Agenda and minutes

The minutes of the meeting held on 31 January 2013 were agreed as a correct record, subject to the following amendments:

Item 17, top of page 3- insert the words ‘a work stream around this’ after the words ‘the Health and Well Being Strategy also included’ and the word ‘good’ to be inserted between ‘continued’ and ‘performance’.

Apologies for absence were received from Cllr Sachin Rajput, Paul Bennett (NHS England), and Cllr Andrew Harper.

The Chairman welcomed Councillor Longstaff as a deputy for Cllrs Rajput and Harper and emphasised that as Cabinet Member for Safety and Resident Engagement, he had a significant interest in and contribution to make to health and well-being.

There were none.

Andrew Nathan, Head of Governance, introduced this report and highlighted that from 1 April 2013, HWBB became a statutory Committee of the Council.

The Board discussed the role of NHS England at HWBB. The Board agreed to revise the terms of reference to include NHS England as a full member of the Board subject to further discussions with Paul Bennett, who was unable to be present, on how he envisaged their role would work. The Chairman requested that NHS England submit a report on priorities and the NHS mandate to the next HWBB in order to mesh together into a single programme of work.

The Chairman requested that all Members nominate a named deputy so that there is continuity of attendance to HWBB. Andrew Nathan would write formally.

Andrew Nathan reported that Appendix B outlined the work programme but that this was in outline form. The Group agreed to revisit this at their next meeting.

He advised that the bi-monthly meeting cycle would be retained for the 2^nd or 3^rd Thursday of the month.and the provisional date of the next meeting was 27 June. He agreed to circulate (including to NHS England) a proposed schedule of dates for the 13/14 meetings to the Group. He advised that these dates would be formally agreed at the next Annual Council meeting but the group were advised to hold these dates their diaries.

RESOLVED

That the Board endorses the governance arrangements agreed by Council on 16 April 2013

That the Board supports the recommendation that NHS England would be a member of HWBB

That the Board agrees the proposed revised Terms of Reference and Work Plan as set out in the report but that a more detailed  work plan be submitted to the next meeting.

5 Quality and Safety in Barnet –A response to The Francis Inquiry Report

The Chairman opened the discussion by reporting that she had sent letters in early February 2013 to the four major NHS Trusts serving Barnet asking how they were addressing the recommendations arising from the Francis Inquiry report and inviting them to the meeting. She thanked the Trusts present for attending but expressed disappointment that Barnet, Enfield and Haringey Mental Health NHS Trust had not replied, and had been unable to send a representative to the meeting.

Mr Morton introduced his report and outlined how Quality and Safety was being managed in the CCG. He and Dr Sumners reported how hard and soft intelligence including from GPs was used and acted upon to ensure quality was delivered, and the governance arrangements that were put in place. Mr Morton highlighted that when a problem is raised it was discussed openly and also advised that the CCG supported honesty and this was paramount to the organisation.

Dr Tim Peachey from the Barnet and Chase Farm Hospital NHS Trust reported that he welcomed Francis’s comments regarding duty of candour . He gave an account of how complaints were handled at Barnet and Chase Farm Hospital NHS Trust and assured the Board that all complaint letters were signed by him or someone of a senior level and if the responses are not accurately written then he would request that they are rewritten to address the concerns. He also advised that all letters of compliments received are responded to.

In addition, Barnet and Chase Farm Hospital NHS Trust were also using feedback from Relatives Group workshops to help facilitate the recommendations made in the Francis report.

He also reported that staff are contacted on a regular basis to discuss how they felt valued, as this can impact on the quality of care they provide to patients. A tracking and message system was also in place.

In response from a question from the Chairman, Dr Peachey gave an account of the practices currently in place at the Trust following the recommendations from the Francis report which included:

o   complaints kept separate from patient records

o   face to face complaints welcomed

o   unique complaints are reviewed

o   patients are informed even if they are not aware of issues

o   development sessions are held to test feedback - the Chairman requested that the results from these sessions are shared with this Board.

o   effective complaints handing by encouraging patients to speak to the board and at the start of every board meeting a letter of complaint is addressed.

In response to a question from the Chairman, he confirmed that all complaints were recorded; this includes patient groups and over the 50’s groups.

The Chairman requested that Barnet and Chase Farm Hospital throughout the year continue to bring back the recommendations arising from the Francis report to this Committee throughout the year.

Dr Stephen Powis from the Royal Free Hospital outlined their response to the Francis report.  ...  view the full minutes text for item 5.

Mr Morton introduced the report and advised that the CCG was an authorised new commissioning organisation that was embedding and continuing existing work initiated by Barnet PCT at a faster pace and that the operational plan did not  set out a significant  change in direction. It was driven by quality and patient outcomes, not finance, but was committed to removing examples of wasted resources.

He explained the ways in which the CCG would achieve the commitments in page 14 of the Plan and highlighted plans for better patient involvement and the importance of conversing with patients and feeding back these responses into the quality agenda.

He also reported that there were three proposed local priorities, selected by GP’s, namely:

Dementia Services

End of Life Care

Stroke Services

In a response to question from the Chairman, Mr Morton explained that for the dementia services, the emphasis would be on diagnosis. Measures would need to be in place to support people with Dementia and additional services were required in addition to those already existing.

Ms Kennally commended the specific links made by the CCG to the Health and Wellbeing Strategy, which the Council would emulate for its own corporate documents. She also highlighted the new Children’s and Young People Plan, to which the CCG’s plan needed to be aligned, and identified the challenge of ensuring the capacity to deliver and work together as an integrated health and social care system.

Ms Wakeling supported the work stream around dementia and agreed to circulate a link to the website to a conference she had attended where two dementia sufferers shared their experiences of using support services and their feedback on medication.

The Chairman referred to the “Supporting Work Programmes” list on page 47

of the (ISOP) and advised that these programmes work together with Healthwatch whenever any new services are commissioned.

RESOLVED

The Board confirms that the Barnet CCG Integrated Strategic and Operating Plan 2013-15 supports delivery of the Health and Well Being Strategy.

The Board notes and agrees the local priorities and measures which will be submitted to NHS England as part of the 2013/14 Operating Plan.

7. Proposal for a Barnet Schools - Wellbeing Programme

Dr Jeffrey Lake from the Public Health Team, Barnet and Harrow, presented a report on the partnership process with Schools, advising that the London Healthy Schools Programme had been re-launched and that the menu of support would be suggested to Schools for implementation from September 2013.

Dr Clare Stephens discussed obesity in both primary and secondary schools and recommended that the programme is extended to these groups. She also advised of the necessity for health messages around cancer, including Breast Cancer Awareness for teenage girls, and the importance of an early diagnosis of some cancers. She pointed out primary school children were known to influence parents and grandparents.

A concern was raised about the messages parents receive in relation to immunisation. Although Dr Howe advised that a major measles outbreak was not expected in London, theBoard identified that particular groups would need to be targeted and encouraged GPs to work with these groups within the community.

Ms Kennally suggested a co-ordinated approach to advise GPs and to use community schools as a vehicle to get the messages out to these particular groups within the community.

Dr Howe agreed to circulate all the recent information on Measles immunisation from NHS England (Central London). 

Dr Stephens encouraged the board to support and endorse the different strands recently announced for the physical activity provision in schools as outlined in paragraph 11.2 of the report and communicate the physical activity strand to Schools. She also advised of the new arrangement for immunisation for MMR boosters and to ensure that this information is reliably circulated to GPs practice.

It was agreed that Dr Howe together with Dr Stephens would communicate with the NHS England Lead contact to ensure the information is circulated to GP’s.

RESOLVED

That the Health and Well Being Board supports the proposal for a Barnet Schools Wellbeing Programme.

Selina Rodrigues highlighted the intention of Healthwatch to fully engage with a range of communities and advised that they should be fully operational with staff by the end of June, and were recruiting volunteers over the next 3 months.

She explained the intention to visit communities within the borough and highlighted May 21 as the launch date for Healthwatch.

She advised of the plans to establish continuation links around GP access project groups with Barnet CCG looking at access to appointments, accessibility access for GPs surgery, mental health & transsexual services and service users experience of using these services within the community; and that Healthwatch would identify areas of work where Healthwatch can engage with mental health; for example, young people focus groups.

The Chairman was concerned to ensure there were robust plans to engage with the various ethnic minorities in the borough. Ms Rodrigues explained that there are plans for Healthwatch to develop links with Grahame Park and that this would also form links with ethnic minorities within a certain geographical location. She advised of actions to approach representatives from ethnic minority steering groups and highlighted that in addition Healthwatch would also be using volunteer recruitment to encourage involvement from ethnic minorities.

Ms Wakeling highlighted the importance of continuing with the social care element of the work during the transition from the LINK. Both she and Dr Howe would communicate with Healthwatch how they might assist in their work.

Ms Kennally highlighted the need for healthwatch to keep an eye on complaints as highlighted in the Francis report, and that future reports should include information on how Healthwatch and the new provider of NHS Complaints Advocacy Services, Voiceability, were discharging their responsibilities. 

Dr Howe suggested using tools to advertise and engaging in different ways such as year 10/11 volunteers in the community and young people involvement, as well as Head Teachers from secondary school involvement.

RESOLVED

That the Health and Well Being Board note the progress report and endorse subject to the above sections.

There were none:

The meeting finished at 12.00 pm