Meeting documents

PRESENT: Councillor Waltham in the chair.

Statutory Members

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

Non-Statutory Members

Christine Bain, Kevan Fridlington, Ewart Gibbs, David Hall, Catherine Griffiths, Alan Usher, Mike Wedgewood and Peter Williams

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

Mick Gibbs, Becky McIntyre, Karen Pavey, Julie Poole and Mel Holmes also attended the meeting.

The meeting was held at the Civic Centre, Scunthorpe.

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

27 DECLARATIONS OF DISCLOSABLE PECUNIARY INTERESTS AND PERSONAL OR PERSONAL AND PREJUDICIAL INTERESTS – There were no declarations of interests.

28 MINUTES – Resolved – That the minutes of the board held on 3 October 2013 be approved as a correct record.

29 (18) PUBLIC PARTICIPATION IN MEETINGS OF THE HEALTH AND WELLBEING BOARD – The Director of Policy and Resources submitted a report which considered arrangements for public participation in meetings of North Lincolnshire Health and Wellbeing Board. As a committee of the council the board was subject to the same requirements of openness and transparency as any other committee. The access to information regulations applied to the board with regard to making copies of agendas and reports of meetings open to inspection by the public.

At its meeting held on 3 October 2013 (minute 25 refers), the board asked for a report to be submitted about how the public could participate in meetings. The council and some other council committees/panels currently had some arrangements in place for public participation. These included the ability to ask questions. It was also noted that any member of the council could attend any meeting of the committee or sub committee of which they were not a member and take part in the business of such meetings if invited to do so.

The report set out three options for consideration by the board which would enable some form of public participation in meetings. It was recommended that option three should be adopted which would set aside a period of time where members of the public could ask questions of either the chairman or any other board member without the questions having to be submitted in advance. If it was not possible to give an answer to questions at the meeting arrangements could be made to inform the questioner by letter or e-mail afterwards.

Resolved – That the board adopts option three as detailed above with immediate effect as the method of engaging with the public at meetings of the board.

30 QUESTIONS FROM MEMBERS OF THE PUBLIC – There were no questions from any members of the public present at the meeting.

31 (19) NORTH LINCOLNSHIRE JOINT HEALTH AND WELLBEING STRATEGY DELIVERY PLANS 2013/2014 – The Director of Public Health submitted a report seeking approval to the Joint Health and Wellbeing Strategy (JHWS) draft delivery plans for 2013/2014.

The report indicated that following approval by the board of the Joint Health and Wellbeing Strategy and supporting technical documents in June 2013 (minute 6 refers) board members and council officers had been tasked with the development of a delivery plan for 2013/2014.

Previously, via a process of using the growing Joint Strategic Needs Assessment (JSNA) evidence based, the outcomes of health and wellbeing board partnership and consultation events and processes, six key strategic priority outcomes had been identified as set out in paragraph 2.2 of the report. The JSNA also identified multiple needs and challenges, but it was not appropriate for all of those to be treated as a priority action within a Joint Health and Wellbeing Strategy. These would continue to be worked on in individual organisations or in partnership and the JHWS provided a framework for them to continue to be priorities where evidence supported a need to do so. By means of a consultation process five priority actions had been identified as set out in paragraph 2.3 of the report. The focus of these actions was on “adding value” and all had been agreed in partnership with the exception of priority action one which was a late addition and based on feedback from members of the board during the draft document consultation period. All five priority actions were identified as having clear links to at least one of the strategic priority outcomes. These delivery plans needed to be established within a framework of themes relating to –

Employability (apprenticeships, internships and volunteering).

Organisational change

Wider environment (place shaping).

The rational for the three themes was based on what could be done organisationally and partnership wide to –

add value

create a high level response

meet more than one of the priority actions and strategic outcomes.

Discussions also agreed that all delivery plan themes and priority actions would be delivered within an infrastructure of organisational commitment, the same as that contained within the JHWS, which focused on –

Integrated working.

Commissioning and investment (value for money).

Monitoring and review.

Organisation information sharing (intelligence hubs) and signposting

Agreement and co-ordination of language and messages (i.e. simplification of messages for staff to understand and deal with debt and financial advice).

Following the identification of priority action lead officers and champions, work had been ongoing to develop a series of delivery actions. A small working group identified a set of draft actions and following a period of discussion and a further development session in September, a framework for the actions had been developed. This had also been discussed at the October meeting of the board with a further development session in November which identified actions within a SMART context and within a potential reporting mechanism. It was also necessary to ensure that the actions sat within a process of partnership action for the board to focus on, demonstrating its commitment to work together to achieve the best possible outcomes in relation to employability, organisational change and place shaping in order to reduce inequalities and improve health and wellbeing for people in North Lincolnshire.

Appendix 1 to the report acknowledged the process and rationale for arriving at the themes and priorities framework for the delivery plan actions.

The report contained further information in relation to the delivery plans.

Resolved – (a) That the board acknowledge the process and rationale for arriving at the themes, priorities and draft delivery actions as detailed in appendix 1 to the report; (b) that the board agree the delivery plan actions in order to enable the progression towards meeting the required outcomes; (c) that the board agree the process and framework for reporting on the delivery actions as detailed in appendix 2 to the report, and (d) that the board agree that progress against the delivery pledges will be monitored by Lead Officers with support from the working group and would be reported to each meeting of the Health and Wellbeing Board and that appropriate timescales be included in the delivery actions.

32 (20) INTEGRATION TRANSFORMATION FUND – The Director of People and the Chief Officer of the North Lincolnshire Clinical Commissioning Group submitted a joint report updating members on the requirements for the creation of an Integration Transformation Fund, including the role of the board. The report also described the work undertaken to date between NHS North Lincolnshire and the council in developing the Integration Transformation Fund plans.

The Comprehensive Spending Review (CSR) 2013 announced the transfer from the NHS to Social Care of an additional 200m (to 900m) in 2014/2015, and in 2015/2016 a further 3.8bn nationally and in turn the creation of an Integration Transformation Fund (ITF). This was described as a ‘single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities.

The ITF created a local ring-fenced budget to deliver health and social care services within the community. The CSR mandated minimum levels of investment in the ITF and locally Clinical Commissioning Groups (CCGs) and local authorities could decide to place additional resources in the ITF. The latest guidance from NHS England and the Local Government Association required that joint plans for the implementation of the ITF had to be agreed by the Health and Wellbeing Board and submitted to NHS England by 15 February 2014.

Appendix 1 to the report summarised the key milestones for the completion and approval of the plan. Appendix 2 provided a detailed summary in respect of the ITF requirements which had been jointly prepared by North Lincolnshire Council and the North Lincolnshire CCG.

The detailed summary attached as Appendix 2 to the report included the minimum mandatory elements of the ITF and indicative amounts based on current year’s allocations. The detailed funding allocation was due to be received during week commencing 16 December 2013. The allocations would be for a two year period for 2014/2015 and 2015/2016. The work of the ICP would determine the scope for other areas to be considered in addition to the allocation for the ITF. However, until the planning guidance was issued in December 2013, the exact requirements for management and governance arrangements for the ITF would not be known. However, it was anticipated that a ‘pooled budget’ under Section 75 of the Health and Social Care Act would be required. Reference was made to the timescales for the completion and submission of the Joint Plans.

Resolved – (a) That the board notes the information contained in the report and the appendices in respect of the Integration Transformation Fund for North Lincolnshire, and (b) that arrangement be made to submit the detailed plans to a special meeting of the board to be held on 14 February 2014.

33 (21) INTEGRATED WORKING PARTNERSHIP – UPDATE – A report was submitted by the Director of People updating the board on the work of the Integrated Working Partnership, including the development of the Integration Statement and process against the priority work streams agreed via the pioneer bid. The board was also requested to approve the Integration Statement.

The board agreed to the submission of the pioneer bid at its meeting on 14 June 2013 (minute 11 refers). The bid set out the principles for integration and the priority integration work streams and although it was not short listed by the Department for Education, the board at its meeting on 3 October 2013 (minute 19 refers) agreed to continue to prioritise local work towards whole system integration.

The priority work streams identified in the bid were

Conception to two (pre birth to 2 years)

Young people who are vulnerable to risk taking behaviours aged 13 to 19 years.

The frail and elderly

The North Lincolnshire Health and Social Care Pioneer Bid had been used as the basis for the development of the Integration Statement which set out the collective ambition to transform services to provide sustainable and integrated care and support where –

Individuals will be supported to be resilient and safeguarded.

Families and carers will be supported.

Communities will be safer and stronger.
Through the pioneer bid, the board had committed to whole system integration across all life stages: starting well; growing well; living well; retiring well; aging well and dying well and across levels of need: universal; targeted and specialist and across the workforce sectors. The single organisational model reference in the pioneer bid provided the framework for the integration intent to be developed.

The aim was to achieve the life service at the right time, in the right place with the right management. This required new and innovative ways of integrated working within and across agencies to support positive outcomes for children and adults.

The Integrated Working Partnership had continued to develop the principles for integration and at its meeting in November 2013 focused on agreeing a common language and understanding in relation to the model of integration and the development of integrated working across levels of need. The outcomes from the workshop had been utilised to inform the development of the Integration Statement. This statement formed the baseline of principles for integration. The Integrated Working Partnership would further define and agree the meaning and shared understanding between these principles. It was proposed therefore that the board agree to signing off the Integration Statement which had been developed in collaboration with partners who had an investment in a three priority work streams and set out North Lincolnshire’s strategic intent to work together more collaboratively in order to improve outcomes for the most vulnerable in society. The statement formed the basis of a shared commitment to improving the lives of the most vulnerable and set out the ambitions, principles and outcomes that were expected.

Attached as appendices to the report were further details of the various work streams and actions outlined together with the detailed Integration Statement and how this would work.

Resolved – (a) That the report be received and the board note the progress and plans in place to implement the priority work streams for integration, and (b) that the board approve the Integration Statement.

34 (22) HEALTHY LIVES, HEALTHY FUTURES – UPDATE – The Chief Officer of the North Lincolnshire CCG submitted a report updating the board and partners on the outcomes of recent public engagement programmes and outlined the timeline for the next steps.

Healthy Lives, Healthy Futures was a programme for which the North Lincolnshire and North East Lincolnshire CCGs were working with key partners in developing and articulating a vision and plans for the development of health services in North Lincolnshire over the next 5 years. Importantly for North Lincolnshire these plans needed to respond to the national challenges outlined in the call to action, meet the needs of local people as outlined in the North Lincolnshire Joint Strategic Needs Assessment and North Lincolnshire CCGs commitments as part of the Joint Health and Wellbeing Strategy.

The vision for Health Services sought to enable the growth and the promotion of self care, independent living, care and support if needed in people’s homes and in their communities. When access to hospitals and specialist care was needed it had to be delivered in a sustainable way meeting health outcomes, qualitative care and affordable constraints. During August and September the CCG had undertaken an engagement programme to raise awareness of the challenges, the case for changes and the evaluation criteria through which options for change could be measured.

A detailed engagement report about the various activities had been produced, and was attached as an appendix to the report. It provided a wealth of detailed analysis about the feedback and detailed comments that had been received via leaflets and questionnaires. Further details were also contained in paragraph 3.1 of the report.

A group had now been established to look at various issues including transport and travel issues and the comments and insight about services had also been fed into the work of the programme board for consideration as part of service development.

Resolved – That the board notes the outcomes of the Healthy Lives, Healthy Futures engagement and the next steps in its development.

35 LOCAL PLANNING POLICIES AND HEALTH AND WELLBEING – The Director of Places and the Director of Public Health gave a joint detailed presentation in relation to local planning policies and their potential impact and implications for health and wellbeing.

Reference was made to the need to embed health and wellbeing issues into local planning policies. The Director of Places referred to the preparation of a supplementary planning document specifically relating to health issues which would be presented to the board at its next meeting. Members also asked for an update in relation to the Community Infrastructure Levy at that meeting.

Resolved – That the Directors of Places and Public Health be thanked for the presentation.

36 (23) SECTION 75 PARTNERSHIP AGREEMENTS TO UNDERPIN INTEGRATED COMMISSIONING BETWEEN THE CLINICAL COMMISSIONING GROUP (CCG) AND THE LOCAL AUTHORITY IN NORTH LINCOLNSHIRE – The Chief Officer of the CCG and the Director of People submitted a joint report informing the board of the progress of the Section 75 Partnership agreements that would underpin integrated commissioning between the CCG and North Lincolnshire Council. The Integrated Commissioning Partnership had agreed a two stage process namely the completion of Section 75 agreements 2013/2014 in relation to mental health and learning disabilities which would be completed by December 2013 and further developments of the agreements to consider expansion from 2014/2015 was underway to be in place by April 2014.

At its meeting held June 2013 (minute 8 refers), the board had approved a statement of intent that confirmed the continued commitment to working in partnership between health and the council whilst the Section 75 Partnership agreements were being finalised. It was agreed that these agreements would be underpinned by a set of agreed principles as detailed in paragraph 2.2 of the report. To date two Section 75 Partnership agreements had been finalised, one in respect of services to adults with learning disabilities and one in respect of services to adults with mental health needs. Each of these agreements was concerned with the commissioning responsibilities of each organisation and the associated partnership arrangements. The separate Section 75 agreements would be influenced by national and local drivers and requirements as detailed in the report.

The report referred to the resource implications involved in the Section 75 agreements so far agreed and indicated that work had commenced to explore the potential pools and associated developments of Section 75 agreements for 2014/2015.

Resolved – (a) That the finalised Section 75 Partnership agreements as detailed in the report be noted, and (b) that the development of 2014/2015 Section 75 Partnership agreements be reported to a future meeting of the board.

37 (24) HEALTHWATCH NORTH LINCOLNSHIRE – UPDATE – The Chair of the Healthwatch Board submitted a report which updated the board on progress on the implementation of Healthwatch, North Lincolnshire.

Healthwatch, North Lincolnshire was a partner on the Health and Wellbeing Board and would continue to –

Support the board to meet its priorities as outlined in the Health and Wellbeing Strategy, and

Fulfil its strategy duty to involve local people and be accountable to the community.

The Healthwatch, North Lincolnshire quarterly report for November 2013 had been produced and was attached as an appendix to the report for consideration by the board.

Resolved – That the progress of Healthwatch, North Lincolnshire be noted and that the organisation continued to fulfil its role on the Health and Wellbeing Board.

38 (25) LOCAL SAFEGUARDING CHILDREN’S BOARD ANNUAL REVIEW REPORT 2012/2013 – A report was submitted in connection with the Local Safeguarding Children’s Board (LSCB) Annual Review report for 2012/2013.

The LSCB had a statutory requirement to publish an annual report on the effectiveness of child safeguarding and promoting the welfare of children in the local area. Statutory guidance ‘Working Together To Safeguard Children 2013’, stated that the annual review report should be a vigorous and transparent assessment of the performance and effectiveness of local services. The Association of Independent LSCB Chairs had also produced a model for annual reviews which LSCBs were advised to use. The LSCB annual review report had been written in line with statutory requirements and the model referred to above.

The report outlined the progress made in respect of LSCB statutory functions details of which were set out in paragraph 2.5 of the report. Of particular note in this annual review was the recognition that North Lincolnshire had received from Ofsted regarding the Cool Kidz Club and the North Lincolnshire Risk Analysis Framework. Both of these had been identified as areas of good practice by Ofsted and had been published as so on the Ofsted good practice website.

As an outcome of reviewing the actions and priority areas within the LSCB Business Plan, it had led to the agreement of three priority areas for the LSCB in 2013/14. These were –

Reduce the harm from exploitation

Provide early help to children and young people

To support effective parenting capacity

The Annual Review Report had been agreed by the LSCB and would be published on the council’s website. A copy of the full report was attached as an appendix to the report.

Resolved – That the board receives the LSCB annual Review Report for 2012/2013 and that it will be considered in the work of the Health and Wellbeing Board.

39 (26) AUTISM SAFE ASSESSMENT FRAMEWORK – The Director of People and the Chief Officer of the CCG submitted a report which outlined the final submission of the National Autism Safe Assessment Framework (SAF) and provided the board with evidence for local planning, health needs assessment strategy development and to support the local implementation work.

The Adult Autism Strategy ‘Fulfilling and Rewarding Lives’ had been published in 2010. It was an essential step towards realising the government’s long term vision and transforming the lives of and outcomes for adults with autism. The 2010 Adult Autism Strategy had five areas for action aimed at improving the lives of adults with autism. Details were contained in paragraph 2.2 of the report.

On 2 August 2013 the Department of Health announced that a second national exercise to evaluate the progress of the Adult Autism Strategy was to be carried out. The purpose of the self assessment was to assist local authorities and their partners in assessing progress in implementing the 2010 Adult Autism Strategy and provided evidence of examples of good progress made that could be shared and of the remaining challenges. Locally the CCG had the lead for strategy development and delivery of the autism strategy for the Autism Partnership Board. North Lincolnshire Council had led the submission of the Autism Self Assessment Framework.

Attached as an appendix to the report was the Autism Self Assessment Framework together with an action plan for implementing the joint North Lincolnshire Autism Commissioning and Implementation Strategy.

Resolved – (a) That the board notes the Autism Self Assessment Framework and the areas of positive achievements in North Lincolnshire; (b) that the board notes the action plan and acknowledges that the Integrated Commissioning Partnership (ICP) was responsible for the ongoing monitoring against the plan and that ICP would ensure a joint approach that built on the work through the North Lincolnshire Autism Partnership; (c) that the board receives annual reports on progress, as appropriate; (d) that arrangements be made for the Joint Strategic Needs Assessment to adequately represent people with autism, and (e) that the Autism Partnership consider what should happen to continue to make progress and what barriers could be resolved.

40 (27) DISABLED CHILDREN’S CHARTER FOR HEALTH AND WELLBEING BOARDS – The Disabled Children’s Charter for Health and Wellbeing Boards was submitted for information.

41 (28) HEALTH INEQUALITIES – RESPONSE TO OVERVIEW AND SCRUTINY RECOMMENDATIONS – The Action Plan in relation to Health Inequalities which had been submitted to the council’s cabinet on 12 November 2013 was submitted to the board for information.

42 DATE AND TIME OF NEXT MEETING – It was noted that the next full meeting of the board would be held at 2.00 pm on 25 March 2014. However, a special meeting of the board, focusing on the Integration Transformation Fund would be held on 14 February 2014 at a time to be confirmed.

43 PHARMACEUTICAL NEEDS ASSESSMENT – Reference was made to the need to consult on the Pharmaceutical Needs Assessment. It was agreed that a report should be submitted to the next meeting of the board in relation to this matter.