Agenda and minutes

Apologies for absence were received from Councillors Mrs P A Bradwell (Executive Councillor for Adult Care, Health and Children's Services), N H Pepper (Support Councillor Culture and Emergency Services) and Dr P Holmes (Lincolnshire East CCG).

There were no declarations made at this stage of the meeting.

RESOLVED

          That the minutes of the previous meeting of the Lincolnshire Health and     Wellbeing Board held on 27 September 2016, be confirmed as a correct        record and signed by the Chairman.

(For the Lincolnshire Health and Wellbeing Board to consider the actions arising from the previous meeting)

The Board received an update of actions since the previous meeting of the Board on 7 June 2016.

A Board Member enquired about the reason for the delay in examining the Board's composition with regard to District Council membership. He requested that this matter should be brought forward for consideration. The Chairman stated that the ideal time to address the matter was after the County Council Election in 2017 as the Council might have new Members elected who would require training, support and added that the Board was a Committee of the Council.

RESOLVED

          That the report be noted.

(For the Lincolnshire Health and Wellbeing Board to note the Chairman's announcements)

The Board received a report in connection with the Chairman's announcements.

The Chairman drew attention to the details of letter she had sent to the Chief Executive of the United Lincolnshire Hospital Trust raising concerns about the level of emergency provision in the south of the county, in particular, the capacity of the Ambulance Service to be able to respond to any increase in demand. She stated that there had been a campaign in the south of the county about the lack of a proper ambulance service and its detrimental impact locally.

Comments by the Board and officers included a specific case of a patient from Grantham who had refused to be taken to Lincoln because of his concerns about getting back to Grantham and the Police had taken patients to hospital because there was no ambulance available. It was noted that the South Lincolnshire CCG was examining this issue because of the importance of this service.

RESOLVED

          That the report be noted.

(To receive a report from Alison Christie, Programme Manager Health and Wellbeing, which asks the Board to agree the Board's Assurance Report and Theme Dashboards)

The Board received a report in connection with the progress being made to deliver the outcomes in the Joint Health and Wellbeing Strategy. The progress was detailed on the Strategy's Scorecard and Theme Dashboard for 2015/16.

Discussion between the Board and officers included the following topics:-

·       There was a declining trend in the eight indicators which was welcome;

·         It was noted that cases of liver disease were increasing and there was a need to focus on the strategy to tackle this issue and for a partnership approach;

·         The elderly population was increasing rapidly and finding beds was becoming an issue. The strategy was going in the right direction but it was recognised that this issue was becoming more prominent;

·         Increased mortality amongst the under 75's was becoming an issue in some communities due to inappropriate life styles. It was noted that an audit of GP practices was being undertaken to assess the take-up of health checks;

·         The District representative queried the point in the report that the Board agreed to hold each other to account but there had been no discussion about at the Board about the decommissioning of services. The District representative was advised that the 2016/17 commissioning intentions for CCGs, Adult Care, Children's Services and Public Health     were discussed at the informal Health and Wellbeing Board meeting in February 2016, to which all District Councils were invited to attend. In addition, the CCGs Operational Plans for 2016/17 were formally presented to the Board in March 2017;

·         The Council had written to the Government about the reduction in funding for Public Health. It was hoped to address the reduction in funding of Public Health when local authorities had responsibility for setting their own priorities;

·         The challenge faced was where to direct preventive resources and how to prioritise these resources as there were no easy choices for the NHS or Local Authorities. There was a need to consult the public and other agencies to identify constraints and the alternative options available;

·         Elected Members faced election every four years and therefore there was a need to regularly examine priorities and the allocation of resources. Prevention was better than cure in the long term;

·         The statistics in Theme One for physical activity did not match those given by Sport England. Officers were unaware how Sport England had produced their statistics or whether it was possible to measure statistics down to a District Council level;

·         The presentation by The Sports Partnership was about the Sports England Strategy and their new arrangements on how funding was going          to be allocated. The Chairman stated that engagement had taken place around these new arrangements and not everyone was aware. Officers stated that they would check exactly what the Sports England document            was and get back to the Board;

·         Gainsborough Town Council had received funding from West Lindsey District Council to support football at youth level but this funding was coming to an end. Over 2,000 young people had been involved and the activity should be encouraged.  ...  view the full minutes text for item 16a

(To receive a report from David Stacey, Programme Manager, Strategy and Performance, which asks the Board to agree the prioritisation framework for the new Joint Health and Wellbeing Strategy; (JHWS) and to agree the process for developing the JHWS)

The Board received a report in connection with the need to agree the Prioritisation Framework for the development of the Joint Health and Wellbeing Strategy following a workshop held on 12 July 2016, involving members of the Board, partners and stakeholders.

Discussion between the Board and officers included the following topics:-

·    There was an error in the criteria within the table under Exercise 2 of

 Appendix A of the report. Officers agreed to change the Public Acceptability weighting from high to medium to correct this;

·    A similar error was included in Appendix B. Officers agreed to review weighting of all criteria in Appendix B to ensure the weighting of criteria in the Prioritisation Framework was correct;

·    The District Councils stated that the Prioritisation Framework accurately the findings from the workshop;

·    The Framework stood up to scrutiny and it was very good to show that comparisons had been made; and

·    The Board discussed whether the criteria covering "Magnitude of benefit" and "Number of people benefitting" should be combined into one criterion as recommended. It was agreed that these were two different things and, as such, should be separated back out into two criteria as originally proposed. Officers agreed to make the necessary changes to the Prioritisation Framework to reflect this.

RESOLVED

1.    That the feedback from the workshop on the Prioritisation Framework be noted and welcomed.

2.    That, subject to the amendments identified by the Board in Exercise 2 of Appendix B, for developing the next Joint Health and Wellbeing Strategy for Lincolnshire, the Prioritisation Framework be agreed.

(For the Board to receive an update report from Glen Garrod, Executive Director Adult Social Services with regard to the Better Care Fund; and Dr Sunil Hindocha, Chairman of the Joint Commissioning Board concerning the joint commissioning arrangements in Lincolnshire)

The Board received a progress report of Lincolnshire's Better Care Fund (BCF) 2016/17.

Officers highlighted various aspects of the report including potential changes to the BCF which were likely to be announced with the Comprehensive Spending Review in November. Disabled Facilities Grants was another issue in Lincolnshire as one District Council had requested their full funding allocation. The Joint Commissioning Board had recommended that the Health and Wellbeing Board should not release the full allocation although there was a risk that this action could lead to a further challenge by the District Council in question as the legal advice was that the available guidance was unclear and open to interpretation. Discussions were on-going with the District Council to secure consensus across the county and a focus on how best to use next year's allocation.

Discussion between the Board and officers included the following topics:-

·         Officers stated that the Delayed Transfer of Care (DTOC) performance was an ongoing challenge and that the national data indicated the worst performance for many years. Both acute and non-acute delays needed to remain a priority;

·    With regard to the issue raised in the report about the Disabled Funding Grant did the District Council concerned have its own housing stock as some Local Authorities allocated this responsibility to Housing Associations? Officers replied that the Council concerned did have its own housing stock;

·    Had officers spoken to the District Council concerned in connection with its funding issues? Officers stated that all of the District Councils had been informed about this matter;

·    The Board needed a consistent approach to all of the District Councils in connection with the Disabled Funding Grants;

·    What were the legal and financial implications for District Councils? Officers stated that the District Councils needed to hold a collective view on this matter so that a more efficient system could replace the current version where each District acted largely in isolation to each other; and

·    The narrative between BCF and the Sustainability Transformation Plan (STP) was important, notably in relation to future integration plans. There was a need to improve care provision to allow people to stay in their own home rather than in hospital and it was important to maintain this vision.

RESOLVED

1.    That the report be noted.

2.    That the recommendation of the Joint Commissioning Board not to accede to the request from the single concerned District Council in connection with their Disabled Fund Grant for 2016/17, be agreed.

(To receive an update report from Sarah Furley, Programme Director for the Lincolnshire Health and Care Sustainability and Transformation Plan, concerning the LSP/LHAC)

The Board received a progress report in connection with the Sustainability and Transformation Plan (STP).

Discussion between the Board and officers included the following topics:-

·         Planning for the STP had been on-going for the last two years;

·         Uncertainty about the ability of being able to transpose information from the Lincolnshire Health and Care Programme to the STP;

·         The public did not have enough information about the STP and there was a need to ensure that they were fully informed. Officers stated that it was proposed to consult the public and there had been a lot of consultation already. It was proposed to have an engagement plan to show how the STP would be delivered. The STP would be published before Christmas 2016 and there would be full engagement with the public;

·         How robust were the financial plans for the STP? Officers stated that there were two elements, one element for changing the requirement and secondly a judgement was required in connection with increasing the workforce as it was going to take a number of years to recruit staff; and

·         It was important that questions to the public should be kept simple as simple as it was a complicated subject.

RESOLVED

          That the report be noted.

(To receive by exception, updates from District/Locality partnerships on issues which may impact on the delivery of the Joint Health and Wellbeing Strategy. No items tabled for this meeting)

It was noted that there were not any District/Locality updates to report.

(For the Health and Wellbeing Board to note decisions taken since June 2016)

The Board received a report which gave details of decisions taken by the Board since its previous meeting held on 7 June 2016.

RESOLVED

          That the report be noted.

(This item provides the Board with an opportunity to discuss items for future meetings which will subsequently be included on the Forward Plan)

The Board received its Forward Plan. It was noted that the meeting of the Board scheduled for 28 March 2017, had been brought forward to 7 March 2017 because of the County Council Election.

The Chairman stated that this was Tony Hill's last meeting as he was retiring. She thanked him for his services to the Board and added that Tony had been at the forefront in establishing the Board and on behalf of the Board she wished him well in his retirement.