Agenda and minutes

The Executive Director – People (Cumbria County Council) gave a brief update on the recent joint Ofsted and Care Quality Commission (CQC) inspection of Special Educational Needs and Disabilities (SEND).  Members were informed it was anticipated a draft report would be available in early January which would be published mid to late January.

The Board agreed that a report on the outcome of the inspection would be provided at their next meeting in March.

Apologies for absence were received from Mrs P Bell, Mr D Blacklock, Mrs A Burns, Mr L Conway, Mr A Cummins, Mr J Duncan, Ms D Earl, Mrs F Musgrave, Mrs S Sanderson, Ms J Scattergood, Mr P Scott, Ms L Simpson, Mrs M Skeer and Ms V Taylor.

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 14 October 2022 (copy enclosed). 

RESOLVED,     that the minutes of the meeting of the Board held on 14 October 2022 be agreed as circulated and thereupon signed by the Chair.

To consider a joint report by the Executive Director - People (Cumbria County Council), Director of Health and Care Integration (South Cumbria) and Director of Place (North Cumbria) (copy enclosed).

The Board considered a report which detailed the work that individual organisations and the health and care systems were undertaking to address workforce issues in the short and long-term. 

A discussion took place regarding future recruitment and it was noted that in order to ensure that the long-term workforce needs of the health and care system could be met joint work was being undertaken to increase recruitment to the sector.  Members were advised this had a particular focus on ‘growing our own’ and making health and social care more attractive as a career for young entrants.

Members acknowledged the challenges regarding recruitment which also included GPs in primary care.  The Board was informed that the Lancashire and South Cumbria Integrated Care Board had established a People Board to look at key principles and the importance of career progression.  It was felt that there was a need to create posts which covered both health and social care sectors whilst also highlighting the positive benefits from peer support.

Whilst members recognised the benefits of working across both health and social care sectors highlighted the difficulties which could be encountered due to the different terms and conditions.  The Board drew attention to the challenges around pay and conditions for care workers and it was felt there was a need to investigate this to make tangible progress.  Members felt there was an opportunity for Integrated Care Boards to look at the issues collaboratively.

The Board was informed of the future workforce models noting that cross sectoral work was being undertaken to develop and build on the previously agreed Workforce Strategy and its six principles.

Members noted that many of the principles had guided the initiatives and agreed that in the long term more work would be required to develop the new models of care and associated workforce to enable the health and care system to be more resilient and respond to increased needs with different sizes and configuration.

The Board acknowledged that in the short to medium term this would need to include the use of an increased overseas workforce.  Members highlighted the need to ensure those staff were helped to integrate into communities, understand local culture, address prejudice and generally benefit from those much needed additional resources.

A discussion took place regarding the significant support provided by unpaid carers and the Voluntary, Community, Faith and Social Enterprise (VCFSE) sector.  Members acknowledged the work required to increase this support which included the need to work with local communities to enable individuals to operate and provide services and the need to obtain local intelligence in order for this to be successful was highlighted.

The Board was informed of the VCFSE capacity in the county whilst noting the increased engagement in the north.  It was felt there was a need to work in a cohesive way to develop a hub and spoke model.

RESOLVED,     that

                            (1)       the work which is currently being undertaken (as set out in section 5 of the report) is noted;

                            (2)  ...  view the full minutes text for item 31.

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

The Board received a report which provided a summary of the Adult Social Care Discharge Fund that was an addendum to the Better Care Fund policy framework.

Members were informed that on 18 November 2022 the Government had published documents that set out the detail of how the £500 million Adult Social Care Discharge Fund was to be distributed and the conditions of its use.

The Board noted that 60% of the funding was allocated to the Integrated Care Boards and 40% to local authorities and would be paid in two tranches.  Officers explained that the first tranche of funding would be received during December with the second tranche being dependent on meeting the conditions of the funding and the completion of a plan and reporting templates. 

Members were informed that Cumbria County Council was allocated £2.089m, Lancashire and South Cumbria ICB had pooled £1.982m from their allocation and North East and North Cumbria had pooled £1.359m from their allocation into the Cumbria pooled fund. 

The Board noted the funding conditions which included the submission of the Funding Template Plan by 16 December 2022, submission of fortnightly reports starting from 30 December 2022 with all funding being spent by 31 March 2023.

Members were informed that given the exceptionally short turnaround from the addendum to the BCF being published and the submission to the national BCF team together with the requirement for schemes to impact on hospital discharge over the winter period the expectation was that schemes would be agreed locally amongst senior system leads ahead of submission dates.

Members raised their concerns with regards to the challenges around recruitment and retention of workforce, highlighting the potential need for additional staff to provide care for any increases in care beds and asked whether it was proposed that NHS colleagues would provide support.  During the course of discussion the importance of patient flow was emphasised whilst acknowledging the challenges with regards to resources.

The Board was informed that Cumbria County Council had provided additional financial support to independent providers across the social care market.  It was explained that an in?year uplift of varying levels would be applied to all contracts linked to the Real Living Wage increase and other inflationary factors. 

That Board noted that officers from Cumbria County Council, North East and North Cumbria ICB and Lancashire and South Cumbria ICB had developed the proposed schemes which were focused on maximum impact on improving the flow of hospital discharges and which were feasible within the timeframe.  Members welcomed the inclusion of schemes linked to mental health services.

The Chair asked for further information regarding the outcome of the additional money to be circulated to the Board in due course.

Whilst recognising the challenges with regards to the tight timescales the Chair, on behalf of the Board, conveyed thanks and appreciation to Colin Phipps and partners for the work undertaken to date and in the future.

RESOLVED,   that

                          (1)          the contents of the report be noted;

                          (2)          the  ...  view the full minutes text for item 32.

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

Members considered a report which set out the guidance and implications for the operation of the Board following Government’s publication of revised guidance on health and wellbeing boards in light of changes to the health and care system architecture following the Health and Care Act 2022. 

The Board noted the requirement for health and wellbeing boards and integrated care partnerships to work collaboratively and iteratively in the preparation of the system-wide integrated care strategy that would tackle those challenges that were best dealt with at a system level (for example, workforce planning, or data and intelligence sharing).

Members were informed the expectation was that all health and wellbeing boards in an integrated care board area would be involved in the preparation of the integrated care strategy.  It was noted there was flexibility in how this would happen in different areas and integrated care partnerships would need to ensure that there were mechanisms within their system to ensure collective input to their strategic priorities, and that sufficient time was provided for this.

RESOLVED,     that

                            (1)       the requirements in the guidance be noted;

                            (2)       the Board works with the ICBs and ICPs to ensure that the required reporting arrangements (as set out in paragraphs 4.7 to 4.11 of the report) are built into the Board’s Work Plan.  The Health and Wellbeing Board(s) for the new authorities following the vesting day of the new authorities will do the same.

To consider a joint report from the Executive Director – People (Cumbria County Council), Director of Place (North Cumbria, North East and North Cumbria) Integrated Care Board and Director of Health and Care Integration (South Cumbria) (copy enclosed).

The Board considered a report which provided an update on Cumbria’s Better Care Fund (BCF) for Quarter 2 2022/23 together with an update on activities regarding future funding arrangements for 2023/24.

Members noted that the report asked for delegations to be in place to approve 2023/24 proposals and funding allocations across Cumberland and Westmorland and Furness.

RESOLVED,     that

                            (1)       the contents of the report be noted;

                            (2)       the delegations to be put in place to allow the Executive Director of People, Cumbria County Council in consultation with the Director of Place North Cumbria, North East and North Cumbria ICB and Director of Health and Care Integration South Cumbria, Lancashire and South Cumbria Integrated Care Board to make required amendments in relation to BCF/iBCF scheme funding allocations (in relation the Cumberland and Westmorland and Furness local authority areas) for the 2023/34 period, with suitable consultation with the Chair and Vice Chairs of the HWBB be agreed;

                            (3)       the delegations to be put in place to allow the Executive Director of People, Cumbria County Council in consultation with the Director of Place North Cumbria, North East and North Cumbria ICB and Director of Health and Care Integration South Cumbria, Lancashire and South Cumbria Integrated Care Board to progress scheme developments and funding allocations for new funding streams that are supplementary to the existing BCF for the 2022/23 period with suitable consultation with the Chair and Vice Chairs of the HWBB be agreed.

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 noted that the Alliance agenda had included items relating to Healthy Start, Healthy Ageing and Public Health Consensus Statement and Public Health Alliance – Future Shape and Function.

The Board received an update on the Healthy Start project which was an NHS scheme administered by Cumbria County Council whose aim was to provide the best start in life and support with the cost of food and milk  Members were informed that the scheme could be accessed at a variety of public venues across the county, including maternity units, libraries, Surestart children’s centres and community centres as well as online and there had been a notable increase between July 2021 and March 2022.

A brief discussion took place regarding the Public Health Annual Report and it was agreed a copy of this would be circulated to the Board.

RESOLVED,   that the following be noted:-

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

                          (2)          each item in the report relates to the pertinent section of the Cumbria Joint Public Health Strategy.

To receive the Forward Plan (copy enclosed).

The Forward Plan was noted.

It was agreed that the following items be added to the next meeting of the Board in March 2023:-

(1)     Outcome of the Ofsted/CQC Inspection;

(2)     Feedback on Adult Social Care Discharge Fund

(3)     Cost of Living Crisis Update/Co-ordination Group

(4)     Initial Response Service.

The Chair welcomed any feedback from members regarding the content of future Board meetings.