Agenda and minutes

Apologies for Absence were received from:-

Councillor Sarah Russell    Deputy City Mayor Social Care and Anti-Poverty, Leicester City Council.

Andrew Fry                            College Director of Research, University of Leicester.

Angela Hillery                       Chief Executive, Leicestershire Partnership NHS Trust.

Haley Jackson                      Deputy Director of Strategic Transformation, NHS England and NHS Improvement.

Rupert Matthews                  Leicester, Leicestershire and Rutland, Police and Crime Commissioner.

Oliver Newbould                  Director of Strategic Transformation, NHS England and NHS Improvement.

Dr Avi Prasad                       Co-Chair Leicester City Clinical Commissioning Group.

Mark Powell                          Deputy Chief Executive, Leicestershire Partnership NHS Trust.

Chief Supt Adam Streets    Head of Local Policing Directorate, Leicestershire Police.

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 29 July 2021 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 29 July 2021 be confirmed as a correct record.

The Chair paid tribute to Christine Jarvis of ADHD Solutions in Leicester who had retired and wished to thank her formally for her work in moving the support for families forward during her 25 years by making great achievements in improving the life chances of children and adults affected by ADHD through support, family coaching and resources for those with ADHD and their families.

The Chair also reported on 2 visits to GP practices to meet front line staff and GPs and praised the work they undertook under difficult circumstances arising from covid and the impacts this had on referrals to the NHS for elective operations and appointments etc.  Both local and authorities and the NHS had large numbers of health vacancies for which there were few applicant at present.  The Chair encouraged a better understanding of the issues faced and for all to work in partnership to support patients and those waiting for operations and health services.   Wherever possible enabling social subscribers to provide support patients should be used wherever possible to support patients until they received their operations etc. There was a need for everyone to show more restraint and respect for the pressures faced by primary care services and the NHS.

The Chair’s comments were echoed and supported by Board Members and Healthwatch asked the Chair to share her visit experiences so they could put an article in their newsletter and publish it to share the story across the networks.

It was recognised that the health services were aware of patients’ frustrations and were working to reduce waiting times by taking action and investing time and money to improve experience of patients.

Andy Williams suggested that it would be helpful to have the PC development plans discussed at a future Board meeting so all partners could help to address the public’s issues.  

Martin Samuels welcomed the comments on how hard all sectors were working under the pressures they faced.  He had been struck by positive contribution to the interdependency of social care services which changed positively in recent years.  Social care generally employed more staff than the NHS, so their inclusion and acknowledgement of the working together was important and was considered to be a good strength of the Leicester system.

The Chair indicated that she would draw a letter together, for agreement, to be sent to social care and health staff summarises the Board’s discussion and support for the work jointly undertaken in partnership to make a different to the people of the City.  The Chair also supported letting Helathwatch have details of the visits so they could add this to their newsletter.  

Dr Katherine Packham, Consultant in Public Health gave a verbal summary on the outcome of the Health and Development Session held on 1 October. 

·         The aims of the Health & Wellbeing Board contained in its Terms of Reference were discussed, and some amendments were suggested which would be submitted to the Council for approval.

·         The Board should set direction through the Health and Wellbeing Strategy and monitor progress and improvements through the Strategy’s action plan.

·         There should be a shared language and terms for initiatives used by all health partners.  The Board should have a strong advocacy role in reducing health inequalities and the wider determinants of health and also ensure there was a focus on children and adults.

·         Consideration was given to the Chairs of the Learning Disability Partnership Board and the Mental Health Partnership Boards having membership of the Board.

·         Good discussion took place around housing and the wider determinates of health.   These and other points discussed would need to be discussed further to consider how they could be progressed.

·         The Board had an important role to link Health and Wellbeing framework with the health system and determine how to implement to  avoid duplications between health partners and formalise links to other groups and committees in the integrated health system and integrated health care sectors and to ensure they are aware of what the Board is  working to achieve.

·         There should be strong links with neighbourhoods in their different forms for community organisations and the differing natures of areas and GPs in the City etc.

·         It was important for health providers hear directly from communities what they wanted from the health service due to their needs and lifestyles and not be just informed the service health providers felt they should receive.

·         There would be a need to provide funding and staff to progress the work forward.

The Chair stated that having arrived at these outcomes she didn’t want to spend lengthy times in Board meetings sorting out the process.  This would be for officers to undertake and submit revised Terms of Reference for circulation.  The Chair supported having the Chairs of the 2 Partnership Boards taking part in Board meetings.  The Board supported these views particularly working with carers differently and for the Board to focus on giving strong leadership of what Leicester’s vision is about this would be achieved to make Leicester a great place to live and work.

The Chair also felt that it was important to understand the responsibilities of the different Boards working in the health sector and how they fitted together in the system.   Shared learning from each other and how they all undertook engagement could lead to joint engagement to avoid duplication and maximise public engagement. 

Board members also felt that it was important not to be driven by a national dictates and agendas but what was considered to work locally to meet Leicester’s health and wellbeing needs.  Care should be taken that the Board did not unnecessarily rebadge or reengineer what was  ...  view the full minutes text for item 42.

Dr Katherine Packham, Consultant in Public He Dr Katherine Packham, Consultant in Public Health, Leicester City Council will present the report.

Dr Katherine Packham, Consultant in Public Health presented the report on the production of a Joint Health and Wellbeing Strategy (JH+WBS), a statutory duty of Leicester City Council and Leicester City Clinical Commissioning Group.  The current JH+WBS was published in 2019 before the Covid pandemic. The draft revised JH+WBS has been updated in light of the pandemic and other changes that have occurred in policy.  The report also outlined a recommended timeline for the 2022-2027 JH+WBS.

As part of the development of the Integrated Care System, each ‘place’ needed to have a place-led plan.  The Leicester draft place-led plan consisted of the draft JH+WBS and the draft priorities for the Leicester City Health, Care and Wellbeing Delivery Plan.  A more detailed delivery plan would follow once the priorities had been through an engagement process and the final version approved by Health and Wellbeing Board in January 2022.

The draft revised JH+WBS and the draft priorities had been developed through partnership working centred on a core working group, with members of this group collaborating with others.

During discussion on the report, it was noted that:-

·         Members of the Board comment on the draft priorities during the meeting or submit their views through the engagement process.

·         The timescale of plan was considered to be the middle ground approach to give 5 years to deliver and achieve priorities and provide for a review not too far in the future as there had been many challenges through the impacts of Covid-19 which were not fully understood at the present and these can be assessed in timely manner to review any new challenges.

·         The Delivery Plan -Framework approach had been built upon the 5 strategic strands of the Joint Health and Wellbeing Strategy.

·         In identifying the priorities, priorities that could have a significant impact through multi- agency/partnership working were selected.  It was aimed to get a balance of health, care and wellbeing priorities.  Some of the priorities required city wide action whilst others required more delivery at a neighbourhood level and sone required act at both levels.

·         Health and wellbeing equity was at the forefront and this included an approach of ‘proportionate universalism’ in which interventions were targeted to enable a ‘levelling up’ of the gradient in health outcomes.

·         The priorities were built on existing engagement insights of what people thought was important in the way services should be delivered and took a strengths based approach building on existing community services and assets.

·         Every opportunity for collaborative delivery of priorities with VCSE and community organisations at either a city wide or neighbourhood level had been considered and they were supported by clear measures of progress ( i.e. SMART).

·         Since the agenda pack had been published, other priorities had come to light including a number of education related themes to young children affected by the pandemic and play development and others linked to deprivation.  Also, healthy minds and other initiatives to be a zero suicide City had been identified.  It would be helpful to have  ...  view the full minutes text for item 43.

a)            LLR Learning Disability and Autism (LDA) 3 Year Plan Progress Report.

Mark Roberts. Assistant Director. Leicestershire Partnership NHS Trust

Cheryl Bosworth. Senior Programme Manager - Transforming Care Programme. LLR CCGs present the

b)         Project Search Opportunities for Children, and Young People with SEND

Steph Beale will introduce the report

Helen Thompson, Director of Families, Young People and Children's and LD Services at Leicestershire Partnership NHS Trust and Chery Bosworth, Senior Programme Manager Transforming Care Programme, LLR CCG presented the LLR Learning Disability and Autism (LDA) 3 Year Plan Progress Report.

The LLR Learning Disability and Autism 3 Year Plan was submitted to NHSEI in May 2021 and was favourably received. The plan seeks to address the health inequalities experienced by this population and is complimented by focused performance management of key outcomes detailed in a presentation shown to the meeting.

The plan contained a large number of projects pertaining to both adults, and children and young people’s services for individuals with a learning disability, autism or both. It brought together multiple funding streams to ensure coordination of commissioning, provision and improvement work.

Funding streams included NHSEI Service Development Funding, NHSEI Spending Review Funding, DHSE Community Discharge Grant, East Midlands CAMHS Collaborative and the Mental Health Investment Standards

Robust governance arrangements were in place to monitor the progress and performance of these projects. New projects had been recently added to the initial plan following successful expressions of interest for additional funding.

Good progress was being made on all projects and progress was overseen by the multiagency Transforming Care Programme (TCP) Delivery Group.  The Learning Disability and Neurodisability Design Group provided governance support.

During the presentation it was noted that:-

·         All people with a learning disability and/or autism would have the fundamental right to live good fulfilling lives, within their communities with access to the right support from the right people at the right time.

·         The average age of death for adults with a learning disability was 59 years old and they were six times more likely to die from covid.

·         NHS England had provided dedicated 3 year funding to transform services enabling long term planning to reduce numbers in hospital settings through a national policy shift around collaboration, integration and innovation to work together to improve social health for all.

·         The Aims and Objectives of Transforming Care were outlined in the presentation which would improve early intervention and pathways, quality of service and reduce health inequalities which would then help to reduce hospital admissions.

·         Working as an integrated team across LLR was showing good benefits and outcomes.  The aim was to enable 100% of people to have a health check to pick up issues earlier and to learn from assessing mortality reviews to make service changes.

·         There was a clear defined governance structure for projects with co-ordination between service managers and the voluntary sector.

·         Currently 77 70% had not had health checks but it was aimed to complete these before April 2022.

·         75% of people with a learning difficulty would have an annual health check by year 3 and whilst this was an improvement over recent years it was still not considered high enough.

Members of the Board commentated that:-

·         There were high none attendance rates for primary care appointments and if care workers could be involved they could book  ...  view the full minutes text for item 44.

The Chair to invite questions from members of the public.

No questions from members of the public had been received.

To note that future meetings of the Board will be held on the following dates:-

Thursday 27 January 2022 – 9.30am

Thursday 28 April 2022 – 9.30 am

Meetings of the Board are scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

The Board noted that future meetings of the Board would be held on the following dates:-

Thursday 27 January 2022 – 9.30am

Thursday 28 April 2022 – 9.30 am

Meetings of the Board were scheduled to be held in Meeting Rooms G01 and 2 at City Hall unless stated otherwise on the agenda for the meeting.

There were no items of Any Other Business to be discussed.

The Chair declared the meeting closed at 11.38 am.