Agenda and minutes

Apologies for absence were received from Councillors Mrs P A Bradwell OBE (Executive Councillor Adult Care, Health and Children's Services), R J Kendrick, C N Worth (Executive Councillor Culture and Emergency Services), Marc Jones (Police Commissioner) and Mike Hill (Healthwatch Lincolnshire).

The Committee noted that Joanne Davison, (Partnerships and Delivery Manager) was replacing Marc Jones, (Police Commissioner) for this meeting only.

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

RESOLVED

That the minutes of the Lincolnshire Health and Wellbeing Board meeting held on 9 June 2020 be agreed and signed by the Chairman as a correct record.

RESOLVED

          That the Action Updates presented in the report be noted.

RESOLVED

          That the Chairman's Announcements as presented be received.

(To receive a report from Derek Ward, Director of Public Health, which asks the Board to agree proposals to review the purpose and membership of the Lincolnshire Health and Wellbeing Board. Alison Christie, Programme Manager and Steve Bedser, Local Government Association Consultant will be in attendance for this item)

The Chairman invited Alison Christie, (Programme Manager Strategy and Development) and Steve Bedser, (LGA Consultant) to present the report to the Board.

The Board noted that the Lincolnshire Health and Wellbeing Board's (HWBs) last review had been conducted in 2017.  The Board noted further it was therefore felt, as there had been a number of significant changes in the last eighteen months in the local health and care system, the HWB should undertake a further review of its purpose, terms of reference and membership.

Details of the proposed review were shown at paragraph 1.2 of the report; and paragraph 1.3 provided the Board with details of the approach to be taken and the timescales allotted for the review.  The Board was advised that two workshops had been arranged, the first one to review the membership and purpose; and the second one to look into refocusing the Joint Health and Wellbeing Strategy priorities in light of Covid-19.

In conclusion, Board was advised that in line with the requirements of the Health and Care Act 2012, the review would seek the views of the Board members and wider partners.  It was highlighted also that any subsequent changes endorsed by the Board, which required changes to the Council's Constitution would need to be submitted to the Council for formal approval.

Detailed at Appendix A to the report was an extract from the Councils Constitution relating to the Lincolnshire Health and Wellbeing Board.

The Board was advised that the Chairman had accepted an offer from the Local Government Association (LGA) to work with the Board to review and refocus.  The Board was advised further that Steve Bedser (LGA Consultant) would be facilitating the review, details of which were shown on page 19 of the report.

During discussion, the Board raised the following points:-

·       The need to develop an integrated care system in Lincolnshire by 1 April 2021.  The potential for the Lincolnshire Health and Wellbeing Board being developed and evolved to become the Integrated Care System Board as well.  It was highlighted that at the moment this proposal was in its infancy stage, but it was felt that this would be a fresh and evolutionary way forward for Lincolnshire;

·       The need to focus on the priorities of the JHWS, particularly in light of Covid-19 and the impact it has had in Lincolnshire, and the impact on Lincolnshire residents;

·       Review of district council membership.  Reassurance was given that all partners would be able to take part in the review; and that the second planned workshop would be opened up to wider partners, to enable them to contribute to the review;

·       The need to review the JSNA in light of Covid-19. Some support was extended for the current JSNA and the need to make sure that it's focus was not lost;

·       Ensuring that the voice of Lincolnshire residents was included; and

·       Consideration of the role of the police; and links to the Safer Lincolnshire Partnership.

RESOLVED

That agreement be given by the Lincolnshire Health and  ...  view the full minutes text for item 15a

(To receive a verbal update from Derek Ward, Director of Public Health on the current Covid-19 position in Lincolnshire)

The Board received an update from the Derek Ward, (Director of Public Health), which set out the current situation for Lincolnshire in terms Covid-19 cases and testing.  It was reported that an increase in figures was being seen, and in the week to 25 September 2020, 8,500 tests had been carried out, with about 130 positive cases.  This gave a positivity rate of 1.5%. 

It was highlighted that a couple of weeks previously, Lincolnshire's increase in cases was mirroring the rest of the country, but indications were now saying that the number of new cases were slowing down again. 

It was noted that sadly there had been 269 deaths (in the Lincolnshire County Council area) up to 27 September 2020.

The Board noted further that as a county, Lincolnshire had fortunately seen some of the lowest rates in the in the East Midlands area.

During a short discussion, the members raised the following points:-

·       Whether the figures for Lincoln included some of the villages.  Confirmation was given that there were figures specifically for the City of Lincoln.  Confirmation was given that data had shown a higher rate in Lincoln and to the north of Lincoln.  The Board also noted that the data was available to district councils;

·       The need for better communication.  The Board was advised that the government was giving further consideration to messaging; and it was hoped that a simpler form of messaging would start in the next few weeks.  It was also noted that the Local Resilience Forum was also responding for the need for better communication; and

·       Whether the return of university students would have any effect on figures going forward.  The Board noted that currently the universities were receiving advice and support; and that a university testing centre would soon be available for all students on campus.

RESOLVED

          That the verbal update from the Director of Public Health be received.

(To receive a report from John Turner, Chief Executive of NHS Lincolnshire Clinical Commissioning Group (CCG), which provides the Board with an update on the new arrangements relating to NHS Lincolnshire Clinical Commissioning Group)

The Board received a report from John Turner, (Chief Executive, NHS Lincolnshire Clinical Commissioning Group (CCG)), which provided the Board with an update on the new arrangements relating to the NHS Lincolnshire Clinical Commissioning Group.

The Board noted that the new NHS Lincolnshire CCG had been established on 1 April 2020 and that the new CCG was coterminous with the boundaries of Lincolnshire County Council.  The Board noted further that the new CCG received an annual budget of almost £1.3bn, with which it commissioned services on behalf of the registered GP population of Lincolnshire.

It was highlighted that new CCG was a strategic commissioner, a role which was evolving nationally and locally in the context of the national NHS Long Tern Plan, the development of Integrated Care Systems, and the Coronavirus pandemic.

It was highlighted that the CCGs immediate focus was working with and supporting colleagues through Phase III NHS Recovery Planning, and winter; and continuing to work with colleagues in establishing an Integrated Care System by 1 April 2021; and in refreshing the Long Term NHS Strategy in line with the national Long Term Plan; and forthcoming Phase IV guidance.

RESOLVED

That the update report concerning NHS Lincolnshire CCG – new arrangements as presented be noted.  

(To receive a report from John Turner, Chief Executive NHS Lincolnshire Clinical Commissioning Group, which provides the Board with an update on the NHS response to the COVID-19 pandemic)

The Chairman invited John Turner, (Chief Executive of the NHS Lincolnshire CCG) to present the report, which provided the Board with an update on the NHS response to the Covid-19 pandemic.

The Board was made aware of the NHS England approach to the management of Covid-19.  Details of the four phases prescribed by NHS England were shown on pages 25 and 26 of the report.  The Board noted that Lincolnshire was currently in Phase 111, which was the full recovery and restoration of NHS services (from 1 August 2020 to, it was currently anticipated, 31 March 2021).

It was highlighted that Phase III guidance was very comprehensive, and that restoring NHS services as fully and as quickly as possible was a huge challenge to the NHS.  It was highlighted further that the NHS in Lincolnshire, staff and partners were all working hard and together in this endeavour.

The Board also noted that there was also a strong and welcomed emphasis being given to reducing health equalities, a role the Board had a strong interest in providing leadership in.  It was noted that within the East Midlands region the priority which has been given to health inequalities was reflected in the establishment of a Regional Strategic Transformation and Recovery Working Group on Health Inequalities, which both the Director of Public and the Chief Executive of Lincolnshire CCG were members of.

Page 26 and 27 of the report provided the Board with details as to how the NHS was aiming to meet the Phase III requirements.

Attached at Appendix A to the report was a copy of the letter of 31 July 2020 from NHS England relating to the Third Phase of NHS response to COVID-19.

During discussion, the Board raised the following points:

·       Appreciation was extended to the task ahead for the NHS over the next six months. The Board was advised that Lincolnshire had done well throughout the pandemic so far and that it was hoped going forward, this would continue.  It was noted that the welfare of NHS staff was paramount in getting Lincolnshire through the winter;

·       Timing of Flu vaccinations – The Board was advised that each CCG was required to have a Flu Plan; and that some GPs had already started their flu clinics, and that the rest would be starting their flu clinics in the next few weeks;

·       Available information concerning visiting arrangements at hospitals.  One member highlighted that from information received, the code system for visiting was not working very effectively;

·       Some concern was expressed that some care homes were still not allowing relatives to visit.  The Board noted that Lincolnshire had been fortunate so far in having low transmission levels in its care homes.  A contributing factor of this had been the Early Discharge Protocol. It was highlighted that the operational running of a care home was down to the home.  It was noted that some national care homes had adopted a no visitor approach;

·       Cancer treatment - The Board was advised that the  ...  view the full minutes text for item 16c

(To receive a report from John Turner, Chief Executive NHS Lincolnshire Clinical Commissioning Group, which updates the Board on a review of collaborative working during COVID-19 undertaken by the Care Quality Commission)

The Chairman invited John Turner, (Chief Executive of NHS Lincolnshire CCG) to present the report, which provided an update on a review of collaborative working during Covid-19 undertaken by the Care Quality Commission (CQC).

The Board was advised that for Lincolnshire, the review had been positive.  It was reported that the CQC had been impressed with everyone's engagement; and that the services in Lincolnshire had worked together and in support of each other in providing care to people.  Attached at Appendix A to the report was a copy of the feedback slides from the Care Quality Commission for the Board to consider.

RESOLVED

1.    That the Care Quality Commission Feedback on Provider Collaboration during the pandemic be received.

2.    That support be given by the Board to the approach taken in working together across the health and care system in the county.

(To receive a report from Glen Garrod, Executive Director, Adult Care and Community Wellbeing, which updates the Board on Lincolnshire's role as the rural strategic partner with the Centre for Ageing Better.  Sem Neal, Head of Prevention & Early Intervention, Public Health and Michelle Howard, Assistant Director People, East Lindsey District Council will be in attendance for this item)

The Chairman invited Semantha Neal, (Assistant Director, Prevention and Early Intervention) and Michelle Howard, (Assistant Director – People, East Lindsey District Council) to present the report.

Sem Neal, (Assistant Director, Prevention and Early Intervention), advised the Committee that the Centre for Ageing Better had conducted a national recruitment process to identify an appropriate rural strategic partner.  It was noted that the selection process had concluded in March 2020 and Ageing Better had confirmed that Lincolnshire had been selected as its preferred rural strategic partner. 

Detailed at Appendix 1 to the report was a copy of the Memorandum of Understanding between the Centre for Ageing Better, Lincolnshire County Council and East Lindsey District Council.  It also included proposed governance arrangements for the Board to consider.

The Committee was advised that Ageing Better's vision was for 'a society where everybody enjoys a good later life'.  Page 70 of the report provided the Board Ageing Better's Vision; and page 71 provided the Board with details of Lincolnshire's ambition and plans.

It was reported that a dedicated Programme Manager had now been appointed.

Also, attached to the report were the following Appendices:

·       Appendix 2 – Partnership Opportunities;

·       Appendix 3 -       Housing Proposals: Aids, Equipment and Adaptions;

·       Appendix 4 – Timeline;

·       Appendix 5 – Draft Commitment.      

Michelle Howard, (Assistant Director – People, East Lindsey District Council) advised the Board that the programme was for five years and provided the opportunity for Lincolnshire to prepare its residents for later life and to keep them active for longer.  The Board noted that Covid-19 had been a challenge for everyone, but provided the opportunity to look at the impact on people in their 50s and 60s to help shape priorities going forward.  Appendix 2 provided details of the four themes being taken forward, which were Healthy Ageing, Housing, Connected Communities and Employment.

Officers responded to questions raised which included the need to work with the community; and the need to help with access to employment and appropriate housing.  

RESOLVED

1.      That confirmation of the relationship between the Centre for Ageing Better and Lincolnshire, including the proposed governance arrangements be noted.

2.      That the vision and goals for the Partnership as detailed in the report presented be noted.

3.      That the developing priorities as detailed in the report presented be noted.

4. That each constituent member organisation of the Board to seek formal commitment from their organisation to work together to achieve the aims of the Partnership.

(To receive a report from Glen Garrod, Executive Director of Adult Care and Community Wellbeing, which provides the Board with an update on the Better Care Fund.  Gareth Everton, Head of Integration and Transformation, will be in attendance for this item)

The Executive Director of Adult Care and Community Wellbeing provided the Board with a brief overview of the report presented.

RESOLVED

        That the Better Care Fund (BCF) report presented be received. 

(For the Health and Wellbeing Board to note decisions taken since June 2020)

RESOLVED

          That the Action Log of Previous Decisions as presented be noted.

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

RESOLVED

That the Lincolnshire Health and Wellbeing Board Forward Plan up to 30 March 2021 as presented be noted.