Agenda and minutes

The minutes of the meeting held on 24 May 2018 were taken as read, confirmed and signed.

The Board also noted the Action Log, which provided an update on actions agreed by the Board at its previous meetings.

There were no urgent items for consideration.

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting. No declarations were made.

The Chairman presented a position statement on the following matters:

·         NHS 70^th Anniversary

·         Self-Care Campaign

·         Improving Access to Urgent Care in Community

·         Leicestershire Health Profiles 2018

·         Stop Smoking Service rated excellent by quitters

Particular reference was made to the Leicestershire Health Profiles for 2018 which indicated that overall Leicestershire County had above average health outcomes with local authority districts in the top 10 nationally for 11 indicators. There were however areas which required improvement, with five district indicators positioned within the worst 10 nationally. In reference to the change in indicator rating for diabetes across the majority of Leicestershire districts, it was noted that the increase in cases recorded could have been as a result of a change in the way Public Heath England measured the prevalence of the condition rather than a decline in performance.

There will be a Powerpoint presentation for this item.

The Board considered a presentation of the Director of Public Health which provided an overview of the Joint Strategic Needs Assessment (JSNA) and proposed timetable. A copy of the presentation is filed with these minutes.

The Director reported that the JSNA formed the evidence base for the Joint Health and Wellbeing Strategy (JHWS). It was intended that the current JSNA would be published on a rolling basis, with an initial 9 chapters scheduled to be available before the end of 2018/19.  Consideration would be given to ensure that the findings of the JSNA would link to NHS and Local Authority commissioning cycles and help services identify those areas most in need.

It was noted that priority areas could be shifted as new needs were identified and whilst frailty had not been identified within the first nine priorities, it was intended that the reference group would be asked to prioritise chapters on  multi –morbidity and frailty at its next meeting.

In reference to a chapter due to be published in August 2018 focusing on Children’s Oral Health, the Director reported that the JSNA had identified areas within the County which had a higher proportion of reported decay among its young population compared to others and would therefore benefit from a prioritisation of future support.

Members welcomed the work being undertaken and recognised the importance of using the data to commission services effectively in order to help meet the health and care needs of the local population.

RESOLVED:

a)    That the presentation be noted;

b)    That the slides forming the presentation be circulated once the chapter on oral health has been finalised.

The Board considered a report of the Director of Health and Care Integration which provided an update on the working progress to refresh and prepare the Leicestershire Better Care Fund (BCF) Plan for 2018/19 to 2019/20.  A copy of the report marked ‘Agenda Item 6’ is filed with these minutes.

Arising from discussion the following points were raised:-

·         Whilst it was expected that Leicestershire’s provisional Delayed Transfer of Care (DTOC) total target of 7.88 delays per 100,000 for 2018/19 would not change, final guidance was still awaited;

·         DTOC data for May showed an improvement in performance compared to the previous month, with 4.02 delays per 100,000 compared to 6.72 in April;

·         Whilst the BCF Plan continued to focus on reducing DTOC days across the country, there was a possibility that there could be a greater emphasis placed on reducing ‘super stranded’ patients (those remaining in hospital for more than 21 days) in the coming months and the position would be monitored carefully;

·         In response to a question concerning as to why BCF metric 1 (residential admissions) had been set a more challenging target for 18/19 despite the reduced target having not been met in 17/18, the Director undertook to provide a response following the meeting.

{The Director subsequently confirmed that although the target was not met during 17/18, the ambition remained to reduce the number of people being admitted to long term care. Despite the number of new admissions having increased during 17/18 the longer term trend was a decrease. The Department had therefore established a three year trajectory to try to improve performance to bring the council into the top quartile nationally and therefore the 18/19 target was a milestone towards the three year overall target}

RESOLVED:

a)    That the provisional BCF outcome metrics be approved, subject to any changes required following the publication of the BCF guidance.

b)    That the Chief Executive of Leicestershire County Council, following consultation with the Chairman of the Health and Wellbeing Board be authorised to finalise the BCF plan refresh, in light of the national guidance, and submit to NHS England.

c)    That it be noted that the members of the Integration Executive (a subgroup of the Health and Wellbeing Board responsible for the day to day delivery of the BCF Plan), will be asked to indicate their agreement ahead of the final submission to NHS England.

The Board considered a report of the Director of Public Health which provided an update on the progress of the Unified Prevention Board (UPB) schemes.  A copy of the report marked ‘Agenda Item 7’ is filed with these minutes.

The Director reported that through the Self Care Communication campaign, consistent and clear public health messages were being successfully shared through various mediums. Similar progress had been made in relation to the engagement between UPB partners and the Integrated Locality Teams to improve local join up. It would be important to ensure that work delivered through the UPB such as social prescribing was not duplicated by individual organisations.

As part of the development of the Healthy Workforce=Healthy Leicestershire programme, The UPB was continuing to support the development of a Workplace Health Needs Assessment tool which would help organisations to identify employee health and wellbeing concerns. The tool was part of a wider Leicestershire Workplace Health offer which was being supported by Leicestershire County and District Councils.  

RESOLVED:

a)    That the contents of the report and progress in delivering the prevention approach in Leicestershire be noted;

b)    That developments through Leicester-Shire and Rutland Sport (LRS) and the Unified Prevention Board of Healthy Workforce = Healthy Leicestershire be supported.

The Board considered a report of the Director of Adults and Communities which provided an update on the Health and Social Care Sector Growth Plan 2017. A copy of the report marked ‘agenda item 8’ is filed with these minutes.

The Director reported that following an extensive assessment of the Leicester, Leicestershire and Rutland health and social care sector, a delivery plan had been produced with a remit to help the sector meet the health needs of the local population and provide a framework for social care providers to use when applying for funding. 

Arising from discussion the following points were noted:

·         In order to improve the recruitment and retention of carers, a review of the carers pathway and pay structure would be evaluated in order to ensure that those entering the profession were able to progress and attain qualifications where available;

·         Whilst services associated with Children and families did not feature on the delivery plan, the service did face similar challenges with adult social care, including recruitment and retention and would benefit from being involved in the process. A representative from the service would be invited to future meetings of the Steering Group;

·         The Health and Social Care Sector Growth Plan had been commissioned partly to recognise the importance of the sector and also identify opportunities for partnership working, especially where gaps had been identified. It was important for health and social care to be a priority sector for the Leicester and Leicestershire Enterprise Partnership (LLEP) as this meant it would be able to bid for development and  business support funding. One of the LLEP’s Enterprise Zones was now focused on life sciences, which demonstrated that the profile of health and social care had been raised within the LLEP. This was also evident in the draft Local Industrial Strategy prospectus.

RESOLVED:

a)    That the progress towards the Health and Social Care Sector Growth Plan be noted;

b)      That the Board consider a further update on the progress of the Health and Social Care Sector Growth Plan in 12 months’ time.

The Board considered a report of the Director of Health and Care Integration which set out proposed changes to the governance arrangements for the integration programme for Leicestershire. A copy of the report marked ‘Agenda item 9’ is filed with these minutes.

The Director reported that the proposed changes would provide greater clarity as to the difference between the roles of the Integration Executive and the Integration Finance and Performance Group (IFPG) and enable the IFPG to have oversight of a wider portfolio of activities including the joint commissioning workshop.  

RESOLVED:

a)    That the revised terms of reference and extended remit for the Integration Finance and Performance Group be noted;

b)    That the revised terms of reference for the Integration Executive be approved

The next meeting of the Health and Wellbeing Board will be held on 27 September at 2.00pm.

It was noted that the next meeting of the Board would take place on 27 September 2018 at 2.00pm.