Agenda and minutes

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

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

Apologies were noted as above.

New members were noted as follows:

Gregg Mitten for David Tilleray, West Lancashire Health and Wellbeing Partnership

Chief Inspector Ian Sewart for Superintendent Andrea Barrow, Lancashire Constabulary

Replacements were as follows:

Paul Blythin for Adrian Leather, Third Sector

David Graham for John Readman, Lancashire County Council

Denis Gizzi for Dr Sumantra Mukerji, Greater Preston CCG (Clinical Commissioning Group) and Dr Gora Bangi, Chorley and South Ribble CCG

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 last meeting.

To note that membership will now include a representative from the following: Lancashire Fire and Rescue Service, housing providers' and the County Council's Executive Director of Growth, Environment, Transport and Community Services.  An approach will be made to obtain nominations in due course.

Resolved:  i)  That the Board noted that the membership would now include a representative from the Lancashire Fire and Rescue Service (LFRS), housing providers' and the County Council's Executive Director of Growth, Environment, Transport and Community Services.

ii)  Clare Platt would seek nominations in due course from LFRS and housing providers'.

There were no other proposals made regarding other representation for the Board.

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

Updates on actions from the meeting on 25 January 2018 were received.  The iBCF Slippage Allocation, Children and Young People Emotional Wellbeing and Mental Health (CYPEWMH) Commissioning Development Framework Programme and Special Educational Needs and Disabilities (SEND) will be added to the Forward Plan as items for future meetings.

All other actions are items on the agenda for this meeting.

Clare Platt reminded the Board that if there were any items members wished to be considered for a future meeting, to inform Clare or Sam Gorton who will take it forward.

To receive an update report on the current and proposed JSNA projects and intelligence links to the Health and Wellbeing Strategy.

Mike Walker and Farhat Abbas, Information, Intelligence, Quality and Performance Team were welcomed to the meeting and presented the attached presentation.

Every year the Health and Wellbeing Board (HWBB) approves the annual work programme for Lancashire's Joint Strategic Needs Assessment (JSNA).  In June 2017, the HWBB agreed the continued development of the neighbourhood intelligence platform to support the Lancashire and South Cumbria Sustainability and Transformation Partnership (STP), and to develop the JSNA service with a range of partners in the County.  The report updated the HWBB on the progress of the agreed actions and the next steps.  It also recommended a programme of work for the JSNA team for 2018/19 proposed by the JSNA Leadership Group.

The JSNA has a core offer of:

·  Lancashire Insight website

·  Bespoke support

·  Thematic JSNAs

The Board agreed there needs to be a data sharing agreement between Primary Care/Local Authorities/Hospitals, however this is met with obstacles, ie legal challenges, information governance.  Discharging service would benefit greatly from the sharing of data for planning purposes.  There also needs to be a more strategic understanding within neighbourhoods of the STP.

Resolved:  That the Health and Wellbeing Board:

i)  Received the main outputs from the 2017/18 work programme.

ii)  Received details of additional work undertaken during 2017/18.

iii)  Commented on and approved the JSNA plans for 2018/19 as recommended by the JSNA Leadership Group to

·  Support the ongoing development of population health analytics at the neighbourhood level to build system-wide business intelligence capacity across the STP.

·  Undertake special educational needs and disabilities (SEND) JSNA.

·  Undertake eye health JSNA.

iv)  Agreed to consult on a Data Sharing Agreement between Primary Care/Hospitals/Local Authorities and to look at what information requires sharing for planning purposes.  Sakthi Karunanithi agreed to lead on this and report back to a future meeting.

The Board to note the report.

The three HWBBs across pan-Lancashire have a statutory responsibility to publish and keep up-to-date a statement of needs for pharmaceutical services of the population in its area.  This is referred to as a pharmaceutical needs assessment (PNA) and needs to be published before 1 April 2018.

The report outlined the PNA process in pan-Lancashire, summarised the findings and recommendations, provided links to the draft PNA 2018 documents and seeked the approval of the HWB to publish the PNA 2018.

The Board discussed the need for promoting the healthy living campaigns and to change the publics' mindset on what they can and cannot use pharmacies for and what they can do for the public.

Resolved:  That the Health and Wellbeing Board:

i)  Received the Pharmaceutical Needs Assessment 2018.

ii)  Noted the finding that there is currently no need for any further additional pharmacies as current pharmaceutical services provision is deemed adequate across pan-Lancashire.

iii)  Noted the recommendations from the PNA 2018.

iv)  Approved the PNA for publication by 31 March 2018.

v)  Asked for an update on Healthy Living campaigns to be brought to a future meeting and for this to be promoted by Central Pharmacies/NHS England in Lancashire.

To receive an update report from West Lancashire on the Local Delivery Plan.

Paul Kingan, Chief Finance Officer/Deputy Chief Officer West Lancashire CCG presented the attached presentation.

The plan as detailed on the Patient Flow Management diagram on the PowerPoint is looking to be implemented in the next 18 months.  Stakeholders will be brought around the table to discuss how to implement it and look at information governance.

Paul reported that innovation is big in West Lancashire and a key piece of work that is happening at Southport Hospital is the linking in with West Lancashire and Sefton.  West Lancashire are currently performing highly for dementia and Improving Access to Psychological Therapies (IAPT) and are piloting new ways of working in mental health for Lancashire.  Paul also reported that West Lancashire are happy to pilot digital services for Lancashire.

Paul Kingan was thanked for his presentation.

To receive an update report on the Better Care Fund (BCF) Quarter 3 performance including the DToC Performance update, DToC Check and Challenge progress, Better Care Support Team DToC diagnostic support through Newton Europe and BCF planning for 2018/19.

Paul Robinson, NHS Midlands and Lancashire Commissioning Support Unit was welcomed to the meeting to present the Quarter 3 performance including the Delayed Transfers of Care (DToC) performance update, DToC Check and Challenge progress, Better Care Support Team DToC diagnostic support through Newton Europe and BCF planning for 2018/19.

i)  BCF Quarter 3 2017/18 report

Non-elective admissions exceed target by 4.3%.  The Q3 performance position for Permanent admissions to residential and nursing care homes is 31 admissions over target (2%).  The effectiveness of reablement continues to be demonstrated with increasing numbers of users 1304, with 1140 of those still at home after 91 days.

ii)  Delayed Transfers of Care (DToC) performance update

There were 7.4% less recorded delayed days than in the same period last year.  However, this is 50% above the target set centrally.  Some improvement against that target can be seen between November and December.  During the quarter the balance between NHS and Social Care attributable delays had shifted slightly to Social Care attributable delays being the greater.  The latest available data, January 2018, shows a continuation of the overall improvement.

From August 2017 to January 2018 there was over 1000 days reduction in delayed days, so something is having an effect.  With regards the 3,479 total of delayed days, Paul was asked how many people this affected. 

Resolved:  Paul Robinson agreed to find out how many people the 3,479 delayed days affected and would report back to the Board.

iii)  DToC support

An offer from the national Better Care Support Team of support had been accepted by the BCF Steering Group.  This was in the form of DToC diagnostic support to be provided by Newton Europe that would add to that commissioned by Lancashire County Council and connect with that already undertaken in Pennine Lancashire and Fylde Coast.  Central Lancashire have been selected to support this and work will begin in May 2018.  There will be regular meetings with the Chief Executive which will be reported back to the BCF Steering Group and needs to be part of the update received from Paul Robinson at the Health and Wellbeing Board.

Resolved:  The Board agreed that Louise Taylor, Executive Director of Adult Services and Health and Wellbeing would be the key lead with whom Newton Europe would work with and who will provide regular updates on this to the Board.

iv)  DToC Check and Challenge…next steps

The System Wide and High Impact Change Model specific challenges, ideas and actions that came from the DToC Check and Challenge session are forming the basis of an action plan that will connect the delivery through BCF, A&E Delivery Boards and the Urgent and Emergency Care Network.

The Action Plan from the Check and Challenge event was circulated and the Board were asked to look at this and take forward the areas relevant to their services.

Resolved:  The Board to consider the action plan and send their views/suggestions/thoughts to Paul Robinson.

Sakthi reported that a similar event to the Check and  ...  view the full minutes text for item 9.

For the Board to receive a summary of County partnership response to date and next steps.

David Graham, Head of Special Educational Needs and Disabilities updated the Board of the County partnership response to date and the next steps.  Since the inspection report, the time had been used productively to address the 12 actions that were highlighted.  The Special Educational Needs and Disability Partnership Board met on 18 March 2018 and signed off the draft action plan in its current form.  It will be sent to Ofsted on 18 April 2018 for sign off and then the Department for Education and NHS England will monitor it.

Governance arrangements are that the statement and Special Educational Needs Improvement Plan will now be a standing item on the Health and Wellbeing Board agenda and the Chair and Vice-Chair are proposed to sign off the statement and plan for submission to Ofsted on 18 April 2018 and then it will come to the Board to note at its next meeting on 15 May 2018 and then receive regular updates.

Resolved:  That the Health and Wellbeing Board agreed that the Chair and Vice-Chair sign off the statement and plan and that Special Educational Needs and Disabilities Improvement Plan be a standing item on this agenda.

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 no matters of urgent business received.

The next scheduled meeting of the Board will be held at 10.00am on Tuesday, 15 May 2018 in Committee Room 'C' – Duke of Lancaster Room at County Hall, Preston.

The next scheduled meeting of the Board will be held at 10.00am on Tuesday, 15 May 2018 in Committee Room 'C' – Duke of Lancaster Room at County Hall, Preston.