Agenda and minutes

The Chair notified that a revised copy of the minutes had been published on the website to include some grammatical errors and would be the minutes for approval.

RESOLVED that the minutes of the meeting held on 16 March 2023 be agreed as a correct record.

Following approval of the minutes, it was reported that MMR (Measles, Mumps, Rubella) vaccination rates had increased by 4% for 1 year olds and 2.6% for 5 year olds. The substantial improvement reflected the large amount of work with GP Practices, the NCL immunisation improvement manager, training and community engagement and specific outreach clinics.

Apologies were received from Colette Wood and Deborah Sanders.

Apologies were also received from Anne Whateley who was substituted by Kathleen Isaac.

The Chair welcomed the new representative from Healthwatch Barnet to the Board.

There were none.

There were none.

There was none.

RESOLVED – that the Board noted the standing item on the agenda which lists the frequently used acronyms in Health and Wellbeing Board (HWBB) reports.

Dr Nick Dattani, Interim Borough Clinical Lead Barnet, North Central London (NCL) Integrated Care Board, elaborated on the report and explained that General Practice continued to be challenged by existing pressures. There had been an increase in the number of face-to face appointments being offered post Covid, with an increase from 50% in 2022 to 60-65% of appointments now being help in person. Access to services had been streamlined alongside digitalisation which included access to GP appointments; the greater number of people accessing services within the community meant fewer people presenting at walk-in centres and Accident and Emergency. It was noted that in comparison to other Boroughs in NCL, Barnet had the most practices, with 50 practices. However, it was reported that this would soon reduce to 48 as a single hander GP was retiring and a merger of practices was soon to be completed. 6 GP practices are currently single handed practices, with the average age of the GP being over 45.

It was further noted that there had been some significant challenges over the winter group as there had been increased reporting of Streptococcus A cases (especially in children) across London, coupled with Covid, post-covid related illnesses and a high level of staff sickness.

 Dr Nick Dattani, elaborated on several of the 23/24 Barnet priority Primary Care estate schemes. It was noted that the schemes would align with the neighbourhood model and build on principles from the Fuller Report and working group. It was reported that Barnet had an aging population which presented a number of pressures with regards to long term health plans with an emphasis being placed on a achieving a wrap-around service. The national Directed Enhanced Service (DES) Access Specification launched in October 2022, meaning that Primary Care Networks would be responsible for the delivery of extended access appointments for their patients between the hours of 6.30pm to 8pm Mondays to Fridays and between 9am and 5pm on Saturdays. This had been advantageous in that patients could access services without necessarily having to be referred by their GP at a time/date suitable to the user.

Dan Heller, the Neighbourhood Model Programme Lead, Barnet borough, NCL ICB updated the Board and delivered a presentation on the emerging emergency model in Barnet, and how it fits with North Central London wide strategies, particularly to the approach to improving the health of the population, describing the vision for an integrated system focused on prevention, early intervention, and proactive care. Reference was made to Neighbourhood level services and proactive, personalised care which would be delivered on hyper-local place-based initiative.

The Chair thanked both contributors and commented that it was encouraging to see collaborative working with proposed new systems that better serves the needs of residents.

The Board raised the following points:

·         Work had been undertaken by Inclusion Barnet with specific cultural groups to helping them to access services.

·         There may be a need for social prescribers to reach in extending the message and being proactive about how  ...  view the full minutes text for item 7.

The Chair resumed the meeting.

Ben Thomas, the Assistant Director of Family Services, submitted his report on the draft Children and Young People’s Plan 2023 – 2027 which set out the ambition, direction, priorities and objectives of partners in Barnet to support children and young people in the coming years. The draft Plan had already been approved by the Barnet’s Childrens Partnership Board and the Children, Education and Safeguarding Committee.

Since the development of the previous Barnet Children and Young People Plan 2019-2023 there had been significant changes impacting the lives of young people in the borough, including national policy changes affecting the delivery of essential services as well as raising standards in social care. The Plan had been driven by input from children and young people from its inception as part of a co-production approach. Following the Youth Perception Survey there was a series of focus groups in summer 2022 with specific groups of young people such as children with a disability, young carers and those in the more deprived wards in Barnet.

There had also been engagement with the Youth Board and Youth assembly as well as a whole range of different partners working on the 4 mains themes of the plan:

·         Safe & Secure

·         Family & Belonging

·         Health & Wellbeing

·         Education & Learning

It was explained that the draft Plan had gone out to consultation and the final version of it would be published in once finalised before the launch of the Children and Young People’s Plan in mid-June 2023.

The Chair thanked the presenter and commented that she had worked with some of the children and young people involved in the draft Plan in her capacity as Mayor. She explained that they had been very engaged throughout the whole process and welcomed the initiative and the opportunity for their voices to be heard.

It was reported that following the results of the Youth perception survey, focus had been placed on those who had been positive in the feedback they had given as it was apparent that these were often the most disadvantaged and unengaged and additional effort was made to connect with those young people. Concern was raised about the role of social media and its impact on Children and Young People, with links to eating disorders, disordered eating and online bullying being a paramount concern.

Whilst the Online Safety Bill may reduce some of the ill-effects of social media and working collaboratively with the network providers, it was recognised that this remained an international issue and a lot of work would be needed especially in conjunction with Schools and the police to address the matter.

RESOLVED: that the Health and Wellbeing Board considered and commented on the draft Children and Young People Plan 2023-27 including the vision and key outcomes

Dawn Wakeling, Executive Director – Communities, Adults and Health, submitted the report that provide the Board with an update on the review of services in Barnet. It was noted that in total, there is £467m of spend, funding a range of services for children, young people and adults across NCL ICB and the five boroughs. In Barnet, S75 agreements and the BCF account for £56.1m of spend on health and social care services. Overall, Barnet has a smaller amount of money in section 75 agreements compared to other boroughs.

The Executive Director – Children’s and Family Services, explained that Officers in Barnet worked alongside ICB colleagues to carry out a review that comprised of assessing value for money, alignment with local and NCL objectives, opportunities for greater integration and the potential for improvements and alternative options, and the outcomes of the review are presented to the board in the report.

RESOLVED: that the Health and Wellbeing Board note the outcome of the Better Care Fund and Section 75 review

Dr Tamara Djuertic -Director of Public Health and Prevention updated the Board and explained that as Director of Public Health she has a statutory duty to produce annual report on the state of population’s health in the area they serve.

This year, the DPH Annual Report focuses on Health Inequalities in Barnet and it was reported that there had been new and innovative ways of delivering services and engaging with communities. There had been some progress made in reducing the health inequalities gap for men in Barnet but it was recognised that more needed to be done and a commitment was in place to continue the journey to a healthier Barnet.

The Board discussed the merits of NHS health checks, and it was noted that although they were paused during the pandemic, they had been effective in raising awareness on risk factors; whilst there had been between 600 – 700 health checks carried out last year, the number of people receiving them had not fully recovered from the pandemic and co-production and partnership working would be key in promoting them in the future.

The Chair thanked the presenter for their contribution to the annual report.

RESOLVED: That the Board approve the recommendations set out in the Director of Public Health Annual Report 2022/23

Claire O’Callaghan, Health and Wellbeing Policy Manager introduced her report and explained that the Joint Health and Wellbeing Strategy (JHWBS) was a statutory document for each Local Authority area. Barnet’s current JHWBS was signed off in July 2021, with the Implementation Plan and Key Performance Indicators signed off by Health and Wellbeing Board in September 2021.

A six monthly reporting cycle had been introduced to Health and Wellbeing Board on progress on the Implementation Plan and Key Performance Indicators, the last update presented to the Board was in September 2022. The report focussed on an update of all the Phase 2 Implementation Plan since September 2022, and presented updated Key Performance Indicator figures (where available) since September 2022.

RESOLVED:

That the Board comments on and notes the current progress of the Implementation Plan, and on the Key Performance Indicators.

That the Board agrees to make updates to the Implementation Plan and Key Performance Indicators, following the recommendations from the Director of Public Health Annual report, and important actions from other key strategies ahead of the next six monthly report.

Dr Emma Waters - Public Health Consultant, elaborated on her report and delivered a presentation to the Board. She explained that Oral health was a key marker of general health in children and while tooth decay was preventable, it remained an important public health issue due to its impact on children’s ability to sleep, eat, speak, play, with wider social and NHS costs. The following information was noted:

·         National Dental Epidemiology Programme (NDEP) oral health survey in 2019 estimated that 1 in 4 five-year-old children in Barnet (23.4%) had experience of tooth decay.

·         Tooth Decay is the most common reason for non-emergency hospital admissions in children aged 5-9 years in England.

·         The percentage of children in Barnet who had experienced tooth decay rose to an estimated 30.2% in the latest survey in 2022.

·         The Barnet Oral Health Partnership Group (OHPG) was established to enhance partnership working and enable oral health partners in the borough to implement the recommendations of the oral Health Needs Assessment, through developing and monitoring an Oral Health Action Plan for Children in Barnet

·         A draft oral health action plan for Barnet has been developed which would be finalised at the next OHPG later in May 2023.

In response to questions raised by the Board the following information was provided:

Ø  There had been extensive Community Engagement to review the provision of toothbrushes and toothpaste in response to the acute cost of living crisis, with foodbanks supporting oral health needs in their provisions.

Ø  Accessibility to dentists and the cost-of-living crises had significantly impacted on oral health care.

Ø  Fluoride varnish was accessible and free on from NHS dentists but a large number of young people were not registered at dentists, in part due to a lack of number of NHS dentists in the area accepting new patients.

Ø  There was a link between dental neglect and child protection; there were rare occasions were safeguarding issues could be deemed necessary with dentists having to make a child protection referral and a Needs Assessment would require regular preventive care. The number of children having extractions under anaesthesia could be in some instances considered neglectful.

Ø  It was noted that the Joint Health Overview and Scrutiny Committee had received an update on the oral health needs of Barnet’s Children and it was evident that poor oral health was often attributed to a lack of resource and investment.

Ø  The Chair stated that on behalf of the Health and Wellbeing Board, she would write to NHS England to emphasise their concerns and request that more funding be put into the service.

RESOLVED that:

a)    the HWBB note the oral health needs identified in the Oral Health CYP Health Needs Assessment 2022.

b)   the HWBB note the key recommendations from the Oral Health CYP Health Needs Assessment 2022 and endorse the initial work on the Oral Health CYP Action Plan.

With the inclusion of ‘Communicable Diseases update’ as a standing item on future agenda, the Board noted the items due to be reported to future HWBB meetings.

RESOLVED that the Board noted the Forward Work Programme.

There were none.