Agenda and minutes

The Board is asked to note the appointment by Full Council on 25 May 2023 of County Councillor Michael Green, Cabinet Member for Health and Wellbeing as Chair and James Fleet, Integrated Care Board, NHS as Deputy Chair of the Committee for the municipal year 2023/24.

The Board noted the appointment by the County Council on 25 May 2023 of County Councillor Michael Green, Cabinet Member for Health and Wellbeing and James Fleet, Chief People Officer, NHS Lancashire and South Cumbria Integrated Care Board as Chair and Deputy Chair respectively of the Health and Wellbeing Board, for 2023/24.

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

The Chair welcomed all to the meeting and thanked the staff at the Pavilion Café, Avenham Park, Preston for hosting the meeting.

Apologies were noted as above.

New members were noted as follows:

County Councillor Graham Gooch, replacing County Councillor Phillippa Williamson, Lancashire County Council

Councillor Jennifer Mein, replacing Councillor Matthew Brown, Central Lancashire, Lancashire Leaders Group

Councillor Chris Dixon replacing Cllr Viv Willder, Fylde Coast, Lancashire Leaders Group

Resolved:  That the Chair requested a letter of thanks be sent to the outgoing members for their time and commitment to the Board.  It was noted that Sam Gorton, Democratic Services, Lancashire County Council would arrange this.

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 9 May 2023.

There were no matters arising from the minutes.

The Board is asked to review the Terms of Reference and Membership.

Resolved:  That the Board noted the current membership and Terms of Reference for the 2023/2024 municipal year, as set out in the agenda pack.

To receive a presentation from the River Ribble Trust and discuss how the Health and Wellbeing Board can support/change ways of working.

The Chair welcomed Harvey Hamilton-Thorpe who provided the Board with an overview of the work of the Ribble Rivers Trust; and prior to the meeting had led on a health walk around Avenham Park for Board members.

The Board noted that Harvey had been involved with the multiyear, multi-million pounds National Lottery Heritage Funded programme called Ribble Life Together.  The project won the coveted UK River Prize in 2022. A copy of HEAL Evaluation 2023 was also shared and is attached for further reference to the minutes.

Harvey spoke to the presentation attached which further detailed the following:

·  Key activities

·  Health and Environmental Action Lancashire (HEAL)

·  HEAL decision support tool (arcgis.com)

·  Working in partnership

·  What have Ribble Rivers Trust achieved?

·  Avenham Park Health Walks

·  Ribble Rivers Trust - Working Together to Improve Our Rivers (ribbletrust.org.uk)

Following the presentation, it was noted that:

·  Social prescribing is progressing, with health walks as a part, as well as volunteering and tree planting.

·  CC Gooch to contact Harvey Hamilton-Thorpe outside of the meeting in relation to opportunities for those with learning difficulties.

·  The work needs to be part of the Health and Wellbeing offer across Lancashire, regardless of how it is funded and is the biggest opportunity to reconnect residents of Lancashire back to nature in their communities.

· For further information, email Harvey Hamilton-Thorpe harvey@ribbletrust.com.

Resolved:  That the Board noted the updated and thanked Harvey Hamilton-Thorpe for his presentation and for leading on the health walk prior to the meeting.

To receive an overview of the Lancashire Better Care Fund (BCF) plan 2023 to 2025.

Sue Lott, Adult Social Care, Lancashire County Council provided an overview of the Lancashire Better Care Fund (BCF) plan 2023 to 2025. Having received approval by both Lancashire County Council and Lancashire and South Cumbria Integrated Care Board the final draft plan was signed off by the Health and Wellbeing Board deputy Chair and submitted to the national Better Care Fund team for the required assurance.  National planning timetables precluded the plan being brought to a formal meeting of the Board earlier. It is anticipated that the plan will receive national approval.

The Board noted that there were two elements required for submission: a planning template (this has been circulated separately to the agenda, to members of the Health and Wellbeing Board) and a narrative plan (Appendix 'A').  Further details can also be found in the report.

The requirement for a two-year plan allows for stability across service planning and delivery in 2023/24 while enabling the flexibility for the shaping and implementation of the necessary changes that are being identified through the Lancashire Better Care Fund reset process for 2024/25.

There will be a requirement for quarterly reporting on Better Care Fund activity and progress. The Board will be engaged and informed as part of that process.

The Board noted that there was a new metric had been introduced for 2023/24 focusing on emergency hospital admissions due to falls sustained by people aged over 65 and a further metric will be introduced in 2024/25 relating to hospital discharges, measuring the time between people being declared fit to leave hospital and the actual date of discharge.

Following the presentation, the following comments/issues were discussed:

·  The Better Care fund monies has to be spent in partnership to drive best value for money.

·  The metrics are still hospital focused.

·  Create capacity to try out different ways of working, which will come from driving better values.

·  Louise Taylor, Executive Director for Health and Wellbeing, Lancashire County Council and Director of Health and Care Integration, NHS Lancashire and South Cumbria and James Fleet, Chief People Officer, NHS Lancashire and South Cumbria Integrated Care Board to discuss the timeline for reset and review with the Integrated Care Board.

·  It is proposed that the Board considers how much of the Better Care Fund Reset programme invests in community wellbeing initiatives that will help engage people away from some of the statutory services (ie the 1% investment as recommended in national documents), preferably done in partnership with the Voluntary, Community and Faith Sector with District Councils at local level.  This will be a practical manifestation of commitment from the Board and the Integrated Care Board.

· Identify opportunities for creative utilisation of Disabled Facilities Grant allocations to address housing issues. It was confirmed that these conversations are taking place already with housing and health co-ordinators. 

· Pathways between social care/occupational therapy and district councils need to be clear, given pressures in recruiting and retaining occupational therapists. 

·  District councils have housing standards expertise to enable  ...  view the full minutes text for item 7.

To receive an update on the work to date and future plans in respect of the:

·  Integrated Care Board Annual Report 2022/23

·  Integrated Care System Capital Resource Plan 2022/23 and 2023/24

·  Integrated Care System Joint Forward Plan 2023 onwards

James Fleet, Chief People Officer, NHS Lancashire and South Cumbria Integrated Care Board provided an update on the work of the Integrated Care Board and its future plans.  The Health and Wellbeing Board had also received the following documents for review prior to the meeting:

Integrated Care Board Annual Report 2022/23 (Appendix 'A')

Integrated Care System Joint Capital Resource Plan 2022/23 and 2023/24 (Appendix 'B' and Appendix 'C')

Integrated Care System Joint Forward Plan 2023 onwards (Appendix 'D')

Further details can be found in the report.

The Board noted that the Integrated Care Board has four key aims:

  i)  Improving outcomes in population health and health care

  ii)  Tackling inequalities in outcomes, experience and access

  iii)  Enhancing productivity and value for money

  iv)  Helping the NHS to support broader social and economic development

Resolved:  That the Health and Wellbeing Board:

i)  Reviewed and commented on the Integrated Care Board annual report for 2022/23 (Appendix 'A').

ii)  Reviewed and commented on the Integrated Care System Joint Capital Resource Plan for 2023/24 (Appendix 'C') and received the plan for 2022/23 (Appendix 'B').

iii)  Considered and commented on the Joint Forward Plan (Appendix 'D'), offering its reflections on the content and particularly on whether the Board felt that the plan takes proper account of the Lancashire health and wellbeing strategy.

To receive an update on the recent decision of the Integrated Care Board to delegate responsibility for some NHS services to all four Places in the Lancashire and South Cumbria Integrated Care System including Lancashire Place.

Louise Taylor, Executive Director for Health and Wellbeing, Lancashire County Council and Director of Health and Care Integration, NHS Lancashire and South Cumbria provided an update on the recent decision of the Integrated Care Board to delegate responsibility for some NHS services to all four Places in the Lancashire and South Cumbria Integrated Care System including Lancashire Place.  The report provides information on the rationale and content of the arrangements, with some practical examples for additional context provided in Appendix 'A', Appendix 'B' and Appendix 'C'. It also explains the impact of the integration deal on the governance options appraisal timeline, alongside an update on the Lancashire Place Partnership workshop; the outputs of which are being used to inform the next phase in development of the Place Partnership.

The integration deal is a significant decision for the Integrated Care Board with implications for the County Council who will also be expected (in due course), in the spirit of supporting deeper integration between health and care, to adopt a similar approach in order to achieve better outcomes and experiences for Lancashire residents as well as value for money.

A report will come back to the Board in September 2023 requesting endorsement of the options appraisal, and preferred option, prior to it being submitted to Lancashire County Council's Cabinet and Integrated Care Board Executives for agreement in October 2023.

After the presentation, the following comments were raised:

·  It is imperative that technology works across the District Councils, NHS and County Council and to maximise opportunities.

·    Clear communication is imperative.

·  A monthly newsletter is circulated to key officers, for wider circulation.

Resolved:  That the Health and Wellbeing Board:

i)  Received a verbal update on the outcome of the decision made at the Integrated Care Board on 5 July 2023.

ii)  Received a verbal update on the recommendations agreed by Lancashire County Council's Cabinet on 6 July 2023.

iii)  Endorsed the ongoing work and timeframes in relation to the development of governance arrangements for the Lancashire Place and how this will connect into the Health and Wellbeing Board.

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 Chair informed that Board that a Notice of Motion had been proposed at Lancashire County Council's Full Council on 13 July and was unanimously agreed with regards to vaping.  Two of the recommendations pertinent to the Health and Wellbeing Board was:

i)  To ask the Cabinet Member for Health and Wellbeing to take a report to   Lancashire's Health and Wellbeing Board, to include enforcement   activity related to the illegal sale of vaping products to children and   opportunities for further communicating the potential dangers of vaping   to young people.

ii)  To ask the Health and Wellbeing Board to consider making available   funding for a Trading Standards campaign to crack down on   unscrupulous vape sales venues.

Resolved:  That the Health and Wellbeing Board agreed to receive a report   on vaping at its next meeting in September 2023.

The next scheduled meeting of the Board will be held at 2pm on Tuesday, 5 September 2023.  The possible area will be Hyndburn, East Lancashire.

The next scheduled meeting of the Board will be held at 2.00pm on 5 September 2023 at Adventure Hyndburn.