Agenda and minutes

The minutes of the meeting held on 26 May 2022 were taken as read, confirmed and signed.

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:-

·       Local pressures being experienced by health and social care providers.

·       Engagement events attended by the Chairman.

·       The development of the Integrated Care Strategy

·       Work to improve mental Health and help those most affected by the cost of living crisis

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

RESOLVED:

That the position statement be noted.

The Board considered a report of the Chief Strategy Officer of Leicester and Leicestershire and Rutland Integrated Care Board which provided an update on the progress with the development of the seven Community Health and Wellbeing Plans within Leicestershire. A copy of the report, marked ‘Agenda Item 5’, is filed with these minutes.

The Chief Strategy Officer said that there had been several emerging themes which had arisen from the plans developed so far, including children and young people’s mental health and wellbeing, SEND provision in education and services for informal carers. In terms of the SEND provision, a significant amount of feedback had focused on the time it was taking individuals to undergo an education assessment and the impact this was having on their learning. The findings would be fed back into the local learning disability collaborative and other partner groups who were already aware of the delays and were working to try to improve the situation. 

It was noted that one of the key challenges and opportunities for partners over the coming year was how the system achieved integrated services in terms of planning and delivery, creating integrated teams using services which were delivered by the County Council, district councils and the NHS as well as those provided by communities such as volunteers and the informal care sector. The creation of Community Health and Wellbeing Plans provided the foundations to make this happen.

RESOLVED:

That the work being undertaken to develop the seven Community Health and Wellbeing Plans be noted.

The Board considered a report of the Director of Public Health which provided a summary of the recommendations that had arisen from the recently completed Joint Strategic Need Assessment (JSNA) End of Life Chapter.  The report also detailed the ongoing work to progress the other JSNA chapters. A copy of the report, marked ‘Agenda Item 6’, and a presentation considered at the meeting is filed with these minutes.

Arising from discussion the following points were noted;

·       The Chapter sought to provide an overview of the data concerning the care and support offered to those who were at the end of life stage, their loved ones and those who worked within the sector. Information from multiple sources had been evaluated which had resulted in recommendations based on unmet need and gaps within local provision.

·       The recommendations, which were set out in the report, had been developed with the aim of improving help, support, and quality of life for people approaching and affected by death in Leicestershire.  Many of the recommendations were relevant across all ages with one specific to children and young people at end of life.

·       The findings of the JSNA would be used to help shape the Integrated Care Board’s (ICB) development of an end of life Strategy for Leicester, Leicestershire and Rutland. It was understood the ICB would be meeting in the early new year to agree a timeline for when the Strategy would be in place.

RESOLVED:

a)    That the recommendations of the Joint Strategic Needs Assessment End of Life chapter be supported, noting that the place priority actions will be delivered through the Joint Health and Wellbeing Strategy delivery plan and system actions via the Leicester, Leicestershire and Rutland End of Life Strategy;

b)    That the timetable for the development of the remaining chapters identified in the current JSNA cycle be noted.

The Board considered a report of the Director of Public Health which provided a summary of a project which explored the perceptions, experiences and influences to attending cancer screening in communities with poor screening uptake. A copy of the report, marked ‘Agenda Item 7’, is filed with these minutes.

It was noted that improving cancer screening rates was an ambition within the Leicestershire Joint Health and Wellbeing Strategy. This included understanding the reasons for the decline in rates and ensuring there was a targeted approach for populations most at risk of premature mortality from cancer.

RESOLVED:

a)    That the work undertaken to explore the reasoning behind the decline in cancer screening rates across GP practices in PCN areas in Charnwood be noted;

b)    That the recommendations set out in the report to increase cancer screening uptake and reduce health inequalities in Charnwood be approved.

The Board considered a report of the Director of Public Health which provided an update on the progress made in the initial stages of delivery of the Leicestershire Joint Health and Wellbeing Strategy (JHWS) 2022-2032. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

The Director said that it was proposed a flexible approach was taken to the way in which the work of the subgroups was reported to the Board, with a move to a yearly cycle with an opportunity for each sub-group to report more often to suit their area of work. 

In refence to the performance indicators used to measure the Strategy’s impact, it was noted that the majority were taken from Fingertips, a public health source which was updated annually. It was therefore proposed that the previously intended quarterly reporting be changed to annually. Work would also be undertaken to consider introducing additional indicators that were reliant on other partner data sources, to provide a richer evidence-based landscape.

An evaluation of the JHWS would be undertaken as part of the yearly annual report that would be presented to the Board in 2023.  This would highlight progress made to date, any challenges and the main priority areas of focus.

As part of this process, members of the Board would be invited to answer a series of questions anonymously to seek their views and perspective on how they thought the Board was developing and what challenges it needed to overcome. 

It was noted that further work would need to be undertaken to consider the outcomes of the JHWS and how they were used to improve the health of the Leicestershire population.

In reference to the creation of a short video to promote the work of the Board, the Director said that officers would explore the possibility of making it available in multiple languages.

RESOLVED:

a)    That the progress made by the Health and Wellbeing Board’s subgroups to deliver upon the priorities and commitments set out in the Joint Health and Wellbeing Strategy be noted;

b)    That the proposal to move to annual reporting of the work of the Board’s subgroups in relation to the delivery of the Joint Health and Wellbeing Board Strategy and the associated Performance Indicators be approved;

c)    That the work being undertaken to evolve the Health and Wellbeing Board be noted.

The Board considered a report of the Chief Strategy Officer of the ICB which provided an update on the recently established Leicester, Leicestershire and Rutland Health and Wellbeing Partnership and the development of the Partnership’s Integrated Care Strategy. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

In reference to the development of the Integrated Care Strategy, it was noted that the draft Strategy would be presented to the Health and Wellbeing Partnership on the 15 December for approval to engage. Engagement would take place during the early part of 2023 and the Health and Wellbeing Board would consider the draft Strategy at its meeting on the 23 February as part of this process. It was intended that a final Strategy would be in place by the Autumn of 2023.

It was noted that the draft Strategy would be circulated to members of the Health and Wellbeing Board and they were welcome to submit any initial feedback they had prior to its formal consideration in February.

RESOLVED:

That the report be noted.

The Board considered a report of Healthwatch Leicester and Leicestershire which presented their Annual Report for 2021-22. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

It was noted that the particular focus on male suicide had helped the NHS identify gaps in service provision, potential barriers which prevented individuals from coming forward to access services and ways in which awareness of local support services could be improved.

RESOLVED:

That the report be noted.

The Board considered a report of the Leicestershire and Rutland Safeguarding Adults Board which presented the Annual Report of the Board for 2021/22, and its Business Plan for 2022/23. A copy of the report, marked ‘Agenda Item 11’, is filed with these minutes.

In refence to the Annual Report having identified the need for further work to improve safeguarding of people with Learning Disabilities and Autism, it was noted that the Safeguarding Adults Board had strengthened its links with the Learning Disability and Autism Collaborative and their working groups to ensure the findings and learning of the Board fed into their respective workplans.

It was noted that the Annual Report also identified that existing services and pathways did not always work well for people with multiple complex needs, particularly relating to mental health and substance misuse.

In response to questions concerning safeguarding adult reviews, it was noted that the Safeguarding Adults Board undertook reviews into cases where individuals with care and support needs had been seriously harmed or died and abuse or neglect was suspected. The reviews focussed on identifying how multi-agency safeguarding systems and practice could be improved in future. Potential referrals were presented to the Board for review which were then progressed based on a set criterion. The process had been amended in order to reduce the period of time it took the review to be undertaken, meaning the learning could be identified much more quickly.

RESOLVED:

That the report be noted.

The Board considered a report of the Safeguarding Children Partnership which presented the Annual Report of the Leicestershire and Rutland Local Safeguarding Children Partnership (LRSCP) for 2021/22. A copy of the report, marked ‘Agenda Item 12’ is filed with these minutes.

RESOLVED:

That the report be noted.

The Board considered a report of the Director of Adults and Communities and Director of Public Health which sought approval for revised Terms of Reference for the Integration Executive, a subgroup of the Health and Wellbeing Board, and the establishment of a new Mental Health subgroup. A copy of the report, marked ‘Agenda Item 13’ is filed with these minutes.

In reference to the proposed establishment of a new mental health subgroup, it was noted that the subgroup needed to have consideration for children’s emotional wellbeing as well as mental health and it would therefore be beneficial for the education sector to be represented on the subgroup.

It was important the Subgroup also had links with other groups across the system which were involved in providing services for those experiencing mental health and emotional wellbeing difficulties to ensure alignment and avoid duplication.

RESOLVED:

a)    That the revised Terms of Reference for the Integration Executive be approved;

b)    That the establishment of a new Mental Health subgroup of the Health and Wellbeing Board (the Leicestershire Mental Health group), be approved;

c)    That subject to b) above, the Terms of Reference for the Leicestershire Mental Health group be approved.

The Board considered a report of the Chief Executive which advised of urgent action taken to approve the Leicestershire Better Care Fund Plan 2022/23 for submission to NHS England and the final version of the Leicestershire Pharmaceutical Needs Assessment for publication. A copy of the report, marked ‘Agenda Item 14’ is filed with these minutes.

The Director of Adults and Communities said that the following the announcement of the national Adult Social Care Discharge Fund, the County Council had been asked to formulate a spending plan which set out how the allocation, anticipated to total circa £4.8m, would be spent. 

The funding, which was to be pooled into the Better Care Fund, would be distributed in two tranches by the end of January 2023. The first 40% would be paid upfront with the remaining 60% allocated on the basis spending plans were approved by the national Better Care Fund (BCF) Team. The funding had to be spent on interventions which best enabled the discharge of patients from hospital and could not be used to compensate existing spend.

The draft plan for the proposed spend would be considered across the system in the coming weeks, including the Integration Executive the 6 December, ahead of submission to the national BCF Team on the 16 December. The Chief Executive of the County Council would be asked to approve the final submission on behalf of the Board. An update on the agreed spend would be presented to the next meeting of the Health and Wellbeing Board in February 2023.

In reference to the potential schemes identified so far, it was noted that several concerned mental health discharge.

RESOLVED:

a)    That it be noted that urgent action was taken by the Chief Executive using his delegated powers to

                        I.         Approve the Leicestershire Better Care Fund (BCF) Plan

2022/23 for submission to NHS England;

                      II.         Approve the final version of the Leicestershire

Pharmaceutical Needs Assessment for publication.

b)    That the Health and Wellbeing Board retrospectively approve the Leicestershire Better Care Fund Plan 2022/23, including the Planning Template and narrative for submission to NHS England;

c)    That the update concerning the local allocation of Adult Social Care Discharge Fund and arrangements for the submission of a spending plan to the national Better Care Fund Plan Team be noted.

{Subsequent to the meeting it was confirmed that the draft plan for the proposed spend would be considered by the NHS Winter Board prior to its submission. Further clarity was also provided regarding the local arrangements for approval of the submission which required the Chief Executive of the County Council to approve the submission to the national BCF Team on behalf of the Health and Wellbeing Board which would not meet before the 16 December deadline.}

Meetings of the Health and Wellbeing Board in 2023 will be held on:

23^rd February

25^th May

28^th September

7^th December

Meetings will start at the usual time of 2.00pm.

RESOLVED:

That meetings of the Health and Wellbeing Board in 2023 will be held on the following dates, beginning at 2pm.

23rd February

25th May

28th September

7th December