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 Adventure Hyndburn, Accrington for hosting the meeting.

Apologies were noted as above.

Joanna Berry, Operations Manager, The Park Child and Family Centre, Adventure Hyndburn gave a brief overview about the organisation and different partners that utilise the building.

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 18 July 2023.

There were no matters arising from them.

To receive a presentation from Maggie Moody, CEO, Community Solutions and discuss how the Health and Wellbeing Board can support/change ways of working.

The Chair welcomed Maggie Moody, Chief Executive Officer at Community Solutions who provided an overview of the work the charity is doing which focuses on improving people's health and wellbeing.

The Board noted that charity is committed to working in effective partnerships to make the most of collective resources, to have the greatest benefit for the communities most in need that Community Solutions serve and support.  The Board were informed that referrals have increased each year since the pandemic with one year seeing a 37% increase.  An example was provided for May in that 735 people were supported, 50% with social isolation, 46% mental health, 26% other significant health issues, 31% unemployment issues, 17% bereavement as well as others facing issues with substance misuse and other significant and challenging circumstances and the barriers, they face in accessing support.  Community Solutions offer a 1:1 model and will support people for as long as they need as well as offering a diverse service and advocating on behalf of the members of the community.

Funding has been secured through the Hyndburn Way to set up a strategic group to enable more collaborative working to develop and secure new opportunities and fits in as part of the Community Action Network.

The request to the Board was that could it look at ensuring that each Borough/District in Lancashire had the equivalent of a Hyndburn Way?

Following the presentation, it was noted that:

·  Approximately 75-80% of those people accessing support are from Hyndburn, however the telephone befriending service supports people from across Lancashire.

·  Rossendale Connect is the equivalent of Hyndburn Way and it was commented that Burnley have something similar also.

·  Hyndburn Way secured lottery funding for three years which will enable investment into how organisations can work together to ensure better commissioning and identify gaps in service provision across the Borough and come together as organisations to bridge the gaps and collectively work together to bring in new resources, contracts to support the work locally.

·  Work is ongoing on a collaborative bid into suicide prevention.

·  Hoarding is becoming a huge issue and a lot of research is being done around this and is something the County Council can link in with.

·  A workshop was taking place on 8 September 2023 where all District Chief Executives would be present, and Louise Taylor, Executive Director for Health and Wellbeing, Lancashire County Council and Director of Health and Care Integration, NHS Lancashire and South Cumbria agreed to share with them what is happening in terms of community work and how Districts can help with targeted support.

·  The majority of Community Solutions funding comes from the National Lottery however, this is not guaranteed going forwards.

Resolved:  i)  That the Board noted the presentation and thanked     Maggie Moody for her presentation.

ii)  Louise Taylor, Executive Director for Adult Services,   Health and Wellbeing, Lancashire County Council and   Director of Health and Care Integration, NHS Lancashire   and South Cumbria would share information on community   work with the District Chief Executives at a  ...  view the full minutes text for item 4.

To discuss the progress update of the Better Care Fund reset work and actions taken since the last report.

Paul Robinson, Midlands and Lancashire Commissioning Support Unit, NHS provided a progress update of the Better Care Fund reset work and actions taken since the last report.

The Board noted that the Lancashire Better Care Fund Board is now in place and operating well, bringing improved oversight and coordination of both the business as usual and the reset work, and is working to progress the three key priority areas agreed.

Since the last update, an initial scoping session has taken place regarding the focus on the Disabled Facilities Grant and associated opportunities, with several actions commenced following the discussions.

Discussions are continuing with the national Better Care Fund Support team, regarding the level of focus of the support offer to Lancashire. 

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

· The Integrated Care Board in July 2023 has taken the decision to create a   delegation arrangement to prioritise the Better Care Fund and mature the   relationship between the NHS and the County Council.

· There will be a lot of support nationally to carry out the spending review.

· There is also going to be some national consultation on how the Better Care   Fund could be better and as a Health and Wellbeing Board it needs to ensure   that a response is provided.

· Need to ensure collaborative spend is being maximised to have the impact.

· The Disabled Facilities Grant will also be discussed at the workshop on 8   September with the Chief Executives from across Lancashire.

· There needs to be a move beyond reporting to being able to demonstrate   where fundamental decisions are being taken and to start to use it to shape   the community offer going forwards.

· In terms of the support the Regional Better Care Fund Team are to   Commission the provider for a fixed period for two years.

·  The Children's Disabled Facilities Grant work has not commenced yet and   that key stakeholders need to be identified across the districts, other   organisations and communities and build from there.

· The report needs to be given a different narrative that starts and ends with   people.

· 20 providers are taking part in a workshop on 6 September 2023 to help   them focus on the voice of the people that receive their support and to utilise   the information received about their customers, to feed into the way that   decisions are made about this work.

· The outcomes or the impacts that the fund was initially set up to achieve and   how success is measured.

· Understanding what impact £70 million is going to achieve.

· It was agreed that regional support should be sought for change models and   what actually works.

· If a baseline review is carried out there needs to be a critical challenge of all   spend.

· There needs to be a fundamental review and it needs to be illustrated in a   way that makes sense and engages people.

· Carry out benchmarking against national initiatives to enable a local   understanding and what to do next.

· In terms of the Children's Disabled Facilities Grant  ...  view the full minutes text for item 5.

To receive the Lancashire Place Governance Options Appraisal.

Jessica Partington, Lancashire Place Development and Delivery, NHS Integrated Care Board provided a report to the Board to consider the future governance arrangements of the Lancashire Place Partnership.  Marie Burnham, Independent Chair of the Lancashire Place Based Partnership Committee was also in attendance for this item.

It was outlined to the Board the requested options appraisal (Appendix 'A') on whether the Lancashire Place Partnership could take on the functions of the Lancashire Health and Wellbeing Board and concluded that whilst in its current configuration this is unlikely.  The report proposes the future consideration of an additional option to consider the potential should the Lancashire Health and Wellbeing Board be reformed. The report also considers the alternative options to Place Partnership arrangements as outlined within national guidance and includes a recommendation for a staged approach to develop the Lancashire Place Partnership and a period of further engagement to refine the proposals.

The Board were reminded that at its meeting in January 2023, it requested that the Lancashire Place Partnership undertake an evaluation to consider if the Health and Wellbeing Board could take on the functions of the Lancashire Place Partnership.  Lancashire Place Partnership was also asked to consider what other options would be available as per the national guidance to ensure that the Lancashire Place was ready to receive delegations from the NHS Lancashire and South Cumbria Integrated Care Board by 1 April 2024, and subsequent delegations from Lancashire County Council.

The options presented were as follows:

Option 1   Place-based partnership Board (Consultative forum)

Option 2   Committee of the Integrated Care Board

Option 3   Joint Committee of the Integrated Care Board and Lancashire County Council

Option 4   Delegated authority to Individual Director

Option 5   Lead provider contract

Option 6  Lancashire Health and Wellbeing Board taking on the functions of the Lancashire Place Partnership

Option 6b  Joint Committee of Lancashire County Council and the Integrated Care Board which can also fulfil the statutory requirements of the Lancashire Health and Wellbeing Board.

Further information on the evaluation that was undertaken can be found in the report and the Options Appraisal at Appendix 'A'.

The report taken to the Lancashire Health and Wellbeing Board concluded that there is a clear rationale to keep the Health and Wellbeing Board (as currently constituted) and the Lancashire Place Partnership as separate entities and for the Lancashire Health and Wellbeing Board not to take on the functions of Lancashire Place Partnership at this time.  The report went on to outline that if the Health and Wellbeing Board were to be reformed from its current state this may be a viable option for the future Place governance in combination with the joint committee of the Integrated Care Board and Lancashire County Council, (the addition of Option 6b) which requires further exploration.  The report also considered the five options as prescribed within National guidance and concluded that the pragmatic option would be to take the staged approach to the implementation of governance options which will enable the partnership to  ...  view the full minutes text for item 6.

To provide a performance update on the key priorities of the Health and Wellbeing Board.

Ruksana Sardar-Akram, Best Start in Life, Aidan Kirkpatrick, Healthy Hearts, Fiona Inston, Happier Minds, Public Health Lancashire County Council provided the Board with an update on work to address the three key Board priorities.  Each priority within the report provided detailed information on:

·  Background

·  Performance Review (Appendix 'A')

·  Forward Look

·  Opportunities for Collaboration/Advocacy of the Board

Best Start in Life

Best Start in Life has been recognised by the Health and Wellbeing Board and the Children and Young People Families as a key strategic priority area.  As previously highlighted inequalities exist which strengthens the case for having a focus on giving children the very best start and improving the outcomes for babies, children and their families.  Further information regarding the update of early education funded places at (Appendix 'B').

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

·  A service review has taken place and taken into consideration views of stakeholders, service user, parents and families and localised groups.

·  Further work is being commissioned in priority areas such as access to dentists, supervised teeth brushing, healthy start vitamins, focus on breastfeeding.

·  The Board would welcome feedback on the campaigns that are happening and how successful they have been regarding Best Start in Life at future meetings.

Healthy Hearts

A Lancashire Healthy Hearts Programme was set up in Spring 2022 which was in line with the National Best Practice Framework which encompasses the following seven thematic 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

The Board noted that one of the key successes over the past nine months since the Board last received an update is the production of a Tobacco Free Strategy (Appendix 'C') for Lancashire and South Cumbria.  There are four key priorities:

i)  Working together as a system for a smoke free tomorrow

ii)  Action to address health inequalities

iii)  Making Smoke Free the new normal

iv)  Lancashire and South Cumbria – A United Voice against tobacco harm

It was noted that this is the most important element of the Healthy Hearts programme and forms part of the forward look for the next six-month.  Further information can also be found in the report.

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

·  In terms of the Tobacco Free Strategy, a Tobacco Free Strategy Steering Group is being established across the 12 districts to support local implementation and discuss further ways of implementing smoke free establishments both in the NHS and the Council.

·  To engage with the Care providers as a whole system, in terms of the implementation the Tobacco Free Strategy across care homes in Lancashire and then devise an action plan to move forwards.

·  To encourage healthier lifestyles from a very early age to prevent hospital admissions later in life and be aspirational for people in Lancashire.

Happier Minds

The Board noted that mental health and wellbeing through the whole life  ...  view the full minutes text for item 7.

Following Lancashire's Full Council meeting on 13 July 2023, the Board is requested to receive and discuss the report which includes 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.  Also the Board is asked to consider making available funding for a Trading Standards campaign to crack down on unscrupulous vape sales venues.

Paula Hawley-Evans, Public Health and Angela Lomax, Trading Standards and Scientific Services, Lancashire County Council provided an update on Tacking Illicit Vapes and Youth Vaping in Lancashire.

The Board were informed that smoking tobacco is still the single biggest cause of preventable illness and death, and the priority remains to achieve a Smoke Free Lancashire. Youth smoking is at its lowest rate, however, there has been a concerning rise in young people under 18 years of age vaping.

The purpose of the report is to set out Lancashire County Council's position on vaping and respond to the Council's motion, 13 July 2023, to bring a report to the Health and Wellbeing Board outlining current enforcement action in vaping in relation to sales to young people in Lancashire, to consider educational opportunities for young people (under the age of 18) in relation to vapes and making available funds for a Trading Standards campaign.

The Trading Standards North West Youth Survey 2023 (Appendix 'A') highlighted that young people are attracted by fruit flavours, attractive packaging, and cheap products with nearly half of the 14–17-year-olds involved in the survey having tried e-cigarettes but not cigarettes. Lancashire Trading Standards Service has seen a significant rise in complaints in relation to underage sales of vape products and in 2023/24 (April–June) seized over 20000 non-compliant/illicit vapes and removed them from the shelves of Lancashire businesses, depriving traders of approximately £100,000 of illicit income.

The increase in youth vaping and illicit products raises several challenges including enforcement capacity and combatting the marketing of products to young people under 18. 

The report outlines current work and opportunities to address these challenges by joint working across public health, schools and colleges, Trading Standards Service and Lancashire's new Stop Smoking Service. It also sets out a Lancashire County Council position statement on youth vaping.  Appendix 'C' contained further information relating to the Law.

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

·  In terms of the "Where's the Harm" leaflet for pupils in Years 8/9, there should be an age appropriate one available for younger children also in Primary Schools.

·  Over 2000 retailers have received information including details on underage sales, Challenge 25 policies and what is a genuine vape and this will continue with every new premises that opens for business selling vapes.

·  Review the partnership working with schools.

·  In terms of advertising, the legal documents set out that advertising vaping, directly or indirectly is illegal, therefore if they appear on TV or in newspapers etc this is classed as advertising and should be challenged legally.

·  More resource is required to tackle the rising issues with vaping.

·  There is a bigger agenda in terms of addiction that needs addressing.

·  Around 70% of young people are trying disposable vapes because they are so accessible.

·  Look at further work with district Planning Committees and look at raising the penalties for illegal selling of vaping products.

·  The Board to agree an action to carry out specific research about  ...  view the full minutes text for item 8.

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 was no urgent business received.

The next scheduled meeting of the Board will be held at 2pm on 14 November 2023.  Venue to be confirmed.

The next scheduled meeting of the Board will be held at 2.00pm on 14 November 2023.  Venue to be confirmed.