Agenda and draft minutes

To receive any apologies for absence.

Apologies were received from Dr Berge Balian, Judith Goodchild, Alyn Jones, David McClay, and Steve Taylor.

To receive and note any declarations of interests in respect of any matters included on the agenda for consideration at this meeting.

(The other registrable interests of Councillors of Somerset Council, arising from membership of City, Town or Parish Councils and other Local Authorities will automatically be recorded in the minutes: City, Town & Parish Twin Hatters - Somerset Councillors 2023 )

Cllr Bill Revans declared an interest in South West Ambulance Service (SWAST) as his son works as a paramedic for SWAST.

Resolved that the minutes of the meeting held on 14^th December 2023 be confirmed as a correct record.

The Chair to advise the Committee of any items on which members of the public have requested to speak and advise those members of the public present of the details of the Council’s public participation scheme.

For those members of the public who have submitted any questions or statements, please note, a three minute time limit applies to each speaker and you will be asked to speak before Councillors debate the issue.

No public questions were submitted.

Jonathan Higman, CEO NHS Somerset ICB, introduced the Joint Forward Plan, which demonstrated links to the Improving Lives and Integrated Health and Care Strategies. He explained the process of developing it and the ongoing public engagement and highlighted several key areas such as the Homeless Health Programme, partnership working on hypertension, and work with the armed forces.

The 5 priorities for the next 3 years are as follows:

• Finance and Resource Allocation
• Workforce
• System Flow
• Integrated Neighbourhood Working
• Population Health Transformation

During the discussion, the following points were raised:

• The importance of housing and health work and discretionary housing payments for people with complex support needs.
• Childhood obesity in Somerset and the complexity of tackling social issues like obesity.
• The need to plan long term activities and think about 30 years in the future
• The importance of both short term and long-term goals.
• The impact of active travel on the health and wellbeing of the local population
• The need to be mindful of green and alternative travel plans, bus routes and accessibility when considering the positioning of treatment centres.
• The importance of not using a cookie cutter approach when working with local communities
• The importance of preventative work for substance misuse
• The need to ensure there are pathways into mental health with the Lighthouse Victim Support programme specifically mentioned.

When considering obesity, need to look at how we feed ourselves at a population level, considering what is provided in food banks, food deserts, and where there may be particular disadvantages.

Lou Woolway, Deputy Director (Service Director) of Public Health Somerset Council, presented on this item, explaining how this needs to fit into other strategies and policies as they are developed, the statutory duty for this strategy sitting with the Integrated Care Partnership element of the Somerset Board, and the strategic aims. Work to date has been led by senior colleagues from the Integrated Care Board, Somerset Foundation Trust and the Council. She also highlighted the importance of measuring outcomes rather than process measures.

During the discussion, the following points were raised:

• It’s important to link outcomes that all parts of the health and care system have to tie this work together.
• There will be a new performance framework for the Somerset Board linked to this work
• The importance of tackling inequalities for all public sector organisations.
• This strategy and the Improving Lives strategy need to sit on top of all other strategies being developed.

Alice Munro, Consultant in Public Health Somerset Council, and Mark Leeman, Specialist Housing Strategy Somerset Council, explained the ongoing work around Housing and health a priority work programme for the Board. 

Health Impact Assessment in planning, Homelessness and Rough Sleeping, and Independent Living have been the key areas of development. They highlighted how housing impacts on physical, social, and mental health and the evidence gathered to support that, as well as the pressures on housing in Somerset. They asked the Board what areas they wanted covered at a future workshop on this topic.

During the discussion, the following points were raised:

• The importance of involving planning in this work and inviting them to the next workshop.
• Reducing inequalities and highlighting where people are stuck in the system.
• The lived experience of homelessness and the complex causes of it and the need for investment for all ages.
• How the Local Plan which is currently under development will feed into this work, ensuring appropriate housing for the aging population.
• The importance of adaptable homes.
• The need for data in order to plan long term, for 30-40 years ahead
• Concern about how many households with children in them living in substandard accommodation
• Highlighting the link between people with experience of the care system and homelessness – 25% of national homeless population have experience of the care system.
• The importance of services for right now as well as prevention.
• The need to focus on practicalities and not repeat conversations.
• There is ongoing work with the Youth Alliance, funded by the ICB, looking at barriers to housing.
• The need to consider how we can learn from other programmes of work
• There is also a need to look at insecurely housed people and the challenges with Local Housing Allowance.
• Section 21 evictions are concerning, as are the 10,000 people waiting on Homefinder.
• Possibility of including Housing Associations and seeing what they are doing.
• The evolving situation on Nutrient Neutrality in Somerset and how that impacts housing.

The link between homelessness and serving in the armed forces, and whether there is any data on that.

Bernie Marden, Chief Medical Director NHS Somerset ICB, presented on behalf of David McClay, explaining the ongoing work around this.

Following the workshop for Board members in March work is progressing in this area and the ICB have recruited a senior staff member to take this work forwards.

During the discussion, the following points were raised:

• An integrated system which allows for shared data and intelligence needs to be the biggest priority.
• This is the most difficult issue in the county and the Board in its previous format has been promoting this agenda for a significant amount of time.
• There is a need to make sure all the things we are currently using are included so that we are not reinventing the wheel.
• A request to include it on the next agenda.

Jonathan Higman, CEO NHS Somerset ICB, introduced this item, and then handed over to Sara Skirton, Service Director for Partnerships and Localities Somerset Council, explaining the need for consistency in approach and creating a climate for resilient communities to develop in Somerset and a framework that enabled people to innovate. There was a request for Board Members to make personal pledges on local communities.

The Board were keen to support this.

There was a request for Senior Responsible Officers for each of the Board priorities. Members of the board volunteered and it was agreed that the SROs for each priority would be as follows:

Housing: Mel Lock, Executive Director Adult Services – Somerset Council, and Cllr Sarah Wakefield, Lead Member for Adult Services.

Integrated Health and Care Strategy outcomes and metrics: Duncan Sharkey, CEO of Somerset Council, and Cllr Heather Shearer, Lead Member for Children, Families and Education.

Shared Data and Intelligence: Paul von der Heyde, Chair – NHS Somerset ICB, David McClay, Chief Officer for Strategy, Digital, and Integration – NHS Somerset ICB, in absentia.

Shared Approach to Neighbourhoods and Localities: Ewan Jones, CEO – Somerset Association of Local Councils, Katherine Nolan, Chief Executive – Spark Somerset, and Jonathan Higman, CEO - NHS Somerset ICB, Claire Winter – Executive Director Children Families and Education – Somerset Council.

There were no comments on the written briefings.