The Chair welcomed everyone to the meeting and informed attendees that this would be Kim Sorsky’s first time attending a meeting of the Health and Wellbeing Board in her new role as the Strategic Director for Adult Services and Health, replacing John Morley.  Apologies were received from Councillor David Wilby and David Williams but Paul Sheldon, Chief Finance Officer attended the meeting as Mr Williams’s representative for the Leicestershire Partnership NHS Trust & Northamptonshire Healthcare NHS Foundation Trust (LPT & NHFT).

To confirm the record of the meeting of the Rutland Health and Wellbeing Board held on the 24^th January 2023.

The minutes of the Rutland Health and Wellbeing Board meeting held on the 24^th January 2023 were approved as an accurate record.

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

Action 1

Katherine to collate falls data and distribute a briefing to Board members for their information.

Katherine Willison, the Health and Wellbeing Integration Lead reported that an anomaly had been found in the data but Public Health would be investigating to clarify the matter.  She confirmed that she would see if the data could be broken down into ‘institutionalised falls’ i.e. hospitals, care homes and ‘domestic falls’ i.e. an individual’s home. The Chair requested that the item be added to the agenda for the next meeting of the Health and Wellbeing Board.

ACTION: Katherine Willison

Action 2

Councillor Harvey to send details of the feedback on the Integrated Care Partnership Strategy from the Rutland Health and Wellbeing Board to Sarah Prema.

Councillor Harvey confirmed that the action had been completed.

Action 3

Sarah Prema to speak to the Clerk regarding report deadlines for the next meeting of the Rutland Health and Wellbeing Board on the 21st March 2023 with regard to the ICB’s 5 Year Forward Plan.

It was confirmed that the item was on the agenda for further discussion.

Action 4

The Clerk to invite NHS England to a meeting of the Health and Wellbeing Board to give an update on the transition of delegated dental services and the overall access of dental services in Rutland.

It was confirmed that the item was on the agenda for discussion.

Action 5

The Health and Integration Lead to update members of the Board (via email) with details of the professional stakeholders to be consulted with regard to the Communication and Engagement Plan to ensure all professional stakeholders were included.

The Health and Wellbeing Integration Lead confirmed that she would email the details of the professional stakeholders to members of the Board and that the Communication and Engagement Plan, including a summary document, would be discussed at the next Board meeting.

ACTION: Katherine Willison

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.

The Clerk confirmed that two questions with short notice had been received, one from Mr Andrew Robinson and one from Mr Ramsay Ross.

Attendees were informed that as per Procedure Rule 73, the time allowed for any questions submitted under this procedure was a maximum of 15 minutes provided that it fell within the total time of 30 minutes allowed for petitions, deputations and questions.  A maximum of one minute was allowed to ask each question, no supplementary question would be allowed and the maximum time for answering a question would be two minutes. It was also confirmed that every question would be put and answered without discussion and that the name of the person who asked the question, a summary of the question and the response would be recorded in the Minutes.

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Mr Andrew Robinson joined the meeting at 2.13 p.m.

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Mr Andrew Robinson addressed the Chair with his question and a response was received from Sarah Prema, Chief Strategy Officer at the Leicester, Leicestershire and Rutland Integrated Care Board.

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Mr Andrew Robinson left the meeting and Mr Ramsay Ross joined the meeting at 2.14 p.m.

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Mr Ramsay Ross addressed the Chair with his question and a response was received from Sarah Prema, Chief Strategy Officer at the Leicester, Leicestershire and Rutland Integrated Care Board.

Councillor Harvey confirmed that written responses to both questions would be sent to Mr Robinson and Mr Ramsay and would also be published with the minutes of the meeting on the Council’s website.

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Mr Ramsay Ross left the meeting at 2.17 p.m.

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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.

To receive a presentation from NHS England – Midlands Region.

A presentation and a verbal update were received from NHS England regarding access to NHS dental services in Rutland.

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The following representatives joined the meeting at 2.21 p.m.

Carole Pitcher, Senior Commissioning Manager, NHS England

Claire Hames, Commissioning Manager (Dental), NHS England

Dr Rizwana Lala, Consultant in Dental Public Health, NHS England

Steven Claydon, Chair of the Local Dental Network or Northamptonshire and Leicester, Leicestershire and Rutland

Adam Morby, Regional Chief Dentist, NHS England and NHS Improvements in the Midlands

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During the discussion, the following points were noted:

·       Dr Underwood, Chair for Healthwatch Rutland informed attendees that, according to their websites, no Rutland dentists were taking on any NHS patients or any new patients unless referred by another dentist.  It was noted that under the new contracts, it would be mandatory for dental practitioners to include the latest dental access information on their website.    

·       NHS England stated that urgent dental care was accessible for all Rutland residents.

·       The Board was informed that it would not be feasible to provide dental care to every Rutland resident. 

·       17% of Rutland residents were currently receiving dental care and that the data regarding the remaining 83% of Rutland residents who were not receiving dental care would be investigated as part of NHS England’s Oral Health Needs Assessment.

·       274 extra sessions per year, which equated to approximately 8 patients per session, had been provided across Leicester, Leicestershire and Rutland along with extended hours for all dental practices. 

·       NHS England stated that the work on their Oral Health Needs Assessment had already begun and, in conjunction with Healthwatch, they were looking at how patients were accessing services.

·       The Chair informed NHS England that Rutland was a place in its own right; that it should not be included with Leicester and/or Leicestershire and that Core20PLUS5 did not apply to Rutland. 

·       The data stated in the presentation was from early 2022 so it did paint a rosier picture than the actual current situation which had resulted following the hand-back and termination of the dental contract in Oakham in 2022.

·       The Director of Public Health for Leicestershire & Rutland informed NHS England that the Rutland Oral Health Needs Assessment had been approved by the Rutland Health and Wellbeing Board in January 2023 so he was concerned that work being done by NHS England was not ‘joined up’ with the work that had already been done as part of Rutland’s Joint Strategic Needs Assessment (JSNA).

·       It was noted that the recruitment of dental staff remained an ongoing issue as existing contractors were unable to recruit sufficient, suitable staff so struggled to deliver a dental service.  Focus was needed on the recruitment of dental staff within Rutland and not just on the data figures.  Adam Morby, Regional Chief Dentist, NHS England and NHS Improvements in the Midlands confirmed that recruitment was a national issue as the service was limited by the number of UK dental graduates and that overseas dental graduates had to pass the General Dental Council’s Overseas Registration  ...  view the full minutes text for item 8.

To receive an update from Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC

An update was received from Adrian Allen, Assistant Director - Delivery, Public Health.  During the discussion, the following points were noted:

·       At the last meeting of the Health and Wellbeing Board it had been agreed to delegate the decision, to take the chapters on ‘Dementia’ and ‘Learning Disabilities’ before the chapter on ‘Mental Health,’ to Councillor Harvey, Mike Sandys, Director of Public Health for Leicestershire & Rutland, LCC and John Morley, Strategic Director for Adult Services and Health (DASS).

·       It had since been agreed that the next four chapters of the JSNA to be reviewed would be:

1. Substance Misuse
2. Alcohol Misuse
3. Preparing for Population Growth
4. Rutland Military and Veteran Health Needs Assessment

·       Substance Misuse, Alcohol Misuse and Preparing for Population Growth would all be presented to the Health and Wellbeing Board in June 2023.

·       Other chapters of the JSNA were continuing on track for the forthcoming year and it was agreed that the latest timetable for the JSNA chapters would be distributed with the minutes (copy attached).

To receive Report No. 49/2023 from Sarah Prema, Chief Strategy Officer, LLR ICB.

Report No. 49/2023 was received from Sarah Prema, Chief Strategy Officer, LLR ICB.  During the discussion, the following points were noted:

·       Two groups were created following the change in legislation in July 2022 – the Integrated Care Partnership (ICP) and the Integrated Care Board (ICB).

·       The ICP would produce the Integrated Care Strategy whilst the ICB would produce the Joint 5 Year Forward Plan. 

·       The first Joint 5 Year Forward Plan was due to be submitted by the end of June 2023 and this would then be reviewed and updated every year in line with the JSNA.

·       The Joint 5 Year Forward Plan would focus on how the NHS services would be delivered across LLR during the next 5 years.

·       Statutory guidance had been published as the Plan needed to be delivery focussed: https://www.gov.uk/government/publications/jsnas-and-jhws-statutory-guidance

·       A draft timeline had been identified but this was open to change due to the local elections being held on the 4^th May 2023.

·       The aim was for the Health and Wellbeing Boards to review/approve the Joint 5 Year Forward Plan post-election in late May/early June 2023, with the ICB formally signing-off the plan in July 2023.

·       Areas of focus in the Joint 5 Year Forward Plan would include mental health and dementia, learning disabilities and autism, management of long-term conditions, women’s health etc. 

·       Greater detail would be available in the draft Joint 5 Year Forward Plan with key actions identified for each focus area.

·       The overall aim would be to ensure that access to primary care was at the right place, at the right time and that the role of the Health and Wellbeing Board would be to ensure that the Joint 5 Year Forward Plan aligned with the Joint Health and Wellbeing Strategy.

·       The Chief Finance Officer for LPT & NHFT confirmed that the NHS would not be able to deliver all the services on its own.  Collaborative work would be vital to ensure the best outcomes for all services.

·       The Chair reminded attendees that only 30% of Rutland patients received health services from LPT.

·       The Deputy Chief Operating Officer of the LLR ICB confirmed that the Health Strategic Group was working in partnership with service providers outside of the Rutland area e.g. North West Anglia NHS Foundation Trust, United Lincolnshire Hospitals NHS Trust and Cambridge University Hospitals NHS Foundation Trust.

·       The Chair requested that a draft copy of the Joint 5 Year Forward Plan be shared with the Rutland Health and Wellbeing Board asap.

ACTION: Sarah Prema

RESOLVED

That the Committee:

a)    NOTED the contents of the report and accompanying presentation.

To receive a verbal update from Sarah Prema, Chief Strategy Officer, LLR ICB and David Williams, Group Director of Strategy & Partnerships, Leicestershire Partnership NHS Trust & Northamptonshire Healthcare NHS Foundation Trust.

A verbal update (details attached) was received from Sarah Prema, Chief Strategy Officer, LLR ICB and Paul Sheldon, Chief Finance Officer, Leicestershire Partnership NHS Trust & Northamptonshire Healthcare NHS Foundation Trust (LPT & NHFT).  During the discussion, the following points were noted:

·       Progress had been made on the business case to create an enhanced procedure suite at Rutland Memorial Hospital (RMH).

·       The scheme aligned to the 5-year health vision for Rutland and would make more outpatient and diagnostic services available locally at RMH.

·       This would help provide more easily accessible services for Rutland residents and would also help provide services for the forecasted population growth in the area.

·       The Chief Finance Officer for LPT & NHFT confirmed that replacement boilers, new taps and sinks and new electrics had all been installed but that roofing work continued due to asbestos issues but would be completed by the agreed deadline.

·       It was agreed that the Chief Strategy Officer and the Chief Finance Officer would find out what palliative care facilities were available at RMH.

ACTION: Sarah Prema / Paul Sheldon

To receive Report No. 53/2023 from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and presented by Katherine Willison, Health and Integration Lead, RCC.

Report No. 53/2023 was received from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and was presented by Katherine Willison, Health and Integration Lead, RCC. During the discussion, the following points were noted:

·       The next step would be to complete an annual strategy review, which would review the actions completed over the past 12 months and identify the proposed plans for the next 12 months.

·       The annual report of the Health and Wellbeing Board was also being written and this would include contributions from all partners as well as details of the next steps and the way forward for the Board.  Members were informed that the report would be presented at the next meeting of the Health and Wellbeing Board for formal approval. 

·       The Chair reassured the Board that the issues raised on Page 45 of the agenda pack regarding the health assessments for children looked after (CLA) were being fully investigated. The Strategic Director of Children and Families confirmed that a report from LPT on the issue would be discussed at the meeting of the Children and Young People’s Collaborative Group on Friday, 24^th March 2023 as there were major capacity issues within the service and that a high number of children were out of the control of the Local Authority as they were placed outside of the county.

·       The Director of Public Health for Leicestershire & Rutland confirmed that NHS England were responsible for the HPV vaccination service.  It was agreed that the Director of Public Health and the Chair would meet to decide what information they would like NHS England to present at the next Health and Wellbeing Board.

ACTION: Councillor S Harvey and Mike Sandys

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Sarah Prema left the meeting at 3.48 p.m.

and re-joined the meeting at 3.50 p.m.

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·       It was noted that the Chair of Healthwatch Rutland and the Deputy Chief Operating Officer for the LLR ICB would discuss the possible promotion of prevention services to the public i.e. breast screening following their re-opening after the COVID lockdown.

·       Ian Crowe, the Armed Forces Representative thanked the Board for the  Armed Forces Survey and requested that the document be made available to the public.

·       The presentation slides from the Health and Integration Lead were taken as read and the Chair thanked Katherine for producing an excellent presentation.

RESOLVED

That the Committee:

a)    NOTED the further development of the Joint Health and Wellbeing Strategy (JHWS) Delivery Plan.

b)    NOTED the latest Rutland Outcomes Report.

To receive Report No. 52/2023 from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and presented by Katherine Willison, Health and Integration Lead, RCC.

Report No. 52/2023 was received from Councillor S Harvey, Portfolio Holder for Health, Wellbeing and Adult Care and presented by Katherine Willison, Health and Integration Lead, RCC.  During the discussion, the following points were noted:

·       The Adult Social Care Discharge Fund had commenced in December 2022 and update reports had been submitted every fortnight since.

·       Good examples of the use of the funding included the commission of reablement beds at Rutland Care Village, the overtime payments for staff to facilitate the hospital discharges over bank holidays and the retention bonuses through fuel allowances for MiCare domiciliary care staff.

·       These schemes had contributed to the flow of Rutland residents being discharged from hospital in a timely manner to appropriate discharge destinations. This had promoted their health and wellbeing and had aided the health system to free up much needed hospital beds for further patients.

·       Notification had been received regarding the budget levels for the BCF for 2023/24 and 2024/25 and work had begun on the plans for the future.  

·       The Deputy Chief Operating Officer of the  LLR ICB confirmed that the Integrated Delivery Group (IDG) would oversee the Better Care Fund (BCF) and the implementation of plans to ensure that the best resources were available and matched ongoing needs.

RESOLVED

That the Committee:

a)    NOTED the content of the report.

b)    NOTED the Rutland 2022-23 BCF Adult Social Care Discharge Fund fortnightly reports which had been submitted to the BCF national team since 6 January 2023.

c)    NOTED preparations undertaken for the 2023-24 BCF programme plans.

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

An update was received from Dawn Godfrey, Strategic Director of Children and Families (DCS).  During the discussion, the following points were noted:

·       The group had met on the 16^th February 2023.

·       Progress had been made against all of the group’s priorities.

·       The main priorities – ‘Best Start in Life’ and ‘Physical and Emotional Health and Wellbeing’ – had made significant progress including the delivery of safer sleeping courses and paediatric first aid workshops via the Children’s Centre.

·       Over 500 children had been seen in health clinics held in the Children’s Centre. 

·       Permanent exclusions had been significantly reduced with only 1 permanent exclusion in the 2022/2023 academic year.

·       The Anxiety Related Non-Attendance Programme had been launched, with the co-operation of all Rutland schools, to support children and young people so that they could return or stay in main-stream education.

·       Focus remained on the risks regarding the sufficiency of special school places.

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

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

·       Work has progressed against all the workstreams.

·       The overall risks detailed in the Risk Register would be reviewed so that any remaining risks could be highlighted and reported on at the next meeting of the Health and Wellbeing Board.

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Emma-Jane Hollands, Head of Community Care Services and Mark Young, Senior Mental Health Neighbourhood Lead joined the meeting at 4.07 p.m.

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·       Work on communication and engagement needed to be more proactive as did the work on the transformation schemes.

·       Healthwatch Rutland had published their findings on people’s experiences of accessing the Urgent Care Centre in Oakham and the Adults Emergency Department at Leicester Royal Infirmary.

·       A review of what each subgroup was responsible for and how they should report back to the Health and Wellbeing Board would be discussed at the next meeting of the IDG and an update provided at the next meeting of the Health and Wellbeing Board.

ACTION: Debra Mitchell

To receive an update from Emma-Jane Hollands, Head of Community Care Services, RCC and Mark Young, Senior Mental Health Neighbourhood Lead, RCC.

An update was received from Emma-Jane Hollands, Head of Community Care Services and Mark Young, Senior Mental Health Neighbourhood Lead.  During the discussion, the following points were noted:

·       A meeting would be held on the 31^st March 2023 to review the applications for Rutland’s first Crisis Café.

·       Following work with LPT, a new Reablement Worker had started work in March 2023 with a focus on supporting people with personality disorders.

·       Meetings of mental health groups had been re-established and new funding had been received for a mental health group for carers.

·       Funding for the Mental Health GP would cease in July 2023 but work was being done to obtain continued funding.

·       The strategy had been updated and community events were ongoing.

·       Mental health pathways had been reviewed/updated and would be distributed once approved.

ACTION: Mark Young

·       Healthwatch Rutland had worked with Healthwatch Leicester and Leicestershire regarding the dementia support services and the experience of Rutland residents.  The report would be distributed once checked and approved.

ACTION: Dr Janet Underwood

To receive an update from Adrian Allen, Assistant Director - Delivery, Public Health and Mitch Harper, Strategic Lead – Rutland, Public Health.

An update was received from Adrian Allen, Assistant Director - Delivery, Public Health and Mitch Harper, Strategic Lead – Rutland, Public Health.  During the discussion, the following points were noted:

·       The meeting planned for the 20^th March 2023 did not go ahead as planned as no health colleagues had been able to attend.

·       The plan for the Rutland Health Inequalities Pilot had been written following the development workshops held in January 2023. 

·       The plan would be presented for formal sign off at the next meeting of the Health and Wellbeing Board.

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 amended accordingly. 

·       It was agreed that the draft agenda plan for the proposed meeting on the 27^th June 2023 would be distributed to members to ensure all items were included.

ACTION: Jane Narey

·       Councillor Harvey confirmed that she would be standing for re-election in May 2023 but noted that she might not be allocated as the Portfolio Holder for Health, Wellbeing and Adult Care.

·       She thanked partners for all their hard work and thanked members of the public for their engagement with the Rutland Health and Wellbeing Board.

·       Special thanks were expressed by the Chair to the Scrutiny Officer for all her hard work and support in ensuring the smooth running of the Health and Wellbeing Board meetings.

·       Members of the Board thanked Councillor Harvey for her leadership over the past municipal year.  The Board had undertaken a large amount of work and had created positive working partnerships to enable good work to be achieved.

The next meeting of the Rutland Health and Wellbeing Board is proposed for Tuesday, 27^th June 2023 at 2.00 p.m. in the Council Chamber, RCC, Catmose, Oakham, LE15 6HP.  [Date/time TBC]

27^th June 2023 at 2.00 p.m. (TBC)