Agenda and minutes

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

Due to the absence of County Councillor Vivien Taylor, CC Driver was appointed as Chair for the meeting.

Apologies were noted as above.

New member as follows:

DCC Sunita Gamblin replaces ACC Mark Bates, Lancashire Constabulary

Adrian Leather replaces Sarah Swindley, Third Sector

Replacements were as follows:

County Councillor Shaun Turner for County Councillor Vivien Taylor, Lancashire County Council

County Councillor Philippa Williamson for County Councillor Susie Charles, Lancashire County Council

Simon Burnett for David Tilleray, West Lancashire Health and Wellbeing Partnership

Tim Almond for Dr Alex Gaw, Lancashire North CCG

Jackie Hanson for Mark Youlton, East Lancs CCG

Supt Andrea Barrow for DCC Sunita Gamblin, Lancashire Constabulary

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 meetings with the following amendment to 7 August 2017 Minute Item 3 i) removal of the word 'That'.

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

The Forward Plan is a working document and items will move by necessity.  Additional items that need adding are:

Pharmaceutical Needs Assessment (PNA)

Child and Adolescent Mental Health Service (CAMHS)

Joint Strategic Needs Assessment (JSNA)

Health and Wellbeing Strategy

Lancashire Safeguarding Adult's Board (LSAB) - Annual Report - November 2017 meeting

Lancashire Safeguarding Children's Board (LSCB) - Annual Report - November 2017 meeting

Members of the Board were requested to send any future items for consideration at a Board meeting to Sam Gorton, email sam.gorton@lancashire.gov.uk.

To discuss proposals and analysis.

Progress on the refresh of the Lancashire Health and Wellbeing Strategy was considered by the Board.

Resolved:  That:

i)  The Health and Wellbeing Board (HWBB) members share the draft Strategy with health and wellbeing partnership colleagues for comment.

ii)  The HWBB agrees the draft strategy and associated appendices as the basis of a workshop to be held on 16 October 2017 where the focus for the final strategy will be agreed.

To receive an update on the STP governance arrangements.

Carl Ashworth, NHS Midlands and Lancashire Commissioning Support Unit on behalf of the Lancashire and South Cumbria STP presented an update to the Board on the proposed new STP Governance Arrangements – details attached.

Upper tier local authority representatives are represented on the STP Board, with County Councillor Vivien Taylor as the Lancashire County Council representative. The STP Board has a relationship with the Joint Committee of Clinical Commissioning Groups (JCCCG) in that the JCCCG is the means by which Lancashire and South Cumbria wide commissioning decisions will be made.

The HWBB noted that there is need to ensure a strong link between the STP Board and the HWBB.

Further to discussion, Carl confirmed that the Public Engagement Policy is a key workstream of the STP.

The HWBB felt a better understanding of the STP Governance Structure would be beneficial if a worked through example was provided and showed how it was followed through the structure.

Resolved:  That the Health and Wellbeing Board agreed that a worked through example be provided to the HWBB at the Workshop on 16 October 2017.

To receive the evaluation of the current BCF Schemes, agree the proposals for the 2017/19 BCF Plan and note the Q1 update.

Paul Robinson, NHS Midlands and Lancashire Commissioning Support Unit, informed the HWBB of the development of the Lancashire Better Care Fund (BCF) Plan for 2017/18/19 and sought the Board’s approval of the plan.

It is a two year plan covering 2017/18 and 2018/19 with some ability to review late in the first year.  It covers three elements of funding - the core BCF, the new iBCF and the Disabled Facilities Grants monies.

The Lancashire BCF Plan is built upon a high level of involvement of a wide range of partners, and in particular health and social care.  The plan again sees the growing influence and engagement with the Voluntary Sector and District Councils.

It has used approaches to support decision making that have required detailed analyses of 2016/17 BCF schemes and the potential of new areas of spend. Its spending plans reflect the decisions to retain the existing BCF schemes and to use the iBCF schemes to innovate, plug gaps and build upon existing success.

A key requirement within the BCF plan is to demonstrate the action to be taken to address the priority of reducing Delayed Transfers of Care.  The plan describes how the BCF will act as an enabler within a wider system approach that will be led by the A&E delivery boards and coordinated through the Lancashire and South Cumbria Urgent Care Network.

The HWBB felt there was a need for better understanding and a flexible approach to what does and does not work.

There is a requirement to track and monitor benefits and outcomes.  Hospitals are signing off the LDP Winter Plans.  There is a need for clear metrics on a Lancashire footprint.  Karen Partington, Lancashire Teaching Hospitals Foundation Trust, agreed to share work around this with Paul.

There is a need to align and learn quickly and be really clear on measured outcomes going forward.  Guidance that will come through later in the year will encourage better alignment across boundaries.

Resolved:  That the Health and Wellbeing Board agreed to:

i)  Endorse the approach taken in developing the Lancashire Better Care Fund plan 2017/18/19.

ii)  Approve the Lancashire Better Care Fund Plan 2017/18/19 and its submission to NHS England.

iii)  Agree a BCF reporting schedule to the board based upon that required by NHS England.

iv)  Request the BCF Steering Group strengthens performance management and evaluation of the schemes, so that their effectiveness is more clearly understood; and opportunities to move resources within and between schemes are identified, prior to any changes being agreed by the Board.

v)  Request the BCF Steering Group strengthen the risk and benefit sharing arrangements between the County Council and the Clinical Commissioning Groups (CCGs) under the Section 75 pooled budget arrangements.

To agree the policy, prior to its approval by Cabinet on 14 September 2017.

The Supporting Patients Choices to Avoid Long Hospital Stays Policy has been developed locally by NHS organisation and local authorities operating within the Lancashire and South Cumbria Sustainability and Transformation Partnership.  It is based on a national framework issued by NHS England.  The aim of the policy is to provide accurate and timely information to patients about their choices when leaving hospital, improve patient flow and increase capacity within hospital to meet growing demand.

To minimise delays and uncertainty about which organisation has funding responsibility for meeting the support needs of particular individuals in the context of this policy, a funding framework has also been developed by NHS and Local Authority partners within the Lancashire and South Cumbria Partnership.

Resolved:  That the Health and Wellbeing Board agreed to endorse the collaborative policy framework, as detailed at Appendices 'A' and 'B' of the report; and supported its adoption across the footprint of the Lancashire and South Cumbria Sustainability and Transformation Partnership.

To agree the plans.

The Lancashire County Council (LCC) Adult Social Care Winter Plan has been updated for 2017/18 to reflect the services in place and the social care planning and response to winter pressures.

The plan includes information about various enhanced responses over the winter period and the proposed service developments through the improved Better Care Fund (iBCF) funding that aim to improve the situation around delayed transfers of care, which typically increase through the winter period.

Whilst some of the funding for enhanced services are being met through the iBCF, there is however no formal designated resilience funding identified within these monies, and therefore further resilience discussions may need to take place with NHS partners around whole system planning.

The plan will be shared both internally in LCC and with each A&E Delivery Board across Lancashire for inclusion in the system wide winter planning and delivery reporting.

Resolved:  That the Health and Wellbeing Board received and noted the LCC Adult Social Care Winter Plan.

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 10am on 14 November 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 10.00am on Tuesday, 14 November 2017 in Committee Room 'C' - Duke of Lancaster Room, County Hall, Preston.

The workshop will be held on Monday, 16 October 2017 at 1.00pm-4.30pm at County Hall, Preston.