REPORT REFERENCE: 3.0 1 LINCOLNSHIRE SHADOW HEALTH AND WELLBEING BOARD 28 SEPTEMBER 2011 PRESENT: DR TONY HILL ((CHAIRMAN) DIRECTOR OF PUBLIC HEALTH) Lincolnshire County Councillors Councillors G A Marsh (Executive Councillor for Adult Social Care) and Mrs S Woolley (Executive Councillor for Health, Housing and Community). Lincolnshire County Council Officers Peter Duxbury (Executive Director Adults and Children s). District Councils Councillors Mrs M Brighton OBE (Leader of North Kesteven District Council) and R J A Metcalfe (Leader of City of Lincoln Council). Clinical Commissioning Groups Dr Vindi Bhandal (Lincolnshire South West), Dr Sunil Hindocha ((Vice-Chairman) Lincolnshire West), Dr James Howarth (Skegness and the Coast), Dr Ken Rigg (Wellcomm), Dr Peter Holmes (Boston) and Dr Kerry Tyerman (East Lindsey). Local Involvement Network Barry Fippard MBE. NHS Lincolnshire John McIvor (Chief Executive). Also in attendance David Stacey (Programme Manger Public Health), Sophie Dickinson (Programme Manager Excellent Ageing), Barry Earnshaw (Chairman of the Excellent Ageing Steering Group) and Katrina Cope (Team Leader Democratic and Civic Services). 17. APOLOGIES FOR ABSENCE/REPLACEMENT MEMBERS Apologies for absence were received from Councillor Mrs P A Bradwell (Executive Councillor for Children s Services and Adult Learning), and Dr Kevin Hill (South Holland).
2 18. DECLARATIONS OF MEMBERS INTEREST No declarations of members interest were declared at this stage of the proceedings. 19. MINUTES AND EXECUTIVE SUMMARY FROM THE MEETING OF THE SHADOW BOARD HELD ON 13 JULY 2011 That the minutes and executive summary of the Shadow Board meeting held on 13 July 2011 be confirmed and signed by the Chairman as a correct record. 20. JOINT STRATEGIC NEEDS ASSESSMENT 2011 Pursuant to Minute No. 12 (2) and 12 (3) of the meeting held on 13 July 2011, consideration was given to a report from David Stacey (Programme Manager-Public Health), which asked the Shadow Board to receive the Joint Strategic Needs Assessment (JSNA) Overview Report 2011, and agree the priorities identified to be taken forward into the Joint Health and Wellbeing Strategy, and to consider the JSNA Consultation report as detailed at Appendix B and agree formal responses to the issues raised. It was noted that the JSNA Strategic Development Group had met formally for the first time on the 8 September 2011, and produced draft Terms of Reference for consideration by the Shadow Board and that these were appended at Appendix C to the report. It was highlighted that current developments were ongoing to create a work plan to deliver ongoing improvements to the JSNA, which would be brought forward to a future meeting of the Shadow Board for approval. It was reported that as part of developing the JSNA work had been undertaken to develop Clinical Commissioning Group (CCG) profiles and that this work had now been released on a beta website in draft form, feedback from members of the board was welcomed, particularly the CCG members, as to the content and presentation of the data. The Board were informed that the Asset Assessments sought to support the more traditional need based assessment of the JSNA by assessing and building on the strengths and resources in a community to increase resilience and deliver improved health outcomes. An initial scoping exercise was underway, which included an options appraisal of potential issues to focus the asset assessment on as well as the development of a proposed framework for undertaking the assessment, with a particular focus on the process of engagement with communities. The Programme Manager-Public Health advised that this option would be brought back later for discussion by the Shadow Board. It was noted that the JSNA had been consider and approved by the Executive (LCC) and the PCT Board prior to the meeting.
3 1. That the Joint Strategic Needs Assessment (JSNA) Overview Report 2011 be received and that the priorities identified be agreed and taken forward into the Joint Health and Wellbeing Strategy (JHWS). 2. That the JSNA Consultation report be agreed. 3. That the Draft Terms of Reference produced by the JSNA Strategic Development Group be agreed. 4. That a regular update report from the JSNA Strategic Development Group on progress on the JSNA Work Plan be receive at future meeting of the Shadow Board. 21. EXCELLENT AGEING LINCOLNSHIRE A joint presentation was received from Sophie Dickinson (Programme Manager Excellent Ageing) and Barry Earnshaw (Chairman of the Excellent Ageing Steering Group) in relation to information pertaining to Excellent Ageing in Lincolnshire. The Programme Manager Excellent Ageing introduced the report advising the Shadow Board that Excellent Ageing Lincolnshire had been set up in July 2010 to put in place long term local solutions, to enable older people in Lincolnshire to enjoy an active and happy later life and reduce social and financial costs. It was highlighted that if the existing system was not reviewed, an extra 348m would be needed by 2030, to support the growing population of older people. Extensive engagement and consultation had shown that currently services were fragmented, siloed and quite often did not offer a good service for the customer. It was noted that inefficiencies and duplication were common, for instance between different assessment processes of across service areas like benefits, a customer journey experience of an average Lincolnshire couple in their early 60 s had 29 different interventions over a 23 year period, costing 500,000 with very poor customer satisfaction. The programme had brought together over 50 partners who had developed 44 different ideas which were now being rolled out as projects. Five working groups with over 150 members were actively taking projects forward with a focus on delivering outcomes that older people had identified. Also, at strategic level, the Steering Group had been discussing with senior stakeholders to start a fundamental shift in the focus of resources to reduce the proportion of spend on acute services. National recognition had been gained by Excellent Ageing, as a unique initiative with central government support, as it reflected national priorities and collaborative working across organisations locally. The Chairman of the Excellent Ageing Steering Group explained further in relation to the five working groups set up in September 2010, which focused in the following cross agency areas: Financial Support; Community Action; Complex Case Management; Prevention and Early Intervention; and
4 Information and Accessibility From the five working groups, projects had been established to respond to some of the key areas where it was felt there was the greatest opportunity for improvement. It was highlighted that a set of principles underpinned all the Excellent Ageing projects and these were detailed at page two of the report. A lot of work had been done with the 44 projects with input from the PCT and other organisations However, not as much engagement had been made with GP s in the programme so far. The Shadow Board were advised that the Steering Group would welcome a representative from the Clinical Commissioning Groups to attend monthly board meetings, or if that was not possible then representatives from the Steering Group would welcome the opportunity to visit GPs in their surgeries. It was highlighted further, that the Steering Group was looking at how it could influence the total spend on older people in order to start to deliver a shift from acute services to prevention and early intervention. It was reported that Baroness Sally Greengross OBE, a crossbench (independent) member of the House of Lords, had been confirmed as the guest speaker at the University of Lincoln public lecture on 1 st December 2011, at which, some of the issues facing the UK today as a result of changing demographics and increased longevity would be reviewed. During discussion, particular reference was made to: Using some of the 9.1 million for independent living and preventative services such as Disabled Facility Grants; Reablement facilities and the lack of joined up working; GP representative on the Steering Group; and Use of volunteers the need to ensure that adequate training is given. That the report be noted. 22. A FRAMEWORK FOR CO-PRODUCTION The Chairman of the Shadow Health and Wellbeing Board advised that the report presented proposed some principles for the Shadow Board to consider around the involvement and engagement of stakeholders in its work. The report also outlined a suggested methodology for the development of the Joint Health and Wellbeing Strategy (JHWS). It was reported that the proposal was to be divided into two broad themes:- The short term, time limited, work required to translate the JSNA into the Joint Health and Wellbeing Strategy; and The ongoing approval to co-producing the work of the Shadow Board across its full range of responsibilities.
5 In conclusion, paragraph 2 of the report detailed arrangements for the co-production of the Joint Health and Wellbeing Strategy, and Appendix A (Figure one) to the report proposed an initial structure, with an allocation from Public Health taking the lead for taking forward the JHWS, and (Figure two) outlined the ongoing structure for the Health and Wellbeing Board. It was noted that it was the intention to bring the main stakeholders together to produce the strategy within the fives areas detailed. The overall strategy document would be short and succinct and concentrate on what s important. Nominations were sought from members of the Shadow Board to an appropriate Policy Development Group (as detailed in Figure one) of Appendix A. The nominations received were as follows:- Promoting Healthy Lifestyles Dr Sunil Hindocha and Dr Kerry Tyeman; Improving Health and Reducing Health Inequalities for Children Peter Duxbury and Dr Vindi Bhandal; Improving Health and Wellbeing for Older People Councillors Graham Marsh and Mrs Marion Brighton OBE; Delivering High Quality Systematic Care for major causes of ill health and disabilities Councillor Mrs S Woolley and Dr James Howarth; and Worklessness Councillor R J A Metcalfe, The infrastructure clearly identified a named professional officer, and the Shadow Board were advised that some administration secretariat would be provided along with help from Martin Wilson s team in relation to engagement issues. During discussion, the following issues were raised:- The potential use of the CYPSP in assisting the Shadow Board; The need to reach parts of the community that the JSNA hasn t managed to reach before, to ensure that the strategy meets the needs of the people of Lincolnshire, and make a difference; The need to take into consideration the need of CCG s; Timescales for completion of the work; and The need to use the headings for the priorities agreed in the JSNA itself. 1. That as a way forward, the suggested methodology in the report and initial structure as detailed at Appendix A to the report, be agreed. 2. That the nominations to the five priority groups as detailed below be agreed; to take forward the engagement process for working together across Lincolnshire to formulate a strategy to make a difference. Promoting Healthy Lifestyles Dr Sunil Hindocha and Dr Kerry Tyerman; Improving Health and Reducing Health Inequalities for Children Peter Duxbury and Dr Vindi Bhandal; Improving Health and Wellbeing for Older People Councillors Graham Marsh and Mrs Marion Brighton OBE;
6 Delivering High Quality Systematic Care for major causes of ill health and disabilities Councillor Mrs S Woolley and Dr James Howarth; and Worklessness Councillor R J A Metcalfe. 23. HEALTH AND WELLBEING STRATEGY The Chairman of the Health and Wellbeing Board explained that the Strategy had to be ready for February or March 2012 to influence expenditure for 2013/14. In order to meet the deadlines, it was That two of the groups be invited to present their strategies to the next meeting of the Shadow Board scheduled to be held on 30 November 2011, with the remaining three priority groups presenting their strategies to the 4 January 2012 meeting. The order is to be agreed by the Programme Manager Public Health. 24. WORK PROGRAMME Consideration was given to the work programme presented, from which it was agreed that the following items should be included: Responses from two of groups being presented to the 30 November 2011 meeting; Responses from the remaining three groups being presented to the 4 January 2012 meeting; CCG s plans to be considered at the 4 January 2012 meeting; and How the Board is going to operate signing off requests from CCG s to be included on the 16 May 2012 meeting. That the work programme be noted. The meeting closed at 3:40 pm.