To be submitted to the Council at its meeting on14th December 2017

HEALTH AND WELLBEING BOARD

11th September2017

PRESENT:Councillor Hyldon-King (in the Chair)

Councillors Patrick andP. Wheatley

Board Members:-

Joanne Hewson / Deputy Chief Executive, North East Lincolnshire Council
Lisa Whitton / Clinical Commissioning Group
Michael Bateson / Chair of Executive Board – Healthwatch
Julie Rigby / Voluntary Sector
Jane Miller / Care Plus Group

Also in Attendance:-

Zoe Campbell / Scrutiny and Committee Advisor, North East Lincolnshire Council
Emma Overton / Clinical Commissioning Group
Geoff Barnes / Deputy Director of Public Health, North East Lincolnshire Council
Claire Ward / Public Health Manager, North East Lincolnshire Council
Jamie Dunn / CSSU Specialist, North East Lincolnshire Council
Julie Walmsley / Chief Executive Officer, Doorstep

There weretwo members of the publicand no members of the press in attendance.

HWBB.10APOLOGIES FOR ABSENCE

Apologies for absence from this meeting were received fromDr Melton (Clinical Commissioning Group), Helen Kenyon (Clinical Commissioning Group), Stephen Pintus (North East Lincolnshire Council), Anne Hames and Geoff Day.

HWBB.11DECLARATIONS OF INTEREST

Councillor P. Wheatley declared a personal interest in all items as an Executive member of Hull and East Yorkshire MIND.

Councillor Hyldon-King declared a personal interest in all items as a member or friend of the following organisations: ACCORD, Hope Street Centre, NAVIGO, Healthwatch and Friendship at Home.

HWBB.12MINUTES

The minutes of the Health and Wellbeing Board meeting held on 19th June 2017 were approved as a correct record.

HWBB.13Integration and Better Care Fund 2016-17 and 2017–18 Planning Submissions

The board considered areport from the Director of Adult Services and Health Improvement setting out the planning submission for the Better Care Fund 2017 – 2019.

Ms Overton explained the vision was to deliver the right care, in the right place, by the right people, as close to home as possible, releasing the capacity and innovation which existed within our community to promote healthy living, self-care and prevention. She explained the model and what it was designed to achieve.Ms Whitton explained to the board the funding and how it would work.

The board discussed the savings that would be made especially around extra care housing and used the Strand Court development as an example of the good work, recognising the benefits it had achieved for local people.

Councillor Wheatley asked what would be the impactif the government decided to lift the 1% public sector pay cap. Ms Whitton could not say for definite as it was unknown. She explained that further money could be released into the system, however efficiencies and savings would have to be made.

RESOLVED – That board approved the narrative plan and planning template for submission.

HWBB.14Health and Wellbeing “Turning the Curve” Seminars 2016

The board considered a report from the Portfolio Holder for Health, Wellbeing and Adult Social Care which provided a summary of the outcomes and recommended actions from each of the “Turning the Curve” seminars held during 2016, and explored whether further similar seminars should be arranged for 2017/18.

Mrs Ward confirmed there were persistent health issues within the borough and, as an area, we were under-performingregionally and nationally in many health outcomes. Mrs Ward explained six turn the curve seminars took place following the health and wellbeing priorities, using the outcome based accountability methodology. The seminars were a great success and as a result,score cards were produced and owned by a lead officer to help improve the health and wellbeing of the residents within North East Lincolnshire.

The board identified mental health as a key issue and felt this would benefit from a turn the curve exercise.

RESOLVED –

(1)That the report be noted and approved.

(2)That the sixissues that had already been the focus of a turning the curve be re-visited and that the following potential topics be pursed as future seminars:

  • financial inclusion
  • mental/emotional health
  • community culture/values regarding disease and symptoms.

HWBB.15Community Capacity Building

The board considered a report from the Portfolio Holder for Health, Wellbeing and Adult Social Care proposing a refreshed approach to use of the remaining £300k earmarked reserve developed in conjunction with representatives from the Voluntary Sector Alliance.

The Chair asked which neighbourhoods would be the focus of the good neighbours scheme. Ms Walmsley explained that it was early days, however she confirmed where possible they would use organisations that already existed within neighbourhoods.

Ms Rigby explained champions were created utilising the releasing community capacity scheme (RCC) so people were not starting from scratch. However, it was agreed there were lessons to be learnt from the releasing community capacity approach.

Mr Barnes explained thatthe community capacity building ethos was a key element which waspart of the Health and Wellbeing Strategy. It aimed to find people in the communities to address the health and wellbeing outcomes for the borough and give them access to the funds to make a difference to local health issues.

Ms Rigby confirmed there were a lot of peoplein the local communities who wanted to get involved and they needed to keep them engaged so they didn’t lose interest in helping within their communities and the fund would help.

The board discussed the good neighbour scheme and could see the benefits for the community to a community capacity approach.

RESOLVED –

(1)That the refreshed approach to a community capacity building be endorsed.

(2)That the allocation of a maximum of £50k for the extension of the Good Neighbours scheme be approved and authority be delegated to the Director of Health and Wellbeing to monitor its progression through the newly established co-produced process.

HWBB.16Sustainable Transformation Locality Plan

The board received an update on the Sustainable Transformation Plan (STP) – Local Delivery Plan. The update included the challenges faced by North East Lincolnshire, the enablers to make the transformation plan successful and the different work streams that were needed to impact on the population’s health and wellbeing together with efficiency and quality of services.

Ms Miller confirmed that the plan could be circulated to the board and she would be happy to discuss the plan in more detail at a future meeting.Ms Miller talked about the place plan and confirmed it was not new but an opportunity to bring together the local plan and it was a starting point. However, there was a long way to go with health inequalitiesin the borough. Ms Miller explained there was an opportunity to look at new ways of doing things, for example new models for commissioning and modelling.

Councillor P Wheatley asked how the STP could change people’s attitudetowards their health and what the council could do locally to make the difference. Ms Miller confirmed North East Lincolnshire were not alone, this issue was common with those areasof high deprivation with people who looked to traditional services for answers, for example A&E. The single point of access had helped to prevent people going to the hospital unnecessarily and made them aware of other services that were available. The board appreciated the need to rationalise where services were being delivered from in the future on the larger area foot print.

RESOLVED – That the update be noted.

HWBB.17DIRECTOR OF PUBLIC HEALTH ANNUAL REPORT

The board received the annual report of the Director of Public Health (DPH) for North East Lincolnshire.The two previous DPH reports had focused on starting well and ageing well. This year’s report looked at the issue of living well, and how employment was a key part of working-age life. The report looked at the local economy, health in the workplace, and how poor health limited work chances.

The board welcomed the report and discussed in particular mental health issues and their impact on employment. The board were concerned about the lack of occupational data and why people were off work. Mr Barnes explained that much of the data came from the Department of Work and Pensions and the Office for National Statistics; local GP data was generally harder to access.The board was pleased to see the reference to zero hours contracts and the impact on mental health.

RESOLVED– That the report be noted.

HWBB.18ANNUAL HEALTH PROTECTION REPORT

The board received the first Annual Health Protection report which covered the performance and outcomes relating to key health protection indicators in North East Lincolnshire and formed part of the assurance process for the Council and the Health and Wellbeing Board.

Mr Barnes explained this was the first report covering the outcomes relating to the health protection indicators in North East Lincolnshire.

The board discussed immunisation specifically relating to Tuberculosis (TB) and the difficulties and delays with prescribing antibiotics to childrenwho had been contacts with TB cases. Mr Barnes confirmed improved paediatric provision in Diana Princess of Wales hospital in Grimsby had been arranged. The board had not appreciated that TB vaccinations were no longer offered in schools.

CouncillorP Wheatley raised the concern about the occasional surges in some sexually transmitted diseasesand questioned whether people were becoming resistant to antibiotics. Mr Barnes confirmed that these were not antibiotic resistant cases. The surges appeared to be short term and generally associated with locally specific factors.

Mr Bateson was concerned about air quality and CO2 emissions within the borough. He picked up from the report that deaths attributed to air pollution had increased in the borough, whilst in other areas of the region they had fallen. Mr Barnes confirmed that he had been in discussion with colleagues in Public Health England on this matter and had been informed that the apparent increase was not due to an increase in air pollution produced within North East Lincolnshire, it was air pollution in other areas of the Yorkshire and Humber and East Midlands regions which had been modelled to impact on air quality in North East Lincolnshire. His view was that the Board should not be unduly concerned due to the wide confidence intervals that existed around the published figures.

RESOLVED – That the report be noted.

HWBB.19NORTH EAST LINCOLNSHIRE CLINICAL COMMISSIONING GROUP AND NORTH EAST LINCOLNSHIRE COUNCIL ENHANCED PARTNERSHIP

Theboard received a verbal update on the enhanced partnership of North East Lincolnshire Clinical Commissioning Group and North East Lincolnshire Council which was referred to as the union.

Mrs Hewson explained that although the union was new, the Council and the CCG had been working together over the last 10 years around planning and commissioning services for the borough. She confirmed the Council and CCG were stilltwo separate organisations legally but would come together in two ways with a Chief Executive Officer and one joint leadership team and work more closely together. Mrs Hewson confirmed the union board had been set up with equal membership and had officer input to support the board. Mrs Hewson explained it was early stages but was developing and there were exciting timesahead.

RESOLVED – That the update be noted.

There being no further business the Chair declared the meeting closed at 3.50 p.m.