 35.