Councillor Harvey welcomed everyone to the meeting.  Apologies were received from Dawn Godfrey, Louise Platt, Sarah Prema and Penny Sharp.

To receive a brief update from the Chair on the Integrated Care Partnership and any other matters arising.

The Chair confirmed that a copy of her statement would be distributed with the minutes.  It was noted that Viv Robbins from Public Health had left to take up a new role but that Adrian Allen, Public Health’s Head of Service Design & Delivery Health would attend these meetings as her replacement.  Members were also informed that Sandra Taylor had left her role as Health and Wellbeing Integration Lead at Rutland County Council and that Katherine Willison had taken over the role.  The Chair welcomed both to the Health and Wellbeing Board.

To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on the 12^th July 2022.

The minutes of the Rutland Health and Wellbeing Board meeting held on the 12^th July 2022 were approved as an accurate record.

To review and update the actions arising from the previous meeting.

Action 1

The Chair to notify Board members of the date for the first meeting of the Health and Wellbeing Partnership.

Councillor Harvey confirmed that she had notified Board members of the date.

Action 2

The amendments to the update reports would be discussed at the next meeting of the Integrated Delivery Group and the agreed way forward reported back to the Chair and the Strategic Director of Children and Families.

Debra Mitchell reported that there had been changes in key personnel since the last meeting so the new report formats had been discussed at the Integrated Delivery Group but were for formerly approval and feedback at this meeting.

Action 3

All members of the Board were requested to complete the consultation on the proposed Rutland Pharmaceutical Needs Assessment.

Action completed.

Action 4

A report on primary care access, diagnostics and outpatients and elective care services was requested to be presented at the next meeting.

It was confirmed that the item was on the agenda for discussion but would be presented by Debra Mitchell as Sarah Prema had sent her apologies.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

There were no declarations of interest declared.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 73.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

There were no petitions, deputations or questions received.

To consider any questions from Members received under Procedure Rule 75.

There were no questions with notice from members

To consider any Notices of Motion from Members submitted under Procedure Rule 77.

There were no notices of motion from members.

---oOo---

Mitch Harper joined the meeting at 2.06 p.m.

---oOo---

To receive Report No. 159/2022 from Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC

Report No. 159/2022 was received from Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC and was presented by Mitch Harper, Public Health Strategic Lead (Rutland).  During the discussion, the following points were noted:

·         Data regarding issues being reported by women armed forces veterans would require further investigation locally and nationally.

·         It was noted that the report only included data from GP surgeries within Rutland but that many Rutland residents were registered at GP surgeries located outside of Rutland.  Mitch Harper confirmed that he would be happy to widen the boundary access in order to include data from the GP surgeries located outside of Rutland but used by Rutland residents e.g. Melton Mowbray.

·         It was confirmed that under the Core20PLUS5 project, Rutland did not qualify for the Core20 funding as it did not meet the deprivation levels required but that it would receive a small amount of funding from the PLUS5 funding.

·         The Group welcomed the plan for a development session on health inequalities and agreed that Mitch Harper should arrange the development session for a date after the publication of the expected census data.

ACTION: Mitch Harper

RESOLVED

That the Committee:

a)    NOTED the report findings and approved publication of the needs assessment on the Rutland Joint Strategic Needs Assessment (JSNA) website.

b)    WELCOMED the development of a Health and Wellbeing Board development session on health inequalities with a deep dive on needs assessment findings (Appendix A) and further discussion on the report recommendations set out in Appendix C

c)    NOTED that Mitch Harper would arrange the development session for a date after the publication of the expected census data.

---oOo---

Dr Shaun McGill joined the meeting and Mitch Harper left the meeting at 2.29 p.m.

---oOo---

To receive Report No. 160/2022 from Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC

Report No. 160/2022 was received from Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC and was presented by Dr Shaun McGill, Specialty Trainee in Public Health Medicine (ST3), NHS England – Midlands.  During the discussion, the following points were noted:

·         The End of Life support service was reported by service users as ‘complicated’ and ‘difficult to access’, with a lack of co-ordination between services.

·         The Board welcomed the feedback from service users and it was felt that the majority of recommendations would be low cost, quick win changes.

·         It was requested that the title for Priority 6 - ‘Dying Well’ be changed e.g. ‘Dying Gracefully’ or ‘Dying with Dignity’ but it was confirmed that ‘Dying Well’ was the national name for the project but that a different phase could be used locally. 

RESOLVED

That the Committee:

a)    ENDORSED the recommendations arising from the JSNA End of Life chapter, which sought to address the unmet needs and gaps identified therein.

b)    NOTED that the JSNA End of Life chapter would be used to inform the refresh of the LLR End of Life Strategy which would be undertaken by the Integrated Care Board.

c)    INTEGRATED the JSNA End of Life chapter into Rutland’s Place Led Delivery Plan and changed the local title for Priority 6 ‘Dying Well’.

---oOo---

Dr Shaun McGill left the meeting at 2.29 p.m.

---oOo---

To receive Report No. 162/2022 from Sarah Prema, Chief Strategy Officer, LLR ICB

Report No. 162/2022 was received from Sarah Prema, Chief Strategy Officer, LLR ICB and was presented by Debra Mitchell, Deputy Chief Operating Officer, LLR ICB.  During the discussion, the following points were noted:

·         A joint development session was held on the 11^th October 2022 regarding the cost of living crisis as part of the LLR Health and Wellbeing Partnership meeting.

·         The next meeting of the LLR Health and Wellbeing Partnership would be held on the 27^th October 2022 and this would be another joint development session.

·         It was noted that the Health and Wellbeing Partnership must produce an Integrated Care Strategy. This strategy must be published in a draft format by the 25^th December 2022 so that it informed the strategic direction of the Integrated Care Board as they planned for 2023/24 and beyond.  Therefore, a SPECIAL in-person meeting of the Rutland Health and Wellbeing Board would be held on Tuesday, 13^th December 2022 at 2.00 p.m. in the Council Chamber at Rutland County Council for the Board to formerly approve the draft Integrated Care Strategy.

·         It was also noted that the Integrated Care Board must develop and publish a 5-year plan by March 2023, which would take account of the Health and Care Partnership’s Integrated Care Strategy.

RESOLVED

That the Committee:

a)    NOTED the update on the Leicester, Leicestershire and Rutland Integrated Care System.

To receive Report No. 164/2022 from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and presented by Katherine Willison, Health and Integration Lead, RCC.

Report No. 164/2022 was presented by Katherine Willison, Health

and Integration Lead, RCC.  During the discussion, the following points were noted:

·       The Chair informed the Board that the update reports received on the progress of the JHWS across the six priority areas were currently not acceptable as the Board needed to measure itself against its targets to see how it was progressing and if the six priorities were moving forward.  It was proposed that Councillor Harvey, Debra, Katherine and John meet to identify an agreed format for the update reports.

ACTION: Councillor Harvey, Debra Mitchell,

Katherine Willison and John Morley

·       It was queried if there was any data that detailed where the greatest number of falls occurred and what measures had been implemented to help prevent falls at home.  It was confirmed that the Falls Prevention Programme had been running across LLR for some years and that the Occupational Therapy Service was in contact with social housing providers, the police, the fire service and GP services regarding the ‘housing MOT’ project, which provided support regarding falls prevention in people’s homes.  Katherine confirmed that she would collate falls data and distribute a briefing to Board members for their information.

ACTION: Katherine Willison

RESOLVED

That the Committee:

a)    NOTED the further development of the JHWS Delivery Plan through the content of this report.

To receive Report No. 163/2022 from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and presented by Katherine Willison, Health and Integration Lead, RCC.

Report No. 163/2022 was presented by Katherine Willison, Health

and Integration Lead, RCC.  During the discussion, the following points were noted:

·       The next BCF submission would be for a 2-year rolling programme.  

RESOLVED

That the Committee:

a)    NOTED the content of the report

b)    NOTED the Rutland 2022-23 Better Care Fund plan, submission of which to the BCF national team on 26 September 2022 was signed off by the Chair of the Health and Wellbeing Board.

To receive an update from Councillor David Wilby, Chair of the Rutland Children and Young People Partnership

A verbal update was received from Councillor David Wilby, Chair of the Children and Young People Partnership.  During the discussion, the following points were noted:

·         The turnover of staff continued to cause some issues.

·         Attendance at schools continued to be good but schools had reported an increase in issues regarding pupil behaviour following the pandemic.

·         Excellent results had been received in the GCSE and ‘A’ level examinations.

·         A positive Peer Review had been carried out on the SEND service.

·         The work regarding the ‘Family Hub’ was progressing.

·         Unaccompanied asylum seeking children (UASC) continued to work well with many now doing post-16 courses.

·         37 Ukrainian children were currently attending Rutland schools.

To receive an update from Debra Mitchell, Deputy Chief Operating Officer, LLR ICB

A verbal update was received from Debra Mitchell, Deputy Chief Operating Officer, LLR ICB.  During the discussion, the following points were noted:

·         A ‘Staying Healthy Partnership’ would be established as a sub-group of the Integrated Delivery Group.  First meeting would be held in November 2022 and chaired by the Public Health team, with a focus on staying healthy and independent. 

·         There had been two key staff changes.  Viv Robbins and Sandra Taylor had moved to new roles but they had been replaced by Adrian Allen and Katherine Willison respectively.  Viv and Sandra were thanked for all their hard work and Adrian and Katherine were welcomed to their new roles.

·         Reporting structures had been reviewed and focus was now needed on the Communication and Engagement Plan.

·         Councillor Harvey stated that the updated Terms of Reference for both sub-groups needed to be formerly approved by the Health and Wellbeing Board at the next meeting in January 2023. 

AGENDA

To receive an update from Dr James Burden, Clinical Place Leader, Rutland Primary Care Network to cover:

·       Changing Landscape to Primary Care Workforce

·       Enhanced Access Plans

·       Update on the Outcomes of the Recommendations from the Primary Care Access Task and Finish Group

Presentations were received from Dr James Burden, Clinical Place Leader, Rutland Primary Care Network (PCN).  During the discussions, the following points were noted:

·       Changes in protocols had enabled long-term conditions to be managed by other health professionals e.g. clinical pharmacists rather than doctors.

·       Work was needed within the Communications and Engagement Plan to inform the public on how the health service had changed and what additional roles there were now that worked alongside that of the traditional GP.

·       The Government’s national ‘Workforce Recruitment Strategy’ was being implemented successfully in Rutland to recruit health professionals to the area.

·       The Enhanced Access survey had received 9000 responses.  Healthwatch Rutland and the Chairs of the various Patient Participation Groups were thanked for their assistance in the promotion of the survey.

·       The Enhanced Access service started on the 1^st October 2022 and under this new service one site of the Primary Care Network (PCN) (Oakham, Uppingham, Market Overton and Empingham) would be open Monday to Friday 6.30 pm to 8.00 pm and Saturday from 9.00 am to 5.00 pm.  Only scheduled appointments were allowed but it was open to all patients registered with a Rutland GP.

·       Rutland residents who were registered with a GP practice outside of Rutland would be able to access the other GP services who were included as part of that area’s Primary Care Network.

·       It was noted that better communication was needed to educate and inform patients of the benefits of digital working and how accessing services online enabled GP services to be more efficient.

To receive an update from Helen Mather, Elective and Cancer Commissioning Lead, LLR ICB.

A presentation was received from Helen Mather, Elective and Cancer

Commissioning Lead, LLR ICB and was presented by Debra Mitchell, Deputy Chief Operating Officer, LLR ICB.  During the discussion, the following points were noted:

·       7-day working would be achieved in a phased approach.

·       1 MRI pad for Rutland patients would be implemented.

·       The out-of-hours services would remain in place until March 2023.

---oOo---

At 4.27 pm, the Chair proposed that the meeting be extended for a period of 15 minutes for the agenda to be completed. This was seconded by Debra Mitchell and was agreed unanimously by a virtual show of hands.

---oOo---

To receive Report no. 161/2022 from Mark Powell, Deputy Chief Executive, Leicestershire Partnership NHS Trust.

Report no. 161/2022 was received from Mark Powell, Deputy Chief Executive, Leicestershire Partnership NHS Trust.  During the discussion, the following points were noted: 

·       Mark Powell apologised to the Board about the lack of communication regarding the proposed changes and improvements to Rutland Memorial Hospital and stated that there would be improved communications moving forward.

·       £1.2m would be spent on Rutland Memorial Hospital including repairs to the roof, new electrics, the conversion of unused bathrooms to useful storage space and the redecoration of patient areas.

·       A stakeholder consultation and engagement process had now been developed and Rutland Healthwatch were engaged in providing the patients’ voice.

·       Work was expected to be completed by early January 2023.

RESOLVED

That the Committee:

a)    NOTED the planned £1.2m essential works by Leicestershire Partnership Trust at Rutland Memorial Hospital

To receive an update from Dr James Burden, Clinical Place Leader, Rutland Health Primary Care Network.

A presentation was received from Dr James Burden, Clinical Place Leader, Rutland Health Primary Care Network.  During the discussion, the following points were noted:

·       It was noted that residents could book an appointment for a vaccination via the national vaccination website but that the vaccination would not be done by the residents own GP.

·       It was confirmed that if residents wanted the vaccination to be done by their own GP, then they would need to wait until their respective surgery contacted them directly.

·       It was proposed that Councillor Harvey, Dr James Burden and Mike Sandys arrange a joint communication regarding the winter vaccination to give the public clear guidance. 

ACTION: Councillor Harvey, Dr James Burden and Mike Sandys

---oOo---

At 4.44pm, the Chair proposed that the meeting be extended for a second period of 15 minutes for the agenda to be completed. This was seconded by Debra Mitchell and was agreed unanimously by a virtual show of hands.

---oOo---

To receive updates from Emma Jane Perkins, Head of Community Care Services and Duncan Furey, Chief Executive Officer, Citizens Advice Rutland.

Updates were received from Emma Jane Perkins, Head of Community Care

Services and Duncan Furey, Chief Executive Officer, Citizens Advice Rutland.  During the discussion, the following points were noted:

·       A presentation was received from Emma Jane Perkins – copy attached – which detailed that a pamphlet entitled ‘Cost of living support in Rutland’ would be available soon for all Rutland residents.

·       Further information would also be available in the future from a new Council webpage: www.rutland.gov.uk/livingcosts

·       It was reported that contacts to Citizens Advice Rutland had increased by 40% between September 2021 and September 2022.  60% of enquiries were regarding benefits, 10% were regarding housing, 5% were regarding debt and 25% were regarding other issues.

·       Enquiries regarding fuel poverty had not yet increased but this was expected as it was suspected that many people had not yet turned their heating on.

·       The number of referrals to the food bank by Citizens Advice had increased and the food bank had confirmed that they had received 30% more users than this time than last year.

·       It was noted that many people now attending Citizens Advice Rutland and/or the food bank were first time users and many were in paid employment.

·       An overview of the income received by people was provided:

People receiving Universal Credit

o   Single person <25 years of age received £265.31 per month

o   Single person >25 years of age received £334.91 per month

o   Couple <25 years of age received £416 per month

o   Couple >25 years of age received £525 per month

People receiving state pension

o   Single person received £791 per month

o   Couple received £1207 per month

·       Many people were already in debt and/or bill arrears and these numbers were expected to increase as other costs increased e.g. food, fuel, heating, mortgage, rent etc.

·       Citizens Advice produced a National Cost of Living Dashboard. This was updated on a regular basis and had national Citizen’s Advice data and some Rutland specific data:

https://public.flourish.studio/story/1634399/?mc_cid=b3c15a4efa&mc_eid=e1d655cb85

·       Dr Underwood confirmed that Healthwatch Rutland would hold a meeting on 3^rd November 2022 at 2 p.m. in the Gover Centre at Voluntary Action Rutland on ‘How can health inequalities in Rutland be addressed in the face of the escalating cost of living’.

To consider the current Forward Plan and identify any relevant items for inclusion in the Rutland Health and Wellbeing Board Annual Work Plan, or to request further information.

The Forward Plan is available on the website using the following link:

https://rutlandcounty.moderngov.co.uk/mgListPlans.aspx?RPId=133&RD=0

The work plan was discussed and updated accordingly.

There was no urgent business

The next meeting of the Rutland Health and Wellbeing Board will be on Tuesday, 24^th January 2023 at 2.00 p.m.

Tuesday, 13^th December 2022 at 2.00 p.m. in the Council Chamber, Catmose, Oakham, Rutland LE15 6HP