Agenda and minutes

To welcome all to the meeting, introduction and receive apologies.

The Chair welcomed all to the meeting.

Apologies were noted as above.

Replacements for the meeting were as follows:

·  Sarah Callaghan for Edwina Grant OBE, Lancashire County Council

·  Paul Hegarty for Caroline Donovan, Lancashire and South Cumbria NHS Foundation Trust

·  DCFO Steve Healey for ACFO Ben Norman, Lancashire Fire and Rescue Service

Dominic Harrison, Director of Public Health, Blackburn with Darwen Council was also in attendance.

Members of the Board are asked to consider any Pecuniary and Non-Pecuniary Interests they may have to disclose to the meeting in relation to matters under consideration on the Agenda.

There were no disclosures of interest in relation to items appearing on the agenda.

To agree the minutes of the previous meeting.

Resolved:  That the Board agreed the minutes of the meeting held on 19 January 2021.

To note the action updates from the previous meeting and the forward plan for future meetings.

Resolved:  That the action sheet and forward plan was noted by the Board.

Any future items for the forward plan should be submitted to Sam Gorton, Clerk to the Board, email sam.gorton@lancashire.gov.uk.

To receive an update on COVID-19 vaccinations.

Jane Scattergood, Covid-19 Vaccination Director for Lancashire and South Cumbria, outlined the current position on the progress of the vaccination programme to date.  A presentation was circulated to the Board, with further details on the following areas contained within it:

·  Covid-19 Vaccination sites across Lancashire County Council locality

·  Timeline for delivery of cohorts and conclusion of the programme

·  Vaccination summary for health and social care staff

·  Vaccination summary for care homes

·  Cohort 2 80+ - detailed by area/district in Lancashire

·  Cohort 3 75+ detailed by area/district in Lancashire

·  Cohort 4 70+ and Clinically Extremely Vulnerable detailed by area/district in Lancashire

The timeline for delivery of cohorts and conclusion of the programme of the Joint Committee on Vaccination and Immunisation 1-9 cohorts which were determined by SAGE (Scientific Advisory Group for Emergencies) and would reduce the incidents of serious illness and hospitalisation and death by 98% was outlined.  The national target is 15 April 2021 to complete first doses and a local ambition has been set for 31 March 2021.  The vaccine supply has been constrained and remains constrained, however, there is a clear message that there will be lots of vaccinations available from 15 March 2021 onwards.  The Prime Minister set a national target of conclusion of completion of the whole adult population (16-50 year olds) by the end of July 2021, however it is uncertain currently as to whether this is for one or both doses of the vaccination.

The vaccination uptake for Health and Social Care staff was reported to be better in Lancashire than nationally.  In terms of the flu vaccine uptake it is normally around 50-60% of NHS staff and 30% of Social Care staff, therefore the figures detailed in the presentation, showed an increase in uptake in terms of the Covid-19 vaccine, however, there is still more work to do on this in terms of protecting critical workforce and more importantly, the workforce these people serve.

Older adult care homes have 100% coverage of offer across Lancashire and there are a handful of individuals in care homes who have either declined or are too unwell to receive the vaccination at this point.  The Board also noted that every Learning Disability Care Home, as well as Mental Health Care Homes, have a planned visit for the vaccination programme in place.

Vaccination numbers across Lancashire are well in excess of 90% of vaccine uptake in Cohort 2 – 80+ and Cohort 3 – 75+ with an offer of 100% to all residents in those cohorts.  Cohort 4 – 70+ and clinically extremely vulnerable uptake again is in excess of 90%.

Abdul Razaq, Interim Consultant in Public Health, Lancashire County Council continued with the presentation including:

·  National latest – ONS (Office for National Statistics) Coronavirus and vaccine hesitancy, 13 January 2021 to 7 February 2021

·  COVID vaccination health inclusion groups

·  Addressing low COVID vaccine uptake

·  Current Lancashire activities

The Board noted that the main reasons of vaccine hesitancy, which are fuelled by social media and negative aspects is  ...  view the full minutes text for item 5.

To discuss how the Health and Wellbeing Board can support health inequalities in terms of what the Board expects to do/achieve, how the Board will know it is on track and be clear on what success looks like.

Dr Julie Higgins, Joint Chief Officer Blackburn with Darwen/East Lancashire Clinical Commissioning Group (CCG) and Integrated Care System (ICS) Lead for Health Inequalities provided the Board with an overview of the national and regional requirements, along with key actions the Integrated Care System (ICS) is proposing to take to reduce health inequalities.  The report also seeks to provide the Health and Wellbeing Board with an opportunity to offer views in relation to the actions and consider how best the Integrated Care System (ICS) and Health and Wellbeing Board could work jointly to take forward work on this critical issue.

Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council, reminded the Board, in terms of health inequalities, a few key markers that the Health and Wellbeing Board are held accountable for:

i)  Average life expectancy at birth (males 78.5 years and females 82.3 years)

ii)  Average healthy life expectancy at birth (males 60.4 years and females 64.6 years)

Therefore, on average currently, there are approximately 20 years of ill-health and disability in both males and females and there are parts of Lancashire where the healthy life expectancy is just above 50 years of age.  This is incredibly important as a marker, not just from a health and care perspective, also for a wider society perspective and this has been seen during the COVID pandemic.  The role of the Health and Wellbeing Board is a unique one in being able to bring partners who can influence a range of sectors across the life course, education to work and health and care service.  There is a long way to go, however this is the first step in, and the role of the Board in addressing these inequalities is even more significant when coming out of the current pandemic.

Dr Julie Higgins, reported that the COVID experience has been really difficult and this is due to health inequalities, however through the pandemic, it has moved it further up the agenda of the NHS.  A proposition has been accepted by the Integrated Care System (ICS) Board to set up a Health Inequalities Commission. 

Detailed further in the presentation were:

·  Tackling health inequalities – making sense of the asks

·  Summary of health inequalities required actions

·  Feedback from NHSEI (NHS England and NHS Improvement) on Lancashire and South Cumbria Integrated Care System (ICS) action on health inequalities (phase 3 planning)

·  COVID-19 Horizons

·  Addressing health inequalities through COVID-19 Horizons

·  Embedding action and assurance on health inequalities at every layer and through every strategy

·  Key actions for the Integrated Care System (ICS)

The Integrated Care System (ICS) has agreed to undertake key actions over the short and medium term to embed a focus on addressing health inequalities throughout everything it does.  The actions, summarised below, are set out in the enclosed Appendix A.

·  In the short term, all organisations/systems will assure themselves they are undertaking the requirements of the Phase 3 guidance and North West Community Risk Reduction Framework and look to identify areas for improvement or where  ...  view the full minutes text for item 6.

To receive an update on the current situation and what has happened since the last Board meeting.

Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council, provided a brief overview of the current COVID-19 situation in Lancashire.  The overall infections rates were reducing significantly, which was due to a combination of vaccinations and people following the guidelines that are in place across Lancashire.  Variation is showing between the districts and that is a risk that was highlighted to the Board.  The number of people in hospitals and deaths were reducing, as well as the severity of the illness and outbreaks in the care sector.  The epidemic has moved to the 30-34 age group across Lancashire and is more pronounced in some districts, ie Preston, South Ribble and East Lancashire.  The agenda therefore, going forwards is one of how the current trajectory is maintained overall, by continuing to focus on getting the basics right (hands, face, space) and continuing to encourage people to come forwards for testing and follow advice on tracing and removing barriers for self-isolation, where there is more support in terms of financial aid to self-isolate and vaccinations.  It is anticipated that restrictions will continue and will be lifted as per the Central Government's plan, however, there is a risk in Lancashire, if after schools return, and the adult population continues to see higher levels of infections, whether the national policy will change from being the whole of the country following the same guidelines/restrictions, to once again, more localised rules.

The Contain Framework plan is currently being refreshed, and the purpose of that is to be ready to respond to any variants of concern (of which Lancashire does not have any currently), and to continue to identify outbreaks early and manage them in time, which is a partnership endeavour between District Councils, County Councils, NHS as well as the business and community sectors in terms of continuing the messaging.

The role of the partnerships is to encourage everyone to receive the vaccinations and to improve the vaccine hesitancy across the County, with different messages and mediums.

There is a fundamental challenge with this, which is timely testing and tracing activities and there are different incentives in place to encourage people to come forward for testing and where it is necessary, local discretionary payments as well as care support through working mainly with District Councils.

Resolved:  That the Board noted the update on the current COVID-19 pandemic in Lancashire.

To receive an update from the SEND Sub-Committee on the latest version of the Accelerated Progress Plan (APP).

Sarah Callaghan, Director of Education and Skills, Lancashire County Council, outlined the minutes from the Health and Wellbeing Board SEND Sub-Committee which met on the 3 February 2021 to discuss the Accelerated Progress Plan (APP) which includes the progress made by officers since the previous meeting of the Sub-Committee held on 24 September 2020.  Further details of the minutes from the meetings can be found here.

Following the inspection carried out by Ofsted and the Care Quality Commission (CQC) in February and March 2020, the report concluded that of the initial twelve areas of concern, seven had made sufficient progress and no longer required monitoring. 

It was noted from the most recent meeting of the Sub-Committee, that good progress was being made in each of the five areas of improvement detailed in the Accelerated Progress Plan (APP) which the SEND Sub-Committee scrutinise and challenge at its' meetings.

Until now, the service has been undergoing check-point meetings with the NHS and the Department for Education (DfE) which have gone really well and the next meeting on 24 March 2021 will be a monitoring visit, where it will be demonstrated, the evidence and impact against each of the five areas within the Accelerated Progress Plan (APP).

Resolved:  That the Health and Wellbeing Board noted the report of the Lancashire Health and Wellbeing Board – SEND Sub-Committee.

An item of Urgent Business may only be considered under this heading, where, by reason of special circumstances to be recorded in the minutes, the Chair of the meeting is of the opinion that the item should be considered at the meeting as a matter of urgency.  Wherever possible, the Chief Executive should be given advance warning of any Members' intention to raise a matter under this heading.

There were no items of urgent business received.

The next scheduled meeting of the Board will be held at 2pm on 15 June 2021, via Microsoft Teams.

The next scheduled meeting of the Bord will be held on Tuesday, 15 June 2021 at 2pm.  Format to be confirmed.