Agenda and minutes

Venue: Hendon Town Hall, The Burroughs, London NW4 4BQ. View directions

Contact: Claire Mundle 020 8359 3478 Email: claire.mundle@barnet.gov.uk 

Items
No. Item

1.

Minutes of the Previous Meeting pdf icon PDF 70 KB

Minutes:

RESOLVED that subject to the corrections - that the duplicate reference to Dr Clare Stephens is removed and Julie Pal is listed as Substitute under Board Members present  - the minutes of the Health & Well-Being Board meeting held on 12 June 2014 be agreed as a correct record.

 

Councillor Helena Hart, Chairman of the Health & Well-Being Board thanked Mr John Morton (previous Chief Officer at Barnet Clinical Commissioning Group) for his contributions to the work of the Board.

 

2.

Absence of Members

Minutes:

Apologies for absence were received from:

Councillor Sachin Rajput (London Borough of Barnet, LBB), substituted by Councillor David Longstaff (LBB)

Paul Bennett (NHS England)

Rob Larkman (Interim Accountable Officer, Barnet Clinical Commissioning Group)
Peter Coles (Interim Chief Operating Officer, Barnet CCG). Mr Larkman and Mr Coles were substituted by Maria O’Dwyer (Director of Integrated Commissioning, Barnet CCG)

 

3.

Declaration of Members' Interests

Minutes:

There were none.

4.

Report of the Monitoring Officer (if any)

Minutes:

None.

5.

Public Questions and Comments (if any)

Minutes:

None were submitted.

6.

Minutes of the Health and Well-Being financial planning group pdf icon PDF 103 KB

Additional documents:

Minutes:

The Chairman stated that at the June Health & Well-Being Board meeting the Board had agreed the recommendation as set out below from the Financial Planning Group to receive a position paper on mental health services:

Note the local plans to review the future of mental health services in Barnet and approves the suggestion that a position paper on mental health services is presented to the Board in September 2014 to help inform future options.

The Board was informed by the CCG that for technical reasons the paper was not available for the meeting. Dr Charlotte Benjamin briefed the Board on plans to review mental health services in Barnet.

Kate Kennally, the Strategic Director for Communities explained that the Financial Planning Group has focused on the development of the Better Care Fund and the completion of the Full Business Case for Integrated Care which will be completed by the end of September 2014.

It was noted that the agenda for the Financial Planning Group’s October 2014 meeting will focus on commissioning to support implementation of the Children and Families Act and commissioning of mental health services.

RESOLVED that the Health & Well-Being Board notes the minutes of the Financial Planning Sub-Group Meetings of 7th August and 4th September 2014.

 

7.

Update on the Better Care Fund proposals/ 5 tier model for integrated care pdf icon PDF 128 KB

Additional documents:

Minutes:

The Board resolved to discuss the Better Care Fund item and the restricted information as one item.

RESOLVED that:

  1. The Health & Well-Being Board agrees the draft BCF Plan

  2. The Board notes the draft full Business Case for Integrated Care prior to its submission to the Adults and Safeguarding Committee and the CCG Board in October 2014

  3. Authority be delegated to the Adults and Communities Director, in consultation with the Chairman of the Health & Well-Being Board, to agree any material changes to the BCF submission made following the Health & Well-Being Board meeting. Agreements to this end should follow on from endorsement of the BCF plan by the Interim Chief Officer of Barnet CCG and Chief Executive of Barnet Council before submission of the Plan to NHS England on 19 September 2014

 

8.

CCG 5 Year Strategic Plan pdf icon PDF 87 KB

Additional documents:

Minutes:

Dr Debbie Frost, Chair of Barnet Clinical Commissioning Group presented the item and provided an update on the development of the CCG 5 Year Strategic Plan developed in line with national priorities and the Health & Well-Being Strategy.

It was noted that under new NHS Planning Guidance  CCGs must demonstrate how they will meet the overall vision of NHS England’s High Quality Care for All strategy. Dr Frost identified the strategic goals and transformation objectives that support the delivery of a comprehensive health system in Barnet.

Dr Andrew Howe, Director of Public Health (Barnet and Harrow) welcomed the draft Strategy. Dr Howe noted the importance of utilising technology to enable patients to live more independently across the Borough. 

The Chief Executive of the London Borough of Barnet, Andrew Travers commended the CCG’s goals to improve health and well-being throughout the Borough by improving efficiency in the health service and enabling people to live healthier lives in the community.

Kate Kennally, the Strategic Director for Communities emphasised the importance of effective partnership working across the five CCGs to support a resilient health system in North Central London. Ms Kennally also stressed the importance of the CCG developing their plan in alignment with the Council’s Adult & Safeguarding, Children, Education, Libraries and Skills, and Public Health 5 Year Commissioning Plans.

The Chairman noted that on p.158 of the agenda report, the word ‘Committee’ should be changed to ‘Board’. A correct record of the recommendation on p.158 should read: 1. That the Board signs up to the proposed Strategy. 

RESOLVED that:

1.         The Health & Well-Being Board signs up to the proposed Strategy

2.         The Board noted that they would receive an annual Progress Report when the Strategy is implemented.

3.         Additional Recommendation: That the CCG Interim Director of Planning and Performance works with Lead Commissioners at the Council to ensure aligned delivery and commissioning plans across the CCG and the Council. 

 

9.

Quality and Safety in health and social care

Additional documents:

Minutes:

The Chairman welcomed Chris Miller, Independent Chairman of the Adults and Children’s Safeguarding Boards and asked him to join the discussion. Kate Kennally, the Strategic Director for Communities at LBB highlighted the importance of continued and closer partnership working to ensure that Safeguarding of both Children and Adults remained a priority within the Borough.

The Chairman noted that in order for the Health & Well-Being Board to ensure the progression of the safeguarding agenda, a joint working protocol between the Boards had been established. Ms Kennally informed the Board about the draft joint working protocol which sets out the expectations of the relationships and working arrangements between the Health & Well-Being Board, Local Safeguarding Children Board and Local Safeguarding Adults Board.

Ms Kennally noted the organisational alignment of an Independent Chair for both Safeguarding Boards to help achieve effective coordination of efforts in addressing safeguarding issues.

The Adults and Communities Director Dawn Wakeling, stressed the importance of good communication between the Boards to ensure that safeguarding risks and issues are considered appropriately.

 

RESOLVED that the Health & Well-Being Board:

  1. Approves the draft joint working protocol between Barnet Health & Well-Being Board, Barnet Local Safeguarding Children Board (LSCB) and Barnet Local Safeguarding Adults Board (LSAB)

 

  1. Refers the approved protocol on for sign off at the next meetings of the Local Safeguarding Children’s Board and the Local Safeguarding Adults Board

  2. Considers the progress that has been made to improve safeguarding practice in Barnet over the past 12 months, with specific reference to the LSAB and LSCB 2013/14 annual reports

 

  1. Reviews Appendix 7 for the most recent update from the Barnet, Enfield and Haringey Mental Health Trust about how it is addressing on-going quality concerns

 

  1. Endorses the continued improvement of multi-agency approaches to safeguarding Barnet residents and quality improvements of health and care services, with involvement from the Council, the CCG, NHS  Health Trusts, the Police, Voluntary Sector, Service User Forums and Faith and Community groups

 

  1. Additional Recommendation: The Board resolved that Mr. Chris Miller, Independent Chair of the Adults and Children’s Safeguarding Boards, be invited to attend future Health & Well-Being Board meetings as a non-voting Observer with full speaking rights.

 

10.

Future of Children's Trust Board pdf icon PDF 94 KB

Minutes:

The Lead Member for Children’s Services, Councillor Reuben Thompstone introduced the item on the future of the Children’s Trust Board (CTB).

Councillor Thompstone explained that the partners of the CTB agreed to develop an alternative governance approach to achieve its objectives. The Board was informed that a survey of members of the CTB and its Executive Management Group was undertaken. It was agreed that the CTB will meet for one or two half day conference sessions per year to review progress on the Children and Young People’s Plan and to refresh priorities. The CTB will have no business to transact but may make recommendations for action to partnerships and other partner organisations.

RESOLVED that: 

  1. The Health & Well-Being Board agrees to oversee the aspects of the Children and Young People Plan’s Plan that relate to health and well-being and to take partnership decisions for these areas.

  2. The priorities outlined in paragraph 2.5 (p.173 agenda pack) are incorporated into the Health and Well-Being Strategy when it is refreshed in early 2015.

 

11.

Domestic Violence and Violence Against Women and Girls (DV/VAWG) Strategy 2013-2016 pdf icon PDF 118 KB

Additional documents:

Minutes:

The Chairman welcomed the CEO of CommUNITY Barnet Ms Julie Pal and invited her to join the discussion. Ms Pal highlighted the need for effective collaboration between the Strategic Boards to drive progress on the Domestic Violence and Violence against Women and Girls Action Plan.  The Board noted the importance of raising the profile of under-reporting in cases of domestic violence and abuse.

The Independent Chair of the Adults and Children’s Safeguarding Boards highlighted the duty to safeguard adults and children who are at risk of violence. The Board noted the need to support clients who are at high risk through sharing information and intelligence. Furthermore it was noted that the Identification and Referral to Improve Safety (IRIS) commissioning guidance addresses the need for improved training and awareness on domestic violence and abuse for GPs and healthcare professionals. 

RESOLVED that the Health & Well-Being Board:

  1. Approves the proposed collaborative approach to address the Domestic Violence and Violence against Women and Girls Strategy and Action plan.

  2. Notes the actions agreed for Health partners under the Domestic Violence and Violence against Women and Girls Action Plan 2013-2016 (see appendix 1 for a list of these actions)

 

  1. Agrees to receive 6 monthly updates from the Domestic Violence and Violence against Women and Girls Delivery Board

  2. Ensures alignment of its work with the Safer Community Partnership Board.

  3. Considers the importance of a local needs assessment for people who are at risk of causing violence, or are experiencing violence to be incorporated in the Joint Strategic Needs Assessment.

  4. Additional recommendation: That the Chairmen of the Health & Well-Being Board and the Safer Communities Partnership Board send a joint letter to NHS England requesting a formal response on funding and allocation of responsibilities in light of the IRIS commissioning guidance

 

12.

Early Intervention and Prevention Strategy

Additional documents:

Minutes:

Duncan Tessier, Assistant Director Early Intervention and Prevention (LBB) briefed the Board about the Early Intervention and Prevention Strategy. The Board noted the purpose of the Strategy to identify and tackle problems as early as possible and to improve outcomes for children and families.

The Chairman emphasised the importance of effective inter-agency working to tackle the key themes identified as most likely to result in poor outcomes for families across the Borough. (p170 Supplementary Agenda report)

Mr Tessier stated that partners in Health, Education, the Police and the Voluntary Sector have agreed to help with work on a shared plan for the Early Intervention and Prevention Strategy. It was also noted that assessment of the success of the Strategy will be carried out by a number of measures such as reviewing impact of early intervention, partnership arrangements and whether intervention could occur at an earlier stage.

RESOLVED that:

1)         The Health & Well-Being Board notes the Early Intervention and Prevention Strategy

2)         That following creation of the Health & Well-Being Early Years Group, this group considers the actions that come from the Early Intervention and Prevention Strategy

 

13.

Report on immunisation coverage in Barnet pdf icon PDF 108 KB

Additional documents:

Minutes:

The Chairman welcomed the following guests from NHS England to discuss the report on childhood immunisation rates: Luke Kwamya, Population Health Practitioner Manager; Kenny Gibson, Head of Early Years; and Amanda Goulden, Population Health Practitioner Manager.

The Strategic Director for Communities queried the drop in immunisation rates in tables 1-6 (pp 208-210 Agenda report). Mr Gibson explained that the decline in figures has been due to data management and linkage issues. It was noted that all Barnet practices are now signed up to Quality Medical Solutions (QMS), enabling immunisation data to be electronically uploaded to a central server. Mr Gibson also noted the importance of sharing relevant data with partners as part of an integrated governance framework. 

The Board noted the report on childhood immunisations in Barnet and the processes in place to ensure that new entrants are offered the appropriate vaccination.

The Director of Public Health (Harrow and Barnet) Dr Andrew Howe, informed the Board that since April 2013, screening and immunisations have been the responsibility of NHS England.

Dr Clare Stephens highlighted the usefulness of clinical representation on the London Immunisation Board. Selina Rodrigues, Head of Healthwatch emphasised that assurances would need to be provided that vaccination reminders were being sent to residents and that data should reflect accurate representation of childhood immunisation rates across the Borough.

 

 

RESOLVED that:

  1. The Board notes the assurance given from NHS England that reported childhood immunisation rates in Barnet are not an accurate reflection of immunisation uptake in the Borough

  2. The Board seeks assurance from NHS England through the Director of Public Health that sufficient action is being taken to address this issue and that alternative surveillance measures are in place whilst childhood immunisation (COVER) data is inaccurate

 

  1. The Board is satisfied that appropriate governance arrangements (as set out in Appendix 1) are in place within NHS England in relation to immunisations to protect the health of people in Barnet

  2. Additional recommendation: The Board requires that an integrated governance framework is in place to allow effective data sharing and to present a more accurate representation of childhood immunisation rates in Barnet

  3. That the Board consults with Health Overview and Scrutiny Committee to enable a referral for remedy to the Department of Health if performance does not improve

 

14.

Screening coverage and uptake in Barnet pdf icon PDF 78 KB

Additional documents:

Minutes:

The Chairman welcomed Dr Jeff Lake, Consultant in Public Health. Dr Lake briefed the Board about the performance reports of screening uptake in Barnet. The Board was informed about the three cancer screening programmes (Breast, Cervical and Bowel) commissioned by NHS England.

Members were informed of the 2% increase in Cervical and Breast Screening coverage and an increase of 13% in uptake of Bowel screening. Dr Lake stated however that the improved performance is still below national targets.

Mr Gibson noted that NHS England has established a London Coverage Technical Group to oversee and ensure robust commissioning and implementation of best practice as a response to the low screening uptake in the Borough.

Action: Kenny Gibson and Dr Clare Stephens to produce a draft action plan for patients who have not participated in the cancer screening programme

RESOLVED that:

  1. The Board notes that Local Authority Public Health assurance reporting is not yet in place, that the London Screening Board has requested urgent resolution and the need to improve communication with London Directors of Public Health and to agree reporting arrangements with London Health and Well-Being Boards.

  2. The Board notes the July 2014 NHS England screening coverage and uptake report to the London Screening Committee showing that in Barnet Cancer screening programme coverage has been improving but remains short of national targets.

  3. The Board notes that the London Cancer Screening Performance Exception Report for Quarter 4 2013/14 reports that as of June 2014 time to receipt of result letter for women tested on the Cervical screening programme remains in breach of quality assurance standards

  4. The Board requests further updates to the Health & Well-Being Board and that this matter is referred to the Health Overview and Scrutiny Committee to ensure that the issues raised in this report are adequately addressed through the work of the London Screening Board

  5. Additional recommendation- The Board requests that NHS England provide suggested targets for screening uptake that can be included in the refresh of the Health & Well-Being Strategy prior to the next Health & Well-Being Board meeting.

 

15.

12 month Forward Work Programme pdf icon PDF 105 KB

Additional documents:

Minutes:

The Chairman requested that all reports be submitted in accordance with publication deadlines.

RESOLVED that:

1.         The Board proposes any necessary additions and amendments to the 12 month forward work programme

2.         Board Members propose updates to the forward work programme before the first day in each calendar month, so that the work programme can be published on the Council’s website more efficiently, with the most up to date information available.

3.         The Board aligns its work programme with the work programmes of the new Council Committees (namely the Adults and Safeguarding Committee and the Children’s, Education, Libraries and Safeguarding Committee), Health Overview and Scrutiny Committee and Barnet CCG’s Board.

 

16.

Any Items the Chairman decides are urgent

Minutes:

There were none.

17.

Motion to Exclude the Press and Public

Minutes:

That under Section 100A (4) of the Local Government Act 1972 the public be excluded from the meeting for the following items of business on the grounds that they involve the likely disclosure of exempt information as defined in paragraph 9 of Part 1 of Schedule 12A of the Act (as amended).

18.

Update on the Better Care Fund proposals/ 5 tier model for integrated care

Additional documents:

Minutes:

RESOLVED that the exempt information be noted.

 

19.

Any Other Exempt Items the Chairman decides are urgent

Minutes:

There were none.