Agenda and minutes

The minutes of the meeting held on 25 May 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:

i)             Adult Social Care Services

ii)            The LLR health and care system

iii)           Development Sessions

iv)           Intermediate Minor Oral Health Surgery Procurement

v)            Engagement Events.

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 Director of Public Health, Leicestershire County Council, which set out revised Terms of Reference for the Health and Wellbeing Board. A copy of the report marked ‘Agenda Item 5’ is filed with these minutes.

RESOLVED:

That the revised Terms of Reference be approved. 

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 6’ is filed with these minutes.

Arising from the discussion, the following points were made:

i)             In response to a query about similar issues arising across the communities and the potential for work to be duplicated, it was noted that reporting arrangements had been put in place with the Staying Healthy Partnership.  More detail on the role of the Staying Healthy Partnership in managing duplication would be included in a future report to the Health and Wellbeing Board.

ii)            It was also noted that the Integration Delivery Group, a subgroup of the Integration Executive, was looking at the Community Health and Wellbeing Plans to identify commonalities and create a single plan that would ensure that there was no duplication of work within the remit of the Integration Executive.

RESOLVED:

That the progress of the seven Community Health and Wellbeing Plans within Leicestershire County be noted.

The Board Considered a report of the Director of Adults and Communities, Leicestershire County Council, regarding the Quarter 2 Performance of the Better Care Fund programme for 2022/23. A copy of the report marked ‘Agenda Item 7’ is filed with these minutes.

Members of the Board were advised that the appendix had been updated since it had been circulated with the papers.  An updated version would be circulated, reflecting the final version which would be submitted to NHS England later that day.

Arising from the discussions the following points were noted:

i)             The Chairman commended the targets that were being maintained and supported the Quarter 2 BCF 2023/24 template be approved for submission to NHS England.

ii)            It was noted that the increase in urgent care co-ordination hubs had resulted in increase in demand at the hubs with people being dealt with in the communities taking pressures off EMAS. Suggestions to potentially increase the community service further with additional capacity to cope with the increased pressures in the winter to minimise on any unplanned admissions.

RESOLVED:

a)    That the performance against the Better Care Fund (BCF) outcome metrics and the positive progress made in transforming health and care pathways up to quarter 2 be noted; 

b)    That the Quarter 2 BCF 2023/24 template be approved for submission to NHS England. 

c)    That the final version of the template be circulated to Board members for information.

The Board considered a report of the Director of Public Health, Leicestershire County Council, which provided an update on JSNA chapter delivery and proposals on the governance and processes by which the chapters within a Joint Strategic Needs Assessment (JSNA) cycle are prioritised and agreed. A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

It was suggested that the Joint Health and Wellbeing Strategy should be used to help prioritise the development of JSNA chapters, as should the views of Subgroup Chairs.

RESOLVED:

a)    That progress on the JSNA chapters to date and the current planned list of future chapters be noted; 

b)    That the re-establishment, terms of reference and membership of the JSNA Oversight Reference Group and proposed governance arrangements be approved; 

c)    That the Reference Group be requested to review and discuss the current list of JSNA chapters scheduled within the cycle to 2025 and bring back any suggested changes/additions to the Board for approval; 

d)    That the Board receives and considers any future JSNA chapters as they become available, including any progress updates on the recommendations highlighted within the JSNA. 

The Board considered a report of the Director of Public Health, Leicestershire County Council, which provided a summary of the headlines, conclusions and recommendations arising from two recent JSNA developed on Leicestershire’s Demography and Oral Health. A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.  The Board also received presentations on both topics, a copy of which is filed with these minutes.

Arising from the discussion, the following points were noted:

Demography

i)             It was felt that the information now provided should be used to inform commissioning decisions and the work of the subgroups. The information would also support Board members to consider how issues such as the decrease in healthy life expectancy would affect their services in the longer term.   

ii)            In response to a suggestion that it would be useful to model the data to predict challenges to the system from 2030 onwards, it was clarified that the Office for National Statistics (ONS) was expected to realise some nationally provided tools for this type of work. In the Adults and Communities Department at the County Council, work was already being undertaken to identify the impact of demand into the future and this could be built on further.

iii)           The Board discussed the higher percentage than the national average of those with A level qualifications and lower percentage level of those qualified up to a degree level in the county. Officers suggested that this partly because there was only one university in Leicestershire and partly because students were not returning to Leicestershire after graduation if they moved away for university.

iv)           The nuances in the data highlighted the importance of Community Health and Wellbeing Plans.  It was suggested that real time information on population change should be fed in to ensure that the demography chapter of the JSNA was continually updated.

v)            It was suggested that consideration should be given to preventative measures that could be put in place to target certain demographics and mitigate the impact on services in the future.

Oral Health

vi)           With regard to improving oral health in care homes, Board members agreed that it would be useful to engage with Teams who already went into care homes.  Consideration should also be given to using the ‘making every contact count’ model, making use of community pharmacists and GPs, for example, to push out messages about the importance of good oral health.  It might be useful for the Task and Finish Group to take this idea forward.

vii)          In response to concerns about children’s oral health, it was noted that positive work was currently being undertaken around supervised toothbrushing across Leicestershire and delivering education to parents.  The Children and Families Service Department was seeking to capitalise on this.

viii)        It was noted that there had been a small increase in the number of children in care who had had dental checks.  The barriers were thought to relate to capacity and access.

ix)           It was suggested that, in the context of the current cost of living crisis, some families did not see oral health as a priority, and it was unlikely that increasing education and awareness of the topic would change that.  To that end, it was suggested that the Health and Wellbeing Board should consider supporting fluoride varnish or water fluoridation, noting that this was a matter for the Government to determine.

x)            The Board noted that there had been issues with recruitment of NHS dentists for a number of years, with the issue being accelerated by the covid pandemic.  National reforms around fairer payments had been introduced in 2022 but  ...  view the full minutes text for item 24.

The Board considered a report of the Director of Children and Family Services, Leicestershire County Council, which provided an update on the delivery of the ‘best start for life’ priorities of the Joint Health and Wellbeing Strategy which sits with the Children and Families Partnership Plan 2021 - 23. A copy of the report marked ‘Agenda Item 10’ is filed with these minutes.

Arising from discussion the following points were noted:

i)             It was confirmed that sustainability was being built into the Children and Family Hubs model.  Some services provided from the Hubs, such as maternity support, would move into ‘business as usual’ and could be provided by volunteers.  The website would need ongoing maintenance and this would be prioritised.

ii)            It was confirmed that the Children and Families Partnership Plan and the Early Help Strategy, which was currently being developed, both aligned to the Joint Health and Wellbeing Strategy.  The priority areas were the same for all plans, although it was noted that the actions to deliver the priorities would be updated.

iii)           Evidence suggested that the increase in referrals for parental conflict were related to the cost-of-living crisis. Ongoing work was underway with the Police on categorisation for calls they attend to ensure accuracy in the reports that were produced. The wrong use of language, for example categorising the referrals as domestic abuse, could result in additional challenges for those accessing support.

RESOLVED:

That the progress in delivery of the Joint Health and Wellbeing Strategic Priorities that sit within the Children and Families Partnership Plan be noted. 

The Board noted a report from the Leicestershire and Rutland Safeguarding Adults Board which presented the Annual Report for 2022/23 and Business Plan for 2023/25. A copy of the report marked ‘Agenda Item 11’ is filed with these minutes. 

RESOLVED: 

That the Leicestershire and Rutland Safeguarding Adults Board Annual Report for 2022/23 and Business Plan for 2023/25 be noted.  

The Board considered a report from the Leicestershire and Rutland Safeguarding Children Partnership which presented the Annual Report for 2022/23 and the Business Plan for 2023/25. A copy of the report marked ‘Agenda Item 12’ is filed with these minutes. 

RESOLVED: 

That the Leicestershire and Rutland Safeguarding Children Partnership Annual Report for 2022/23 and Business Plan for 2023/25 be noted. 

The Board considered a report of the Director of Public Health, setting out his Annual Report for 2023, which presented data on the health of the population across Leicestershire.  A copy of the report marked ‘Agenda Item 13’ is filed with these minutes. 

The Director of Public Health offered to present his report in detail to partner organisations.  It was felt that this offer would be useful for the Integrated Care Partnership and that his report should be considered by the Partnership alongside the reports for Leicester City and Rutland. 

RESOLVED: 

a)    That the Director of Public Health’s Annual Report for 2023 be noted;  

b)      That the recommendations in the report setting out priorities for Public Health be noted;  

c)    That the Board’s own priorities for the medium term be considered in light of the findings in the report. 

The next meeting of the Health and Wellbeing Board will be held on 7 December 2023 at 2.00pm.

It was noted that the scheduled meeting on 7 December 2023 would be a development session for the Board. 

The next formal meeting of the Health and Wellbeing Board would take place on Thursday 29 February 2024 at 2pm.