Agenda and minutes

Members of the public are welcome to attend our meetings to watch them in person at any of the venues across the County. Publicly accessible meetings held in County Hall will be webcast, which means they are available to be watched live or recorded on our website. Please see our webcasting notice here. The Committee may, in certain circumstances, resolve to hold part of the meeting in private. If this is the case, you will be required to leave the meeting.

Venue: Committee Room 'C' - The Duke of Lancaster Room, County Hall, Preston. View directions

Contact: Samantha Gorton  Tel: 01772 532471, mobile 07585 983954 . Email -  sam.gorton@lancashire.gov.uk

Items
Note No. Item

10.00am

1.

Welcome, introductions and apologies

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

Minutes:

All were welcomed to the meeting and round table introductions took place.

 

Apologies were noted as above.

 

New members were noted as follows:

 

Sheralee Tuner-Birchall for Mike Wedgeworth, Healthwatch, Lancashire.

Superintendent Andrea Barrow for Detective Chief Constable Sunita Gamblin, Lancashire Constabulary.

 

Replacements were as follows:

 

Victoria Gibson for Jane Booth, Lancashire Safeguarding Adult and Children Boards.

Steve Winterson for Heather Tierney-Moore and Dee Roach, Lancashire Care NHS Foundation Trust.

Dr Tony Naughton for Jennifer Aldridge, Fylde and Wyre Clinical Commissioning Group (CCG) and Fylde and Wyre Health and Wellbeing Partnership.

Denis Gizzi for Dr Sumantra Mukerji and Dr Gora Bangi, NHS Greater Preston CCG and Chorley and South Ribble CCG.

Dr Andy Knox for Jacqui Thompson, North Lancashire Health and Wellbeing Partnership.

Anthony Gardner for Dr Alex Gaw, Morecambe Bay CCG.

 

John Readman was welcomed to the meeting as the Interim Executive Director of Education and Children's Services who was in attendance as an Observer on this occasion.

 

2.

Disclosure of Pecuniary and Non-Pecuniary Interests

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.

Minutes:

There were no disclosures of interest in relation to items appearing on the agenda.

 

3.

Minutes of the Last Meeting held on 14 November 2017 pdf icon PDF 78 KB

To agree the minutes of the previous meeting.

Minutes:

Resolved:  That the Board agreed the minutes of the last meeting.

 

4.

Membership Update pdf icon PDF 68 KB

To note that the Executive Director of Adult Services and Health & Wellbeing and Executive Director of Education and Children's Services have been appointed to the Board and that the Director for Adult Services and Director for Children's Services will substitute when required for the Executive Directors.  These changes reflect Lancashire County Council's new Senior Management structure.  Amended Terms of Reference are attached.

 

Minutes:

Resolved:  That the Board agreed the Amended Terms of Reference and noted that the Executive Director of Adult Services and Health and Wellbeing and Executive Director of Education and Children's Services have been appointed to the Board and that the Director for Adult Services and Director for Children's Services will substitute when required for the Executive Directors.  These changes reflect Lancashire County Council's new Senior Management structure.

 

Discussion took place regarding broadening the representation on the Board to include Lancashire Fire and Rescue Service (LFRS), Housing Providers, Lancashire Enterprise Partnership (LEP).

 

Resolved:  i)  That members of the Board consider additional representatives appropriate to the HWBB outside of the meeting, and report back at the next meeting on 20 March 2018.

 

ii)  That additional representation was agreed to include Lancashire Fire and Rescue Service, Housing Providers and the County Council's Executive Director of Growth, Environment, Transport and Community Services.

 

 

10.10am

5.

Forward Plan and Action Sheet pdf icon PDF 41 KB

To note the action updates from the previous meeting and the forward plan.

Additional documents:

Minutes:

Resolved:  That BCF Planning for next year and an update from the BCF Steering Group meeting on 26 January 2018 be added to the Forward Plan for 20 March 2018 meeting.

 

On the action sheet, Clare Platt confirmed that there was a date in the diary to meet with all Leads to discuss the way forward on the Lancashire Health and Wellbeing Strategy workstreams.

 

10.10am

6.

Better Care Fund Performance and Finance Update pdf icon PDF 153 KB

To receive an update report including progress against iBCF schemes, allocation of slippage monies and Delayed Transfers of Care performance.

Additional documents:

Minutes:

Paul Robinson, NHS Midlands and Lancashire Commissioning Support Unit was welcomed to the meeting to present an update report including progress against iBCF schemes, allocation of slippage monies and Delayed Transfers of Care performance.

 

i)  Improved Better Care Fund (iBCF) slippage allocation

 

Following an approach endorsed by the Health and Wellbeing Board, the Chair, County Councillor Shaun Turner led a process of proposal, scrutiny, review and approval of allocation of iBCF slippage monies in December 2017.  The allocations and process followed were set out in a letter to the board on 22 December 2017 as attached at Appendix A in the agenda pack.  The agreed process was that the money was to be divided into two equal tranches:

 

Tranche 1 - £1.4m was allocated based proportionately on population.

Tranche 2 - £1.4m was made available subject to a bidding process.

 

Mobilisation of activity begun soon afterwards and detail of spend, activity and impact will be reported back to the board in March 2018.

 

ii)  Delayed Transfers of Care (DToC) performance update

 

Data for DToC performance is now available for October and November 2017 with targets not currently being met.

 

However, there is an acknowledgement by the Secretaries of State for Communities and Local Government and Health that there has been improvement against DToC in Lancashire, highlighted in a letter to the Leader of Lancashire County Council, removing the likelihood of reduction in 2018/19 iBCF allocations.

 

DToC performance data by hospital provider highlights variations in DToC identification and recording practice.  This is being looked at through shared scrutiny and learning with a report to be presented to a future Health and Wellbeing Board meeting.

 

iii)  Better Care Fund (BCF) and iBCF Governance

 

The BCF Steering Group is to review governance arrangements at its meeting on 26 January 2018 and is seeking input from all partners individually, and collectively through the Health and Wellbeing Board. Its conclusions and recommendations will be brought to the HWBB for consideration at the meeting on 20 March 2018.

 

BCF funding is supporting the Voluntary, Community and Faith Sector (VCFS) with £100,000 funding to support alignment of resources and support the acute patients to return to the community with the Active Age Alliance.  There are 88 organisations involved and around 140 individuals.  A business case is being developed and this will be presented to the BCF Steering Group for consideration.  An update to the Board will be provided in due course.

 

Resolved:  That the Health and Wellbeing Board:

 

i)  Confirm the decisions made by County Councillor Turner, on its behalf, for allocation of iBCF slippage monies.

ii)  Note the performance of DToC for October and November 2017 against the trajectory set for those months.

iii)  Note the decision set out in the letter of 5 December 2017, from the Secretaries of State for Communities and Local Government and Health, not to review Lancashire iBCF allocations for 2018/19.

iv)  Provide observations, comments and guidance for the BCF Steering Group to help it produce proposals  ...  view the full minutes text for item 6.

10.30am

7.

Delayed Transfers of Care (DTOC) in Lancashire

To receive an update from the Check and Challenge Day held on 8 January 2018.

Additional documents:

Minutes:

Louise Taylor presented the attached presentation to the Board which detailed key themes emerging from the Check and Challenge Day. 

 

As of 24 January 2018 there were 36 individuals delayed which is good progress, however system pressures are still slowing things down.  There needs to be consistency in applying the eight points on the High Impact Change Model.

 

The eight points on the High Impact Change Model which has been set out Nationally are as follows:

 

i)  Early discharge planning

ii)  Systems to monitor patients flow

iii)  Multi-disciplinary agency discharge teams

iv)  Home first/discharge to assess

v)  Seven-day services

vi)  Trusted assessors

vii)  Focus on choice

viii)  Enhancing health in care homes

 

Members of the Board confirmed that the Check and Challenge Day was a very useful exercise and invaluable in setting out the scene on how things are going to be done differently and what needs to be transferred to other workstreams.  How different partners are measuring the High Impact Change Model needs to be aligned and shared going forward.

 

10.50am

8.

Morecambe Bay Local Delivery Plan

To receive on update report from Bay Health and Care Partners on the Local Delivery Plan.

Additional documents:

Minutes:

Dr Andy Knox, newly appointed Director of Population Health and Engagement in Morecambe Bay presented the attached presentation. 

 

Dr Knox reported that there was fantastic partnership working with both Cumbria and Lancashire County Councils.

 

Research shows that People in Morecambe die 15 years earlier than people in the wide Bay and once this information is shared with people in Morecambe, they action to do things to improve this and stop it happening and work with professionals to bring about positive changes.

 

The next steps is the total neighbourhood approach to health improvement.

 

Dr Knox is attending the Pan Lancashire Headteachers conference and will be covering four areas – Mental Health, Healthy Eating, Adversity and Movement/Exercise. 

 

Resolved:  That Amanda Hatton and the Virtual Schools Headteacher be invited to the Conference.

 

Dr Knox was thanked for his presentation.

 

11.20am

9.

Children and Young People's Emotional Health and Wellbeing pdf icon PDF 119 KB

To receive an update on progress with the Children and Young People's Emotional Health and Wellbeing Programme.

Additional documents:

Minutes:

Gill Simpson and Dawn Howarth from the Children and Young People's Emotional Wellbeing and Mental Health (CYPEWMH) Transformation Team and Dave Carr, LCC were welcomed to the meeting and presented the attached presentation.

 

The programme is now in its second year of delivery against the Pan-Lancashire Children and Young People's Emotional Wellbeing and Mental Health Transformation Programme which has resulted in a number of key objectives which enable children and young people to benefit from enhanced services and greater access to support.  The Programme Board has consulted on shared priorities for the future and a refreshed Transformation Plan will be published by the end of January 2018.

 

Alongside this activity, Clinical Commissioning Group (CCG) commissioning leads have been working with the provider organisations to define the scope of the redesign project for Child and Adolescent Mental Health Services (CAMHS) across Lancashire and South Cumbria.  The aims of the project are to further improve access to CAMHS and reduce variation in service offer and investment. 

 

A new Commissioning Development Framework, sponsored by senior leaders in each CCG, NHS England (Lancashire and South Cumbria) and the Commissioning Support Unit, has been developed during the autumn to set out how commissioning arrangements can evolve in the light of the Five Year Forward View.  The work undertaken on the CAMHS Redesign Project to date provides an early illustration of how some of the legacy challenges of variable investment and inconsistent service delivery can start to be addressed by such an approach.  Engagement will continue with Partners to determine whether there is an appetite for the Commissioning Development Framework to be applied to the wider system for children and young people's emotional wellbeing and mental health, bringing together the collective resources of health Partners and Local Government across the Sustainable Transformation Partnership (STP).

 

The Board noted some of the highlights of the programme which included:

 

·  Lancashire Active Healthy Minds Programme targeted at schools to build resilience through sport.

·  Dedicated place of safety for Lancashire wide children and young people in September 2017.

·  Implemented a new community dedicated all age "eating disorder" service.

 

The green paper is out for consultation until March, then hope the white paper will be published in Summer 2018 and hopefully this will ease the pressure on teachers dealing with mental health issues and stress.

 

Variability of provision needs to be identified from the Health and Wellbeing Board and the Safeguarding Boards.

 

Resolved:  That the Health and Wellbeing Board agreed to:

 

i)  Note the report and accompanying presentation.

ii)  Consider the potential opportunities for more collective commissioning by all Partners across the system for children and young people's emotional wellbeing and mental health, bringing together the collective resources of health Partners and Local Government across the STP.

 

11.50am

10.

Special Educational Needs and Disabilities (SEND) Services pdf icon PDF 99 KB

To receive an update from the recent Ofsted/Care Quality Commission Inspection.

 

Additional documents:

Minutes:

Amanda Hatton, Director of Children's Services updated the Board on the recent Lancashire Local Area Special Educational Needs and/or Disabilities (SEND) Inspection which happened in November 2017.  Ofsted and the Care Quality Commission (CQC), conducted a joint inspection of the local area of Lancashire, to judge how effectively the special educational needs and disability (SEND) reforms have been implemented, as set out in the Children and Families Act 2014.  The final report has now been received and was attached as Appendix A in the agenda pack for reference.

 

The local area strategic partnership, including school leaders, will be working with Ofsted, CQC and the Department for Education (DfE) to deliver a SEND action plan to address the issues identified by the inspectors.

 

A list of the main issues that will be being worked on and actions agreed to help achieve the improvements were detailed in the report in the agenda pack.

 

The Board noted that it was good to see that some issues were improving prior to the Inspectors arrival which had been picked up in-house.

 

CC Driver stated that his Members see this as a high priority and resources will be made to ensure improvements are made.

 

Resolved:  That the Health and Wellbeing Board agreed to:

 

i)  Note the detail of the Ofsted/CQC report.

ii)  Receive an update, including draft action plan, to a future meeting of the Board.

 

12.20pm

11.

Urgent Business

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.

Minutes:

There were no matters of urgent business received.

 

12.25pm

12.

Date of Next Meeting

The next scheduled meeting of the Board will be held at 10.00am on 20 March 2018 in Committee Room 'C' – Duke of Lancaster Room at County Hall, Preston.

Minutes:

The next scheduled meeting of the Board will be held at 10.00am on 20 March 2018 in Committee Room C – Duke of Lancaster Room, County Hall, Preston.