Agenda and minutes

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

The Chair welcomed all to the meeting and thanked the volunteers at Chipping Village Hall for hosting the meeting, particularly Hannah Dainty and Simon Hore.

Apologies were noted as above.

Simon Hore, Trustee, Chipping Village Hall, gave a brief overview of the community owned facility which this year celebrates 25 years and is at the heart of the community.  The hall was funded partly through the Millennium Village Hall Fund and fundraising, with the principal fundraiser being the Chipping Steam Fair, run and planned by volunteers from the village.  The village takes part in the North West Village in Bloom and this year are representing the North West in Britain in Bloom.  Chipping Community Energy is a group that was set up three years ago and are looking at alternatives to oil as there is no mains gas in the village and are looking to develop a community heat network.

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 meeting held on 7 May 2024.

There were no matters arising from the minutes.

To receive and comment on the:

·  Governance and Role of the Better Care Fund Board, in providing assurance to the Health and Wellbeing Board

·  2024/25 Better Care Fund Plan

·  Better Care Fund Review of Spend

·  System Leadership Report and Action Plan

·  Integrated Care Board End of Year Assurance

Sue Lott, Countywide Head of Service for Urgent Care, Acute and Prisons, Lancashire County Council provided a report which contained the following:

The Board noted that the report shared prior to the meeting, was the final 2024/25 Better Care Fund Plan submission, following the run through of the draft template at the last Board meeting on 7 May 2024. The final version was signed off by the relevant executives in the Council and the Integrated Care Board, as well as County Councillor Michael Green in his role as Chair of the Lancashire Health and Wellbeing Board.  The final plan was submitted on 11 June 2024.

The Board noted that there were some challenges in finalising the plan, relating to the additional NHS contribution.  Formal notification is awaited of the outcome of the assurance panel.

Also detailed were progress reports on the three Lancashire Better Care Fund projects. More detailed feedback was provided on the Leadership and Governance support. The Demand and Capacity support piece is continuing, however has encountered difficulties in progressing to the desired outcome due to data quality issues. The Discharge to Assess work is nearing conclusion and the draft outputs were now being shared widely.

The role and function of the Better Care Fund Board was shared in the report, enabling the Health and Wellbeing Board to better understand its' role in assurance, and the connectivity across the system partnership.

The Board received a presentation on the following and further details can be found in the report that was attached to the agenda:

·  Response to the queries raised in the last Board meeting on 7 May 2024

·  Better Care Fund Plan 2024/25

·  The Governance and Role of the Better Care Fund Board

·  Integrated Care System Better Care Fund Review Project

·  Lancashire Better Care Fund Reset Progress: Support Projects

(i)  Discharge to assess (D2A)

(ii)  Intermediate Care Demand and Capacity

(iii)  Leadership and Governance

Following the presentation, discussion ensued, and comments were provided as below:

·  The national Better Care Fund Team have requested a call to discuss the challenges with the fund, and as part of that call, there will be a mediation process with the Integrated Care Board and Lancashire County Council identifying who will take part in the process. 

·  There are four Better Care Fund areas that will fall within the scope of the review (Lancashire, Blackburn with Darwen, Blackpool and Westmorland and Furness).

·  The governance and relationship of the Better Care Fund Board with the Health and Wellbeing Board needs to be reviewed to ensure it works,  ...  view the full minutes text for item 4.

To provide a performance update on the key priorities of the Health and Wellbeing Board.

Officers of Public Health and Wellbeing, Lancashire County Council provided an update on work to address the three key Health and Wellbeing Board priorities:

(i)  Best Start in Life

(ii)  Healthy Hearts

(iii)  Happier Minds

An update was given on the associated milestones and performance as outlined in Appendix 'A' on the agenda.  Further information can also be found  in the report.

Ruksana Sardar-Akram, Interim Consultant in Public Health – Best Start in Life, Lancashire County Council provided a further update on activity and progress to date, including performance metrics, forward look and opportunities for improvement/further collaboration which can be found in the report.

Opportunities for Collaboration/Advocacy of the Board was to continue its support to ensure:

·  An integrated approach to deliver on the areas identified across services including health partners.

·  Commitment to joint commissioning and funding between the NHS Integrated Care Board, County Council, and other relevant partners where appropriate, for example in relation to speech and language services and Looked after Children support.

 Following the Best Start in Life presentation, the following comments were made:

·  One of the modifiable factors identified in the Child Death Overview Panel Review is childhood trauma, with an action plan being developed. 

·  It was requested for future updates that data be presented by district as far as possible, so that issues of local concern can be identified

·  Self-harm is an issue of concern in relation to 10-14 year olds and it was requested that future updates address this.

·  Family Hubs are working well, not just for children and young people, for families as well.

Aidan Kirkpatrick, Consultant in Public Health – Healthy Hearts, Lancashire County Council provided a further update on activity and progress to date, including performance metrics, forward look and opportunities for improvement/further collaboration which can be found in the report.

Opportunities for Collaboration/Advocacy of the Board was that it had been a positive nine-month period for Healthy Hearts and key opportunities for collaboration included:

·  The need to ensure that broader prevention approaches are further embedded in the work of emerging partnership/place-based boards as part of the Place Integration Deal.

·  The importance of aligning resource allocation to this broader prevention agenda so that the appropriate level of assurance can be offered to the Health and Wellbeing Board regarding the implementation of the respective workstream delivery plans.

·  The newly developed Healthy Weight collaboration agreements continue to be supported and any opportunities to expand the reach of the programme be actively explored.

Following the Healthy Hearts presentation, the following comments were made:

·  The Board was given assurance that health policies would be linked into the new Local Plans and that the Wider Determinants Team are working on this.

·  The Board noted that an amendment on Healthy Hearts, bullet point 2, page 22 of the agenda pack, should read " Alcohol: Alcohol treatment services continue to make good progress a position has been reached where the estimated proportion of alcohol dependent residents are in treatment is circa 21% which is a favourable  ...  view the full minutes text for item 5.

To receive and comment on the Draft Health and Wellbeing Strategy, prior to wider consultation.

Clare Platt, Head of Health Equity, Welfare and Partnerships, Lancashire County Council reminded the Board that there was a requirement to prepare a Joint Health and Wellbeing Strategy, to guide partnership working for health and wellbeing improvement, and health inequality reduction. The Board had been working on key priorities for a while now, and these were reflected in the draft strategy (Appendix 'A').

Following the presentation the following comments were made:

·  It welcomed the work being undertaken on Gambling Harms.

·  Under Principles in the Strategy and Context, change the third bullet point to "inequality" to align with the rest of the document.

·  The strategy is set out to coalesce partners on the Board to agree the key strategic areas to work better and manage priorities collectively, with actions plans for each of the three current priorities of the Board, and the Better Care Fund.

·  The Health and Wellbeing Partnerships work to the three priorities set by the Health and Wellbeing Board and report to the Lancashire Place Partnership of which a Voluntary, Community, Faith and Social Enterprise representative is a member on each Partnership and on Lancashire Place Partnership.

Resolved:  That the Health and Wellbeing Board:

(i)  Considered and discussed the draft strategy.

(ii)  Explored including gambling harms in the Happier Minds workstream.

(iii)  Endorsed the resulting draft for wider consultation with key stakeholders, including the constituent Board partners, prior to final design and publication.

To receive an overview of oral health in Lancashire and the opportunities afforded by UCLAN's developments in this area of work.

Dr Claudia Cunningham, Head of Dentistry, University of Central Lancashire provided an overview on oral health which is one of the key markers of overall health in the community and contributes to general wellbeing. The report provides contextual information relevant to Lancashire, including opportunities to improve oral health outcomes and address dental health inequalities.

The Board noted that there are issues accessing dentistry and the responsibility for commissioning dentistry is moving to the Integrated Care Board over time, so there will be more opportunities to work locally and collaboratively.  One constraint is that the current contracts in place are in perpetuity, and they can only be changed through mutual discussion. 

The Board received a presentation, from Dr Cunningham, which covered the following:

·  Oral Health in Children in Lancashire-12 Area

·  Hospital Admission for Dental Caries (0-5 years) 2020/21-2022/24

·  UCLan Dentistry

·  Key Points

Information provided in terms of Children Oral Health in Lancashire-12 Area was as follows:

·  The average number of teeth (1.16) affected by decay per 5 year old child is significantly worse than the England average (0.80), with ranges from 0.53 in Ribble Valley to 1.87 in Preston.

·  27.4% of 5 year olds have visually obvious dental decay in 2021/22; England rate 23.7%, however:

Ø  Pendle 41.9%

Ø  Hyndburn 35.4%

Ø  Preston 32.6%

Ø  Burnley 29.3%

In terms of hospital admissions, dental decay is the number one reason for general anaesthetic in 0-5 year olds who will often undergo several extractions in one go taking upwards of 10-12 teeth out of the 20 teeth a child has, in one procedure with significant consequences for that child.  Over the last 5/6 years an 83% increase has been seen in some hospital admissions for tooth extraction and this is partly due to access problems in Dentistry.

·  Lancashire-12 has a rate of 389.7 per 100,000, significantly worse than the England rate (178.8)

It was also highlighted that there is a rise in DIY Dentistry due to access issues across Lancashire.

UCLan Dentistry in Preston is one of three Dental Schools that were opened in 2008 and supply approximately 60 dental undergraduates into the dental professional system every year.  The School trains dentists, dental technologists and dental therapists.  There are state of the art facilities across Lancashire including onsite training facilities as well as an onsite laboratory and operate throughout the whole of Lancashire (Carlisle, Blackpool, Accrington and Morecambe Bay as well as some additional Dental practices in the community). 

The Board noted that there is 100% employment on graduation and following the National Student survey results received earlier in the day, UCLan was top in the UK for learning opportunities offered to its students.

The Board noted the key points:

·  There is a lack of dental provision in Lancashire and a need to increase the number of dentists and specialists trained.

·  The specialist staff, facilities and training are available to make a significant improvement in the oral health of the Lancashire population.

·  Students stay within the local area and further career and training  ...  view the full minutes text for item 7.

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 not any items of urgent business received.

The next scheduled meeting of the Board will be held at 2.15pm on 3 September 2024, venue to be confirmed.  Prior to the meeting on the same date, there will be a joint informal workshop between the Lancashire Health and Wellbeing Board and the Lancashire Place Partnership at 1.00pm.

The next scheduled meeting of the Board will be held at 2.15pm on 3 September 2024, venue to be confirmed.  Members will also be invited to attend the joint informal workshop prior to the meeting, with members of Lancashire Place Partnership from 1.00pm-2.00pm.