Agenda and minutes

RESOLVED:

That Dr Nikhil Mahatma be elected Vice Chairman of the Health and Wellbeing Board.

The minutes of the meeting held on 1 December 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.

Mrs L. Richardson CC, Mike Sandys, Jane Moore, Sarah Prema and Harsha Kotecha all declared a registerable interest in agenda item 6 (LLR Health and Wellbeing Partnership’s Integrated Care Strategy – Initial Draft for Engagement) as members of the LLR Health and Wellbeing Partnership.

Mike Sandys, Sarah Prema and Harsha Kotecha all declared a registerable interest in agenda item 7 (LLR Integrated Care Board’s Five Year Joint Forward Plan) as members of the Integrated Care Board.

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

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

·       The Leicester, Leicestershire, and Rutland Integrated Care Strategy.

·       Armed Forces Act 2022 and Armed Forces Covenant

·       Time to Talk Day Conference

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

A draft Joint Health & Wellbeing Strategy video was also shared with members. In response to feedback, the Director of Public Health agreed to add the NHS logo to the part which listed representatives of the Board. It was noted that a communications plan had been developed with regard to how the video would be shared externally.

RESOLVED:

That the position statement be noted.

The Board considered a report of the Leicester, Leicestershire and Rutland Health and Wellbeing Partnership which sought its views on the initial draft of the Leicester, Leicestershire and Rutland’s Health and Wellbeing Partnership’s Integrated Care Strategy. A copy of the report, marked ‘Agenda Item 6’, is filed with these notes.

Arising from discussion, the following points were noted:

      I.         The draft Strategy focused on six priority areas which would complement the three Leicester, Leicestershire and Rutland Joint Health and Wellbeing Board Strategies, the Integrated Care Board’s (ICB) Five Year Joint Forward Plan and service level plans. The aim of the Strategy was to set out a framework for partners to work collectively together and not duplicate the work already being undertaken at place.

    II.         The draft Strategy would benefit from a greater focus on mental health, specifically in relation to children and families. It was noted that the Health and Wellbeing Board had recently approved the establishment of a Mental Health Subgroup, which needed to be referenced in the document.

   III.         The reporting arrangements for some of the collaborative groups needed to be re-considered. The Strategy suggested they would report to the ICB however some would be better placed feeding into the Health and Wellbeing Partnership. It was confirmed that the governance elements within the document would be reviewed to ensure it correctly referenced the structures in place across the system.

  IV.         The draft Strategy would benefit from an increased focus on children and young people. It was noted that the Children and Families Partnership (a Subgroup of the Health and Wellbeing Board) had recently considered in detail the Family Hubs model and the opportunities it presented in terms of integrated care and it would therefore be beneficial for this and other examples to be included within the document. 

    V.         The development of an easy read version was being considered. Members agreed that the Strategy would benefit from a simplification of the language used where possible.

  VI.         The interventions set out in the draft Strategy were narrow and care specific. It would therefore benefit from the inclusion of broader ambitions such as keeping people healthy and the importance of prevention.

VII.         The district authorities were in conversation with the Chairman of the Health and Wellbeing Partnership with regard to the lack of district representation on the Board.

VIII.         It was important the Strategy linked to the Community Health and Wellbeing Plans being developed at neighbourhood level, setting out clearly how they aligned.

  IX.         Following comments received from the three Health and Wellbeing Boards and those submitted separately by members, the draft Strategy would be amended before a period of wider engagement commenced.

It was intended that the final Strategy would be approved by the Health and Wellbeing Partnership no later than the Autumn of 2023.

    X.         Clarification would be sort with regard to the ‘best start in life’ Integrated Care Strategy priority and whether it should be referenced as ‘best start for life’

RESOLVED:

That the Health and Wellbeing Partnership be requested to consider the comments now raised regarding the draft Leicester, Leicestershire and Rutland Integrated Care Strategy.

The Board considered a report of the Chief Strategy Officer, NHS Leicester, Leicestershire and Rutland Integrated Care Board (ICB), concerning the initial development of the ICB’s Five Year Joint Forward Plan. A copy of the report, marked ‘Agenda Item 6’ and presentation shared at the meeting, is filed with these minutes.

Arising from discussion the following points were noted;

      I.         The ICB had a requirement to produce a Five Year Joint Forward Plan which would detail how NHS services were delivered within the system. The Plan would take into account the findings of the Joint Strategic Needs Assessments and have regard to the LLR joint health and wellbeing strategies and align to the NHS Long Term Plan.

    II.         It was a requirement that the Plan aligned with wider system ambitions, built on existing local strategies and plans and was delivery focused with specific trajectories and milestones. The Plan was required to be updated each year.

   III.         Ahead of the final Plan being submitted to NHS by the deadline of the 30 June, a period of engagement would be undertaken, including the Health and Wellbeing Board’s consideration of the draft document.

  IV.         The emerging focus areas had been developed based on the areas which need additional focus in order to become sustainable in terms of finance, quality and performance within the next five years. Findings of previous engagement exercises with the public had also shaped the  nine areas of focus which included mental health and dementia, learning disability and autism, management of long term conditions, prevention and Children and Young People. 

    V.         Each of the emerging focus areas were being explored via officer groups within the system, the outcome of which would be used to develop the Plan. It was noted that whilst the groups had representatives of both the NHS and local authorities, it would be beneficial for their findings to be shared with the Health and Wellbeing Partnership and Health and Wellbeing Boards to ensure there was system wide understanding.

  VI.         In line with the findings of the Fuller review concerning integrated primary care, and the prevention focus area of the Five Year Plan,  local Integrated Neighbourhood Teams would be developed and they would become an important mechanism to combine partner services to deliver a prevention approach to patients and enable closer working with local authorities to address neighbourhood level inequalities.

VII.         There was a role for the Health and Wellbeing Partnership to explore how partners could use their budgets more effectively across system and place, especially in terms of prevention services.

RESOLVED:

That the report and presentation be noted.

The Board considered a report of the Director of Public Health which provided an update on the progress of the Leicestershire Joint Health and Wellbeing Strategy since the last Board meeting in December 2022, including an outline of the areas to be developed over the coming months. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

Members acknowledged the significant amount of work that was being undertaken by officers and members of the Health and Wellbeing Board’s subgroups to progress the delivery of the Strategy.

In reference to the trend in the proportion of Leicestershire residents being screened for breast and cervical cancer, it was noted that latest data suggested the trend remained very similar to previous years and it was recognised there was more work to be done as part of the covid recovery process.

RESOLVED:

That the report be noted.

The Board considered a report of the Director of Public Health which provided an update concerning the delivery of the Leicestershire Healthy Weight Strategy 2021 – 2026. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

In response to questions from members concerning the impact the cost of living was having on individual’s eating habits, the Director said that the Strategy had a particular focus on affordable ways of accessing nutritious food, such as the provision of food boxes and recipe cards to help develop skills to produce lower cost meals. Officers also worked with foodbanks to try and ensure there was a good balance of healthy foods available. It was noted that the Staying Healthy Partnership (subgroup of the Health and Wellbeing Board) was also exploring issues around the cost of living crisis and therefore it would be beneficial to ensure the two workstreams were aligned.

The Strategy currently focused on the activities that local authorities and the NHS provided whilst the delivery of the Leicestershire Food Plan had led to joint working with the local business sector such as the food festival in Melton Mowbray, however, it was recognised that more work was needed to understand what initiatives were available, including those provided by the voluntary and community sector.

It was noted that when NHS funding initiatives were introduced , such as the Digital Weight Management Service, it was important local provision already available was considered and the pathways were joined to ensure patients that were not eligible for a specific service could be directed to others. 

It was noted that efforts were being made to ensure the work undertaken to deliver the Strategy aligned with that being undertaken in regard to the County Council’s Family Hubs Model and Holiday and Activity Programmes, however it was recognised that closer collaborative working would benefit.

In reference to the Body Mass Index number at which support was provided, it was noted that anyone with a number of 25 or over was eligible for some form of support. Speciality services (Tier 3) would have a higher threshold of BMI. The thresholds were adjustable for different ethnicities, recognising the number may need to be lower.

Whilst this Strategy focused on helping those who were overweight it also supported children who were classed as underweight as part of the measurement programme. Whilst the Strategy did promote the wider benefits of healthy eating, those adults suffering from being underweight and or malnutrition would be supported via the GP referral pathways.

RESOLVED:

That the report be noted.

The Board considered a report of the Director of Public Health which informed the Health and Wellbeing Board of progress made to establish the Leicester, Leicestershire and Rutland Combating Drugs and Alcohol Partnership, to oversee local delivery of the National Drugs Strategy. A copy of the report, marked Agenda Item 10, is filed with these minutes.

It was noted that the Strategic Partnership Board Executive would act as the statutory LLR Combating Drugs Partnership whilst an operational Working Group would be established to deliver upon the agreed priorities. NHS representation on the Group was important and work was ongoing to appoint representatives of LPT, UHL and mental health services.

RESOLVED:

a)    That the arrangements for the LLR Combating Drugs and Alcohol Partnership and its future work be supported;

b)    That Health partners be requested to continue to engage in the process of the local delivery of the National Drugs Strategy to ensure joint solutions are developed to address drug and alcohol misuse locally and where appropriate, become members of the LLR Combating Drugs and Alcohol Partnership.

The Board considered a report of the Chief Executive which advised the Health and Wellbeing Board of urgent action taken to approve the Adult Social Care Discharge Grant submission to NHS England. A copy of the report, marked ‘Agenda Item 11’ is filed with these minutes.

RESOLVED:

a)    That the urgent action taken by the Chief Executive using his delegated powers to approve the Leicestershire Adult Social Care Discharge Grant submission (December 2022) to NHS England be noted;

b)    That the Leicestershire Adult Social Care Discharge Grant submission be retrospectively approved.

The Board considered a report of the Director of Adults and Communities  concerning the refresh of the Leicestershire Better Care Fund Section 75 agreement for 2022/23 and sought approval to continue with the pooled budget arrangements. A copy of the report, marked ‘Agenda Item 12’, is filed with the minutes.

RESOLVED:

a)    That the work being undertaken to refresh the Section 75 (s75) pooled budget agreement for the Better Care Fund be noted;

b)    That the continuation of s75 pooled budget arrangements between Leicestershire County Council and the Leicester, Leicestershire and Rutland Integrated Care Board be approved.

The next meeting of the Health and Wellbeing Board will be held on Thursday 25 May at 2.00pm.

It was noted that the next meeting of the Board would take place on the Thursday 25 May 2023.