Agenda item

To be presented by Dr Jane O’Grady, Director of Public Health and Katie McDonald, Health and Wellbeing Lead Officer.

The Health and Wellbeing Recovery Plan is part of Buckinghamshire’s 3R’s recovery framework and the oversight for planning and delivery of this action plan sits with the Health and Wellbeing Board.

Related Joint Health and Wellbeing Strategy Priority:The Health and Wellbeing Recovery action plan supports the delivery of the priorities (start well, live well, age well) set out in the Joint Health and Wellbeing Strategy refresh, Happier Healthier Lives – A Plan For Buckinghamshire.

Recommendations:

• The Health and Wellbeing Board is asked to receive an update on the Health and Wellbeing Recovery plan and the plans for publication of the Joint Health and Wellbeing Strategy in early 2021 at the meeting.
• The Health and Wellbeing Board is asked to approve the action plan for year one included in this report.
• Health and Wellbeing Board members are asked to commit to delivering the action plan and provide regular updates to the board on progress.
• The Health and Wellbeing Board is asked to receive an update on two priority areas. Keeping residents healthy (supporting healthy behaviours) and Promoting Mental Health and Wellbeing at the meeting.

Dr Jane O’Grady, Director of Public Health, provided a presentation (slides 1-12), appended to the minutes, and highlighted the following key points:

• The data covered the period 29 November to 5 December 2020.
• Buckinghamshire was in tier 2; the tier level was due to be revised on 16 December 2020 as legislation stated that tiers were reviewed fortnightly. 
• The tier level was determined by the all ages weekly infection rate; the over 60s weekly infection rate; test positivity; trend and rate of growth; hospital pressure and other local factors.
• Slide 3 provided the weekly detection rates and tiers; locations on the dotted line were where the case rate had remained the same; a location above the dotted line indicated that rates had fallen; locations shown below the dotted line were where rates had increased.  The distance of the location from the dotted line indicated the level of increase or decrease. 
• Slide 4 showed the impact of the second lockdown on Buckinghamshire.  A reduction in the number of cases would have been expected until 9 December 2020; however, the cases started to increase before the end of the lockdown.  Buckinghamshire had entered and exited lockdown at almost the same level; lockdown had worked but the key message was that cases were already on a steep incline and there was concern that the rates would escalate dramatically.
• Slides 5-8 showed the rates for the legacy council areas. 
• Slide 9 was a ‘heat map’; the darker the purple colour the higher the rates. 
• The excess deaths had crept up in weeks 47-48.
• There was a new interactive website which provided the data – visit www.buckinghamshire.gov.uk/covid-dashboard.

Katie McDonald introduced the Health and Wellbeing Recovery Action Plan which had been included in the agenda pack and was part of the wider Buckinghamshire Plan; there were ‘three R’s to recovery’ – reset, restore and resilience.  K McDonald explained that the Health and Wellbeing Board (HWB) had oversight of the recovery plan which set out the framework for Buckinghamshire in terms of the social, economic and environmental challenges which had occurred from the COVID-19 pandemic.  At the start of the year, the HWB had started developing its Joint Health and Wellbeing Strategy Action Plan and the Board agreed that it would align its first year of delivery with the Recovery Plan, therefore the action plan linked across with the Integrated Care Partnership recovery plans.  K McDonald emphasised that the action plan was at a draft stage and encouraged further input from partners before it was published in the New Year. It had been agreed that the HWB would be presented with a different section of the plan at each meeting in order to monitor the success of the action plan.  K McDonald asked the HWB to support the action plan; a revised version would be circulated in the New Year.

Sarah Preston, Public Health Principal, provided a presentation (slides 13-16), appended to the minutes, on two healthy behaviours actions that were included in the year one action plan.

Food Poverty, Grow to Give – this community led project, developed as a result of Covid, enabled surplus fruit and vegetable produce from allotments and back gardens to be donated to support food banks and community fridges; approximately 1.5 tonnes of produce had been donated this year.  Funding was being provided to enhance and expand the community project, developing the infrastructure for sustainability and helping volunteers build skills and connections so the surplus food could continue to be shared once the funding ends.  A number of allotments in priority areas across the county would be given focused support and the provider would also develop and promote resources to support any community in Buckinghamshire who wanted to grow to give. S Preston asked the HWB for support to help promote the project once the growing season started in 2021.

Community Food Growing and Cooking – to support communities across Buckinghamshire to develop sustainable community-led growing and cooking projects with a focus on growing and cooking on a low income.  It wouldl be a countywide offer with intensive support in the communities with the highest poverty levels (High Wycombe, Aylesbury, Buckingham, Chesham and Wexham and Iver West).  All communities in Buckinghamshire would be able to access online tool kits, resources, support and training to help set up community growing projects.  Expert gardeners would support a network of volunteers to develop the growing sites within their communities with funding and starter kit to set up sites in the priority areas.  Initially, the focus would be on the growing element; the cooking element of the project would be developed during 2021.  S Preston asked the HWB to identify communities and volunteers who might be interested as well as any potential growing sites and existing projects that were already underway to ensure they were linked up and to avoid duplication.

A Community Approach to Reducing Sedentary Behaviour - Covid-19 had increased sedentary behaviour by approximately 30%.  This project aims to promote achievable, sustainable and long-term behaviour change to help people build new habits and reduce sedentary behaviour.  As a by-product it would increase physical activity, particularly for those who would not consider getting more active in any other way.  The project would work closely with local residents and stakeholders to develop, promote and sustain the project and ensure it was relevant, accessible and culturally appropriate for the communities involved.  It would be delivered in a Covid secure way and embedded in local assets e.g. schools, care homes, parks, GP practices and retailers and be tailored for each asset.   Home packs would be available for the socially isolated and housebound residents.   All the different elements would be joined up with a community approach as the more places people hear the messages the more likely it was that they would take action and start building changes into their everyday routine.  Pilot locations had been identified in High Wycombe and Aylesbury and the pilot project would be tested and evaluated.  S Preston asked for engagement and support from the HWB to promote the pilot and engage key assets.

Whole Systems Approach to Obesity - Excess weight was one of the modifiable risk factors in Covid-19; obesity is a complex issue which required input from a wide range of stakeholders to make a difference.  The Public Health England Framework had set out a cyclical process to follow a number of phases starting with building the local picture, mapping the local system, followed by collaborative action planning and prioritisation in order to develop and manage a system network which would be regularly reviewed and refreshed to ensure it was effective. It would be a long-term project with short, medium and long-term actions to address obesity levels across Buckinghamshire.  The process would start in January 2021 and S Preston asked for the HWB’s support.

The following points were raised in discussion:

• Katie Higginson, Chief Executive Officer, Community Impact Bucks, was fully supportive of the projects and emphasised that they would reduce social isolation and address food poverty.  It was agreed that S Preston would attend a Voluntary Community Sector Recovery Board meeting to cascade the message to volunteers.
• Following a suggestion that the growing and cooking project could be linked into primary schools; S Preston stated that this would be considered for every growing site developed.  In the first phase a growing site in school grounds was unlikely due to covid restrictions, however, this would be considered in the future.
• In response to a question on the duration of the funding that was being provided; S Preston advised that, initially, most of the projects were currently funded for the first year with some funding to support sustainability in the second year.  All the projects would have sustainability built into them from the start as well as providing support to communities to identify new funding opportunities if required to support their community led projects.
• S Preston confirmed that discussions were taking place with the Community Boards to identify land for growing sites and engage target communities.  It was suggested that the Parish Councils be contacted to find out if there were any unused allotments.

Promoting Mental Health and Wellbeing in Recovery - Louise Hurst, Public Health Consultant, provided a presentation (slides 17-21), appended to the minutes.  The Covid-19 pandemic had impacted the mental wellbeing of people of all ages resulting in an increase in demand for mental health services.  As well as the impact on people’s mental health for those who had had Covid-19 or lost family and friends due to the virus, there had also been the challenge of dealing with the lockdown and the economic shock that had to be faced going into recovery.  A new way of working was developed early in the pandemic and a strategic group, co-chaired by Louise Hurst and Donna Clarke, Oxford Health NHS Foundation Trust, was set up and included representation from the CCG, Primary Care, BHT and the VCS.  The Mental Health Strategic Group had been established and now worked alongside the active VCS Response Group which had helped identify the vulnerable groups and develop the priorities.  There had been a number of key achievements across Buckinghamshire since the start of the pandemic, the continuation of which formed part of the action plan.

Debbie Richards, Managing Director, Oxford Health NHS Foundation Trust, added that a huge amount of work had been carried out across the system.  D Richards provided an update on the mental health helpline which was a free phone number with mental health professionals based in the 111 control room.  It was a ‘One Stop Shop’ and since it was launched almost 4,000 callers had accessed support.  The Oxford Health website contained a large number of self-help resources and easy to read materials that had been developed with service users and carers.   Partners in MIND were working in partnership with Oxford Health on the safe havens and a large amount of work was being undertaken to support callers to cope with the second wave. 

The following points were raised in discussion:

• Dr Juliet Sutton reported that admissions for respiratory illnesses in children had decreased but there had been an increase in the number of admissions of children with mental health issues.  There was a feeling of extreme tiredness across the workforce, resilience was low and the workforce needed to be looked after.
• It was noted that there was a lack of awareness by staff in care homes of the wider mental health support that was available.  A weekly newsletter was sent to all the care homes in Buckinghamshire and had previously signposted staff to the mental health resources and it was agreed that the information should be included again.
• The phone numbers for the 24/7 mental health helpline were provided:  Adults: 0800 783 0119 or 01865 904 997
  Children and young people: 0800 783 0121 or 01865 904 998.
• A member of the Board emphasised that it was a collaborative effort and the mental health services had been provided throughout the pandemic; access had increased and repeated communication was needed to cascade the message.

RESOLVED:  The Health and Wellbeing Board:

·         RECEIVED an update on the Health and Wellbeing Recovery plan and the plans for publication of the Joint Health and Wellbeing Strategy in early 2021 at the meeting.

·         APPROVED the action plan for year one included in the report.

·         COMMITTED to delivering the action plan and provide regular updates to the board on progress.

• RECEIVED an update on two priority areas. Keeping residents healthy (supporting healthy behaviours) and Promoting Mental Health and Wellbeing at the meeting.