Meeting documents

Richard Cassidy gave members a short presentation to explain what Health and Wellbeing is and to highlight the changes to the Health and Wellbeing Strategy.

Members asked questions, made comments and received responses as follows:

1. Councillor Yeulett stated that he feels that Fenland has gone backwards with regards to deprivation which is linked to health inequality, he asked for reassurance that what is being proposed within the strategy will start to make a difference; he asked how this will be measured and demonstrated. Councillor Cornwell stated that these are not small issues and we have to work with partners to tackle those issues, not one of which is wholly deliverable by us. The plan is to move forward involving as many partners as we can to make a real difference. There is an indication already of what we have done to help the situation but there are other problems developing in the areas that we have been trying to focus on with regards to deprivation. Funding is always an issue but some of the shortfall will now be funded by the Controlling Migration Fund (CMF). It might appear that this has been slow moving but actually improvements are being made. He added that this area affects all of the Portfolios and all of the Portfolio Holders take a very keen interest in these issues and play their part;


2. Councillor Yeulett stated that we realise that there is not a quick fix for any of these issues but we do not appear to be making progress with regards to deprivation and in fact some patches in the district are deteriorating further. Councillor Mason stated that referring to the Public Health Outcomes Framework which was published in May, it appears that we are slipping behind, for example adult smoking and mortality rates, he asked if we have taken the opportunity to use the resources of the Combined Authority. Val Thomas confirmed that some work has planned for phase 2 of the devolution moving forward. Richard Cassidy stated that the current devolution is around skills and employment and a lot of the phase 1 issues will have a positive impact on public health. The combined authority focuses on areas of inequality and that will be good for Fenland in the long term, it is suggested that in Devolution 2 there is more of a public health focus with more of an emphasis around working with the community to come up with ideas. Councillor Cornwell stated that with regards to smoking, ultimately people make the personal decision to smoke or not to, we have to enable those people who want stop to have access to the help and support they need;


3. Councillor Mason stated that we do not appear to be making progress with regards to smoking but other authorities are and he asked how we can learn from what other authorities are doing. Councillor Cornwell confirmed that we do not work in isolation; we talk to the organisations that deliver various projects across the country. Councillor Tanfield stated that if you measure like for like areas there is not very much difference. We can only make services accessible for people and cannot force people to attend, we try to make the events as enticing as possible to encourage people to get involved;


4. Councillor Mason stated that smoking statistics across the country are at about 15%, we are in a more rural area and we are at 21%. We need to address that gap and learn from other people. Val Thomas stated that smoking statistics have reduced in the last year from 27% down to 21%, but those statistics tend to fluctuate. In areas where there are migrant manual workers the figures are much higher and this goes hand in hand with economic deprivation. Richard Cassidy stated that getting the information into workplaces is important and is high on the priority for the public health team, we try to help to facilitate that through our contacts. Val Thomas confirmed that they work with about 2 workplaces within fenland and this is one of the big challenges for them;


5. Councillor Booth stated that the objectives within the Strategy are not smart, specific or measurable and is concerned that we will not get an indication how we deliver against the objectives and suggested that is an area that needs some more work. He added that the document appears to have a 'scattergun' approach and although he appreciates that there are wider health points he feels it needs to be more focused and the objectives need to be more defined. The district's role is less in the area of health and more in wellbeing and that does not come across in the document. He referred to page 11 and 12 of the pack relating to education, stating that it is like we have already given up as we talk about helping people to get access to benefits. Councillor Cornwell stated that we are not overlooking the need to engage with education providers and understand that we have to persuade the higher education providers to provide something of use in the area and this is a focus for us. The strategy is our ability to do something it is FDC's Health and Wellbeing strategy and many other districts are looking to see how we are approaching this;


6. Richard Cassidy stated that it is a long strategy but what we are trying to do is to explain what each part of the Council is doing to contribute to health. We are doing a lot of work internally with our managers using the catchphrase 'Health is everyone's business' and are asking all teams that might impact on health to consider the health impacts of decisions they are making moving forward;


7. Councillor Mrs Davis stated that during the presentation Wisbech seems once again to be the focus. She added that she understands that there are deprivation problems in that area and that it is the biggest town and therefore their problems are greater but would like to know what is happening elsewhere in the district. Councillor Yeulett stated that resources follow need and that is, at this time, where the greatest need is. Councillor Cornwell stated that bids have had to be concentrated in areas where the demand is the highest, when a bid for funding is submitted you have to focus in on certain areas with the most need to have a chance of being successful. Councillor Mrs Davis stated that the concern is that there is too much being concentrated in that area and even if the work is successful in making improvements to Wisbech, in the meantime other areas are being overlooked and could start to fail. Councillor Cornwell confirmed that all areas are being monitored. Councillor Tanfield confirmed that from a Leisure point of view all areas are a focus;


8. Councillor Booth stated that it is not just Wisbech that has areas of deprivation and the report states that there are other areas in Fenland. Richard Cassidy stated that it depends on the service, when we look at leisure, we have 4 leisure centres, one in each of the Market Towns and there are lots of community sports events taking place across the district often focussed in more rural locations. However, when we look at issues with regards to HMO's the problems are in Wisbech and therefore that is where the resources need to go. Councillor Mrs Davis stated that she feels we need to be careful when we are producing these reports to ensure that we have a Fenland wide report;


9. Councillor Hodgson stated that Wisbech has been mentioned a lot and although he appreciates what is being done in that area, people are moving out of town into the villages and asked what problems the villages face. Richard Cassidy stated that some of the issues around the villages are poor transportation and rural isolation which can affect mental health and this is a focus which is being increasingly recognised;


10. Councillor Yeulett stated that there has been a lack of success at dealing with problems around deprivation in this area and appreciates that it is a national problem, he asked if all areas have these issues. Councillor Tanfield stated that every area has the same type of issues, the difference is that they may be in a better situation financially to be able to deal with those issues. We look at and compare ourselves to areas that are not like us, and she would like to see us comparing ourselves to areas that are more like for like, to be able to find examples of success in areas that we would be able to better relate to. Councillor Yeulett agreed that we should look at comparative areas with the same challenges that we face;


11. Councillor Booth stated that the Indices of Multiple Deprivation covers the whole country and there are so many factors that go into those statistics. Councillor Cornwell agreed that this may be a point that is worth us looking into moving forward;


12. Richard Cassidy stated that Great Yarmouth is one area in this region that we look at that is a good comparator as they have similar issues to us and they are doing some good work around regeneration in the town. We are increasingly looking at areas like this where the needs are similar to Fenland;


13. Councillor Mrs Mayor confirmed that with regards to Licensing they do use like for like comparators and suggested that the same areas should be used when comparing all services;


14. Councillor Mrs Hay referring to page 15 of the report stated that some of the data spinal chart is out of date. Richard Cassidy stated that we get an updated chart every year but some of the figures are not measured every year and some are synthetic estimates. Val Thomas confirmed that it is very frustrating but very little of the data is real time data;


15. Councillor Mrs Davis referring to page 17, the 'Priority Action' and 'What have we done' table, asked for clarification about how we have raised our profile with partners and the Clinical Commissioning Group (CCG). Councillor Cornwell stated that we do our best to engage with the CCG's and ensure that they understand our view too. The Area Executive Board is trying to bring together more of the people under the health partnership but has not been an easy journey. GP Practices are businesses and have to balance the business demand with the services that they are offering;


16. Councillor Mrs Davis referred to clinics at Doddington Hospital which are referring back to GP's instead of giving follow up appointments, GP's will then have to refer back to the hospital consultants which increases the gaps between appointment times and therefore could lead to a decrease in the footfall at Doddington Hospital dramatically. Councillor Cornwell stated that this also goes against the ideas that are emerging, which was to speed up the flow. Richard Cassidy stated that we have offered to help the CCG to get some of the community messages out to the residents, we have a lot of expertise in terms of how to engage with communities and have offered to assist with the consultation with regards to North Cambridgeshire Hospital redevelopment and the MIU;


17. Councillor Mrs Davis reiterated the point that the report does not give any indication of what we are doing. Richard Cassidy agreed to look at the wording around this in the document by adding an example;


18. Councillor Mrs Hay asked for clarification about the Travel Choices Project. Richard Cassidy stated that we are lucky to have a Transport Manager working for us and she works hard on our behalf across Cambridgeshire. He stated that Wisbech Travel Choices work is a 12 month project, the aim of the project is to encourage more people to walk, cycle and use public transport. The project surveyed over 1500 people about their travel choices and offered advice around alternative transport. 4000 transport information packs were distributed across Wisbech and personalised travel information was provided to around 750 homes. Work in partnership with Sustrans a training course was developed and around 50 people were trained as Transport Champions. The role of the Transport Champion is about providing transport advice to others and understanding how to provide such advice. Wisbech Travel Choice was delivered, managed and monitored by the Fenland Strategic Partnership Transport and Access Group with FDC as the leading body. The project was funded through the Government's Local Sustainable Transport Fund and funding applications have since been submitted with the aim taking the travel choices work Fenland wide;


19. Councillor Mrs Hay asked if we should be doing more as the planning authority where we have large applications to encourage developers to include cycling routes. Richard Cassidy agreed and stated that one of the points within our local plan for large planning applications is the potential to require a health impact assessment, and we want to look into this in more detail moving forward;


20. Councillor Mrs Davis referring to page 24 of the report about delivering apprentices and stated that this will depend how we are going to move forward with the LEP, she asked if there has been any updates about how this is progressing. Councillor Yeulett confirmed that we have formulated an update following our meeting which outlines responsibilities for the actions from that meeting. We update members moving forward. Richard Cassidy stated that with regards to apprenticeships, as a council we can lead by example and we are working hard across the council to increase the number of apprenticeships that we have and are working with local colleges to provide new courses. The framework in place to support the apprenticeship levy has the potential to significantly increase the numbers;


21. Councillor Yeulett asked how we compare in Fenland with other areas with regards to delayed transfers of care. Val Thomas agreed to investigate and feedback to members;


22. Councillor Mrs Hay asked if we now have a more meaningful dialogue with the LEP. Richard Cassidy stated that it is a work in progress;


23. Councillor Mrs Hay stated that the chart on page 40 is broken down by persons, male and female but the amounts do not add up. She asked for clarification. Val Thomas clarified the reasoning behind the breakdown;


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    Councillor Mrs Davis stated that the report refers to vulnerable disabled people but suggested that the wording should say vulnerable 'or/and' disabled. Richard Cassidy agreed they are different categories and he would look at the wording around this.

Anna Goodall outlined recommendations with regards to the draft strategy as follows:

• There should be a greater clarity regarding the wellbeing District Council focus of the strategy rather than a primary health focus so we can demonstrate where FDC can make the most beneficial impact;


• The objectives are smart with clearer actions over a 1, 2 and 3 year period;


• We look at comparative areas to learn lessons and emulate successful projects and best practice. Focussing on the assets of the area rather than the problems;


• Greater transparency with regards to examples, as certain statements within the strategy would be brought to life by including examples for greater clarity;


• Great engagement in relation to prevention particularly with younger people with measures around the span of engagement, particularly as the Youth Community Council will not have measures within their role;


• Ensuring that there is a synergy with this strategy and the Wisbech 2020 Vision;


• Greater focus on pursuing funding opportunities;


• Greater engagement with Town and Parish Councils.

Members asked questions, made comments and received responses as follows:

1. Councillor Mason offered congratulations to the Golden Age project that offers advice and guidance to the older population but asked what we are doing to engage younger people. Councillor Tanfield confirmed that the Youth Council have re-launched and have had their first meeting, moving forward they will be working more in partnership with other groups. They are all students in local schools and are a contact for us within those schools as it can be difficult to engage with younger people. Councillor Mason stated that in Whittlesey a screening process has been taken into schools for young people with heart conditions, this is educational and is supportive with regards to health and has proved to be very successful. He added that you have a captive audience at school and will get the information out to more young people than you would if you tried to get them to come to an event;


2. Councillor Booth stated that with regards to the Youth Council you are engaging with a group of engaged young people but it is the others that we need to engage with. Councillor Tanfield stated that the members that are engaged will engage with the others, and have more chance working with their peers than we would have going in;


3. Councillor Mrs Hay stated that the report refers to homelessness and asked how does Fenland compare to other areas and has it improved. Richard Cassidy agreed to circulate a table of statistics. The headline news is that in Cambridgeshire the amount of homelessness depends on the size of the district, so larger districts have higher levels and smaller districts have less. The number of homeless in this area is relatively stable, the number of people accepted as homeless in priority need has increased in the last year across all of the districts in this area. We have Government funding to pilot a new approach to homelessness, there is new legislation coming in giving a duty to do more for homeless people moving forward. Some of the key points around this are recognising people earlier in the system who are at risk of becoming homeless and supporting them at an earlier stage;


4. Councillor Booth stated that he had heard that East Cambridgeshire had a scheme where loans were given out for people to secure their own accommodation and asked if this had been investigated by FDC. Councillor Sutton stated that we had a scheme where instead of placing people into temporary accommodation which costs a lot of money, we would pay the deposit for them to go into their own accommodation as very often this is the barrier for people finding their own accommodation. Richard Cassidy stated that all of the districts involved in the Trailblazer project will share good practice, and by the time we get to the end of the project we will be in a good position across the whole of the area;


5. Councillor Booth asked for clarification about the statement on page 21 which says Encourage Parish and District Council's to build the resilience of their communities. Richard Cassidy stated that the County Council is working through Cambridge County for Voluntary Service (CCVS) and as part of this we are in discussions with them around how we could carry out some work with Parish and Town Councils looking at how we could work with them to deliver more in their community, this links to the Parish and Town Council survey which has just been completed. We are looking to pilot an approach in the next 6 months with a parish council about how we can take this forward;


6. Councillor Booth referring to page 56 asked for clarification about Recovery Walks of which the report says there is one per month, he asked if once a month enough? Val Thomas stated that it is a difficult measure but agreed to look at the data. Richard Cassidy stated that we have a very successful alcohol partnership working in Wisbech as it has specific problems around street drinking. We have applied to Government for a National status as an alcohol action area, they will provide expertise and will share best practice to help us to tackle street drinking. He stated that he hopes that this will start to show some benefits;


7. Councillor Mrs Davis asked why the 'Let's Get Moving' project is concentrated in the towns. She suggested offering these classes in rural village halls. Val Thomas stated that the overall vision was that this project would work with different communities. Councillor Tanfield agreed that this is the direction that the project will move into;


8. Councillor Mrs Davis asked for clarification with regards to assisted refuse collection as when she looked for information online it was not clear. Richard Cassidy confirmed that the system is there for people who have nobody to help with their bins. If residents do not have a neighbour or a family member that can help then we can assist. Councillor Mrs Davis stated that the wording on the website is not clear and states that if you have nobody to help in your household. Richard Cassidy agreed to have a look at the wording on the website to ensure that it is clear.

Members asked questions, made comments and received responses as follows:

1. Councillor Mrs Davis stated that there does not seem to be very much publicity about what the Tourism Partnership is doing and asked for clarification about this. Councillor Tanfield stated that the Tourism Partnership have done a lot of work during the past 18 months but the difficulty is that we do not have the officer support and they are responsible for their own publicity and are getting this out via Twitter and Facebook. This was the plan for this partnership, for everyone to take ownership of the work involved, with further discussions and agreement the group plan to become an independent group. This will put them in a better position moving forward and they will be able to apply for grant funding which they are not eligible to apply for at the moment;


2. Councillor Yeulett asked for an update on the performance of the Leisure Centres. Councillor Tanfield referred members to page 85 of the report and stated that we have an independent marketing company on board and the Leisure Centres are running extremely well. Richard Cassidy stated that we are above expectations for our leisure income and memberships are as high as they have ever been, Whittlesey Centre is not doing quite as well as the other centres and we are working to find out what the reasons behind that might be;


3. Councillor Yeulett asked if the marketing company that has been used with regards to leisure can be used for any other services in the Council. Richard Cassidy stated that they are primarily a leisure based marketing company but we are sharing tips with the Communications team here at the council. Councillor Tanfield stated that the staff in the leisure centres are fundamental and play an important role, the personal relationship within the leisure centres is very important and our customers speak very highly of that part of the service;


4. Councillor Booth suggested that as Whittlesey is close to Peterborough this could be what is having an impact on the leisure centre there as Peterborough have leisure facilities too. Richard Cassidy stated that the pool use data has been down, this could have been due to the changing room facilities and also some restrictions around the memberships, but these have both been addressed now so we would hope to see an improvement. He stated that Peterborough is very close and so Whittlesey probably has the biggest competition than any of the other leisure centres;


5. Councillor Mrs Hay referring to page 76 asked if the Housing Options Team is under resourced. Richard Cassidy stated that the team are well respected and work hard, we maintained the resource where we have had periods of sickness, with people that understand the system rather than bringing in new people without relevant experience. Councillor Mrs Hay stated that she is concerned that we will lose experienced staff. Richard Cassidy stated that they are a close team who work very closely with their manager so she has a good understanding of how they are feeling;


6. Councillor Booth referred to the area within Wisbech with police power to take alcohol from people and asked how well that is policed. Richard Cassidy stated that we are looking to move that to a drinking ban in specific parts of the town to strengthen those powers;


7. Councillor Mrs Davis stated that the report says that we have received a grant to secure a multi-lingual outreach recovery worker. Richard Cassidy agreed stating that is part of the funding from the Controlling Migration Fund and links to the national initiative;


8. Councillor Yeulett asked for clarification with regards to Healthier Options - Fenland. Richard Cassidy stated that this project encourages people to make healthier choices and Nestle Purina came forward to join the initiative. There are other interested businesses in the area but businesses are busy and do not always see it as a priority. Val Thomas agreed and stated that some employers are sympathetic and some are not;


9. Councillor Booth suggested that it would be useful to know how many employees the businesses involved have, to give us an idea of the scope;


10. Councillor Cornwell stated that we also have difficulty engaging with the schools when we are looking at projects around childhood obesity, there are a number of ways of addressing these issues, starting with the school kitchens and then looking at projects within the classroom i.e. healthy eating and growing your own produce, the influence of what they learn at school is taken home and passed on to parents. Val Thomas stated that while some schools perform very well other schools need more encouragement. Councillor Cornwell suggested that it may be of interest to some members, who have a connection with a local school, to find out more about these projects;


11. Councillor Yeulett asked for clarification with regards to the energy switching service outlined on page 88 of the agenda pack. Councillor Cornwell stated that we are getting close to launching this project. It is almost ready but we are looking to make it easier to join via the website and looking at ways of joining which are not online as not everyone has access to the services online and we want to ensure that the service is accessible for everyone before the launch. He added that we are also looking to see if arrangements can be made to access the scheme for residents on pre-pay meters, and although they will not be eligible for the same deal they can be secure in the knowledge that they are also getting a good deal;


12. Councillor Booth asked how the energy switching service is funded. Richard Cassidy stated that the project is run by a commercial company called ichoosr who run the scheme in many other locations across the country. Should a person sign up for a cheaper rate as a result of a switching round, ichoosr would be paid a fee by the relevant energy company;


13. Councillor Booth asked what due diligence has taken place to ensure that the scheme to ensure that the scheme is a legitimate one. Richard Cassidy confirmed that it is a national scheme and is part our auditable work;


14. Councillor Booth asked if the Council will be getting commission from this scheme. Richard Cassidy agreed to check;


15. Councillor Mrs Mayor, referring to page 93 of the report, asked when the Dementia Action Alliance plans to be extended to other areas in Fenland. Richard Cassidy stated that we do not run that scheme but are a partner to it and agreed to find out;


16. Councillor Yeulett asked for clarification around Early Help Centres and asked if they are the same as Children's Centres. Richard Cassidy confirmed that this is still under consultation. Councillor Mrs Hay agreed to forward some more information as she is on the Children and Young People Board;


17. Councillor Yeulett referred to page 75 of the report and a performance measure with regards to total number of private rented properties where positive interventions are taken to address safety and cohesion issues and asked for further information. Councillor Sutton stated that these figures relate to areas where either tenants or their relations have made representation to the team, the team would then have gone out to investigate a range of different issues which do not meet the standards, this is part of housing responsibilities;


18. Councillor Yeulett asked for clarification with regards to the red indicator for the number of households prevented from becoming homeless. Councillor Sutton stated that as mentioned earlier we have had some sickness within the team and that may have added to the pressure, but generally the team are fast to respond to a report of homelessness. Richard Cassidy agreed to check if this should be identified as a green variance;


19. Councillor Mrs Hay asked why the target figures are less than the baseline with regards to the Golden Age customer satisfaction feedback. Richard Cassidy stated that the baseline figures are based on last year's outturn. Councillor Mrs Hay stated that we should be looking to improve but appear to be lowering our target. Richard Cassidy stated that the baseline is not a trend over a number of years but is just last year's outturn. 90% is a very good performance, it did very well last year and there may be some specific reasons why that is, but setting the target at 97% would be very high;


20. Councillor Mrs Mayor stated that on that specific table the number of customers who responded is 17 and the number of customers satisfied is 17, so that is 100% and therefore a green variance but she feels that it is not proportionate. Richard Cassidy stated that the RAG rating was introduced following a recommendation from the Overview and Scrutiny Panel. Anna Goodall confirmed that the RAG rating was suggested by the Overview and Scrutiny Panel so that it could easily highlight the differences and identify any issues.

Councillor Yeulett thanked everybody for attending the meeting today.