To appoint the vice-chairperson of the board; the Council’s constitution (paragraph 2.8.10) requires that ‘one of the board members representing NHS Herefordshire and Worcestershire Clinical Commissioning Group will be appointed vice chairperson annually by the board’.

The council’s constitution required that one of the board members representing NHS Herefordshire and Worcestershire Clinical Commissioning Group be appointed vice-chairperson annually by the board.  Dr Ian Tait was nominated as the vice-chairperson.

Resolved:       That Dr Ian Tait be appointed vice-chairperson of the board for the remainder of the municipal year.

Apologies for absence had been received from: Cllr Crockett (Chair of the board), Cllr Tyler (Herefordshire Community Safety Partnership), Chief Fire Officer Jonathon Pryce (Hereford & Worcester Fire and Rescue Service), Simon Trickett (NHS Herefordshire and Worcestershire CCG), Mark Yates (Herefordshire and Worcestershire Health and Care NHS Trust), Julie Grant / Hayley Allison (NHS England and NHS Improvement) and Mandy Appleby, Richard Ball, and Neil Taylor (Hereford Council)

To receive details of any member nominated to attend the meeting in place of a member of the board.

The following named substitutes were present: Cllr Norman for Cllr Crockett (Hereford Council).

The following named substitutes were in attendance virtually and therefore were able to participate in the debate but not cast a vote:

Anna Davidson for Chief Fire Officer Jonathon Pryce (Hereford & Worcester Fire and Rescue Service). David Mehaffey for Simon Trickett (NHS Herefordshire and Worcestershire CCG) and Sarah Duggan for Mark Yates (Herefordshire and Worcestershire Health and Care NHS Trust).

To receive any declarations of interests of interest in respect of schedule 1, schedule 2 or other interests from members of the board in respect of items on the agenda.

Dr Ian Tait reminded the board that he was a member of Worcestershire’s health and well-being board.

Sarah Duggan representing the Herefordshire and Worcestershire Health and Care NHS Trust registered she was also a member of Worcestershire’s health and well-being board.

To approve and sign the minutes of the meeting held on 8 March 2021.

The minutes of the previous meeting were received.

Resolved:       That the minutes of the meeting held on 8 March 2021 be approved and be signed by the chairperson.

To receive any written questions from members of the public.

For details of how to ask a question at a public meeting, please see:

www.herefordshire.gov.uk/getinvolved

The deadline for the receipt of a question from a member of the public is Tuesday 20 July 2021 at 5.00 pm.

To submit a question, please email councillorservices@herefordshire.gov.uk

No questions had been received from members of the public.

To receive any written questions from councillors.

The deadline for the receipt of a question from a councillor is Tuesday 20 July 2021 at 5.00 pm, unless the question relates to an urgent matter.

To submit a question, please email councillorservices@herefordshire.gov.uk

Questions received and responses given are attached as appendix to the minutes.

The purpose of this report is to raise awareness of the LeDeR programme with a view to providing opportunity for the key objectives and priorities of the programme to be aligned with Health and Wellbeing Board priorities and workstreams.

The Associate Director of Nursing and Quality (ADNQ), NHS Herefordshire and Worcestershire CCG, introduced the annual report, the principal points of the presentation included:

·       The report reflects the past 12 months and how the Covid19 Pandemic has impacted on people with learning difficulties. Herefordshire has been in a strong position where it was reported that no single confirmed Covid related death for somebody with a learning disability has been registered.

·       The report reflects the third full year of data for Herefordshire and Worcester and for the first year provides clear understanding of the context for people living in Herefordshire compared to other areas. This has given some helpful reflections in particular: The mean age of death for Men is significantly better than the England average. The percentage of younger people, particular those aged 24 and younger with a learning disability who die within Herefordshire is better than the England average.

·       The programme is a quality improvement program and is founded in listening to and working with experts with lived experience in local communities to understand their perspective.

·       The priorities highlighted in the annual report will be taken in to a strategy which is required to be produced by March 2022, it will be a three year strategy and will provide much more details of how we are collectively working together to improve outcomes for people.

Board members were invited to comment, the principal points included:

·         It was queried where links could be made in terms of social care for people with learning difficulties. One of the priorities in the report focused on obesity along with mental health and the prospect of combining this with opportunities to exercise, walking etc. was raised. The example was given of a programme in Leominster “Walking for Health programme” for people for learning.

The ADNQ explained that the strategy would go into much more detail in terms of how priorities were taken forward. A Learning action group existed represented by all agencies, from health and social care, public health, family carers and people with lived experience. The group reviewed themes as they arose and discussed how best priorities can be taken forward, address best practices, identify gaps and propose solutions.

·       It was noted that Health Watch supported the document and were closely involved in groups looking at the right kind of investment into the future.

·        It was queried whether work was ongoing with hospices and if the service had enough resources to do everything they wanted to do.

The ADNQ confirmed that although hospices are not directly linked to the LeDeR programme they are working closely with the end of life network across Herefordshire and Worcestershire. It was highlighted that Herefordshire may be one of the best areas in the region for people not dying in an acute hospital bed. There have been a number of examples where people have utilized hospice beds appropriately, or have been supported to have really good end of life care at home and to learn much more about how  ...  view the full minutes text for item 8.

To consider the draft carers strategy for 2021 to 2026 from the adults and communities directorate and to determine any recommendations the Health and Wellbeing Board wishes to make.

The Board received a report from the senior commissioning officer concerning the Carers Strategy. The Interim Assistant Director, All Ages Commissioning (IADAAC) introduced the report and outlined: the extensive engagement that had taken place; the vision of the strategy, its overarching/cross cutting themes and 5 key points; the establishment of a board to oversee the implementation of the strategy; and the timeline for the strategy’s approval and publication.

During the course of the debate the Board raised the following points and questions:

·       The funding that would be available for the strategy and the importance of parity with other areas.

The IADAAC explained that there would be no change to the funding arrangements locally;

·       The importance of a focus on providing support to young carers.

The IADAAC explained that the strategy sought to support vulnerable carers. The strategy co-ordinated help from early help and family support services at Herefordshire Council with existing third sector organisations to support young carers. All-family assessments would identify support needs for young carers including educational/training, primary care and social needs;

·       The support of the Adult and Wellbeing and Children and Young People Scrutiny Committees for the strategy was noted;

·       The wide-ranging and extensive consultation undertaken for the strategy was commended. In particular it was noted that the engagement had taken place during the difficult circumstances of the pandemic;

·       It was noted that the strategy was the first element of the Integrated Care System (ICS) to be publicised and progressed which provided a whole-system approach to be delivered with the coordination of all partners; 

·       The importance of the Think Carer initiative was highlighted to address a lack of awareness of young carers and the challenges they faced;

·       It was queried what support could be provided by members of Board to assist the strategy.

The IADAAC explained that support would be provided through the ICS.

·       A query was raised regarding additional resource that might be necessary to support some of the initiatives in the strategy, including the check-in proposed for carers, or whether teams existed that would take on the work.

The IADAAC explained that teams were already in place to take the work forward and there would be monitoring of the take-up of the check-ins by carers.

·       It was highlighted that a proactive approach was necessary to raise awareness among carers of entitlement to support revenue and benefits.

The Acting Director for Adults and Communities highlighted the money on your mind website which provided awareness to people of available support.

·       The fundamental importance of the interaction of the strategy across the system with other pathways was raised.

The Acting Director for Adults and Communities explained that the ICS would ensure that themes in the strategy would be embedded in the whole-system approach.

·       The strategy was welcomed by the Board.

The Board agreed a change to recommendation (b) in the report to include the words as a system. The change reflected the emphasis placed upon the whole system approach which had been highlighted by the Board during  ...  view the full minutes text for item 9.

To review the better care fund (BCF) year-end 2020-2021 report as per the requirements of the programme.

The Board received a report from the Acting Director for Adults and Communities concerning the Better Care Fund (BCF) year-end report 2020-21.

The report was introduced by the Interim Assistant Director, All Ages Commissioning and the council's finance business partner and joint strategic finance lead for the council and CCG, who explained the impact that the COVID-19 pandemic had upon reporting arrangements and spending through the programme during the 2020-21 year. The requirement for regular reporting of performance throughout the year had been greatly reduced and underspends had occurred in some areas of the BCF including long-term placements and recruitment. In Herefordshire the BCF had been compliant with national requirements during 2020-21.

The Board raised the principal points below in the discussion that followed:

·       It was queried what learning had occurred through the reduced need for performance reporting and if this had enhanced a more localised approach in Herefordshire.

The acting director for Adults and Communities and the council’s finance business partner responded to explain that the previous year had been exceptional. It was likely that requirement for more detailed reporting would return in future however a reduced requirement may continue in the current year due to the ongoing response to COVID-19. It was noted that the BCF was currently subject to review which might change the priorities of the fund but was likely to still require detailed reporting.

·       The social care settlement was raised and the potential impact it could have upon the BCF.

The acting director for Adults and Communities and the council’s finance business partner explained that the announcement had been delayed until the autumn and that funding through the BCF had become a significant proportion of the core budget to support adult social care services. The BCF may change following review but it was unlikely to be withdrawn due to its central importance to the adult social care budget.

The recommendations in the report were proposed and seconded and agreed unanimously.

Resolved: It is recommended that

a)    the Better Care Fund (BCF) 2020-2021 year-end template at appendix 1, as submitted to NHS England, be reviewed and the board determine any further actions necessary to improve future performance.

The schedule of meetings are proposed as follows:

Monday 18 October 2021, 2:30pm

Monday 6 December 2021, 2:30pm  

Monday 28 March 2022, 2:30pm  

Monday 6 June 2022, 2:30pm  

No concerns were raised with the proposed schedule of meeting dates 2021/22. The next meeting will be held on Monday 18 October 2021.

Resolved:       The schedule of meeting dates are confirmed for the municipal year.

On behalf of the committee, the chairperson expressed his gratitude to Councillor Crockett for her enormous contributions to the board over the years.