Agenda and minutes

To note that the County Council’s Lead Member for Health, Mrs L Richardson CC, has been appointed Chairman for the period ending with the date of the Annual Meeting of the County Council in 2023.

RESOLVED:

That Mrs L. Richardson CC be appointed Chairman for the period ending with the date of the Annual Meeting of the County Council in 2024.

Mrs. L. Richardson CC in the Chair

The minutes of the meeting held on 23 February 2023 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:-

·        Adult Social Care;

·        NHS/Integrated Care Board.

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 Integrated Care Board which presented the draft NHS Leicester, Leicestershire and Rutland Integrated Care Board (LLR ICB) 5-Year Joint Forward Plan (5JFP). A copy of the report, marked ‘Agenda Item 6’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)           Should partners wish to give any further feedback on the 5JFP outside of the meeting then they were welcome to do so as the final Plan would not be completed until the end of June 2023.

(ii)         The 5JFP would contain an annex which would set out how the Plan would be delivered. It was important to ensure that the 5JFP delivery plan aligned with the delivery plan for the Health and Wellbeing Strategy to avoid duplication and ensure resources were managed effectively. Further conversations with Health and Wellbeing Board Leads would take place after the publication of the 5JFP to ensure full alignment.

RESOLVED:

That:

(a)             The contents of the report and the Leicester, Leicestershire and Rutland Integrated Care Board 5-Year Joint Forward Plan be noted;

(b)             The Board agrees that the 5 Year Joint Forward Plan takes account of the Leicestershire Health and Wellbeing Strategy.

The Board considered a report of the Integrated Care Board which provided an update on the progress of the seven Community Health and Wellbeing Plans (CHWPs) across Leicestershire. A copy of the report, marked ‘Agenda Item 7’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)           The Leicestershire Health and Wellbeing Strategy set out the overall vision for Leicestershire and the CHWPs were an opportunity to tweak the vision for particular localities. One of the main aims of the CHWPs was to tackle health inequalities, particularly in areas of the County with high deprivation levels. The Plans had resulted in closer partnership working taking place in the districts.

(ii)         There were Action Plans and Performance Indicators to go alongside the CHWPs.

(iii)        Working Groups and Delivery Groups had been established in the seven Districts to aid implementation of the CHWPs. A mapping exercise was being carried out regarding which Boards and Committees would need to be kept abreast of the work of the Working Groups and Delivery Groups and how best to feed into them to ensure there was no duplication. Reassurance was given that the Health and Wellbeing Board would be regularly updated.

(iv)       There was no additional funding for the CHWPs therefore the work would have to be carried out from existing funding. Some reassurance was given that most of the work was not new, it was about working in a different way therefore new funding was not required. Grants would be bid for where appropriate and volunteers would also be used. This issue of funding would be monitored going forward.

(v)         Health and Wellbeing Board Leads needed greater clarity on what work their staff were being required to do in relation to CHWPs. Membership lists of the Working Groups would be circulated to Health and Wellbeing Board members to ensure that the Board was satisfied with the representation on the Groups.

(vi)       Public Health representatives had been invited to attend the Working Groups. In response to concerns that this could create a resources problem for Public Health some reassurance was given that there had been no problems so far and Public Health apprentices had been fulfilling the role which had worked well. In order to reduce the amount of representatives that were required, the Working Groups had been combined as much as possible. The issue of resources would be closely monitored going forward.

(vii)      Healthwatch and Leicestershire Police were also welcome to take part in the Working Groups and further conversations regarding their involvement would take place outside of the meeting.

(viii)    Local Area Co-ordinators and Social Prescribers were heavily involved in the CHWP work.

(ix)       Reassurance was given that the CHWP work would link in with the existing Leicestershire Carers Strategy and Dementia strategy and the CHWP work would not be carried out independently from partners. The Community Health and Wellbeing Teams would play an important role in highlighting where existing resources and services were.

(x)         The Hinckley and Bosworth Community Health and Wellbeing Plan 2023 – 2026 stated that deaths by suicide in Leicester, Leicestershire and Rutland increased by 40% between 2021 and 2022 however this figure was not correct and required amending. It was agreed that this would be corrected after the meeting.

(xi)       Whilst there was a strong evidence base for the priorities set out in the Community Health and Wellbeing Plans the results of the May 2023 local authority elections could have some impact on the delivery of the Plans.

RESOLVED:

That the progress of the seven Community Health and Wellbeing Plans within Leicestershire County be noted.  ...  view the full minutes text for item 7.

The Board considered a report of the Director of Adults and Communities, Leicestershire County Council, regarding the end of year performance of the Better Care Fund programme for 2022/23. A copy of the report, marked ‘Agenda Item 8’, is filed with these minutes.

RESOLVED:

That:

a)           The performance against the Better Care Fund (BCF) outcome metrics, and the positive progress made in transforming health and care pathways in 2022-23 be noted;

b)           The action taken by the Chief Executive of Leicestershire County Council, following consultation with the Chairman of the Health and Wellbeing Board, to finalise the BCF Year End report and use his delegated powers to approve it for the NHSE submission deadline of 23rd May 2023 be noted;

c)           The Board retrospectively approves the year-end BCF 2022-23 template, attached as the appendix to the report, for submission to NHS England.

The Board considered a report of the Director of Adults and Communities, Leicestershire County Council, which provided an overview of the progress to date on the submission of the Leicestershire Better Care Fund (BCF) Plan 2023-25. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)               On 25 May 2023 a draft of the Plan was being submitted to the BCF Regional Lead and other key stakeholders for feedback. Once that feedback was received the Plan would then be submitted to the Integration Executive before submission to NHS England ahead of the 28 June 2023 deadline.

(ii)             The Plan contained metrics relating to falls in people aged 65 and over and consideration was therefore given to whether there should be further detail in the Plan about the falls prevention work which was taking place in Leicestershire. It was noted that the Narrative section of the Plan contained some information on how the target set out in the metric would be achieved however further detail was needed on the community prevention falls work taking place. It was agreed that liaison would take place with Active Together regarding this and the additional information would be included in the second draft of the Plan.

(iii)            The Narrative section of the Plan also contained details on supporting people back into living in the community after they have spent a period of time in a mental health facility. It set out what work was being carried out to ensure these people had appropriate housing.

RESOLVED:

That: 

(a)    The contents of the report be noted;

(b)    The assurance document, attached as Appendix E, that details the proposed contents of the BCF Plan return against the key lines of enquiry be noted;

(c)    The Board authorises the Chief Executive of Leicestershire County Council, following consultation with the Chairman of the Health and Wellbeing Board, to finalise the BCF Plan prior to the national deadline for submission of 28th June 2023.

(d)    The Board notes that the members of the Integration Executive will be asked to indicate their support for the BCF Plan ahead of the final submission to NHS England at its meeting of the 6th June 2023.

The Board considered a report of the Director of Public Health, Leicestershire County Council, which looked back on the previous two years (2021-2023) and reflected on what had been achieved and where the Board saw itself in the next 12-24 months. A copy of the report, marked ‘Agenda Item 10’, is filed with these minutes.

RESOLVED:

That the Board:

(a)    Notes the contents of the report and acknowledges the progress to date;

(b)    Recognises the work needed to further strengthen and develop the Board as a Place-based leader.

The Board considered a report of the Director of Public Health, Leicestershire County Council, which provided an update on the progress of the Leicestershire Joint Health and Wellbeing Strategy (JHWS) 2022-32. A copy of the report, marked ‘Agenda Item 11’, is filed with these minutes.

The Chairman emphasised that the reporting timetable set out in the report was the minimum frequency required and the Board would welcome updates more frequently.

RESOLVED:

That:

(a)      The progress made to date be noted;

(b)      The reporting cycle timetable be approved.

The Board considered a report of the Director of Public Health, Leicestershire County Council, which provided an update on the ongoing development of the Leicestershire Joint Strategic Needs Assessment (JSNA), and a summary of the headlines, conclusions and recommendations arising from two recent JSNA chapters developed on Children and Young People’s Mental Health and Health Inequalities. A copy of the report, marked ‘Agenda Item 12’, is filed with these minutes.

Arising from discussions the following points were noted:

Children and Young People’s Mental Health

(i)           The report stated that in England in 2022, 18% of 7–16-year-olds and 22% of 17–24-year-olds had a ‘probable mental health disorder’. In response to a question as to what definition was used for what constituted a probable mental health disorder it was agreed that this would be checked and clarification would be provided after the meeting.

(ii)         Consideration needed to be given to where the gaps in provision were and how these gaps would be affected by funding decisions and which areas needed strengthening.

(iii)        The Joint Strategic Needs Assessment Chapter on Children and Young People’s Mental Health required more detail in relation to the Transition to Adult Services and all the work which was taking place in that regard. It would be helpful to add a recommendation regarding improving co-ordination of all the work which was taking place particularly linking in the work of the voluntary sector.

(iv)       Almost one-third of year 4-6 and year 8-10 school pupils reported feeling afraid to attend school sometimes due to bullying. Bullying in connection to racial background was a particular problem in Leicestershire. Members expressed concern that the figures were so high given the work that had already taken place to tackle the problem. There was a need to keep persevering and try different methods.

Health Inequalities

(v)         In response to a suggestion that more engagement with communities needed to take place to encourage the public to use services and ask the public what would make them more likely to use services, reassurance was given that this was covered in the recommendations contained within the JSNA chapter.

(vi)       In Leicestershire there was a more nuanced picture than in Leicester City with regards to deprivation and health inequalities. Auditing of the services needed to take place to show how health inequalities were being tackled. It would be useful for a toolkit to be developed to help partners. Organisations were also thinking of their own solutions to tackle the problem and this needed to be encouraged.

It was concluded that more work needed to take place to ensure all partners received the JSNA chapters and were aware of the contents, not just at Place level but at System and Neighbourhood level as well.

RESOLVED:

That:

(a)    The findings and recommendations of the Children and Young Peoples’ Mental Health Joint Strategic Needs Assessment Chapter be supported and the Chapter be approved for publication;

b)     The findings and recommendations of the Health Inequalities Joint Strategic Needs Assessment Chapter be supported and the Chapter be approved for publication.

The Board considered a report of the Director of Public Health, Leicestershire County Council, which provided a summary of the findings from analysis of GP record data viewed through the Aristotle system in April 2023. A copy of the report, marked ‘Agenda Item 13’, is filed with these minutes.

Arising from discussions the following points were noted:

(i)           The analysis had been commissioned by Leicestershire Partnership NHS Trust and the Health Inequalities Learning Disability and Autism Group. The analysis provided the evidence base for that Group and would feed into their work and be taken forward as part of their Action Plans.

(ii)         The analysis indicated that there were some links between deprivation and learning disabilities and Board members considered what those links could be and whether this was reflected on a national level. It was suggested that one of the reasons for the link could be that Residential Care Homes were often located in more deprived areas which could be affecting the figures and giving the impression that there was stronger links between deprivation and learning disabilities than there actually was. Nevertheless, the analysis made it clear that when health partners were working in areas of deprivation extra consideration needed to be given to people with learning disabilities and how to engage with them.

(iii)        People with a learning disability were entitled to an annual health check. In terms of pure numbers more health checks had been carried out in the County than in Leicester City, however in terms of proportion of the population the County had a lower percentage than the City. A contributory factor to this could be that many people that resided in the County were registered with out of county GP Practices and therefore would not appear in the Leicestershire figures for health checks.

(iv)       Board members welcomed the work that had been carried out and gave their support to future projects of this nature.

RESOLVED:

That:

(a)    The findings of the analysis contained in the report and accompanying presentation be noted;

(b)    The work of the Learning Disability Health Inequalities Group in co-ordinating work to address the issues identified be supported.

The Board considered a report of Healthwatch Leicester and Leicestershire  which presented their Young People’s Mental Health Special Project report.  A copy of the report, marked ‘Agenda Item 14’, is filed with these minutes.

RESOLVED:

That the contents of the report, with particular reference to the recommendations and corresponding action plan, be noted.

Future meetings of the Health and Wellbeing Board will be held at 2.00pm on the following dates:

28 September 2023

7 December 2023

29 February 2024

23 May 2024

27 September 2024

6 December 2024.

RESOLVED:

That future meetings of the Board take place on the following dates all at 2.00pm:

28 September 2023;

7 December 2023;

29 February 2024;

23 May 2024;

27 September 2024;

5 December 2024.