Agenda and minutes

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

Welcome and introductions were made.

Apologies were noted as above.

Replacements were as follows:

Jan Ledward for Dr Gora Banghi (Chorley and South Ribble Clinical Commissioning Group (CCG)) and Dr Dinesh Patel (Greater Preston CCG)

Jacqui Thompson for Dr Alex Gaw (Lancashire North CCG)

Paul Kingan for Dr John Caine (West Lancashire CCG)

Paul Havey for Karen Partington, Lancashire Teaching Hospitals

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.

The Board were asked to agree the minutes with the following additional paragraph to Item 10 – Lancashire CYP Emotional and Mental Health Transformation, being inserted after the paragraph beginning 'Following on from the CQC Inspection… on page 5.

'The Board welcomed the progress report.  It challenged the pace of change, particularly in improving access and the care of the most vulnerable.  Specific concerns will be highlighted to the programme via the LSCB.  The Board requested further updates on a regular basis'.

Resolved:  that the Board agreed the minutes of the meeting held on 13 June 2016 with the addition of the amendment as detailed above.

Matters Arising from the Minutes

Following on from the CQC Inspection, the final report was issued on 17^th August, following which, 20 days are given to present the action plan to the CQC for them to agree it, which makes the submission date for the plan, 15 September 2016.

The action plan is currently being drawn up from the report and this will be presented to the Board at the next meeting on 24 October.

Resolved:  the Board to receive the action plan at the next meeting in October.

To note the amendments and agree the revised terms of reference.

The Board were asked to agree the suggested amendments as detailed in the report.

Discussion ensued as to whether there was a need for a Safeguarding representative on the Joint Strategic Needs Assessment (JSNA) Leadership Group.  The Director of Adult Services is on the group so safeguarding is represented, however it was felt that someone from the Lancashire Adult Safeguarding Board (LASB)/Lancashire Children's Safeguarding Board (LSCB) should also be a member of the JSNA Leadership Group

Resolved:  i)  that the Board approve the amendments to the Terms of Reference for the Joint Strategic Needs Assessment (JSNA) Leadership Group.

ii)  that Gemma Jones presents the suggestion to the JSNA Leadership Group, as made by the HWBB,  that a member from LASB/LSCB be added to the membership.

To receive a presentation on the report.

Paul Robinson presented to the Board the attached Powerpoint.

In terms of Delayed Transfers of Care (DTOC) it was noted that:

•  A DTOC Plan (with targets) was required.

•  Five plans to be drawn into one.

•  A pan Lancashire planning group has been set up including Blackburn with Darwen and Blackpool and met in June and are due to meet again in September.

•  Connections are being made to existing activities e.g. 90 day DTOC Rapid Improvement programme.

•  Coordination with the NHS England NHS Improvement and Association of Adult Social Services (ADASS) 2016/17 Accident and Emergency Improvement Plan was required.

District Councils are also reviewing the Disabled Facilities Grant (DFG) activity and are engaged in the BCF Governance.  A meeting will be held on 22 September where all District Councils will look at what they can offer to the BCF and this will also include the Voluntary, Community and Faith Sector (VCFS).

Blackpool and Blackburn with Darwen are doing some BCF work which is overlapping and feeding into the STP programme.

Concern was raised over what discussions were being had with the Morecambe Bay health/social care economy.

It was recognised that performance of individual schemes needs to be reported on too, so that what is working can be rolled out.

Resolved:  i)  Paul to report back on Quarter 2 at the December meeting and include information about individual schemes in the reporting, in particular reablement/rehabilitation schemes.

ii)  Paul agreed to speak with Lancashire North CCG and have discussions around Morecambe Bay on the BCF.

To note the report.

Paul Robinson presented the evaluation as requested by the HWBB as attached in the agenda.

Discussion following the presentation was around the perceived lack of progress/change as a consequence of BCF scheme activity.  It was pointed out that the BCF relates only to adults over 65 years of age.  There still needs to be better joint working between CCGs, District Councils, NHS and Lancashire County Council.

I Performance information needs to be compared in terms of the planned savings from Non-Elective Admissions (NEA) and Delayed Transfers of Care (DTOC) against the actuals.  While it appears to demonstrate a lower level of saving than anticipated, it does not take into account factors such as increase in demand and complexity of need, which may underplay the level of financial savings made through BCF scheme activity.

There was consensus about the need to work more effectively in collaboration in order to transform the system, moving resources into preventive activity.  There was discussion about reablement as a means of reducing demand, but where more resources are needed, to scale up activity.

Similarly Disabled Facilities Grant (DFG) activity helps keep people safe and health at home, but need to be used more effectively.  Funding from the BCF pool could be used to support reablement and DFG activity, and linking to other services such as home improvement services.

Resolved:  i)  The BCF schemes need to be reviewed and then recommendations about those which are most effective and provide value for money identified for progression by the BCF Steering Group.

ii)  Representatives of district councils on the Board need to ensure that relevant information is passed on to other district council colleagues.

To note the report.

Sam Nicol was welcomed to the meeting along with Roger Baker, Involvement Communications and Engagement Director who was introduced to the Board for the first time.

Sam spoke to the report that was circulated with the agenda.  It was noted that the Lancashire and South Cumbria Change Programme Board (LSCCPB) had met twice and a third meeting was planned.  The Board welcomed the offer of an update following each meeting of the LSCCPB.

The detailed STP narrative needs to be submitted by 21 October 2016.  Discussion ensued around the narrative that needs to be submitted before the next HWBB meeting and whether a joined up approach would be more effective with Blackpool, Blackburn with Darwen and South Cumbria going forward.  The Board welcomed this suggestion along with Sam and Roger, and it was agreed that Sam Gorton look to arrange a special meeting, Pan-Lancashire including South Cumbria where an update will be provided prior to submission.

The Board requested an update at the next meeting on solutions and workstreams.

It was noted that the CCGs have agreed a Joint CCG Group to help design the offer across the localities.

Resolved:  i)  that the Board agree the recommendations as set out in the regular report back to HWBB.

ii)  As agreed by the HWBB, Sam Nicol to provide a Director's report from the LSCCPB meetings.

iii)  To receive an update at the meeting in December on solutions and workstreams.

iv)  To hold a special meeting to ensure the STP narrative is shared ahead of submission on 21 October 2016.

Roger stated that there was ongoing engagement and work in Lancashire is consistent with that across Blackpool and Blackburn with Darwen.  If anybody feels that there are any gaps that need addressing to contact Roger direct, email roger.baker3@nhs.net.

To receive an update from the HWBB Summit meeting held on 26 July 2016.

Following on from the Pan Lancashire HWBB Summit meeting that was held on 26 July 2016, there was an agreement that this was the way forward and discussions were held around the model, democratic and governance issues around the Terms of Reference and Memorandum of Understanding.

A Pan Lancashire approach will strengthen local delivery and enable better planning with the BCF for 2017/18. The JSNA is currently developed on a Pan-Lancashire footprint, then drills down to the five health economy areas and then further still to districts.

Legislative requirements are currently being considered by legal officers.

The next steps are that a report will be presented to Lancashire Leaders on 15 September 2016 and the final framework will be agreed in October.

A paper will come back to the HWBB on 24 October with a further update.  It is anticipated that a report will then be presented to Cabinet on 10 November 2016 and to Full Council on 15 December 2016; with powers transferred to the Pan Lancashire HWBB in May 2017.

Members of the Board were advised to look at the proposals and participate in the discussions going forward.

Resolved:  that the Board receive an update at the next meeting on 24 October 2016.

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 Monday, 24 October 2016 in the Duke of Lancaster Room, (Cabinet Room C), County Hall, Preston, PR1 8RJ.

The next scheduled meeting of the Board will be held at 10.00am on Monday, 24 October 2016 in the Duke of Lancaster Room – Cabinet Room 'C', County Hall, Preston.

Details of the special meeting which will take place before the next scheduled meeting to discuss the STP will be forwarded as soon as possible.