Agenda and minutes

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

Contact: Samantha Gorton  Tel: 01772 532471 - Email:

Note No. Item



Welcome, introductions and apologies

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


The Chair welcomed all to the meeting.


Apologies were noted as above.


New members of the Board were as follows:


Edwina Grant OBE replacing John Readman, Lancashire County Council

Dr Julie Higgins replacing Mark Youlton, East Lancashire CCG

David Blacklock, Healthwatch Lancashire replacing Sheralee Turner-Birchall


Replacements were as follows:


Philomena Cunningham for Tammy Bradley, Housing Providers

Denis Gizzi for Dr Sumantra Mukerji, Greater Preston CCG and Dr Gora Bangi, Chorley and South Ribble CCG

Jerry Hawker for Dr Geoff Jolliffe, Morecambe Bay CCG



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.


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




Minutes of the Last Meeting pdf icon PDF 96 KB

To agree the minutes of the previous meeting.


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




Action Sheet and Forward Plan pdf icon PDF 52 KB

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


Additional documents:


Resolved:  That the Board noted the actions from the last meeting that had been included on the forward plan, along with other items for the Board's consideration at future meetings also detailed on the plan.




Children's Services Update pdf icon PDF 94 KB

To receive an update on:

Children's Services Getting to Good Plan

Special Educational Needs and Disabilities (SEND) Improvement Plan

Additional documents:


Edwina Grant OBE, Executive Director of Education and Children's Services was welcomed to her first meeting as a member of the Board to present the following reports:


Children's Services Getting to Good Plan


The Ofsted re-inspection of Children's Services in June 2018 noted significant improvements, with an overall effectiveness judgement of requires improvement to be good and good for our adoption service.  However, there is still more to do to ensure that all children receive a consistently good service.  The Lancashire Getting to Good Plan sets out the actions required to address the 11 recommendations in the report, further improving the quality of practice and outcomes for children.


There was a new Governance Section within the plan which includes the Lancashire Health and Wellbeing Board, Corporate Parenting Board, Children's Services Scrutiny and Education Scrutiny and each of these Boards/Committees will scrutinise areas relevant to them and be guided on this by Edwina.


Following on from a previous meeting in September 2018, the Board were still awaiting the outcomes on the key issues from the Lancashire Safeguarding Boards Annual Report 2017/18 and what the Adults and Childrens Boards were doing regarding those issues.  Jane Booth confirmed that this would be presented at the next meeting in March 2019.


Resolved:  That the Health and Wellbeing Board noted the Lancashire Getting to Good Plan and considered how the Board could contribute to the achievement of outcomes in the plan.


Lancashire Special Educational Needs and Disabilities (SEND) Partnership – Update on the Implementation of the Written Statement of Action


Since the report to the last Health and Wellbeing Board meeting in November 2018, work had continued to progress the actions set out in the written statement of action.


This was the fourth update to the Health and Wellbeing Board.


Resolved:  That the Health and Wellbeing Board:


(i)  Noted the progress of delivery on the written statement of action;

(ii)  Will receive an update on the Improvement Plan and progress at the March 2019 Board meeting;

(iii)  Noted the changes to the external monitoring process in 2019 as described in paragraph 3 of the report.




NHS Long Term Plan pdf icon PDF 93 KB

To note the contents and key deliverables of the plan, and discuss next steps in implementation.


Additional documents:


Dr Amanda Doyle OBE, Integrated Care System Lead, Chief Clinical Officer, NHS Blackpool and Fylde and Wyre Clinical Commissioning Groups (CCGs) presented the report and the attached PowerPoint to the Board highlighting key elements from the NHS Long Term Plan. 


The government announced a five year funding settlement for the NHS in June 2018; an additional £20.5 billion a year in real terms by 2023/2024.  In response to this, the NHS Long Term Plan had been developed and was published in January 2019. 


The purpose of the discussion today was to apprise the Health and Wellbeing Board of the content of the plan and to discuss how the Board accelerated greater collaboration and enhanced system working to deliver the ambitions outlined within the plan. 


Discussion ensued around the NHS Long Term Plan and even though the budget was enormous it was still not enough to do what the NHS wanted and needed to do, still leaving a significant gap in funding.  Managing demand and increasing focus on prevention would help to support the long term plan.  They are looking at changing the model of care to enable 85 year olds and above to live well in their own homes and work closely with the Local Authority in doing so with reablement services and personalised care as people are living longer and this was increasing annually.


The Health and Wellbeing Board welcomed the NHS Long Term Plan, however to improve the health and wellbeing in Lancashire, the role of the Board needed to strengthen as the key statutory lever as well as supporting the NHS to deliver the plan.  This was the Board's opportunity to work with the NHS and wider public services as well as Lancashire Leaders.  Deprivation in Lancashire is evident and with the Government removing funds to support it, this would have an impact in most districts which will cause issues delivering prevention services.  Working in partnership on prevention was crucial.  It was really important to align the efforts of all services.  There was a very systematic approach to spend funds out of hospital instead of increasing hospitals.


The next step as an Integrated Care System was to produce a five year local plan.


The Health and Wellbeing Board needs to align all the services and be accountable for the plan and agree and sign up to it.


Resolved:  That the Health and Wellbeing Board noted the contents and key deliverables of the plan and discussed next steps in implementation.




Better Care Fund Progress pdf icon PDF 124 KB

To receive an update and feedback on Better Care Fund spending proposals for 2019/20 onwards.

Additional documents:


Paul Robinson, NHS Midlands and Lancashire Commissioning Support updated the Board on the Better Care Fund progress.


Better Care Fund Metrics


1.  Reablement - performance continued to be better than target with 88.2% of people being at home 91 days after discharge from hospital and an increase in the number of those using the service.

2.  Permanent admissions to residential and Nursing Care - for the full year up to the end of Q2 performance had improved slightly and remained better than plan.  However, Lancashire still had a high rate of admission to permanent residential and nursing home care for older people.

3.  Non-elective admissions - from a position of being above plan in Q3 2017/2018 actual had decreased gently to being better (below) plan in Q2 2018/2019.

4.  Delayed Transfers of Care - performance had been better (below) target. However, this disguised that Delayed Transfers of Care increased in September to above plan and were continuing to do so.


The Future of the Better Care Fund/Integration


The NHS Long Term plans confirmed the continuation of the Better Care Fund into 2019/2020 but with a national review of it underway. The review outcome and planning framework were promised soon.


Alongside this review and the anticipated new framework, planning of a Lancashire wide review was underway that would reset the Better Care Fund in a context of integrated care system proposals for the integration of health and social care.


In developing further the Better Care Fund there were plans to hold a workshop in March around integration which would explore lots of factors in the care system and link in with whatever was coming out of the NHS Long Term Plan and not just focus on what was in-scope from the Better Care Fund.  The Board would like to see the workshop on integration to be more transformational than transactional when we review the future arrangements for the Better Care Fund.  Paul Robinson would inform the Board of the date when this had been arranged.


Active Ageing Pilot


The Better Care Fund Steering Group had considered the proposal and recommended that this was not supported at this time.  Should the funding position become clearer with increased flexibility the proposal could be reconsidered at the request of the Health and Wellbeing Board.


Chair of Better Care Fund Steering Group


Since Mark Youlton's retirement from the NHS and stepping down from the Health and Wellbeing Board and role of Chair of the Better Care Fund Steering Group, Tony Pounder as the Deputy Chair had taken on the role of Interim Chair of the Better Care Fund Steering Group, probably until the end of March 2019. 


The Better Care Fund Steering Group would agree a nomination to the role of permanent Chair in due course and seek the approval of the Chair of the Health and Wellbeing Board to confirm the nomination, with the intention of picking up the role from April 2019.  Dr Julie Higgins agreed to continue Mark's role as Chair of  ...  view the full minutes text for item 7.



Proposals for 2019/20 Joint Strategic Needs Assessment Work Plan pdf icon PDF 88 KB

To discuss the proposals for the 2019/2020 work plan.



Gemma Jones, Joint Strategic Needs Assessment Manager and Hayley Sumner, Business Intelligence Officer, Joint Strategic Needs Assessment Team, Lancashire County Council updated the Board on the proposals for the 2019/20 Joint Strategic Needs Assessment Work Plan and sought approval from the Board to carry out three major projects.  They were: support for population health management, health inequalities and children and young people.  The Board were also requested to consider nominating Board sponsors for each of the three projects.


It was noted that one of the next plans following these three projects should be an older peoples plan.


Also with regards accessing information, a relaunch of the Neighbourhood Dashboard would be useful so all partners were aware of it and how to access it.


Resolved:  That the Health and Wellbeing Board approved the three proposed projects for the 2019/20 joint strategic needs assessment project year.




Motor Neurone Disease Association Charter pdf icon PDF 102 KB

To request that the Council adopt the Motor Neurone Disease Association Charter.

Additional documents:


Sue Muller, Regional Care Development Adviser, Lancashire and Cumbria, Motor Neurone Disease Association introduced the other presenters and the background to the Charter to the Health and Wellbeing Board.  The Board received a presentation by someone affected by the disease and nurses that supported them.


It was clarified that the request was for the Health and Wellbeing Board and not Lancashire County Council to endorse the charter.


County Councillor Gooch expressed concern that the County Council could not endorse the full charter as it required other partners to act as well.


Resolved:  That the Health and Wellbeing Board adopted the Motor Neurone Disease Charter.



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.


Lancashire Safeguarding Adults Board Self-Neglect Framework


Jane Booth, Independent Chair, Lancashire Safeguarding Adults Board informed the Health and Wellbeing Board that the Framework was due to be launched on 20 March 2019 and wanted to share this with members of this Board.


The purpose of the framework was to provide a process guide for all Lancashire Safeguarding Adults Board partner agencies on how to respond when concerns of self-neglect had been identified.


Resolved:  That Sam Gorton, Clerk, would attach the Framework to the minutes for members to peruse the document.


National Initiative - Fit and Fed


Adrian Leather, Chief Executive, Active Lancashire informed the Board of a National Initiative he would like to apply for on behalf of the Health and Wellbeing Board.


Fit and Fed or Holiday Hunger is aimed at deprived young people in the Country and as Lancashire had the third highest number of young people on free school meals in the Country this initiative would be most welcome.


Resolved:  That the Health and Wellbeing Board supported Adrian Leather in submitting an application for the National Initiative – Fit and Fed.


12 noon


Date of Next Meeting

The next scheduled meeting of the Board will be held at 10.00am on 19 March 2019 in Committee Room 'C' – Duke of Lancaster Room at County Hall, Preston.


The next scheduled meeting of the Board would be held at 10am on Tuesday, 19 March 2019 in Committee Room 'C' – Duke of Lancaster Room at County Hall, Preston.