Agenda and minutes

Members of the public are welcome to attend our meetings to watch them in person at any of the venues across the County. Publicly accessible meetings held in County Hall will be webcast, which means they are available to be watched live or recorded on our website. Please see our webcasting notice here. The Committee may, in certain circumstances, resolve to hold part of the meeting in private. If this is the case, you will be required to leave the meeting.

Venue: Committee Room 'C' - The Duke of Lancaster Room, County Hall, Preston. View directions

Contact: Samantha Gorton  Tel: 01772 532471, mobile 07585 983954 . Email -  sam.gorton@lancashire.gov.uk

Items
Note No. Item

10.00am

1.

Chair of the Health and Wellbeing Board

To note County Councillor Shaun Turner's appointment of Chair of the Board.

Minutes:

Resolved:  That the Health and Wellbeing Board noted that County Councillor Shaun Turner, Cabinet Member for Health and Wellbeing had been appointed as Chair of the Board.

 

10.05am

2.

Welcome, introductions and apologies

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

Minutes:

County Councillor Shaun Turner introduced himself to the Board and round table introductions were made.

 

Apologies were noted as above.

 

Replacements were as follows:

 

Steve Winterson for Dee Roach, Lancashire Care NHS Foundation Trust

Helen Curtis for Dr Sumantra Mukerji and Dr Gora Banghi, Chorley and South Ribble CCG and Greater Preston CCG

Claire Lewis for Jennifer Aldridge, Fylde and Wyre CCG and Fylde and Wyre Health and Wellbeing Partnership

Andrew Bennett for Dr Alex Gaw, Morecambe Bay CCG

Ian Sewart for DCC Sunita Gamblin, Lancashire Constabulary

 

10.10am

3.

Disclosure of Pecuniary and Non-Pecuniary Interests

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.

Minutes:

There were no disclosures of interest in relation to items appearing on the agenda.

 

10.15am

4.

Minutes of the Last Meeting held on 5 September 2017 pdf icon PDF 77 KB

To agree the minutes of the previous meeting.

Minutes:

Resolved:  That the Board agreed the minutes of the last meeting.

 

10.20am

5.

Forward Plan and Action Sheet pdf icon PDF 51 KB

To note the action updates from the previous meeting.

Additional documents:

Minutes:

Resolved:  That the Forward Plan and Action Sheet be noted and if any Board members wishes to place an item on the forward plan, to email details to Sam Gorton, email sam.gorton@lancashire.gov.uk.

 

10.25am

6.

Lancashire Health and Wellbeing Strategy pdf icon PDF 96 KB

To receive a report detailing outcomes from the workshop, updated draft strategy, identify workstream leads and agree way forward.

Additional documents:

Minutes:

Members of the Board had previously agreed that a refresh of the Health and Wellbeing Strategy be undertaken, with a subsequent workshop to agree key areas of focus for the Strategy.  The report provides an update subsequent to the workshop, with potential workstreams identified and a refreshed Strategy for consideration.

 

Members of the Board were requested to consider the groupings and workstreams proposed for action under the headings of Early Years, Activating Communities for Health and Wellbeing, Early Help and Managing Demand, Wider Determinants of Health, together with the opportunities to facilitate delivering, agreeing whether they were an appropriate reflection of the future focus required to improve health and wellbeing outcomes in Lancashire.

 

The Board also agreed on members which will lead activity on the workstreams and the frequency that progress will be reported back to future meetings:

 

Workstream

Lead

 

Early Years

 

County Councillor Charles

Activating Communities for Health and Wellbeing

 

Adrian Leather and Greg Mitten supporting

Early Help and Managing Demand

 

County Councillor Gooch

Wider Determinants of Health

 

Possibly Gary Hall

 

There is an opportunity for support with this from the Local Government Association (LGA) which is available.  Also engage with the Health and Wellbeing Partnerships as their role is crucial in delivering these outcomes across the County along with the District Councils and the Leads should make these contacts.

 

Resolved:  That the Health and Wellbeing Board:

 

i)  Considered the outcomes from the workshop and agreed the proposed areas of work required to improve health and wellbeing outcomes in Lancashire.

ii)  Agreed lead Board members for each programme of work.

iii)  Would receive progress reports on the proposed work streams on a regular basis at future Board meetings.

iv)  Adopted the updated draft Health and Wellbeing Strategy.

v)  Clare Platt to discuss with Gary Hall re leading on the Wider Determinants of Health workstream.

vi)  Clare Platt to initiate the first meeting with all the leads to discuss going forward.

 

10.55am

7.

Better Care Fund (BCF)/Improved Better Care Fund (iBCF) Performance Update Report pdf icon PDF 141 KB

To receive an update report, with particular focus on iBCF and Delayed Transfers of Care (DTOC) performance; and agree way forward.

Additional documents:

Minutes:

The Board received a report on the progress on Lancashire BCF Plan 2017/19, Improved Better Care Fund (iBCF) Plans, Performance against BCF metrics in Quarter 1 of 2017/18 and action taken to reduce Delayed Transfers of Care (DToC) and the level of impact.

 

Work is currently ongoing to agree the Section 75 with the Clinical Commissioning Groups (CCGs) and Lancashire County Council (LCC).

 

iBCF reporting at the next Board meeting in January 2018 will detail spending financial arrangements and performance of schemes.

 

Delayed Transfers of Care (DToC)

 

This area has been recognised as the top priority for joint working by NHS and Social Care.  There is significant national scrutiny that has placed Lancashire in the worse performing quartile resulting in an impending review of the use of the iBCF monies in improving DToC performance.

 

When considering the iBCF/BCF Plan for future sign off, the Board needs to have sight of the trajectory prior to receiving the plan.

 

It is important to understand performance across different health economies and the role of LCC on the DToC Trajectory.

 

There was discussion about DToC performance and it was agreed that there would be a Check and Challenge Group that would meet in between Board meetings that will feed back into this group.  The membership of this group was agreed as follows:  Louise Taylor, Karen Partington and Jayne Mellor.  Louise Taylor agreed to lead this group and convene the meetings.

 

Resolved:  That the Health and Wellbeing Board:

 

i)  Noted the level of performance, in quarter 1 of 2017/18 against the BCF metrics.

ii)  Noted the progress updates for the BCF and iBCF plan delivery for 2017/19.

iii)  Confirmed the role of the Better Care Fund Steering group and encouraged all partners and system leaders to take a full part in supporting it and the delivery of the BCF and iBCF plans.

iv)  Noted actual DTOC performance and the requirements of and expected roles of all partners in achieving extremely challenging improvements in this.

v)  Noted that Lancashire 2018/19 iBCF allocations will be subject to review in November 2017 as a result of significant DTOC performance challenge.

vi)  Approved the proposed process for managing any necessary changes in iBCF spending plans subject to the Chair of the Health and Wellbeing Board agreeing final details with the Chair of the Better Care Fund Steering Group.

vii)  Establish a working group to provide Check and Challenge re DToC.

 

11.25am

8.

Review of Lancashire Residential and Nursing Home Market pdf icon PDF 132 KB

To receive the report and presentation about the state of the market and agree a way forward.

Minutes:

The Health and Wellbeing Board were provided with an up to date position regarding Quality of Care in Residential and Nursing Homes across Lancashire.  The report provided information on bed numbers across Lancashire and also those homes that were currently closing due to either insolvency or Care Quality Commission regulated actions.  Members of the Board were asked to support the establishment of a leadership programme to develop leadership, capacity and capability in the residential and nursing home sector to support and encourage the best outcomes for those receiving care, and to achieve a buoyant and resilient care market.

 

The emerging issues around provider failure was financial sustainability and quality of care.  The Safeguarding Board has been looking at quality of care for vulnerable adults coming into the MASH (Multi-Agency Safeguarding Hub) and are looking at joint funding to improve this.

 

Care Quality Commission has closed a number of residential homes recently and LCC have found beds for those residents.  A long term view at providing apprenticeships and caring as a carer packages to provide Managers of the future is needed.

 

Resolved:  That the Health and Wellbeing Board:

 

i)  Noted the availability and quality of the residential and nursing home care sector as detailed in the report.

ii)  Supported the proposal to develop a quality improvement programme.

iii)  Nominated Louise Taylor to act as champion for this piece of work and contribute to its development and approval in the future.

iv)  Noted that a detailed proposal with timescales and costings would be developed by the BCF Steering Group.

 

11.55pm

9.

Lancashire Safeguarding Boards: Annual Reports 2016/17 pdf icon PDF 126 KB

To receive the Annual Reports.

Additional documents:

Minutes:

Lancashire Children Safeguarding Board (LSCB) and Lancashire Adult Safeguarding Board (LASB) are required to produce and publish an annual report which reflects on safeguarding practice and issues in the area.  The report covers the period from April 2016 to end of March 2017 and can be accessed online.

 

Additionally a separate Annual Report is prepared by the LSCB's Child Death Overview Panel (CDOP).  A brief summary of key issues were detailed in the report.

 

The Board noted key points from the reports:

 

i)  Policies, procedures and guidance around Mental Capacity Act (MCA) implementation have been commended nationally as an example of best practice.

ii)  Applications in respect of Deprivation of Liberty (DoLs) far outsrip capacity to deal with them and there are significant backlogs and this is also a national pressure and concern.

iii)  A significant backlog of safeguarding alerts was reported in the previous Annual Report.  This has continued to be a concern throughout 2016-17.  Recently the Local Authority have found additional resources to deal with this and the outcome will be reported in the 2017-18 report).

iv)  Referrals to MASH include too many children whose interests would be best met by early help.

v)  Agreed to fund a piece of development work in Children's MASH through to Adult.

vi)  It is anticipated that new partnership arrangements with the three key agencies, the Local Authority, Police and CCGs are likely to be referred to as "Multi-agency Safeguarding Arrangements".  These will need to be in place by end of June 2019.

vii)  The Children's Commissioner has also published a report and this will be shared with the Board.

 

Resolved:  That the Health and Wellbeing Board noted the contents of the reports, commented on any key issues and considered the implications for the conduct of business.

 

12.10pm

10.

Urgent Business

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.

Minutes:

There were no matters of urgent business received.

 

12.15pm

11.

Date of Next Meeting

The next scheduled meeting of the Board will be held at 10.00am on 25 January 2018 in Committee Room C – Duke of Lancaster Room at County Hall, Preston, PR1 8RJ.

Minutes:

The next scheduled meeting of the Board will be held at 10.00am on 25 January 2018 in Committee Room C – Duke of Lancaster Room, County Hall, Preston.