Agenda and minutes

The Chair welcomed Dr Katherine Packham, Mukesh Barot and David Sissling to their first meeting.  Davis Sissling was the new Independent Chair of the Integrated Care System for Leicester, Leicestershire and Rutland and Dr Katherine Packham was a Public Health Consultant specialising in integrated care.  It was intended to appoint them as members of the Board at the Annual Council in May.

Apologies for absence were received from:-

Rebecca Browne     Acting Chief Executive University Hospitals Leicester

|Andrew Fry               College Director of Research, Leicester University

Oliver Newbould      Director of Strategic Transformation, NHS England & NHS Improvement - Midlands

Andy Williams           Chief Executive, Leicester, Leicestershire & Rutland Clinical Commissioning Groups

Members are asked to declare any interests they may have in the business to be discussed at the meeting.

Members were asked to declare any interests they may have in the business to be discussed at the meeting.  No such declarations were received.

The Minutes of the previous meeting of the Board held on 19 November 2020 are attached and the Board is asked to confirm them as a correct record.

RESOLVED:

The Minutes of the previous meeting of the Board held on 19 November 2020 be confirmed as a correct record.

Sarah Prema, Executive Director of Strategy and Planning for Leicester, Leicestershire and Rutland CCGs will present a report on the Leicester Leicestershire and Rutland System Health Inequalities Framework.  The aim of the Framework is to improve healthy life expectancy across LLR, by reducing health inequalities across the system.

Sarah Prema, Executive Director of Strategy and Planning for Leicester, Leicestershire and Rutland CCGs presented a report on the Leicester Leicestershire and Rutland System Health Inequalities Framework. The aim of the Framework was to improve healthy life expectancy across Leicester, Leicestershire & Rutland (LLR), by reducing health inequalities across the system.

The purpose of the Framework was to:-

·         Provide a system mandate for action to address health inequalities from communities upwards through the whole life course from birth to death across LLR.

·         Establish a collective understanding of the terms ‘Inequality’, ‘Inequity’ and ‘Prevention’ in relation to population health, across all parts of the LLR Integrated Care System (ICS). 

·         Strengthen a whole system collaborative approach to reduce or remove avoidable unfairness in people’s health and wellbeing in LLR as the issues affecting health were complex and joint working was important as all the factors interacted.

·         Establish the high-level principles of how LLR ICS partners will approach the work of reducing health inequity at system level.

·         Recognise that the framework will be implemented and agreed at system level, with much operational, political and community action being undertaken at ‘place’ and ‘neighbourhood’ level.  It is the systems’ minimum ask of Place in relation to reducing health inequalities.

·         Set out some key actions that can be delivered at system level with support through the ICS, with recognition that some actions will be primarily for individual organisations e.g. the NHS or the Local Authority with many others requiring partners to work together.

·         As the ICS developed there would be a need to adopt proportionate realism to use resources better to bring service provision delivery together around health inequalities.

·         The training and development of staff was important, and organisations would need to learn from Covid-19 experiences for service delivery.

·         There would be a consistent approach to health equity audits when commissioning and delivering services to ensure there was fair access to all; e.g. digital services did not disadvantage unintentionally.

It was noted that the principles of the approach would be:-

·         Health inequalities are the preventable, unfair and unjust differences in health status between groups, populations or individuals that arise from the unequal distribution of social, environmental and economic conditions within societies.

·         The principles and actions outlined are deliberately high level – the framework is clear in identifying that it will be at place level and footprints below that specific action will be defined.  Health and wellbeing Boards have a key role in leading and overseeing the work to establish local needs and action plans.

·         Health outcomes are the result of a mixture of the wider determinants of health and the quality of the health service.  It is estimated that non-medical factors influence as much as 80% of life expectancy.

·         To optimise the health, wellbeing and safety of our population then all partners involved have to work together to impact all the factors that influence health inequalities.

·         Reducing health inequalities will create a fairer society in which people are enabled to realise the best potential and contribute to  ...  view the full minutes text for item 21.

All organisations represented on the Board will present a verbal update on their engagement work during the last year.

The Chair invited all organisations represented on the Board to present a verbal update on their engagement work during the last year.

The Chair commented that there was tendency to continually engage with the same people in the same way and partners should think about how engagement could be carried out differently.  People’s sense of place was often very different to officers.  The recent example of the government establishing a vaccination centre at Peepuls Centre to improve vaccinations in an area had low usage but when it was suggested that it should be moved to a moved to a property within the community the vaccination rates increased.  Those living in the community intended to be vaccinated did not see the original location as part of their community area, but then moving it a relatively short distance into their recognised community area had achieve a better outcome. 

Kevin Routledge (Strategic Sports Alliance Group) reported that professional sports clubs meet regularly in relation to the importance of physical activity as it was recognised it had a positive impact on health.  Engagement was discussed together with the following :-

·         How the clubs and participants had been impacted by Covid.

·         Had it created opportunities and redefined how people interface with health, hospitals, health centres and GPs.

·         Had there been transformation and demand changed and would that return to normal or would it be transformational.

·         Was there room in this change from the normal and whether something should be done in the short term to recognise the total demand on the whole system has changed.

The Chair suggested that these issues could be picked up in a development session.

Martin Samuels (Adult and Children’s Services) commented that:-

·         Work had been undertaken with the Participation Strategy and the Professor Lundy Report and staff had embraced the exciting opportunities offered by a different approach to service delivery.  A Rights Based Model had been embraced as recognising children had a right to a voice about the service they received for their needs and should not just be given the service determined by officers.  It was an opportunity for an innovative engagement.

·         There had been full consultation on the new approach during lockdown through active social media, daily polls, online consultation, webinars and topic groups to connect with young people in ways they chose and preferred.

·         Children had been supported by having access to devices and they could meet in private.

·         Valuable lessons had been learned and had brought out strongly the mental health of young people in a difficult year and an understanding of the pressures they had been under. 

·         Children did not want to use Teams and Zoom for meeting but preferred Facebook Live instead.

·         Children could be far more resilient than often they were thought to be when facing pressure.  They do respond well and if officers used their preferred technology they do engage positively.

·         Professor Lundy had also said that Leicester’s work was exemplary, and she uses it as a reference to others.

The Chair  ...  view the full minutes text for item 22.

Leicester Partnership Trust will give a presentation on the co-design with service users of local mental health services.

Leicester Partnership Trust gave a presentation on the co-design with service users of local mental health services.  Paula Vaughan and Gordon King

During the presentation it was noted that:-

·         Following new funding of £815k, there was a for a new piece of work on mental health and wellbeing and to do a piece of work in partnership with primary care networks as key partners. Initially groups within the networks would be asked to do the following 5 things

o   Have a real understanding and intelligence and narrative around the mental health needs of their local in neighbourhoods

o   Have a quantative assessment impact of Covid on mental health and wellbeing needs in each of the communities

o   Have conversations in the neighbourhood about what would make an impact in making lives better for them in the community.

o   Formalise the partnerships in the local community in a more formal way to enable those involved in the partnerships such as local voluntary sector, faith and youth groups etc to meet, talk and work together.

o   Think about the investment we have given them and what sort of things would they want to put in place locally that would work specifically for their community and we will help them to measure the outcomes in a common format to see what the impact the community assets and investments have been.

·         It would be launched in the next week or two.  LPT and CCG some management capacity and resources to help with this piece of work.

·         Poor mental health services had always tried to be at the heart of understanding how the inequalities and the wider determinants of poor mental health play through around poverty, race, trauma and discrimination.  Chronic mental health was also strong driver for poverty. It also carried a lot of baggage around race and dangerousness and we will use that to inform specific work we will be doing around black mental health and the wider BAIME agenda.

·         Undertaking a wider public engagement with service users on the wider transformation changes ready for public consultation. There is a legal duty and also a moral duty to do this address stigma etc.

·         Targeted engagement to address historical lack of engagement from some groups around patient engagement on mental health.

·         At the heart of delivery is daily engagement and co-production.

·         It was important to ensure that everything done on a care plan, a care pathway people’s medication plan, work with CPN and other organisation staff was how engagement was delivered in a way that was a genuine partnership to deliver high level mental health care and attain recovery for the patient.   Recovery required agency in mental health and people having some hope and some control of what happens. If work was in partnership better outcomes were delivers for people.

·         There was a recovery and collaborative care plan and cafe which was a 9-week programme shared space focusing on chine, connectivity, hope, opportunity and identity and meaning.

·          Service users and carers were heavily involved  ...  view the full minutes text for item 23.

To note that future meetings of the Board will be held on dates to be approved at the Annual Council Meeting in May 2021.  These will be circulated as soon as they are approved.

Meetings of the Board will continue to be held in a virtual format until such time as meetings are allowed to be held again in City Hall without any social distancing restrictions.

The Board noted that future meetings of the Board would be held on dates to be approved at the Annual Council Meeting in May 2021. These will be circulated when they were approved.

Meetings of the Board would currently continue to be held in a virtual format until such time as meetings are allowed to be held again in City Hall.

The Chair stated that no items of Any Other Urgent Business had been notified to be discussed.

The Chair declared the meeting closed at 12.05pm.