Agenda item

This report summarises discussions at a recently held workshop for the Health and Wellbeing Board, facilitated by the Local Government Association (LGA), the purpose of which was to develop the work of the Board and enable it to become more effective.

The report also proposes a series of changes to the way the board operates, emerging from those discussions, to be agreed by members at today’s meeting.

 The report was presented by the Director of Public Health who advised that this item had deliberately been allocated a significant amount of time on the agenda because it was intended to set out how the board would function in future years. He noted that the report built upon a private developmental workshop attended by board members and that this was the first time they had been able to discuss this in public.

He stated that in consultation for the workshop, the Local Government Association (LGA) had advised the board not to lose sight of key objectives, and he therefore intended to break down where the city was against these:

·       Healthy life expectancy had been declining, particularly over the past 5 years (males by 4.4 years, females by 4.9). England as a whole was experiencing a similar trend, but York’s trend was sharper.

·       There was a 10-year life expectancy gap between the wards of Westfield (76.1 males/80.6 females) and Copmanthorpe (87.1 males/91.8 females).

·       Adolescent mental health had also been declining, benchmarking lower than the national average for happiness and with 4,225 children and young people accessing community mental health services, half of whom were required to wait over 12 weeks.

He drew the board’s attention to the wording of its 10-year Joint Health and Wellbeing Strategy (JHWS); that “York will be healthier and this health will be fairer in 2032 than it was in 2022”.

He outlined that the LGA had interviewed Health and Wellbeing Board members in February, and the following conclusions had been reached:

·       Reducing health inequalities remains the perceived central purpose of the York HWBB.

·       York benefits from strong partnership relationships and good will across organisations.

·       The HWBB has the potential to play a stronger strategic leadership role in the system.

·       Lived experience and community voices are vital to shaping effective policy.

·       There is support for reviewing how the board works to maximise its impact.

·       There is an opportunity to consider evolving the HWBB so it becomes a more focused, influential and community connected forum.

He discussed the changes to the model of an effective Health and Wellbeing Board proposed by the LGA, with increased focus on neighbourhoods, partnership, impact and collaboration. He also highlighted areas identified by the workshop as needing to be “stopped”, “started” and “sharpened”.

The resulting proposal was that meetings one and three of the year had been set out as Health and Wellbeing Board Ambition and Engagement Workshops. These would:

·       Be 2.5 hour daytime workshop sessions, not held in public.

·       Not be restricted to members of the board – while board members would be mandatory attendees, other subject matter experts would be invited.

·       Held in other, less formal venues in the community and involve active engagement with residents.

·       Focus on strategic discussion around two or three strategic priorities aligned to the JHWS, which would continue to be the focus of the board until members request a change. These become “obsessions” of the board.

·       End each session with a list of specific actions and commitments for partners to ensure this is not just talk.

By contrast the proposal for meetings two and four of the year was to maintain the statutorily required formal public meetings. These would be:

·       Twice yearly formal board-style meetings which would be live-streamed, lasting 2 hours.

·       Include formal, pre-submitted reports published via the council’s democratic services team.

·       Continue to include an opportunity for public participation, in as “soft” a style as possible, with clear accountability around follow-up for comments.

·       Receive papers for assurance and decisions, for instance:

o   An update on the key statutory duties of the board.

o   A summary by the chair of any recent workshops held.

o   Any other key reports, to note and bring into the public domain.

To lead discussion, he suggested that board members decide whether or not they approved these proposed changes, and asked them to consider what the “obsessions”/key priorities of the board should be.

Board members agreed that the workshop had prompted a helpful discussion, and that the proposed changes – particularly taking workshops to the community – were very sensible. Members generally agreed that the new structure (workshops and formal meetings) struck the right balance.

Board members suggested that in terms of narrowing down the board’s focus, improvement of health or health inequalities was an overarching mission statement, but within that there should be more tightly focused action.

They noted that the data presented showed that the JHWS statement outlined by the Director of Public Health was not on track and that the board could not just move the goalposts due to a failure to date to make healthcare fairer.

Members suggested that the obsession/focus should be on an area that supported the Health and Wellbeing of Children and Young People specifically. Members also suggested that a focus on preventing falls, as a well understood area that could benefit many people.

It was suggested that these points could be selected for a period of 12 months/6 months/3 months and then the board might move on to a different focus. Members agreed that a review period should be built in when the focus was decided. A limit should be set, then the board should acknowledge success or failure with a review.

Members suggested neighbourhood health and communities as a focus, and that members of the public be made aware of the ways in which they could make themselves heard by the members of the board.

Given the agreed emphasis on neighbourhood health, Members suggested the approach of neighbourhoods to the areas of focus should specifically be considered alongside the overarching approach of the board.

Members suggested that prevention of poor physical and mental health in children was a preventative focus would make the board more forward-looking.

Members expressed concern that workshops scheduled during the day could potentially exclude participation of working people/young people in education. It was also considered that others, such as people with young children or care responsibilities, could similarly not come in during the evening.

Members suggested that health at home was a good area of focus that could cover all areas; allowing early intervention with children, adults who may need help at home, older adults (which would include falls).

The Executive Director of Communications, Marketing and Media Relationsnoted that York and Humber life expectancy trends were similar, so the sharper decline than the national one was a regional rather than a city issue. She felt that the board’s focus should be on the factors leading to this deterioration.  

The Director of Public Health said that he would explore the subjects of Depression and Anxiety as contributing factors to mental health and Obesity as a contributing factor to physical health as a large-scale focus. He resolved to follow up with more detailed thoughts on this to members via email. Consequently, the board

Resolved:

i.                To agree the proposed new format, approach and meeting rhythm for the Health and Wellbeing Board for the municipal year 2026/27.

ii.               To further discuss and identify two or three ‘obsessions’ the HWB will choose to focus its partnership and engagement sessions on initially.

Reason:      This report aligns with the Health and Wellbeing Strategy and will enable the Board to deliver this strategy in a more impactful manner