Agenda and draft minutes

Members were welcomed to the meeting by Councillor Alistair Bradley, introductions made and apologies noted.

Minutes were agreed as correct record with no matters arising.

Actions from previous meeting noted as:

·         All Executive members to have a discussion with relevant Implementation Group representative on their capacity to deliver the elements of the work programme. The commitment to deliver work needs to be confirmed before the next Executive meeting in March to the PMO. Cleared, communications to be open to ensure support on capacity, direction and decision making.

·         Executive Members to consider work planned, confirm representatives from each organisation, in particular confirming proposed leads. Cleared, leads in place.

·         For the PMO to ensure regular updates on the Sustainability and Transformation Plan (part of Agenda), Lancashire Combined Authority and Central Lancashire Health and Wellbeing Partnership are provided. Cleared, planned into Executive Forward Look.

·         Steve Winterson to ensure that the Implementation Group remains fit for purpose and provides regular updates on progression of activity. Cleared, planned as part of the discussion at the IG group meeting in April.

·         Executive Members to provide an honest self-assessment of where the collective partnership is at currently in terms of Leadership. Scores to the PMO ahead of the next meeting. Cleared, part of Agenda item 5.

Steve Winterson advised that following the Implementation Group in February, three pieces of work are now underway. Due to the work involved in these areas a decision was made to cancel the Implementation Group meeting on Tuesday 1^st March. An update was provided to the Implementation Group on progress, and members have been involved in progressing the work required.

Hayley Hughes provided an update on two areas of work, which included the Task Group for Partnership Connectivity and a test of an Extended MDT.

Partnership Connectivity

The task group met for the first time on 3^rd March, with a good representation from services operating in the locality of Chorley inner-East, with a wealth of experience across the group in both the locality and in services provided.

The group considered how to improve connections across organisations to establish a more consistent frontline approach and raise awareness of support available to residents with a view to improving health and wellbeing outcomes through preventative help and early interventions. It is within the remit of the group to be creative in testing different approaches in delivering services.

In the context of the locality of Chorley inner-East, the group considered current organizational activity; how we could start to work differently as partners in this area as part of a more joined up approach; and what mechanisms could be utilized to engage more effectively.

Outcomes from the group included confirmation of key areas of focus (elderly, families with complex needs, carers, and ethnic minority groups); understanding of media available to support awareness and improve connections across services; suggestions of possible activities, including befriending; wider engagement, improvements to referrals.

The group will meet again to define a plan of activity on 16^th March.

Extended Multi- Disciplinary Team (MDT)

This work stream is to look at how we can more effectively share information and put in place interventions to support individuals placing highest demand on the system, identified from a primary care point of view, as part of early intervention and prevention.

From an initial discussion with the Chorley Surgery, Chorley Council and Police based on a cross section on anonymised cases causing the GP concern, it was established that:

·         The co-hort of patients could be expanded to cover a wider range of vulnerable adults causing concern; and

·         The co-hort of patients could have support from a wider network of partners to give early help, subject to relevant consent being provided.

Plans to deliver the wider remit of the MDT are in progression, and will include the consideration of additional GP practices, and support to administer the group. Findings from the group will be reported back to the next Executive

Vicky Willett provided an update on the third area of work under the Implementation Group, which is on Building Community Capacity. There are four elements in development which are:

Community Capacity and Engagement (£70k) – will be an intensive programme to increase community resilience by facilitating behaviour change towards residents helping themselves and others.  To incorporate community engagement and a smaller community conversation in Chorley inner-East. Contract length six months. Procurement due out for tender in next couple of weeks, with start date of 1^st May.

Co-ordination and Intelligence (£40k) – will involve Multi agency coordination, data gathering, analysis and initial assessment of existing befriending provision. This will act as a single point of contact and cover front line, and support activity including analysis, very much a short term role to produce momentum in gathering intelligence required to support wider work.

Community Co-production (£20k) – will involve actions to assess, model and develop options for community coproduction.  This will be progressed slightly later in the timeline, as it will be informed by outcomes of Community Capacity and Engagement.

Community Befriending (£40k) – To support service development, infrastructure, including ICT, and promotion based on the needs identified from the initial assessment as part of the co-ordination role.

A set of outcomes and outputs expected from the procurement on Community Capacity were noted, including increasing community resilience, engagement with residents/partners and businesses.

The board supported the approach on the procurement activity, with the consideration of including harder measures to understand system change through the activity. This could include access to Lancashire Wellbeing Service, reduction of admissions, which are part of a number of aspirational deliverables in the Public Service Reform Programme.

Following the recommendation of the Executive at the meeting in February, all members of both the Executive and Implementation Group were asked to complete a simple leadership assessment questionnaire based on a framework developed to establish a benchmark position.

Ten completed responses have been received representing the majority of partner organisations, although not consistently across both groups (4 responses from the Executive and 6 from the Implementation Group). 

The scoring was based on a range of levels from Commitment (1) to Sustainable Delivery (5). These have been applied to eight domains. The average score was 2, and it was noted that the results from the Implementation Group were slightly higher than the Executive.

This was seen as a realistic assessment against the new structure of the Public Service Reform Partnership, and programme which have been in place since September 2015. The exercise gives a good position marker, and some indicators of what to progress to.

The Executive agreed to the next steps and recommendations set out:

·         All members of the Executive to complete the assessment to ensure a consistent understanding and then a final summary report completed

·         Areas for development to be identified by the Executive along with any further action for the programme office to consider

·         The assessment to be undertaken again in 6 months time with the aim of achieving improvement in the current scoring.

Key points from discussion included:

·         That further learning from testbed activity will form how we adapt our organisations, and deliver a natural progression through the stages in the framework.

·         Although this will mainly be an organic process, a plan of delivery to the next stages would be useful.

·         By it’s nature, self-assessment tends to score lower – 360 degree appraisal may be an alternative way of making an assessment. 

·         Need to look at increasing understanding from within each organisation, partners and residents on what we are trying to achieve in Public Service Reform, by having something tangible to share and easily understand.

·         Good time to reiterate consumption of purpose, including understanding of ambition of partnership, three year plan, activity being measured and outcomes expected.

Action: PMO to request assessments from relevant areas; propose activity to move to next stages, against work programme development; and develop core information that could be shared with services to support better understanding.

Gary Hall advised that the Health Sector are required to produce a Sustainability and Transformation plan, to support the NHS Five Year Plan. The Sustainability and Transformation plan has key objectives of improvements to health outcomes and supporting gaps in budgets through significant transformation, which will include a drive to deliver prevention and early intervention.

There will be a Lancashire plan, with five local delivery plans for each health economy. Gary Hall as Chair of the Health and Wellbeing Partnership, and Karen Sharrocks as the SRO are tasked with producing the local delivery plan for Central Lancashire. Guidance from Lancashire level is needed to support this work, and the first draft is expected by the end of April. Healthier Lancashire will pull the local delivery plans together, which will need to refer to cross cutting Lancashire wide themes including Care Homes, hospital configuration and specialised services.

It was noted by the Executive that the plans being developed cut across much of the activity in Chorley in terms of reducing dependence, building resilience, and community prevention.

The Executive will continue to be updated on progress of this work.

Rebecca Huddleston provided an update on the Lancashire County Council Wellbeing and Prevention and Early Help consultation, which is available on the LCC website. This proposes changes to service with £7.4million in savings by 2017/18. At present it is unclear what the service will look like in delivery as the detailed plans will need to be developed. It is likely that services will be delivered through the Neighbourhood Service Centres, with relevant service providers to support universal/targeted needs. Priorities will be “at risk” groups, and although there is a want to support early intervention, there is a concern that this element will not be resourced.

Rebecca asked the group on awareness of the consultation, and potential changes to services. Observations included:

·         Changes to service delivery to demand led;

·         Ability to support at universal level is likely to be less;

·         Need to understand where resources are coming from, and how moderate level of need will be addressed, to avoid escalation;

·         Context of young people/families – identify cases when need presents, rather than anticipate where it will occur;

·         Understand how we collect data/pick up trends;

·         Understand how the 0-19 service links into other parts of the system; and

·         Integrated Children Modelling should be flagged from Lancashire Care and Hospital as this may have an impact on property considerations.

Mel Ormesher advised that the service is in development, and needs to address a range of complexities in the consultation, as well as linking to the property strategy delivery. There is a want to ensure prevention is in place to reduce escalation into statutory services.

The Executive were encouraged to respond to the consultation from their own organisations, and Rebecca will send a response on behalf of the Chorley Public Service Reform Partnership to express want of the group to be recognised as part of the consultation, and to encourage the need to develop service for early intervention and prevention.

Action: Rebecca Huddleston to send a response to the Lancashire County Council Wellbeing and Prevention and Early Help consultation on behalf of the Chorley Public Service Reform Partnership.

Mel Ormesher provided an update on the LCC Property Strategy. Papers submitted to Strategy in November, which included 220 front facing buildings covering a range of services. The proposals include the Neighbourhood Centre Model to ensure that buildings in place following the review, are delivering at full capacity and linking services together for the needs of the communities. This will include multi-agency services, although the majority will be LCC employed staff. Using the strategy of 34 service planning areas, and context from datasets of population/areas of deprivation, a publication of the list of properties to become the Neighbourhood Centres will be published in May 2016 for consultation. This will include reconfiguration of library services. A decision is expected at Cabinet in September, which will look at the buildings being developed, implications of remaining buildings e.g. asset transfer.

Observations made included:

·         That Chorley has three planning areas, and there are opportunities to co-locate services in areas, not just within the LCC structure, but across all services to ensure that the right services are delivered in the right place;

·         Chorley Council have flagged interest in potential assets which could continue to support a public service role;

·         Piece of work completed by the CCG to review all GP practice buildings, considering footprint, treatment rooms capacity, impact of growth City Deal, and co-location opportunities. This work would be beneficial to link to the property strategy; and

·         Task Group on Public Service Reform are also looking at co-location opportunities which could act as a testbed to proposals.

·         Any co-located/new services should provide support, and look to reduce signposting in services.

Diane Gradwell advised that, building on the success of the Community Champions project (recently show-cased to Cabinet Office), Lancashire West Citizens Advice Bureaux which covers Chorley, South Ribble and West Lancashire, have had further success in securing five years funding for the Help through Crisis programme under the Big Lottery Fund. More updates to be given as the project progresses.

At present the Executive meetings are set monthly, and from discussion it was agreed that the Executive would run less frequently during the next six months, and come together to consider findings from the programme delivery.

Next meetings planned:

17^th May 2016

19^th July 2016

27^th September 2016