Agenda item

(To receive a report by David Stacey (Programme Manager (Strategy and Performance), Lincolnshire County Council) which provides details on how the Lincolnshire Health and Wellbeing Board (LHWB) will engage with stakeholders, service users and the public to identify the priorities for the next Joint Health and Wellbeing Strategy (JWHS).  Councillor Mrs S Woolley (Portfolio Holder for NHS Liaison and Community Engagement), David Stacey (Programme Manager (Strategy and Performance)) and Alison Christie (Programme Manager (Health and Wellbeing)) will be in attendance for this item)

Consideration was given to a report by David Stacey (Programme Manager (Strategy and Performance)) which provided details on how the Lincolnshire Health and Wellbeing Board (LHWB) would engage with stakeholders, service users and the public to identify the priorities for the next Joint Health and Wellbeing Strategy (JHWS).

David Stacey (Programme Manager (Strategy and Performance)) and Alison Christie (Programme Manager (Health and Wellbeing)) were in attendance for this item.

The Committee was reminded that Local Authorities and Clinical Commissioning Groups (CCGs) had an equal and joint duty under the Health and Care Act 2012 to prepare a Joint Strategic Needs Assessment (JSNA) and Joint Health and Wellbeing Strategy (JHWS) through the Lincolnshire Health and Wellbeing Board.

The JSNA was an assessment of the current and future health and care needs of local populations and used by the LHWB to inform the development of the JHWS.  It also provided a shared evidence base to support the planning and commissioning of health and care services.

The Committee had been involved in the development of the JSNA by providing a response to the JSNA, following consideration by a working group on the rationale for the development of the 35 JSNA topics, on 16 December 2015. 

All stakeholder feedback was then reviewed by the LHWB and had instigated a fundamental review which began in April 2016.  Expert panels, which comprised of representatives from Lincolnshire County Council, CCGs, health providers, District Councils, voluntary and community sectors were set up to support Topic Leads to refresh each of these topics.  In May 2017, the JSNA was published by the Lincolnshire Research Observatory as a web-based resource with a scheduled update annually.

The JSNA was also the shared evidence utilised by the LHWB to inform the priority setting for the development of the JHWS 2018-2023. 

Guidance from the Department of Health identified partners who 'must be involved' in the production of the JSNA and JHWS as well as partners who 'should' be involved.  The LHWB had taken account of this guidance and agreed to approach this by holding a series of engagement events to identify health and wellbeing priorities based on the evidence within the JSNA.  This engagement was to be grouped into three stages:-

1.    Initial work to review all the evidence against the 35 topics in the JSNA and to prioritise the topics using the scoring criteria and framework agreed by the LHWB in September 2016;

2.    A number of public engagement events would take place across the county in order to ensure the inclusion and engagement of wider stakeholders in the prioritisation process.  Evidence from the JSNA would then be thematically presented.  A progress report would also be presented to the Health Scrutiny Committee for Lincolnshire to enable review of the initial prioritisation work and to feedback their response to the LHWB; and

3.    Discussion and moderation of the prioritisation would take place by LHWB members and other invited stakeholders at an informal session of the LWHB.

It was recognised that engagement mechanisms needed to be inclusive to ensure that the 'voice' of more marginalised individuals was captured.  As a result, reference groups of under-represented individuals or groups, identified by the Equality Impact Assessment, would be held under stage 3 of the engagement.

Multiple partners and boards required identification to enable their inclusion within the review.  The Engagement Framework of LHWB set out the principle on how engagement with key stakeholders, partners and the public would take place.  A mapping exercise of existing networks and boards, including Patient and Participation Groups, would be undertaken as part of the development of a detailed delivery plan for communication activity.

In producing a JHWS for Lincolnshire, the LHWB intended to:-

·       Understand local need to ensure that services delivered were appropriate, effective and met needs;

·       Work with organisations and the public to identify the key issues and needs of the community on an ongoing basis; and

·       Involve people in Lincolnshire so that they can inform local priorities to enable work to continue to improve the health and wellbeing of the local community and reduce health inequalities.

The timescales of 'Next Steps' was reported:-

·       April to June 2017 – Initial nomination of lead officers from each member organisation of the LHBW to undertaken prioritisation scoring;

·       June to July 2017 – Wider stakeholder engagement within the prioritisation process, including feedback from the working group of the Health Scrutiny Committee for Lincolnshire;

·       July 2017 – Discussion and moderation of prioritisation by LHWB at an informal session;

·       July to August 2017 – Reference groups of under-represented individuals/groups as a means of verification;

·       September 2017 – Report the final proposed outcome and draft structure of the JHWS to the LHWB;

·       October to December 2017 – Allocate theme lead organisations to the draft JHWS;

·       January to March 2018 – Finalise and sign off the JHWS for Lincolnshire 2017-2023; and

·       April 2018 onwards – Ongoing communication and promotion of the new JHWS.

Members were invited to ask questions, during which the following points were noted:-

·       Concern was raised that the reference groups were to be held over the holiday period.  The Committee was assured that the LHWB was confident that there would be an opportunity for all to engage with the process as this covered a large period of time, despite being over the holiday period;

·       A Committee member raised concern that none of the topics covered neurology and asked how this could be included in the future.  It was explained that this had been considered by the LHWB but that the evidence presented had not been sufficient for the Board to develop a topic specifically for neurology.  It was reported that there were thousands of residents within Lincolnshire with neurological issues and that this information could be provided to the LHWB.  It was suggested that all the information compiled by the Lincolnshire Neurological Alliance be sent to the Health Scrutiny Officer in the first instance;

·       Reported over prescription of antibiotics would be considered within a number of topics within the JSNA but was not a topic in its own right.  Antimicrobial resistance was a significant national topic and therefore was not a local issue currently;

·       GP practices keep data on the management of immunisations for children and discussions with practices were undertaken should they not meet the required standards.  Practices used the data to recall patients who had not had the required immunisations, especially children;

·       Parents were reportedly frustrated as they were unable to gain access to immunisation records for children over the age of 12.  These frustrations were acknowledged but it was explained that these rules were for all public bodies.  There may be elements of a child's medical records which they may not wish for their parents to access;

·       It was reported that up to three different organisations were responsible for the commissioning of immunisation programmes which was a cause for concern.  The Interim Director of Public Health would welcome the attention of the Committee and it was agreed that this would be included in the list of potential Work Programme items for consideration in the future.

RESOLVED

1.    That the report and comments be noted;

2.    That the establishment of a working group from newly constituted Health Scrutiny Committee for Lincolnshire, to meet in July 2017, be agreed; and

3.    That the topic of Immunisation Programmes be included in the list of potential Work Programme items for consideration at a future meeting of the Committee.