Agenda and minutes

Venue: Committee Room One, County Offices, Newland, Lincoln LN1 1YL

Contact: Rachel Wilson  Democratic Services Officer

Items
No. Item

27.

Apologies for absence/Replacement Members

Minutes:

Apologies for absence were received from Debbie Barnes OBE (Head of Paid Service), Glen Garrod (Executive Director of Adult Social Care), Dr Sunil Hindocha (Lincolnshire West CCG) and Elaine Baylis (Lincolnshire Co-ordinating Board).

28.

Declarations of Members' Interest

Minutes:

There were no declarations of interest at this point in the meeting.

29.

Minutes of the Lincolnshire Health and Wellbeing Board meeting held on 11 December 2018 pdf icon PDF 168 KB

Minutes:

RESOLVED

 

            That the minutes of the meeting held on 11 December 2018 be signed by the Chairman as a correct record.

30.

Action Updates from the Previous Meeting pdf icon PDF 384 KB

Minutes:

RESOLVED

 

            That the completed actions, as detailed in the report, be noted.

31.

Chairman's Announcements pdf icon PDF 155 KB

Minutes:

An additional Chairman's announcement in relation to suicide prevention was circulated.  The Chairman also advised that she had visited a number of districts with the Director of Public Health presenting the refreshed Joint Health and Wellbeing Strategy for Lincolnshire, and had recently visited Boston.  The Strategy was being well received.

 

It was also reported that the methadone substitute, Buprenorphine, used to treat substance misuse, had recently seen an up to 700% increase in price, and Public Health was responsible for the delivery of the drug and alcohol services.  This price increase would eat into the budgets.  The County Council had no say on what the market value of this drug was.  The NICE guidelines stated that this drug had to be provided in the right circumstances.  It was emphasised that the authority was doing the right thing in terms of providing treatment, but that there was no control over the prices.  It was highlighted that this increase was not exclusive to Lincolnshire, and it was a nationwide issue.  The CCG's, health representatives and the PCC were all urged to push back and challenge this price increase where possible.

 

The Chairman also advised that she had been made aware of an issue in relation to the provision of continence pads to residential care homes, which should be provided by the NHS.  It had been reported that this was not happening in a timely manner in some places.  It was unclear whether this was an ordering or delivery issue.  It was requested, if anyone on the Board had any influence in this matter, could they please look into it.  John Turner advised that he would pick this up. 

32.

Discussion Items

33.

NHS Healthy Conversation 2019 pdf icon PDF 418 KB

(To receive a report from John Turner, Chief Officer, South Lincolnshire Clinical Commissioning Group (on behalf of the Sustainability and Transformation Partnership) on the plans to engage with partners, staff and the public on service changes during 2019)

34.

NHS Long Term Plan and Lincolnshire's Planning/Intentions for 2019/20 pdf icon PDF 313 KB

(To receive a report from John Turner, Chief Officer, South Lincolnshire Clinical Commissioning Group (for Lincolnshire CCGs), which provides an overview of the NHS Long Term Plans and asks the Board to review the commissioning intentions for 2019/20 against the priorities in the Joint Health and Wellbeing Strategy)

Minutes:

It was suggested that the NHS Healthy Conversation 2019 and NHS Long Term Plan and Lincolnshire's Planning/Intentions for 2019/20 items were considered as one as there would be overlapping information.

 

John Turner, Chief Officer, South and South West Lincolnshire Clinical Commissioning Group, presented reports to the Board and provided updates in relation to the NHS Healthy Conversation 2019 and NHS Long Term Plan and Lincolnshire's Planning/Intentions for 2019/20.

 

It was reported that in the three to four months leading up to 5 March 2019 (launch of the Healthy Conversation 2019) a number of conversations had been held with the Health Scrutiny Committee for Lincolnshire, this Board, County and District Council colleagues as well as other partners.  The NHS had been preparing to start an open conversation in very broad terms on the direction for the county.  Work had been taking place on this for a significant amount of time.  In early January 2019, the NHS Long Term Plan was launched.  Planning discussions had been taking place over the past year or so.  The Healthy Conversation 2019 had now started and was an open engagement exercise which was running across the county.  The approach being put forward included things that a lot of partners were already doing and it was highlighting a lot of good examples of changes.

 

Board members were encouraged to look at the website which had been set up as there was a large amount of information available which was presented in a user friendly way.

 

Health colleagues were starting to think about what the next stage of the engagement activity would look like, as there was a lot of information coming in, and it was planned to deal with it according to area as there would be different issues for different localities.  The Healthy Conversation 2019 was planned to run into the autumn.

 

It was expected that there would be more work around prevention and how to keep people as healthy as possible including work around self-care.  There would be a stronger emphasis on developing integrated community care services.  Acute hospital services should be there to provide specialised care that it was not possible to provide in the community.  There would be a push towards system working as the NHS was very fragmented, both in the services it provided and the way it worked with partners.  There would be work to move towards becoming an integrated care system and working more systematically with partners.  Partnership and collaboration would be much stronger going forward.

 

Health colleagues were required by NHS England and NHS Improvement to produce a local version of the Long Term Plan for the County.  This had to be informed by open discussions with people who used the services and partners and so it was timely that the Healthy Conversation had just commenced.

 

Members of the Board were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion  ...  view the full minutes text for item 34.

35.

Neighbourhood Working pdf icon PDF 936 KB

(To receive a report from Sarah Jane Mills, Chief Operating Officer, Lincolnshire West CCG (on behalf of the Sustainability and Transformation Partnership) on the development of Neighbourhood Teams across Lincolnshire)

Minutes:

Consideration was given to a report by Sarah-Jane Mills, Chief Operating Officer, Lincolnshire West CCG, which provided the Board with an update on the development of neighbourhood working in Lincolnshire.  It was reported that stakeholders across Lincolnshire had all agreed that the default location for providing care and treatment should be the community unless there is a clinical need for an economic case for it to be delivered in an acute hospital setting.

 

It was also reported that this approach was about preventing people from becoming unwell, and how health organisations could work with partners and other agencies to tackle some of the root causes of poor health.  Another aspect which would be looked at would be the age up until people were living well (healthy life years), for example, in Gainsborough people were expected to be living with at least one long term condition by the age of 58.

 

There was a need to build resilient communities and it was queried how this could be done.  It was noted that the neighbourhoods were built around a geographical framework and there were 12 neighbourhoods with 10 neighbourhood leads.  The role of the Neighbourhood Lead was about bringing teams together to support the local population.  The Multi-Disciplinary Team (MDT) was not just social care representatives, but also included the Police and the Fire Brigade.  Social prescribing would look for opportunities to connect people with systems, and this could be a variety of services including voluntary organisations, for example breakfast clubs.

 

Arrangements for supporting people with complex needs were also being built, whilst this would be a relatively small number of patients, the impact it could have would be significant.  There were a few examples highlighted in the report.

 

Social prescribing was a really important part of the approach going forward, however, it was noted that this was not a new concept, but it was not currently consistent throughout the county.  It needed to be determined what the core things were which should exist in every community, and these core requirements should be signed off in the coming months.

 

The Board was advised that Stamford was a very good example of neighbourhood working, and work was currently taking place with colleagues in Public Health.  There was a need for safeguards to be in place for information governance and sharing of records etc.

 

The Board was provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         In relation to the Spalding Neighbourhood Team, it was noted that there had been some really good case studies.

·         It was confirmed that there were information sharing agreements in place where appropriate.  However, it was important to note that the information was not the GP's information. It was the patients information to share.

·         It was highlighted that it had taken four years to get to this point.  There was a greater need to get something up  ...  view the full minutes text for item 35.

35a

Implementing the NHS Long Term Plan - Proposals for possible changes to legislation pdf icon PDF 368 KB

(To receive a report by Alison Christie, Programme Manager Health and Wellbeing, which asks the Board to consider whether a response to the 'call for views' should be produced following its launch by NHS England on 28 February 2019)

Minutes:

Consideration was given to a report by Alison Christie, Programme Manager, which advised the Board that on 28 February 2019, NHS England (NHSE) had launched a 'call for views' on potential proposals for changing current primary legislation relating to the NHS.  The document stated that it was possible to implement the NHS Long Term Plan without primary legislation, but legislative change could make implementation easier and faster.  The closing date for the submission of responses was 25 April 2019.

 

It was queried whether the Board would like a response to be sent on its behalf and if so this would be put together by Alison Christie and Derek Ward.    There was agreement by the Board that a response should be sent.

 

RESOLVED

 

            That the Lincolnshire Health and Wellbeing Board respond to the 'call for views' and agreed that a response should be drafted by Alison Christie (Programme Manager) and Derek Ward (Director of Public Health).

36.

Information Items

37.

Better Care Fund Update pdf icon PDF 441 KB

(To receive an information report from Steve Houchin, Head of Finance – Adult Care and Community Wellbeing, which provides the Board with a quarterly finance and performance update on Lincolnshire's BCF Plan 2017/19)

Additional documents:

Minutes:

Consideration was given to a report by Steve Houchin, Head of Finance - Adult Social Care, which provided an update to the Lincolnshire Health and Wellbeing Board on Lincolnshire's (Better Care Fund) BCF plan for 2017 – 2019.  A finance and performance update showing the current position and an update in relation to 2019/20 BCF arrangements was also included within the report.

 

It was reported that 2019/20 would be the final year of the BCF in its current form.  Officers were still waiting for clarity on what form it would take after this date.  The estimate for the amount of funding that would be received for 2019/20 had been received and details were included within Appendix A of the report.  This funding would be in the region of £246m compared to £232m for 2018/19.  However, this was still subject to confirmation.

 

RESOLVED

 

            That the Lincolnshire Health and Wellbeing Board note the BCF update report.

38.

An action log of previous decisions pdf icon PDF 406 KB

(For the Health and Wellbeing Board to note decisions taken since June 2018)

Minutes:

The Board received a report which noted the decisions taken since December 2018.

 

RESOLVED

 

            That the report for information be received

39.

Lincolnshire Health and Wellbeing Board Forward Plan pdf icon PDF 492 KB

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

Minutes:

The Board received and considered a copy of its Forward Plan.

 

RESOLVED

 

            That the report for information be received.

 

 
 
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