Health and Wellbeing Board – 22 March 2016

Chairman:  Councillor Rob Waltham
Venue:  The International Room, Civic Centre

Time:  2pm


1.  Welcome and Introductions.

2.   Substitutions.

3.    Declarations of Disclosable Pecuniary Interests and Personal or Personal and Prejudicial interests.

4.    To approve as a correct record the minutes of the meeting of the Board held on 3 November 2015.

5.   Questions from members of the public.


6.    Local Safeguarding Adults Board Annual Report – Report and presentation by the Independent Chair.

7.    Director of Public Health Annual Report.  Report and presentation by the Chief Executive

8.    Update on the Joint Strategic Assessment for North Lincolnshire.  Report by the Chief Executive.

9.     Review of North Lincolnshire Joint Health and Wellbeing Strategy Priorities and Actions 2013-18.  Report by the Chief Executive.

10.  North Lincolnshire CCG Commissioning Plans for 2016/17.  Report by the Director of Commissioning, North Lincolnshire CCG.

11.  Healthy Lives, Healthy Futures – presentation by the Chief Officer, North Lincolnshire CCG.

12.  Better Care Fund: 2015-16 Plan Update and 2016-17 Plan Requirements.  Report by the Chief Officer, North Lincolnshire CCG, and the Director of People.

13.  Outcome of Care Quality Commission’s Quality in a Place Pilot – Feedback.  Report by the Director of People, and the Chief Officer, North Lincolnshire CCG.

14.  Progress Report: LGA Peer Challenge Action Plan.  Report by the Chief Executive

15.  Health and Wellbeing Board – Governance and Accountability Framework.  Report by the Director of People and the Chief Officer, North Lincolnshire CCG.

16.   Development of a diabetes ‘Super 6’ Pathway – presentation by the Chief Officer, North Lincolnshire CCG.


17.   Child and Adolescent Mental Health Services (CAMHS) Transformation Plan Update.  Report from the Chief Officer, North Lincolnshire CCG.

18.   Transforming Care for People with Learning Difficulties.  Report of the Chief Officer, North Lincolnshire CCG.

19.   Healthwatch North Lincolnshire – update by the Chair of Healthwatch.

20.   Date and time of next meeting:  TBC

21.  Any other items which the Chairman decides are urgent by reason of special circumstances which must be specified.


PRESENT:-  Dr Sanderson (Vice-Chair) in the Chair.

Sandra Barker, Chris Blacksell, Caroline Briggs, Ed Cook, Simon Driver, Ewart Gibbs, Denise Hyde, Liane Langdon, Gillian Laurence, Becky McIntyre, Andy Orrey, Fiona Phillips, Julia Pollock, Anne Tyrell, Kristy Temperton, Alan Usher, Mike Wedgewood, Paul Wilkin, and Moira Wilson.

Councillors Ali, Davison, Longcake, and Mumby-Croft attended the meeting in accordance with Procedure Rule 1.37(b).

Mick Gibbs, Dean Gillon, Greg Gough, Julie Poole, and Tracey Wartnaby were in attendance.

The meeting was held at the Civic Centre, Scunthorpe.

155  WELCOME AND INTRODUCTIONS – The Vice-Chair welcomed all those present to the twelfth meeting of the board and invited all members and officers to introduce themselves.


157  MINUTES – Resolved – That the minutes of the meeting of the board held on 3 November 2015 be approved as a correct record.

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

159  (11) LOCAL SAFEGUARDING ADULTS BOARD ANNUAL REPORT – The Independent Chair, Moira Wilson, gave a comprehensive presentation on the work of the Local Safeguarding Adults Board and an overview of its Annual Report 2014/2015.  The Board had a statutory requirement to publish and share an annual report detailing its activities within the year to help and protect adults in North Lincolnshire, and to mark performance against the Board’s objectives, priorities and strategic plan.

Moira assured the Health and Wellbeing Board that adult safeguarding was performing well, and described a number of key achievements throughout 2014/2015, particularly around service user involvement.  Moira also discussed performance against previous priorities, which future priorities had been identified, and a small number of other pieces of work for the Board to work towards throughout the year.

Resolved – (a) That the Local Safeguarding Adults Board Annual Report 2014/15 be received and noted, and (b) that Moira Wilson be thanked for her presentation.

Cllr Waltham, as Chairman, then assumed the Chair.

160  (12)  DIRECTOR OF PUBLIC HEALTH ANNUAL REPORT – The Chief Executive submitted the annual report from the Director of Public Health.  This mandatory report constitutes a professional statement about the health of local communities, based on sound epidemiological evidence and interpreted objectively.  The annual report enabled the identification of key issues, the signalling of any problems, the reporting of progress, and also aided local inter-agency action.  The 2015 report focussed on tobacco as a key influence on the health and wellbeing of the population of North Lincolnshire.

The Chief Executive noted the contents of the report and the recommendations contained within.

Resolved – That the Board take note of the Annual Report of the Director of Public Health, including the recommendations.

161  (13)  UPDATE ON THE JOINT STRATEGIC ASSESSMENT FOR NORTH LINCOLNSHIRE The Chief Executive submitted a report updating the Board on the Joint Strategic Assessment (JSA) for North Lincolnshire, highlighting the need to ensure that this evidence base was used in the development of the Board work plans.  The Chief Executive encouraged all Board members to explore and utilise the web-based JSA, describing the wide-ranging chapters of the assessment, and how the evidence could inform the work of all partners.

Resolved – That the Health and Wellbeing Board note the content of the updated JSA.

162  (14)  REVIEW OF NORTH LINCOLNSHIRE JOINT HEALTH AND WELLBEING STRATEGY PRIORITIES AND ACTIONS 2013/18 – The Chief Executive submitted a report noting progress on Board priorities in recent years, and recommending future priorities and actions.  The report noted the progress made on 2013/18 Joint Health and Wellbeing Strategy (JHWS) priorities, and outlined recommendations for ‘Big Ticket’ priorities and actions to focus activity for the remaining life of the JHWS 2016 to 2018.

The Chairman led a detailed discussion on the work completed to date, and on the proposed priorities, asking the Board whether the suggested actions were likely to lead to improved health and wellbeing for local residents.  Further issues such as measurable outcomes, delivery mechanisms and Board oversight were also discussed.

Resolved – (a) That the Health and Wellbeing Board note the review of JHWS priorities, (b) that the Board note progress made against current priorities and a process identified for overseeing any remaining action for the remainder of the 2013-18 JHWS, and (c) that the identified ‘Big Ticket’ priorities and supporting actions be included in the production of a refreshed JHWS Action Plan, and brought to the next meeting of the Health and Wellbeing Board.

163  (15) NORTH LINCOLNSHIRE CCG COMMISSIONING PLANS FOR 2016/17 – A report was submitted by the Director of Commissioning, North Lincolnshire CCG, updating the Board in respect of the NHS Planning Requirements for 2016/17 and implications for North Lincolnshire.  The Director gave a presentation on progress and successes throughout 2015/16, plans for 2016/17 contained within the Operational Plan, and the rationale and implications for the local agreement of a Sustainability and Transformation Plan (STP).

The Board discussed how the proposed STP may impact on the planning and commissioning of services, particularly around various ‘footprints’ for service delivery and natural patient flows, and how that may align with the Greater Lincolnshire devolution deal.  There was general agreement that the provision of the best possible services was more important than local and regional geography.

Resolved – That the Health and Wellbeing Board note the contents of the report and presentation.

164  HEALTHY LIVES, HEALTHY FUTURES: THE FUTURE FOR HEALTH AND CARE IN NORTH LINCOLNSHIRE – The Director of Commissioning gave a presentation on the development and implementation of the Healthy Lives, Healthy Futures programme.  The presentation covered the rationale for the programme, work to date and next steps, and the role of the Board and contribution of partners.

A discussion took place around planned engagement work with the public and health and care professionals, and the move of joined-up services away from hospital towards the community and the three Care Networks.

Resolved – (a) That the Health and Wellbeing Board note the contents of the presentation, and (b) that a Development Session be arranged to discuss the Board’s role and input within the Healthy Lives, Healthy Futures programme in more detail.

165  (16)  BETTER CARE FUND: 2015/16 PLAN UPDATE AND 2016/17 PLAN REQUIREMENTS – The Chief Officer North Lincolnshire CCG and the Director of People submitted a joint report informing the Board of the key deliverables and implementation against the Better Care Fund (BCF), providing an update on the requirements for the BCF planning and delivery 2016/17, and seeking approval for delegation to the Chairman to approve the final BCF plan for 2016/17 for submission to NHS England on 25 April 2016.

The report set out the work to date on establishing various schemes to enable local people to live independently and to be supported within their communities, along with current performance data.  NHS England had published new BCF guidance for 2016/17, requiring submission of a revised BCF plan, narrative, and indicative metrics and budgets for the year.  This was being finalised, following discussion between the local providers and commissioners on the Joint Board for Health and Social Care.

Resolved – (a) That the Health and Wellbeing Board note the progress against the BCF Plan and its implementation arrangements and key deliverables, and (b) that the Board approve the proposed submission plans and delegate final approval of the BCF Plan to the Chairman.

166  (17) OUTCOME OF THE CARE QUALITY COMMISSION’S QUALITY IN A PLACE PILOT – The Director of People and the Chief Officer submitted a joint report arising from a pilot undertaken across North Lincolnshire in October 2015, following the publication of the prototype report on 3 February 2016.  The Care Quality Commission (CQC) used key lines of enquiry to inform what the quality of health and social care was like in North Lincolnshire, across providers, populations, and beyond what is known about these.  Further detail on the CQC’s approach and methodology was contained within the report.

A discussion commenced around the strengths and weaknesses of the CQC’s work, and it was agreed that the report provided a useful assurance that services were increasingly being joined-up and were generally performing well.

Resolved – (a) That the Health and Wellbeing Board note the outcomes of the report and welcome its findings, (b) that the Board receive a quarterly update report in respect of inspection outcomes for health and social care in North Lincolnshire, and (c) that Health and Wellbeing Board members invite the CQC to attend a future Development Session to further share learning from the pilot.

167  (18)  PROGRESS REPORT: LOCAL GOVERNMENT ASSOCIATION PEER CHALLENGE ACTION PLAN – The Chief Executive submitted a report updating the Health and Wellbeing Board on progress against the action plan agreed in response to the LGA Peer Challenge, and to acknowledge progress made and confirm the actions undertaken.

The Local Government Association (LGA) was invited by the Board to undertake a peer challenge of North Lincolnshire’s Health and Wellbeing arrangements in March 2015.  A report was subsequently prepared and discussed both at a formal Board meeting and at a Board Development Session, and an action plan prepared.  The Chairman highlighted that there was an intention to move from a council-led committee model, to a genuine system leadership partnership approach.

Resolved – (a) That the Health and Wellbeing Board note the progress made against the action plan, (b) that the Board receive a further update on the action plan progress at the next Board meeting, (c) that the Board agree to an annual development session to consider self-evaluation of the Board’s effectiveness, and (d) that all partners submit information regarding possible meeting rooms for future meetings.

168  (19)  GOVERNANCE AND ACCOUNTABILITY FRAMEWORK – A joint report was tabled by the Director of People and the Chief Officer proposing revised governance and accountability arrangements for the functions of the Health and Wellbeing Board, with a revised Memorandum of Understanding.  The report also outlined the partnerships and system accountability that supported the functions of the Board, and sought support for a dedicated resource to support the functions set out in the proposed framework.

The proposed revisions to the governance arrangements built upon the agreement of revised Board priorities (minute 162 refers) and the LGA Peer Challenge and subsequent action plan (minute 168 refers) and a streamlined Memorandum of Understanding, contained as an appendix.  The Director of People explained that the required governance and support arrangements was a key element to ensuring the promotion and integration of health and wellbeing across North Lincolnshire.

Resolved – (a) That the Health and Wellbeing Board approve the revised framework for governance and accountability, as illustrated in Appendix 1 of the report, and within the Memorandum of Understanding, (b) that the predecessor reporting groups, the Integrated Commissioning Partnership and the Integrated Working Partnership, be dissolved and Board members updated of the new arrangements, and (c) that the Board support the development of a dedicated role to ensure effective delivery of the functions of the Health and Wellbeing Board and links to the wider underpinning system.

169  DIABETES IN NORTH LINCOLNSHIRE – The Vice-Chair, Dr Sanderson, gave a presentation on the local situation, the development of a North Lincolnshire Integrated Diabetes Model, and the outcomes to date. The new model was achieved by closer working between primary care practitioners, secondary care, and others, and was implemented in November 2015.  There has now been a significant reduction in the number of those patients cared for in a hospital outpatient setting, freeing up acute care to focus on those most at-risk.  Local practice skill was also improving through directly delivered education and training to practices.

Dr Sanderson also covered the greater focus on diabetes prevention, accessibility criteria, and next steps.  A discussion took place regarding publicising positive health messages such as this, and Dr Sanderson also answered questions on attendance at Accident and Emergency and the wider wellbeing and preventative agenda.

Resolved – (a) That the Health and Wellbeing Board thank Dr Sanderson for her presentation and note the encouraging progress on diabetes care, and (b) that the Board consider methods of public engagement and the dissemination of information to the public as part of the proposed dedicated Board support (minute 168 refers).

170  (20)  CHILD AND ADOLESCENT MENTAL HEALTH SERVICES (CAMHS) TRANSFORMATION PLAN UPDATE – The Chief Officer submitted a report updating the Health and Wellbeing Board in relation to the CAMHS Transformation Plan.

Resolved – That the Health and Wellbeing Board note the finalised CAMHS Transformation Plan and the process for implementation, receiving updates as implementation progresses.

171  (21) TRANSFORMING CARE FOR PEOPLE WITH LEARNING DIFFICULTIES – The Chief Officer updated the Board in respect of the Transforming Care Agenda, confirming that North Lincolnshire was part of a sub-regional group to develop area-wide action plans for delivering the national programme.

Resolved – That the Health and Wellbeing Board note the contents of the report and endorse the joint arrangements with South Yorkshire and North Lincolnshire Transforming Care Partnership.

172  (22)  HEALTHWATCH NORTH LINCOLNSHIRE PRIORITIES 2016/17 – The Chair of Healthwatch North Lincolnshire submitted a report sharing the strategic priorities for 2016/17.

Resolved – That the Health and Wellbeing Board note the priorities of Healthwatch North Lincolnshire during year four, and that Healthwatch North Lincolnshire continues to fulfil its role on the Health and Wellbeing Board.

173  DATE AND TIME OF NEXT MEETING –  The date and time of the next meeting of the Board would be set at the council’s AGM on 10 May 2016.  The Chairman invited all parties to submit preferences for future meeting dates and times, to inform the drafting of a timetable.  A timetable of future Development Sessions would be consulted on and communicated in due course.

Resolved – That the situation be noted.