Agenda and minutes

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

Welcome and introductions were made.

Apologies were noted as above.

New member as follows:

Dr Dinesh Pantel – Greater Preston CCG (Clinical Commissioning Group) has retired and Dr Sumantra Mukerji is the new representative.

Replacements were as follows:

Stewart Lucas for Sarah Swindley, Third Sector

Cllr Ben Aitken for Cllr Viv Willder, Lancashire Leaders Group

David Keddie for Dee Roach, Lancashire Care NHS Foundation Trust

Jan Ledward for Dr Gora Bangi, Chorley and South Ribble CCG and Dr Sumantra Mukerji, Greater Preston CCG

Victoria Gibson for Jane Booth, Adult and Children's Safeguarding Boards

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 of the last meeting.

Item 4 – Pharmaceutical Needs Assessment – Legislative Briefing (NHS England)

v)  This was still a work in progress and would come to a future meeting.

Item 8 – Urgent Business – Fylde and Wyre CCG – Annual Report and Accounts 2016/17

It was reported that a number of Annual Reports and Accounts had been received and these would be dealt with by the Director of Public Health whom would report back to a future meeting of the Board.

i)  To receive an update on progress of the STP, in light of recent guidance.

ii)  To receive a report on the Central Lancashire Local Delivery Plan (LDP).

i)  Update on progress of the Sustainability and Transformation Plan (STP)

Gary Raphael was welcomed to the meeting and delivered an update on the Sustainability and Transformation Plan (STP) as attached to these minutes.

There had been a change in focus from a plan to a partnership and there needed to be a refocus on this.  There was a workstream looking at the development of joint plans for regulated and other social care provision.

The Healthier Lancashire and South Cumbria document was published at the end of March and other supporting documents would be available soon also.

ii)  Central Lancashire Local Delivery Plan (LDP)

Jan Ledward updated the Board on the Central Lancashire LDP which was very similar to the East Lancashire LDP which was presented at the last Board meeting.  Engagement events have been taking place since October 2016 across Preston, South Ribble and Chorley with patients and the public have been very generous coming forward with suggestions and they have also worked with young people too.  The use of Information Technology (IT) needs to be improved and a lot more could be done with that.  There was a long list of options going forward which would be shared with the public around May time, they would then be shortlisted and costed and options would be highlighted which would then go for consultation around October.  Health Scrutiny Committee was being kept informed regularly.  This was no different to what was happening across Lancashire. 

Lancashire and Cumbria are considering a range of service options at the STP level.  There was an amount of variation and how it was delivered and would look at standardising this and what was happening locally would also feed into the STP.  They have got a shared plan and Integrated Neighbourhood Schemes also want to be involved.  It was about sharing good practice and learning from Morecambe Bay at Vanguard and Blackpool.  As a Board we were doing it rather than having it done to us.  It puts Lancashire in a good position and we were all working together in Health and Care over the next five years.  It was not about money it was about making a difference.

Attached is a Powerpoint on Central Lancashire LDP which was not presented at the meeting, but was agreed to be circulated.

To receive verbal updates on current activity of Health and Wellbeing Partnerships:

·  Lancaster

·  Fylde and Wyre

·  Preston, Chorley and South Ribble

·  East Lancashire

·  West Lancashire

Jamie Carson reported on the Preston, Chorley and South Ribble Health and Wellbeing Partnership (HWBP) that all District Councils had met and it had highlighted just what roles they play in people's health care.  It had opened up a number of conversations especially with the Voluntary, Community and Faith Sector (VCFS).  A paper was discussed with health leads and it would go to the STP and also come to this Board.

Councillor Bridget Hilton reported on East Lancashire HWBP that a lot of progress had been made from a year ago.  There were now two standing items on their agenda where feedback was received from health and social care and the HWBB.  They also talk about the STP, BCF and national issues and try to focus on early intervention at every meeting.  There was a new model of service delivery to GPs across Ribble Valley and there were two members from East Lancs CCG in attendance as well as four GPs that attended regular meetings.  Two main issues that had been flagged up were lack of Health Visitors and that GP's work had increased due to this.  The other one was health in rural communities – no public transport, poor housing, loneliness, isolation, mental health, no mobile broadband.  It was suggested that maybe the HWBB could look at these issues and present back to the HWBP.

Resolved:  i)  Jamie Carson to ensure that the paper from the District Councils for the STP be presented to the Board at a future meeting.

ii)  Sakthi Karunanithi agreed to attend the next meeting of the Ribble Valley HWBP to discuss Early Help Services and Health Visitors.

To receive the report and discuss the report.

Mark Youlton presented the report that was attached to the agenda.  The purpose of it was to inform the Board of the progress of the delivery of the BCF Plan through updates of performance against the BCF metrics.  In addition it gave detail of the planning requirements, as known, for BCF 2017/19, planning activity so far and changes to funding streams within the BCF.

Quarterly performance has been better than plan for non-elective admissions but considerably worse than plan for delayed transfers of care (DTOC).  The latter reflecting the whole system locally and nationally.  Residential and Nursing Home admissions continue to show a good downward trajectory and the success of reablement services remains a point of note.

There was a significant amount of money coming into Pan Lancashire - £33 million.  Clinical Commissioning Groups (CCGs) needed to maintain levels of investment into social care and invest £400,000 into reablement because it was proven to work.  Partnership working was key and of the £33 million invested in Pan Lancashire, £25 million of that the Health and Wellbeing Board (HWBB) could have a say on how that was spent at scale and needed to be clear how it would work.  Tony Pounder was to meet with the five Accident and Emergency Delivery Boards in the very near future.  The challenge was agreeing the spending across Pan Lancashire albeit to do it quickly, once and in a planned way.

NHS England have held a meeting and will be meeting with local Authorities.

Home care domiciliary in Lancashire was currently undertaking a huge recommissioning exercise across Lancashire for a good set of providers.

Resolved:  i)  that the plan be presented at a future meeting of the Board for sign off.

ii)  to discuss at a future meeting around expanding on residential homes and how we use our in-house provision.

To receive further updates.

Louise Taylor spoke to the Powerpoint as attached to the minutes and tabled the document titled The Story of our Transformation which was also attached.  Details included timelines, results and next steps for the Passport to Independence programme.  This time last year, 14 people each week were starting in residential or nursing care.  This year, that number had dropped to 10.  In the East, eight out of ten service users were fully independent after reablement, now eight out of ten service users were fully independent.  For community assessments and reviews a reduction in East Lancashire waiting lists went from 775 to 60.  This was the opportunity to make a lasting improvement to the residents of Lancashire. 

To receive further update.

A letter had been attached to the agenda from NHS England on the consultation on the redesign of learning disability and autistic spectrum disorder services across the North West.

Louise Taylor summarised the implications of the NHS England consultation outcome (Calderstones/Whalley Site):

·  Learning Disability (LD) In–Patient service would not be delivered from the Mersey Care Whalley Site it would close as an LD facility.

·  Medium Secure Service would relocate to Ashworth Hospital site (Maghull).

·  Low Secure Service would be re-provided in smaller specialist units dispersed across the North West (70 beds across the NW) – there was no detail in the consultation of where these would be – a decision for Lancashire sites was referenced as required from Mersey Care in the National decision making minutes.

·  There was a model preferred for co-location of Mental Health and LD in-patient beds that appears to be preferred by NHS England.

·  A decision on the money available to re-provide the low and medium secure service would be decided at NHS England Board level.

·  Whalley staff would be redeployed across the new services offered across the North West – fast track training offered (partnership with Edge Hill).

·  A new Specialist Support Team (SST) was being developed by Mersey Care (agreed as part of the acquisition) which would offer an enhanced community based specialist service – the main aim of this team would be to gate keep and reduce admissions by supporting the mainstream Community Team provision and Social Care providers, they would also help community services better manage the Forensic population when they moved to live in the community.

Another couple of key areas were:

·  A new specification had been written and consulted on for Community LD Teams – there was an aspiration from the Transforming Care Partnership to develop an Integrated Learning Disability and Autism service.

·  In development of the pooled budget for LD and Autism – meetings were ongoing with NHS Finance Directors with the aim of developing a Shadow Pooled arrangement by July 2017 and fully operational by April 2018.

To receive a verbal update on the Well North in Lancashire initiative, and discuss future opportunities.

Clare Platt updated the Board on a recent visit that had taken place to the Bromley-by-Bow Centre in London on 29 March 2017 which included Public Health colleagues from Lancashire County Council and Blackburn with Darwen Council along with East Lancashire and West Lancashire CCGs.  This was a community owned asset in a church with a GP practice, community facilities eg job club; ITC skills, financial skills which had improved connectivity, encouraged confidence and a 'can-do' attitude in the community. 

A visit to the Olympic Park made connection with the Olympic Legacy Board and showed the utilisation of the derelict land and maximised and exploited opportunities.

The group also visited St Paul's Way which was a trust school.  This showed aspirational leadership and focus on ambition.  The teachers were committed to getting their pupils through their GCSEs and the pass rate had improved.

Burnley Community Partnership and GPs in Burnley Wood were wanting to do something similar.  Well North would facilitate the discussion and get different leaders involved.

A number of discussions were held during the day with a lot of positives ie look at delivering primary care differently, mobilising in East Lancashire – just do it, build on what is there, discuss with community leaders.

Work was ongoing in East Lancashire and West Lancashire (Skelmersdale) around unemployment and transforming lives.

It was about developing community resilience, relationships and assume that it was possible.

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 2pm on Tuesday, 20 June 2017 in the Duke of Lancaster Room - Cabinet Room 'C' at County Hall, Preston.

The next scheduled meeting of the Board will be held at 2.00pm on Tuesday, 20 June 2017 in the Duke of Lancaster Room - Cabinet Room 'C' at County Hall, Preston.