Agenda and minutes

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

The Chair welcomed all to the meeting and thanked staff at YMCA St Annes for their support in hosting the meeting.

Apologies were noted as above.

The Board welcomed Teri Stephenson who had been appointed to the Board as VCFSE Representative and Councillor Margaret France who had been appointed to the Board temporarily as the Central Lancashire Leaders Group representative for this meeting only.

To receive an overview of the activities at the Fylde Coast YMCA.

Graham Oatridge, CEO, YMCA Fylde Coast, gave a brief overview of what the YMCA Fylde Coast provides in the community.

YMCA Fylde Coast is a registered charity who employ around 350 people and have a turnover of £8m.  The vision is of communities where all young people can thrive and believe that the YMCA should work to provide the relationships and networks so that people can be healthy in mind, body and spirit as recognised determinants of health.  The YMCA work with others to deliver joint priorities, transactional relationships as well as relational with other third sector agencies.  YMCA Fylde Coast's current offer is around four key work areas which are: Health and Wellbeing, Housing, Outdoor Education and Youth and Community.  The Emotional Health and Wellbeing programme is funded by Lancashire County Council and delivered via a network of partners which is aimed at 4-19 year olds with low level emotional health and wellbeing needs.  With regards to the future, they are looking at how to have a greater impact in the community and how that can be achieved along with the support from partners.

Following the presentation, members were asked to :

·  Follow YMCA Fylde Coast on Facebook and LinkedIn and repost information.

·  Be an advocate and consider them in conversations.

·  Help YMCA understand the Health and Wellbeing sectors requirements of third sector collaborators.

·  Discreet 'proof of concept' of work.

Thanks were expressed to Graham Oatridge for his presentation and members were informed, if any further information was required, to contact Graham at graham.oatridge@fyldecoastymca.org.

Resolved:  That the presentation be noted.

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 15 July 2024.

There were no matters arising from the minutes.

To receive, review and comment on the Quarter 1 Better Care Fund submission.

Jane Cass, Director of Partnerships and Collaboration/Deputy Chief Operating Officer, NHS Lancashire and South Cumbria Integrated Care Board provided a report authored by Sue Lott, Countywide Head of Service for Urgent Care, Acute and Prisons, Lancashire County Council which contained the following:

·  A summary of the 2024/25 Quarter 1 Better Care Fund submission (Appendix 'A' - confidential to members only).

·  A summary of the Quarter 1 finance report (Appendix 'B' - confidential to members only).

·  A brief update and progress on the three Lancashire Better Care Fund support projects.

·  A brief update on the Lancashire and South Cumbria Integrated Care System Better Care Fund review project (Appendix 'C' - confidential to members only).

·  Governance and role of the Better Care Fund Board.

The report shared with the Board the Better Care Fund Quarter 1 template, which was submitted by the deadline of the 29 August 2024. It was signed off by Asim Patel in his delegated role as Deputy Chair of the Health and Wellbeing Board, due to the submission date falling before the Board meeting. The Q1 template is set by the national team and focusses only on the Additional Discharge Fund.

The Board were informed that Lancashire had received confirmation that the 2024/25 Better Care Fund Plan has not been formally signed off yet in the Assurance process, due to the position between the two partners on the NHS additional £10m contribution to social care. The Better Care Fund national team has commissioned external facilitation, to support both parties to find a mutually agreeable solution.

Also detailed in the report were progress reports on the three Lancashire Better Care Fund support projects. The Demand and Capacity support piece was continuing and has unfortunately been slightly delayed due to other urgent priorities for the Council but is now back on track. The Discharge to Assess support piece has now concluded and final outputs are being collated.

The Board noted that data quality and access to data had been identified as a challenge in the outputs of all the support projects so far. A briefing paper is being prepared for the Lancashire Place Partnership Board pulling the various challenges and implications together, to enable a discussion on how this can be progressed and improved for Lancashire.

The Lancashire and South Cumbria Better Care Funds support project continued to progress, with initial desktop analysis taking place following the collation of significant volumes of information from each Health and Wellbeing Board area.

At the last Board, the intention was shared to further refine the Lancashire Better Care Fund Board. Discussions have been delayed slightly due to unavoidable absences of some key people and will take place during September; the Health and Wellbeing Board will receive a further update at its next meeting in November 2024.

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

·  It is understood that data is collected in varying ways from the different Trusts which makes it difficult to make comparisons and therefore further work  ...  view the full minutes text for item 5.

To review the report and discuss the progress made on developing the strategy.

Craig Frost, Associate Director Urgent and Emergency Care, NHS Lancashire and South Cumbria Integrated Care Board provided the report which presents the Lancashire and South Cumbria Integrated Care System’s Urgent and Emergency Care 5-year draft strategy, as set out at Appendix 'A'. 

The Board were informed that the purpose of the strategy was to guide how urgent and emergency care services are transformed over the next five years to enable people to easily access the right care and support which meets their needs. It describes the challenges and the opportunities for the future, and it sets out the vision and priorities.

It should be noted that the draft strategy, which at the time of writing the report and the Health and Wellbeing meeting, was still under development and is scheduled to be considered for approval at the Integrated Care Board's (ICB) Board meeting on 11 September 2024.  It was agreed that Craig Frost would circulate a link to the Integrated Care Board's agenda following its publication on 4 September 2024 to Sam Gorton, Democratic Services Officer, Lancashire County Council who would share with members of the Health and Wellbeing Board.  The Board also noted that the strategy shared with members at the point of agenda publication for this meeting, has been amended further following feedback from the Integrated Care Board at a development session held in July.

The Board also received a presentation, which is appended to the minutes for reference and detailed the following:

·  Why we need a long-term strategy

·  We have a new draft Urgent and Emergency Care strategy for Lancashire and South Cumbria

·  Given unprecedented pressures in Urgent and Emergency Care, we need to do things differently

·  Vision and aims

·  Commitments – priority actions we will deliver to achieve our aims

·  We shared the strategy with a feedback form on Friday, 3 May to gather comments from system partners and patient representatives

·  Feedback questions

·  Strategy feedback

·  Themes from comments received

·  What we have done

·  Key actions or next steps

The Board noted the following key headlines:

·  The development of the strategy and the improvement plans that underpin it is a culmination of substantial collaborative effort across the system.

·  The three key areas of focus at the Urgent and Emergency Care event which was delivered by the Integrated Care Board and supported by the National Emergency Care Improvement Support Team and included key stakeholders were:

(i)  The need to develop an Urgent and Emergency Care Strategy given the pressures within that area.

(ii)  Delivery of the key priorities - strategy to be underpinned by the Place-Based Improvement Plans.

(iii)  Need to refresh and strengthen governance arrangements that wrap around Urgent and Emergency Care and the need to establish a system wide Urgent and Emergency Care Collaborative Improvement Board.

All of the above have been completed and the development has been channelled through local delivery Boards from a Place-Based perspective as well as a system perspective by the development of an Improvement Board.

The Board noted that in  ...  view the full minutes text for item 6.

To receive an update on older people's housing including:

·  Extra Care Housing – Learning from Tatton Gardens

·  Disabled Facilities Grant Utilisation

Chris Sinnott, Chief Executive, Chorley Council and South Ribble Council, Lancashire Chief Executive Group presented a report which sets out the lessons learned from the Tatton Gardens Extra Care Scheme in Chorley and provided an update on the work being undertaken to review the process of Disabled Facilities Grant administration across Lancashire.

At the Health and Wellbeing Board's meeting in November 2023, a request was made following discussions, to receive a report around the lessons that might be learned from the development and running of the scheme.

The Board noted that Tatton Gardens had been opened now for around 12 months, while Primrose Gardens – Chorley's other extra care facility – had been operating for around five years.  Both sites give an opportunity for the council and wider public services to reflect on the strengths and challenges of building, opening, and operating extra care schemes.  Further information is detailed in the report.

The Board were asked to consider the following points:

·  Is extra care accommodation viewed by partners as a priority in supporting people to live independently for longer? 

·  If so, how do we develop a model where: 

a)  funding for schemes can be made available from various parts of public services who should benefit; 

b)  encourages close working across public services to support residents and the community; and, 

c)  supports developers (whether public or private) to navigate the complexities of decision making? 

The Board were also informed that a review of the disabled facilities grants commenced in September 2023 where a workshop of the District Council Chief Executives and Lead Officers for Health, was held to identify how District Councils could be better engaged in the work to improve integration of health and social care, and to ultimately improve the health and wellbeing of residents of Lancashire.

The objectives of the review were:

·  Review the literature relating to Disabled Facilities Grants and their impact on the health and wellbeing of service users, and the delivery of public services. 

·  Review the current Disabled Facilities Grants processes in place across Lancashire, identifying consistencies, differences, best practice and challenges 

·  To identify changes that could be implemented to improve the impact of Disabled Facilities Grants, both on the residents of Lancashire and on public services. 

The Board noted that the initial work was now complete, and a report is currently being drafted. This will initially be considered by the District Chief Executives group to ensure that it reflects the position and understanding of the 12 districts. It will then be presented for discussion by others, including the Place Partnership. 

The Board noted that there were some emerging themes, which included:

a)  The positive impact that adaptations have both in direct benefit to service users and in cost savings to wider public services 

b)  While there are broad similarities in the process used to award disabled facilities grants across the county, there are differences. 

c)  Greater benefits could be secured if: 

i)  a best practice model policy was adopted; 

ii)  a consistent set of  ...  view the full minutes text for item 7.

To receive an overview of gambling harms in Lancashire and support available through Beacon Counselling Trust.

Paula Hawley Evans, Consultant in Public Health and Aston Monro, Public Health Practitioner, Lancashire County Council, presented the report which outlines the gambling related harm, its impact, and the current position in Lancashire.  It also identifies examples of current activity to reduce gambling related harms including support for people with lived experience, and the Beacon Community Trust’s Workplace Charter. A systemwide approach is needed to address this public health issue and the report seeks to explore how this can be collaboratively addressed as part of the Happier Minds programme. 

The Board received a presentation (appended to the minutes) which outlined:

·  What is gambling related harm?

·  The picture in Lancashire

·  Tackling gambling related harm eg good practice presentation

·  Beacon Counselling Trust – James Callaway and Chris Summers

·  Discussion on next steps

Aston Monro explained that when exploring the impact of gambling, datasets concerning 'problem gambling' are often used with the individuals assessed using the Problem Gambling Severity Index (PGSI).  This measure includes nine questions relating to gambling behaviour and each assessed on a four-point scale.  The Board also received the prevalence of gambling harms at a local level, taken from data from the Annual Great Britain Treatment and Support Survey (published November 2022) which included the Lancashire-12 districts.  Burnley, Hyndburn, Pendle and Preston have higher rates of low, moderate and high-risk gambling than the averages for Lancashire and Great Britain.

The Board were informed that across Lancashire there are examples of good practice to reduce harm, including work by district councils under the Licensing Act 2003 to license premises, and inclusion of gambling as a risk behaviour in the work on suicide prevention.  There is also support through the voluntary sector, including Red Rose Recovery and the North-West based charity, Beacon Counselling Trust (BCT).  Beacon Counselling Trust (BCT) provides education, treatment, and support around gambling-related harms. Their services include various therapeutic interventions such as cognitive-behavioural therapy (CBT), trauma-informed interventions, and couple's therapy.

In conclusion, reducing gambling harm is complex and requires a system wide approach. The data available is likely to be an under-representation of the extent of gambling in Lancashire, and are aware that its affects are unevenly distributed to some of our most disadvantaged areas. There are already some programmes underway to support the reduction in harms from gambling, and we want to continue to improve our intelligence and identify evidence-based ways to address this important public health issue. 

James Callaway, Beacon Counselling Trust spoke to the Board about the Gambling Related Harms Early Intervention and Education offer.  The Beacon Counselling Trust is a Mild-Moderate Mental Health Service provider and part of the work is providing free confidential treatment and support for anyone aged over 16 years who has been affected as a gambler, part of a family or a friend of a gambler, as part of the National Gambling Support Network. 

The core programme includes:

·  National Gambling Support Network Treatment provider

·  'Arresting Gambling Related Harms' – Criminal Justice

·  'Battling the Odds' – Armed Forces Community

·  Workplace Charter to  ...  view the full minutes text for item 8.

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 12 November 2024 in Committee Room C, County Hall, Preston.  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 12 November 2024 in Committee Room C, County Hall, Preston.  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.