Agenda and minutes

The minutes of the meeting held on 9 July 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. Dr Varakantam declared a personal interest in item 6 (Coronavirus Impact and Response of the Local Care System) as his wife worked for a private care company within the County.

The Chairman presented a position statement on the following matters:-

·       The crucial work being undertaken by health, social care and community partners during the ongoing coronavirus pandemic.

·       Suicide Prevention.

·       Weight Management.

·       Warm Home Fund Project.

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

The Chairman sought and obtained the consent of the Board to vary the order of business from that set out on the agenda for the meeting.

The Board considered a report of Leicester, Leicestershire and Rutland (LLR) Clinical Commissioning Groups which outlined the planned consultation process concerning the proposed reconfiguration of acute and maternity services across LLR. A copy of the report, marked, ‘Agenda item 5’ is filed with these minutes.

Arising from discussion the following points were noted:

·       The consultation approach, which would commence on the 28 September for a period of 12 weeks, had been revised as a result of the coronavirus pandemic, with less reliance on face to face communications, instead utilising more innovative methods to engage with stakeholders. The approach would include a range of virtual engagement events in addition to online content and a mail drop to all households within LLR.

·       A dedicated social media campaign would be launched to encourage participation. The advice of external digital specialists had been sought to support digital engagement and to ensure that responses generated via such mediums would be considered as part of the overall consultation response.

·       It was acknowledged that not all residents used digital platforms and it was important they were actively engaged. Along with the mail drop, offline engagement would take place in the form of broadcast media campaigns and telephone interviews. A review of the consultation approach would be undertaken mid-way through the consultation period to consider its effectiveness and to enable any necessary changes to the approach to be made.

RESOLVED:

That the consultation arrangements on the proposed reconfiguration of acute and maternity services at Leicester’s Hospitals be noted.

The Board considered a report of the Director of Adults and Communities which provided an overview of progress to refresh the Leicestershire Better Care Fund (BCF) Plan for 2020/21. A copy of the report marked ‘Agenda item 7’ is filed with these minutes.

The Director said that whilst BCF guidance for 2021 was still awaited, it was anticipated that the policy framework and guidance would essentially be a continuation of the guidance from 2019/20.

Whilst the four national conditions were also expected to remain unchanged, there had been a change of focus in relation to the improving transfers of care condition, with an emphasis on implementing the new discharge to assess guidance as a result of the coronavirus pandemic. This was expected to continue as part of the 2020/21 reporting requirements.

In reference to the four national BCF metrics, metrics three and four (delayed transfers of care from hospital and non-elective admissions into hospital) had been suspended for 20/21 as a result of the pandemic. The Authority had continued to record performance against metrics one and two (permanent admissions of older people (aged 65 and over) to residential and nursing care homes and the proportion of older people (aged 65 and over) who were still at home 91 days after discharge from hospital) however it was unclear at this stage as to whether there would be a requirement to submit the data. 

RESOLVED:

a)    That the provisional BCF outcome metrics attached as Appendix D to the report, be approved, noting that it is 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 should the publication of the national guidance and submission date not align with future meetings of the Board;

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

The Board considered a report of the Director of Adults and Communities which provided a progress update on the Leicester, Leicestershire and Rutland (LLR) Health and Social Care Sector Growth Plan. A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

The Director said that the County Council had engaged extensively with adult social care providers throughout the coronavirus pandemic in order to understand the challenges they faced and the additional support they required.

It was noted that the current Plan, which covered the period 2017-2020, was coming to an end. A new Plan would be developed in line with the Leicester and Leicestershire Enterprise Partnership’s Industrial Strategy and Economic Recovery Plan, both of which recognised the importance of health and social care across LLR.

The Board thanked those who had developed and delivered the Plan over the past three years which had highlighted the importance of the sector across LLR and the need for its continued support to promote further growth and development.

RESOLVED:

That it be noted that:

a)    The final year’s progress in delivering the Health and Social Care Sector Growth Plan;

b)    The cross-system workforce initiatives which have taken place during the Covid-19 period;

c)     The intention to include this sector in the Economic Recovery Strategy that is currently in development across Leicester, Leicestershire and Rutland;

d)    A new plan for the sector will be developed once the Economic Recovery Strategy has been finalised;

e)    The new plan will fall within the economic recovery work being led by the Leicester and Leicestershire Enterprise Partnership (LLEP). New governance arrangements will be put into place for the Economic Recovery Strategy and will incorporate work on this sector.

The Board considered a joint report of the Leicester and Leicestershire Clinical Commissioning Groups (CCGs), the Director of Adults and Communities and the Director of Public Health which detailed the impact of the coronavirus pandemic within the County and the initial response of the local care system. A copy of the report marked ‘Agenda item 6’, is filed with these minutes.

Arising from discussion the following points were noted:

·       There had been a significant number of people who had been discharged from hospital since the start of the pandemic who had received NHS funded care. The Council was now working with partners to undertake reviews and re-assessments to determine those individual’s care arrangements and how their requirements would be funded.

·       Bed occupancy rates within the County’s care homes had fallen considerably since the start of the pandemic. A number of factors had led to the fall, including a lack of confidence in the market, the newly developed discharge process and an increased number of deaths. Rates were now beginning to rise as confidence returned and the Council was implementing plans to further support providers.

·        Infection prevention and control procedures within medical settings across LLR had been developed and were working well. It was crucial that people requiring medical care continued to access services.

·       It was noted that whilst the impact on the Adult Social Care workforce as a result of the UK’s exit from the EU would be minimal (only 3% were EU nationals), there was a risk that supplies of equipment such as Personal Protection Equipment could be disrupted and work was ongoing to ensure supply chains were robust.

·       The cancellation of daycare services as a result of the pandemic had had a significant impact on service users and their carers/families. The Council was working with providers and service users in order to be able to re-introduce services which were ‘covid safe’.

RESOLVED:

That the report be noted.

The Board considered a report of Healthwatch Leicestershire which detailed the findings of a survey which sought people’s experience of using Child and Adolescent Mental Health Services (CAMHS) in Leicestershire. A copy of the report marked ‘Agenda item 9’ is filed with these minutes.

The Board noted that analysis of the responses indicated that the majority of service users felt listened to and the treatment they received met their needs.

In reference to the delays between individuals being referred to the Service and attending their first appointment, the Deputy Chief Executive of Leicestershire Partnership Trust (LPT) said that in light of Healthwatch’s findings, an improvement plan had been developed. She added that since the survey had been undertaken the majority of service users were now being provided with their first appointments within the Trust’s target period. She added that a 24/7 Mental Health Helpline had also been established to help people of all ages access support during the coronavirus pandemic. 

In response to questions concerning LPT’s engagement with CAMHS users, it was noted that the Trust had established a Youth Advisory Board to consider matters such as user experience and the Board had recently reviewed Healthwatch’s findings.  

RESOLVED:

That a report concerning the Child and Adolescent Mental Health Service’s Improvement Plan be presented to a future meeting of the Board.

The Board considered a report of the Housing Services Partnership which provided an update on the work of the Partnership and the Chief Housing Officers Group. A copy of the report marked ‘Agenda item 10’ is filed with these notes.

It was noted that rent arrears were continuing to increase and were expected to continue to do so once the Government’s furlough scheme ceased. The national suspension on evictions had been extended until March 2021.

In reference to questions concerning the prevalence of hoarding across the County, it was noted that whilst the current total number of cases was not as high as anticipated, the cost to help those affected was extremely high. Partners were focusing on the wide range of complex issues that contributed to hoarding in order to identify and resolve cases at an early stage and reduce the need for more costly interventions.

RESOLVED:

That the report be noted.

The Board considered a report and presentation of the Director of Public Health which provided a summary of the findings and subsequent recommendations arising from the Joint Strategic Needs Assessment (JSNA) Tobacco Control chapter. A copy of the report and presentation are filed with these minutes.

Arising from discussion the following points were noted:

·       The chapter was published in late 2019 and therefore it did not reference the coronavirus, however available evidence indicated that smoking was associated with increased severity of illness and death in hospitalised coronavirus patients. The Stop Smoking Service had used these findings within its promotional material to encourage more people to seek support.

·       The rate of smoking attributable hospital admissions and deaths had decreased over the last 5 years and Leicestershire remained below the national average.

·       The Service was using its links with organisations such as Turning Point to address the higher than average smoking prevalence amongst looked after children and the homeless population.

·       As a result of the findings, a Tobacco Control Strategy for Leicestershire would be developed which would set out a clear vision and priorities for reducing smoking related health inequalities and reducing the burden of illness and disease caused by smoking.

·       As part of a smoke free housing pilot, the service was working with district colleagues in Blaby and North West Leicestershire District Councils to raise awareness amongst tenants as to the dangers of smoking in the home and encourage smoke free tenancies. It was hoped the pilot would be extended to include other Leicestershire districts.

·       Evidence suggested that vaping was a successful way of helping people to stop smoking. The Service advocated vaping and provided e-cigarettes along with nicotine replacement therapy.

·       Whilst the Stop Smoking Service was no longer locality based, the community-based approach, which was established in 2017, enabled users to access support via digital formats and/or over the telephone. Quarterly survey results indicated the Service was well received and the majority of users welcomed the ability to access help from the comfort of their own homes.  

RESOLVED:

That the recommendations of the Joint Strategic Needs Assessment - Tobacco Control be supported.

The next meeting of the Health and Wellbeing Board will be held on 26 November at 2.00pm.

was noted that the next meeting of the Health and Wellbeing Board would be held on Thursday 26 November 2020 at 2.00pm.