Agenda and minutes

RESOLVED

That Councillor Mrs S Woolley (Executive Councillor for NHS Liaison, Community Engagement, Registration and Coroners) be elected Chairman of the Lincolnshire Health and Wellbeing Board for 2022/23.

COUNCILLOR MRS S WOOLLEY IN THE CHAIR

RESOLVED

That John Turner (Chief Executive of NHS Lincolnshire Clinical Commissioning Group) be elected Vice-Chairman of the Lincolnshire Health and Wellbeing Board for 2022/23.

Apologies for absence were received from Councillor Mrs P A Bradwell OBE, (Executive Councillor Children’s Services, Community Safety and Procurement), Dr Gerry McSorley (Chair - NHS Lincolnshire CCG), Dr Sunil Hindocha (Chair – Primary Care Network Alliance), Sarah Connery (Chief Executive – Lincolnshire Partnership Foundation NHS Trust), Sarah Fletcher (Healthwatch Lincolnshire) and Julia Debenham (Lincolnshire Police).

It was reported that Pauline Mountain (Healthwatch Lincolnshire) had replaced Sarah Fletcher (Healthwatch Lincolnshire) on the Board for this meeting only.

The Board was also advised that Philip Clark (Deputy Police and Crime Commissioner) was to be the representative for the office of the Police and Crime Commissioner and Julia Debenham was the now the representative for Lincolnshire Police.

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 29 March 2022 be agreed and signed by the Chairman as a correct record.

RESOLVED

              That the Action Updates presented be noted.

The Chairman advised that an inaugural meeting of Integrated Care Partnership (ICP) Chairs had taken took place during the last week and that it was evident from the meeting that no two systems in the country were the same.  It was also felt that the approach adopted previously by Lincolnshire to link in with the Health and Wellbeing Board was still one that was being discussed.

The Board was also advised of a meeting early in the day for ICP Chairs and Chairs elect, at which Claire Fuller a GP from West Sussex had reported back on the position regarding GPs and primary care.

The Chairman invited comments relating to the Joint Health and Wellbeing Strategy Assurance Update – May 2022 detailed in Appendix A of the Chairman’s Announcement on pages 19 to 46 of the report.  No comments were received.

RESOLVED

              That the Chairman’s announcements presented be noted.

(To receive a report from Alison Christie, Programme Manager, Public Health, which asks the Board to endorse the changes to the Terms of Reference, Procedural Rules and Board Member’s Roles and Responsibilities and to recommend the changes to the Council meeting on 16 September 2022)

Consideration was given to a report from Alison Christie, Programme Manager, Public Health, which advised the Board of its duty to review its governance arrangements on an annual basis; and to agree to amend the Terms of Reference previously agreed at the 9 March 2021 meeting, to remove reference to the functions of the Integrated Care Partnership (ICP) from the Terms of Reference, following Royal Assent of the Health and Care Act 2022, which required the County Council and the newly formed Integrated Care Board to jointly establish an ICP as a statutory joint committee of the two bodies.  It was noted that the Health and Wellbeing Board (HWB) was a Committee of the County Council, and as such had a different legal status to the ICP, and the ICP had been given statutory responsibility to produce an Integrated Care Strategy for the area and was unable to pass that responsibility on to another body, therefore the HWB could not fulfil the role of an ICP.

A copy of the amended Terms of Reference and Procedural Rules along with Board Members Roles and Responsibilities were detailed in Appendix A to the report for consideration.

It was also highlighted that to ensure a focus on reducing equalities for the population across Lincolnshire, it was proposed to offer an opportunity of membership for the HWB to a representative from Higher Education and the Greater Lincolnshire Local Enterprise Partnership to become Associate Members of the Board.

Reference was also made to the workshop held on 26 April 2022 regarding the development of Lincolnshire’s ICP, at which details of the practicalities around the running of the ICP were proposed and these were detailed on page 39 of the report.

In conclusion, the Board were asked to endorse the governance documents and recommend the proposed changes to full Council on 16 September 2022, to enable the relevant changes to be made to the Council’s Constitution.

RESOLVED

1.      That the changes to the Terms of Reference, Procedural Rules and Board Member’s Roles and Responsibilities as detailed in Appendix A to the report be endorsed.

2.      That the changes be recommended to full Councill on 16 September 2022, to enable the relevant changes to be made to the Council’s Constitution.

3.      That the update on the development of Lincolnshire’s Integrated Care Partnership be noted.

4.      That the recommendation to extend Associate Membership to a representative from Higher Education and the Greater Lincolnshire Enterprise Partnership be endorsed.

(To receive a report from Gareth Everton, Head of Integration and Transformation, which asks the Board to approve the 2021/22 end of year Better Care Fund Final Report)

The Board considered a report from Gareth Everton, Head of Integration and Transformation, which asked for approval of the 2021/22 end of year Better Care Fund (BCF) Final Report.

The Board was advised that the end of year return had been submitted by the deadline of 17 May 2022, a PDF copy of the document was attached at Appendix A to the report.  It was agreed that a full copy of the Excel spreadsheet of the return would be circulated to members of the Board after the meeting.

It was noted that for the last four years the national BCF planning, and assurance framework had been ‘rolled on’ with the planning framework and reporting requirements being confirmed within year, and that for the period 2022/23 there was no indication that this would change.  The Board was advised that it had been suggested that 2022/23 could be seen as a further roll on year, with only minor changes to the framework, with a longer term BCF planning framework to follow in 2023/24.

It was reported that discussions were ongoing with the Government regarding the future of the BCF and its association with the recently published White Paper.

The Board noted that Disabled Facility Grants (DFG) formed part of the BCF allocation and that on 10 May 2022 confirmation had been received that the DFG for 2022/23 would remain the same as the previous year, just below £7m for Lincolnshire and that funding would continue to rise over the next three years.  Confirmation details of this were shown in Appendix B to the report in a letter from the Department for Levelling Up, Housing and Communities.

The Chairman extended thanks to Councillor Bowkett and the Health and Housing Care Delivery Group for all their work with the DFG.

RESOLVED

              That the 2021/22 end of year Better Care Fund return be approved.

(To receive a report from John Turner, Chief Executive NHS Lincolnshire CCG, which provides the Board with an update on the development of the Integrated Care System)

The Board considered a report from John Turner, Chief Executive NHS Lincolnshire Clinical Commissioning Group (CCG), which provided an update on the development of the Integrated Care System.  

Reference was made to the Health and Care Act 2022 and the requirement for ICS’s to have two statutory functions, which were to have an Integrated Care Board (ICB) to improve population health and care as well as the functions currently being performed by the CCG being conferred onto ICB’s; and to have an Integrated Care Partnership (ICP), a joint Committee of organisations and representatives to improve the care, health and wellbeing of the population.  Reference was also made to the ICB Constitution; ICB recruitment, details of which were shown on pages 84 to 86 of the report.

The Board was advised that the ICP was a statutory function required to be in place in each ICS; and that a key early focus of the ICP would be the development of a five year Integrated Care Strategy, which needed to be completed by December 2022.  It was highlighted that the formal process for establishing the ICP would commence on 1 July 2022 when ICSs became statutory.  The Board noted that progress was already underway with the development of the Terms of Reference and membership of the ICP; and plans were being made to refresh the Health and Wellbeing Strategy (HWBS) in 2022 to inform the ICB Strategic Plan for 2023.

During consideration of this item, the Board raised some of the following comments:

·       The need to make sure that members of the public were aware of the changes from 1 July 2022, and that these were communicated in a positive manner; and to make sure that all the media for the ICS was joined up to ensure the correct picture was portrayed;

·       To ensure that meetings of the ICP, ICB were held in public.  Confirmation was given that meetings would be held in public;

·       The need for the ICS to improve health and care for the population of Lincolnshire; reduce wating lists and times; improve patient flow and improve connectivity; and

·       The need for all organisations to work together in Lincolnshire, to avoid duplication to get the best outcomes for the population of Lincolnshire.

RESOLVED

              That the current position in relation to the ICS legislation be noted.

(To receive a report and presentation from Emma Tatlow, Chief Executive, Active Lincolnshire, which provides the Board with an update on the refreshed physical activity strategy for Lincolnshire. Lorna Leach, Director of Transformation – Active Lincolnshire will also be in attendance for this item)

Consideration was given to a report and presentation from Emma Tatlow, Chief Executive, Active Lincolnshire which provided the Board with an update on the refreshed physical activity strategy for Lincolnshire.

The presentation made reference to:

·       The Let’s Move Lincolnshire Strategy timeline and delivery model national alignment with local need across six strands;

·       Ensuring there was connection with health and wellbeing;

·       Activity levels across Lincolnshire;

·       The Let’s Move Lincolnshire focus;

·       Tackling Inequalities to ensure access to activities and opportunities were available to all in Lincolnshire;

·       Workforce development 2022/27;

·       To have connected systems to provide intensive support for specific pathways;

·       Narrative building by growing the Lincolnshire evidence base to inform decisions making,

·       Connect partners and create consistent messages; and

·       Active Lincolnshire’s current work in Health. 

In conclusion, it was highlighted that there was a significant opportunity to scale up the work across system partners to influence and better embed options to be active across the system to have a real long term sustainable impact in Lincolnshire.

During discussion, the Board made some of the following comments:

·       Communication with the Education System.  The Board noted that one of the key themes was around children and young people and making sure that every child and young person experienced the enjoyment and benefit of being active could bring to them.  It was noted that the focus would be on educational settings, parents/carers and digital, as key influences and enablers.  It was noted that some work would be done with the Council to help educate children and young people to get involved in activity.  It was noted further that there was a need for the provision of safe spaces in communities for this to happen;

·       The challenge of getting the population encouraged and mobilised in activities, ‘Health by Stealth’. Some examples given were being able to meet new friends and explore the Wolds; where safe to do so cycling to school and encouraging influencing partners to build physical activity back into a person life;

·       Access to facilities especially in the more rural communities. It was suggested that sessions targeted a range of individuals with similar issues/concerns/goals to help with the continuity of an activity and the motivation of individuals attending;

·       The need for a platform to promote community settings, so that all parties involved where able view to see what was available in the local community;

·       Support was extended for the presentation and to the good work being done already and the potential for further integrated offers i.e., active hospitals and GP practices; and

·       The need to ensure that all communities get involved.

The Chairman on behalf of the Board extended thanks for the presentation.

RESOLVED

That the direction of the Let’s Move Lincolnshire – Physical Activity Strategy refresh and specifically the health and wellbeing outcome be received.

(To receive a report from Andy Fox, Consultant Public Health, which provides the Board with an overview of the 2020/21 National Child Measurement Programme data and Lincolnshire’s plans for addressing this issue)

The Board considered a report from Andy Fox, Consultant Public Health, which provided an overview of the 2020/21 National Child Measurement Programme (NCMP) data and Lincolnshire’s plans for addressing the issues.

In guiding the Board through the report reference was made to the national picture which had seen a sharp increase in the prevalence of childhood obesity, particularly amongst the most deprived areas and the potential impact for Lincolnshire, with Lincolnshire historically having slightly higher levels of childhood obesity than the national average.  Table 1 on page 110 provided percentage point increases in obesity and severe obesity, England 2020/21; and Table 2, on page 110 provided the Board with information relating to the difference in percentages of obesity and severe obesity between the most and least deprived areas.  It was highlighted that severe obesity in deprived areas had not been expected to have been nearly six times higher in the most deprived areas than in the least deprived areas and that this represented a significant, and worsening, inequality in health.

To help address the situation in Lincolnshire, the Board was advised that the County Council’s Public Health Division was developing a new Child & Family Weight Management Service (CFWM), which would be delivered via the Integrated Lifestyle Service, and that funding had been ringfenced, and agreed to enable this to be piloted for a two year period.  It was reported that the service was to commence in the summer of 2022.  The pilot would supplement the support provided by schools, and via the 0-19 Children’s Health Service, and provide a referral route for children identified as being overweight. 

Attached at Appendix A to the report was a copy of the 2019/2020 NCMP Lincolnshire data summary; and Appendix B provided a copy of the draft service specification for the Lincolnshire Child and Family Weight Management Service for the Board to consider.

The Board was also advised that the CFWM provider, One You Lincolnshire, were working closely with the Council’s NCMP team to ensure a seamless referral into the service.  It was noted that the CFWM service would work with a range of referral partners, including schools, GPs, and paediatric services, which would help support the development of a ‘whole system’ approach to childhood obesity in the county.

It was highlighted in addition to delivering the CFWM, the Council provided several other services, which included Family Hubs and Children’s Centres who could play an important role in addressing childhood obesity through family based support.  The Board was also advised that over the next three years the Council would be expanding the county’s Holidays Activities and Food programme for school children up to year 11 who were in receipt of free-school meals.

During consideration of this Item, the Board raised some of the following comments:

(Note: Glen Garrod left the meeting at 3.53pm).

·       Support was extended for the service, and for the need to be able to motivate children and young people to bring about change in their life at an early stage;

·       The  ...  view the full minutes text for item 9c

(For the Board to note decisions taken since June 2021)

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 14 June 2022 to 27 September 2022)

RESOLVED

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