Agenda and draft minutes

Health and Wellbeing Board - Thursday, 8th October, 2020 10.00 am

Venue: Virtual - Microsoft Teams

Contact: Darren Kristiansen, Business Manager - Commissioning  Email:

No. Item


Minutes pdf icon PDF 305 KB

To approve as a correct record the minutes of the Health and Wellbeing Board meeting held on Insert dateInsert year.



The minutes of the Health and Wellbeing Board meeting held on 8 October 2020 were approved as a correct record.



Urgent Items

To receive additional items that the Chair is of the opinion should be considered as a matter of urgency, in accordance with Section 100B (4) (b) of the Local Government Act 1972.


There were no urgent items raised in advance of the meeting.



Declaration of Interests


There were no declarations of interest.



BTUH CQC outcome for maternity services pdf icon PDF 140 KB

This item will be presented by Diane Sarker, BTUH. 


A report is provided in member’s papers to support this item

Additional documents:


This item was presented by Diane Sarker Chief Nursing Officer, Mid and South Essex NHS Foundation Trust.   Key points included:

·         6 incidents were reported as a cluster whereby 6 babies were sent for cooling.  Incidents were proactively reported to CQC.

·         The CQC carried out an inspection of maternity services at Basildon University Hospital on Friday 12 June 2020. Following this inspection, and a review of Trust incident reports, the CQC published its report on Wednesday 19 August 2020. This rated the service as Inadequate.  Key findings included:

o   Poor multi-disciplinary working

o   Training was not always up to date Training has been introduced to monitor women and babies.  It had been reported to CQC that not all doctors had completed training which was not the case.

o   Staff shortages

o   Safety concerns were not always identified and escalated

o   Junior medical staff were not supported sufficiently

o   High-risk women were giving birth in a low-risk area

o   Incidents were not always graded correctly


·         Members learned that following the Inspection report 9 women wanted care transferred to Southend hospital following the report. 


·         Members were asked to note that while a number of improvements that had been made which include: 

o   A new senior management team has been recruited.  An interim Director of Midwifery has also now been appointed.

o   £1.8m has been invested in new staff, including an additional 20 Midwives

o   Three more delivery beds have been created for high risk women

o   A 24hour triage service has been created to ensure women can be seen immediately when they need hospital support. 

o   Currently in the process of developing a new birthing pool

o   Building work completed to drug rooms to ensure better medicine management safety

o   Improved security to protect mothers and children

·         It was acknowledged that there is still more to do, particularly around internal governance arrangements to ensure there are robust reporting and monitoring arrangements, underpinned by the new leadership team.


During discussions the following points were made:

·         Members welcomed the thorough feedback and the substantial action being taken, as reported.

·         The importance of engaging patients and families and capturing the views of women, mothers and people that use the maternity was acknowledged.  Members were advised that feedback is currently sought from a sample of 10 women per day on what is going well and not so well, which is reported to the CQC on a weekly basis.  No substantial concerns raised with most comments being positive and happy with their experience.  BTUH is also working closely with the maternity voices partnership who provide feedback on surveys that they complete.  Any concerns raised are reported to the Head of Midwifery who investigates and provides feedback to women and families on their concerns.

·         It was made clear that Southend are not in the same position as BTUH.  Members noted the challenges experienced at BTUH Maternity Suite when compared to the wider trust across Mid and South Essex.    

·         It was acknowledged several references to poor culture and colleagues not  ...  view the full minutes text for item 4.


Update report from SEND Improvement Board to include SEND stretch targets pdf icon PDF 237 KB

This item will be presented by Sheila Murphy / Michele Lucas.


A report is provided in Member’s papers to support this item


This item was introduced by Sheila Murphy.  Key points included:

·         Report focusses on Written statement of actions, highlighted in the report following Ofsted inspection

·         WSOA will be inspected again by Ofsted in due course.  Multi-agency operational group and improvement board have been established to support the delivery of the Written Statement of Actions which includes a comprehensive action plan.

·         Some delays experienced due to COVID-19 whereby statutory guidelines have been suspended.  Statutory guidelines and timescales have now recommenced. 

·         Progress has been reported in members’ papers (pages 48/49)

·         Timeliness of EHCP are now being delivered above the national average, ensuring children’s needs are being identified earlier and appropriately and their needs are being met sooner

·         Additional SEND case workers have been recruited, enabling them to manage approximately 150 cases each, in line with other SEND services. 

·         Further work to be done around quality assurance to underpin a timely

·         Lots of work on participation on engagement and we are in the process of reenergising participation


·         We are now meeting target of EHCP which has resulted in a reduced number of complaints being received.


During discussions the following points were made:

·         The positive report and that we are responding to calls within 48 hours to parents was welcomed

·         Concerns were raised that two stretched targets not included relate to outcomes of the plan itself, to ensure the plan supports the delivery of improved outcomes for individual children

·         Plans are now written to reflect the needs of individual children and young people, a multi-agency group considers EHCPs to consider whether plans are addressing the needs of children and young people.

·         Reassurance was given that quality assurance processes have been established for the plans which but also consider how the plan is sufficiently ambitious for that child.  It was agreed that we need to ensure that plans are designed to support young people.

·         Some plans need to be informed by professional opinion.  COVID impacted on children attending school.  For example some children with emerging SEND needs and were in the process of assessments being undertaken were no longer attending school, which reduced the ability to undertake assessments, a national issue.  In terms of SEND during COVID-19 the authority were required to evidence reasonable endeavours had been undertaken to ensure assessments were taking place.  Now schools have returned assessments have recommenced.


RESOLVED: Health & Wellbeing Board members scrutinised the work that has been undertaken during this period and offered challenge and support.



Economically Vulnerable Task-Force update pdf icon PDF 486 KB

This item will be introduced by Roger Harris and Cllr Halden


A report is provided in Member’s papers to support this item

Additional documents:


This item was presented by Roger Harris, Corporate Director, Adult’s Housing and Health.  Key points included:

·         Initiative set up by Chair of HWB.  Four meetings have been held to date.  The Group meets monthly and aims to bring together partners to ensure that as a result of COVID those people that are economically vulnerable

·         Group of people who traditionally find it hard to access mainstream full time employment

·         Report provides progress update and additional report provided which was approved by Cabinet

·          Initiatives include

o   Understanding the data – claimant count.  Working closely with DWP to ensure coordinated activity

o   Programme of work funded through World of Work we provided additional funding between now and March 2021, work with people with learning disabilities to support them with work, employment and training. 

o   Inspire supports post 16 young people linking up services across Southend and Thurrock. 

·         recognise that there will be potential challenges of young people gaining employment

·         Concerns for young people around mental health – Individual placement and support being supported by Health Partners.

During discussions the following points were made:

·         Members noted that Inspire supports post 16 young people linking up services across Southend and Thurrock. 

·         Members recognised that there will be potential challenges of young people gaining employment

·         Members acknowledged that employment is a key determinant of health and wellbeing.

·         It was acknowledged that employers can have unconscious bias regarding people with learning and wider disabilities.

·         The Economic Development Strategy makes substantial references to people with learning and wider disabilities.  Members recognised the merits of working closely with local businesses and will engage the local business board.  DWP are also working directly with businesses around placements and wider opportunities. 

·         EPUT are attending HOSC in November to provide an update on mental health and EPUT have a team of employment specialists specifically focussed on supporting people with mental health with employment

·         Consider the Anchor institutions work which focusses on the role of public sector agencies as employers


RESOLVED: Members noted the content of this report and agreed to a further progress report in six months’ time.



Greater Essex LeDeR Annual Report pdf icon PDF 218 KB

This report will be provided by Rebekah Bailie, Essex County Council


A report and accompanying documentation is included within Member’s papers to support this item

Additional documents:


This item was introduced by Rebekah Bailie, LD Health Commissioner, Essex County Council.  Key points included:

·         People with learning disability across Southend Essex and Thurrock die on average 20 years younger than other people in the population and experience health inequalities which impact on their quality of life.

·         Between the beginning of the programme in SET and the end of the 19-20 year there were 272 deaths of people with Learning Disability. At the end of March 137 reviews had been completed with 318 recommendations identified. (These are summarised by organisation and cross-system issues in the LeDeR Themes document)

·         Pneumonia is the leading direct cause of death (on part 1a of a death certificate) often as part of a pattern of early frailty and deterioration (45 years onwards). Aspiration pneumonia (caused by swallowing difficulty) was the second cause and cancer the third. Underlying cardiac issues were prevalent and need further investigation.

·         More people with learning disability die in hospital than in the rest of the population and there needs to be earlier and better end of life planning.

·         We have a small number of people from BAME backgrounds and need to have better understanding and representation of issues which impact. All but one of the BAME deaths were of children.

·         Most care was good or satisfactory. There are some examples of excellent care, but a similar level of very poor care which impacted on the death. We need more established processes to alert quality and safeguarding issues to councils and CCGs.

·         318 recommendations have been made and it is important to understand all of the recommendations.  Four themes have been identified comprising Annual health checks frailty dynamic support and case management 


During discussions the following points were made:

·         Learning disabled – substantial backlogs in NHS regarding cancer treatment.  Members agreed that there is a need to ensure that the learning disabled are not over burdened by delays in accessing care due to COVID-19.  It was agreed that consideration should be given to how implications of health decisions are explained to people. 

·         LeDeR has been very positive on raising awareness and highlighting challenges experienced by people with a Learning Difficulty.  There were improvements being made regarding health action plans.  It was recommended that HWB considers a more comprehensive overview about our strategic thinking regarding learning disabilities at the meeting scheduled for January 2021.  

·         Members welcomed the significant work undertaken on LeDeR and acknowledged that the reduction in sepsis may be a result of training programme provided to carers

·         Reasonable adjustments and communications.  It was agreed that Patricia would engage the patient group to consider how people with learning disabilities can be effectively communicated with and engaged.

Action Patricia Dorsey


·         Annual health checks were recognised as important.  LD health checks are now being prioritised following Simon Stephens phase 3 letter.

·         During the first wave of COVID a patient list was compiled whereby some people have poorly managed health conditions – GP’s were effectively supporting people who did not wish to attend hospital.  ...  view the full minutes text for item 7.


Work Programme pdf icon PDF 374 KB