Agenda and minutes

To elect the Chair for the meeting.

Clare Platt requested nominations for Chair for the meeting as County Councillor Jennifer Mein had presented her apologies.  County Councillor Azhar Ali was nominated and seconded and subsequently took the chair for this meeting.

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 CCG and Dr Dinesh Patel – Greater Preston 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 Minutes of the meeting held on 2 September 2016 are confirmed as an accurate record.

To receive and discuss the Annual Report.

The Board were asked to consider the content of the Annual Report and identify any areas it may wish to comment on and any action it may wish to take.

Jane Booth highlighted to the Board that adult safeguarding is challenging and this is clear from the report as attached to the agenda.  The demographic profile of the community will continue to include increasing numbers of people who fall into service user groups that are more vulnerable to risk of abuse or neglect (including self-neglect) because of their health or social care needs or issues of mental capacity, abuse and neglect.  The challenge will be, at a time of reducing resources, making a proportionate response and delivering a personalised service.

It was noted that access to early help could help to reduce the number of safeguarding cases.

The LSAB has benefitted from the learning arising from the members' association with such pan-Lancashire and national activities as work concerning the Mental Capacity Act 2005 and Prevent, the Chair's North West network and the English network of Safeguarding Adult Board Chairs.

With regards to inspection risk, Adult Social Care is inspected regularly through the Care Quality Commission (CQC) and work is commencing on audits and looking at comparative data sets.

Resolved:  That the Board considered the content of the Annual Report provided comment, with no further actions are identified.

To receive and discuss the Annual Report.

The Board were asked to consider the content of the Annual Report and identify any areas it may wish to comment on and any action it may wish to take.

Jane Booth highlighted to the Board that the Annual Report provides information about services and their effectiveness.  The LSCB shares the concerns set out in the Ofsted report.  The LSCB is working as part of the Improvement Board to ensure an effective response and has seen evidence of plans to restructure services, reduce caseloads of social workers and improve quality assurance.  However, these things will take time to show an impact and at the end of 2015-16 it was not possible to identify significant improvement in practice.  In addition the LSCB is particularly concerned about the quality and availability of appropriate Child and Adolescent Mental Health services where the resource allocation is too low and progress towards improved services too slow.

The report sets out the priorities of the LSCB and the areas identified for future work.

It was raised as to whether there had been an increase or decrease in Serious Case Reviews (SCR) and Jane stated that there had been a significant increase in SCRs in the last 15 months where eight had been received, compared to a general figure of four or five a year.  There was a query about the availability of this information by Districts are notified on an individual basis when a SCR does arise.  However it was noted that the majority of SCRs were in the North, but this is not on trend.

Jane reported that there is a link in with the workstream around CAMHS and the report to the LSCB every three months.  The findings are then reported back to executive forums.  Jane is concerned that the whole system is not being considered.

It was noted that there appears to be a lack of early help in schools and some schools are unaware of what services are accessible.  Jane commented that a piece of work is being carried out in Fylde and Wyre, looking at new ways of working.

The LSCB regularly reports to the Local Children's Partnership Boards and any concerns by district are raised there, together with child sexual exploitation (CSE) concerns.  It was highlighted that CSE figures had increased, however this was felt to be good as it is high profile in the media and the local Authority is putting more time and resources into this area of work.  The challenge however, is around on-line safeguarding and keeping up to date with technology.  An on-line guide for schools has been published as this is the biggest concern for schools.

Resolved:  That the Board considered the content of the Annual Report provided comment, with no further actions are identified.

To receive the quarterly update on the transformation.

Dave Carr, Policy, Information and Commissioning (Start Well), Shirley Waters, NHS Commissioning Support Unit and Julia Westaway, Commissioning Manager, Lancashire North CCG gave the quarterly update on the Lancashire CYP Emotional Wellbeing and Mental Health Transformation.

The presentation attached gave and overview on what has happened in Year one and what is planned for the second year.  The plan is on a Pan Lancashire footprint.  It also gave tables with dates when it is intended that work will be completed by.

Going forward in year 2 there needs to be an approach that builds on the decision making principlesand what has been described in year 1 and it also needs to help plan for sustainable and deliverable decisions.

The biggest target is the shift from local delivery plans to a Pan Lancashire approach requiring certainty from individual partners to commit.

There needs to be more work done around what services are available to schools and it was noted that there was a Schools Conference arranged for January 2017, where information will be shared and going forward will start to see the benefits and work with schools to help them understand and access what is available.

This is the current ‘Lancashire Children & Young People’s Resilience, Emotional Wellbeing and Mental Health’ it contains timelines for the delivery of the plan C&YP EWMH Transformation which will be refreshed and republished early in the New Year.

There was also a request for the Governance diagram which is attached to the minutes.

It is envisaged that there is one route in to all services and that duplication is removed.

Resolved:  that the Board be provided with the CAMHS scorecard and the timelines for certain workstreams and the Governance diagram, which are attached to these minutes.

To discuss the report and the action plan.

The Board were asked to note and endorse the action plan from Lancashire County Council and also note that the action plan from NHS organisations be presented to the Board once they have been signed off.

Resolved:  i)  that the Board noted and endorsed the action plan from Lancashire County Council (Appendix 'A').

ii)  that the Board noted that the action plans from NHS organisations included in the CQC review will be presented to the Board once they have been signed off by the individual organisations.

To note the request from Health Scrutiny.

County Councillor Steven Holgate, Chair of the Health Scrutiny Committee was welcomed to the meeting and presented the Emergency Care Crisis report as attached to the agenda and requested that the Board produce a formal response to Recommendations 7 and 10 below:

Recommendation 7

That the developing crisis in Emergency Care is given the required priority in the development of the Lancashire and South Cumbria Sustainability and Transformation Plan, and a plan for Emergency Care across Lancashire is developed as a key priority, and that the Lancashire Health and Wellbeing Board be asked to take responsibility for the implementation and monitoring of this priority.

Recommendation 10

For the future, a more open approach to the design and delivery changes to the local health economy needs to take place, working with wider public services through the Lancashire Health and Wellbeing Board to make our hospitals more sustainable and better able to serve the needs of residents. Partners must also demonstrate robust engagement with local residents on the proposed location of future services.

Resolved:  that the Board produce a formal response to the relevant recommendations contained within the report by 22 November 2016.

To receive the report.

Sakthi Karunanithi informed the Board that the response to the STP from Lancashire, Blackpool and Blackburn with Darwen collectively was submitted on Friday 21 October 2016.  All three Health and Wellbeing Boards had met on Wednesday 19 October to discuss the response.  Copies of the report will be circulated when available.

Sakthi also presented Lancashire's Local Digital Roadmap (LDR) with the Board asked to endorse the strategic direction of the LDR.

Resolved:  That the Board endorsed the strategic direction of the LDR.

To discuss progress on utilising the Better Care Fund (BCF) to support and fund more preventive activity.

Following on from the evaluation of the Better Care Fund (BCF) which is working towards keeping people in their own home, specific activities need to happen at a district level.  This is an ideal opportunity for LCC (Lancashire County Council) and CCGs (Clinical Commissioning Groups) to work together and approach the VCFS (Voluntary, Community and Faith Sector) for support and to be a part of the locality and integration and identify a joined up approach by joining resources at a community level.

It was considererd that a list of Community Groups in each district needs to be widely available and shared.  Sakthi commented that a Community Support Programme has always been in place however it now needs to join with Health services, this is being developed further but it needs to be lined up with all initiatives and maximised.  GPs also need to be kept informed with regards voluntary schemes.  CC Ali agreed to discuss this further with Sakthi outside of this meeting as there are a number of funding opportunities available for communities.

Resolved:  that CC Ali will speak with Sakthi Karunanithi on connecting both LCC and the Health Service in working together in localities with voluntary groups.

To receive an update and discuss the report.

Claire Platt updated the Board on the development of the Pan Lancashire Health and Wellbeing Board.

It was proposed that a small working group be formed to look at membership of the Pan Lancashire Health and Wellbeing Board from a Lancashire perspective and to ensure that everybody has a voice.  The membership of the working group was agreed as follows:

Jan Ledward - CCG

Cllr Bridget Hilton – District

CC Mein – LCC

CC Martin – LCC

CC Tomlinson – LCC

CC Ali – LCC

It was also noted that here needs to be safeguarding on the Board.

Dr Alex Gaw, North Lancashire CCG, was unable to attend the meeting, however forwarded comments to be noted for this item as below:

'This CCG supports the proposed development of a pan Lancashire HWBB and endorses the approach to clarify the respective roles of the Boards and local HWB partnerships. I can see in the paper that there is a reference to a Morecambe Bay LHWBP to be  established jointly with members from the Cumbria HWBB. Again, this makes a lot of sense given the proposed boundary change to create a Morecambe Bay CCG from 1^st April and the ongoing STP process.

I would like to emphasise that the (new) CCG would like to use this opportunity to have further discussions both with colleagues in the Cumbria HWBB and the valued local partnerships which exist in South Lakes and Furness. This will enable all partners to agree an approach which enables us to involve locally communities fully in their health and wellbeing'.

Resolved:  that the Board considered and commented on the report and that a small working group be convened to discuss further.

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 13 December 2016 in Cabinet Room 'D' – Henry Bollinbroke Room at County Hall, Preston.

The next scheduled meeting of the Board will be held on Tuesday, 13 December 2016 at 10.00am in Cabinet Room 'D' – Henry Bollinbroke Room, County Hall, Preston, PR1 8RJ.