Decisions

BwD Public Health Specialist, Charlotte Pickles, provided the Health and Wellbeing Board with an update and presentation of the Healthy Weight Declaration.

The presentation covered the following topics:

·       Our 5 Core Areas of Commitment

·       Our journey to date and timeline of Local Authority declarations on Healthy Weight

·       The rationale behind the Healthy Weight Declaration

·       Progress of the 5 Key Themes including our Recipe 4 Health Scheme and adoption of the new Local Plan

·       Progress of the 10 additional commitments made in 2017

·       Partnership Engagement

·       Next Steps

It was noted that there were some real opportunities to align interventions via existing Place Based Partnership arrangements.

It was agreed that further work needed to be undertaken for BwD to become a designated Sugar Smart Town. In addition, the licences provided to local businesses as part of the Food Charter, promoting healthy and sustainable food, needed to be revisited as there was some concern that businesses were no longer meeting the licensing requirements. It was noted that childhood obesity was a problem not just at local level but was a national issue.

Further investment and resources were necessary, with more work to engage with local communities. Communications and Big Screen advertising needed to be more proactive, promoting healthy rather than unhealthy options.

It was acknowledged that it was difficult to make long-term plans as the Household Support Funding was provided in 6 monthly blocks by Central Government, with little notification of extension periods - resulting in intermittent staffing levels to cover administration of the project.

It was noted that the Covid Pandemic had set progress back on our commitment to the Healthy Weight Declaration. There were lots of areas that need to be joined up and much more work to do. It was the ambition of the Board for local children to thrive and was strongly linked to our future economic growth. Conversations were ongoing with Local Government departments and NESTA (National Endowment for Science, Technology, and the Arts) regarding further programmes of work.

RESOLVED – That the Board

a)    Supported our renewed commitment to the Local Authority Healthy Weight Declaration.

b)    Strengthened our commitment by pledging their support.

c)    Considered the use of the NHS Healthy Weight Declaration and the School’s Pledge for a Healthy and Active Future to strengthen our partnership approach to tackling obesity and complications of excess weight at Place.

The Deputy Director of Adult Social Care, Adults and Health, Katherine White, provided an update on the Better Care Fund (BCF) end of year position for 2023/24 and an update on the pooled BCF budget for 2024/25.  An account of progress against the five BCF performance metrics, scheme priorities and financial expenditure during 2023/24 was included within the report.  

The Board was asked to:

a)    Note the Blackburn with Darwen Better Care Fund (BCF) 2023/24 end of year position in relation to delivery and performance against targets.

b)    Note the BCF Quarter 1 2024/25 delivery plan and financial position.

Schemes and services funded via the BCF were focused on a collaborative approach to delivering integrated, person-centred services across health, care, housing, and wider public services. The overarching aim of these schemes and services was to support people to remain living well and independently at home, to improve outcomes for people in our neighbourhoods (including those discharged from hospital) and to reduce inequalities.  

An overview of BCF reporting requirements and associated governance was provided within the report. All the statutory planning and reporting requirements had been met throughout 2023/24. 

Metric Targets and End of Year position reported as:

Metric 1 – Avoidable Admissions. Data not available to assess progress

Metric 2 – Discharge to normal place of residence. Achieved

Metric 3 – Falls and Emergency Hospital Admissions. Data not available to assess progress

Metric 4 – Residential Admissions. Not Achieved

Metric 5 – Reablement. Achieved

It was noted that Secondary Uses Service (SUS) activity data within the national system for healthcare data was not complete due to the main provider across the BwD area (ELHT) implementing a new EPR system which resulted in issues with data submissions affecting reporting this year. Data was expected to be available for all reporting periods at the end of Qtr 3, however there were ongoing issues due to ELHT undertaking data quality checks and a time lag with data filtering through to national datasets. This was escalated to ELHT Executives with a request for an urgent resolution.

The Board acknowledged that our local geography and housing stock had a huge impact on enabling residents to live independently at home as there was not enough single level accommodation being created or maintained.

There was concern that the Metric data only indicated 2 out of 5 achieved, but the Board was reassured that the National Team and ICB were aware of the reporting difficulties regarding Metrics 1 and 3 and that our reporting was good and on time.

Liasing with successful Metric 4 ICBs and scrutiny of their models was suggested as it was acknowledged that our ICB was not the only one to miss the Metric 4 Target.

The Board welcomed the Disabled Facilities Grant (DFG) carry over was less than last year and further reduced due to discretionary allocation for small repairs and an improved All-Age pathway.

Better care via Albion Mill, with integrated care focussed on rehabilitation rather than residential care could be utilised more effectively. Access to GPs to reduce the risk of A&E attendance could achieve better outcomes for residents with multiple health needs.

RESOLVED – That the Board

a)    Noted the Blackburn with Darwen Better Care Fund (BCF) 2023/24 end of year position in relation to delivery and performance against targets.

b)    Noted the BCF Quarter 1 2024/25 delivery plan and financial position.

Director of Health and Care Integration BwD, Claire Richardson, provided an update on the delivery programme of the Place Based Partnership (PBP) arrangements for Blackburn with Darwen. The intention was for the Board to be fully sighted on progress during the development and subsequent phases of the partnership arrangements. It also included a summary of areas of work undertaken since the last report to the Board and an update from the Lancashire and South Cumbria Integrated Care Board (ICB).

The Health and Wellbeing Board was recommended to:

a)    Note the update provided in the report on the development of the Blackburn with Darwen PBP and the collaborative delivery that is underway to integrate health and care for the residents of Blackburn with Darwen.

b)    Note the update with regards to the Lancashire and South Cumbria ICB.

Summary of the key achievements of the PBP;

·       Review and refresh of neighbourhood working arrangements

·       Developed Intermediate Care at Albion Mill

·       Approval of Community Services (adults and CAMHS) transaction proposal and business case

·       Mobilisation of community mental health transformation programme – including collaboration on Lancashire and South Cumbria ICB mental health commission for voluntary, community, faith, and social enterprise services

·       Supported development of key BwD strategies – carers, learning disability and autism “Big Plan” refresh, mental health wellbeing and suicide prevention

·       Led on public engagement to promote service awareness and gain insight into residents needs and behaviours

·       Innovative delivery of flu vaccines; coordination of response to MMR vaccination

·       Supported a co-ordinated response to urgent and emergency care system pressures over winter

·       Development of successful funding bids – Work Well Programme; Urgent and Emergency Care (UEC) Programme, which will support the delivery of innovative service models across the borough

The PBP was in the process of identifying and agreeing key delivery priorities for the coming year and would be outlined for the Board in September 2024.

The priorities are likely to include;

·       Continued deep engagement with our communities with a focus on working with them to improve health and wellbeing  

·       Agreeing and delivering improvements in a small number of health improvement priorities  

·       Deliver the evolved model for Integrated Neighborhood Teams – focused on proactive identification and support to keep people safe and well at home 

·       Effective transfer of adult physical health community services and child and adolescent mental health services to their new providers 

·       Delivering our Getting to Outstanding End of Life Care plan – early identification and advance care planning, all age focus, improving access to bereavement support and ensuring timely and coordinated access to support 

·       Development of transformed model for intermediate care – shifting our focus towards enablement and supporting people to remain as independent as possible, for as long as possible – co-production of model with residents and service users 

·       Reviewing how we jointly commission packages of care and support for adults and children who need health and care support 

·       Working across Blackburn with Darwen and East Lancashire to deliver the urgent and emergency care action plan 

Arif Patel, Development Director at ELHT, advised the Board that there were 800 reported attendances at Royal Blackburn Hospital A&E Dept today, with 20 residents being supported via corridor care. It was noted that waiting times in A&E remain high and corridor care was becoming the “norm”. Traditionally Wednesday and Thursday were days to prepare for the weekend influx, but this was no longer the case.

There was still work to be done to inform residents of the options available to them and to empower them to maintain their own health and wellbeing.

A discussion took place regarding the translation of strategies into practice from a community level to develop the prevention agenda. It was agreed that mental health challenges for residents were as big as physical health needs, with more clarity required as to why residents present at A&E with minor or mental health needs.

More work needed to be done on Public Health messaging. It was felt the current initiatives were not cohesive enough and too much information via the media was unhelpful “fake news”.

It was noted that it took 6-7 contacts to achieve a vaccination result. A discussion took place about vaccination engagement; Do we have the right resources in the right places? How do we make best use of our services? What are the barriers? It was agreed that there was a need to change the way we engage with our local communities.

RESOLVED – That the Board 

a)    Noted the update provided in the report on the development of the Blackburn with Darwen PBP and the collaborative delivery that was underway to integrate health and care for the residents of Blackburn with Darwen.

b)    Noted the update with regards to the Lancashire and South Cumbria ICB.

Consultant in Public Health, Cath Taylor, provided an update on delivery of the Joint Local Health and Wellbeing Strategy ‘Live Well’ priorities and actions, specifically those relating to the Wider Determinants of Health including Priority 2: Healthy homes, places and communities and Priority 4: Good quality work and maximising income.  (A report on Priority 3: Mental and physical health and wellbeing was provided at the last meeting) 

The aim of the update was to provide assurance to the Board that the ‘Live Well’ strategy priority areas and objectives were being delivered.  The report collated headline activity by relevant groups who are delivering work related to those two priorities.  The relevant groups were identified via a mapping exercise previously reported to the board. 

The Board was recommended to:

a)    Note the contents of the report which was for information and update on progress.

b)    To consider any areas which it would like to know more about or would like to see accelerated.

Key issues included:

·       There was a significant amount of activity within the borough which was ongoing around both Priority 2: Healthy homes, places and communities and Priority 4: Good quality work and maximising income. 

·       On Priority 2: Healthy homes, places and communities, there were two objectives where no specific group was identified to deliver against the objective.  This included: 

·       Building on the assets and strengths of specific communities to enable residents to identify the services and support they need to develop strong and resilient communities. 

·       Tackle loneliness and isolation and foster positive social connections among children, young people, working age adults and older adults.

NB. This did not mean that activity around the objectives was not being undertaken, but it did not sit with a specific group. 

·       On Priority 4: Good quality work and maximising income, there was some focused work being undertaken around work and health, however, further work was required to ensure linkages between the HWBB and the Employment and Skills Board. 

The Board discussed 3^rd sector involvement as it was felt it wasn’t well recognised in the report, however, it was accepted that despite the report being comprehensive, it was not a full picture of activity. Filling data gaps could be achieved by liaising more closely with the Household Support Fund, Cosey Homes, Healthy Living Team, Shelter, and the Foodbank for example.

Clarity needed to be made on where the Digital Inclusion Agenda would sit going forward.

It was agreed that Digital Inclusion was important, and the Work Well Programme was holding a mobilisation workshop in July 2024. £800,000 had been allocated to BwD, paid in increments, to support residents on the fringes of work (short term unemployed) providing Health and Wellbeing Coaches, Talking Therapies etc to encourage staying in work / employment. The Work Well Programme was only one aspect of the support available and was stemming the tide of long-term unemployment. Concern was expressed that there was a risk that the programme could drive a wedge between service providers and a balanced approach was required. It was important to utilise the 3^rd Sector as well as local employers.

It was noted that a further report on the Impact Analysis Metrics for the next 12 months was being planned and would be shared with the Board.

RESOLVED – That the Board

a)    Noted the contents of the report which was for information and update on progress.

b)    Considered areas which it would like to know more about or would like to see accelerated.

The Public Health Development Manager, Rabiya Gangreker, provided the Board with an update on health protection assurance arrangements in Blackburn with Darwen and health protection activities undertaken during 2023/24 with accompanying slides. 

The report summarised the key achievements against health protection priorities in 2023/24

The Board was asked to:

a)    Note the information within the report.

b)    Note that the report provides assurance that effective processes are in place to protect population health.

There was a range of ongoing work across partners to protect the health of the local population and much progress had been made during 2023/24 to address the key issues and deliver on action plans. Whilst challenges remained, the local Health Protection Board was well established and provided an effective mechanism for bringing partners together to work on health protection issues, share and review action plans and provide challenge and support.

Examples of Health Protection Activity in 2023/24 included;

·       Ongoing support provided to care homes, educational settings, and other complex settings to manage COVID19 and other outbreaks. Support provided by Quality Assurance colleagues and LCC’s IPC team via our service level agreement.

·       IPC audits completed in

o   10 care homes

o   1 SEN school

o   6 maintained nurseries

o   Hand hygiene awareness sessions delivered in 7 BwD primary schools

·       IPC forums held in BwD on the following topics:

o   Sepsis

o   Antimicrobial resistance

o   General infections

·       Facilitation of the seasonal flu group to support the increased uptake of the seasonal flu vaccination

o   40.2% of primary school aged children and 19.2% of secondary school aged children in BwD accepted the offer of flu vaccinations, similar to last year’s uptake

·       Continued support to partners (primary care, NHS England and L&SC ICB) to increase uptake of immunisations and screening programmes across the life course

It was noted that there was some uncertainty regarding future planning for the screening and vaccinations programmes due to the upcoming election. Coordination was at a regional rather than local level and Directors of Health and the Place Based Partnership were 2/3 layers removed from the decision-making processes.

It was acknowledged that vaccination uptake was poor, with the HPB vaccination uptake dropping from 95% to 45% in recent years. MMR / Covid / Flu vaccinations also had poor uptake. Insight and targeting were required. Public scepticism had grown, and Public Health Adverts needed recommissioning.

Place Based Initiatives needed to be funded by the NHS / Primary Care providers. Funding was fragmented but conversations were starting to take place.

Measles and shingles were reported as being on the increase and deaths confirmed to Whooping Cough. It was felt that lives were now at risk due to lack of herd immunity in the Community.

It was agreed that the priorities for the coming year must include supporting the increased uptake of the flu vaccination across all priority cohorts. To continue to provide an enhanced IPC support offer to complex settings in the Borough. Ensure equitable coverage and uptake of screening and immunisation programmes via the ICB’s screening and immunisations oversight group, and implement the authority’s sexual health strategy.

RESOLVED – That the Board

a)    Noted the information within the report.

b)    Noted that the report provided assurance that effective processes were in place to protect population health.

Speakers:

Rachael Graham, on behalf of applicant

Cllr John Slater, Objector

Applicant – Persimmon Homes Lancashire

Location and Proposed Development – Land at Benk Hey Farm, Heys Lane, Blackburn

Proposed development: Hybrid Application seeking Full Planning Permission for a phased development for the erection of 553 No. residential dwellings (Use Class C3) together with associated landscaping, open space, access and infrastructure; and Outline Planning Permission for up to 45 dwellings with all matters reserved except for access.

It was highlighted in the Update Report that the revised trigger dates for payment of s106 contributions towards highway improvements had been agreed between the Council and the applicant. Changes related to the first and second trigger payment dates that were now January 2025 and July 2025.

The revised payment supersedes that published in the main report at paragraph 3.5.50.

Decision under Town and Country Planning Acts and Regulations –

RESOLVED – Approved subject to an agreement under Section 106 of the Town & Country Planning Act 1990, relating to the payment of £7,556,401 (including a monitoring fee).

[Should the Section 106 agreement not be completed within 6 months of the date of the Committee meeting, the Strategic Director of Growth and Development and Deputy Chief Executive will have delegated powers to refuse the application]

Against – Cllrs Derek Hardman and Paul Marrow

Abstain – Cllr Rana Khan