Agenda, decisions and minutes

Apologies for absence were received from Mark Axcell (Black Country Integrated Care Board), Councillor Margaret Bell (Warwickshire County Council), Councillor Ian Bevan (Dudley Metropolitan Borough Council), Cllr Kamran Caan (Coventry City Council), Councillor Tony Dicccico (Solihull Metropolitan Borough Council), Councillor Julian Gutteridge (Nuneaton & Bedworth Borough Council), Councillor Suzanne Hartwell (Sandwell Metropolitan Borough Council), Councillor Jasbir Jaspal (City of Wolverhampton Council), Lisa Stalley-Green (Birmingham & Solihull Integrated Care Board), Peter Wilson (West Midlands Fire Service), Justin Varney (West Midlands Association of Directors of Public Health Representative) and Mike Wade (Office for Health Improvement & Disparities / NHSE Midlands).

The substitutes attending the meeting on behalf of Mike Wade was Giri Rajaratnam (Office for Health Improvement & Disparities) and for Justin Varney was Rebecca Howell-Jones (Birmingham City Council).

The meeting was inquorate and therefore the decisions contained within the  recommendations of the reports would be ratified at the WMCA Board on 12 January 2024.       

Apologies for absence were received from Mark Axcell (Black Country Integrated Care Board), Councillor Margaret Bell (Warwickshire County Council), Councillor Ian Bevan (Dudley Metropolitan Borough Council), Councillor Kamran Caan (Coventry City Council), Councillor Tony Dicccico (Solihull Metropolitan Borough Council), Councillor Julian Gutteridge (Nuneaton & Bedworth Borough Council), Councillor Suzanne Hartwell (Sandwell Metropolitan Borough Council), Councillor Jasbir Jaspal (City of Wolverhampton Council), Lisa Stalley-Green (Birmingham & Solihull Integrated Care Board), Peter Wilson (West Midlands Fire Service), Justin Varney (West Midlands Association of Directors of Public Health Representative) and Mike Wade (Office for Health Improvement & Disparities / NHSE Midlands).

The substitutes attending the meeting on behalf of Mike Wade was Giri Rajaratnam (Office for Health Improvement & Disparities) and for Justin Varney was Rebecca Howell-Jones (Birmingham City Council).

The meeting was inquorate and therefore the decisions contained within the recommendations of the reports would be ratified at the WMCA Board on 12 January 2024.      

The Chair welcomed attendees of the Wellbeing Board to the meeting and encouraged future in person meetings to improve on inquorate meetings to  enable attendees the ability in getting to know each other better in person during discussions and to share ideas together.         

The minutes of the meeting were approved as a correct record, subject to an amendment of Mike Wade’s dual representation which was noted incorrectly as NHS England and to amend to Office for Health Improvement & Disparities / NHSE Midlands.   

The minutes of the meeting were approved as a correct record, subject to an amendment of Mike Wade’s dual representation which was noted incorrectly as NHS England and to amend to Office for Health Improvement & Disparities / NHSE Midlands.   

(1)  The key areas of discussion from the Wellbeing Board development day on 5 October 2023 as provided in the report was reviewed.

(2)  The Terms of Reference for the Mayor’s Equity Advisory Council was noted.

(3)  The revised Terms of Reference and governance of the Wellbeing Board which would be approved by the WMCA Board was endorsed.

The board considered a report from the Head of Health & Communities, Mubasshir Ajaz, to note the key discussion points from the Wellbeing Board development session held on 5 October 2023 that was facilitated by the West Midlands Combined Authority’s (WMCA’s) Governance team to outline the proposed changes to the Wellbeing Board governance and to organise the board in a way which was more meaningful and utilised the considerable leadership qualities of members from local authorities to be able to align itself to the health in all policies approach being promoted from within the Wellbeing Board.  The changes included the introduction of new sub-groups and the new Mayor’s Health Equity Advisory Council, as well as consideration to on-going Wellbeing Board membership and consideration for hybrid meetings to continue to increase engagement with members.

The Head of Corporate Support & Governance, Julia Cleary, noted the feedback from the development session that focussed on the purpose of the Wellbeing Board to highlight key discussion points and the importance in understanding the added value of the board in which ideas and best practices were shared between local authorities, health organisations and partners for the West Midlands region, improved engagement with communities, consistency of approach, effective leveraging and ensuring that the passion from a local level was not lost. 

Furthermore, the establishment of the new Mayor’s Health Equity Advisory Council would bring together expert advice feeding into the Wellbeing Board to enable a more strategic approach to be built into the Wellbeing Board Terms of Reference and approved at WMCA Board to support the health in all policies due to an overarching approach and better connection internally with other directorates within the WMCA, as well as external work being carried out at local levels.

Councillor McCarthy noted the importance in member engagement, whether in person or virtually, was vital to the success in the changes, to which the Chair agreed and outlined her preference in at least one or two in person meetings per year as opposed to hybrid meetings.  The Head of Health & Communities noted that in-person meetings would continue to be encouraged, however as proposed within the report to continue to provide a hybrid meeting option to encourage more engagement and to take advantage of broader engagement with the health system through the Mayor’s Health Equity Advisory Council and through the sub-groups, led by Wellbeing Board members, which aligned to the health in all policies area.  The Chair responded to note that the sub-groups would prove extremely valuable in bridging across the different board meetings.

In response to Councillor McCarthy who noted that as there was no health duty, the context of work needed to focus on the role of the WMCA, particularly as some of the functions around hyper local working within communities still sat with relevant local authorities and health organisations.  The Chair agreed and noted that the Wellbeing Board’s focus had always been to provide additionality for approval at WMCA Board rather than to reinvent what had already been achieved in  ...  view the full minutes text for item 57.

(1)  The outline of the Health of the Region 2023 report was noted.

(2)  The draft of the report that had been shared with members was reviewed, with comments and feedback provided.  

(3)  The launch of the final report and to promote its implementation through the role of Wellbeing Board members as local leaders was supported.

The board considered a report from the Head of Health and Communities who noted that the Health of the Region 2023 report was due to be published by the WMCA in January 2024 and that his team had been drafting the report and would present the emerging findings to the Wellbeing Board during the meeting.  

The report was supplemented by a presentation that was introduced  by the Head of Health & Communities and to note that the WMCA had a pivotal role to play in shaping the conditions that create unfair differences in health outcomes for the West Midlands region and provided an update on the key outcomes from the previous Health of the Region 2020 report where Covid-19 highlighted the extent of the region’s health inequalities, the WMCA fostered collaboration between partners in the region to address health inequalities and also established a Health of the Region roundtable.

The Senior Delivery Manager – Healthy Communities & Mental Wellbeing, Rachael Clifford, continued the presentation to note the key health issues and impacts for the region following the previous report iteration in 2020 and comparative data used.

The presentation noted that life expectancy in the region had decreased and was falling at a faster rate than the national average, which was further broken down in to the seven Constituent areas within the region that had the greatest impact dependant on where a person lived.  The causes of preventable diseases as a contributing factor for the WMCA area were noted as higher levels of being overweight and obesity in adults and children, the lowest levels of physical exercise in England, increased alcohol related deaths and adult smoking rates that had remained unchanged across the region, apart from Wolverhampton that had seen a significant reduction since 2014.  The presentation noted the causes of preventable diseases was further exacerbated by an increasing number of children living in poverty and that the WMCA area had some of the highest rates of fuel poverty in the country.

There had however since the previous report been some positive outcomes in that there had been a reduction in the number of 16-17 years not in employment education or training since 2018, that since 2013/14 there had been progress on reducing the gap between those with physical or mental long term health conditions and the overall employment rate, and that since 2013/14 there had  been improvements in self-reported wellbeing for the WMCA area.

The presentation further noted the WMCA’s role in improving health outcomes to shape the conditions that influence residents’ health outcomes across the region, through the WMCA’s devolved responsibilities and role as convenor, as advocate, as commissioner and in delivery across its core responsibilities and by leveraging investment in transport, housing, energy, environment, skills, employment and economy to support the existing collaborative approach and effort between NHS and local authority partners who had a statutory focus on clinical inequalities (Core20PLUS5) and the specific needs of their population (Health and Wellbeing Strategies).

The Senior Delivery Manager – Healthy Communities & Mental  ...  view the full minutes text for item 58.

(1)  The progress against high level deliverables for 2023/24 was reviewed.

(2)  Brief updates against key delivery programmes aligned to the high level deliverables was noted.

The board considered a report from the Head of Health & Communities to provide an update on the progress made against high level deliverables for 2023/24.

Resolved:

(1)  The progress against high level deliverables for 2023/24 be reviewed.

(2)  Brief updates against key delivery programmes aligned to the high level deliverables be noted.

Wednesday 6 March 2024.