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.

The Board welcomed Councillor Margaret France who had been permanently appointed as the Central Lancashire Leaders Group representative and Councillor Liz McInnes who had been appointed as the East Lancashire Leaders Group Representative.

The Board noted that Dave Carr, Policy, Commissioning and Children's Health, Lancashire County Council had replaced Jacqui Old, Education and Children's Services Lancashire County Council for this meeting.

The Chair welcomed Dr Rebecca Mead, Division of Health Research, Lancaster University who was observing the meeting as part of a research study.  The title of the project is "An analysis of how local public health systems interact with complex policy initiatives addressing social and health inequalities" and the meeting had been identified as one which would help to illuminate how the systems within which public health functions address health inequalities.  Following the meeting, if further information is required, please contact r.mead2@lancaster.ac.uk.

On behalf of the Board, the Chair thanked Louise Taylor, Adult Services Lancashire County Council and Health and Care Integration (Lancashire), NHS for her distinguished service and contribution and commitment to the Board as well as the Council and NHS over the years and wished her all the best for her retirement at the end of the year.

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 3 September 2024.

Chris Sinnott, Lancashire Chief Executive Group, provided the Board with a brief update on the Disabled Facilities Grants work which is progressing and it was noted that the Lancashire Place Partnership had received a presentation at its meeting recently and the next steps will be for the report to be presented at the District Chief Executives Group and to take formal next steps within District Councils as well as a report to the next Better Care Fund Board meeting in January 2025.  Work is now progressing on working through the recommendations coming into the system.

To receive, review and comment on the Quarter 2 Better Care Fund submission.

Balwinder Kaur, Adult Community Social Care, Sue Lott, Urgent Care, Acute and Prisons, Lancashire County Council and Paul Kingan, Finance, Lancashire and South Cumbria Integrated Care Board provided a report which contained the following:

·  A summary of the 2024/25 Quarter 2 Better Care Fund submission (Appendix 'A' – Confidential to members only).

·  A summary of the Quarter 2 finance report (Appendix 'B' - confidential to members only).

·  A brief update and progress on the 3 Lancashire Better Care Fund support projects.

·  A brief update on the Lancashire and South Cumbria Integrated Care System Better Care Fund review project (Appendix 'C' - confidential to members only).

The report shared with the Board the Better Care Fund Quarter 2 template, which was submitted at the end of October 2024. It was signed off by County Councillor Michael Green in his delegated role as Chair of the Health and Wellbeing Board, due to the submission date falling before the Board meeting. The Q2 template is set by the national team and requires information on progress against the  Better Care Fund metrics in Quarter 1 and spend and activity for Quarters 1 and 2.

Lancashire received confirmation that its' 2024/25 Better Care Fund Plan had not been formally signed off yet in the Assurance process, due to the unresolved position between the two partners on the NHS additional contribution to social care. Both partners remain committed to finding a solution and have committed to participate in facilitated discussions to reach a resolution.

Also detailed in the report were progress reports on the three Lancashire  Better Care Fund support projects. The last remaining one, the Demand and Capacity support project was now nearing completion, with the draft modelling tool in place and being tested.

The Lancashire and South Cumbria  Better Care Fund's support project continued to progress, with initial desktop analysis by 31ten Consulting taking place following the collation of significant volumes of information from each Health and Wellbeing Board area. The steering group was considering how best practice can best be shared as well as the development of agreed and shared principles.

The Board also received a presentation, which is appended to the minutes for reference and detailed the following:

·  What the Health and Wellbeing Board Report will cover

·  Summary of the 2024/25 Quarter 2 Better Care Fund Submission

·  A Summary of the Quarter 2 Finance Report

·  Better Care Fund Resets Project Progress: Support Offer Projects

Ø  Leadership and Governance

Ø  Discharge to Assess

Ø  Intermediate Care Demand and Capacity Modelling

·  Lancashire and South Cumbria Integrated Care System Better Care Fund Project

·  Facilitated Support to Find a Solution

·  Better Care Fund Board Update

Following the presentation, discussions ensued, and comments were provided as below:

·  There was a point of clarity raised in terms of the £10 million the Council are already spending this from funding that can be used to offset some of the pressure. It was  clarified that it was a complicated issue and both partners are committed to finding a way  ...  view the full minutes text for item 4.

To receive an overview of the background and purpose of the Lancashire Pharmaceutical Needs Assessment (PNA) 2025 together with a series of options regarding the proposed methodology to be utilised in order to ensure that the Pharmaceutical Needs Assessment (PNA) is as comprehensive as possible in meting the needs of the residents of Lancashire.

Aidan Kirkpatrick, Public Health, Lancashire County Council provided the Board with a report of an overview of the background and purposes of the Lancashire Pharmaceutical Needs Assessment (PNA) 2025 together with a series of options regarding the proposed methodology to be utilised to ensure that the Pharmaceutical Needs Assessment (PNA) is as comprehensive as possible in meeting the needs of the residents of Lancashire.

The Board noted that the production of the 2025 Pharmaceutical Needs Assessment (PNA) is a statutory function of all three Health and Wellbeing Boards across Lancashire, and the Board was assured that the  function will continue to be carried out to an elevated level of rigor, with an intended publication date of September/October 2025.

The Board were asked to discuss the intention to make one material change to the methodology that is used, which is to assess the concept of geographical access to the network of community pharmacies across Lancashire, which historically has been based on a 20 minute drive time across all in Lancashire communities, whilst being mindful that there is an association between levels of car ownership relative to both deprivation and income levels, both locally and nationally.  In order to mitigate this, it is incumbent upon the Pharmaceutical Needs Assessment (PNA) steering group that oversees the assessment, to propose a more nuanced and responsive approach, utilising driving, public transport and walking times. The Board noted that public transport arrangements can change over a three-year cycle and therefore the Pharmaceutical Needs Assessment (PNA) steering group that oversees the assessment will therefore need to assure itself that there is no deleterious change or impact on public transport times over that three-year period and if in discharging that function there is a deleterious impact the Health and Wellbeing Board will be informed.

Following the presentation, discussion ensued, and comments were provided as below:

·  The paper had been consulted with the Integrated Care Board commissioning colleagues and the role of the Health and Wellbeing Board was to conduct the Pharmaceutical Needs Assessment (PNA)  every three years and in practical terms, it is used when pharmacies change their services, withdraw or consolidate and any discrepancies found, would be brought to the attention of the Board.

·  An assessment of the provision of pharmacies is carried out locally, as well as regionally and nationally.  When the assessment is carried out, there is some pragmatic balance between what that looks like at a Lancashire level, as well as a sub-Lancashire level to mitigate impact on uneven distribution of community pharmacy locations.

·  A methodology of a national tool called Shape helps to assess the travel time in terms of access to public transport annually, and that is the basis upon which the intention is to keep a more regular assessment of what that looks like.

·  In terms of provisional pharmaceutical services, it is not just access to medicines it is about broader services that pharmacies deliver and as a Board it is important to be advocates for them.

·  The proposal is a  ...  view the full minutes text for item 5.

To discuss and approve the draft Lancashire Self-Harm and Suicide Prevention Strategy 2024-29 and actions plans, along with an insight through lived experience.

Paula Hawley Evans, Public Health, Lancashire County Council, Liz Dover and Helen Parry, NHS Lancashire and South Cumbria Integrated Care Board and Angela Allen, Spring North and Bags for Strife Charities provided the Board with a report which outlined the development of a Lancashire Self-Harm and Suicide Prevention Strategy which is one of the commitments under the Health and Wellbeing Board's Happier Minds priority. The Strategy has been produced with partner agencies including Lancashire and South Cumbria Integrated Care Board, district council leads, voluntary sector organisations including individuals who have been affected by suicide. It mirrors the national Suicide Prevention Strategy's key areas but with a clear focus on local priorities in Lancashire. It outlines the data and intelligence of suicide and self-harm and sets out an all-age partnership action plan to deliver the ambition to reduce suicides and self-harm.

The Board received a detailed presentation which is appended to the minutes for reference, with further information on the following:

·  National Position

·  Lancashire Position

·  Development of a Lancashire Self-Harm and Suicide Prevention Strategy and Action Plan 2024-2029

·  Action Plan 2024-2025

·  Governance

·  Lancashire and South Cumbria Integrated Care Board System Leadership and Children and Young People's Services

·  Bags for Strife (https://www.bagsforstrife.co.uk/)

The Board noted that the Lancashire Self-Harm and Suicide Prevention Strategy 2024-2029 reflects ambition in the National Suicide Prevention Strategy 2023 and is a call for action to reduce self-harm and suicides by focussing on eight action areas:

(i)  Improving data and evidence

(ii)  Providing tailored support and targeted support to priority groups

(iii)  Addressing risk factors

(iv)  Online safety, media and technology

(v)  Providing effective and appropriate crisis support

(vi)  Tackling means and methods of suicide

(vii)  Providing timely and effective bereavement support

(viii)  Making suicide everyone’s business

With regards to the Action Plan 2024-2025 across the eight areas above, the actions have included:

·  Data and intelligence activity: Real Time Surveillance (RTS), Child Death Overview Panel (CDOP) Thematic review, Annual all age suicide audit

·  Work with districts and Voluntary, Community and Faith Sector Enterprise (VCFSE)

·  Specific actions on Children and Young People eg all school mental health leads, Compassionate Leadership Hub

·  Drug related death panels

·  Support for prisoners – continuity of care

·  Mental health first aid training for front line staff (Orange Button)

·  Links to gambling and social isolation work

·  Coordinated campaigns

·  Access to bereavement support

The Board were informed that regular reporting on self-harm and suicide prevention would be presented to the Board as part of the Happier Minds programme which of one of the six priority areas.

The Integrated Care Board suicide prevention programme works in partnership with Local Authorities and other stakeholders to support a collaborative approach to suicide prevention activities across the Lancashire and South Cumbria patch.

The logic model consists of five key pillars supporting the national Suicide Prevention Strategy for England.  They are as follows:

(i)  Leadership

(ii)  Prevention

(iii)  Intervention

(iv)  Postvention

(v)  Intelligence

The Board were informed of the Orange Button Community Scheme, which is a button  ...  view the full minutes text for item 6.

To note the calendar of meetings for 2025/26 as detailed via the link: https://council.lancashire.gov.uk/ieListMeetings.aspx?CommitteeId=825.

Resolved:  That the Board noted the calendar of meetings for 2025/26.

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.

NHS Review

Dr Sakthi Karunanithi, Director of Public Health reminded the  Board that a 10 year Health Plan for England being developed by the Government, with  a national conversation about the NHS.  There is an opportunity to share insights and experiences via https://change.nhs.uk/en-GB/.  The deadline is 5pm on 2 December 2024.

Resolved:  All Board members were encouraged to complete the questionnaire.

The next scheduled meeting of the Board will be held at 2pm on 21 January 2025 at Lancashire Adult Learning, Glen Way, Brierfield, BB9 5NH.

The next scheduled meeting of the Board will be held at 2pm on 21 January 2025 at Lancashire Adult Learning, Glen Way, Brierfield, BB9 5NH.