Agenda and minutes

The Chair welcomed new members of the Board to their first meeting.

In accordance with the Board’s Terms of Reference to appoint two Vice?Chairs who shall be representatives from health organisations which cover North Cumbria and South Cumbria.

Members noted that in accordance with the Board’s Terms of Reference the two Vice?Chairs should be representatives from health organisations which covered North Cumbria and South Cumbria.

RESOLVED,   that Mr E Tallis, Integrated Care Board Director of Place (North Cumbria) and Professor M Thomas, Chair of University Hospital Morecambe Bay NHS Foundation Trust be elected Vice?Chairs of the Board.

Apologies for absence were received from Mr M Adams, Mrs A Burns, Mrs P Bell, Mr L Conway, Mr A Cummins, Mr J Duncan, Mr D Levy, Mrs S Sanderson, Ms J Scattergood, Ms V Taylor and Mr M Thomas.

Mr D Blacklock, Chief Executive Officer, Healthwatch Cumbria declared a non-pecuniary interest in agenda item 8 – Asylum Seekers, Evacuees and Refugees (minute 23 refers) as People First were working in partnership with Cumbria County Council to establish a new service to support asylum seekers and refugees.

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 17 June 2022 (copy enclosed). 

RESOLVED,     that the minutes of the meeting of the Board held on 17 June 2022 be agreed as circulated and thereupon signed by the Chair.

To note the revised Terms of Reference of the Board (copy enclosed).

The revised Terms of Reference were noted.

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

The Board received a detailed update on the work and recommendations of the Cumbria Health and Wellbeing Board Inequalities Task and Finish Group.  It was explained that the aim was to construct a framework around what approach was required to mitigate inequalities which had developed due to the COVID?19 pandemic and any further potential impacts of COVID-19 which was currently still circulating in the population and to address inequalities as part of Cumbria’s stabilisation and recovery plans.

Members were informed that reducing inequalities required action by Central and Local Government, NHS, third and independent sectors, and sectors working with communities across a range of public policy areas.

Officers explained to members that following their recommendation a multi?agency, non?executive Task and Finish Group (Group) had been established to take forward the outcomes of discussion and refresh the Health and Wellbeing Board Recovery Priorities.

Members were informed that the Group had determined that COVID-19 had detrimentally impacted on the existing inequalities faced by certain population groups within Cumbria.  It was explained that the Group had developed priorities for the Board to address inequalities as part of Cumbria’s stabilisation and recovery plans and the Health and Wellbeing Board’s priorities.

The Board was informed that the Group, on behalf of the Board, responded to the ‘ASK’ of the Lancashire and Cumbria Health Equity Commission (HEC).  Members noted the Group had worked with partners to collate evidence and presented a report endorsed by the Board to the HEC Panel.

Members noted that the findings of the Group had been presented to the Board’s development session and the main themes/priorities that resulted included poverty, early years, children and young people’s mental health, minority groups (including disability), anchor institutions and creating good employment, housing (including environmental retrofitting) and strengthening the third sector including revisiting contracting.

The Board welcomed the priorities and particular attention was drawn to Priority 1 ‘to establish a programme of action to review, consolidate and improve a system wide approach to reducing health inequalities in children and young people with a focus on the ‘Think Family’ model.’

Members felt that the return on investment in deprived areas was greater, whilst highlighting the difficult decisions to be made about moving provisions from one area to another.  The Board acknowledged the challenges regarding recruitment to areas that needed support and the problems incurred when moving resources.  Whilst members agreed with the challenges regarding recruitment and retention it was felt there was an opportunity for the NHS to provide healthcare in different ways in the future.

A discussion took place regarding the Government’s White Paper for the integration of health and social care and it was suggested this may be an opportunity to look at prioritisation and ensure that a number of the priorities were included going forward.

The Board highlighted those with learning disabilities and the Chief Executive from Healthwatch Cumbria drew attention to the concerns raised through engagement with People First of a potential void in support.  Members noted that a conference  ...  view the full minutes text for item 22a

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

The Board received an update report from the Lancashire and Cumbria Health Equity Commission (HEC) and the final HEC report and recommendations together with a detailed presentation.

Members were informed that over the last 10 months partners across Cumbria and Lancashire had been working with the Lancashire and Cumbria Health Equity Commission.  It was explained that the aim of the HEC was to bring Lancashire and Cumbria up to date following the pandemic by using evidence to demonstrate where the biggest health inequalities were, what worked and make clear how best to govern for health, invest and take priority actions in the short, medium and long?term. 

The Board was informed it was felt this would demonstrate financial impacts to crystallise cross sector commitment to shared priorities as well as provide a platform for influence of national policy.  Officers explained this would be followed by engagement with the public and staff to determine how best to deliver the priority actions.

A discussion took place regarding the need to create and develop healthy and sustainable places and communities and the need to map and ensure the availability of good-quality provision of housing stock.

The Board noted the intention to involve communities and voluntary, community, faith and social enterprise sectors and commission and ensure long?term funding to enhance support for the social determinants of health.  Members highlighted how this sector was fundamental and emphasised the need to find a way to utilise and engage with those resources at local level, together with a need for better collaboration and partnership working with organisations.  Whilst the Board acknowledged the challenges with regards to procurement due to national legislation it was felt that longer term commitments for contracts would be beneficial.

Members discussed the challenges regarding recruitment and retention, highlighting how digital exclusion and poverty impacted on this, and felt it was incumbent for alternative methods of recruitment to be investigated.  During the course of discussion the Board emphasised the importance of support and training for the workforce.

The Board drew attention to the increase in addiction and how this impacted on mental health services.  During the course of discussion a suggestion was made to split the commissioning of services between clinical and other services as well as requesting support from employers. 

Members discussed locality work and whilst it was felt that good structures were currently in place there was a need to consider working collaborative together to provide sustainability which could have a big impact on young offenders.  It was agreed this matter would be considered further by the Children and Families Partnership. 

The Chair thanked officers for an informative presentation.

RESOLVED,   that

                          (1)          the final HEC report be welcomed and noted;

                          (2)          the discussion and the priorities identified at the HWBB development day be reflected on;

                          (3)          the HEC report be commended to the two new authorities, namely Cumberland and Westmorland and Furness, and ask them to consider the report and the agreed Health and Wellbeing Board priorities (as detailed in  ...  view the full minutes text for item 22b

To consider a report by the Assistant Director - Customer & Community Services (Cumbria County Council) (copy enclosed).

Members considered a report which provided an overview of the range of refugee, evacuee and asylum programmes currently in operation across the county, response to date and considerations for the Board.

The Board was informed that Cumbria had a well?established Multi-Agency Officer Partnership Group which had been in place for a number of years to support joint planning and sharing of information in relation to refugee resettlement.  It was explained that the terms of reference for the Group and membership were currently being reviewed to take into account the widened scope of schemes in operation.

Members were informed that connectivity with other strategic partnerships would be important and similar discussions had been taken into the Safer Cumbria Community Partnership and the CSCP to raise awareness of the current position with schemes and explore what this changing context meant in relation to safeguarding matters, community safety and community cohesion.

The Board was informed that temporary accommodation in four hotels in Cumbria for asylum seekers had been delivered by Serco on behalf of the Home Office and that there was no formal role for local authorities.

A discussion took place regarding potential employment opportunities and it was confirmed that refugees were allowed to take up employment but asylum seekers could not as they had not been afforded the right to remain.

The Board drew attention to the Homes for Ukraine scheme which enabled those living in the UK to sponsor a named Ukrainian national or family to live with them.  Members raised their concerns that host families had initially agreed to house families for six months and that future accommodation had not been agreed.  During the course of discussion a concern was also raised regarding the lack of support for the host families.  Officers confirmed these matter had been highlighted and were currently being monitored by the district councils; a Re?Matching Officer would be employed to deal with these issues.

Members raised their concerns regarding future access to health and care and highlighted the need to support organisations to enable a workforce to be ready to deal with the increase in demand.  The Board asked what work was taking place between health and care to map future changes to demand.  The Officer explained that some joint working had been undertaken whilst acknowledging there was a lack of information available to understand the local need.  The Board’s attention was also drawn to the lack of a multi?cultural service and it was suggested this was an opportunity to investigate this.

Members were informed of the availability of staff groups who could potentially champion the changes in the county and it was suggested that the Strategic Partnerships should consider undertaking a needs assessment.  Officers highlighted the importance of future mapping for care, health and education and suggested that the Chief Executive (Cumbria County Council), Director of Public Health and Assistant Director - Integration and Partnerships investigate this matter further.

The Chair thanked Helen Blake and her Team for the tremendous work  ...  view the full minutes text for item 23.

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

The Board considered a report which provided an update on the status of the SEND Written Statement of Action (WSOA) and the implementation of the newly developed SEND Partnership Continuous Improvement Plan (CIP) together with feedback from the last formal monitoring meeting with the Department of Education and National Health Service England (DfE/NHSE). 

A discussion took place regarding future Alternative Provision facilities in Cumbria and the Officer confirmed that the provision in Carlisle was scheduled to open in January 2023 and anticipated the facility in Barrow would open in September 2023.

The Board received a positive update on the work of SEND Alliance Cumbria (SENDAC) who lead the work with parents, children and young people to ensure their experiences and the outcomes they achieved inform and were central to the programme of improvement. 

Members noted that a revisit by the inspectors to assess the progress against the WSoA was significantly overdue; officers explained that positive and significant progress had been made and welcomed the revisit.

RESOLVED,   that

                          (1)          the status of the Written Statement of Action and implementation of the Continuous Improvement Plan which aims to ensure the momentum of improvement is maintained be noted;

                          (2)          the progress reports on the improvement being driven through the Continuous Improvement Plan be received.

To consider a joint report from the Executive Director – People (Cumbria County Council), Director of Place – North East and North Cumbria ICB and Chief Officer - NHS Morecambe Bay CCG (copy enclosed).

The Board considered a report which provided an update on Cumbria’s Better Care Fund (BCF) for Quarter 1 2022/23 together with the planning submission requirements for 2022/23.

RESOLVED,   that

                          (1)          the report be noted;

                          (2)          the submission of the Cumbria BCF plan be supported.

To receive the Forward Plan (copy enclosed).

The Integrated Care Board (ICB) Director of Place (North Cumbria) informed members that the consultation on the ICB Strategy would end before the next meeting of the Board and it was agreed this would be circulated to members for virtual comments.

The Forward Plan was noted and it was agreed that an item on Workforce would be considered at the next meeting.

The dates of future meetings were noted and it was agreed that future scheduled Member Development Sessions would be cancelled due to the pressures on resources.