Agenda and minutes

(1)       The Chair and Cabinet Member for Children’s Services paid tribute to the late Anne Sheppard, Strategic Manager Emotional Wellbeing & Mental Health (Cumbria County Council).

(2)       The Chair welcomed Ms S Allen, ICB Chief Executive Designate, North East & North Cumbria to her first meeting of the Board.

Apologies for absence were received from Ms L Berryman, Mr D Blacklock, Mr L Conway, Mr A Cummins, Ms C Donovan, Mr D Eva, Mr A Gardner, Mr J Lawlor, Mr C Ranshaw, Mrs S Sanderson, Mr P Scott, Ms L Simpson, Mr M Thomas and Ms C Whalley.

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 3 December 2021 (copy enclosed). 

RESOLVED,     that the minutes of the meeting of the Board held on 3 December 2021 be agreed as circulated and thereupon signed by the Chair.

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

(b)       To receive a report from the Director of Public Health (Cumbria County Council) (copy enclosed).

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.

Members noted the key statistics which included 132,000 COVID cases with a total of 3,130 hospital admissions within the North Cumbria Integrated Care NHS Foundation Trust (NCIC) and 3,881 in the University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB) footprint.  It was explained that during peak hospitalisation there were 303 in NCIC and 226 in UHMB with 1,754 deaths (ONS: recorded on death certificate).

The presentation was supported by a report from the Director of Public Health (Cumbria County Council) with regards to living safely with COVID-19.

The Board was informed that a very different phase of managing the COVID?19 pandemic was being entered, with high levels of vaccination in particular contributing to the virus tending to cause much less severe disease, and a consequent national policy change that had moved away from all formal restrictions and national interventions, including contact tracing.  Officers explained it was, therefore, necessary for Cumbria to revise the local strategic approach and learn to live safely with COVID-19.

A concern was raised about the community vaccination centre being discontinued in Barrow with nearest centres being located at Ulverston or Lancaster.  This was felt to be particularly important given the lower rates of take?up in disadvantaged communities in Barrow.

The Board was informed that primary care would continue to offer vaccinations through appointments.  However, there was still concern given the additional barrier that this may place on receiving vaccinations and it was agreed the Director of Public Health would raise this issue with health colleagues.

Members noted that living safely with COVID-19 did not mean simply going back to the way things were in 2019; SARS-COV-2 remained and had the potential still to cause serious harm to some people as well as to return in more virulent forms.  It was explained, therefore, an approach had to be taken that, whilst much closer to what was normal life pre-COVID, retained a number of different layers of protection from vaccination, personal and environmental risk mitigations, protection of the most vulnerable, the ability to step up response to new variants, and provision of life saving treatments, all backed by ongoing pandemic surveillance and public communications.

A discussion took place regarding the vaccination programme and the need for the continuation at local level of the ongoing efforts to increase vaccination uptake within the existing programme to be continued at local level.  The Board highlighted the lower uptake of the vaccination in more deprived areas and it was agreed this would be considered further with health colleagues.

The Board recognised the challenges and system pressures experienced during the pandemic and their long-term effects.

RESOLVED,  

                          (1)          that the accompanying presentation on the local pandemic epidemiology be noted;

                          (2)          that the strategic framework for the ongoing pandemic response (as  ...  view the full minutes text for item 47.

To receive a presentation from the Chief Executive Designate of the North East and North Cumbria Integrated Care System.

(NB:    A similar update from the Chief Executive Designate of the Lancashire and South Cumbria Integrated Care System will be given at the next meeting of the Board).

The Board received a detailed presentation from Sam Allen, Integrated Care Board (ICB) Chief Executive Designate, North East & North Cumbria. 

Members noted the recruitment which had taken place to date ready for the introduction of the ICB on 1 July 2022.  Officers explained that work was being undertaken across CCGs to support the transition into the ICB with a review of the meeting infrastructure to ensure it was fit for the future, formalising governance arrangements and recognising the need for further engagement with partners.

The Board was informed that to recognise the long?established sub?regional partnership working between CCGs, Trusts and LAs it had been agreed there would be one Strategic ICP supported by four Sub ICPs.  Members noted that the Sub ICPs would build a needs assessment from each of their Health and Wellbeing Boards, feeding into the Integrated Care Strategy.

A discussion took place regarding the ICP and its four Sub ICPs and officers acknowledged this should be bottom up to shape the whole strategy and plan.

The Board highlighted the current well developed relationships between local communities and ICPs and asked how communities would be supported in future.  Officers acknowledged the current partnership working and explained this would be built on in the future, highlighting that prominence of partnerships at place was critical. 

Members received details of the operating model and noted that national guidance and the Joint Management Executive Group process had shaped a high-level outline of how the ICB would work at system and place level.  It was explained that within the next few weeks a more detailed operating model would be finalised which would include place-based working arrangements.

A discussion took place regarding current financial arrangements at place level which tended to focus predominantly on the Better Care Fund and those services closely aligned with it.  The Board noted that from 1 July 2022, Place-Based ICB staff would be responsible for all long?term care packages, community-based services, local primary care services and VCSE provision with the aim of transitioning this to the Place Based partnership.  It was acknowledged, therefore, that Place Based Partnerships would need robust governance to manage a more significant level of resource.

During the course of discussion concerns were raised regarding the future relationships between the Health and Wellbeing Board and ICPS in North Cumbria, taking into account the Authority’s Local Government Review which would impact on ICS boundaries and the limited time available to ensure robust governance was in place.  The Chief Executive Designate acknowledged the challenges and highlighted the need to ensure there was clarity as to where decisions were made to avoid duplication, whilst confirming the commitment to look at ICS boundaries.

The Chair thanked officers for their presentation and informed members that the Board would receive a similar presentation from Lancashire and South Cumbria at their next meeting.

To receive a verbal update from the Director of Public Health (Cumbria County Council).

The Director of Public Health (Cumbria County Council) gave a brief update on the Health Equity Commission (HEC).

The Board was informed that a response had been made to the draft recommendations; the HEC would meet imminently to consider the final recommendations with a final report being published later in the month.

Members noted that this matter would be discussed further at the next Health and Wellbeing Board Development Day in April.

To consider a report by the Strategic Lead for SEND Improvement (Cumbria County Council) (copy enclosed).

The Board considered a report from the Strategic Lead for SEND Improvement which provided an update on the delivery of the SEND Written Statement of Action (WSOA) and the supporting Accelerated Progress Plans (APPs) together with feedback from the last formal monitoring meeting with the Department of Education and National Health Service England (DfE/NHSE). 

Members were informed of the work undertaken to progress the remaining actions set out in the WSOA and the APPs which had continued across the partnership since the last formal report to the Board.

The Board noted that given the limited number of actions that remained within the WSOA and the need to ensure the improvement of services for SEND was a continuous process, it was proposed that a Continuous Improvement Plan for SEND would be developed for implementation in April 2022.

Officers explained that the Plan would include any remaining actions from the WSoA and the APPs.  Members noted it would also consider action required to respond to areas of concern evident from the annual survey to parents, ongoing performance monitoring, as well as the developing Ofsted/CQC Framework for SEND and any recommendations presented following the SEND Review where these were known.

Members highlighted that the inspection had taken place three years ago whilst drawing attention to the remaining concerns in performance areas and asked whether sufficient progress was being made.  During the course of discussion the Board noted that the main focus of the Strategic Lead for SEND Improvement was now on the Local Government Review (LGR) and asked whether this would affect progress.

The Strategic Lead for SEND and Acting Chief Executive (Cumbria County Council) confirmed that sufficient progress had been made and although not complacent were confident they were sufficiently at a point where they were out of intervention and would welcome the inspection.  Members were also informed that the Team now had additional resources to backfill the LGR work being undertaken.

The Cabinet Member for Children’s Services gave a positive update on the Parent/Carer Forums and asked how work could be further accelerated.  Officers explained that additional resources were required to meet the significant increases in the SEND system which was projected to continue in the future.

The Board welcomed the update and felt this was a partnership which now had a clear programme and had made significant improvements.

RESOLVED,   that

                          (1)     the progress in relation to the Written Statement of Action, the Accelerated Progress Plans and the feedback from the DFE/NHSE meeting which took place in December 2021 be noted;

                          (2)     the Board continue to receive progress reports on the Written Statement of Action and the three Accelerated Progress Plans (APPs);

                          (3)     a SEND Continuous Improvement Plan for 2022-2023 be presented to the Health and Wellbeing Board following consideration and approval by the SEND Partnership Board.  

To consider a joint report from the Acting Director – Adult Social Care (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 report from the Acting Director – Adult Social Care, Cumbria County Council, Chief Operating Officer, NHS North Cumbria CCG and Chief Officer, NHS Morecambe Bay CCG which provided an update on Cumbria’s Better Care Fund (BCF) for Quarter 3 2021/22. 

RESOLVED,   that

                          (1)       the report be noted;

                          (2)       delegations to be put in place to allow officers to review and make adjustments to the BCF funded schemes and to make required submissions to NHS England/Improvement with suitable consultation with the Chair and Vice Chairs of the Health and Well-Being Board for 2022/23.

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

The Board considered a report by the Director of Public Health (Cumbria County Council) which gave 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 the North and South Cumbria Vaccine Inequalities Partnership supported specific communications to increase uptake, with these being co-produced with local communities; this included an on-line resource of Frequently Asked Questions along with information on remote clinics to increase uptake in more rural, less populated areas.

The Board welcomed the discussions which had taken place regarding housing, highlighting a clear correlation between poor housing and health of the population

RESOLVED,   that the following be noted:-

                          (1)       the update and any identified plans for future activity;

                          (2)       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. 

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 on Friday 22 April at 10.00 am at a venue to be confirmed.

(2)       the next meeting of the Board would take place on Friday 17 June at 10.00 am in County Offices, Kendal.