Agenda and minutes

Apologies for absence were received from Councillor N H Pepper, Heather Sandy (Executive Director – Children's Services and Elaine Baylis (Lincolnshire Co-ordinating Board).

The Board noted that Linda Dennett (Lead Nurse, Children's Services) had replaced Heather Sandy (Executive Director – Children's Services) 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 1 December 2020 be agreed and signed by the Chairman as a correct record.

(For the Board to consider actions arising from the previous meeting)

RESOLVED

          That the Action Updates presented be noted.

Further to the Chairman's announcements circulated.  The Chairman advised the Board of the sad news of the death of Michael Oliver, Chairman of the Board of Trustees at Linkage Trust.  The Chairman advised further that he would be sadly missed and that the Board's thoughts were with his family at this time.

RESOLVED

That the Chairman's announcements on pages 21 to 25 of the report pack be noted.

(To receive a report from Councillor Mrs Sue Woolley, Chairman of the Lincolnshire Health and Wellbeing Board and John Turner, Chief Executive, NHS Lincolnshire Clinical Commissioning Group, on the proposal to change the Health and Wellbeing Board's Terms of Reference to incorporate the functions of the Integrated Care System Partnership Board)

The Board gave consideration to a report which proposed changes to the Health and Wellbeing Board's (HWB) Terms of Reference to incorporate the functions of the Integrated Care System (ICS) Partnership Board.  The Board were reminded that discussion on this item had been deferred from the 1 December 2020 meeting, due to the publication of a consultation document on Integrated Care Systems (ICSs) by NHSEI on 26 November 2020.

The Board noted that the ICS guidance and the White Paper announced on 11 February 2021, built on the route map set out in the NHS Long Term Plan for health and care to join up locally around people's needs.

The Board was advised that the approach in Lincolnshire was to incorporate the functions of the ICS Partnership Board into the HWB; pages 28 and 29 provided a list of advantages for this approach, which included building on the strong partnership working of the HWB; continuing focus on the wider determinant of health; collaborative working; population health management and neighbourhood working; and the genuine desire across the health and care system to develop innovative ways of working.

Paragraph 1.3 advised the Board of the main changes to the HWB Terms of reference.  The main changes were in Section 2 Context, Section 3 Objectives, Section 4 Functions and Responsibilities, Section 5 Membership, Section 7 Accountability and Section 11 Quorum.  A copy of the revised Terms of Reference was provided in Appendix A to the report for the Board to consider.

The Board noted that subject to the HWB endorsing the changes, the revised terms of reference would then need to be reflected in the Council's Constitution and agreed by Full Council in the new municipal year.  It was noted further that the first meeting of the HWB under the new terms of reference was scheduled to take place on 8 June 2021.

In conclusion, it was highlighted that every area was required to have an ICS by April 2021, with an overarching board in place to provide a strategic steer and to oversee the work of the local integrated health and care system.  The proposal to incorporate the function of the ICS Partnership Board with the HWB would put Lincolnshire in a unique position and at the forefront of partnership working.

During consideration of this item, it was highlighted that district councils had been heavily involved in partnership working during the pandemic; and it was felt that district council representation on the Board should be increased to two representatives from one, to enable them to have more representation.  There was recognition that district councils had played a huge part throughout the pandemic.  Reference was also made to the fact that there were some 'dual hatters' on the Board representing both the county and the district.  It was highlighted that membership would be reviewed again in twelve months' time when, subject to legislation, the Clinical Commissioning Group was discontinued and the ICS came into effect.  The Board noted that the proposals put forward  ...  view the full minutes text for item 34a

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

The Chairman invited Derek Ward, Director of Public Health, to provide an update on the current Covid-19 position in Lincolnshire.

The Board was advised that the England infection rate was currently at 66 per 100,000 population; and that the Lincolnshire rate of infection had come down to 70 per 100,000 population (7 day rolling average up to 6 March 2021).  It was noted that there was some variance across Lincolnshire.

The Board noted that 70,000 Covid-19 tests had been carried out (up to 6 March 2021).

The Chief Executive of the Lincolnshire CCG extended his thanks to the Director of Public Health and his team for all their assistance throughout the pandemic.

The Board noted that 650,000 people over the age of 18 had been offered the vaccine; and that 300,000 had received their first vaccine.  It was noted that good progress was being made with the vaccination programme and that Lincolnshire was on target for the over 50's to have received their vaccination by the 15 April 2021; and for the whole adult population of Lincolnshire to have had their vaccinations by 31 July 2021.

During discussion, the Board raised the following comments:

·       If the seven day summary information was available to district councils.  Confirmation was given that all district councils had access to the information, through the restricted Share Point site;

·       How many people had refused to have the Covid-19 vaccination?  The Board was advised that only a small number of people had refused the vaccination in Lincolnshire;

·       The longer term effects of Covid-19.  The Board noted that there was a lot of complexity with regard to the longer term effects of Covid-19, as it was impacting people in different ways.  Assurance was given that clinical leads were doing lots of work with regard to this, as there were mental health issues as well as physical issues; and

·       Reassurance was given that Lincolnshire would meet the target set for 15 April 2021.

RESOLVED

          That the verbal update be received and noted.

(To receive a report from Derek Ward, Director of Public Health, which presents the Board with the Director of Public Health's Annual Report, which focusses on Covid-19 and the impact of the disease on health and wellbeing in Lincolnshire)   

The Chairman invited Derek Ward, Director of Public Health, to present this item to the Board.

Note: Councillor Mrs P A Bradwell OBE left the meeting at 2:47pm.

The Board was advised that Director of Public Health's Annual Report for 2020 focussed on Covid-19 and the impact of the disease on health and wellbeing in Lincolnshire.  Appendix A to the report provided a copy of the aforementioned annual report for the Board's consideration.

RESOLVED

That the Annual Report from the Director of Public Health be received and noted.

(To receive an update report from John Turner, Chief Executive, NHS Lincolnshire Clinical Commissioning Group, on the progress being made on the Integrated Care System in Lincolnshire)

The Chairman invited John Turner, Chief Executive, NHS Lincolnshire Clinical Commissioning Group, to present the item, which provided an update on the Integrated Care System (ICS).

The Board noted that a shared understanding had been reached with the NHSEI regional team concerning the proposed governance arrangements for the Lincolnshire ICS.  The Board was advised that the final submission of the Lincolnshire ICS designation application was made on 15 February 2021 and that it was anticipated that designation would be received by April 2021.

During consideration of the item, it was highlighted that Lincolnshire had learnt a lot from the pandemic, and that the learning, innovation and community involvement needed to be maintained as part of the ICS.

RESOLVED

          That the Integrated Care System Update report as presented be noted.

(To receive a report from Dr Kakoli Choudhury, Public Health Consultant and Shabana Edinboro, Acting Programme Manager, Public Health, which advises the Board on the progress being made towards the implementation of the Suicide Prevention Action Plan)

The Chairman invited Dr Kakoli Choudhury, Public Health Consultant, to present the report, which advised of the progress made towards the implementation of the Suicide Prevention Action Plan.  A copy of the Action Plan was detailed at Appendix A to the report for the Board's consideration.

The Board noted that the Strategy and Action Plan had been produced in collaboration with the Suicide Prevention Steering Group, which was a system-wide, multi-agency partnership consisting of statutory and non-statutory organisations.  Details of the progress made on delivery of the action plan were provided on page 70 of the report pack.

Overall, it was noted that progress on the action plan had been good, despite the pandemic.  The Committee noted further that the majority of actions were on target.  Two actions shown in 'Red' on the action plan 1.2 – Identify/develop clear pathways of support for both individuals and professionals and 4.2 – Develop Real Time Surveillance  were behind target, mainly as a result of the re-deployment of staff into the Covid-19 response; and that their delivery dates would need to be adjusted.  It was also highlighted that it was planned to contract 4.2 out for a short period of time. The Committee was advised that the one action 4.1 – Explore alternative data sources to gather intelligence to aid prevention of suicidal behaviours shown as being 'Yellow' was behind target as a result of the current time commitment of Intelligence Teams across the system on the Covid-19 response; and as a result of this, the delivery date might have to change.

During consideration of this item, one member enquired whether the number of deaths by suicide had increased during the pandemic.  The Board was advised that there had not been an increase in the number.  A further point raised was whether there was data available to identify those individuals who had been near misses, as those individuals were likely to need further help and support.  The Board noted that near misses did pose challenges as two thirds of them did not enter mental health services, as not all had mental health issues.  There was recognition that there needed to be a whole approach which looked at mental health and wellbeing.

RESOLVED

That the report presented be received and noted and that support be given to the work the Public Health Division are leading on for Suicide Prevention.

(To receive a report from Sarah Connery, Acting Chief Executive, Lincolnshire Partnership NHS Foundation Trust, which provides the Board with a summary of the 'Reforming the Mental Health Act White Paper' and details of the consultation questions)

The Chairman invited Sarah Connery, Acting Chief Executive, Lincolnshire Partnership NHS Foundation Trust (LPFT), and Lorraine Graves, Interim Head of Mental Health Services, to present the item, which provided the Board with a summary of the Reforming the Mental Health Act White paper and details of the consultation questions.

Note: Councillor C E H Marfleet joined the meeting at 15:10pm.

The Board was advised that the White Paper proposed a substantive programme of legislative reforms to give people greater control over their treatment; and to ensure that people were treated with dignity and respect.  It also included steps to improve how people with a learning disability and autistic people were treated in law and reduce the reliance on specialist inpatient services for this group.

Note: Councillor R J Kendrick left the meeting at 15:13pm.

The White paper also included a series of questions on the implementation and impact of the proposed reforms, which the government was seeking views on (Appendix 2).  It was noted that the consultation concluded on 21 April 2021.

Attached to the report for the Board's consideration were the following Appendices:

·       Appendix 1 – provided a summary of the key proposals in the Reforming the Mental Health White Paper;

·       Appendix 2 – provided a list of the consultation questions;

·       Appendix 3 – provided a copy of the proposed Lincolnshire Health and Care System response to the consultation.  (this was a 'To Follow' document, which  was circulated to the Board prior to the meeting)

It was noted that Appendix 3, the proposed Lincolnshire health and care system response had been compiled with input from LPFT, the County Council, the NHS Lincolnshire Clinical Commissioning Group, East Midlands Ambulance Service, Lincolnshire Police, primary care, third sector, voluntary sector and wider community services.  The Board was advised that there had been positive feedback and that the system had responded swiftly to agree a joint consultation response.

The Board were very supportive of the changes the White Paper proposed and to the Lincolnshire health and care system response to the consultation. 

The Chairman agreed to write separately in support of the system response.

RESOLVED

1.    That the content of the briefing note and consultation questions in Appendices 1 and 2 to the report be noted.

2.    That the proposed system response to the consultation as detailed in Appendix 3 be noted and approved.

Note: Marc Jones (Police and Crime Commissioner) left the meeting at 3:22pm.

(To receive a presentation from Sarah Connery, Acting Chief Executive, Lincolnshire Partnership NHS Foundation Trust, which updates the Board on Mental Health Services in Lincolnshire)

The Chairman invited Sarah Connery, Acting Chief Executive, Lincolnshire Partnership NHS Foundation Trust (LPFT), to provide a presentation on Mental Health Services in Lincolnshire.  A copy of the presentation slides were contained in the report pack on pages 107 to 116.

The presentation provided the Board with information as to the number of people serviced by the Trust in Lincolnshire and North East Lincolnshire.

The presentation advised the Board of the following:

·       that the Trust's overall ratings were 'Good';

·       that the Trust operated from 50 locations;

·       that the Trust had a total of 220 in-patient beds;

·       that the Trust's income was approximately £115 million;

·       that the Trust had 50,000 service users;

·       that the Trust employed 2,500 staff; and had 10,000 members.

The services the Trust provided were in four broad categories which were: Adult inpatient and urgent care, Adult community; specialist; and older people and frailty.  It was highlighted that the Trust's vision was 'To support people to live well in their communities'.

The Board was advised that during the Covid-19 pandemic there had been reduced capacity and that teams had been innovative in dealing with demand, having safety as their first priority.

The Board was advised of the emotional wellbeing helpline open to all Lincolnshire health and care staff, the steps2change talking therapies; the mental health advice line for professionals; and the Who's looking after you information available to support health and care staff in Lincolnshire.

In conclusion, it was noted that due to the increased demand that had been driven by Covid-19, more was being done to transform mental health services, with reference being made to the Lincolnshire Community Mental Health Transformation.

During consideration of this item, the Board made reference to the importance of social interaction, the stigma attached to mental health issues; and the need for quick referrals.  The Board noted that there was provision for self-referral or referral through the GP.  The Board noted further that a person going through the Step2Change referral could be waiting up to 18 weeks.  Reassurance was given that the individual would be given a suite of tools to use during this time, after assessment but before treatment; and that they would be signposted as to what to do if their condition was to escalate.

RESOLVED

That the presentation on Mental Health Services in Lincolnshire be received and noted.

(To receive an update report from Derek Ward, Director of Public Health, on the progress made towards implementing a Population Health Management approach in Lincolnshire)

RESOLVED

That the Implementing a Population Health Management Approach in Lincolnshire report be noted.

(To receive a report from Gareth Everton, Head of Integration and Transformation, which confirms the national requirements for the Better Care Fund 2021/22) 

RESOLVED

          That the Better Care Fund 2021/22 report presented be noted.

(For the 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 a copy of the Lincolnshire Health and Wellbeing Board Forward Plan for the period March 2021 to December 2021)

RESOLVED

That the Lincolnshire Health and Wellbeing Board Forward Plan presented be noted.