Lancaster District Health and Wellbeing Partnership

Agenda Item 22.0.

MINUTES

Wednesday 21st August 2019 13:00 – 16:00 Hours Large Lecture Theatre, Moor Lane Mills, Lancaster

Present: Andy Knox (Chair) AK Executive GP, MBCCG Paul Blythin PB Active Lancashire Ian Dewar (for Items 1-6) ID UHMBT Helen Greatorex HG North Lancashire CAB Nick Howard NH Lancaster District Council Louise Jefferson (for Items 1-10) LJ Lancashire County Council Suzanne Lodge SL Lancaster District Council Claire Niebieski CN MBCCG Cllr Alistair Sinclair ASc Lancaster District Council Debbie Thompson DT Lancashire County Council

Apologies: Ian Cooper IC Lancashire Constabulary Geoffrey Hornby GH Lancashire Fire and Rescue Mark Hutton MH Lancashire Fire and Rescue Jackie Kingsman JK Lancashire Constabulary Adrian Leather AL Active Lancashire Gill Milward GM Lancashire County Council Yak Patel YP CVS Julia Westaway JW MBCCG Jared Williamson JdW Lancashire County Council

In Attendance: Alison Scott AS UHMBT Mark Wight (Secretary) MW MBCCG

No. Action

1.0 Welcome, Introductions and Apologies The Chair welcomed Councillor Alistair Sinclair, the new Cabinet Member for Communities and social justice at Lancaster City Council, as a new member of the Partnership. It was noted that Councillor Caroline Jackson would be his substitute if he was unable to attend a meeting.

2.0 Minutes from meeting held 19th June 2019 The Minutes of the last meeting were agreed as an accurate record.

3.0 Action Log Members noted updates to the Action Log.

4.0 Matters Arising There were no matters arising from the Minutes.

5.0 Transformation Challenge Award Project update Members considered the written report provided and received verbal reports in relation to specific TCA Project work streams:

 Social Prescribing – Anji Stokes An update would be provided at the next meeting.

 Challenge through Sport – Tamasin Lamb/Jane Moodie An update would be provided at the next meeting.

 Targeted Enforcement – Housing – Fiona Macleod An update would be provided at the next meeting.

 Poverty Truth Commission – Roger Mitchell An update would be provided at the next meeting.

 Community Connecting – Yak Patel An update would be provided at the next meeting.

 Art of Hosting – Yak Patel It was reported that the Communications Team was undertaking a piece of work to was investigate what has changed and developed as a result of the various community conversations which have taken place across Morecambe Bay. This could be linked to information about applications to the Lancaster District Community Wellbeing Fund. Anecdotal evidence suggests that the Art of Hosting has had a significant impact on both individuals and communities (e.g. lady in Grange-over-Sands who set up a Fair Share Food Club).

 Seed Fund – Fiona Cruchley/Amanda Spavin It was suggested that the Lancaster District Community Wellbeing Fund could be advertised on Beyond Radio.

 Food Poverty – Richard Walsh An update would be provided at the next meeting.

There were some concerns that not all organisations were working in unity and that there may be some key organisations that were not currently engaged. It was suggested that Richard Walsh should invite any missing organisations to join the Food Poverty Alliance. These organisations might include West End Impact and Stanley’s in Morecambe and the Free Methodists and Salvation Army in Carnforth. It was also suggested that a representative from Social Services could be invited to join the Food Poverty

Alliance or to at least advise on clear referral pathways into Social Services. It was also reported that an action plan was currently being developed and would be shared with the Partnership when completed.

 Adverse Childhood Experiences – Andy Knox It was reported that mindfulness training in schools had been completed. It was rumoured that significant additional funding for Trauma Informed Practice could be made available via The Wellcome Trust and Lancashire Constabulary. The funding would amount to c. £3.2M (i.e. c. £1.2M from Lancashire Constabulary and c. £2M from The Wellcome Trust). The funds would be sued to prevent harm to future generations, intervene now with people to build resilience and establish a safety net and to heal people who have physical, mental and health concerns arising from childhood trauma. It was envisaged that training would be provided to all GP practices and 700 schools in Lancashire. Work would also be undertaken to try to understand the role of trauma in explaining why prisoners have offended and would also look at reintegration and rehabilitation. It was reported that all primary and secondary schools in North Lancashire were now trauma informed. A new Early Action Intervention Team was being established and it was an agreed objective that Lancashire becomes a trauma informed county.

6.0 Lancaster Health Festival Members received an update about the organisation of the Lancaster Health Festival on 19th – 22nd September including arrangements for Love Lancaster, events in Williamson park for Year 7 pupils, events linked to spiritualty at St Thomas’ Church, a two-minute silence for people who have been trafficked and the return of the LRI Mortuary tours.

7.0 Population Health Update It was reported that a lot of activity had been underway to develop a programme plan which reflected the priorities of two county councils, three district councils, two county constabularies, two fire and rescue services, several NHS organisations and the Charity, Voluntary and Faith sector (CVFS). The plan – which is based on the Pentagram Model agreed by the Population Health Strategic Group – is still very health focussed in terms of both activity and terminology.

The draft programme plan and general direction of travel was agreed by the Bay Health and Care Partners Leadership Team on 1st August 2019. The next steps would be to co-produce the next version of the plan with key stakeholders from district councils, county constabularies, fire and rescue services and the third sector. An awayday with district council colleagues would be held in late September 2019 and to hold wider stakeholder co-production events in the district council footprints in October/November 2019.

It was explained that the plan aimed to bring together both existing and new activity that related to population health. All key stakeholders were

responsible for delivering the programme together and representation and accountability at all levels in the governance structure was being addressed.

Members were keen that there were clear links to public health and expressed the view that the programme plan must incorporate existing plans, the views of elected members and leadership and must, as far as possible, align with existing governance arrangements.

8.0 Lancaster and South Cumbria Economic Region It was reported that the three district councils – Barrow Borough Council, Lancaster City Council and South Lakeland District Council – had come together to develop a new economic partnership to promote economic growth across Morecambe Bay.

It was agreed that the recently published Prospectus for the Lancaster MW and South Cumbria Economic Region would be circulated to Members for information.

9.0 Workplace Health and Productivity It was reported that a meeting will take place on 6 September 2019 involving key stakeholders - including the Local Enterprise Partnership (LEP), Healthier Lancashire and South Cumbria and local authorities – to discuss the issues relating to low productivity due to sickness absence. High sickness absence rates can have a significant impact on Small and Medium-sized Enterprises (SMEs) due to the disproportionate impact of sickness in a small workforce (i.e. 85% of SMEs have between 10-15 employees in total). The LEP is investing in workplace wellbeing using funds which it administers from the European Structural and Investment Funds (ESIF) and UK Shared Prosperity Fund (UKSPF). This initaiative also fits into the governments Aging Society Grand Challenge (https://www.gov.uk/government/publications/industrial-strategy-the- grand-challenges/industrial-strategy-the-grand-challenges#ageing- society).

Members welcomed this initiative and commented that it was a positive step as employers had a responsibility to the health and wellbeing of their staff and that they would benefit economically from any actions taken to reduce the impact of smoking, inactivity and poor diet on their workforce. It was suggested that links to the third sector should be promoted, including links to advice services, to help tackle issues including low wages, access to in-work benefits and poor housing.

10.0 Anchor Institutions

Members noted the new economic model adopted by Preston (https://cles.org.uk/the-preston-model/) and other successful cities including New York, Amsterdam and Seoul. It was suggested that Lancaster should consider adopting this economic model.

The model has also been adopted in Oldham where positive discrimination in recruitment has been successfully used to recruit new staff from the most deprived areas to improve health and wellbeing.

Other initiatives in Preston had included rest days and revised rotas for Council employees, the reinvestment of pension funds in local infrastructure to support regeneration and the introduction of local procurement.

It was reported that a meeting had been arranged between the Chief Executive of University Hospitals of Morecambe Bay Trust and the Chief Officer of Morecambe Bay Clinical Commissioning Group (CCG) to discuss the role of both organisations as anchor institutions and to what extent they could put in place some elements of the Preston model. This was the start of a wider conversation across the Bay which would involve district councils, county councils, Higher Education Institutions, the GP Federation and other major employers (e.g. BAE, EDF, James Cropper etc.).

It was noted that Newcastle had introduced an initiative to provide public sector workers with free public transport which had had a positive impact on congestion, air quality and climate change.

It was suggested that the new Community Advocate roles at Lancaster City Council could be used to engage with community groups about the development of similar initiatives to promote health, wellbeing and social inclusion in Lancaster District.

11.0 Older People: Alzheimer’s, Dementia and Frailty Members commented that it was important not to underplay the impact of wider determinants and social isolation when considering frailty in the older population. There were concerns that issues relating to the health and wellbeing of the elderly, including Alzheimer’s and Dementia were being overlooked. It was important for the third sector to mobilise its lobbying power to address these issues and to raise awareness about the support offered by both local authorities (e.g. handyman scheme) and the voluntary sector.

After discussion, it was agreed that Claire Niebieski and Alison Scott AS/CN would undertake some fact finding in relation to the frailty work stream and that Claire Niebieski would commit to attend the Frailty Working Group.

12.0 Active Practice Charter Members noted a briefing on a range of initiatives by Sport England and the Royal College of General Practitioners (RCGP) or the Richmond Group. These included:

 Active Practice Charter (https://r1.dotdigital-pages.com/p/49LX- 5IR/active-practice-charter) It was reported that this was a programme between Sport England and the RCGP that sought to help GP practices make changes in

order to promote physical activity and movement to staff and patients. Practices just needed to sign up and demonstrate they have taken steps to meet 5 criteria: 1) Support a reduction in sedentary behaviour in staff; 2) Support a reduction in sedentary behaviour in patients; 3) Support an increase in physical activity in staff; 4) Support an increase in physical activity in patient; and 5) Partner with a local physical activity provider, to support the practice in getting more people active.

 Long Term Health Campaign (https://www.sportengland.org/our- work/health-and-inactivity/richmond-group-of-charities/) It was reported that Sport England would be launching a national campaign on Thursday 29th August that would run for 6 weeks and aimed to encourage people with Long Term Health Conditions to become physically active. The campaign was a partnership with the Richmond Group of charities. Every GP practice in the country would be sent at information pack and online promotional materials would be ready early next week. Active Lancashire would be promoting the campaign and were keen to see as many GP Practices as possible engaged.

 Physical Activity and Lifestyle Toolkit (https://www.rcgp.org.uk/clinical-and- research/resources/toolkits/physical-activity-and-lifestyle.aspx) This toolkit had been designed by the RCGPs in partnership with Sport England, to be used by primary care professionals in the UK. Any health professional concerned about their own activity levels might find the toolkit useful. The toolkit was designed to have something for all clinicians. It contains a variety of information including links to information sheets regarding physical activity and specific conditions.

 GP Clinical Champions Programme (https://publichealthmatters.blog.gov.uk/2018/06/21/clinical- champions-embedding-physical-activity-into-routine-clinical-care/) It was reported that there is a national footprint of PHE Clinical Champions who provide free training sessions to groups of healthcare professionals regarding physical activity and that they have trained 10,000 healthcare professionals to date.

It was agreed that further information and web links about these initiatives MW would be circulated to Members.

13.0 Any Other Business

 Morecambe Bay Health Needs Assessment It was suggested that the recently completed Morecambe bay Health Needs assessment should be considered at the next meeting of the Partnership.

 Liverpool Health Commission It was noted that Liverpool Health Commission (LHC) was currently investigating the first 1,000 days of life – encompassing conception to 24 months old – the key period in human development when the foundations of optimum health, growth and neurodevelopment are established. The LHC would be visiting Morecambe on 24-25 September 2019 to gather evidence about access to antenatal and postnatal care and advice from professionals working with women, babies and young people and from those with lived experience of the impact of poverty and its associated conditions in accessing healthcare opportunities.

 The King’s Fund Big Population Health Conversation Members noted that Bay Health and Care Partners and Lancaster City Council would be hosting a live streaming of The King’s Fund Big Population Health Conversation on 18th September 2019 at Salt Ayre Leisure Centre in Lancaster.

 Thanks It was noted that Nick Howard would be leaving his current post at Lancaster City Council on 30 September 2019 to take up a new post as Assistant Director Regulatory for South Norfolk District Council and Broadland District Council in Norfolk.

It was also reported that Ian Cooper would be leaving his current post on 2 September 2019 to take up a new role in Burnley. Ian would be replaced by James Martin, Acting Chief Inspector, or Superintendent Jackie Kingsman as the Lancashire Constabulary representative on the Partnership.

The Chair thanked both members for their professionalism and valuable contributions to the work of the Partnership and wished them both well in their new and exciting roles.

The next meeting is scheduled to be held on Wednesday 16th October 2019 in the Large Lecture Theatre at Moor Lane Mills, Moor Lane, Lancaster.