Agenda and minutes

Apologies were received from Liz Robin, Antoinette Jackson, and Mark Freeman.

This is an opportunity for members of the public to ask a question or make a statement to the Partnership. Please refer to the Public Participation section at the end of this agenda.

There were no public questions.

To approve the minutes of the meeting held on 3^rd July 2014.

The minutes for the meeting of the 3^rd July 2014 were agreed as a correct record.

Wendy Quarry, Joint Strategic Needs Assessment (JSNAs) lead for Cambridgeshire Public Health will outline the main findings from recent JSNA reports that include:

Final JSNA Report - Carers 2014

Final JSNA Report - Older People's Mental Health 2014

Final JSNA Report - Primary Prevention of Ill Health in Older People 2014

And will seek the views of members about issues for future JSNAs.

A paper showing the findings of the above reports, for background, is attached.

The Partnership received a presentation from Wendy Quarry, the Joint Strategic Needs Assessments (JSNAs) lead for Cambridgeshire Public Health regarding JSNAs for, Carers, Older People’s Mental Health 2014 and Primary Prevention of Ill Health in Older People 2014.

The Committee made the following comments in response to the presentation:

     i.        The inclusion of air quality and transport  as the subject of future JSNAs was welcomed.

    ii.        Suggested that transport was not just an issue for rural communities.

   iii.        Endorsed the initiatives involving Carers and suggested they were an undervalued resource.

In response to Members of the Committee Wendy made the following statements:

  iv.        A scoping and strategic planning summit of key players involved with the production of JSNAs was planned to improve service linkages and assist cost effective interventions.

   v.        A forward work plan was being developed and suggestions from the Partnership for themes for additional JSNAs would be helpful.

The Partnership welcomed the work done on the JSNAs and looked forward to progress reports at a later date.

Jill Eastment, Public Health Analyst at Cambridgeshire County Council, will provide some additional information to the Public Health Outcomes Framework indicators, households that experience fuel poverty and hip fractures in people aged 65 and over, that members asked for at the last meeting.

A background paper is attached.

The Partnership received a report and a presentation from Jill Eastment, Public Health Analyst of Cambridgeshire County Council regarding the issues identified by members from the Public Health Outcomes Framework. She highlighted the following points:

     i.        The data for falls and hip fractures did not break down numbers sufficiently to see where the falls where occurring (home environment or in the street) or patients who lived in care homes.

    ii.        An ongoing study is looking at seasonal variations and comparing neighbouring authorities.

   iii.        There were variation across the city wards but they were not statistically significant.

  iv.        She highlighted the high number of those aged 80 and over living in Cambridge which was higher than the national average.

   v.        More work was underway on a Falls Prevention Strategy.

  vi.        Basic information on fuel poverty was included.

The Partnership made the following comments on response to the report:

 vii.        Councillor Roberts welcomed the report and stated that Cambridge City Council was looking at ways that social housing and open spaces could be improved to aid falls prevention work.

viii.        The Partnership noted that the fuel poverty mapping did not match other patterns of deprivation across the wards. It was suggested that there were a number of asset rich, cash poor, older people living in large, hard to heat, houses in affluent wards, which could be the reason for the variation.

In response to questions from the Partnership Jill Eastman stated the following:

  ix.        Older City Council tenants had highlighted footpaths as a high priority but the data on where falls occurred was not easy to access.

   x.        Fuel poverty estimations were based on the age of the property and the data was unclear and not up to date.

Jill Eastman undertook to circulate her presentation to the Partnership.

Kate Parker gave the Partnership an update on the Winter Warmth campaign. “Winter Health Packs”, that have information about keeping well in the winter months and local support services, will be used to launch the campaign in October. These have been developed and provided by Public Health to GP practices for distribution to vulnerable patients when they attend for their flu vaccinations. Jas Lally suggested that City homes could promote this work.

Councillor Roberts undertook to forward the presentation findings about falls and footpaths to Councillor Blencowe to see if there were any opportunities for pavement improvements.

Health and Wellbeing Board

The last meetings of the Health and Wellbeing Board were on:

·        11 September 2014 where progress with a Better Care Fund was discussed. New guidance recently issued by Central Government requests that plans be resubmitted by 19th September 2014. These are to be signed off by Board Members. Papers can be found here - http://www2.cambridgeshire.gov.uk/CommitteeMinutes/Committees/AgendaItem.aspx?agendaItemID=10274

·        2 October 2014. Papers can be found here –

http://www2.cambridgeshire.gov.uk/CommitteeMinutes/Committees/Meeting.aspx?meetingID=940

          The agenda includes:

i.             Domestic Abuse Strategy Report

ii.            Children Safeguarding Board Annual Report

iii.           NHS England Strategy item

iv.          CCG  Commissioning Intentions

v.           JSNA Transport & Health Briefing Paper

The partnership noted the updates from the Health and Wellbeing Board as detailed in the agenda.

The meeting of the 11 September of the Health and Wellbeing Board had raised concerns over future funding cuts.

The meeting of the 2 October had looked at on-going issues and highlighted the following:

     i.        The prevalence of Mental Health issues and dual diagnosis.

    ii.        The role of carers and how best to support them.

   iii.        Transport links to health facilities and alternative access solutions, against a backdrop of cuts.

  iv.        The good work achieved regarding the improvements in Autism diagnosis but fears of diagnosis creep.

   v.        The impact of further NHS re-organisation on services.

  vi.        Funding for CCG commissioning strategies.

Jo Dicks, Cambridge City Council lead officer for action on energy, will provide a view on the extent of fuel poverty in Cambridge and outline some of the local schemes being delivered through partnerships that are looking to improve energy efficiency. Jo will also discuss with members opportunities for the health sector to assist this work.

In particular the presentation will cover:

·        Who are our target groups and communities

·        How we can assist our target groups

·        What is our current and potential future funding streams

·        What will the shape of our future partnerships and engagement be like

The Partnership received a report from Jo Dicks, Cambridge City Council lead officer for action on energy. Work on utility poverty was at an early stage of development. Early evidence supported the links between, low income, cold homes and poor health. It was noted that a quarter Cambridge households had an income of under £15,000 per annum.

Energy bills were related to property efficiency and how occupants used the property. Once areas of poverty had been defined, targeted action would follow. Social housing was generally of a good standard. However, private rented properties had not enjoyed the same level of energy efficiency upgrades. Also, there were thought to be high numbers of older, vulnerable owner occupiers living in properties they could not afford to upgrade.

A Fuel and Poverty Action Plan was being developed and it should be in place by the end of December. The scope for interventions would be from the low level, such as replacement light bulbs, to a large scale retrofit. Some contribution would be required from the householder. Clear referral pathways from health groups were under consideration. Funding options were being explored  for longer-term work.

In response to questions from the Partnership Jo Dicks stated the following:

     i.        Initially, simple solutions to utility poverty would be explored.

    ii.        Contacts with care providers would be looked at later on.

   iii.        There were insulation solutions available for solid wall properties in conservation areas.

i.          Update on discussion at the last meeting about how local advice services can contribute an improvement in well-being locally. A proposal is being prepared for piloting an outreach CAB advice session at East Barnwell practice. Rachel Talbot, Chief Executive of Cambridge CAB will be in attendance to discuss this developing project and to seek the views of members.

The Partnership received an update from Rachel Talbot regarding the discussions of the last meeting concerning outreach work, by the Citizens Advice Bureau in East Barnwell GP surgery.

A one year, pilot project was proposed. Staff would be on site for three days a week and would offer advice to patients with the aim of saving GP time which is currently used to offer non-medical services and providing a better service. The time saved would be monitored.

The partnership discussed adding a social tariff to water charges and Jo Dicks agreed to discuss this with Councillor Owers.

The face to face service would offer financial advice, early intervention for debt issues, and education on fuel spending. GP at the surgery welcomed the initiative. The results of the pilot would be monitored and it was hoped it would demonstrate an economic as well as a social value.

The Partnership discussed various ways of providing robust data from the pilot. Suggestions included the following:

     i.        Measure against similar work done in Rotherham.

    ii.        Invite a research university to monitor the work (Cambridge University, Essex University, Norwich University)

   iii.        Invite Councillor Herbert, Councillor Johnson or Councillor Owers to suggest suitable university contacts.

Jas Lally undertook to arrange bring people together outside the meeting to agree a way forward.

29 January 2015 at 12 noon in the Guildhall.

The Committee noted the date of the next meeting: 29^th January 2015.