Agenda and draft minutes

Apologies for absence were submitted on behalf of Councillor Ann Allen, Graham Harris, Jo Pannell and Theresa Oliver.

The Chairman welcomed Linda Starkie, Area Clinical Manager, School Public Health Service, and Gwen Box, Project Manager HeadStart (Gravesend) to the meeting.

There were no declarations of interest.

The Minutes of the meeting of the Dartford Gravesham and Swanley Health and Wellbeing Board held on 11 April 2018 are attached for confirmation.

Issues arising from the Minutes not addressed elsewhere on the Agenda can be raised at this item.

The minutes of the Dartford, Gravesham and Swanley Health and Wellbeing Board held on 11 April 2018 were agreed as an accurate record.

There have been no meetings of the Kent County Council Health and Wellbeing Board since the Dartford, Gravesham and Swanley Health and Wellbeing Board last met.  

It was noted that no meetings of the Kent Health and Wellbeing Board had taken place since the Dartford, Gravesham and Swanley Health and Wellbeing Board last met. However since the last meeting there had been considerable progress with launching the joint Kent & Medway Health and Wellbeing Board which would hold its first meeting at 4.00pm on Thursday 28 June and would focus on delivering the STP. The meetings would take place during the day and the chairmanship would alternate between Kent and Medway each year.    The new Board would have to establish new working arrangements both with the Kent Health and Wellbeing Board which retained its statutory role and the Kent-wide Board which dealt specifically with issues affecting young people aged 0-25 years.

The Chairman said that he had not contacted members of the Dartford, Gravesham and Swanley Health and Wellbeing Board to discuss the future and purpose of the Board as it seemed sensible to assess what the impact of the new Joint Board might be and the views of the disparate Local Boards were being ascertained by KCC. He noted that structures in West Kent were quite well advanced and it was important to see how these would interact with the new Joint Board. There was still a need for ongoing interaction with the Clinical Commissioning Groups. He would follow up further on this issue.

The Chairman will report on any urgent item and determine its position on the Agenda.

There were no urgent items.

All of the action points arising from previous meetings had been picked up in the agenda or dealt with as matters arising from the minutes of the last meeting. It was noted that the date of the October meeting should be Wednesday 3 October 2018 rather than 6^th October as stated in the Appendix to the report.

To receive a presentation from Linda Starkie, Area Clinical Manager, School Public Health.

The Board received a presentation on the Primary School Public Health Service (PSPHS) from Linda Starkie, Area Clinical Manager. The PSPH had come into being in April 2017 and had remodelled and restructured. There were now 4 clinical hubs plus a Single Point of Access (SPA) and an outreach team working with schools and young children outside the school environment. There was an internal referral process within the SPA and Early Help team for young people up to 19 years of age and the service based much of its work on the Lancaster model of care. The SPA was provided by the North East London Foundation Trust (NELFT) in partnership with the Kent Community Health Foundation Trust (KCHFT). From 1^st September 2017 NELFT had been commissioned to deliver integrated Children and Young People’s Emotional Health and Mental Health Services (CYPMHS).

The referral criteria for the service were outlined and the system allowed for open referral both online or by phone and also offered group interventions, also online or by phone. The PSPHS had a universal offer based on the Lancaster model of early identification and prevention with health assessments at Year R and Year 6, tier 1 interventions for a range of health needs (including emotional wellbeing) and referral to specialist services where necessary. The service also provided drop-in clinics in schools for advice and information, weighing and measuring children in year R and year 6 as well as vision and hearing screening for Year R. The PSPHS also provided help for primary schools in developing their School Public Health Plans to deliver a whole-school approach to improving pupil health. The same tools were applied by the Adolescent Health and Targeted Emotional Wellbeing Service with the health assessments being carried out at Year 10 and Year 12 and support being provided for secondary schools.

The Board noted that there was provision for parents to opt out of the online assessments and asked how this would capture information on those children whose parents had their own reasons for not taking part and in particular where there was concern about the wellbeing or vulnerability of the child. It was explained that where the child was in the safeguarding arena health visitors and school nurses would intervene where there was any evidence to warrant concern and that safeguarding priorities overrode any issues relating to parental consent. In the case of the adolescent health and wellbeing services the adolescents filled in a questionnaire themselves but the outcomes fed into aggregated data for each school which could be used to develop a profile and to identify issues to be tackled and the tools and resources available to meet these requirements.

The key was early identification and prevention and the ‘Lancaster model’ was used to deliver this. This included the use of 4 key assessments at year R, Year 6, Year 10 and post 16. The questionnaires used had been designed to provide early intervention alerts by using research, government targets and public health  ...  view the full minutes text for item 61.

To receive a presentation from Gwendolen Box, HeadStart Kent Youth Participation Worker.

Gwen Box, Project Manager HeadStart Gravesnd attended the meeting to update the Board on the work of Phase 3 of the HeadStart Kent Project in Gravesend which was nearing its conclusion.

The HeadStart programme aimed to improve the resilience and emotional wellbeing of at risk 10-16 year olds, to promote and facilitate cross- disciplinary, whole school/system/family approaches, to develop best practice across these areas and to generate sustainability, which was a key objective . To support this an evidence based approach was applied and working collaboratively to promote changed behaviours. The programme was organised into five groupings with a resilience hub and work phased across 4 geographical groups across the timescale of the project until July 2021 and the focus was due to move from Gravesend to Maidstone during the next phase of work.

In terms of current achievements work had been undertaken to upskill staff so that they could provide better support to young people with their emotions using three types of training; Resilience Domains, Youth Mental Health First Aid training, and ‘mindfulness’  (being “in the moment”, not focussing on the future or the past and clearing the mind  to promote calmness).

Working closely with Kent Police, HeadStart was informing schools via secure email if a domestic incident had occurred at the registered address of one of their students thereby allowing school staff to monitor the behaviour of the young person and intervene if necessary and to facilitate the links between home, school and the police. Young people were at the heart of these initiatives and helped to lead and shape aspects of the programme through their participation in local and Kent-wide speak-out groups.

The Board heard how practitioners had adopted “Domains based conversations” as a tool to talk to young people about resilience focussing on having a secure base, education, friendships, talents & interests, positive values and social competencies. Young people were also able to access safe spaces, peer mentoring and online counselling in schools and communities. HeadStart also provided grants of up to £7,500 for small projects which were led by and assessed by 10-16 year olds and were designed to benefit the emotional wellbeing of young people and also undertook a programme of family transition work which provided help and support within the family and groups of families. There was also a resilience toolkit for schools to use to assess and monitor change and to identify opportunities for improvement, and talents and interests grants.

The HeadStart services would be available for 10-16 year olds in Gravesend until December 2019 despite HeadStart moving on to the next geographical phase of its work and some more generic work would continue to be available, such as online counselling.    

The Board noted with regret that the services offered by HeadStart were not available to all of the Kent Districts, 3 (including Dartford and Sevenoaks) not being covered by the programme, and questioned the criteria that had been applied in selecting areas for inclusion. Gwen Box explained that these had been assessed  ...  view the full minutes text for item 62.

There were no matters for discussion.