Agenda and minutes

It was noted that all of the above members and officers were present at the meeting.

Apologies for absence were received from Mr M Adams, Mr A Cummins, Ms C Donovan, Mr J Hawker (Mr A Gardner attended as substitute), Mr G Jolliffe, Mr J Lawlor, Mrs F Musgrave, Mr J Readman (Ms C Whalley attended as substitute), Ms L Simpson and Mr M Thomas.

There were no disclosures of interest on this occasion. 

RESOLVED,     that the press and public be not excluded from the meeting for any items of business.

To confirm as a correct record the minutes of the meeting held on 5 February 2021 (copy enclosed). 

RESOLVED,     that the minutes of the meeting of the Board held on 5 February 2021 be agreed as circulated.

To receive a joint presentation by the Director of Public Health (Cumbria County Council), North Cumbria and Morecambe Bay Clinical Commissioning Groups (copy to follow).

The Board received a detailed presentation from the Director of Public Health (Cumbria County Council), Chief Operating Officer (North Cumbria Clinical Commissioning Group) and Director of Planning and Performance (Morecambe Bay Clinical Commissioning Group) which illustrated a COVID 19 update.

The Director of Public Health highlighted that overall the summary of epidemiology was positive across the whole of Cumbria and the number of people in hospital had stabilised at low levels.  Members welcomed the positive news regarding care homes noting that as of 12 April, the first time in the last 12 months, there had been no active outbreaks of COVID.  It was explained this had, therefore, had an impact on mortality rates which were now at low levels with few COVID?related deaths registered recently. 

A discussion took place regarding the impact of the pandemic on deprived areas of the county and the level of analysis which had taken place with regards to prevention and interventions put in place during the recovery phase.  The Board noted that the rates of mortality in areas of inequalities and deprivation were significantly higher.  Members were informed of the challenges and the need to address inequalities to ensure those communities were more resilient in the future and it was suggested this would also be considered further by the Health Protection Board.

The Board was then updated on the response structure which included the formal handover from the multi?agency Strategic Co?ordination Group (SCG) to the Strategic Recovery Co?ordination Group which would manage recovery, together with the Health Protection Board also managing the ongoing response.  It was explained that that SCG could be reconvened in the future if necessary.

Members received an update on the Strategic Framework which included vaccinate, prevent, respond treat and communicate.  The Board was given a positive update on the vaccination programme in Cumbria noting that two out of three adults across the county had received their first vaccine and one in five people in Cumbria were in receipt of their second vaccination; highlighting that this was due to the phenomenal efforts of all those involved.

The Board was informed that during the past month there had been a reduction in the supply of the vaccine into the country.  It was explained this had, therefore, resulted in a reduction in delivery of first vaccinations across the county but there was still an expectation that original targets would be reached by the end of July.

A discussion took place regarding the availability of resources if a booster vaccination was required in nine months’ time for the Pfizer vaccine.  The Chief Operating Officer, North Cumbria Clinical Commissioning Group explained that evidence had not been fully established to date but a top?up vaccination programme did form part of the national, regional and local planning.  Members were informed that preparations were required with an aim to have a strong mixed economy to make it more sustainable to deliver the vaccination programme. 

Members noted that work continued through the national roadmap for  ...  view the full minutes text for item 6.

To consider a joint report by the Independent Chair, Cumbria SEND Improvement Board and the Strategic Lead for SEND Improvement (Cumbria County Council) (copy enclosed).

The Board received a joint report from the Independent Chair, Cumbria SEND Improvement Board and the Authority’s Strategic Lead for SEND Improvement which provided an update in relation to the SEND improvement programme, highlighted key areas of progress in the delivery of the SEND Written Statement of Action (WSOA) together with areas of challenge.

Members welcomed that the work had improved understanding of local need and enabled senior leaders to hear directly from families about their experiences of the services provided.  It was explained that it had secured greater engagement with families as part of the improvement process and ensured that increasingly this influenced the delivery, development, and commissioning of services.  The Board noted that supporting guidance had been developed and training delivered to support operational practice, alongside improving the pathways and access to services which continued to be a priority.

The Chief Executive Officer, Healthwatch Cumbria commented on the significant progress which had been made regarding engagement and highlighted the positive feedback which had been received regarding the establishment of a new parent carer forum.  The Chair of the Board thanked Healthwatch and colleagues for the work they had undertaken in supporting this.

The Board noted that the report also summarised the feedback from recent formal monitoring visits by the DfE/NHSE and provided an overview of the current priorities ahead of the inspection revisit expected to take place this year.

Members were informed that the aim of the revisit was to assess the progress made in addressing each of the nine areas of significant weakness and consideration of the arrangements and adaptations made during the pandemic. It was noted that preparation for the revisit inspection was being led by the SEND Strategic Lead on behalf of all partners which would require additional work by all those currently contributing to the improvement programme. 

A discussion took place regarding the revisit and whilst officers acknowledged this would be a challenge they felt confident about the improvements which had been made and were confident they would be able to evidence positive feedback. 

The Independent Chair of the SEND Improvement Board, whilst acknowledging challenges still remained, highlighted the progress and improvements which had been made since the appointment of the Strategic Lead for SEND Improvement; explaining that partnership working had been welcomed, confidence in the system had grown and emphasised the importance and success of parent carer representation.

Members thanked officers for their positive update and whilst they were aware further progress was still required they drew attention to the improvements which had been made and welcomed the SEND support which was now evident in schools.

RESOLVED,     that

                            (1)       the progress made to date in relation to the SEND improvement programme of activity, including the feedback from the DFE/NHSE review meetings in November 2020 and March 2021 be noted;

                            (2)       the Board consider what additional information would be helpful in exercising their role, particularly in relation to the key issues and priorities highlighted within the report;

                            (3)       the Board consider and  ...  view the full minutes text for item 7.

To consider a joint report by the Executive Director – People (Cumbria County Council), Chief Operating Officer - North Cumbria Clinical Commissioning Group and Chief Officer - NHS Morecambe Bay Clinical Commissioning Groups (copy enclosed).

Members considered a joint report by the Executive Director – People (Cumbria County Council), Chief Operating Officer (North Cumbria Clinical Commissioning Group) and Chief Officer (NHS Morecambe Bay Clinical Commissioning Group) detailing the White Paper published by the Government on 11 February 2021 which set out proposed reforms to health and care.  The report highlighted that many of the measures introduced through the Health and Social Care Act 2012 were set to be abolished, with a broad move away from competition and internal markets and towards integration and collaboration between services.

The Board noted that a duty to collaborate would be created to promote collaboration across the healthcare, public health and social care system which would apply to all partners within systems, including local authorities.

Members were informed that the White Paper proposed that Integrated Care Systems (ICSs) were to be established on a statutory footing through both an `NHS ICS Board’ (though this would also include representatives from local authorities) and an ICS Health and Care Partnership.  It was explained there would be significant changes to procurement; it was proposed that section 75 of the Health and Social Care Act 2012 (including the Procurement, Patient Choice and Competition Regulations 2013) would be repealed and replaced with a new procurement regime.

The Board noted that the Health White Paper was not expected to be enacted until next year, however, in the meantime, NHS England had published planning guidance which set out a timetable for work required to establish ICSs.  Members highlighted the challenges around the fast pace at which this was intended to proceed and a suggestion was made to schedule an additional Health and Wellbeing Board Development session before June to allow discussions to take place with all partners.

The Board agreed there was a need to continue to engage across both systems and seek to influence wherever possible.

RESOLVED,     that

                            (1)       the publication of the White Paper and the potential implications for the operation of the health and care system in Cumbria be noted;

                            (2)       the Board agrees to engage with both NHS/DHSC and the two ICSs covering Cumbria to plan for future implementation.

To consider a report by the Executive Director – People (Cumbria County Council) (copy enclosed).

Members received a report from the Executive Director – People which detailed issues which had been discussed at the Cumbria Health and Wellbeing Board development session held on 12 March 2021 and sought formal agreement on some of the proposals which had emerged.

The Board had considered the draft recovery strategy and members were provided with feedback.  This included overall recognition that the recovery strategy set out a clear position about how Cumbria could emerge stronger from the pandemic, support for the use of the Public Health Strategy priorities as the framework for the recovery strategy and that sufficient metrics were in place to measure the impact of the final strategy.

Members had also asked that consideration be given by the Cumbria Strategic Recovery Coordination Group (CSRCG) to increasing reference in the recovery strategy.  The Board requested the inclusion of people with SEND and Learning Disabilities who had been impacted by COVID, the fragility of the care market and the need to ensure its sustainability going forward and involvement of schools as key drivers within the recovery process.

Members had received a presentation setting out the work of the Cumbria Mental Health Concordat and was asked to consider a number of issues.  It was explained that it was proposed that the Board supported the formation and work of the Cumbria Mental Health Concordat, received a report on a six?monthly basis from the Concordat, endorsed the intention to appoint an independent chair of the Concordat, agreed to sign up to the Consensus Statement in the Public Health Prevention Concordat and for this to be ‘owned’ by the Cumbria Mental Health Concordat and agreed to receive a future report on work that was undertaken to align Public Health and Mental Health activity.

RESOLVED,   that

                          (1)          the response to the Cumbria Strategic Recovery Coordination Group consultation on its draft recovery strategy (referred to above and in Appendix 1 of the report) be agreed;

                          (2)          the proposed mechanisms for the Mental Health Concordat referred to above (detailed in paragraph 4.14 of the report) be agreed.

To consider a joint report by the Executive Director – People (Cumbria County Council), Chief Operating Officer - North Cumbria Clinical Commissioning Group and Chief Officer - NHS Morecambe Bay Clinical Commissioning Groups (copy enclosed).

The Board considered a joint report by the Executive Director – People (Cumbria County Council), Chief Operating Officer (North Cumbria Clinical Commissioning Group) and Chief Officer (NHS Morecambe Bay Clinical Commissioning Group) which provided an update on Cumbria’s Better Care Fund (BCF) for Quarter 4 2020/21, including the end of year summary return.

Members were also provided with an update on the 2021-22 BCF and improved Better Care Fund (iBCF) proposals and asked the Health and Wellbeing Board to indicate their approval of the proposed allocations (referred to in Appendix A of the report).

The Board was asked for delegations to be put in place to allow officers to review and make adjustments to the schemes (detailed in Appendix A of the report) and to make required submissions to NHS England/Improvement with suitable consultation with the Chair and Vice Chairs of the Health and Wellbeing Board.

RESOLVED,     that

                            (1)       the contents on summary return (detailed in Appendix B of the report) for 2020-21 be noted;

                            (2)       the proposals (set out in Appendix A of the report) for 2021-22 be agreed;

                            (3)       delegations to allow officers in consultation with the Chair and Vice Chairs of the Board to review and make adjustments to the schemes (referred to in Appendix A of the report) and where required make submissions to NHS England/Improvement be agreed.

To consider a report by the Director of Public Health (Cumbria County Council) (copy enclosed).

Members considered a report by the Director of Public Health which provided an update on the development of the Cumbria Public Health Alliance/Outbreak Engagement Board (PHA-OEB), its links to the Locality Forums and the mechanisms for ensuring two-way influence and dialogue between the Board and each locality through agreed strategic aims and locally identified priorities.

Members were informed that progress on the Joint Public Health Strategy had been brought to a halt due to the COVID pandemic but it was proposed to revisit this to determine which areas should be prioritised.  It was explained that in light of this, there were 3 key goals: mobilising at local government and community level for determinants of health; mobilising whole health sector – including lifestyle change; mobilising individuals and communities to improve health and wellbeing which would be considered at their next meeting in April 2021.

RESOLVED,     that the following be noted:-

                            (1)       the update from the PHA-OEB and any identified plans for future activity;

                            (2)       where appropriate, each item in the report includes reference to the pertinent section of the Cumbria Joint Public Health Strategy.

To receive the Forward Plan (copy enclosed).

The Board received a copy of the Forward Plan and welcomed any feedback from members regarding the content of future meetings. 

Members’ attention was drawn to the Lancashire and South Cumbria New Hospitals Programme.  The Board acknowledged this was an important issue and suggested it should be considered at a future meeting.

To note the list of future meeting and development dates (copy enclosed).

The Board noted that:-

(1)       the next Cumbria Health and Wellbeing Board Development day would take place virtually on Friday 4 June 2021 at 10.00 am.

(2)       the next meeting of the Board would take place on Friday 2 July 2021 at 9.30 am at a venue to be confirmed.

Members were informed that Katherine Fairclough, Chief Executive, Cumbria County Council would be leaving the Authority to take up the post of Chief Executive at Liverpool City Region, therefore, this would be the last meeting of the Board that she would attend.

The Chair and Vice?Chair, on behalf of the Board, thanked Katherine for her positive contributions and wished her well for the future.

Katherine thanked the Board, highlighting the strength of relationships which had been made during her four years, and wished everyone success for the future.