Agenda and draft minutes

Cumbria Health and Wellbeing Board
Thursday, 18th April, 2019 10.00 am

Venue: Council Chamber - County Offices, Kendal, LA9 4RQ. View directions

Contact: Lynn Harker  Email: lynn.harker@cumbria.gov.uk

Items
No. Item

1.

Apologies for Absence

To receive any apologies for absence.

 

Minutes:

Apologies for absence were received from Mr D Blacklock (Ms H Horne attended as substitute), Mr A Cummings (Mr D Walker, Medical Director attended in his absence), Ms K Fairclough (Dr D Roberts attended as substitute), Mr J Hawker (Mr A Gardner attended as substitute), Mr I Johnson and Ms B Reilly, NHS England.

 

2.

Disclosures of Interest

Members are invited to disclose any disclosable pecuniary interest they have in any item on the agenda which comprises

 

1          Details of any employment, office, trade, profession or vocation carried on for profit or gain.

 

2          Details of any payment or provision of any other financial benefit (other than from the authority) made or provided within the relevant period in respect of any expenses incurred by you in carrying out duties as a member, or towards your election expenses.  (This includes any payment or financial benefit from a trade union within the meaning of the Trade Union and Labour Relations (Consolidation) Act 1992.

 

3          Details of any contract which is made between you (or a body in which you have a beneficial interest) and the authority

 

            (a)       Under which goods or services are to be provided or works are to be executed; and

 

            (b)       Which has not been fully discharged.

 

4          Details of any beneficial interest in land which is within the area of the authority. 

 

5          Details of any licence (alone or jointly with others) to occupy land in the area of the authority for a month or longer. 

 

6          Details of any tenancy where (to your knowledge)

 

            (a)       The landlord is the authority; and

 

            (b)       The tenant is a body in which you have a beneficial interest.

 

7          Details of any beneficial interest in securities of a body where

 

            (a)       that body (to your knowledge) has a place of business or land in the area of the authority; and

 

            (b)       Either –

 

(i)                 The total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body; or

 

                        (ii)        If that share capital of that body is of more than one class, the total nominal value of the shares of any one class in which the relevant person has a beneficial interest exceeds one hundredth of the total issued share capital of that class.

 

In addition, you must also disclose other non-pecuniary interests set out in the Code of Conduct where these have not already been registered.

 

Note

 

A “disclosable pecuniary interest” is an interest of a councillor or their partner (which means spouse or civil partner, a person with whom they are living as husband or wife, or a person with whom they are living as if they are civil partners).  

 

Minutes:

Ms H Horne declared a pecuniary interest as she was a member of Healthwatch England Committee which was a Sub?Committee of the Care Quality Commission.

 

3.

Exclusion of Press and Public

To consider whether the press and public should be excluded from the meeting during consideration of any item on the agenda.

 

Minutes:

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

 

4.

Minutes pdf icon PDF 243 KB

To confirm as a correct record the minutes of the meeting held on 5 February 2019 (copy enclosed). 

 

Minutes:

RESOLVED,     that the minutes of the meeting of the Board held on 5 February 2019 be agreed as circulated and thereupon signed by the Chair.

 

5.

SEND Inspection

To receive a presentation from the Executive Director – People.

 

Minutes:

This item was deferred until the next meeting of the Board.

 

6.

Cumbria's Local Transformation Programme to Improve the Resilience, Emotional Wellbeing and Mental Health of Children and Young People 2015-2020 pdf icon PDF 177 KB

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

 

Minutes:

Members considered a report from the Executive Director – People which provided an update on Cumbria’s Local Transformation Programme to Improve Resilience, Emotional Wellbeing and Mental Health of Children and Young People 2012-2020 programme following a Cumbria Health and Wellbeing Board development session which took place on 19 March 2019.

 

The Board noted that last November the Health and Wellbeing Board acknowledged that children and young people’s emotional health and wellbeing was a key shared priority area for Cumbria and committed to a higher level of involvement, scrutiny and direct support for the multi-agency whole system work underway to address current challenges and improve mental wellbeing outcomes.

 

Members received a brief summary of the discussion at the Development Session followed by an outline plan of how the 2019/2020 Local Transformation Plan process would be undertaken and direct the programme actions for this year to increase the impact of improvements and capture clearer evidence of where things were working well and where challenges remained.  It was acknowledged that a key challenge for all statutory organisations was to find a way of shifting resources to support prevention and reduce overall demand in the longer term. 

 

A discussion took place regarding outcomes and the availability of statistics or performance measures for service.  Members were informed that there were challenges to have a coherent dashboard and noted that this year the development plan would focus on performance with a robust outcome framework for service users. 

 

The importance of early intervention to allow preventative measures to be undertaken was highlighted to members.  The Board noted the need to identify schools where support to staff was required to allow work to be undertaken with pupils in crisis.

 

Whilst members noted this was part of the 2015?2020 Plan it was felt this should form part of the Long Term NHS 5 Year Plan highlighting the need for both the north and south plans to be consistent with the Health and Wellbeing Strategy.  It was agreed that a discussion on how all the different Plans fit together would form part of the next Health and Wellbeing Development Day

 

The concerns of the Board were acknowledged and members were reassured that despite the Clinical Commissioning Group boundaries a countywide approach remained.

 

RESOLVED,   that the approach outlined in the report to support the refresh of the North Cumbria and Lancashire and South Cumbria Local Transformation Plans for Children and Young People’s Resilience, Emotional Wellbeing and Mental Health (2015-2020) be endorsed.

 

7.

The Lancashire & South Cumbria Children and Young People's Emotional Wellbeing and Mental Health Transformation Plan 2015-2020 (Refreshed March 2019) pdf icon PDF 239 KB

To consider a report by the Lancashire & South Cumbria, Children & Young People’s Emotional Wellbeing and Mental Health Transformation Partnership Board (copy enclosed).

 

Additional documents:

Minutes:

The Board considered a report by Lancashire & South Cumbria, Children & Young People’s Emotional Wellbeing and Mental Health Transformation Partnership Board which provided an overview of the refreshed 2019 Lancashire & South Cumbria Transformation Plan Supporting Children and Young People’s Emotional Wellbeing and Mental Health (CYPEWMH). 

 

Members were informed that in 2018, it was agreed that following Clinical Commissioning Group boundary changes in North Lancashire and with the formation of the Integrated Care System for Lancashire and South Cumbria, the CYPEWMH Transformation Plan should also represent the needs of children, young people and their families across the Lancashire & South Cumbria geographical footprint.  Concerns were raised regarding the size and diversity of the footprint involved.

 

The Board noted that the aim was to improve the resilience, emotional wellbeing and mental health of children and young people, especially those who were at increased risk due to their vulnerability, making it easier for them and their families to access help and support when they needed it and improving the standard of mental health services across Lancashire and now, South Cumbria. 

 

Members emphasised the importance of good communication and noted that the Plan had been informed by consultation with children, young people and families, and based on comprehensive identification of needs and evidence-based practice, as well as a clear understanding of the local context.  The commitment of co?production was reinforced highlighting the co?production which had taken place between Lancashire and Cumbria.  During the course of discussion the necessity for engagement with the Barrow?in?Furness community was emphasised and it was confirmed this was taking place.

 

Whilst appreciating the diverse and geographical areas in Lancashire and South Cumbria it was explained that Healthwatch Cumbria were involved in the co?production and their remit was for inclusion of every part of Cumbria.   It was explained the commitment to deliver services across the county required the necessity to work within assets in communities to building on resilience.

 

During the course of discussion, whilst it was acknowledged there were a number of challenges, the Board were reassured by the CCG that the progress undertaken to date was positive. 

 

A suggestion was made that the ‘Review of Achievements’ to Date should refer to ‘people’ rather than ‘workstreams’.

 

The Board were informed that the Transformation Plan had afforded the opportunity to strengthen commitments to children, young people and their families and in particular to children and young people who were at increased risk due their vulnerability and those identified as young carers.  Members noted the agreed priorities for 2019/20 which included:-

 

·               Developing an online portal known locally as ‘Digital THRIVE’ offering information, advice, self-help, care pathways and a self-referral process (Objective 3);

 

·               Redesign CAMHS and the Complementary Offer in line with the THRIVE model (Objective 2 & 4);

 

·               Define and deliver appropriate specialist inpatient and community intensive supports as part of ‘Getting More Help’ within THRIVE (Objective 6).

 

It was highlighted that the Programme and workstreams would continue to work closely with children, young people and their families, and  ...  view the full minutes text for item 7.

8.

Transfer of Mental Health Services in Cumbria pdf icon PDF 186 KB

To receive a verbal update from NHS Morecambe Bay CCG.

 

Additional documents:

Minutes:

Members received a verbal update from representatives of NHS Morecambe Bay Clinical Commissioning Group regarding the transfer of mental health services in Cumbria.

 

The Board were informed that plans had been announced to improve mental health services in South Cumbria with the aim of delivering better health and care to the population of Morecambe Bay.  It was explained that the Adult Mental Health Services, Child and Adolescent Mental Health Services (CAMHS) and Learning Disability services would be provided by Lancashire Care Foundation Trust from October 2019 as part of the ambitions of the Bay Health & Care Partners.

 

It was explained that the services would be transferring from Cumbria Partnership Foundation Trust (CPFT) to Lancashire Care Foundation Trust (LCFT) on 1 October 2019 following agreement between the two organisations and Morecambe Bay Clinical Commissioning Group (CCG).  The Board noted that this followed the agreement earlier in the year to transfer mental health services in the north of the county from CPFT to Northumberland, Tyne and Wear Foundation Trust by the same date.

 

The Board were informed that the transfer would be undertaken safely and effectively, with a plan to improve services being developed within South Cumbria over the coming 12 months.  Members noted that a commitment had been made to a significant investment in the mental health service in 2019 to support the improvement in local services in line with the new NHS Plan.

 

Members received an update on the proposed engagement with staff, patients and the public.  It was explained that engagement had begun with clinical leaders from both CPFT and LCFT to develop a model for mental health care delivery in Morecambe Bay following listening events with the public and stakeholders.

 

Members were informed that a new Chief Executive had been appointed to Lancashire Care who would hold meetings with staff in Kendal and Barrow to discuss the proposed changes in service across South Cumbria.  The Board also welcomed the opportunity for a meeting as a matter of urgency.

 

During the course of discussion members were informed that NHS staff were extremely concerned about the change in service highlighting the lack of need of a consultation as this was only a change of contract rather than a change of service.  The Board raised their concerns regarding the past performance of Lancashire Care.  It was explained they had been rated ‘require improvement’ by regulators, although its mental services were ranked as ‘good’ emphasising the necessity to provide the right services at an agreed quality.

 

It was highlighted to the Board that there was a commitment to ongoing improvement work associated with the transfer.  It was explained there were very good services delivered in Lancashire and Cumbria, and the intention was to keep the best of those and learn from them, acknowledging the transfer needed to deliver for patients in both counties.

 

The Chair thanked officers for their update and emphasised the importance of collaborative working to ensure good services were delivered.

 

9.

Update on Healthy Weight Declaration pdf icon PDF 173 KB

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

 

Minutes:

The Board considered a report by the Director of Public Health (Cumbria County Council) which provided an update on the implementation of the Healthy Weight Declaration, which had been signed by the County and all six District councils in Cumbria in June 2018.

 

Members were informed that plans to implement a whole-system approach to develop local action plans were stalled due to the delayed release of the Public Health England toolkit in October 2018, and delayed feedback on trailblazer funding in late January 2019.  It was explained that a Cumbria?wide and local action plans were now being developed as part of the Joint Public Health Strategy (referred to in Appendix 1 of the report).

 

The Board welcomed the latest statistics from the National Child Measurement Programme which had shown that the proportion of overweight or obese children of reception age had fallen from 28% to 26%.  It was explained that this represented a significant reversal of the trend over the last four years highlighting the improvement had arisen a year after work by councils in Cumbria to spread the healthy weight message.  It was anticipated that if work continued around healthy weight further reductions would continue in the future.

 

The Board’s attention was drawn to a number of local authorities who were limiting licensing for food outlets, including takeaways, in certain areas.  Whilst this was welcomed by members the legal implications and necessity for district councils to change their planning policies were highlighted.  District council representatives explained they were investigating how they could initiate changes which would have a positive impact on this.  Members were informed that Carlisle City Council had introduced a Policy which prevented street trading within 100 metres of a school entrance and suggested this should be considered across the whole of the county.

 

During the course of discussion attention was also drawn to those who were underweight and it was felt there was an opportunity to reflect on this and strengthen work to achieve a balance for everyone.

 

RESOLVED,   that the report be noted.

 

10.

Joint Health and Wellbeing Strategy 2019-2029 pdf icon PDF 84 KB

To consider a report by the Director of Public Health (Cumbria County Council), Chief Operating Officers – North Cumbria and Morecambe Bay Clinical Commissioning Groups (copy enclosed).

 

Additional documents:

Minutes:

The Board considered a report by the Director of Public Health (Cumbria County Council and Chief Operating Officers of North Cumbria and Morecambe Bay Clinical Commissioning Groups.

 

Members were informed that local authorities and clinical commissioning groups (CCGs) had equal and joint duties to prepare the Joint Health and Wellbeing Strategy (JHWS) through the Health and Wellbeing Board.  It was noted that the previous Strategy expired at the end of 2019 and at its April 2018 meeting the Board agreed the timeframe to revise the Strategy.

 

The Board was informed that the draft Strategy was published for a three month period of public consultation which ran from 1 November 2018 until 31 January 2019.  A summary of the feedback from the public consultation and stakeholder engagement events held for Cumbria’s new Health and Wellbeing Strategy 2019–2029 was contained within the report.  It was explained that the information had been used to shape the immediate priorities and direction of travel for the new Strategy.

 

Members and officers welcomed the Strategy and thanked everyone involved.  During the course of discussion it was felt there was a need to strengthen inequality issues.  A suggestion was also made that ambitions over a 10 year period and the appropriate impact they had should be considered for inclusion.

 

A discussion took place regarding the Key Themes and, whilst it was appreciated this was work in progress, it was suggested that a baseline was required in order to measure progress.  It was felt there was a need to align this to the wider health outcome framework as things moved to the 10 year Strategy. 

 

Members discussed social isolation and the affects this had on the health and wellbeing of communities.  The lack of regular transport in areas of the county were highlighted as a concern and it was felt engagement with the private sector to develop relationships with transport operators would be beneficial.  It was suggested that a further discussion on this matter should also take place at a future meeting of the Public Health Alliance.

 

RESOLVED,   that

 

                          (1)          the summary of the consultation feedback be noted;

 

                          (2)          the Joint Cumbria Health and Wellbeing Strategy be approved subject to the comments above;

 

                          (3)          the senior sponsors for each of the Key Themes and priorities for immediate action be considered further at the Cumbria Health and Wellbeing Board Development Day.

 

11.

NHS England Consultation on Possible Changes to Legislation pdf icon PDF 126 KB

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

 

Additional documents:

Minutes:

Members received a report from the Executive Director – People which requested delegations be put in place to allow the Health and Wellbeing Board to respond to NHS England’s consultation on proposed changes to legislation.

 

The Board were informed that in January NHS England had published its Long-Term Plan (LTP) which set out some suggested changes to legislation that would help facilitate the LTP’s implementation.

 

Members noted that the NHS had outlined eight groups of suggested legislative changes in the NHS Long Term Plan and were now setting those out in further detail.  It was explained that in February 2019 NHS England and NHS Improvement published a further paper formally asking for responses to a consultation exercise on the proposed changes to legislation.  It was noted that the NHS had asked that interested stakeholder provide feedback through a short feedback form.

 

The Board were informed that the NHS intended to share the feedback they received with the Parliamentary Health and Social Care Select Committee to inform their inquiries.  Members were asked to submit any comments on the Consultation direct to Derek Houston for inclusion in the response.

 

RESOLVED,   that the response to the Consultation be delegated to the County Council’s Executive Director – People in consultation with the Chair and Vice-Chairs of the Board.

 

12.

Care Quality Commission Action Plan - Closedown Report pdf icon PDF 162 KB

To consider a report by the Chief Executive (Cumbria County Council) (copy enclosed).

 

Additional documents:

Minutes:

The Board received a report from the Chief Executive – Cumbria County Council which provided an update on the delivery of the Action Plan that arose out of the Care Quality Commission (CQC) system review process and asked the Board to note the progress against the action plan (referred to in Appendix 1 of the report).  It was noted that at the Board’s November meeting it had been agreed to close down the CQC action plan as a separate action.

 

RESOLVED,   that the performance report on the CQC Local System Review Action Plan (attached as Appendix 1 to the report) and what action will be taken to mainstream any outstanding actions be noted.

 

13.

Health and Wellbeing Board Outcome Framework pdf icon PDF 217 KB

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

 

Minutes:

The Board received a report from the Executive Director – People (Cumbria County Council) regarding the Health and Wellbeing Board Outcome Framework.

 

Members noted that the revised Health and Wellbeing Strategy (HWBS) would be agreed at this meeting of the Board, therefore it afforded the opportunity for members to review its performance management arrangements.

 

It was explained that when the Board’s Terms of Reference had been revised it had been agreed it would have a wider role in seeking assurance about the performance of the system.  Members noted that in order to fulfil this function it was proposed to develop a performance outcomes framework to provide a structure for those considerations detailed in the HWBS and other areas as required in the Terms of Reference. 

 

The Board was informed that details of indicators was proposed to be further developed.  It was explained they would need to include consideration of, but were not limited to, the Public Health Strategy, Children and Young Peoples Plan, Care Quality Commission Action Plan, North Cumbria System Plan and Morecambe Bay Integrated Care Partnership and Lancashire and South Cumbria Integrated Care System Plan.

 

A discussion took place regarding the development of the outcome framework and members highlighted the need to ensure indicators could be measured, noting that whatever the outcomes were the CCGs and County Council should be informed of how they were being achieved. 

 

It was explained that the development of the framework would be considered by the Health and Wellbeing Board highlighted it was not intended to include new indicators.  Members were informed there was a need to identify which indicators were the most relevant and useful measures to report back to the Board.  It was felt there was a need to look at how the work was accelerated to develop a more sophisticated approach in context of the 10 Year Plan, highlighting the importance of measuring impact in a meaningful way.

 

Members noted it was proposed that those measured would be reviewed by the Board annually.  However, there were issues with those outcome measures including time lags and detail available within the measure.  It was explained, therefore, that the “How will we measure success” and “what outputs we will measure” sections of the outcomes framework would be expected to provide a stronger link to more detailed activity to provide assurance work was taking place to deliver the high level outcomes.

 

A discussion took place on the ability to meet demands within the existing resources available and members agreed there was a requirement for more focus on the prevention and early help agenda to reduce demand.  It was suggested that there was a need to take responsibility in individual localities by using services differently to meet demands.  During the course of discussion it was felt that resources and services also needed to be targeted around deprivation.

 

Members were informed that initial discussions on priorities had taken place at the Health and Wellbeing Board Development Day and the outcomes would be reported to the next  ...  view the full minutes text for item 13.

14.

System Strategies - Update Report pdf icon PDF 562 KB

To consider a report by the Chief Executive (NCUHT/CPFT), Chief Executive (UHMBT) and Chief Officer (Morecambe Bay CCG) (copy enclosed).

 

Minutes:

Members considered a report by Chief Executive - NCUHT/CPFT, Chief Executive – UHMBT and Chief Officer – Morecambe Bay CCG which set out the process that was being undertaken to ensure that system plans were produced and could be considered by the Health and Wellbeing Board.

 

The Board noted that the NHS Long Term Plan, published earlier this year, had set out the main areas of focus for the development of the NHS over the forthcoming ten years.  It was explained that a detailed national implementation programme would be produced by the autumn to enable NHS England to properly take account of Government Spending Review decisions on workforce education and training budgets, social care, councils’ public health services and NHS capital investment.

 

Members were informed that as part of the five year funding allocations (2019?2024) local health systems would be asked to produce local plans setting out how they would deliver the commitments set out in the long term plan.  It was explained that given the different system architectures that existed in North and South Cumbria the detail of what was required would differ.

 

Members were informed that many of the features of the North strategy over the next five years would build on the key foundations already established over the last two years.  It was explained that whilst this would not set out specific service reconfiguration proposals it would seek the views of patients, the public and staff about the longer term strategic aims which were set out.  It was emphasised to members that this was not a consultation exercise but about engagement to obtain direct feedback to reshape key areas.  The Board noted that the core principles for engagement was to ensure it was open, inclusive and was extended to the broad ranges of places and interests across communities. 

 

The Board received a similar update for Morecambe Bay/Lancashire and South Cumbria.  Members were informed that in the south of the County two linked strategy developments were taking place; a refresh of Lancashire and South Cumbria Integrated Care System (ICS) Strategy and a refresh of the Better Care Together Strategy.  The challenges of the geography of the County and connecting with the North and the County Council were highlighted. 

 

Members noted that the South Cumbria local system meant the Lancashire and South Cumbria ICS.  It was explained that NHS England had confirmed that further guidance regarding the development of Integrated Care Systems 5 Year Strategies was expected later in April as part of the implementation framework for the Long Term Plan.  Members were informed the ICS strategy development had commenced to ensure early involvement of partners, stakeholders and the public.

 

A discussion took place regarding the NHS Long Term Plan and the Board sought clarity on its references to plans for local health systems and the role of the Health and Wellbeing Board.  Members highlighted that the Board’s Terms of Reference included consideration of future plans emphasising the importance of engagement with elected members of both  ...  view the full minutes text for item 14.

15.

2018-19 Better Care Fund Quarter 3 Report pdf icon PDF 875 KB

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

 

Additional documents:

Minutes:

The Board received a report by the Executive Director – People (Cumbria County Council), Chief Operating Officer, NHS North Cumbria CCG and Chief Officer, NHS Morecambe Bay CCG which provided an update on Cumbria’s 2017-19 Better Care Fund (BCF) and asked members to note the submission of the joint BCF/iBCF 2018/19 Quarter 3 (Q3) performance return (referred to in Appendix 1 of the report) and also financial and activity reporting.

 

Members raised their concerns regarding the downturn in performance in the south of the County for Delayed Transfers of Care (DToC).  The Board were informed there were concerns regarding data issues which were being investigated.  It was explained there was marginal improvement for Q4 but were assured this would be investigated to understand the reasons behind it with a view to a resolution.  It was noted there had been a slight improvement in performance in the North and this was believed to be the result of the shift based implementation and the ICCs making an impact.

 

The Board were informed that the greatest reason for DToCs was the completion of assessments, awaiting residential home placement or availability followed by awaiting a care package in the home.  It was explained that there was capacity in Barrow but not in South Lakeland and it was agreed further information would made available to the Board.

 

RESOLVED,   that the report be noted.

 

16.

NHS Morecambe Bay CCG Primary Care Commissioning Committee pdf icon PDF 66 KB

To consider a report by the Chief Officer – Morecambe Bay Clinical Commissioning Group (copy enclosed).

 

Additional documents:

Minutes:

Members received a report from the Chief Officer – Morecambe Bay Clinical Commissioning Group which asked the Board to nominate a representative to the NHS Morecambe Bay Clinical Commissioning Group Primary Care Commissioning Committee.

 

The Board agreed that the nomination could be either an officer or elected member and should be delegated to the Executive Director – People in consultation with the Chair and Vice?Chairs of the Board.  The nomination would be reported to the next meeting of the Board.

 

RESOLVED,     that the nomination of the Board’s representative to the NHS Morecambe Bay Clinical Commissioning Group Primary Care Commissioning Committee be delegated to the Executive Director – People in consultation with the Chair and Vice-Chairs.  The nomination would be reported at the next meeting of the Board.

 

17.

Cumbria Public Health Alliance Update pdf icon PDF 164 KB

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

 

Minutes:

The Board received a report from the Director of Public Health (Cumbria County Council) which gave an update on the development of the Cumbria Public Health Alliance (PHA), 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 there was a need to review the work of the PHA and its links to the Locality Forums in the areas in accordance with local footprints.

 

RESOLVED,   that the report be noted.

 

18.

Future Meeting Dates pdf icon PDF 11 KB

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

 

Minutes:

The Board noted that:-

 

(1)       the next Cumbria Health and Wellbeing Board Development day would take place on Friday 21 June 2019 at 10.00 am at Cumbria House, Carlisle.

 

(2)       the next meeting of the Board would take place on Friday 5 July 2019 at 10.00 am at Cumbria House, Carlisle.