Agenda and minutes

The Chairman of the Health and Wellbeing Board, Councillor Helena Hart opened the meeting and welcomed all attendees. It was noted that the actions arising from the previous minutes have been taken forward under this agenda and the forward work programme.

The Chairman briefed the Board about the Motion which was passed at Full Council on 13^th December 2016 calling for concerted local action to tackle the ever growing incidence of Diabetes in the Borough. Council has specifically requested that the Health and Wellbeing Board devises a local improvement strategy to try and mitigate this most worrying problem.

The Board heard that as part of the Annual Commissioning Plan, the Public Health team will provide an update to the Board on the work currently being delivered and the workstreams that are due to take place. Dr Jeff Lake (Consultant in Public Health) provided a brief update on some of the plans already underway. The Board received an update on local commissioned services for Diabetes and noted that a bid for funding had been submitted around Diabetes to expand structured education and a digital based offer. This includes working closely with partners to review the current mechanism in place to aid early diagnosis and the local commissioned services for Diabetes.    

The Chairman thanked Dr Lake for the briefing and noted the update due to be reported to the Board at its meeting in March.

The Chairman then noted that colleagues at the Barnet Clinical Commissioning Group have been shortlisted for two national awards. The CCG has been nominated for two entries in the Health Service Journal Value Healthcare Awards - namely Medication Optimisation for Respiratory Conditions at Barnet CCG and Reimagining Mental Health in the Primary Care services category.  The Chairman and the Board congratulated Barnet CCG colleagues on the nominations and their sterling achievements.

RESOLVED that the minutes of the previous meeting held on 10^th November 2016 be agreed as a correct record.

Apologies were received from:

·         Dr Debbie Frost, who was substituted by Dr Ahmer Farooqui

·         Dr Andrew Howe, who substituted by Dr Jeff Lake

·         Mr Michael Rich, who was substituted by Ms Julie Pal

·         Ms Ceri Jacob (NHS England)

Dr Ahmer Farooqui made a joint declaration on behalf of Barnet CCG Board members, Dr Clare Stephens, Dr Charlotte Benjamin and himself in relation to agenda item 7 by virtue of offering immunisation services to children and membership of the GPs Federation through their respective GP practices.

Councillor Helena Hart declared a non-pecuniary interest in relation to agenda item 7 by virtue of her son being a Consultant at the Royal Free Hospital which in the future could be affected by any changes.

None.

The Board noted the details of the submitted public questions and the public answers which were provided for the meeting. Responses to the supplementary public questions were given verbally at the meeting.

Ms Mary O’Connor addressed the Board and made a public comment in relation to agenda item 12 (Forward Work Programme).

The Chairman introduced the report which sets out the activities undertaken as part of the Ageing Well Programme. The Programme is an initiative aimed at reducing demand for adult social care service by supporting people to live independently in their own homes and communities for longer and to build support networks within local communities.

To present the report, the Chairman invited Zoë Garbett, Commissioning Lead Health and Wellbeing, Lisa Smith, East Finchley Altogether Better Officer and Nazra Zuhyle, Altogether Better Burnt Oak and Edgware and Stonegrove Altogether Better Officer.

Ms Garbett introduced the report and briefed the Board about the expansion of the project on a borough wide scale. It was noted that the project, which was initiated in 2013 has been progressing through a number of community activities.

The Board received a presentation from a resident who is a Community Friend at Altogether Better Burnt Oak. The resident shared her personal experience. She stated that her participation in the various community run activities had had a most positive impact on her and had prompted her to encourage other residents to participate in the activities.

In relation to a query about promotion of the Programme, Ms Smith noted that information about the activities is disseminated through various methods such as newsletters, publication in the local press and word of mouth.

Dr Jeff Lake, Consultant in Public Health highlighted the benefits of the Programme in helping to build connections with communities and noted that more leaflets will be distributed throughout the Borough.

The Board very much welcomed both the Presentation and the beneficial effects of the Programme. Dr Farooqui encouraged publicity of the Programme throughout the Borough and via GP practices.

The Commissioning Director for Adults and Health, Ms Dawn Wakeling requested that the synergies between various community development programmes be reviewed to make sure they are working together effectively for maximum impact – Altogether Better, Age UK Barnet Neighbourhood Model,  Care Space and initiatives in Public Health.

The Chairman welcomed the discussion. Councillor Hart moved a motion which was seconded, to amend the wording of the recommendation to read:

The Health and Wellbeing noted and appreciates the progress made by the Ageing Well programme to reduce dependence on social care by facilitating community led activities for older people

The motion was declared carried and became the substantive motion. It was therefore RESOLVED that:

The Health and Wellbeing noted and appreciates the progress made by the Ageing Well programme to reduce dependence on social care by facilitating community led activities for older people.

The Chairman introduced the report which sets out the Barnet CCG Commissioning Intentions for 2017-18.

She noted that in December 2016, the CCG agreed two year contracts with providers which reflect activity, workforce and performance assumptions within the vision of the local Sustainability and Transformation Plan (STP). Mr Neil Snee, Director of Integrated Commissioning, Barnet CCG joined the meeting. 

Mr Snee presented the report and informed the Board about the focus of this contracting round. He noted that involvement of GP’s, residents and service users in the process has been beneficial and a reduction in payments for over-performance had also been agreed. Mr Snee further briefed the Board about the intention to move services locally where they are needed, whenever this is possible. It was noted that the development and utilisation of the Finchley Memorial Hospital is at the centre of these plans.

The Commissioning Director for Adults and Health, Ms Dawn Wakeling welcomed the report and supported the commissioning intentions which fit in well with Care Closer to Home.

Board Members welcomed the report and highlighted the importance of engagement with residents, stakeholders and service users. Mr Snee welcomed the comments and informed the Board about future plans for resident engagement and patient representation - including carers.

Following sign off, it was noted that the Commissioning intentions will be published on the CCG website and issued throughout the Borough via service providers.

It was RESOLVED:

That the Health and Wellbeing Board noted Barnet CCG’s 2017/18 Commissioning Intentions (see Appendices 1, 2 and 3) for each provider where it is the lead commissioner.

The Chairman noted that Child and Adolescent Mental Health Services have been an ongoing concern for the Board for some time. This has very much been reflected in the JHWB Strategy priority to improve mental health and wellbeing for all residents. She introduced the CAMHS Report and welcomed it both as an opportunity to shape the delivery of the joint programme as well as to focus on prevention.

The Commissioning Director for Children and Young People, Mr Chris Munday presented the item and briefed the Board about the service development and improvements. He noted that for 2017, there will be an additional service to provide targeted early intervention to vulnerable young people. This will be targeted for young people who are experiencing difficulties with anxiety, depression, and emotional distress but who are not yet at a diagnostic threshold for specialist CAMHS.

Mr Eamann Devlin CAMHS Joint Commissioning Manager (interim) joined the table and provided a presentation. Mr Chris Miller, Independent Chairman of the Barnet Adults and Children’s Safeguarding Boards highlighted the need for specific care for children particularly in light of the population size in Barnet.

Mr Munday informed the Board about efforts to configure services appropriately and make services more accessible as well as increasing take up. Following a query from the Board, Mr Munday explained that schools are the heart of the development and implementation of the programme around the THRIVE model. So far, it has been well received within the schools where it had been piloted and the intention was to roll this out with other schools.

Mr Munday also noted that further work will be undertaken with schools to encourage young people to access services and tackle stigma around mental health.

It was RESOLVED that:

1.    The Health and Wellbeing Board noted and approved the progress made in jointly commissioning a new Emotional Wellbeing and Mental Health System for Children and Young People.

2.    The Board noted and approved the commissioning intentions as planned with the procurement process based on the timetable Appendix A.

3.    The Board noted and approved the monitoring of progress against milestones in the procurement plan Notes the successful funding bids received and progress toward improving local provision.

4.    The Board noted that an update report on procurement is due to be provided to the HWBB in July 2017.

The Chairman welcomed the shisha update report and invited Ms Natalia Clifford, Consultant in Public Health to join the meeting. Councillor Hart introduced the report and thanked the Task and Finish Group for all their hard work on the Shisha campaign, particularly for the communication campaign and the posters. She re-iterated the very strong messages contained in these very well received posters that smoking Shisha could double your risk of Cancer, that Shisha contains tobacco and that Shisha had as much addictive nicotine as cigarettes.

In response to a query about addressing the increase in shisha usage, Ms Clifford stated that work has commenced with Environmental Health to consider options available taking into account legislation and licensing provisions.

She noted that shisha smoking itself is not a licensing activity however she informed the Board that the full range of levers available will be explored together with partners. Ms Clifford also stated that in-depth planning consultation will take time to achieve.

Following discussion, the Leader suggested that the Board make a submission to the Mayor of London as part of the Local Plan, which sets out the framework for how development and growth will be managed in the borough. (Action)

Dr Clare Stephens commended the work that had been done so far and welcomed the report. She noted that the Board could make a formal representation to the All-Party Parliamentary Group on Cancer to address the increase in shisha use. (Action)

Councillor Sachin Rajput queried the options available around curtailing visibility of shisha activity. Councillor Reuben Thompstone welcomed the suggestions to address the increase in shisha usage and associated health risks. Ms Wakeling welcomed the issues raised and noted that this will be considered as part of the options. (Action)

In relation to a query about enforcement, Ms Clifford noted that warning displays of shisha and smoking is an enforceable licensing activity. 

The Board noted that an evaluation report will be brought to the June meeting of the HWBB.

The Chairman welcomed the comments from the Board Members and expressed support for taking the actions forward.

It was RESOLVED:

1.    That the Health and Wellbeing Board endorsed the next phase of the Shisha campaign (sections 1.2-1.4)

2.    That the Health and Wellbeing Board approved and supports the distribution of campaign materials and proposed communications techniques aimed at all Barnet residents.

The Chairman welcomed the report which sets out the key achievements, risks, finance and commissioning intentions across the Section 75 agreements.

Ms Wakeling and Mr Munday presented the item and noted the overarching agreements and schedules in place as set out in the agenda report. The Board heard that the Section 75 Agreement mechanism has been used in Barnet for both adults and children services and the delivery of the agreements is monitored through the JCEG.

The Board welcomed the update and it was RESOLVED:

That the Health and Wellbeing Board noted the impact of the Section 75 agreements in delivering improved outcomes for Barnet’s residents.

The Commissioning Director for Adults and Health presented the standing item on the agenda which includes the minutes of the JCEG meetings held on 24^th October 2016 and 23^rd November 2016.

Ms Wakeling noted that, although it was expected in early December, the guidance and policy framework in respect of the BCF has not yet been published by NHS England. Ms Wakeling stressed the importance of the BCF being linked to the North Central London (NCL) Sustainability and Transformation Plan (STP) with clear governance.

RESOLVED:

That the Health and Wellbeing Board approved the minutes of the Joint Commissioning Executive Group meetings of 24 October 2016 and 23 November 2016.

The Board noted the standing item on the agenda which lists the work programme for 2017.

It was RESOLVED:

1.    That the Health and Wellbeing Board notes the Forward Work Programme and proposes any necessary additions and amendments to the forward work programme (see Appendix 1).

2.    That Health and Wellbeing Board Members continue to 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.    That the Health and Wellbeing Board continue to align its work programme with the work programmes of the 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).

None.