http://wrexham.gov.uk/framework
Healthy and Active
Strategic Co-ordinating Group
Meeting
Date: 29 October 2007
Attendees

Name
Sue Willis (Chair)
Angela Roberts
Yvonne Harding
Patrick Howells
Dawn Cooper
Jonathan Miller
Karen Allen
Jan Jones
or
Venue: Erlas Centre
Time: 1.00 – 4.00
X
/X



Apols
Apols
Apols


/X
Donna Dickenson
Susan Evans
Graham Edwards
Vicky Barlow
Pauline Preston
Margaret Southall
Police - TBA
Economic Devel - TBA
Apols

Apols



X
X
/X
Apols
Viv Davies
Alex Carson
Kathryn Uche
Janet Williams
Ken Danskin
Gillian Cowan
Jerry O’Keeffe
Vicky Jones
X

X

Apols

Apols
Outcomes
Agenda Item and Details
1.
2.
3.
Actions/Who
Responsible?
Apologies
 See table above
Minutes and matters arising not on the agenda
 Item 7 from meeting of 01 June 07: Slide 23 of JO’K’s
presentation
 Addressing Alcohol Misuse – What Works? - now
deferred as a group is likely to be set up by Health
Alliance to look at risky behaviour.
 Pg. 1 Representation from Trust Programme Groups
via CR – YH can cover Well Child and Disability. Dawn
can cover Maternity. PH covers emotional Health and
Wellbeing. The Trust child protection committee feeds
information to LSCB and Safe from Harm
 Item 3.2: CAMHS Strategy: JHJ to check that last set of
minutes and strategy are on website.
 Big Lottery - Mental Health (KU): the deadline was met.
Must wait to hear (takes about 3 months).
Standing items: Group/Board updates
3.1 Integrated Children’s Disability Service (ICDS) (YH)
 Project brief taken to the point where the consultant needs
to take it forward. TF Group completed its Part 1 work –
consultant needs to step in now. The TF Group will,
therefore, disband in its current form. The next phase of
work will be set up once consultant reports.
 The consultant will network with the TF Group which will
1

JOK to keep
SCoG informed
of progress

JHJ to action

KU to keep
SCoG informed
of progress
Agenda Item and Details


3.2
Actions/Who
Responsible?
support her/him. Phased implementation of ICDS
expected. Project brief has gone to potential consultants.
(Without any indication of funding). They also had copy of
the Prince 2 plan forwarded.
There are two ‘applicants’ for the consultancy post –
interviews in November.
Grading of the full time post from March 08 – JD now
drafted. There is sufficient funding available to pay the
higher salary which it is felt would be merited by the
responsibility implicit in the post, but it will have to go back
to Flexibilities as a business case once it is known for
certain that there will be Flexibilities funding in 80/09.
Business case to be put together by AR/YH/MS. If there is
no Flexibilities funding the post will have to go forward as
part of the requests for funding generally from RSG.
Emotional Health, Well-being and Counselling (AR)
 At last EHWBC meeting, PH informed that all but one post
for Tier 2 had been filled – final one going for re-advert.
Business proposal was shared with Estyn as part of
inspection evidence. LC also interviewed. Work on CAMHS
well received by Estyn – JHJ confirmed this and stated that
Estyn are considering highlighting Wrexham’s partnership
working on CAMHS in a good practice box (a rare honour!
 Two PMHW (education) appointed – not yet certain which
schools they will be deployed in.
 NE Wales has been allocated £50k plus for training of T2/3
staff.
 Solutions Caia now have agreed funding. Working with
Julie Gillbanks of NCH to integrate them into supervision
processes.
 CAMHS is a key priority across all partnerships and
organisations in Wrexham. The LSB has asked for
information on what it can do to help to progress/realise the
Strategy. A workshop session has been arranged for 09
November for CAMHS Strategy Group members to look at
this. A paper will produced for CYPFWP Board in
November this will be circulated to HA SCoG. Paper to go
to the LSB for 12 December (not January as previously
stated).
 HIW/Wales Audit Office Review of CAMHS: A team of
reviewers is undertaking fieldwork involving staff from WAO
and HIW, and peer and lay reviewers. Work with education
and social services will be undertaken either by WAO staff
with relevant backgrounds, and/or Estyn and CSSIW staff.
 They are planning to visit each region and undertake all
detailed fieldwork during the course of a single week during
November and early December. Regional feedback will be
provided.
 The target is to produce a draft all-Wales report by the end
of February 2008. This will then be subject to internal
discussion and external consultation prior to publication,
which is likely to be at the end of April 2008. Wrexham LHB
2

AR/YH/MSto
note and
action.
Agenda Item and Details
Actions/Who
Responsible?
has been notified that they wish to interview the Chief Exec,
Angela, Patrick plus others including a Focus Group of
doctors and practice nurses on 13 December and possibly
14th also. Letter received by JHJ today re this.
3.3
3.4
3.5


CYP Substance Misuse (linked via SMAT)
 VJ not present at today’s meeting. Updated SMAT
diagram of relationships was sent out by VJ soon after last
meeting. JHJ will try to get dates of all TF Group meetings
for SCoG information.
Sexual Health (linked via Health Alliance)
 No real change from minutes of last meeting.
 Business plan for extending Darland Outreach project
(JOK) needs to wait until pilot ends in December. Also
more work to be done on smoking cessation. SW outcomes of evaluation would need to go to the three
Boards. Funding issue re pharmacy costs.
 Conwy/Denbighshire provision: a meeting has been set
up by AR on12 November with Liz Morgan etc. to look into
the specifics of the service which is provided for
Wrexham, and any proposed changes to this service.
Does the service comply with NICE Guidance? This will
be Wrexham’s opportunity to articulate what it wants from
a Sexual Health Service for YP in Wrexham.
 YH has seen some paperwork on proposed changes but
currently such plans are not to be disclosed. It is clear,
however, that they involve a significantly streamlined
service. There appears not to have been any consultation
on changes as yet; commissioners have not been made
aware that of any intention to change the services
previously purchased. Phase 2 being mooted as
opportunity to include C&YP services.
 Our position is strongly rooted in the principle that funding
should follow the service user – including young people.
 YH has sent a paper through to CR this morning on this
issue and would hope to be able to share with the SCoG
in due course.
 Following the meeting on 12 November, J O’Keefe to be
asked to develop a paper stating what we need and what
the gaps are.

JHJ to action.

JO’K to keep
SCoG
informed.

AR to report
back to SCoG.

YH to action.

AR to action
with J’OK .
Young Carers (MS)
MS – will take this TF Group forward for the SCoG. Key
priorities need to be established. There was a meeting earlier
this month following on from Young Carers presentation to
CYP Scrutiny Committee re. education issues and support in
schools. SW: Carers was a priority in previous HSCWB
Strategy and a group was set up in relation to carers in general
- Carers Programme Group. The earlier group did not function
effectively in respect of YP. JHJ will send MS all information

we have. NB NSF key actions in respect of this.
JHJ: Young Carers has not been identified by CYPFWP Board 
as a priority; SW in agreement with this. It should not appear in
3
JHJ to action.
Gillian Cowan
to note.
Agenda Item and Details



3.6
3.7
Actions/Who
Responsible?
HSCWB Strategy as a CYP priority.
Questions were raised about funding previously allocated to
Young Carers - NCH funding – and how used. The LHB has
also given money in the past to support young carers through
NCH.
AR – there was also funding for mental health project workers
re carers, with a point 5 post for Young Carers caring for
parents/siblings with mental health problems. AR will send
documentation re this to JHJ/MS. There are some issues
around funding for posts which used to go across adults and
children’s social care now that children’s social care is part of
CYP Service. JHJ/MS to pursue with the help of BMcL.
SE had spoken to NCH last week and they said they have
someone coming into post shortly. JOK has been working with
Kate Meredith looking at issues in relation to adults –
transport, leisure access, etc?
Speech and Language (K/A)
 KA provided an A4 overview of activities thus far.
Membership listed. AR summarised.
 A Visioning Day is planned for 19 November (date may
change).
 KA has had copy of eMail from WAG saying that they are
bringing in their consultants much earlier than expected in
November 07 to gather feedback (project is funded until
March and so this can only be interim feedback). JHJ
wondered if WAG come to the Visioning Day rather than
scheduling a separate visit. Steering Group needs to
consider.
 WAG very keen to hear more about service user
consultation, which went very well (36% response rate).
 AR currently chairing this group and will liaise with Sarah
Morris and with WAG. AR not originally chair of group –
may need to take a view on this as F’Shire was originally
chairing and this has been disrupted.
Health Alliance (general update) (JO’K)
 Health Alliance Performance Information (tabled).
 Active 8-2-16: funded from Cymorth and has 18 months to
go. Evaluation went to sub-group looking at Exercise on
Referral (report on this also provided). Has an impact on
mental health. JOK producing paper on referral routes for
exercise. NPHS has provided evidence-base for this. There
has been consideration of extending Active 8 to obese
children but there is no capacity.
 Obesity being looked at strategically at the moment by
Health Alliance. Junior Gym in Queensway – largely
referrals-in for obesity and struggling to support its
operational costs – might have to ask Head Teachers to
pay for it though HW/CF providing some funding.
 Wrexham Leisure Card – acts as an entitlement card –
when swiped tells people on reception what people are
they’re entitled to. Flexibility to tag-on whatever we want
4

AR to action.

JHJ/MS to
action.

KA to contact
Hywyn about
this.

Steering Group
to consider.
Agenda Item and Details






Actions/Who
Responsible?
without stigmatising – just need it to be evidence-based. In
future will also provide a reward scheme. Can target
discounts and concessions against need (PURE card and
DASH Card 50% reduction) Currently looking at discounts
for students and at identifying quiet times for them to
access at £1 per session. NB. LAC and Young Carers.
Stay Safe – releases whole package of safety equipment
for the home (eg. fireguards).
Management of injury data – data-capture database about
to be set up. Will enable us to explore background to
injuries so that these can be reduced.
Breastfeeding Co-ordinator: funding from Cymorth. Need
to look at protecting funding for post if Cymorth goes into
RSG
Appetite for Life agenda – AR: no point in having healthy
eating approaches while children are allowed out of school
and can go into the nearest chip shop. VB – has been
discussed at WASH – not just from eating point of view but
also ethos also. JOK – need to look at whole service side of
healthy eating.
Allotments policy – involving primary schools – YOS
funding to make allotments in primary schools. VB – very
good scheme and improves children’s language levels and
enthusiasm also.
Sexual Health – last year 4 sessons were delivered – high
demand. Yale college to deliver at OCN Level 2. Also
meeting with Sarah Jowett at NEWI re. enhanced provision.
VB: policy development in Wrexham recognised as good
practice by all-Wales PSE Conference. Need to explore
stronger links with NEWI and Yale – significant possibilities
here. Some kind of strategic understanding needed
especially re. student projects and dissertations. They have
taken on SAP and think highly of it. AR – any chance of
working with Nursing Students at Yale in respect of sexual
health – could contribute to capacity issues at Info Shop.
YH – work at Kelsterton College demonstrating how
productive this can be. 14-19 – Learning Core: Partnership
Working around PSE.
3.8
NSF (AR)
 Looking at these as part of the TF Groups and Service
Management Plans (SMPs). Draft NSF plan on website –
no comments received.
 CYPFWP Board have agreed to extend MW’s contract (1day per week) until the end of March 2008.
 NSF Co-ordinators’ meeting eMail received.
3.9
EMARS (AR)
 NE Wales has been allocated £8k for EMARS; there is
meeting re. this on 15 November to determine referral
logic. Virtual integration of the service could be developed
from this project.
5
Agenda Item and Details
3.10
Actions/Who
Responsible?
Issues from Trust Programme Groups
 YH: Disability Trust Focus Group – purely health-focused
for professionals to look at professional issues. There won’t
be a need for this group once ICDS goes ahead – just a
need to ensure that there is appropriate representation.
 Well Child – looking with WAG at universal minimum
standard for all YP – frustration at the slowness with which
things are agreed and they are then locally interpreted,
which can destroy the universality which was aimed for.
Getting there slowly - NSF underpinning document for this.
 Well Child has a particular focus on childhood obesity –
there is poor data to support this. It is a multi-faceted issue
and there is a need for accurate baseline data.
 Y7 pupils to have height, weight and body mass index
recorded; already measure on entry at age 4. Waist
measurements will NOT be taken – ethical issues re. this could be mass opt out if varied from agreed normal
screening across Wrexham and Flintshire. Debate ensued
re. the effectiveness of this indicator vs. BMI; clearly so for
adults – is it also true for children?) –
 Information will go onto national child health database. Is
postcoded and can be geo-coded. Data also goes to WAG.
 LW of NPHS will provide data to us provided we are very
clear on what we want and why we want it.
 Other two big issues – Y8 girls inoculation and catch-up
campaign re cervical cancer rates.
 Immunisation is a standing item on Well Child. Either GPs
or NHS Trust can do it – money goes to whoever carries out
the work. Rates for some age groups have increased but
pre-school has decreased. There will be a need to ask both
delivery groups to explain what they are going to do about
increasing rates.
 School nurse capacity – a discussion took place re. a letter
which had been sent to schools. Secondments of
experienced School Nurses have led to posts being
backfilled leading to a need for new school nurses to be
inducted. Short term capacity issue; NO suggestion that this
service will be reduced. Wrexham is one of the few areas in
Wales which meets the expected ratios – we’re the best in
Wales. WAG is committed to having a Family Health Nurse
in every school – AR – this is based on the Scottish model
which was abandoned there because it didn’t work!
 School Nurse Teams in Wrexham have been developed to
support schools, to provide specialisms and create a career
structure – so not just one person but a range of people is
involved. For example, they provided cover throughout the
school holidays. JHJ – schools not fully aware of what’s
being done and what’s on offer – need to keep them
constantly informed. VB: Can YH attend a future PSE QC

to share information?
 Summary sheet goes to schools on a CD. NW NHS Trust
website – provide link to this on schools intranet and

Framework webpage (JHJ). MW working on this. AR:
6
VB to invite YH
to PSEQC.
JHJ to action
and speak to
Agenda Item and Details
Include data in NSF SAAT. Also invite YH to attend WASH
and Primary Headteachers’ Federation.
 F’Shire and Wrexham going to move towards Integrated
Primary Healthcare teams for chronic illness and for
preventative work. Wrexham to be split into three areas for
this purpose - same as police boundaries. Has to fit around
the estates.
 Conwy/D’shire in consultation re. maybe progressing
proposed amalgamation.
 Needs to be remembered that Trust Children’s Service is
accountable to both the Trust, Board and CYPFWP.
Actions/Who
Responsible?
MW re. website
and JD/JOR.
3.11 FWP Board/YPP/CP/HSCWB Partnership/Community
Safety Partnership/LSB/Other SCoGs/Other
 Estyn Inspection of YSS: self-evaluation report (SAR)
distributed. Apologies that timescales and pressures
created by October inspection of LEA meant that there was
no time to share for comments before sending to Estyn.
 Pro forma was created and sent to potential contributors –
75 returns – very pleasing (though quality variable). Selfevaluation based on these returns and so reflective of
contributions. Health colleagues had stated that they did
not feel that their services to young people were suited to
the Estyn seven Key Questions in the inspection
Framework.
 Clear when writing the SAR that there is a lot of excellent
work (outstanding?) going on in Wrexham. However, we
have graded ourselves as 3 rather than two in recognition
that we are not yet joined up enough at the strategic and
SCoG level (next phase to be addressed).
 Thanks to those who got involved in October inspection. (If
you are asked to be interviewed again the angle should be
different)
 NB: Next FWP Board meeting scheduled for 21 Nov. 07.
4.
Other items arising/tabled
4.1 A Strategy to Reduce the Prevalence of Smoking in
Wrexham (JO’K – tabled at previous meeting)
 Being delivered in 4 secondary schools.
 Smoke bug – 30 primary schools engaged.
 JOK will get an update from JM on these schemes.
 Chris McMahon currently analysing outcome data – not
sure that the schemes are being effective.
 NPHS would be very helpful in relation to this and identify
data streams and evidence-based approaches.
4.2
4.3
Exercise Referral Schemes in Wrexham (JOK report
attached with agenda)
 JOK will bring an evaluation report to next meeting.
SCoG Representation
 Request for Therapy Services Representative on SCoG –
agreed. Gareth Evans, Head of Therapy Services and
Community Hospitals for the Trust to identify someone
7

JOK/JM to
action.

JOK to action.

JHJ to action.
Agenda Item and Details


4.4
4.5
4.6
5.
Actions/Who
Responsible?
from this Directorate
AVOW – request for CG of Dynamic to be second
representative from Third Sector (instead of Janet
Williams). Absolutely no problem with this - job description
provided by AVOW re. representation of sector rather than
own organisation. Invite to next meeting.
NPHS representative would strengthen the SCoG. PS to
identify representative please.
Discuss posts that may be required for CYPs Integration
agendas when the Joint Working Special Grant becomes
RSG
 BMcL had asked AR to raise this. CYP representation
needed on Flexibilities Group – TDG asked to identify
someone to do so – not sure re. progress on this. YH
thought that there had been discussions re. joint working in
respect of Occupational Health? Each to accept the other’s
referrals?
 Criteria to be sent to JHJ by AR for circulation with these
minutes for consideration. Need to address these closely.
TF Group Chairs to prepare suggestions for Flexibilityfunded posts and projects with a tightly argued business
case which pays close attention to the criteria – This is a
common TF Group Task which all TF Groups must
address in next meeting please – info to come to next
SCoG for consideration/support.
Draft National Targets 2008/2009 for inclusion in the NHS
consultation exercise
 SAAF 2008/09 targets are out for consultation now – the
only CYP-specific target relates to CAMHS. Teenage
pregnancy/Sexual health are there – lots of targets touch
on CYP but are not specific to this group. Closing date is
soon. Acute work takes precedence and adult chronic
disease management takes priority too.
Children and Young People’s Plan (CYPP)
 Memo and overview paper which has gone to Council staff
distributed. JHJ talked the group through the main points.
Agreed that SW will share with Board after JHJ adds
some of the timescale information from previous papers.
AOB
5.1 Review of TF Group Action Plans and outcome measures
 Common TF Group task for next meeting: review ToR
(using template already prepared and shared) and Work
Programme Action Plan with outcome measures. These to
be agreed by next SCoG in future. Intention is to move
away from descriptive updates towards progress reporting
and raising actions which require SCoG support/advice re.
next steps.
5.2
Sexual Health Consultation (tabled) (JOK)
 Closing date 31 October. This was in fact tabled by JHJ at
8

JHJ to action.

JHJ to contact
PS.

TDG to provide
information
please.

AR to send
criteria to JHJ.

TF Group
Chairs to note
and to action
please.

SW/AR to send
to JHJ for
publication on
HA SCoG
webpage, for
information/

JHJ to amend
and send to
SW for sharing
with Board.

TF Group
Chairs to note
and to action
please.
Agenda Item and Details
Actions/Who
Responsible?
the September CYPFWP Board meeting. A response has
been received from DD. LHB response being drafted very medically focused but hasn’t gone to their Board yet
– coming at it from a different angle. This is perfectly
acceptable and the two responses do not clash. Key
concerns – original framework tabled in 2000 but they
appear to be making same mistakes again. Also YP
consultations – there do not appear to have been any. AR
has passed on corrections to JOK and he will send this off
on behalf of Council and Health Alliance. SW/AR will deal
with LHB response. Both to be placed on webpage when
finalised, for information.
5.3
5.4
6.
Health Alliance Performance (tabled) (JOK)
 Dealt with mainly in 3.7, above.
 The Sexual Health Group wants to change its name to
Teenage Pregnancy (the name used in England). SCoG
very firmly NOT in favour. JOK will make sure that DD and
the group is aware of this and takes this on board.
Additional After Meeting
 Big Way of Life Lottery Bid – report from Janet Williams,
AVOW – this was sent to JHJ on 18 October but she
missed it amongst eMail tsunami – apologies. SW/AR to
be asked to consider report on behalf of SCoG and to
confirm support or otherwise for bid to JW/GC and update
SCoG members at next meeting please.

JOK/SW to
action. Send
final versions to
JHJ for posting.

JOK/DD to
pass this strong
message
through.

SW/AR to
consider and
respond to
JW/GC.
Date and time of next meeting (nb. next PAG meeting: 12 February 08 and CYPFWP
Board meeting 27 Feb 08).
 Mon 28 Jan 08: 11am – 4pm: JHJ book lunch
 JHJ to action.
 Venue Erlas Centre unless otherwise notified.
9