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 Tatton Community Centre, Tatton Gardens, Chorley.

Apologies were noted as above.

Replacement for the meeting was Dave Carr for Jacqui Old, Education and Children's Services, Lancashire County Council.

The Board noted that the Deputy Chair of the Board, James Fleet had resigned from his role and as Chief Officer for Lancashire and South Cumbria Integrated Care Board as he commences a new role with Sandwell and West Birmingham Hospitals NHS Trust as Interim Chief People Officer.  The Board thanked James for his leadership and significant contribution to the Lancashire and South Cumbria health and care system and the Health and Wellbeing Board and wish him all the very best in his new role.  The Board noted that a new Deputy Chair from the Integrated Care Board was being sought and an announcement would be made as soon as possible.

Chris Sinnott, Chief Executive, Chorley Borough Council gave a brief overview about the project and Tatton Community Centre which opened in early 2023 and offers extra care residential facilities, a nursery, GP Surgery, café, hairdresser and pharmacy.  The Board also noted that there was another residential extra care facility at Primrose Gardens in Chorley.

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 5 September 2023.

The Board were asked to note the following matters arising:

On 13 November 2023, the Council was notified that £8.4m had been awarded to support further work on alcohol and drug abuse in Lancashire, which was part of the Board's Happier Minds priority.  It was also noted that Lancashire was specifically mentioned as an area of best practice.

CC Green updated the Board that he had visited premises that sold vapes with Trading Standards officers from Lancashire County Council.  He had visited eight businesses and four of those failed the test on underage sales.  It was agreed that it was an ongoing struggle to ensure businesses were selling products that were both legal and being sold to the right age of consumers.

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

The Chair welcomed Caroline Greer, Manager, UDevelop CiC who provided an overview of the work they do in creating structured programmes aimed at helping shape, change and have a positive ongoing impact on a person's life.

The Board noted the various opportunities/programmes on offer such as:

·  Chorley Shed which is a community project provided for people who are referred through the social prescribing system and is a six-week program to help support them to grow in confidence and to balance their wellbeing for a sustainable life.

·  Remote confidence building courses in the home for people who are unable to leave the home due mental health issues.

·  Coaching services to integrate people back into society through various community programmes.

·  UDevelop CiC was commissioned by Rise Construction Framework, supported by Chorley Council to run, and enhance the provision into Tatton Community Centre to target the people of Chorley to help improve wellbeing and to also improve employability opportunities, personal and career development for adults.

·  Over the last six months, consultations have taken place within the local community to find out what residents would like to see happening alongside working with local Councillors.

·  Provision is being delivered in Phases 1 and 2 with regards to different local workshops, such as Yoga, coffee and chat/community drop in, health discussions to help reduce health inequalities.

·  There has been an increase in groups, in terms of people with specific individual needs, neurodiverse groups, and working with Adult Social Care, Lancashire County Council and the NHS who bring groups to community drop-in sessions.

·  Monday and Thursdays are warm space days and the over 50s have been targeted who are in isolation and are given opportunities to participate in arts and craft sessions and make new friends.

·  There is a walk and talk session on a Thursday and case studies can be found in the monthly blogs that are produced and shared on social media.

·  Chorley Women's Centre are also integrating and UDevelop are working with them on cultural and information days to bring a diverse community together in a community space.

·  They are supporting local businesses such as JellyTots (0-4 years provision) and Rhythmicality.

·  Phase 3 is looking at creating some more male and female groups as a drop in for Chorley East which are required due to over-spill.

·  There is a special educational needs drop-in for people with neurodiverse doing board games in the evenings.

·  With regards to the digital element, eight residents have completed a digital programme, and this has enabled them to speak with families across the world, online shopping etc and in working closely with Cellnet, once they completed the course, it has given them the opportunity to obtain a tablet or computer.

Further information on how UDevelop have developed the community including monthly blogs and what is on offer, can be found here: https://www.udevelop.org.uk/.

Following the presentation, the following comments were made:

·  Connections with young families are starting to improve, particularly with remote services, however, discussions are underway with regards to  ...  view the full minutes text for item 4.

To outline to the Board the Government's intention around creating a Smoke Free Generation and how the Lancashire Health and Wellbeing Board can support the Government's associated consultation which has recently been launched.

Marie Dermaine and Paula Hawley-Evans, Public Health, Lancashire County Council provided the report which outlines the Government's intention around creating a Smoke Free Generation (as outlined at Appendix 'A') and how the Lancashire Health and Wellbeing Board can support the Government's approach to national and local implementation.

The report provides a short briefing on the recent Government command paper: Stopping the start: our new plan to create a smoke free generation setting out ambitious proposals to prohibit the sale of tobacco products for future generations, measures to support current smokers to quit as well as wider actions to curb the rise in youth vaping, which alludes to the report that was received by the Health and Wellbeing Board on 5 September 2023.

The Board noted that additional funding had been confirmed as of 13 November 2023 of £1.6m to support this agenda and that the money is ringfenced under Section 31 meaning it is very specific on what it can be spent on in addition to the work that has already been committed to in terms of the smoking cessation.

The second part of the report is a program that has been announced on additional funding for a swap to stop program to help current smokers stop smoking.

The Board were informed that there are approximately 145,000 smokers across the 12 districts of Lancashire with a smoking prevalence of around 13.4% in comparison to England which is 12.7%. There is a trajectory of variants between 6% and 20% per area, which averages at around 23% of smokers per district.  83% of smokers start before the age of 20.  The target by 2030 is to reduce the number of smokers in Lancashire to 5%.

The costs of smoking to Lancashire are significant at approximately £372m and are accrued through productivity loss, healthcare (£50m) and social care (£28m) and includes former smokers with smoking related illnesses.

In terms of supporting the Government's intention to achieve a smoke free generation, on the 1 October 2023, Lancashire County Council launched the service, Smoke Free Lancashire and continues to invest in reducing tobacco related harm.  This service has a specific focus on vaping for children and young people to support them to stop, not take up smoking, and to support educating around vapes.  There is a consultation that has been to schools, circulated to the Integrated Care Board, promoted through primary and secondary care and through internal comms.  The Board were asked to encourage completion of the consultation.  Further work is being carried out with Trading Standards on the issues around underage sales and the Where's the Harm booklet has been circulated to schools.

There is also support for over 18s too through Smoke Free Lancashire through the Tobacco Free Lancashire group and will target place-based areas where smoking prevalence is high and link in with NHS colleagues to ensure a joined-up approach and have a focus with population health.

The Board noted that in terms of the Swap to Stop, cohorts of people  ...  view the full minutes text for item 5.

To receive the Winter Preparedness plans and consider any future areas for improvement and collaboration.

Clare Platt, Health Equity, Welfare and Partnerships, Sue Lott, Adult Social Care – Urgent Care, Acute and Prisons, Lancashire County Council and Craig Frost, Urgent and Emergency Care, Lancashire and South Cumbria Integrated Care Board provided members with a collaborated report which highlighted plans in place across NHS and Local Government organisations to support health and wellbeing needs of Lancashire residents during the winter.

A presentation was given to the Board and is appended to the minutes and was circulated to members following the meeting.  It provides further information on the following:

·  Winter Preparedness 2023/24

Ø  Public Health, Wellbeing and Communities

Ø  Highways

·  Adult Social Care Winter Plan 2023/24

Ø  Winter Planning - Context

Ø  Winter Planning – Funding and Oversight

Ø  Winter Planning – What's in the Plan

·  Resilience and Surge Planning for Winter 2023/24

Ø  Winter Planning Guidance 2023/24

Ø  Winter Planning Process 2023/24

Ø  Place Winter Plans 2023/24

Ø  Urgent and Emergency Care (UEC) Investment Schemes 2023/24

Ø  Winter Campaign

Ø  Governance

Ø  Summary of Key Changes to System Co-ordination Centres (SCC) and Operational Pressures Escalation Levels (OPEL)

Following the presentation, the following comments were made:

·  In terms of the discharge to assess, the offer is being expanded.  Currently there are a number of beds in in-house older people's care homes, which are dedicated to residential rehabilitation and also spend on discharge to assess beds which is in the independent sector.  Therefore, people being discharged from hospital who cannot return directly home, go into a care home for a period of up to four weeks and are assessed in that care home.  The offer is now expanding on in-house beds by widening the criteria to include people who need a period of recovery, recuperation or a period of assessment.  Currently people who are going into the independent sector are not always getting therapy intervention and through in-house beds they will receive this quicker by working collaboratively between Adult Social Care and the NHS as well colleagues who support those beds from a therapy provision.

·  With the help of the Better Care Fund, it is hoped that improvements will be made as currently, too many people are going from hospital into a care home placement and that is an action from the Better Care Fund to improve that metric.  The Board noted that there is a working group set up around discharge to assess and part of the work is to review some of the procedures and ensure they are aligned with national guidance.

·  The independent sector care homes will still be required, particularly for people who need a nursing level of care that the Local Authority do not provide.

·  In terms of support through public health, it is improving, however, there is still work to do, which also short-term depends on funding from year to year, as well as having discussions on collaboration work and working with Districts and their communities.

Resolved:  That the Health and Wellbeing Board:

(i)  Endorsed the  ...  view the full minutes text for item 6.

To receive an update and also sign-off of the quarterly report.

Sue Lott, Adult Social Care – Urgent Care, Acute and Prisons, Margaret Ashton-Gray, Health and Social Care Integration Finance, Lancashire County Council and 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 Health and Wellbeing Board in September 2023.

The Board were informed that the quarterly report has been submitted and requires formal sign-off from the Health and Wellbeing Board at this meeting. The report shows that it is broadly on track with regards performance against the mandated Better Care Fund metrics, except for admissions to long term residential care for which mitigating actions are in place.

The quarterly finance report (circulated separately to the Board) is a first iteration of what will become a regular part of the Better Care Fund quarterly reporting. A template will also be circulated separately for which the ambition is to use as the reporting template for future finance reports.

The reset programme is progressing and updates regarding various elements are provided within this report, including take up of the Better Care support offer and proposals on which element of the thematic review the system should commence first.

Information is also provided on the Hospital Aftercare service (circulated separately to the Board) which is one of the services funded through the Better Care Fund. The stories demonstrate the positive impact the service has for the people it supports. The intention is to regularly provide this type of information to the Health and Wellbeing Board, to support awareness of the scope of the services and teams delivered through use of the monies in the pooled fund.

Further detailed information can be found in the report on the following:

·  The Lancashire Better Care Fund Quarterly Report

·  Section 75

·  Quarterly Finance Report

·  The Review and Reset Work

·  Better Care Fund (BCF) Support Offer Update

·  Hospital Aftercare – Stories

Following the presentation, the following comments were made:

·  That delays in funding payments from the Integrated Care Board to the Better Care Fund, from a Board's perspective raises concerns and assurance was needed.  Lancashire County Council is the accountable body for the Better Care Fund, and for example the Discharge to Assess (D2A) fund is paid into the fund by the Integrated Care Board and then distributed back to the Board.  This is the current mandated mechanism to receive the monies into the pool and the schemes that have been approved which are carried out by the Integrated Care Board, will then be returned, so they can continue to provide those services.

·  The Better Care Fund pooled funding mechanism needs to be reviewed.

·  In terms of the additional Integrated Care Board funding allocation of £10m into social care, the Board were informed that discussions commenced in the last financial year when the benchmarking information was shared with the Integrated Care Board and that there continues to be discussions on allocation of spend and it is hoped that a decision on that spend will  ...  view the full minutes text for item 7.

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 not any items of urgent business received.

The next scheduled meeting of the Board will be held at 2pm on 23 January 2024, venue to be confirmed.

The next scheduled meeting of the Board will be held at 2pm on 23 January 2024.  This meeting is likely to be a workshop following by a short formal meeting of the Board and will be held at County Hall, Preston.