Agenda and minutes

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

The Chair welcomed all to the meeting and thanked the staff at Burnley Boys and Girls Club for hosting the Board meeting and thanked officers from the Public Health Team and Democratic Services for arranging the meeting.

Apologies were noted as above.

It was noted that Elaina Quesada, Deputy Executive Director of Adult Services was attending on behalf of Louise Taylor, Executive Director of Adult Services and Health and Wellbeing, Lancashire County Council.

Graham Vernon, Chief Officer of Burnley Boys and Girls Club gave a brief overview of how the Club supports children and young people in providing them with safe spaces to talk, socialise, make friends and acquire new skills in environments free from judgement or discrimination.  The Board noted that it is Lancashire's oldest youth organisation, celebrating 125 years in 2023, and offers safe, fun, friendly environments where children and young people can learn, develop and grow together.  The Club empowers young people through education, recreation and wellbeing and works closely with Lancashire County Council's Children's Services and the Youth Zones.  The Board were informed that the Club's biggest resource currently was in mental health services and staff offering support to young people as trained Councillors.

Resolved:  That the Board thanked Graham Vernon for his inspiring presentation of the work that is undertaken at Burnley Boys and Girls Club.

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 24 January 2023.

There were no matters arising from them.

To receive a real life story from a citizen or group in East Lancashire and what they want to see different or expect the Health and Wellbeing to support/change ways of working.

The Chair welcomed Sajda Majeed MBE who provided the Board with an overview of the work she has been involved in over the last 30 years in the Daneshouse and Stoneyholme area in Burnley, with the local community.  Sajda Majeed MBE informed the Board that she had built wider and significant networks across Burnley, Pendle, Hyndburn, especially in South Asian communities and was awarded an MBE in 2018 in recognition of service to the community and in particular work to secure funding for the Healthy Living Centre, The Chai Centre, locally, becoming the Project Manager in 2004.

Sajda Majeed MBE presented the Board with three topics that the local Black, Asian and minority ethnic (BAME) community faced challenges with, in terms of:

i)  Employment and Skills – difficulties in communicating with organisation

ii)  Community Engagement – sustaining relationships when jobs have been completed and building on relationships

iii)  Commissioning and Procurement – long term planned funding from organisations and ensuring the voice of the communities is heard in meetings

The Board noted that Sajda Majeed MBE was a key contact for public services (Police, local councils, Education) to support community engagement on key issues; including recruitment of volunteers to participate in Lancashire Constabulary People’s Voice, to ensure a range of voices including Muslim, Bengali, Polish, Romanian, refugees, and young people are heard.  She has worked as the main community contact for universities carrying out research on issues relevant to South Asian communities, on behalf of UCLAN, Liverpool John Moores and Manchester Metropolitan Universities. Most recently Sajda Majeed MBE supported sub-ethnic populations participation in research into culturally acceptable diets to manage type 2 diabetes. She also facilitated the involvement of young people in an arts-based project on forced marriage.

Following the presentation the Board raised the points that:

·  Relationships need to be built on with regards to long term relationships and find a way of sustaining those relationships.

·  There is a need to include communities at grassroots level with different partners/services across Lancashire.

·  There is a need to ensure there is success planning in communities.

·  The long-term commissioning with long term partnerships and invest in the work needs to be reviewed.

Resolved:  That the Board thanked Sajda Majeed MBE for her inspirational speech.

To receive information on the development of the draft Lancashire and South Cumbria Integrated Care Strategy and the next steps for further engagement and finalisation of the document.

Craig Harris, Lancashire and South Cumbria Integrated Care Board (ICB) provided an update to the Board on the development of the draft Lancashire and South Cumbria Integrated Care Strategy (Appendix 'C') and the next steps for further engagement and finalisation of the document.

The report provides further information on:

·  Requirements of the Integrated Care Partnership (ICP) and the Integrated Care Strategy

·  Development of the draft Strategy: Work to date including finalising the strategy and the next steps

Appendix 'A' – Listening to our communities on our draft priorities: final summary of findings

Appendix 'B' – Listening to our communities on our draft priorities: analysis of text feedback

Locally it has been agreed that the final version of the strategy will be agreed by the Integrated Care Partnership (ICP) in April 2024 following further engagement with residents and stakeholders.

Following the presentation, the following points were raised:

·  Within each place/area there needs to be place-based plans and within that plan the deliverables need to be described, the milestones to be achieved and over what timescale and have 2/3 measures that can then be challenged locally in each place on each intervention of start well, age well, live well and die well.  This information will be presented to the Place Based Partnerships for each area.

·  Need to ensure that the Strategy is aligned with some of the longer-term strategies in Lancashire ie Lancashire 2050.

·  Challenge partners as to how they engage with people and challenge the tone and longevity of those conversations and do things differently to be more sustainable.

·  The Strategy needs to ensure it is clear as to which areas refer to Lancashire and which refer to South Cumbria or indeed both.

Resolved:  That the Health and Wellbeing Board:

i)  Endorsed the current version of the Lancashire and South Cumbria Integrated Care Strategy, noting that this will be further updated in the coming weeks to reflect the feedback from partners and residents.

ii)  Noted that the final version of the Lancashire and South Cumbria Integrated Care Strategy will be presented to the Integrated Care Partnership (ICP) in April 2023 for formal agreement.

To receive an overview of the emerging Joint Forward Plan (JFP) for the Lancashire and South Cumbria Integrated Care Board (ICB).

Carl Ashworth, Lancashire and South Cumbria Integrated Care Board (ICB) provided an update to the Board of the emerging Joint Forward Plan (JFP) for the Lancashire and South Cumbria Integrated Care Board (ICB).  It included the background, requirement and context for a Joint Forward Plan (JFP), and the key issues for consideration in development of the Plan and provided assurance on alignment with the Health and Wellbeing Board strategies.

The report provides further information on:

·  The requirement and context for a Joint Forward Plan (JFP)

·  Key issues for consideration in development of the Joint Forward Plan (JFP) for Lancashire and South Cumbria

The Board noted the three principles describing the Joint Forward Plan's (JFP) nature and function which have been co-developed nationally with Integrated Care Boards (ICBs), trusts and national organisations representing local authorities and other system partners.

Principle 1:  Fully aligned with the wider system partnership's ambitions

Principle 2:  Supporting subsidiarity by the building on existing local strategies   and plans as well as reflecting the universal NHS commitments

Principle 3:  Delivery focused, including specific objectives, trajectories and   milestones as appropriate.

The Board were informed that the Lancashire and South Cumbria Integrated Care Board (ICB) is intending to produce a draft version of the Joint Forward Plan (JFP) by 31 March 2023 for consultation - further iterations may continue after this prior to the plan being finalised in time for publication and sharing by 30 June 2023.

Also, that an overview of the emerging themes of the Joint Forward Plan (JFP) will be presented to the Health and Wellbeing Board at its meeting on 7 March 2023.

Resolved:  That the Health and Wellbeing Board:

i)  Considered the key themes highlighted within the emerging Joint Forward Plan (JFP) for Lancashire and South Cumbria Integrated Care Board (ICB), offering their reflections on the content and particularly on whether they feel that the key themes take proper account of the Lancashire Health and Wellbeing Strategy.

ii)  Noted that a draft version of the Joint Forward Plan (JFP) will be presented to the Health and Wellbeing Board after signing off by the Integrated Care Board (ICB) at the end of March 2023.

iii)  Noted that a final version of the Joint Forward Plan (JFP) will be presented to the Health and Wellbeing Board prior to its sign off by the Integrated Care Board (ICB) the end of June 2023.

To receive a progress report on the actions taken to develop the Lancashire Place-Based Partnership.

Sarah James, Lancashire and South Cumbria Integrated Care Board (ICB) provided a progress report on the actions taken to develop the Lancashire Place-Based Partnership.  It covers the period January – March 2023 following the last update to the Board in January 2023 and intends to ensure that the Health and Wellbeing Board are fully sighted on the progress during the development phase.

The report provides further information on:

·  Developing the Lancashire Place – Workshops

·  What we want to do together – developing our priorities

·  How we want to work together – developing our ways of working in localities

·  How we want to work together – developing our ways of working at a Lancashire level

·  Why we want to work together – developing our narrative

Appendix 'A' – Draft Lancashire Priorities

Following the presentation the following comments were made:

·  That work was ongoing to reach the hard to engage partners and communities.

·  There is a need to engage with people central in communities ie community champions/ambassadors that are rewarded for their time and invest and support them.

Resolved:  That the Health and Wellbeing Board noted the progress report on the development of the Lancashire Place-Based Partnership.

To discuss the transformation work.

James Fleet, Lancashire and South Cumbria Integrated Care Board, Helen Ashworth, Integrated Care Partnership, Aidan Kirkpatrick, Public Health, Lancashire County Council presented the "Partnership approaches to prevention in communities: Healthy Hearts" with regards to bringing together partners and communities to look at the priorities from a practical perspective of policies and plans and to discuss amongst members if the Board is doing all it can with regards to this priority and being held to account also.

The Board were reminded that Cardiovascular Disease (CVD) is the leading cause of death worldwide and accounts for one in four of all deaths in England, the equivalent of approximately one death every four minutes.  Lancashire has higher levels of premature (under 75) mortality rates from Cardiovascular Disease (CVD) relative to England.  The prevalence of key risk factors for the development of Cardiovascular Disease are broadly also higher than the England average but crucially with wide variation across respective neighbourhoods within Lancashire.

The Board were also reminded its' commitments so far which were:

•  It had agreed to work together to establish a Lancashire Health Hearts programme and will work over a ten-year period to reduce the development of Cardiovascular Disease (CVD) within Lancashire local communities.

•  It will use an evidence-based approach that encompasses seven key workstreams:

i)  Tobacco

ii)  Alcohol

iii)  Physical Activity

iv)  Supporting Healthy Weight 

v)  Food Diet and Nutrition

vi)  Health in All Policies approach 

vii)  Cardiovascular Risk Modification

•  It will also acknowledge the closely related work programmes around clinical risk management (Atrial Fibrillation (AF), Hypertension and lipid management) with NHS colleagues within the broader Integrated Care System (ICS).

•  It will set challenging interim targets between now and 2030 and report regularly to the Lancashire Health and Wellbeing as well as seek their support in how best to implement this programme as it evolves.

Key targets that the Board had agreed up to 2030 across the seven key workstreams were also presented and the current performance was outlined, and it was reiterated the importance of taking a place-based systems approach in tackling 'the cause of the causes'.

The Board discussed what it meant in practice to take a place-based partnership working approach around the Healthy Hearts priority.

A case study of community partnership working was presented to the Board which was where the NHS had teamed up with community groups to deliver vital health checks in Burnley.  Health clinics are being delivered by Burnley East and West Primacy Care Networks (PCNs) and offer a variety of baseline health checks, such as height, weight and blood pressure, as well as more complex screening opportunities for conditions like asthma, chronic obstructive pulmonary disease and diabetes etc.  There is also a provision for vaccinations, annual learning disability health checks annual serious mental illness health checks, and a Dietetics clinic, with organisations working together to coordinate care and any onwards referrals where necessary.

The Board were asked to think what opportunities their own organisations can take action on with this agenda  ...  view the full minutes text for item 6.

To receive an update on the impact of the Discharge Support Fund and the progress on the Better Care Fund 'Reset'.

Sue Lott, Adult Social Care, Lancashire County Council updated the Health and Wellbeing Board on the Lancashire Better Care Fund reset work which continues to move forward with the Finance Workstream having been established and the first workshop taken place. An interim Governance Board is being set up, with work to commence on defining the governance on an ongoing basis.

The Discharge Support Fund continues to support timely discharges for Lancashire residents from both the general Acute Hospitals and the Mental Health Hospitals locally.  There is a fortnightly reporting requirement against the plan for spend until the end of March 2023, and Lancashire activity is reported in line with this. For 2023/24 there will be an allocation nationally of £600 million to the Adult Social Care Discharge Fund and conversations will be taking place to agree how this will be spent.  Further detailed information can be found in the report.

Resolved:  That the Health and Wellbeing Board:

i)  Noted the progress in the “reset” of the Lancashire Better Care Fund and next steps.

ii)  Received further updates on reset activity beginning with outcomes of the financial review and recommendations for governance.

iii)  Noted the approach to using the Adult Social Care Discharge Fund as set out in the plan and formally record Health and Wellbeing Board approval and Chair's sign-off.

iv)  Received updates on the impact of the use of the Adult Social Care Discharge Fund.

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.

The Board had a brief discussion with the young people who attended the Burnley Boys and Girls Club who informed the Board about what they do at the club and how it supports them and what it means to them. 

Following the meeting the young people gave members a tour of the premises.

Resolved:  That the Board thanked the young people for their engagement and young person's insight into how they benefit from attending the club.

The next scheduled meeting of the Board will be held at 2pm on 9 May 2023, venue to be confirmed.

The next scheduled meeting of the Board will be held at 2pm on 9 May 2023, venue to be confirmed.