Agenda and minutes
Venue: Committee Room 'C' - The Duke of Lancaster Room, County Hall, Preston. View directions
Contact: Samantha Gorton Tel: 01772 532471 - Email: firstname.lastname@example.org
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.
Replacements for the meeting were as follows:
County Councillor Keith Iddon for County Councillor Geoff Driver CBE, Lancashire County Council
Roger Parr for Julie Higgins, East Lancashire Clinical Commissioning Group
Ian Crabtree for Louise Taylor, Lancashire County Council
Sian Rees for Edwina Grant OBE, Lancashire County Council
Kelly Short for Dr Geoff Jolliffe, Morecambe Bay Clinical Commissioning Group
Adrian Griffiths for Karen Partington, Lancashire Teaching Hospitals Foundation Trust
Apologies were also received from Dominic Harrison and Councillor Mohammed Khan from Blackburn with Darwen Council.
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.
To agree the minutes of the previous meeting held on 10 September 2019 and to discuss any matters arising from them.
Resolved: That the Board agreed the minutes of the last meeting.
To note the action updates from the previous meeting and the forward plan for future meetings.
Resolved: That the Board noted the actions from the last meeting, along with items for the Board's consideration at future meetings as detailed on the forward plan.
To receive a summary of the finding from the Focus Groups on the NHS Long Term Plan.
Sue Stevenson, Chief Operating Officer, Healthwatch Lancashire provided a summary of the findings from the Focus Groups on the NHS Long Term Plan. Lancashire and South Cumbria Integrated Care System wanted to ensure that the needs of those with complex health conditions were being addressed by recent developments within the healthcare system. Healthwatch Cumbria, Healthwatch Lancashire, Healthwatch Blackburn with Darwen and Healthwatch Blackpool were asked to conduct focus groups that targeted certain priority groups. The priority groups were identified by the local Integrated Care Partnership and Clinical Commissioning Groups.
The presentation demonstrated how the individual views and experiences of people gathered by Healthwatch could provide rich intelligence and real insight into how services could be improved from the perspective of service users.
The Focus Groups took place between June and September 2019. The priority groups were:
· Aged 18-65 with a mental health condition
· Living in areas of high deprivation
· Living in rural areas
· Of working age
· With a long term medical condition
· Who were military veterans
· Who were older, transgender persons
· Suffering from frailty
· With dementia
· One group of older residents and one group of younger residents
The groups were asked to focus on the following key areas:
· Changes and developments to the health care system
· Feedback on Associate Physicians
· Links between different services
· Mental health
· Primary Care Networks
· Community Services
The Board received the feedback on the key areas that were discussed by the priority groups and discussed ways forward. The Board agreed it needed to hold the Integrated Care System to account and be aware of what each service was doing with regarding this. Communication was still a major issue within organisations and how residents were communicated with, should be more user-friendly. Again the biggest challenge was financially and decisions were still being made within individual organisations unaware of the consequences across the piste and learning needed to be shared across the system. Communities also needed to come together and help each other and organisations should be offered to communities to help them set this up.
Resolved: That the Health and Wellbeing Board:
i) Noted the key messages from the Focus Groups including:
· The level of understanding about the health and care system and its on-going changes.
· What was working well and less well.
ii) Considered how Healthwatch could further assist Lancashire Health and Wellbeing Board ensure that more people were engaged and involved more people in shaping local services. As a consequence it was agreed that the Chair, on behalf of the Board, engage with the Integrated Care System and Integrated Care Partnerships to request their response to the report and identify actions they intended to take; with a view to bringing findings back to a future Board meeting and that the Health and Wellbeing Strategy be revisited in light of the report to inform Board agendas and activity going forward.
To receive a further update in relation to life expectancy and health and wellbeing outcomes for people with learning and disabilities and their carers.
Rachel Snow-Miller, Director of Commissioning – All Age Mental Health and Learning Disability Services, Lancashire and South Cumbria Integrated Care System and Sue Hastewell-Gibbs, Clinical Lead for Transforming Care, NHS England and NHS Improvement (North) presented to the Board an update on Transforming Care – Learning Disabilities Mortality Review (LeDeR).
The report updated the Board on the findings of the 3rd Annual National Mortality Review report and this had been implemented locally and to highlight the health inequalities suffered by people with Learning Disability and/or Autism across Lancashire and South Cumbria.
The Learning Disability Mortality Review (LeDeR) programme was established in June 2015 in response to significant ongoing concerns about the likelihood of premature deaths of people with learning disabilities.
In Lancashire and South Cumbria the estimated number of deaths of people with learning disabilities is 102 per year. The local challenges include a lack of reviewers across health and social care, lack of awareness of the Learning Disability Mortality Review programme and provider sign up.
To date, Blackpool Teaching hospital has implemented learning disability awareness training within the Adults Community division as a direct consequence of the learning from some Learning Disability Mortality Reviews together with development of two, seven minute briefings on reasonable adjustments and capacity/consent for sharing with all staff in the division/trust. There were also plans to review the Speech and Language/dysphagia processes in place in the Trust.
Priorities for Lancashire and South Cumbria going forward are:
· Commence and complete the backlog project by March 2020.
· Develop a communication plan to raise awareness of the Learning Disability Mortality Review programme across the Integrated Care System.
· Support learning into action.
· Work with Public Health England to explore key focus areas for action.
Resolved: The Health and Wellbeing Board:
i) Supported the implementation of learning into action across Lancashire and South Cumbria.
ii) Supported the focus on reasonable adjustments being made in relation to people with Learning Disability and/or Autism across the region.
iii) Supported communication of the Learning Disabilities Mortality Review (LeDeR) programme across the region.
To receive an update on the assessment of progress on the Special Educational Needs and Disabilities plan and accelerated plans.
Sian Rees, Improvement Partner, Special Educational Needs and Disabilities presented the Board with an update report on the assessment of progress on the Improvement Plan and Accelerated Plans.
Following the inspection which was carried out by Ofsted and the Care Quality Commission in November 2017 there were two fundamental failings and twelve areas of significant concern identified.
Partners in Lancashire were required to produce a Written Statement of Action, setting out the immediate priorities for action. Progress on the implementation of these actions had been monitored by the Department for Education (DfE) and NHS England. The Written Statement of Action had been updated and any ongoing actions included in the Special Educational Needs and Disabilities Partnership Improvement Plan for the period April 2019 to December 2020.
On the Improvement Plan, there were five delayed actions. Of these the review of the Personal Budget policy was expected to be completed in November 2019; the improved Local Offer site was soft launched on 10 October 2019; the development of a Special Educational Needs and Disabilities Sufficiency Strategy and work with post-16 providers to develop Special Educational Needs and Disabilities provision had commenced.
Of those actions yet to commence there was risk of delay with one action due in January 2020 i.e. to review the access criteria for support from the Children with Disabilities Social Work team. This was as a result of capacity.
On the Accelerated Plans, there were five plans in total; four were on track. These were focused on: improving the quality of Education Health and Care Plans; improving education outcomes; implementing the Neuro-developmental Pathway and the process of transition from Children’s Social Care to Adult Services. The fifth plan to improve the accessibility of and information on the Local Offer was delayed - the soft launch of the new site took place on 10 October 2019 and information continued to be updated and revised. The full launch, supported by promotion, would take place in January 2020 followed by user testing.
Resolved: The Health and Wellbeing Board:
i) Noted the delay in the re-visit from Ofsted.
ii) Considered the report on progress to date in delivering the actions in the Special Educational Needs Improvement Plan and the Accelerated Plans.
Pan-Lancashire Health and Wellbeing Board
To receive feedback from the recent Pan-Lancashire Health and Wellbeing Workshop on 9 October 2019 and discuss options going forward.
The Local Government Association facilitated an event on 9 October 2019 at Winter Gardens, Blackpool on the possible collaboration between Lancashire, Blackpool and Blackburn with Darwen Health and Wellbeing Boards. The event was attended by a range of key Board members from all three Health and Wellbeing Boards.
Overall, there was no consensus in terms of either developing a single Health and Wellbeing Board or coming together as an alliance or collaboration.
The facilitators identified two key actions:
i) That a smaller representative group across the Pan Lancashire system come together to explore the transformational opportunities that could be achieved by working at a Pan Lancashire level with clear proposals that could then be tested with partners to establish commitment to take the next steps.
ii) That development work takes place in each of the three Health and Wellbeing Boards to help identify the strengths of current working and identify where there might be areas for improvement. This would include looking at how each partnership board was clear about its role, purpose and focus and how this would be communicated and owned.
Subsequently, County Councillor Turner had had discussions with Councillor Khan (chair of Blackburn with Darwen Health and Wellbeing Board) and Councillor Cain (chair of Blackpool Health and Wellbeing Board). Although there was no consensus in terms of function of form or any pan Lancashire arrangements and commitments to retain current structures, it was agreed that:
i) Officers be requested to map out current health and wellbeing partnership arrangements, to understand how they related to each other.
ii) Officers be requested to organise a meeting of the three Boards to consider a joint response to the Integrated Care System Strategy Delivery Plan (including population health plan) once it had been agreed by the Integrated Care System Board.
In terms of the Lancashire Board, members had been sent a questionnaire by County Councillor Turner, to consider the strengths of the current arrangements and opportunities for improvement.
Cumbria were also involved in talks in working together on a Pan-Lancashire basis and wished to be linked in however, wanted the Pan-Lancashire Board establishing first.
Resolved: That the Board be requested to complete the questionnaire by 30 November 2019.
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 items of urgent business received.
Date of Next Meeting
The next scheduled meeting of the Board will be held at 2pm on 28 January 2019 in the Duke of Lancaster Room - Committee Room 'C' at County Hall, Preston.
The next scheduled meeting of the Board would be held on Tuesday, 28 January 2020 in the Duke of Lancaster Room – Committee Room 'C', County Hall, Preston.