Agenda and minutes

The Chairman of the Health & Well-Being Board Councillor Helena Hart, welcomed the attendees to the meeting. The Chairman also welcomed Zoë Garbett Policy and Commissioning Advisor (for Public Health and Wellbeing) who has replaced Claire Mundle. The Chairman also welcomed Regina Shakespeare Interim Director of Commissioning and Chief Operating Officer (Barnet Clinical Commissioning Group).

It was noted that following initial publication corrections have been made to the front cover of the Agenda pack to reflect the current membership of the Board.

Members of the Board were provided with a verbal update on the progress of actions taken forward from the previous minutes of the Health & Well-Being Board meeting on 13 November 2014.

It was noted that in relation to HWB Strategy Year 2 Report a discussion would follow between Barnet CCG, Primary Care and Public Health regarding an approach to drugs and alcohol and that a paper would be presented to the Board in June. The Board heard that the draft Pharmaceutical Needs Assessment is out for a 60 day period consultation and that the PNA has been added to the work programme for July.

In relation to the Sexual Health strategy- the Board heard that a a local strategy is being developed for supporting victims of sexual assault and FGM.

RESOLVED that the minutes of the Health & Well-Being Board meeting held on 13 November 2014 be agreed as a correct record.

Apologies for absence were received from:

Cllr Sachin Rajput (substituted by Cllr David Longstaff)

Dr Andrew Howe (substituted by Dr Jeff Lake)

 Dawn Wakeling (substituted by Matthew Kendall)

Paul Bennett

There were none.

None.

None were submitted.

The Chairman informed the Board that the Better Care Fund Update report was set out before the Board for ratification.

The BCF Plan had already been reviewed and agreed by the Chairmen of the Board and the Barnet Clinical Commissioning Group together with the Chief Executive of the Council.

It was noted that following submission of the BCF Plan to NHS England in September 2014, and the response received from them, the Plan had been further refined giving additional technical information regarding each of the schemes, their costs and specific contributions to the 3.5% reduction of non-elective admissions.

The Chairman drew attention to the fact that the updated submission did not change the vision or aims of the Better Care Fund in any way.

In answer to questions, Maria O’Dwyer (Barnet CCG) stated that the Rapid Response service had been launched in August 2013 and that the Homes Locally Commissioned Service had been operational since September 2014. Ms O’Dwyer noted that the scheme has helped in reducing unplanned emergency admissions to hospitals and additionally had helped people remain independent. 

The Adults and Communities Director Mathew Kendall briefed the Board about the further progression of the BCF Plan and how it will enable the delivery of the schemes of work help realise the outcomes identified for 2014/2015 and beyond.

Mr Kendall further stated that the HWB Finance Planning Group will enable LBB and CCG to monitor budgets from the Business Case for Integration across health and social care.

Kate Kennally Strategic Director for Commissioning noted that the BCF requires Local Areas to deliver integrated health and social care services through a pooled budget for closer partnership working and to take forward integration at scale and pace.

Ms Kennally highlighted the importance of ensuring that appropriate and robust mechanisms are in place to support the governance arrangements to create an HSCI Steering Group (as set out in diagram 1.6.15 of the Agenda report).

RESOLVED that:

1)    The Health & Well-Being Board ratifies the final BCF Plan submitted with the Chairman’s agreement, along with the Chair of NHS Barnet CCG and the Council Chief Executive, to NHS England on 9 January 2015.

2)    The HWBB notes the next steps described in the report following approval of the Plan.

3)    The HWBB notes and comments on progress on delivering and embedding the 5 Tier Integrated Care Model for older people in Barnet.

4)    The HWBB comments on work to date to create a pooled Budget for the delivery of services in the BCF Plan and that an update on the pooled Budget will be brought to the Board in March.

5)    The HWBB notes that final approval for the Pooled Budget will be given by the Council’s Policy and Resources Committee and by the Barnet CCG Board.

The Chairman welcomed the report and noted the plans for the establishment of a Joint Commissioning proposal to come into existence from April 2015 to formally start operating as a Joint Committee.

The Chairman highlighted the importance of the need for representation of the local perspective in Barnet at NCL level.

Dr Jeffrey Lake Consultant in Public Health noted the importance of effective partnership working and communication between Barnet CCG and Barnet Public Health department in regards to the Joint Commissioning proposal.

The Head of Healthwatch Selina Rodrigues highlighted the importance of patient communication and engagement and queried the status of the terms of reference of the Joint Committee.

The Director of Integrated Commissioning (Barnet CCG) Maria O’Dwyer informed the Board that the terms of reference and membership of the Joint Committee are currently under discussion and that this information would be shared with Healthwatch.  (Action: Head of Healthwatch to receive an update on the development of terms of reference and membership of the Joint Committee by Barnet CCG)

Ms O’Dwyer noted that the CCG is required to confirm membership support and any necessary changes to the CCG constitution. Dr Jeff Lake informed the Board that changes to the Health and Social Care Act 2012 allow for CCGs to take on joint responsibility with NHS England for the primary care contracts.

RESOLVED that:

1)    The Health & Well-Being  is requested to note and support Barnet CCG’s decision to develop a proposal to jointly co-commission with the other 4 North Central London CCGs

2)    Consider and discuss how the Health & Well-Being Board will participate in Joint Co-Commissioning Committee across NCL

3)    Consider the role of Public Health in Joint Co-Commissioning through the Director of Public Health (Harrow and Barnet) Dr Andrew Howe as the HWBB link member and feed any views/ considerations into NCL on-going discussions

Dr Jeff Lake Consultant in Public Health introduced the Annual Report of the Director of Public Health which sets out broad themes and issues across the health and local government sectors over the past 50 years. Dr Lake informed the Board that the Director of Public Health has a statutory duty to publish an annual report on health in the borough.

The Strategic Director for Commissioning Kate Kennally noted that the issues covered in the report would be considered in the development of the Health and Well-Being Strategy refresh and presented to the Board in Autumn 2015.

Vice-Chair of the HWBB and Chair of Barnet CCG Dr Debbie Frost requested that the report be circulated to GPs and community groups.

Action: Public Health to circulate the Annual Report of the Director of Public Health to GPs and community groups

The Chairman thanked Dr Lake for the presentation and welcomed the report.

RESOLVED that the Health & Well-Being Board notes the Annual Report of the Director of Public Health

The Chairman welcomed this report, bearing in mind the importance of joint working, given the significance of the transition of the Health Visitor service from NHS England to the local authority. Councillor Helena Hart welcomed Val White Interim Commissioning Director Children and Young People to the Board. Ms White introduced the report and the proposed approach towards establishing an Early Years sub-group to improve integration and joint working across early years.

The Board heard that the Early Years Review was informed by an independent review of health visiting, school nursing and family nurse partnership. The sub-group would oversee the approach for closer working and integration between health visitors, midwives, children’s centres and other health services.

It was noted that the Early Years sub-group would be accountable to the Health & Well-Being Board and that in order to improve the Early Years provision, the sub-group would focus on four key work streams as set out in the report on p193 of the Agenda.

Ms Kennally welcomed the report and requested that in order to provide support and leadership to the sub-group, the minutes of the Early Years sub-group be circulated to the Board Members with specific responsibilities towards Children’s Services.

Action: Minutes of the Early Years sub-group to be circulated to

• Kate Kennally (Strategic Director for Commissioning)
• Councillor Reuben Thompstone (Lead Member for Children’s Services)
• Dr Clare Stephens (Barnet CCG)

RESOLVED that:

1)    The Health & Well-Being Board approves the terms of reference, including objectives and high level work plan for the Health and Wellbeing Early Years sub-group.

2)    The Board makes any comments, amendments or recommendations on the Health and Wellbeing Early Years sub-group proposed approach.

The Chairman reminded the Board that it had considered the Dementia Manifesto on 13 November 2014 and that the Board had requested additional information about signing up to the Dementia Manifesto for London. She drew the Board’s attention to 1.2.4 of the report which stated that no boroughs have signed up to the London Dementia Manifesto and that the Alzheimer’s Society had stated that this was not the intention of the Manifesto.

The Chairman welcomed the suggestion of a local alternative which allowed Barnet to create a local vision for dementia care and to develop relevant local actions and measures of impact.

Mathew Kendall introduced the item and updated the Board on the discussion about dementia at the meeting of the Older People’s Partnership Board on 22 January 2015.

Mr Kendall confirmed that no London borough has signed up to the Dementia Manifesto for London and that there is currently no mechanism for enabling organisations to sign up to the Manifesto. Additionally he stated that this was not the intention of the Dementia Manifesto for London. Dr Debbie Frost Chair of Barnet Clinical Commissioning Group expressed support for signing up to a Barnet Dementia Manifesto.

The Head of Healthwatch Barnet Ms Rodrigues noted the necessity for a constructive engagement strategy which also involved local residents and community organisations. Mr Kendall also highlighted the importance of creating awareness of the local offer with all stakeholders and residents.

RESOLVED that:

1)    That the Health and Well-Being Board agrees to the development of a local Barnet Dementia Manifesto, which includes an engagement strategy developed with Barnet Healthwatch and which builds on the progress to date on dementia care in Barnet.

2)    That, subject to agreeing recommendation 1, the Health and Well-Being Board embeds the actions from the final Barnet Dementia Manifesto, when complete, into the Health and Well-Being Strategy refresh.

3)    That, subject to agreeing recommendation 1, the Health and Wellbeing Board recommends to NHS Barnet CCG’s Governing Body that actions from the final Barnet Dementia Manifesto are embedded into the NHS Barnet CCG Delivery Plan.

4)    That, subject to agreeing recommendation 1, the Health and Well-Being Board recommends to the Council’s Adults and Safeguarding Committee that actions from the final Barnet Dementia Manifesto are embedded into the Adults and Safeguarding Commissioning Plan.

The Chairman welcomed the report and commended the thorough inspections that have been carried out around hospital discharge and meals.

Selina Rodrigues Head of Healthwatch Barnet introduced the item which included a status report on how Healthwatch is meeting its contractual targets for engaging with a wide range of local communities.

The Chairman welcomed guests from Jewish Care and Advocacy in Barnet to the Board meeting. She asked for the Board to be updated on whether providers were taking notice of the findings and implementing changes. She requested that Healthwatch report back to future meetings.

It was noted that Healthwatch charity partners, Jewish Care and Advocacy in Barnet had reported difficulties experienced by patients including long waits for medication and hospital transport and lack of communication and care. Reports have been sent to local hospitals to request information on how services will be improved.

Ms Rodrigues briefed the Board about the engagement and awareness project undertaken to reach a wider group of people. The Board noted that approximately 160 people were reached in the last quarter through charity networks, Job Centre Plus, drop-in sessions at local libraries and stalls at all local hospitals.  

Dr Frost commended the report and noted that effective review of patient feedback is pertinent to improving services. Councillor Hart thanked Healthwatch for the update report.

Action: Healthwatch to request a response from Adult Social Care to their report

Action: Healthwatch to provide an update on progress made by providers to the Health & Well-Being Board

RESOLVED that the Health & Well-Being Board notes the report and provides comments on their content.

The Board noted the standing item which presents the minutes of the last two meetings of the Financial Planning Sub-Group on 5 November 2014 and 14 January 2015 respectively.

RESOLVED that the Health & Well-Being Board notes the minutes of the Financial Planning Sub-Groups of 5^th November 2014 and 14^th January 2015.

The Strategic Director for Commissioning Kate Kennally informed the Board that the forward work programme of the Health & Well-Being Board is published online and where necessary updated at the beginning of each calendar month.

RESOLVED that:

1)    The Health and Well-Being Board notes the Forward Work Programme and proposes any necessary additions and amendments to the forward work programme (see Appendix 1).

2)    The Health and Well-Being 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 Health and Well-Being 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. (see Appendix 2)

The Chairman commended the efforts undertaken and the successful meeting with representatives from the Royal Free, People’s Choice and CCG with regards to providing a Changing Places facility at Barnet Hospital. It was noted that approval was received in principle from the Royal Free with regard to the provision of the facility.

The Chairman thanked all Board members and guests for their attendance.

The meeting finished at 12.10pm.