Agenda and minutes

Apologies for absence were received from Councillors Mrs P A Bradwell OBE, C E H Marfleet, Kevin Lockyer (Nominated Chair, representing NHS Providers in Lincolnshire) and Andrew Morgan (Nominated Chief Executive, representing NHS Providers in Lincolnshire).

It was noted that Karen Dunderdale (Director of Nursing Lincolnshire Community Health Services and United Lincolnshire Hospitals NHS Trust) had replaced Andrew Morgan (Nominated Chief Executive, representing NHS Providers in Lincolnshire) for this meeting only.

There were no declarations of members’ interest made at this point of the proceedings.

RESOLVED

That the minutes of the Lincolnshie Health and Wellbeing Board meeting held on 26 September 2023 be approved and signed by the Chairman as a correct record.

RESOLVED

              That the Action Updates presented be noted.

The Chairman extended thanks on behalf of the Board to Glen Garrod for his support and dedication as a long-standing member of the Health and Wellbeing Board, and for all his work in establishing good working relationships with health, and other organisations.

The Chairman also welcomed Martin Samuels, who had been recently appointed as the new Executive Director for Adult Care and Community Wellbeing.

RESOLVED

That the Chairman’s Announcements as detailed on pages 17 and 18 of the agenda pack be noted.

To receive a report from Councillor Wendy Bowkett, Executive Councillor for Adult Care and Public Health and Chair of the Lincolnshire Ageing Better Steering Group, which requests the Board to consider the proposal to incorporate the Lincolnshire Ageing Better Steering Group with the Housing, Health, and Care Delivery Group to form the Housing, Health and Ageing Well Delivery Group.  Anne-Marie Scott, Assistant Director, Prevention and Early Intervention will be in attendance for this item)

Consideration was given to a report from Councillor Wendy Bowkett, Executive Councillor for Adult Care and Public Health and Chair of the Lincolnshire Ageing Better Steering Group, which asked the Board to consider the proposal to incorporate the Lincolnshire Ageing Better Steering Group with the Housing, Health, and Care Delivery Group to form the Housing, Health, and Ageing Well Delivery Group.

Anne - Marie Scott, Assistant Director, Prevention and Early Intervention, presented the item to the Board; and during discussion the following comments were noted:

·       Support was extended to the work of the Lincolnshire Housing Health and Care Delivery Group and the Lincolnshire Ageing Better Steering Group and to the fact that both groups had moved forward the healthy living agenda, not just in the county, but also nationally; 

·       General support was extended for the proposal, but some concern was raised as to whether broadening the remit would have an impact on what needed to be achieved. Reassurance was given that it was the intention to refresh the delivery plan for the Housing Health and Care Delivery Group and to incorporate into that plan ageing actions; and 

·       It was highlighted that every care decision was also a housing decision and that bringing the two areas together, would enable the group to think in a more preventative way, to help older people maintain an independent life in their communities.

Appendix A, to the report provided a copy of the draft Terms of Reference for the proposed Housing, Health, and Ageing Well Delivery Group for members of the Board to consider.

The Chairman on behalf of the Board extended her thanks to the presenters.

RESOLVED

1.      That support be given to incorporating the Lincolnshire Ageing Better Steering Group with the Housing, Health, and Care Delivery Group to form the Housing, Health, and Ageing Well Delivery Group.

2.      That the draft Terms of Reference for the Housing Health and Ageing Well Delivery Group be agreed, subject to any minor amendments being made by the Group.

(To receive a report and presentation from Michelle Andrews, Assistant Director Integrated Care System – Public Health and Alison Christie, Programme Manager Strategy and Development – Public Health, which provides the Board with an update on the review of Lincolnshire’s Joint Local Health and Wellbeing Strategy)

The Board considered a report from Michelle Andrews, Assistant Director Integrated Care System – Public Health and Alison Christie, Programme Manager Strategy and Development – Public Health, which provided the Board with an update on the review of Lincolnshire’s Joint Local Health and Wellbeing Strategy (JHWS).

(Note: Karen Dunderdale joined the meeting at 14:13pm).

The Board received a presentation which made reference to the five JHWS priorities set by the Board at its June 2023 meeting and the objectives and outcomes set by each of the JHWS Priority Delivery Groups for each of the JHWS priorities, using the life course approach of Start Well, Live well, and Age Well.

The Board noted the that the next steps would be, the objectives and outcomes would be finalised by mid-January 2024, and a draft delivery plan would then be produced for 2024/25, ensuing that the work was aligned with the development of the next iteration of the Integrated Care Strategy.  It was reported that both strategies would then be presented for consideration by the Health Scrutiny Committee for Lincolnshire on 21 February 2024, with sign of the new JHWS strategy by the Health and Wellbeing Board at its next scheduled meeting on 12 March 2024.

During consideration of this item, the following comments were noted:

·       Reassurance was provided that the life course approach being taken would ensure that children were highlighted across all of the priorities;

·       Support was extended to the life course approach as this would help support primary care prevention; and

·       Some concern was expressed relating to the number of outcomes and the disciplined approach required. The Board noted that focus would be made on the new actions/deliverables, but it was felt that the mechanism would also help link things together to know what was going on, which would then be fed back to the Health and Wellbeing Board.

The Chairman on behalf of the Board extended thanks to the presenters.

RESOLVED

That the update on the Joint Health and Wellbeing Strategy for Lincolnshire be noted.

(To receive a report from Kevin Johnson, Commissioning Manager, Lincolnshire County Council and Eve Baird, Associate Director of Operations - Specialist Services Lincolnshire Partnership NHS Foundation Trust, which provides the Board with an update on the range of mental health and emotional wellbeing services available for Children and Young People in Lincolnshire)

Consideration was given to a report from Kevin Johnson, Commissioning Manager, Lincolnshire County Council and Eve Baird, Associate Director of Operations – Specialist Services Lincolnshire Partnership NHS Foundation Trust (LPFT), which provided the Board with an update on the range of mental health and emotional wellbeing services available for children and young people in Lincolnshire.

It was noted that since the pandemic extra pressure had been put on services with more children and young people needing help with their mental health and wellbeing.  The Board was advised that increased investment had enabled waiting times for support to reduce, but more needed to be done.

It was reported that the children and young people Mental Health Transformation programme had commenced, which would result in service improvements to best meet the needs of children and young people in Lincolnshire. It was however highlighted that the Mental Health Transformation programme would take time to be fully implemented, and that further planned developments would continue to improve access and support to children and young people.

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

·       The need for members of the Board to communicate to others the amazing services available across the organisations to those working with children and families;

·       Support was extended to the online mental health support for young people aged 11 to 18 years (25 SEND/Care Leaver, living in or attending education in Lincolnshire), ‘Kooth’.  One member enquired about the amount of usage of the on-line service in East Lindsey.  Officers advised that more data could be provided, but reassurance was given that the service was well used across the whole of the county; and

·       One member enquired as to what had been learnt so far from the outcomes and interventions already in place for children and young people.  The Board was advised that Lincolnshire was leading the way with regarding to its mental health services, and that Lincolnshire had been asked to talk to other systems in this regard.  The Board noted that within the specialist services, there was a focus on both clinical outcome measures, and patient experience measures, to ascertain what the service meant for the child or young person.  It was noted that more needed to be done with some of the community services.  It was noted further that one of the challenges was to invest more in prevention, which would then see less people needing secondary health care.  The Board was advised that this was a piece of work being developed through the transformation work.

The Chairman on behalf of the Board extended thanks to the presenters.

RESOLVED

That the update on the Children and Young People’s Mental Health and Emotional Wellbeing be noted.

(To receive a report from the Mental Health Community Transformation Programme, which provides the Board with an update on the Mental Health (Adults) priority.  Sara Brine, Head of Mental Health and Transformation NHS Lincolnshire Integrated Care Board and Victoria Sleight, Head of Adult Community Mental Health Transformation Lincolnshire Partnership NHS Foundation Trust will be in attendance for this item)  

The Boad considered a report and presentation from Sara Brine, Head of Mental Health and Transformation NHS Lincolnshire Integrated Care Board and Victoria Sleight, Head of Adult Community Mental Health Transformation Lincolnshire Partnership NHS Foundation Trust, which provided an update on the Mental Health (Adults) priority.

Appendix A to the report provided a copy of a presentation which referred to the Adult Community Mental Health and Wellbeing Transformation.  The presentation made reference to: the NHS England Roadmap; what had been achieved so far; the benefits of the mental health transformation programme; the ten year vision; the mental health and wellbeing community investment scheme; organisations support by ‘Shine’; night lights cafés; the wellbeing hub offer; mental health population profiles; psychological interventions across all pathways; co-production networks; next steps; and how success would be measured.

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

• Thanks were extended for the comprehensive report, presentation, and the fantastic work being undertaken with regard to Mental Health (Adults) priority;
• Some concern was raised regarding services being moved into the community more and the closing down of crisis services.  It was highlighted that coastal and rural communities still struggled to get the services they required, with reference being made to primary care mental health practitioners and access to them by the homeless community.  It was highlighted further that there were gaps in provision across the county. The Board was advised that homeless teams in the East Lindsey area were really struggling to get mental health support and a plea was made for extra mental health support to be made available. It was also highlighted that those in crisis should not have to go to an emergency department to receive the care they needed.  Presenters agreed to take away the comments raised; 
• The Board was advised that work was ongoing to try and expand, and re-commission what used to be called the dual diagnosis model;  
• One question asked was how it was known that the strong network of services provided was embedded across communities, across services, and partners, to continually evolve and be sustainable.  There was recognition that the programme was interactive and that the scope had been widened, which had impacted across the crisis services.  The Board noted that the success of the network of services had been down to partnerships with colleagues working across the  integrated care system and really understanding what communities wanted.  The Board noted further that work was starting on what the vision was going to be for the next ten to twenty years;
• One member highlighted that the section 75 agreement and the approach of the Better Care Fund had really helped to bring everyone together, and that building on that through the priorities of the health and wellbeing strategy and the integrated care strategy would help enable transformation;
• The need for the faith sector to be included in the Voluntary, Community & Social enterprises (VCSE) provision;
• That there needed to be better sharing of support information and signposting  ...  view the full minutes text for item 23c

(To receive a report from Gina Thompson, Dementia Transformation Programme Lead, Lincolnshire Partnership NHS Foundation Trust, which updates the Board on the Dementia priority)

Consideration was given to a report from Paula Jelly, Associate Director of Operations Older People & Frailty Division Lincolnshire Partnership NHS Foundation Trust (LPFT) and Gina Thompson Dementia Transformation Programme Lead LPFT, which updated the Board on the progress made, and partners contribution to the work of the Dementia Programme.

Appendix A to the report provided the Board with details of the key feedback received from engagement on the draft strategy goals.

The Board noted that the Dementia Transformation Programme had only started in March 2023, and was not as far forward as other transformation programmes.

The presentation of this item covered the dementia strategy development; the prevention agenda, aimed at raising awareness of the importance of good brain health across all ages, to reduce the risk of dementia; the Dementia Diagnosis Rate (DDR) target, it was noted that the nationally mandated DDR target was 66.7% and that Lincolnshire’s DDR target was currently 64.8%, which was below the national target but was above the regional average; memory assessment service; Antipsychotic medication; and improvements made. Details of which were contained within the report presented.

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

·       The need to ensure that information was readily available about dementia, and that help was there to signpost individuals/families to get the assistance they needed; and

·       Thanks were extended to the good work being undertaken in relation to the dementia programme.  It was however noted that the programme was not as far forward as other transformation programmes and that there needed to be clear commitment from members present to support and evolve the programme going forward.

The Chairman on behalf of the Board extended thanks to the presenters.

RESOLVED

1.      That the progress made on the Dementia Programme be noted.

2.      That the Board notes that the standalone Memory Assessment Services (MAS) is subject to change as it is dependent on funding being secured. 

(To receive a report from Martin Samuels, Executive Director – Adult Care and Community Wellbeing, which provides the Board with an update on the Better Care Fund.  Paul Summers, Programme Manager - Better Care Fund will also be in attendance for this item)

The Board considered a report from Martin Samuels, Executive Director Adult Care and Community Wellbeing, which provided an update on the Better Care Fund.

Paul Summers, Programme Manager – Better Care Fund was also in attendance for this item.

Attached to the report for members of the Board to note were:

·       Appendix A - a copy of the NHS England Approval letter;

·       Appendix B - a copy of the Better Care Fund 2023/25 Quarter 2 Quarterly Reporting Template; and

·       Appendix C – details of the Better Care Fund Guidance and Assumptions.

Members attention was brought to Appendix A, the NHS England Approval letter and to the fact that approval had been received in September 2023, which meant that as a local area approval for the two-year plan had been received before the start of the year.

It was reported that the system was currently in the process of doing a refresh of the demand and capacity for quarter two upwards towards quarter three, for quarter three updates to be submitted in January/February 2024.  That for 2024/25 it was noted that there would be an extension of the existing Homelink pathway, as well as an increase in the number of active recovery beds from 40 to 60 with effect from 1 January 2024.

The Chairman extended thanks on behalf of the Board to the presenters.

RESOLVED

That the Lincolnshire Better Care Fund 2023-2025 Quarter 2 update be noted.        

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 5 December 2023 to 10 December 2024)

RESOLVED

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