Agenda and minutes

The minutes of the meeting held on the 22^nd March 2012 were agreed as a correct record.

Apologies for absence were received from:

·   Dr Charlotte Benjamin

·   Dr Andrew Burnett (Cynthia Folarin substituting)

·   Robert McCulloch Graham (Jay Mercer substituting)

·   Kate Kennally (Dawn Wakeling substituting)

The Chairman took the opportunity to place on record the Board’s thanks and appreciation to Robert McCulloch Graham, Director of Children’s Service, for all his sterling work in improving the lives of young people in the Borough and his contribution to the establishment of the Health and Well-Being Board. She wished him every success on his secondment to the Department for Communities and Local Government’s Troubled Families Programme.

The Chairman noted that Kate Kennally would be taking on Robert’s role as Director of Children’s Service which presented an opportunity for the linking together of the work of both Adults’ and Childrens’ services.

None.

Dawn Wakeling, the Deputy Director of Adult Social Care and Health presented a report asking the Board to review its Terms of Reference, working arrangements and membership for 2012/13. 

The Chairman noted the importance of ensuring that the key message of the King’s Fund report on Health and Well-Being Boards was adopted with the Board providing strong and credible leadership along with partners on issues of health and well-being, and not becoming a “talking shop”.

Action - The Chairman requested that the membership of the Board as set out in appendix A be edited to reflect the Director of Adult Social Care and Health taking on the role of Director of Children’s Service.  

The Board members noted the importance of partnership and integration with Cllr Harper, the Cabinet Member for Education, Children and Families citing the example of Special Educational Needs (SEN) as an area where the Board needed to think about how integration would work.

David Riddle, the Vice-Chair of NHS North Central London, suggested that the Board should consider how it engaged with Acute Providers as dialogue would be required with providers to deliver effective integration.

The Board acknowledged that its Terms of Reference should be reviewed in twelve months time to reflect the changing environment in which the Board operates.

RESOLVED that –

·   the Board approve the Terms of Reference as set out in Appendix A of the report

·   the draft Action Plan as set out in Appendix B of the report be implemented with the Board to review progress at future meetings

Cynthia Folarin, the Assistant Director of Public Health, presented the Annual Report of the Director of Public Health. The focus of the report was based upon prevention in the areas of tobacco consumption, obesity and overweight and the improvement of the home learning environment for children living in poverty and the consequences of these issues for health inequalities and poor educational achievement.

The Chairman welcomed the report being entirely consistent with the objectives of the Health and Well-Being Strategy.

In response to the issues relating to educational attainment Cllr Harper noted that upon visiting schools in the Borough he had witnessed a high level of aspiration among the children of families recently arrived in the Country and suggested that it was important that these aspirational values were encouraged among all Barnet’s children and parents.

The Chairman suggested that there should be a more explicit reference to addressing the Childhood Obesity within the report.

Dr Stephens, CCG Lead, North Locality Cluster, commented upon the possibility of considering town planning as an opportunity for influencing the location of fast food outlets in communities and on the need for dialogue with schools to ensure they were best contributing to the health agenda.

David Riddle, Vice-Chair NHS North Central London, commented that references to Bariatric Surgery were not consistent with NCL commissioning policy practice. He also noted that the report could be clearer in what actions it was promoting health partners to undertake. He noted that in terms of childhood obesity and fast food outlets it was possible to map the locations of such outlets to areas of high obesity to see if there were any correlations. However, the Board would need to be mindful of the limited resources available and to be smart in the use of funds.

The Board discussed possible routes for reaching out to residents in relation to influencing their eating behaviour, observing that potential options included work with schools and food retail outlets.

Ceri Jacob advised the Board that potential proposals would be brought back to the Board via the Prevention Plan that sat within the Health and Well-Being Strategy and that a draft Action Plan would be presented at the next meeting.

RESOLVED that:-

The Board notes the report.

Cynthia Folarin, the Assistant Director of Public Health, presented the Health and Well-Being Implementation Group Action Plan, the purpose of which was to keep the Board up-to-date with actions being taken to enable the delivery of the Board’s intentions.

RESOLVED that:-

The Board note the Action Plan as set out in Appendix A of the report.

Dr. Sue Sumners, Clinical Commissioning Group Chair and Lead, West Locality Cluster, presented a report on the key themes of the North Central London Primary Care Strategy. She invited the Board to comment on the ways in which they could support the implementation of the Strategy in Barnet.

The Chairman of the Board highlighted the need to ensure that the needs of Barnet residents were not overlooked in the Strategy, noting that, contrary to popular perception, Barnet faced serious Public Health challenges, particularly in light of the shortfall Public Health funding allocation for the Borough.

David Riddle drew attention to the favourable funding allocation towards Barnet and Enfield based on numbers of patients to GP practices. Mr Riddle stated it was important to note that the strategy presented a £10 million funding allocation over three years for Barnet that would not have been otherwise available.

Ceri Jacob highlighted the link to the integration of IT, in particular the replacement of the SWIFT system, which would present the opportunity for closer working between health partners.

RESOLVED that:-

The Board note the report.

Dr Sumners presented a report updating the Board on progress in the development of local clinical commissioning arrangements. She reported that the CCG expected to appoint senior post holders in June and also outlined the Authorisation Process for the CCG which would include seeking the views of the Health and Well-Being Board. The Board welcomed progress to date and the opportunity to be involved.

RESOLVED that:-

The Board note the report and the progress and development of the CCG.

Dawn Wakeling presented a report that set out the Health and Social Care Integration Strategic Outline Business Case (SOC) for formal endorsement. The report included a summary of the outputs from the workshop of 22 March for which the Boards comment and agreement was sought.

The Board was asked to endorse the Health and Social care Integration SOC, comment on the proposed vision for integration; agree the shared governance structure and integration initiatives; and endorse the initial commitment of £1 million by London Borough of Barnet to fund the delivery of a Local Health and Social Care Integration Work Programme.

David Riddle raised a concern in relation to wording of paragraph 12.4, specifically the reference to the Health and Well-Being Board as the design authority questioning whether this presented the Board as an executive and seeking clarification on how this would impact on the autonomy of NHS providers. Mr Riddle also queried paragraph 11.4 stating he was reluctant to agree something that signed up providers without their involvement as he felt that they needed to have a clear understanding of the Board’s intentions.

Ceri Jacob suggested that the points raised by Mr Riddle could be discussed at the forthcoming summit with health and care service providers.

RESOLVED that:-

Subject to the points raised by Mr Riddle being addressed, the Board:

1.                  Endorses the Strategic Outline Case for the integration of health and social care.

2.         Agrees the proposed shared governance and delivery structure for implementing joint health and social care integration projects.

3.         Endorses the proposed health and social care integration programme and investment priorities.

Dawn Wakeling presented the Minutes of the Financial Planning Subgroup drawing the Board’s attention to the following issues:

·   In terms of the Public Health Baseline Allocation, work by Public Health colleagues has identified a potential £724,000 shortfall in the budget to deliver the Local Authority’s statutory Public Health responsibilities. Agreement had been sought from the Subgroup for proposed adjustments to submissions to the Dept. of Health by NCL and for representations by the Cabinet Member for Public Health.

·   The need to attain sign-off on the Equipment Section 75 Agreement

ACTION:- In terms of the requirement to have a CCG Board member represented on the Health and Well-Being Financial Planning Subgroup Dawn Wakeling would liaise with Dr Sumners.

RESOLVED that:-

The Board notes the minutes of the Financial Planning Subgroup

Andrew Nathan presented the Board’s Forward Work Programme for 2012/13.

The Cabinet Member for Education, Children and Families, Cllr Harper, informed the Board of the government green paper on Special Educational Needs (SEN) and Disability, Support and Aspiration: A New Approach to Special Educational Needs and Disability and the imminent Children and Families Bill which he stated would have significant implications for the Council of which the Health and Well-Being Board would need to be aware.

Action:- An item on the potential changes to SEN be added to the work programme for October, as a workshop item. This would also encompass the item on transitions identified in the work programme.

It was agreed that the strategic review of leisure was a suitable topic for the July workshop, so that the Board could share ideas and thoughts and shape the outcome of the review.

Andrew Nathan informed the Board that there were currently 15 items scheduled on the agenda for the July meeting of the Board and that some revisions may be necessary.

Dr Sumners advise the Board that there was a clash between scheduled Board meetings during December and meetings of the CCG.

Action:- Andrew Nathan to liaise with Dr Sumners regarding the future scheduling of meetings.

RESOLVED that:-

The Board note the Forward Work Programme