Agenda and minutes

The Chair, County Councillor Valerie Wilson, welcomed all the meeting and outlined the agenda for the meeting.

Apologies were noted.

To agree the minutes of the meeting held on 8 March 2012.

The minutes of the meeting held on 8 March 2012 were agreed as an accurate record.

Report attached.

Members of the Strategy Task Group jointly gave a presentation on the work undertaken so far. 

Habib Patel, Lancashire County Council, opened the presentation and explained that the purpose of the strategy was to:

Work together …..

·  Achieve shifts in the way that partners work; resulting in more effective collaboration and greater impact on health and wellbeing in Lancashire. 

·  Learn the lessons arising from this collaboration to strengthen future working together

…. get results

·  Deliver improvements in ‘priority outcomes’ in Lancashire.

·  Deliver ‘early wins’ i.e. specific areas for action that will help deliver the priority outcomes whilst ‘modelling’ desired shifts in the ways that partners work together.

Habib explained that the Task Group had looked at what the current Health and Wellbeing strategy is in 2012 and what the goals and aspirations are for how the strategy will look in 2020.  In order to achieve the goals and aspirations set for 2020 a number of priority shifts and priority outcomes (detailed in the circulated report) would be implemented.

Lorraine Norris, Chief Executive, Preston City Council explained that "Priority Shifts" is about the way we work and the goal is to promote greater individual health care.

The Task Group supported the view expressed by the shadow Health and Wellbeing Board that the strategy must emphasise the delivery of ‘concrete’ interventions (services, sets of services, pathways) where partners will get significant and demonstrable results and through which the Board can test out and learn from new ways of working.

The Task Group had a view that these "interventions" are those which we cannot allow ourselves to fail. It was described as we have a moral duty to get these interventions right for the people of Lancashire. 

SuggestedInterventions

·  Identify those who are at risk of admission into hospital and provide appropriate  intervention

·  Holistic support to those vulnerable families (from first pregnancy)

·  Early response to domestic violence

·  Support for carers (of dementia patients)

·  Address loneliness in older people

·  Affordable warmth to those who need it most

·  Alcohol liaison nurses

·  Healthy Weight – environmental measures

·  Tackling smoking in pregnancy

·  Self-care –  encourage people to take control of their own health & wellbeing 

Habib also outlined the proposed timetable for implementation of the strategy and that by the next meeting on 29^th May 2012 the aim is to complete initial engagement with Clinical Commissioning Group representatives, District Councils, Third Sector, Children and Young People's Trust and other partners.  With a proposal to present the draft strategy to the Board at the 10^th July 2012 meeting.

Members of the Task Group presented a number of suggested interventions (circulated at Appendix 'A' to the report) as follows:

Smoking in Pregnancy

Helen Denton, Executive Director for Children and Young People, Lancashire County Council, introduced this suggested intervention and explained that smoking cigarettes in pregnancy is one of the major causes of adverse outcomes for babies, increasing risk of babies being born prematurely, too small, and dying before they can be born at all or in their first  ...  view the full minutes text for item 4.

Ian Roberts to facilitate discussion.

Ian Roberts facilitated a discussion regarding the leadership role of Board Members and asked groups to consider how the Board Members could use their roles within their respective authorities and organisations to strengthen the Health and Wellbeing Strategy and achieve the objectives that will be set out in the Strategy.  Each group discussed the subject and feedback the following:

Things all Groups liked

·  Deliverable Interventions.

·  The priority outcomes seem more or less right.

·  Life course approach – something for everyone.

·  Inter-related interventions.

·  Early intervention.

·  Narrow the gap in healthy life expectancy.

·  Long term objectives are to be made clear.

·  Four priorities – a good size and manageable.

Recommendations from all Groups

·  Engage provider organisations in the Strategy and delivery.

·  Identify the levers in the system to bring about the shifts.

·  Provide opportunities to learn from good practice and up-scale across the County.

·  Disseminate our priorities widely.

·  Reflect these priorities in our own strategic and commissioning plans.

·  Focus on loneliness in old age to be made sharper – possibly get Help Direct in every GP's surgery across the County by the end of the year.

·  Partners need to take ownership of the Strategy and also sign off the Strategy.

·  Alcohol intervention – recommend specific projects be used to target this specifically.

·  Engage provider organisations – include them in the commissioning plans.

·  Provide opportunities wherever you live – ensure all residents of the County receive the same level of services.

·  For each priority the Board needs to map existing services and how the existing services can be developed around each priority.

·  Arrange workshops on the strategy for the Third Sector.

·  All Board members should go back to the various Boards and Committees that they sit on and take the recommendations forward.

·  District Council members should go back to their District Leaders and discuss support for the Strategy.

·  "Train the Trainers" – create a "champion" within each organisation.

Following the feedback from each group Habib Patel explained the next steps for the Board and for developing the Health and Wellbeing Strategy.  A further Task Group meeting would be arranged to refine the Strategy.  Habib highlighted the following proposed actions and timeline:

Report attached.

Janet Soo-Chung presented the report and explained that the Health and Social Care Act was passed on 27 March 2012.  The Key legislative changes of the act are:

• Clinically led commissioning
• Provider regulation to support innovative services
• A greater voice for patients
• A new focus for Public Health
• Greater accountability locally and nationally
• Streamlined arms-length bodies

Janet stated that there are eight CCG's that cover Lancashire, with six within the Lancashire County Council footprint.  The Act is moving through the authorisation process, there are four phases to the authorisation process, phase one is to be completed in June, with the final phase to be completed in January 2013 with the new Health and Social Care system to be in place by 1 April 2013.

The content of authorisation is built around six domains and has been developed through a wide range of stakeholder involvement including patients, carers, clinicians and partner organisations.

The six domains are:

In order to become a statutory organisation in their own right and to assume full accountability each CCG has to go through a nationally managed authorisation process between  now and March 2013. 

The NHS Commissioning Board

Janet explained that the Board will be organised into nine national Directorates, four slim sub-national regions and a national network of local offices.  This means that the local office for Lancashire will sit within the North of England region and is similar to the current configuration of the PCT Cluster (NHS Lancashire) and SHA North.  The bulk of the staff employed by the NHSCB will be based in the local office and their key functions will include oversight of the CCGs, be members of local Health and Well Being Boards and the direct commissioning of primary care services, specialised NHS services, military health services, offender health services and a range of public health services. It was noted that Richard Barker has been appointed as Regional Director for North of England.

Commissioning Support

Janet also explained that a key feature of both the eight CCGs and the NHSCB local office is that the staffing structures will be kept to a minimum and they will be expected to acquire additional services from Commissioning Support Organisations.  These CSOs whilst initially hosted by the NHSCB are expected to be outsourced by 2016.  The Lancashire and Cumbria joint venture is developing well and robustly and will offer services in areas such as contract management, service redesign, analytical  ...  view the full minutes text for item 6.

Report attached.

Debs Harkins presented the report (circulated) and explained that an estimated baseline for the public health grant has been published by the Department of Health and is based on public health spending during 2010/11. The estimated baseline for Lancashire is £45,891,000 which equates to £37 per person. The DOH are currently developing A needs-based allocation formula for the public health ring-fenced grant is currently under development and is expected to be published for consultation after the local elections with an allocation formula published along with the actual allocations in December 2012.

In February 2012 a formal consultation was launched on ‘Delivering the public health reforms in Lancashire’.  This set out: proposals for the functions to be undertaken by the local public health service within Lancashire County Council, including the mandatory services above; a timetable for the implementation of the public health reforms; and a draft Human Resources Framework. The consultation closed on the 22 March 2012. A paper setting out proposals in response to the consultation and a process and timescale for developing a structure for the public health workforce is being considered by the County Council's Management Team and NHS Lancashire Executive Team. It proposes that shadow arrangements are put in place from the end of October 2012.

The Director of Public Health in the County Council will have chief officer status and within Lancashire County Council it has been agreed that the DPH will be an Executive Director reporting to the Chief Executive. Recruitment to the Lancashire DPH post is underway and it is hoped that interviews will take place no later than the end of June.

Resolved: The Shadow Health and Wellbeing Board agreed to note the report and update on Public Health Transition.

None.

The Board is asked to note the programme of meetings for 2012 and the date of the next meeting as indicated below:

All meetings are now a 2pm start, with tea, coffee and biscuits available from 1.45pm.

The Board is also asked to note that the next meeting of the Board will be held on Tuesday 29 May 2012, 2pm in the Rowan Room at Woodlands, Chorley.

END OF MEETING

Resolved: The Shadow Health and Wellbeing Board noted the programme of meetings for 2012 and noted that the next meeting would be held on Tuesday 29 May 2012 at 2pm, in the Rowan Room at Woodlands Conference Centre, Chorley.