Agenda and minutes

To note that Mr L. Breckon JP CC has been appointed Chairman.

RESOLVED:

That the appointment of Mr L. Breckon JP CC as Chairman of the Health and Wellbeing Board be noted.

To note that Dr Mayur Lakhani (Clinical representative of West Leicestershire Clinical Commissioning Group which has responsibility for chairing the Integration Executive) has been appointed Vice Chairman.

RESOLVED:

That the appointment of Dr Mayur Lakhani, as Vice Chairman of the Health and Wellbeing Board be noted.

The minutes of the meeting held on 14 March 2019 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:-

·         Joint Strategic Needs Assessment

·         BCF Outcomes Metrics

·         Mental Health Investment Standards

·         Fall in Leicestershire Teenage Pregnancy Figures

·         Dementia Action Week

·         5 Ways to Wellbeing

·         Good Food Leicestershire

·         Infection Prevention Control·        

A copy of the position statement is filed with these minutes.

The Board considered a report of the Director of Children and Families which provided a progress update on the Leicestershire Children and Families Partnership Plan 2018 – 2021. A copy of the report marked ‘Agenda item 7’ is filed with these minutes.

The Director reported that since the launch of the Plan in September 2018, priority leads had been working closely with partners and stakeholders to deliver against each of the five priority areas and significant progress had been made.

Members welcomed the detailed progress update, which not only illustrated the progress made, but also the potential issues which could affect further progress. In reference to those future risks highlighted within the appendix of the report, the Director confirmed that work was ongoing to ensure a joined up approach was taken wherever possible and partners remained committed to the Plan and the Partnership which had enabled those involved to own and address key issues.

In reference to the work on Adverse Childhood Experiences, the Director said that the Partnership recognised the severe impact such experiences had on individuals and the influence it had on behaviours as they grew older. The Partnership was therefore developing its own trauma based approach shaped through feedback from stakeholders and best practice from other authorities which had implemented an approach.

In response to questions concerning the partnership’s other focus areas, the Director confirmed that the ‘Future in Mind’ service was being used as a framework in which to develop its approach to children’s mental health services, whilst messages concerning healthy eating and the risks of obesity continued to be emphasised as part of the ‘To make obesity everyone’s business’ focus area.

RESOLVED:

That the report be noted.

The Board considered a report of the Director of Public Health which provided a summary of health related data at a locality level and an update on the development of Primary Care Network profiles. A copy of the report marked ‘Agenda item 8’ is filed with these minutes.

Arising from discussion the following points were noted:

·         Analysis of the data enabled partners to highlight areas where health performance could be improved. It was therefore important that commissioners considered the findings carefully when deciding upon their focus areas;

·         The Syston, Long Clawson and Melton (SLAM) locality had been formed based on long standing historical working relationships between medical practices. The majority of the other localities mirrored Leicestershire’s district boundaries;

·         The formation of Primary Care Networks would mean the 10 current localities in Leicestershire would be reformed into a larger number of networks. More information concerning the geography of these networks would be available in the coming months;

·         Whilst the national data used to compare the indicator performance was several years old, partners benefited from having a benchmark by which to measure local performance against national trends. Work was ongoing to produce comparative dashboards which could utilise more recent local data.

RESOLVED:

a)    That a further report be considered by the Board once the Primary Care Networks (PCN) locality profiles have been developed;

b)    That a report detailing the newly formed PCNs, including the geographical boundaries of each network, be considered by the Board at a future meeting.

Members considered a report of the Unified Prevention Board (UPB) which detailed the UPB’s work in delivering the prevention offer, in conjunction with partners, across Leicestershire during the 2018/19 financial year. The report also included the Board’s plans and communications approach for the next financial year   A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.

The UPB’s delivery of a Healthy Workforce Programme, including the development of a web based Health Needs Assessment tool, had encouraged local organisations to further consider the health of their workforce. Members welcomed the work already undertaken and recognised the benefits such an approach had not only for employees, but also the organisations themselves. They noted that the UPB would look to further develop the programme during the next financial year and consider the benefits of implementing a system wide approach amongst LLR NHS partners.

RESOLVED:

That the report be noted.

The Board considered a report of the Director of Public Health which provided an update on progress made in Leicestershire to develop the existing social prescribing and care coordination models. The report also detailed potential options to further develop the models aligned with the NHS Long Term Plan. A copy of the report marked ‘Agenda item 10’ is filed with these minutes.

Arising from discussion the following points were noted:

·         Whilst the ‘First Contact Plus’ service operated effectively as an initial access point for a range of social prescribing solutions, it was recognised that the help patients had access to often depended on where they lived within the County, with each district council’s delivery approach being tailored differently;

·         The newly formed Care Coordination Task and Finish Group would be exploring the types of support delivered through the social prescribing link offer (via link workers) compared with that of a care co-ordinator. It was important that the future model avoided duplication; 

·         The NHS Long Term Plan (LTP) emphasised the importance of integrated care systems and there was therefore an opportunity to enhance the social prescribing offer via the newly formed Primary Care Networks (PCNs). Whilst an approach that followed the current social prescribing model would enable the established system to remain, the decisions regarding the employment of link workers would rest with PCN’s;

·         Whilst additional funding would be made available in 2019/20 from the NHS LTP in order for a social prescribing link worker to be employed by each PCN, national guidance was awaited with regards to how the funding would be spent and whether it would cover expenditure in addition to salary costs. Public Health officers would be attending PCN engagement events to understand the proposed arrangements further and report back to the Board once more was known.

RESOLVED:

a)    That the development of the social prescribing and care coordination models across Leicestershire be supported, including identifying a systematic approach to embedding these roles into the existing social prescribing system (as detailed in paragraph 19 of the report), engagement with Primary Care Networks through planned engagement events and the newly established care coordination task and finish group;

b)    That a further report detailing the funding arrangements for the revised model be considered by the Board at a future meeting.

The Board considered a report of the Director of Health and Care Integration which provided an update on the Better Care Fund (BCF) Programme for 2018/19. A copy of the report marked ‘Agenda item 11’ is filed with these minutes.

In reference to the BCF plan for 2019/20, concerns remained with regards to the delay in the publication of the technical guidance and information concerning the CCG minimum allocation into the pooled budget and the implications should the current funding arrangements not continue. An update would be provided to the Board once the information was made available.   

RESOLVED:

That the good performance across all of the four BCF outcome metrics and the positive progress made in transforming health and care pathways in 2018/19 be welcomed.

The Board considered a report of the Leicestershire and Rutland Safeguarding Adults Board which presented the Board’s Development Plan for 2019/20.  A copy of the report, marked ‘Agenda item 12’, is filed with these minutes.

It was noted that the Board intended to work with organisations such as ‘The Bridge’ homeless centre in Leicester to understand how the regions support offer for the homeless and rough sleepers in Leicestershire and Rutland could be improved. It was noted that whilst the funding made available via the rapid rehousing pathway had helped, gaps in the support prevision remained.

In reference to national plans to replace Deprivation of Liberty Safeguards with Liberty Protection Safeguards, it was noted that the changes, which would include the NHS replacing local authorities as the supervising body, would result in a significant shift in how local care providers worked to safeguard individuals who lacked capacity to consent to care and treatment.

RESOLVED:

That the Leicestershire and Rutland Safeguarding Adult Board Development Plan for 2019/20 be noted.

The Board considered a report of the Director of Public Health which provided a summary of the assurance functions of the Leicester, Leicestershire and Rutland Health Protection Board. The report also detailed the health protection performance, key incidents and other significant matters during 2018. A copy of the report marked ‘Agenda item 13’ is filed with these minutes.

The Director reported that poor air quality was the largest environmental risk to the public’s health. The Health and Wellbeing Board would be considering a Joint Strategic Needs Assessment Chapter on the issue at its next meeting which would provide insight into its impact locally. In response to questions from members concerning the development of new roads and housing and their impact on air quality, the Director confirmed that unless a proposed development was within an ‘air management area’ there was not a requirement for the local planning authority to consider air pollution when granting applications.

In reference to the uptake of the measles mumps and rubella vaccine, it was noted that the recent immunisation figures in Leicestershire were in line with the national average however, there still remained cohorts of older students, particularly those reaching university age, who had not been vaccinated. Efforts would continue to encourage those individuals to receive the vaccine.  

RESOLVED:

That  the specific health protection issues that have arisen locally, the steps taken to manage them and the areas of focus for the coming year be noted.

The next meeting of the Health and Wellbeing Board will be held on 11 July 2019 at 2.00pm.

It was noted that the next meeting of the Health and Wellbeing Board would be held on Thursday 11 July 2019.