Health and Wellbeing Board – 25 March 2014

PRESENT:  Councillor Waltham in the chair.

Statutory Members

Allison Cooke, Simon Driver, Denise Hyde, Frances Cunning and Julia Pollock

Non-Statutory Members

Christine Bain, Chris Blacksell, Brian Booker, Geoff Day (representing Julie Warren), Ewart Gibbs, David Hall (representing Anthony Forbes), Alex Noakes, Andy Orrey, Anne Tyrell, Alan Usher, Mike Wedgewood and Peter Williams.

Councillors Barker, Mrs Bromby, Collinson, Wells, Whiteley and Wilson attended the meeting in accordance with Procedure Rule 1.37(b).

Chris Barwell, Caroline Briggs, Darren Chaplin, Dean Gillon, Becky McIntyre, Karen Pavey, Julie Poole and Lesley Potts also attended the meeting.

The meeting was held at the Civic Centre, Scunthorpe.

49  WELCOME AND INTRODUCTIONS – The chairman welcomed all those present to the fifth meeting of the board and invited all members and officers to introduce themselves.


51  MINUTES – Resolved – That the minutes of the special meeting of the board held on 14 February 2014 be approved as a correct record.

52  QUESTIONS FROM MEMBERS OF THE PUBLIC – There were no questions from members of the public.

53  (30)  MEMBERSHIP OF THE HEALTH AND WELLBEING BOARD The Director of Policy and Resources submitted a report seeking agreement of some minor changes to the board’s membership and the temporary appointment of a non-statutory adult lay member.  The report highlighted that appointing two GPs to the board, one as a commissioner and one as a provider, would widen the board’s level of knowledge, experience and skills.

Resolved – (a)That the proposed adult lay member be temporarily appointed to the Health and Wellbeing Board, and offered relevant support and training (if required); (b) that the board write to the Seniors Forum to seek a permanent appointment in due course; (c) that the board write to North Lincolnshire Clinical Commissioning Group (CCG) requesting the appointment of a GP Commissioner as a non-statutory appointment to the board, and (d) that the board write to the local GP Federation requesting the appointment of a GP Provider as a non-statutory appointment to the board, with a preference for the above GP appointments to reflect the geographical make-up of North Lincolnshire.

54  (31)  NORTH LINCOLNSHIRE’S JSNA 2013/14 The Director of Public Health submitted a report summarising the headline findings from the latest Joint Strategic Needs Assessment (JSNA) for 2013/14.  This updated the 2012/13 JSNA report presented to the ‘shadow’ joint health and wellbeing board in March 2013.

The report highlighted the health and wellbeing assets and strengths of North Lincolnshire, as well as identifying areas for improvement.  The report also included a brief summary of findings from recent consultation with the public and other stakeholders on a range of health and wellbeing issues, as well as recent trends in performance on a range of health and wellbeing outcomes.  These findings had already been used to inform the development of the CCG’s commissioning strategy for 2014/17 and a number of other documents and strategies.

Resolved – (a)That the Health and Wellbeing Board notes the findings of the report, and (b) that its publication on the newly developed Council Data Observatory JSNA webpage with signposts to more detailed evidence and the commissioning and action plans it informs, be approved.

55  (32)  UPDATE ON THE BETTER CARE FUND PLAN A joint report was submitted by the Director of People and the Chief Officer, CCG, providing the Health and Well Being Board with an update on the assurance process of the Better Care Plan submissions following the submission of the draft plan on 14 February 2014.

A joint assurance process was being undertaken by the Local Government Association and NHS England at a regional and national level.  In accordance with the NHS Planning Guidance, the Better Care Planning Template must be submitted to NHS England on 4 April 2014.  A joint strategic board was being established with equal membership from the CCG and the council that would have responsibility for implementation and delivery of the Better Care Fund plans, and be the accountability body for the operation of the pooled budget in 2015/16.  Members of the Board discussed relevant issues, including data sharing, metrics and provider engagement.

Resolved – (a) That the Health and Wellbeing Board note the update on the Better Care Fund Plan, (b) that the Health and Wellbeing Board receive regular reports on the implementation and delivery of the Better Care Plan, and (c) that the Chairman be authorised to sign off the Better Care Plan and related documentation on behalf of the Board for submission to NHS England.

56  (33)  FRAIL AND ELDERLY PLAN – The Chief Officer, CCG, and the Director of People submitted a joint report, updating Board members on the progress against the priority work stream, Frail and Frail Elderly 2014/15 (Phase 1).

The Board previously agreed the submission to NHS England of the draft plans to deliver Better Care in North Lincolnshire (minute 46 refers) and to the focus for this to be placed on the Frail and Frail Elderly.  To ensure that this group of people could keep well and maintain their independence a service redesign was underway across health and social care to provide appropriate Universal, Targeted and Specialist Services. Within phase 1 the universal wellbeing offer was due to be launched during April.  The Well Being Offer included the creation of designated Community Well Being Hubs, in Scunthorpe, Brigg and Barton, with a Community Well Being and Youth Centre in Epworth. It was intended that the hubs would offer a range of activities and access to services to engage people in keeping well.

Further phases were planned to reshape and redesign the five existing locality teams to further improve integration, access and the quality of the care and support provided.

Resolved – That the Health and Wellbeing Board notes the progress and plans in place to implement the priority work stream for the Frail and Elderly.

57  (34)  NHS NORTH LINCOLNSHIRE CCG COMMISSIONING PLAN – The Chief Officer, CCG, submitted a report briefing Board members on the planning requirements in relation to the CCG, progress to date and the role of the Board in supporting the CCG Commissioning Plan.

NL CCG was required to lead the production of a five year strategic plan for North Lincolnshire to bring together the plans for CCG, Northern Lincolnshire and Goole Foundation Trust, Rotherham, Doncaster and South Humber, and North Lincolnshire Council. In addition, the CCG must set out a detailed two year Operational Plan (2014/15 and 15/16) including finance and activity plans.

The Director of Commissioning, CCG, gave a presentation on the draft Commissioning Plan, setting out the shared vision, ambitions and priorities, quality premiums, and how these would be met.

Resolved – That the Health and Wellbeing Board notes the briefing on the planning requirements in relation to the CCG, progress to date and the role of the Board in supporting the plans.

58  HEALTHY LIVES, HEALTHY FUTURES – The Chief Officer, CCG, gave a short verbal presentation on progress with the ongoing Healthy Lives, Healthy Futures review.  The CCG had recently held a stakeholder event and published a report entitled ‘Moving the Conversation On’ outlining the work to date and the possible services that would be consulted on in the summer.

Resolved – That the presentation be noted.

59  (35)  NORTH LINCOLNSHIRE JOINT HEALTH AND WELLBEING STRATEGY DELIVERY PLANS 2013/14 – A report was tabled by the Director of Public Health, alongside three delivery plans.  Following the Board’s approval of the Joint Health and Wellbeing Strategy Delivery Plans 2013/2014 in December 2013 (minute 31 refers), lead officers and identified champions had been working to develop individual SMART report cards against each of the strategic priority actions in line with Outcome Based Accountability (OBA) methodology.  The OBA methodology allowed for a systematic approach to identifying priorities, commissioning services and measuring impacts.

A series of workshops had been held to develop the plans and the reporting framework, and more were planned in future weeks.

Resolved – (a) That the process and rationale for arriving at the report cards be acknowledged, (b) that the report card contents be agreed in order to enable the progression towards meeting required outcomes, and (c) that future meetings of the Board be tailored around the contents of the five Priority Outcomes.

60  (36)  UNICEF BABY FRIENDLY STAGE 2 ASSESSMENT – The Director of Public Health submitted a report updating the Board on progress to achieve UNICEF Baby Friendly status, and to seek support to undertake any further required actions.

In 2011 all key partners (Chief Executives of North Lincolnshire Council, Northern Lincolnshire and Goole NHS Foundation Trust and NHS North Lincolnshire) signed up to work towards becoming UNICEF Baby Friendly.  Stage 1 was achieved in September 2012 and partners were currently working towards Stage 2 assessment in October 2014.

In North Lincolnshire breastfeeding rates have historically been much lower than the national average and, although there are signs of improvement, only 62.6% of women initiate breastfeeding compared to 73.9% nationally.  This number drops to 34.3% breastfeeding locally by 6-8 weeks compared to 47.2% nationally.

A decision was made at the multi-agency Maternity Partnership Board to move forward with Baby Friendly as a Northern Lincolnshire collaborative including maternity services, health visiting services and children’s centres in North and North East Lincolnshire.  It was also agreed at this meeting that assessment for stage 2 would take place in October 2014.

Resolved – (a) That the Health and Wellbeing Board supports the ongoing commitment to achieving UNICEF Baby Friendly accreditation, and (b) that all organisations signed up to achieving UNICEF Baby Friendly ensure that their organisations undertake all necessary measures to be ready for Stage 2 assessment by October 2014.

61  (37)  DRAFT OUTLINE OF PLANNING FOR HEALTH SUPPLEMENTARY PLANNING DOCUMENT – A report was submitted by the Director of Places building upon a previous decision by the Board (minute 35 refers) to develop a Planning for Health Supplementary Planning Document (SPD).  The report contained a draft, pre-consultation document.

As local authorities were now responsible for public health, planning and related disciplines such as housing, transport planning and regeneration an opportunity had arisen to work better to improve health and reduce health inequalities locally, through improved spatial planning and regulation.

The purpose of the SPD was to provide supporting information and guidance to planners, developers and investors on how decisions on environment and planning could have a positive impact on the health and wellbeing of local residents.  Once adopted, the SPD would be utilised when making policy decisions. These include determining planning applications and preparing future plans, strategies and development briefings.  A project timescale was included in the report.

Resolved – (a) That the Board acknowledge the process and rationale for arriving at the draft SPD; (b) that the Board agree the draft, pre-consultation SPD, and (c) that the Board agree the timescale for development of the SPD.

62  (38) UPDATE ON THE COMMUNITY INFRASTRUCTURE LEVY – The Director of Places submitted a report updating the Board on the latest developments in respect of the Community Infrastructure Levy.  This follows a resolution by the Board in December 2013 (minute 35 refers) to monitor progress.

The Community Infrastructure Levy (CIL) allowed local planning authorities in England and Wales to fund infrastructure by charging on new developments, based on the size and type of the new developments in their area. The money could be used to support growth by paying for a wide range of infrastructure, including things like health facilities, parks, schools, community facilities, and leisure centres.Its aim was to remove some of the problems associated with obtaining infrastructure funding through the existing planning regime (S106 Agreements).

Details of the role and operation of CILs and the current position within the council were set out as an appendix in the report.

Resolved – (a) That the Health and Wellbeing Board note the update on the Community Infrastructure Levy, and (b) that closer alignment of planning issues and health and wellbeing be included as a topic for further discussion at a future development session of the Board.

63  DIRECTOR OF PUBLIC HEALTH ANNUAL REPORT – The Director of Public Health gave a presentation covering population health, achievements and challenges for health improvement and actions underway to prevent premature mortality.  The Director made six recommendations to improve the health and wellbeing of North Lincolnshire residents.

Resolved – (a) That the presentation be noted, and (b) that the Board take all appropriate steps, in partnership with others, to address the Director of Public Health’s recommendations.

64  (39)  INTEGRATED WORKING PARTNERSHIP UPDATE – The Director of People submitted a report updating the Board on the work of the Integrated Working Partnership (IWP).  The most recent meeting of the IWP had been used to focus discussions on implementing the conditions necessary for successful integration.  Various workstreams were underway to address the issues that were raised in this meeting.

Resolved – That the Board notes the activity undertaken through the Integrated Working Partnership since the last Board meeting.

65  (40)  INTEGRATED COMMISSIONING PARTNERSHIP UPDATE – A report was submitted by the Chief Officer, CCG, briefing the Board on the work and decisions taken by the Integrated Commissioning Partnership (ICP) since the last Board meeting.  Much of the ICP’s work had been around the development of the Better Care Fund, but the ICP had also considered the CCG Commissioning Plan, the Autism Strategy, the Dementia Strategy, and obesity pathways/commissioning.

Resolved – That the Board notes the work undertaken by the Integrated Commissioning Partnership since the last Board meeting.

66  (41)  PRIMARY LIFESTYLE SURVEY UPDATE – The Director of Public Health submitted a report updating the Board on the outcomes of the Primary Lifestyle Survey, to confirm proposals for wider distribution and to update the outline action plan.

The Primary School Lifestyle Survey took place in North Lincolnshire in May 2013, coordinated by staff within North Lincolnshire Council (People’s Directorate and Public Health intelligence staff in the Places Directorate).  The questions were developed in consultation with a range of stakeholders including staff from children’s services, health, safer neighbourhoods, and headteachers.

In the first instance, it was developed as a pilot survey, directed at Years 5 and 6 pupils (9 to 11 years) to complement the Adolescent Lifestyle Survey (ALS).  The ALS took place every three years in North Lincolnshire and acts as an important source of data for both schools and commissioners on the perceptions, lifestyles and behaviours of 11-16 year olds. The fourth ALS had just been completed in all North Lincolnshire secondary schools, 6th forms and colleges and findings and emerging themes were being analysed.

It was intended that the findings were fed back to individual schools, and were also used to inform a host of strategies and further pieces of work.

Resolved – That the Health and Wellbeing Board acknowledges the outcomes of the Primary Lifestyle Survey, and, (b) that the Board notes the emerging findings and the arrangements for distribution and further action.

67  (42)  HEALTHWATCH NORTH LINCOLNSHIRE UPDATE – The Healthwatch Chair submitted a report updating the Board on the progress of Healthwatch.  A detailed quarterly report on planned and ongoing work was included as an appendix.

Resolved – That the Board notes the progress of Healthwatch North Lincolnshire and that Healthwatch North Lincolnshire continue to fulfil its role on the Health and Wellbeing Board.

68  DATE AND TIME OF NEXT MEETING –  It was noted that the next full meeting of the Board would be agreed at North Lincolnshire Council’s Annual Meeting on 13 May 2014.  Members of the Health and Wellbeing Board would be informed of future dates and times of meetings in due course.