Agenda item

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 mature properly, at a sensible pace with systems and processes around it that support the current phase of development.

The next steps were identified as requiring further exploration and details can be found in the report.

It was proposed that further engagement activity took place with statutory and non-statutory partners to consider these and other issues, in order to inform future decisions of the Health and Wellbeing Board and, where necessary, Cabinet and Full Council, as well as the Integrated Care Board.  It is anticipated that a firm decision upon the future governance of the Lancashire Place be taken by December 2023 to enable a progressive move towards implementation.  There will, however, be work undertaken in parallel commencing with immediate effect to ensure that the Lancashire Place is operating as effectively as possible with current and development arrangements.

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

·    The key difference between the Health and Wellbeing Board and the NHS is that the Board has local democratic oversight for the whole of the health and wellbeing agenda, and includes housing, welfare, finance etc where the NHS Integrated Care Board agenda is specifically related to the clinical and care services.

· There needs to be a move towards a joint committee between Lancashire County Council and the Integrated Care Board and there is an opportunity to do something different in Lancashire.

·  Explore having a Committee in Common as an alternative option.

· The Integrated Care Board took a decision in June/July 2023 where they recognised that they needed to ensure that there was a set system in place as there is an opportunity for different decisions to be made about how funding is used effectively.

·  Kevin Lavery, Lancashire and South Cumbria Integrated Care Board has written to the Chair of the Health and Wellbeing Board, indicating that the Integrated Care Board welcomes the discussions taking place to explore options and how joint decision making in the Lancashire Place can be strengthened.  It was agreed that the letter be sent to Sam Gorton, Democratic Services, Lancashire County Council to share with members of the Health and Wellbeing Board.

·  Delegation around finances is key, alongside who is responsible for managing the risk.

·  There is an opportunity for the Board to think about how it is framed and to think about what the purpose is and what difference it will make to people in Lancashire.

Resolved:  The Lancashire Health and Wellbeing Board:

i)    Approved that the Lancashire Health and Wellbeing Board and the Lancashire   Place Partnership remain as separate entities at this time, acknowledging that   further work and engagement needs to be undertaken to consider the   potential for this in the future should there be viable options to reshape the Health and Wellbeing Board from its current form.

ii)  Considered the options appraisal (Appendix 'A') and supported the preferred approach of the staged proposal as set out in the report.

iii) Endorsed and supported the next steps for further engagement within the Lancashire Place upon the questions as set out in section 4.

iv) Louise Taylor, Executive Director for Adult Services, Health and Wellbeing, Lancashire County Council and Director of Health and Care Integration, NHS would forward the letter received from Kevin Lavery, Lancashire and South Cumbria Integrated Care Board on Governance Arrangements to Sam Gorton. Democratic Services will forward on to members of the Board.

v)  Asked for the additional option, Option 7, to appraise whether a committee in common would be suitable for the future of the Lancashire Place Partnership.