Agenda and draft minutes

Apologies for absence were received from Councillor Mrs P A Bradwell OBE, Julia Debenham (Associate Member, Lincolnshire Police), Neil Juster (Associate Member, Higer Education and Greater Lincolnshire Local Enterprise Partnership), Andrew Morgan (Nominated Chief Executive, representing NHS Providers in Lincolnshire) and Heather Sandy (Executive Director of Children’s Services).

It was noted that Linda Dennett (Assistant Director, Children’s Health, and Commissioning) had replaced Heather Sandy, (Executive Director – Children’s Services) for this meeting only.

There were declarations of members’ interest made at this point of the proceedings.

RESOLVED

That the minutes of the Lincolnshire Health and Wellbeing Board meeting held on 5 December 2023 be approved and signed by the Chairman as a correct record.

RESOLVED

That the Action Updates presented be noted.

RESOLVED

That the Chairman’s Announcements as detailed on page 19 to 22 of the agenda pack be noted.  

(To receive a report from Michelle Andrews, Assistant Director ICS, and Alison Christie Programme Manager Strategy and Development, which asks the Board to approve the updated Joint Health and Wellbeing Strategy)

Consideration was given to a report from the Assistant Director ICS and the Programme Manager Strategy and Development, which asked the Board to approve the Joint Introduction document, the Health and Wellbeing Strategy, and the publication of the said documents on the Lincolnshire Intelligence Hub alongside the Integrated Cate Partnership Strategy.

The Chairman invited the Alison Christie, Programme Manager Strategy and Development to present the item to the Board.

The Board was reminded that it was a statutory duty of the Board to prepare and publish a Joint Health and Wellbeing Strategy (JHWS), based on the evidence identified in the Joint Strategic Needs Assessment (JSNA).

It was noted that the current version of the JHWS had been produced by the Board in 2018; and that following the publication of the latest JSNA, in March 2023, work had begun with partners and priority delivery groups to review the strategy.  It was noted further that the strategy had been produced following the life course approach, with objectives and outcomes being set against each of the five strategic priorities.  A copy of the updated strategy was attached at Appendix B to the report; and a copy of the Joint Introduction document was detailed at Appendix A for the Board to consider.

The Board was advised that the Health Scrutiny Committee for Lincolnshire had considered the JHWS at their meeting held on 12 March 2024, and had been broadly supportive of the strategy.  Appendix C to the report provided a copy of the Health Scrutiny Committee for Lincolnshire comments for the Board to consider.

It was reported that it was the intention for the Joint Introduction document and the updated JHWS to be published on the Lincolnshire Health Intelligence Hub alongside the Integrated Care Partnership Strategy.

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

RESOLVED

1.      That the Joint Introduction Document as detailed at Appendix A to the report be approved.

2.      That the Joint Health and Wellbeing Strategy 2024, as detailed in Appendix B to the report be approved.

3.     That the publication of the Joint Introduction document and the Joint Health and Wellbeing Strategy 2024 on the Lincolnshire Health Intelligence Hub alongside the Integrated Care Partnership Strategy be approved.

(To receive a report from Derek Ward, Director of Public Health, which asks the Board to approve the publication of the Pharmaceutical Needs Assessment 2022 Supplementary Statement March 2024.  Tony McGinty, Consultant Public Health will be in attendance for this item)

Consideration was given to a report from the Director of Public Health, which asked the Board to approve the publication of the Pharmaceutical Needs Assessment (PNA) 2022 Supplementary Statement March 2024.

The Chairman invited Tony McGinty, Consultant Public Health to present the item to the Board.

The Board was reminded that it had a statutory duty to produce a PNA every three years, and that Lincolnshire’s current PNA had been approved in September 2022. The Board noted that since the PNA publication in 2022, there had been several changes to the availability of pharmaceutical services, and as a result the Board was permitted to publish a supplementary statement detailing changes without the need to undertake a full review.  A copy of the said supplementary statement was provided in Appendix A to the report for the Board to consider.

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

RESOLVED

That approval be given to the publication of the Pharmaceutical Needs Assessment 2022 Supplementary Statement, as detailed in Appendix A to the report presented.

(To receive a report from Pete Burnett, Director of Strategic Planning, Integration and Partnerships, NHS Lincolnshire Integrated Care Board, which invites the Board to note the requirement for the NHS to develop a Joint Forward Plan and to involve the Health and Wellbeing Board in its preparation, and for the Board to provide assurance that the plan takes account of the Joint Health and Wellbeing Strategy and the Joint Strategic Needs Assessment)

The Board considered a report from the NHS Lincolnshire Integrated Care Board (ICB), which invited the Board to note the requirement of the NHS to develop a Joint Forward Plan (FP), and to involve the Health and Wellbeing Board (HWB) in its preparation, and for the Board to provide assurance that the Plan took account of the Joint Health and Wellbeing Strategy (JHWS) and the Joint Strategic Needs Assessment (JSNA).

The Chairman invited the Pete Burnett, Director of Strategic Planning, Integration and Partnerships, NHS Lincolnshire ICB to present the item to the Board.

The Board was advised that the Health and Care Act 2022 required the Lincolnshire ICB and partner trusts to prepare a Joint Forward Plan before the start of each financial year.

The Board was reminded that the Lincolnshire Joint Forward Plan 2023-2028 presented to the Board on 13 June 2023, had set out the key priorities for the NHS in Lincolnshire for the next five years.  The HWB had agreed that the JFP had taken into account the JLHWS, and the document was subsequently published on the NHS Lincolnshire ICB website. It was noted that since June, the NHS in Lincolnshire had been developing a multi-year delivery plan to underpin the JFP, which was more technical in nature and would also be published. 

A copy of the delivery plan was provided at Appendix A to the report pack for the Board to consider and comment on and give assurance that the delivery plan took account of the JLHWS.

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

·       How progress on the headline ambition ‘by April 24 over 40,000 people will have had a what matters to me conversation’ would be measured. The Board noted that the Personalisation Programme through general practice would record if those conversations were taking place.  It was noted further that this headline was one mandated from NHS England and one that had been measured for a number of years;

·       The Board was advised that information would be available on ‘its all about people’ webpage on the ICB website, which provided information on the personalisation programme;

·       Some concern was expressed that the plan had been written in isolation just for NHS targets, rather than joint integrated targets, as other agencies were currently doing work alongside the NHS targets.  The Board was advised that the nature of the plan was focused on the national agenda. The Board noted that joint working would be covered more in the Integrated Care Strategy. There was however recognition that all the documents did give the impression of individual targets rather than a joined-up approach.  The frustration raised was recognised, and that steps were continuing to be raised to push for what was best for Lincolnshire; and

·       Reassurance was provided that there was a partnership approach to digital technology, as the Integrated Care Partnership Strategy had a Digital and Technology Enabler, and that part of the cross-cutting themes was bringing together all the different elements.  It was highlighted that  ...  view the full minutes text for item 31a

(To receive a report from Andy Fox, Consultant Public Health, which provides the Board with an update on the Healthy Weight priority)

Consideration was given to a report from the Director of Public Health, which provided the Board with an annual update on the Healthy Weight Priority.

The Chairman invited Andy Fox, Consultant in Public Health to present the item to the Board.

The Board was updated on how Lincolnshire was addressing the challenge of high overweight and obesity in the county; the successes within the county of the following services: the Healthy Weight Networks, the Integrated Lifestyle Service, the Child and Family Weight Maintenance Service, and the Holiday Activities and Food Programme.

The Board noted the challenges of reaching deprived communities; exit strategies and signposting; and the opportunities for expanding the service provision.

In conclusion, the Board was advised that healthy weight at all ages was vital to a happy, thriving population, economy, and sustainable NHS.  It was recognised that the county faced some challenge in terms of helping its population of all ages achieve and enjoy and sustain a healthy weight were significant.  It was however noted that the Healthy Weight Partnership was leading in making the whole-system, multi-agency approach effective.

(Councillor C E H Marfleet joined the meeting at 14:41pm)

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

·       The importance of getting families back into cooking healthy and preparing food;

·       Making use of what was available to individuals in their own communities across the county to be able to get some exercise, for example walking; playing football in the local park, as quite a lot of individuals would be intimidated about joining a gym;

·       The importance of children and young people having a good diet from an early age.  The Board noted that input was received from the Children’s Health Service in relation to breast feeding and also the Children Centres and Family Hubs;

·       Reassurance was provided that all the people from all the organisations taking the healthy weight priority forward were the right ones for Lincolnshire.  There was recognition that there was always more that could be done;

·       It was highlighted that some of the work done historically and currently might unintentionally increase some of the inequalities seen across the county. The Board noted that to help prevent barriers to services, they needed to be designed to understand the kind of challenges people faced in taking them up.  It was highlighted that health inequalities was a key requirement for the system;

·       The importance of family hubs, children’s centres and day care centres;

·       The need to ensure that flexibility remained at the heart of what was to be achieved;

·       That some consideration needed to be taken to the fact that some people were unable to exercise as a result of having to wait for an operation or other health conditions; and

·       That further consideration needed to be made to environmental factors.

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

RESOLVED

That the annual update report on the Healthy Weight Priority, and that partners continue to work together to contribute to delivering  ...  view the full minutes text for item 31b

(To receive a report from Emma Tatlow, Active Lincolnshire, which provides the Board with an update on the Physical Activity priority)

The Board considered a report from Active Lincolnshire and the Let’s Move Lincolnshire Strategy, which provided an annual update on the Physical Activity Priority.

The Chairman invited Emma Tatlow, Voluntary and Community Sector Representative and lead for the Physical Activity priority to present the item to the Board.

The Board were advised of the background to the Let’s Move Lincolnshire Strategy; the challenges and barriers; opportunities and solutions to the system wide approach; the progress and success during 2023-2024, with reference being made to placed based investment; the Together Fund; Opening of Schools facilities; UK SPF skills; Let’s Move Lincolnshire Connect events; One you Lincolnshire Move More Pathway; Pre and post-natal pathway; Districts Health and Wellbeing Strategy; and the Wheels for Life Scheme.

The Board was advised that Lincolnshire faced some very challenging issues around physical inactivity and that there was a need to continue to better connect existing investment and capacity in the system, and secure future funding through a prevention focused place-based model to tackle the challenge of inactivity.

It was also highlighted that some organisations were struggling to survive.  It was highlighted further that sometimes commissioned services could unintentionally put an additional strain on some smaller organisations alongside the financial strain of short-term funding.

It was reported that potential place-based investment from Sport England would provide additional capacity to focus on areas identified as the top 10% places of need in England regarding physical activity; inactivity; health inequalities and deprivation.  It was felt that there needed to be a system-based approach to tackling inactivity and it was hoped that the Health and Wellbeing Board would support that approach.

During discussion, the following comments were noted:

·       Clarification was provided that Sports England’s definition of place varied.  It was however highlighted that any new investment was unlikely to cover a whole county and that it was more likely to cover one, or a multiple number of Middle Layer Super Output Areas (MSOA), or a district;

·       The challenges community groups were experiencing trying to keep local sporting facilities available or obtaining funding to provide necessary facilities;

·       The Board was made aware of seventy-eight volunteer led wellbeing walks being held across the county being led by the Lincolnshire Co-op.  It was highlighted that lots of people were still unaware of what was available to them within their own community;

·       Some concerns were raised regarding the place based approach; as currently this was not mandated by the government;

·       The challenges of getting people to engage in in physical activity;

·       Clarification was provided that place-based investment did not necessarily mean investment in new facilities; it was actually connecting all what was available together and learning and exploring things differently to make it easier for people to be more active as part of their daily lives; and

·       That more information regarding what activities were available in Lincolnshire would be signposted by a widget on the Connect to Support website.

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

RESOLVED

1.      That  ...  view the full minutes text for item 31c

(To receive a report from Derek Ward, Director of Public Health, which invites the Board to note the contents of the Director of Public Health Annual Report 2023 – Adding Life to Years)

RESOLVED

That the Director of Public Health Annual Report 2023 – Adding Life to Years be noted.

(To receive a report from Derek Ward, Director of Public Health, which provides the Board with an update on the Health Protection assurance arrangements in Lincolnshire, summarises activities undertaken during 2023-24, and outlines key priorities for 2024-25)

RESOLVED

1.      That the Director of Public Health’s Annual Protection Summary Report be noted.

2.     That support be given to the focus and priorities for 2024-2025, including programmes of work delivered through the Integrated Health Protection Working Group.

(To receive a report from Martin Samuels, Executive Director Adult Care and Community Wellbeing, which invites the Board to review the 2023-2025 Quarter 2 Lincolnshire Better Care Fund report)

The Chairman invited the Executive Director – Adult Care and Community Wellbeing to present the update on the Better Care Fund to the Board.

The Board noted that all the schemes were within their planned expenditure and that there were no specific implementation issues; that things were on track to meet three of the five metrics, and steps were being taken to address the two metrics not meeting their targets.

RESOLVED

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

RESOLVED

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

(This item provides Board with a copy of the Lincolnshire health and Wellbeing Board Forward Plan for the period 12 March 2023 to 10 December 2024)

The Chairman invited members of the Board to contact the Programme Manager Strategy and Development if they had any items they wished to have included in the Health and Wellbeing Forward Plan.

RESOLVED

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