Agenda and minutes

The Chairman of the Health & Well-Being Board Councillor Helena Hart, welcomed the attendees to the meeting and thanked Claire Mundle, Policy and Commissioning Advisor, for all her contributions to the work of the Board.

The following corrections were noted – that Dr Jeff Lake and Julie Pal are listed as ‘in attendance’ on p1 of the agenda and on p8, for Dr Andrew Howe to receive an update on improved screening levels across London from the London Coverage Technical Group (NHS England).

RESOLVED that subject to the above corrections the minutes of the Health & Well-Being Board meeting held on 18 September be agreed as a correct record.

Apologies for absence were received from:

Maria O’Dwyer, Barnet Clinical Commissioning Group (Substitute)

Mathew Kendall, London Borough of Barnet (Substitute)

There were none.

None.

None were submitted.

The Chairman welcomed Dr Jeff Lake, Consultant in Public Health. Dr Lake introduced the item and referred to the performance indicators on pp 47-57 as an indication of how Barnet services are responding to local population need.

The Director for Public Health (Harrow and Barnet) informed the Board that the performance report will be presented to the Partnership Boards Autumn Catch-up on 20 November 2014 to ensure continued engagement with Partners in support of the delivery of the Barnet Health & Well-Being Strategy.

The Board noted the recommended priorities for Year 3 in light of the most recent performance data and achievements of the past 12 months. Dr Lake highlighted the challenges identified (p91) to ensure that the best possible health and well-being outcomes are achieved for the population of Barnet.

The Chairman noted that the wording of the third recommended priority for Year 3 (p.13) should include ‘especially children in care’ to read:

‘3. That the Health and Well-Being Board partners work collectively and collaboratively to promote early intervention and prevention of mental health problems for children, especially children in care, working aged adults and older people and ensure robust local service provision.’

Dr Jeff Lake further noted the Partnership Boards progress reports in Appendix 1, highlighting the progress made by these Boards over the past 12 months in relation to the priority areas identified by the Board.

Action: Further discussion to be held between Barnet CCG, Primary Care and Public Health regarding an approach to drugs and alcohol.

Chris Miller, Independent Chairman of the Adults and Children’s Safeguarding Boards welcomed the discussion and raised concerns in relation to the upward trend in higher risk alcohol consumption.

Dr Lake informed the Board of the health risks associated with excessive alcohol consumption. Furthermore, the Board heard about the importance of delivering information regarding units in different alcoholic beverages and the risks associated with drinking patterns in excess of the recommended daily limit.

Action: For the Board to give further consideration to effective ways of tackling excessive alcohol consumption across the Borough.

The Strategic Director for Communities, Kate Kennally commended the priorities identified in the report (p 13-14) and highlighted the importance of addressing social isolation and loneliness as part of priorities 9 and 10 (p14).

The Adults and Communities Director, Dawn Wakeling informed the Board that the Care Act 2014 places a duty on local authorities to provide information and advice relating to care and support locally. Ms Wakeling also noted the importance of linking the duties under the Care Act with the priority areas for Year 3. 

Selina Rodrigues, Head of Healthwatch emphasised that feedback from young people, teachers and youth workers suggested that there is an inconsistency in pathways experienced by young people accessing social and health support services.

RESOLVED that:

1. The Health and Well-Being Board considers the second annual Health and Well-Being Strategy performance report and assesses the progress that has been made so far to meet the Strategy’s objectives.
   
   
2. That the Board endorses the recommendations outlined in  ...  view the full minutes text for item 6.

Dr Andrew Howe noted the proposed timeline to produce an updated Joint Health and Well-Being Strategy (HWBS) and a Joint Strategic Needs Assessment (JSNA) in 2015.

The Board noted the proposals to establish a task specific Steering Group to support the updates of the JSNA and HWBS. Dr Howe informed the Board that a Steering Group would be established to ensure that the delivery of the JSNA and HWBS is on track and the process is collaborative.

The Strategic Director for Communities commented that taking into account the comments and information gathered from various sources and stakeholders, the JSNA will be used to inform the future Joint HWBS which will in turn drive local commissioning decisions.

The Chairman stressed the importance of effective partnership working necessary to undertake a successful JSNA and HWBS and to engage with all Partnership Boards to improve health and well-being outcomes.

The Chairman, Councillor Reuben Thompstone and Councillor Sachin Rajput (Chairman of the Adults and Safeguarding Committee) noted that Council on 4 November 2014 had agreed the following motion:

“Council instructs the governance service, when scheduling the calendar of meetings for the next municipal year, to align the meetings of the Health and Well-Being Board and the Adults and Safeguarding Committee so that the meeting of the latter will have sight of the papers for the former and could, should the committee agree, make comments and suggestions to the Health and Well-being Board, through the Chairman of the Adults and Safeguarding Committee.”

RESOLVED that:

1.    The Health and Well-Being Board approves the approach to updating the Joint Strategic Needs Assessment and Joint Health and Well-Being Strategy.

2.    The Board approves the proposals to establish a Steering Group to oversee the JSNA/ HWBS updates. The Health and Well- Being Board notes that this Steering Group has a distinct set of roles and responsibilities to the 3 standing sub-groups of the Board (set out in para 1.5)

3.    That the Board appoints membership to the JSNA and HWBS Steering Group.

4.    That the Board approves the recommendations from the Health and Well-Being Board away day (set out in Section 1.10) and implements these recommendations immediately.

The Director for Public Health (Harrow and Barnet) Dr Andrew Howe introduced the item and informed the Board that the Commissioning Plan is based on an assumption that spending on Public Health will be maintained at the present level through to the end of the decade.

The Commissioning Plan sets out the commissioning intentions and the revenue budgets and capital requirements for recommendation to the Policy and Resources Committee on 2 December 2014. It was noted that subsequent to agreement of the draft plan at the Policy & Resources Committee meeting in December 2014, public consultation will commence before the final Commissioning Plans are agreed in February 2015.

The Chairman noted that tackling obesity, particularly in children, by promoting physical activity and other measures is essential to increasing life expectancy and improving the quality of life. The Chairman requested that measures to tackle smoking in pregnancy and excess alcohol consumption should be included in the Public Health Commissioning Plan.

Dr Debbie Frost noted the importance for partners to share information and data to tackle obesity and promote physical activity with health visitors in Barnet with caseloads in London. Kate Kennally informed the Board that the Council will assume responsibility for the commissioning of Health Visiting services from October 2015.

Ms Kennally advised the Board that health visiting has historically been underinvested within the Borough. Dr Howe noted that action should be taken to work with other boroughs and the Department of Health to improve the health visiting work force in relation to the health visitor case load.

Paul Bennett expressed support for plans to work in close partnership with the Board to address the level of concern regarding the Health Visiting service levels, sufficient to allow for Barnet to deliver mandated HV services from October 2015.

RESOLVED that

1. The Health & Well-Being Board approves the proposed Commissioning Plan (Appendix 1), subject to consultation.
   
   
2. The Board agrees to public consultation on the proposed Commissioning Plan commencing immediately following Policy and Resources Committee on 2^nd December 2014, before final Commissioning Plans are agreed by Policy and Resources on 17 February 2015.

Dr Jeff Lake briefed the Board about the importance of expanding the provision of sexual health services in primary care, pharmacy and community settings to offer further accessible venues to the population in Barnet.

Chris Miller, Independent Chairman of the Adults and Children’s Safeguarding Boards, queried the provision of services to support victims of sexual assault. Dr Lake stated that in light of a review of local mechanisms for onward referral, a local strategy is being developed for victims of sexual assault and Female Genital Mutilation (FGM).

Action: Public Health to develop and incorporate a local strategy for supporting victims of sexual assault and FGM as part of the Sexual Health Strategy.

Councillor Sachin Rajput asked what could be done to encourage a greater level of HIV testing among at risk population groups. Dr Lake noted that Public Health (Harrow and Barnet) will conduct an option appraisal for HIV testing for high risk populations in the Borough including the provision of home testing facilities.

Dr Debbie Frost advised that resources would need to be made available in order to shift provision in to Primary Care and Community Services.

The Chairman welcomed Lead Clinician, Sarah Pillai (CLCH) to join the discussion. Sarah Pillai expressed interest in working in partnership with the Public Health team to consider a broader range of interventions, such as social marketing to address concerns for young people and help develop a comprehensive strategy accordingly.

RESOLVED that

1. The Health and Well-Being Board agrees that the Public Health team should participate in collaborative commissioning of Genitourinary Medicine (GUM) services.
   
   
2. The Board agrees the plans to expand the provision of sexual health and reproductive services in primary care and community settings, especially in ‘hotspot’ and deprived areas of the Borough to facilitate the shift from hospital based services.
   
   
3. The Board agrees the plans to review current services, increase the uptake of testing for HIV and Chlamydia among high risk groups and introduce an awareness and signposting campaign.
   
   
4. Additional recommendation: The Health and Well-Being Board agrees that the Sexual Health Strategy 2015-2020 should be aligned to addressing FGM and sexual exploitation with the Safer Communities Board and LSCB.

The Director of Public Health (Harrow and Barnet) Dr Andrew Howe, introduced the report and identified the risk of a delay in data processes to the extent that it will not be possible to publish a final Pharmaceutical Needs Assessment (PNA) in Barnet prior to 1^st April 2015.

Dr Howe noted the need for a pragmatic solution to meet the statutory duty under NHS Act 2006, as amended by the Health and Social Care Act 2012, to deliver a PNA before April 2015. Paul Bennett reported that the Board would receive an update in terms of meeting the deadline as set out in the paper.

Action: The Board to receive an update on the timeline for submission of the draft PNA

The Chairman noted that on p.162 of the Agenda, the wording ‘sign of’ in the first recommendation should be changed to ‘sign off’. 

RESOLVED:

1. That authority to sign off the consultation draft of the PNA be delegated to the Director of Public Health in consultation with the Chairman of the Health and Well-being Board.
   
   
2. That Health and Wellbeing Board seeks assurance from NHSE that they accept responsibility for resolving the issues outlined in this paper by 17 November so that the PNA Consultation can begin on 16 December in order for Barnet to be compliant with the regulations by 1 April 2015.

The Chairman noted the evidence of the commitment and the work undertaken in Barnet to meet the commitments of the Charter over the last 12 months.

The Strategic Director for Communities, Kate Kennally informed the Board that Education, Health and Care plans will set clear outcome measures for children and young people with special educational needs, who will also be given the option to use a personal budget to meet the outcomes in their Education, Health and Care plans.

In light of the submission of evidence to EDCM, the Chairman noted the importance of ensuring on-going commitment to the Charter.

RESOLVED that

1. The Health and Well-Being Board agrees that the content of this report provides sufficient evidence that Barnet has met the commitments of the Disabled Children’s Charter.
   
   
2. The Board considers how they will continue to monitor implementation of the Charter’s Commitments in future years.

The Adults and Communities Director Dawn Wakeling introduced the item. Councillor Helena Hart welcomed Karen Ahmed, Later Life Lead Commissioner (LBB) to join the discussion. Karen Ahmed briefed the Board on the three key outcomes set out in the Dementia Manifesto.

It was noted that the Barnet diagnosis rate is already above the national average diagnosis rate but is working towards a target of 67% for 2015. Ms Ahmed further explained that LBB has begun to implement a ‘dementia friendly community’ approach in key areas to strengthen and main stream this approach through a dementia action alliance.

Peter Coles (Barnet CCG) noted the importance of a response to the Dementia Manifesto to ensure that the recommendation of the Manifesto has been addressed.

Dr Debbie Frost advised that Barnet CCG would like to support the National Dementia Manifesto.

The Board noted that the position in Barnet has been to integrate the approach to dementia as part of on-going work in recognition of other needs that people with dementia and their carers often have. 

RESOLVED that

1. The Board notes the current work that is being carried out in Barnet which aligns with the Dementia Manifesto.
   
   
2. The Board considers whether any further action needs to be taken with respect to implementing the Dementia Manifesto.
   
   
3. Additional recommendation: The Board supports the achievement of the three key outcomes of the Dementia Manifesto in Barnet (p209)
   
   
4. Additional recommendation: The Board asks that officers bring back a further report setting out the implications of signing up to/ not signing up to the Dementia Manifesto for London

Ms Kennally noted that the commissioned Task and Finish group will receive assurance of compliance with the Children and Families Act by December 2014.

RESOLVED that

1. The Health and Well-Being Board notes the minutes of the Financial Planning Sub-Groups of 8th October 2014
   
   
2. The Board requests a verbal update on progress to develop the approach to risk pooling that will underpin delivery of the Better Care Fund from April 2015
   
   
3. The Board agrees to receive the minutes of the Health and Social Care Integration Board as a standard item on the agenda, to ensure that adequate attention is given at Board level to the work that providers are doing to support delivery of Barnet’s integrated care proposals.

Kate Kennally, the Strategic Director for Communities, informed that the forward work programme of the Health & Well-Being Board will be made available online and updated (where necessary) at the beginning of each calendar month. 

RESOLVED that

1. The Health and Well-Being Board proposes any necessary additions and amendments to the 12 month forward work programme (see Appendix 1).
   
   
2. The Board Members proposes 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.

There were none.