Agenda and minutes

The Chairman of the Health & Well-Being Board Councillor Helena Hart, welcomed all attendees to the meeting. She indicated that the Minutes needed to be amended to show both the Chairman and Vice Chairman were present together with Councillor Longstaff, Dr Jeffrey Lake and Matthew Kendall as substitutes also being present. Members of the Board were provided with a verbal update on the progress of actions from the previous minutes of the Health & Well-Being Board on 29 January 2015.

In relation to the CCG Implementation of co-commissioning item, it was noted that Healthwatch will receive an update on co-commissioning which was presented to the CCG Governing Body in February and which included the Joint Committee’s terms of reference.

It was noted that the Annual Report of the Director of Public Health has been circulated to primary care services via the CCG, CommUNITY Barnet and the Partnership Boards.

It was further noted that the first meeting of the Early Years Sub-Group was held on 25 February 2015.

The Board heard that in relation to the Healthwatch Update report, a meeting has been arranged between Adult Services and Healthwatch Barnet and that a progress report will be presented by Healthwatch at the June Health & Well-Being Board which will include information on the progress made by all providers.

RESOLVED that the minutes of the Health & Well-Being Board meeting held on 29 January 2015 be agreed as a correct record.

Apologies for absence were received from:

Dawn Wakeling (substituted by Mathew Kendall)

Selina Rodrigues (substituted by Julie Pal)

Paul Bennett

There were none.

None.

None were received.

The Chairman welcomed the report which sets out the key findings from the public consultation conducted by the Council in relation to the Public Health Commissioning Plan.

The Chairman expressed concern for the low response rate of only seven respondents. The Chairman noted that as part of the consultation, two respondents had indicated that alcohol, exercise and obesity would require further robust solutions. It was noted that this Report Agenda included an item on obesity and that the Health and Well-Being Board will receive a paper on substance misuse in June.

Dr Andrew Howe, Director of Public Health, informed the Board about the feedback received from the public consultation, drawing the attention of the Board to the consultation responses which are in line with the direction of the commissioning plan and stated that the Public Health Commissioning Plan 2015-2020 aligns with the priorities identified in the Health and Well-Being Strategy 2012-2015 and is informing the Council’s Corporate Plan. The Director of Public Health stated that some of the indicators and targets will be developed following data received at the end of the financial year.

Following queries from Board Members, Dr Andrew Howe noted that the priority objectives identified in the Public Health Commissioning Plan 2015-2020 will reflect the importance of providing protection to individuals against Female Genital Mutilation (FGM) and sexual exploitation.

Julie Pal, CommUNITY Barnet Chief Executive Officer, stated the importance of engaging with residents to ensure their understanding of services and their role in their own health and well-being, the Director of Public Health agreed and stated that the Health and Well-Being Strategy refresh offers an appropriate opportunity for this.

The Strategic Director for Commissioning, Kate Kennally, welcomed the ambitions identified in the Public Health Commissioning Plan and asked the Director of Public Health to comment on areas of development. The Director of Public Health informed the Board that the school nursing and substance misuse procurement exercises are almost complete and that work is being completed ahead of the transfer of the Health Visiting service to the Local Authority on 1 October 2015.

RESOLVED that:

1. The Health and Well-Being Board notes the consultation feedback on the draft Public Health Commissioning Plan.
   
   
2. The Health and Well-Being Board notes that no changes have been made to the Public Health Commissioning Plan 2015-2020 as consultation feedback was overwhelmingly supportive of the Plan.
   
   
3. The Health and Well-Being Board approves the final Public Health Commissioning Plan 2015-2020.

The Chairman of the Health and Well-Being Board invited Dr Laura Fabunmi, Consultant in Public Health, to join the table and stressed the importance of partnership working in order to commence the development of a response to obesity, both for adults and children.

The Chairman stated the difficulty of making a real difference to the entire overweight and obese adult population in Barnet (over 55%) and the need to look at prevention initiatives. She placed particular emphasis on preventing those at the upper scale of overweight from becoming obese.

Dr Andrew Howe, the Director of Public Health introduced the item and Dr Laura Fabunmi gave the Board an overview of the paper including the four tiers of services for weight management, stating the difficulty of gaining a true picture of prevalence in the borough due to self-reports and difficulties in routinely collecting BMI data by all GP practises and stated that obesity levels double from reception to Year 6 for children.

The Board heard the importance of making use of open spaces to encourage physical activity and promoting schemes that reduce obesity and incorporating these into the strategy and action plan.

Dr Fabunmi stated that, in terms of the pathway for children, tier 1 is running well, interventions aimed at enabling children to be more active and improving healthy eating habits are available in children’s centres and schools. However, the lack of tier 2 has been a big gap; this has just been commissioned and will start in April. For adults, a business case for tier 2 was presented to the Board (Appendix 3 of the report).

Dr Laura Fabunmi explained the need for reviewing the commissioning of Tier 3 services to ensure that a clear pathway exists which clarified the referral pathways for both children and adults and further informed that this is the responsibility of the CCG.  Dr Debbie Frost stated that this is something the CCG need to further consider from an NCL perspective in addition to the relevant resources.

The Chairman asked Dr Fabunmi to explain the type of service which was envisioned for the expenditure of £25,000 a year for 2 years. Dr Fabunmi explained that the business case outlines an evidence based approach.

The Board discussed the funding model for the tier 2 intervention, stating that there will be a lot of demand and to consider a reduced fee structure in order for more people to access the intervention.

Dr Clare Stephens, Barnet Clinical Commissioning Group, explained the importance of a family based approach when promoting physical activity and healthy eating habits. Dr Stephens further noted the importance of looking for contribution and involvement of Education. Dr Fabunmi explained that the Public Health Team are working with schools on a number of programmes.

The Strategic Director for Commissioning, Kate Kennally, stated that the re-commissioning of LBB Leisure Services offers an opportunity to take this agenda forward and will include a family based approach. The Strategic Director for Commissioning went on to stress the importance  ...  view the full minutes text for item 7.

The Chairman thanked colleagues for their efforts to progress the Better Care Fund and noted that final approval of the Barnet Better Care Fund (BCF) Plan was received from NHS England on 6 February 2015. She drew the Board’s attention to very positive comments contained in NHS England’s letter of approval.

It was noted that following approval by the Health and Well-Being Board, the final draft pooled fund arrangements for 2015/2016 will be reported to the Policy and Resources Committee on 24 March 2015 and the CCG Audit Committee in March 2015.

Dr Debbie Frost, Chairman of the CCG, welcomed the approval and commended the partnership working and noted that conversations are ongoing about the contingencies between partners.

Following requests from the Board, particularly regarding section 256 funding which comes from the NHS for social care, the Adults and Communities Director Mathew Kendall, noted the importance of clarifying the difference between the Source and Purpose of BCF funding in Table 1 at page 91 of the Agenda report.

The Adults and Communities Director explained that the pooled fund for 2015/16 is not new or additional funding, but the reallocation of existing service budgets for services to a pooled fund structure.

RESOLVED that the Health and Well-Being Board notes the proposed approach to the BCF pooled fund for the delivery of services in the BCF Plan, prior to final approval by the Council’s Policy and Resources Committee and NHS Barnet CCG Audit Committee, as noted at the HWBB meeting on 29 January 2015.

The Board noted the Domestic Violence (DV) and Violence against Women and Girls (VAWG) Report which provides a six monthly update as requested by the Health and Well-Being Board in September 2014.

The Chairman informed the Board that the JSNA will incorporate the DV and VAWG agenda and that this will also be reflected in the 2015 refresh of the Health and Well-Being Strategy. 

The Chairman highlighted the recent training session organised about Child Sexual Exploitation and stressed the importance of linking this training with the DV and VAWG agenda. She stressed the important role that GP practices across the Borough had to play in early identification and reporting and the necessity of this for early intervention.

The Strategic Director for Commissioning, Kate Kennally, welcomed the update and stated the importance of the lessons learnt from the Domestic Homicide review for the Local Authority, the NHS and primary care.

The Strategic Director for Commissioning highlighted the importance of early identification of domestic violence in primary care and the need for adequate training to equip health staff to recognise when someone may be experiencing domestic violence. 

Chris Miller, Independent Chairman of the Adults and Children’s Safeguarding Boards, explained the importance of suitable training to identify risks and the impact this has on the quality and quantity of referrals about DV and VAWG. Mr Miller further noted that NHS England has provided commitment of partial funding for a training programme for GP practices in Barnet.

Dr Debbie Frost, Chairman of the Barnet Clinical Commissioning Group, commended the discussion and expressed support for a pragmatic approach to pilot the training programme with a cohort of GP practices in Barnet. Dr Frost stated that financial implications will also need to be considered.

Dr Frost also mentioned the importance of including violence against boys and men in the discussion. The Strategic Director for Commissioning stated that the Council’s DV service has staff trained to work with boys and men.  

Action:For the Council’s Domestic Violence Lead Coordinator to commence discussions about proposals of a pilot, phased GP training programme (including prevalence mapping) with Vivienne Stimpson, Director of Quality and Governance (Barnet CCG) and Chris Miller, Chairman of the Adults and Children’s Safeguarding Boards.

RESOLVED that:

1. The Health and Well-Being Board notes the recommendations of the completed Domestic Homicide Review (DHR A) recommendations pertinent to health organisations as set out under section 2 of this report.
   
   
2. The Health and Well-Being Board members consider the way forward for the IRIS project in Barnet following the rejection by NHS England to fund this initiative in its entirety.

The Chairman welcomed the minutes of the Health and Social Care Integration (HSCI) Programme Board and noted that the report sets out the progress made to deliver the vision for integration in Barnet through the successful implementation of a health and social care integration programme.

The Adults and Communities Director, Mathew Kendall, stated that the meeting was very positive and that there was a clear direction to further the HSCI Model.

The Chairman of the CCG, Dr Debbie Frost, agreed that the meeting was good, particularly hearing from people delivering care to patients and noted the closer focus on patients and care delivery.

RESOLVED that the Health and Well-Being Board notes the minutes of the Health and Social Care Integration Board of 17^th February 2015

The Board noted the items on the Forward Work Programme for the period March 2015 to January 2016 as set out in Appendix 1 of the report.

The Strategic Director for Commissioning, Kate Kennally, asked about the appropriate engagement with the CCG around their Delivery Plan. Regina Shakespeare (Interim Director of Commissioning and Chief Operating Officer Barnet CCG) informed the Board that the current submission date of the CCG Delivery Plan to NHS England is on 10^th April 2015 and that this date could be subject to change due to tariff calculations, therefore it was not appropriate for the paper to come to the Health & Well-Being Board for consultation in June and separate engagement is required around the Delivery Plan. It was noted that the Delivery Plan focuses on finance and activity and that the CCG Strategic Plan will be presented to the Health and Well-Being Board in June for consultation. 

The Board also agreed to receive an update on the strategic direction for mental health services in June. Dr Charlotte Benjamin advised that a stakeholder meeting will take place in May.

The Board also agreed to receive a paper, in July, on learning disability services covering the expiry of the section 75 joint commissioning agreements and links with re-commissioning of services for March 2016.

Action:For Barnet CCG to circulate papers relating to the CCG Delivery Plan to all members of the Health and Well-Being Board for comments.

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 (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, the Children, Education, Libraries and Safeguarding Committee), Health Overview and Scrutiny Committee and Barnet CCG’s Board (Appendix 2).
   
   
4. Additional Recommendation: The Health and Well-Being Board establish a one-off sub-group consisting of the Director of Public Health, the Strategic Director for Commissioning and the Commissioning Director for Adults and Health and Healthwatch Barnet  to meet with the CCG to review and provide comments on the CCG Delivery Plan prior to submission to NHS England.

There were none.

The meeting finished at 12pm.