Agenda and draft minutes

Venue: Hendon Town Hall, The Burroughs, NW4 4BG

Contact: Salar Rida 020 8359 7113, Email: salar.rida@barnet.gov.uk 

Note: Public Questions and Comments must be submitted by 10am on the third working day before the meeting. The deadline for this meeting is 10am on Monday 11 September. 

Items
No. Item

1.

Minutes of the Previous Meeting pdf icon PDF 111 KB

    Minutes:

    The Chairman of the Health and Wellbeing Board, Councillor Helena Hart opened the meeting and welcomed all attendees.

     

    In relation to matters arising from the previous minutes, the Board noted that an updated version of the terms of reference of the Joint Commissioning Executive Care Closer to Home Programme Board will be presented to the HWBB at its next meeting.  

     

    It was RESOLVED that subject to the corrections under item 9, to read as below, the previous minutes of the Health and Wellbeing Board meeting held on 20th July 2017 be agreed as a correct record.

     

    Amendments: Dr Lake briefed the Board about the issues set out in the report and noted that there has been a steady improvement in life expectancy but that inequalities have been stubbornly persistent. Close analysis of trends does not suggest any increase in life expectancy inequalities. 

    He noted that work has commenced to review the pathways that respond to suicide self-harm and the follow up on that with health partners.

     

2.

Absence of Members

    Minutes:

    Apologies for absence were received from:

    • Councillor Sachin Rajput who was substituted by the Leader of the Council, Councillor Richard Cornelius.
    • Dr Andrew Howe who was substituted by Dr Jeff Lake

     

    The Board noted that NHSE will formally be asked to appoint a substitute for Ms Ceri Jacob

     

3.

Declaration of Members' Interests

    Minutes:

    Councillor Helena Hart declared a personal non-pecuniary interest in relation to agenda item 8 – which includes Care Closer to Home and reforms to Secondary Care by virtue of her son being a Consultant at the Royal Free Hospital which could be affected in the future by any such reforms.

     

    Dr Debbie Frost made a joint non-pecuniary declaration on behalf of Barnet CCG Board members, Dr Clare Stephens, Dr Charlotte Benjamin and herself, in relation to agenda items 7 and 8 by virtue of being impacted through their respective GP practices. 

     

4.

Report of the Monitoring Officer (if any)

5.

Public Questions and Comments (if any) pdf icon PDF 58 KB

    Minutes:

    The Board noted the responses to the six Public Questions which were published and circulated prior to the meeting. During the meeting, the Board received a number of supplementary questions from Mr D. Hurley which were responded to verbally by officers.

     

6.

Public Health Annual Performance Report for 2016/17 pdf icon PDF 200 KB

    Additional documents:

    Minutes:

    The Chairman welcomed the report which provides the Board with the opportunity to review the annual performance and the achievements of the Public Health service against the Joint Health and Wellbeing Strategy for 2016-2017.

     

    The Chairman noted the progress that had been made in many areas and commented that the majority of plans and targets have green performance ratings and this is the best performance we have had in recent years. She drew particular attention to Barnet having the highest number of schools registered with the London Healthy Schools scheme – 101 – with 10 schools achieving Gold Awards, the superb coverage and results from the excellent Shisha Campaign - especially the positive reception from young people, our innovative and unique work to build health improvement into leisure services and our lead in the work to develop a pan-London approach to sexual health services. 

     

    Rachel Wells and Natalia Clifford Consultants in Public Health joined the table. Ms Wells highlighted the key achievements and actions achieved during the period 2016-17. 

     

    With regard to the Red rating for the London Heathy Schools Programme, it was confirmed that this was in relation to targets for the number of new school registrations within the performance year. The Chairman requested that this clarification be noted by the insertion of the word new in the target descriptor. (Action)

     

    Ms Clifford provided an update in relation to the ongoing commissioning of support to the Healthy Schools programme. The Board noted that targets were exceeded for Gold and Silver awards, but not met for Bronze awards or primary or secondary school registrations.

     

    Ms Clifford explained that going forward one of the areas of focus around the Healthy Schools scheme will be working with special schools. The Board heard that a drive to increase secondary school registrations is also under way, with increased promotion of those schools that achieve awards.

     

    Following comments from the Board about encouraging uptake of the Healthy Schools programme, Ms Dawn Wakeling noted the work that has gone into promoting physical activity – which includes the Mayor’s Golden Kilometre initiative. Ms Wakeling stated that the Director for Education will be asked to consider this issue and remind Heads of Schools in Barnet about the Healthy Schools programme. (Action)

     

    The Board requested an update about the work being done around promotion of physical activity and tackling obesity in children and young people. It was agreed that the annual report of the Joint Health and Wellbeing Strategy would include an update on the Fit and Active Barnet Framework. (Action: Forward Work Programme)

     

    The Chairman queried the reasons for the increase in smoking prevalence in connection with KPI reference PH/S5 on page 33.

     

    Ms Wells explained that the previous indicator was described as smoking cessation and that under the new indicator smoking prevalence PH/S5 a wider approach can be taken towards reducing health risks. She spoke about the target that was set last year and the tiers of work including the communications campaign which  ...  view the full minutes text for item 6.

7.

Update on childhood immunisations 0-5 years pdf icon PDF 265 KB

    Additional documents:

    Minutes:

    The Chairman asked Ms Clifford to join the meeting again for this item and welcomed Mr Kenny Gibson (Head of Public Health Commissioning) of NHS England to the meeting. The Chairman welcomed the update report and noted that this item has been considered on numerous occasions by the Board and previously referred to the Health Overview and Scrutiny Committee.

     

    Councillor Hart drew attention to the Board’s commitment to prevention and early intervention with Immunisation and |Screening set out as key priorities in the Joint Health and Wellbeing Strategy. Given the concerns expressed by the Board around data reporting issues the Chairman asked for assurance that future reports will provide an accurate picture of immunisation coverage.

     

    Mr Gibson presented the report and informed the Board about the plan to improve childhood immunisation uptake and coverage. He noted the objectives which have been set to improve immunisation uptake rates. The Board noted the improvement in respect of the school age vaccination rates for the last two years. Mr Gibson noted that for flu vaccination Barnet has performed better than London averages for school aged children.

     

    Dr Clare Stephens Barnet CCG, highlighted the importance of improving communication with schools and GP practices across the borough about immunisation given. Mr Gibson noted the actions underway to promote immunisation awareness through various communication channels.

     

    Mr Gibson spoke about future steps which will be taken by NHSE in collaboration with partners to address health inequalities in immunisation and better align patient information.

     

    The Board agreed an additional recommendation as follows:

     

    That the Board support and endorse all necessary action by member and partner agencies to enable and encourage GPs to record immunisations on the relevant systems.

     

     

    The Chairman thanked the Board for the discussion and it was RESOLVED:

     

    1.    That the Health and Wellbeing Board noted the update on the work done by NHS England and Barnet Public Health, since the HWBB’s request in November 2016

    2.    That the Board noted that Child Health Information Systems (CHIS hubs) have now been mobilised and the next update will provide more accurate data.

    3.    That the Board noted that a further update will be presented in early 2018.

    4.    That the Board supported and endorsed all necessary action by member and partner agencies to enable and encourage GPs to record immunisations on the relevant systems.

     

8.

Better Care Fund Plan 2017-2019 pdf icon PDF 462 KB

    Additional documents:

    Minutes:

    The Chairman welcomed the report which presents the Better Care Fund Plan for 2017-2019 as submitted to NHSE. She commended the positive achievements of the Better Care Fund to date and the beneficial impact that integrated care is having for the residents of Barnet. She highlighted the positive performance in reducing the use of emergency care, demonstrating that we are preventing crisis and helping people stay independent and that we had overachieved on helping people with health and care needs to stay in their own homes and avoid admission to residential care.  She particularly commended the positive work done to develop community dementia services and the benefits of our prevention services.

     

    Following a query about Delayed Transfers of Care, the Strategic Director of Adults, Communities and Health Dawn Wakeling noted that DToC have gone up on a national and London level. Ms Wakeling stated that despite the increase, London remains one of the best performers and improvement work will continue to address the interface between health and social care.

     

    The Board noted that due to its location, several sites in Barnet receive ambulance traffic stemming from neighbouring areas which adds to the pressure.

     

    She informed the Board about the targets within the BCF Plan to reduce DToCs and the plans going forward. It was noted that the process will be reviewed to ensure maximum efficiency, increase in care brokers and improvement to the referral mechanism.

     

    The Chief Operating Officer Barnet CCG, Kay Matthews commended the plans and the ambitious systematic approach to improve alignment of services.

     

    Ms Wakeling highlighted the importance of the partnership approach towards building community capacity and early intervention which will prevent unnecessary hospital visits and DToCs. 

     

    Dr Debbie Frost, Chair of Barnet CCG noted the ongoing work to address the issues and together with the Chairman commended the input towards continued partnership working.

     

    It was RESOLVED:

     

    1.    That the Health and Wellbeing Board noted that the Barnet Better Care Fund Plan 2017-2019 was agreed under Chairman’s and Vice-Chairman’s action for submission to NHS England on 11 September 2017.

    2.    That the Health and Wellbeing Board endorsed the attached Barnet Better Care Fund Plan following its agreement by the Chairman and Vice-Chairman.

    3.    That the Health and Wellbeing Board commented as above on the plan.

    4.    That the Health and Wellbeing Board (HWB) noted that progress will be monitored by the Joint Commissioning Executive Group and regularly reported to the HWB.

     

9.

Volunteering in public services: promoting health and wellbeing pdf icon PDF 266 KB

    Minutes:

    The Chairman welcomed the report and invited Sophie Leedham Strategy Officer, Community Participation and Engagement to join the meeting.

     

    In relation to a question from the Chairman, Ms Wakeling informed the Board that although the number of volunteers with specific language skills has been low, work has continued to promote volunteering and its benefits.

     

    Ms Leedham presented the report. Dr Jeff Lake and Dr Debbie Frost noted the importance of promoting and developing social prescribing and signposting.

     

    Dr Clare Stephens emphasised the need to link young volunteers with long termsvolunteering opportunities by making use of schools’ curriculum offer. 

     

    The Chairman thanked Ms Leedham for the report and the Board for the discussion.

     

    It was RESOLVED:

     

    1.    That the Health and Wellbeing Board noted the areas where volunteering is working well in Barnet.

    2.    The Board considered and advised as above how volunteering could be developed in partnership, in order to further Joint Health and Wellbeing Strategy priorities and as set out under section 1.10 of this report.

     

10.

Healthwatch Barnet Annual Report pdf icon PDF 186 KB

    Additional documents:

    Minutes:

    Councillor Hart welcomed the annual Barnet Healthwatch report which sets out the good work of Healthwatch over the last year. The Chairman praised the activities and reach of Healthwatch in Barnet, especially in terms of Enter and View visits, the level of engagement with local residents and the value of the reports which have been produced.

     

    Selina Rodrigues, Head of Healthwatch Barnet presented the report and spoke about the priorities for this year. Ms Matthews welcomed the report and encouraged closer working and data sharing between partners. 

     

    RESOLVED:

     

    That the Health and Wellbeing Board noted and commented as above on the content of the report and appendix.

     

11.

Minutes of the Joint Commissioning Executive Care Closer to Home Programme Board pdf icon PDF 123 KB

12.

Forward Work Programme 2017-2018 pdf icon PDF 186 KB

    Additional documents:

    Minutes:

    The Chairman noted the items listed on the Forward Work Programme for 2017-18. The Board during this meeting, agreed to incorporate the following items into its Forward Work Programme for 9th November 2017:

     

    ·         Ofsted Improvement Action Plan

    ·         Update on tackling obesity in children and young people to be incorporated within the Joint Health and Wellbeing Strategy Implementation plan annual report

     

    It was therefore RESOLVED:

     

    That the Health and Wellbeing Board considered and commented as above on the items included in the Forward Work Programme (see Appendix 1).

     

13.

Any Items the Chairman decides are urgent

    Minutes:

    The Chairman drew attention to an urgent matter which required the Board’s attention.

     

    She stated that in July of this year, Ofsted published its inspection findings, giving Barnet an inadequate rating. The Council and partners are in the process of developing an action plan in response to the inspection findings.

     

    The Chairman invited Board Members to comment about the Board’s role in delivering the improvements required and what the Board needed to contribute to the Action Plan. She underlined the necessity to work together and focus on multi-agency aspects, on the MASH and on health outcomes for vulnerable children and young people.

     

    The Strategic Director of Children and Young People, Chris Munday updated the Board about the current position. Following the finding, an independent DfE commissioner has been appointed to assess whether the Council has the capacity and capability to continue improvements, or whether the services should be taken outside of Council control.

     

    An Improvement Board has been set up and the Commissioner has met with several key teams and stakeholders. Mr Munday noted key challenges and that work has been ongoing to develop the Ofsted improvement Action Plan which is out for consultation and will be submitted in October.

     

    The Improvement Plan has been informed by input from partners. He noted that the Improvement Plan has been developed around five key themes which were noted as (1) Leadership, governance, partnership (2) Practice leadership (3) Thresholds (4) Improving assessments and (5) Improving planning. The Board received a summary account of the workstreams under each of the branches within the Improvement Plan. Mr Munday noted the importance of partnership work, particularly in areas such as CAMHS, Looked after Children, school nursing and health visiting.

     

    The Leader noted the importance of engagement with partners. It was agreed that the same version of the Ofsted improvement Plan report, once reported to CELS Committee would also be taken to various Committees/ bodies.

     

    Ms Matthews stated that it would be beneficial, in light of the amount of work and overarching strategies, for partners from CCG to join the Improvement Board.

     

    Following discussion, the Board agreed the following recommendation.

     

    It was RESOLVED:

     

    1.    That the Health and Wellbeing Board and its partners have committed to doing everything required of it to drive improvements for children and young people in Barnet.

    2.    That the Board continues to carry out is responsibilities particularly in light of the Joint Health and Wellbeing Strategy and to take forward actions that come under its remit under the Improvement Plan.

    3.    That the Board noted that Board Members will join the Improvement Board.