Agenda and minutes

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

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

Items
No. Item

1.

Minutes of the Previous Meeting pdf icon PDF 121 KB

Minutes:

The Chairman of the Health and Wellbeing Board, Councillor Helena Hart welcomed all attendees to the meeting and informed the Board that Ms Ceri Jacob, Director of Commissioning Operations for NCEL, NHS England has joined the Board replacing John Atherton.

 

The Chairman also noted that the actions arising from the previous meeting had been taken forward many of which were covered under today’s agenda.

 

RESOLVED that the minutes of the previous meeting of the Health and Wellbeing Board held on 12th May 2016 be agreed as a correct record.

 

2.

Absence of Members

Minutes:

Apologies for absence were received from Dr Charlotte Benjamin and Mr Chris Miller.

 

 

3.

Declaration of Members' Interests

Minutes:

Dr Debbie Frost and Dr Clare Stephens made a joint declaration in relation to various items on the agenda by virtue of offering immunisation services to children through their respective GP practices.

 

There were no other interests declared.

4.

Report of the Monitoring Officer (if any)

Minutes:

None.

5.

Public Questions and Comments (if any)

Minutes:

None were received.

6.

Update on childhood immunisations 0-5 years pdf icon PDF 204 KB

Additional documents:

Minutes:

The Chairman introduced the report and welcomed Ms Joanne Murfitt, Director of Public Health Commissioning, Health in the Justice System and Military Health, London Region, NHS England to join the meeting.

 

The Chairman welcomed the additional update on childhood immunisation rates in Barnet following discussions at the previous Health and Wellbeing Board meeting where the Board had expressed serious concerns over continually reported low childhood immunisations rates for Barnet. The Chairman expressed her personal disappointment that, contrary to undertakings given at the last HWBB, the Board had not been provided with an Audit of all of the GP Practices in the Borough and wondered why this had not been done. She felt such an Audit to be essential if the Board was to be satisfied that sufficient action had been taken to address what still appeared to be poor childhood immunisation rates in Barnet - as well as to identify any particular areas of concern regarding low coverage or take up. She also noted that this issue has also been raised by the Health Overview and Scrutiny Committee who had made a formal referral.

 

The Chairman also asked what is being done in other NCL boroughs in comparison to Barnet.

 

Ms Murfitt informed the Board that there are still on-going data reporting issues with TTP System One which moving forward will be raised nationally. She briefed the Board that discussions have taken place and that agreement was obtained to focus on QMS data which means that actual month by month immunisation data can be looked at and to focus on particular Practices where help is needed.

 

In relation to the vaccine schedule, Ms Murfitt also noted that a number of other vaccinations have been added and that as part of a number of work-streams to improve the update, information will be provided to various groups such as parents and young people to raise awareness and increase understanding. 

 

The Commissioning Director for Children and Young People, Chris Munday welcomed the report. Mr Munday expressed concerns over the low immunisation rates in Barnet and stated that the rates set out in the appendix to the report appear low considering the population of the borough and in comparison to national rates for childhood immunisation.

 

Mr Munday asked whether there were particular concerns in specific geographical areas or for specific groups in the borough. Ms Murfitt stated that in order to respond to the question, it would be necessary to refer to the action plan on improving the quarterly immunisation report.

 

Mr Munday noted that there were actions still outstanding in the action plan from 2015 and 2016 based on the information previously presented to the Board. He queried how the outstanding actions were going to be taken forward and expressed specific concerns over risks of measles and immunisation rates. Ms Murfitt stated that the action plan will be revised with a view to address outstanding issues. (Action)

 

Following a query from the Commissioning Director for Adults and Health, Dawn Wakeling,  ...  view the full minutes text for item 6.

7.

Children and Young People's Plan 2016 - 2020 pdf icon PDF 133 KB

Additional documents:

Minutes:

The Chairman introduced the item which sets out the revised Children and Young People’s Plan (CYPP) 2016-2020.  This was reported and agreed by the Children, Education, Libraries and Safeguarding Committee at its Meeting on 14 June 2016 following a six-week public consultation She noted that one of the main roles of the HWB was for all members and their organisations to work together to ensure the best possible fit between the available resources to meet the health and social care needs of the residents of Barnet. This was why it was so important for the Board to consider and hopefully support the Children and Young People’s Plan, the strategic framework which seeks to improve outcomes for children and young people in Barnet. The Board noted the action plan contained within the appendix to the report.

 

Mr Munday informed the Board that the Partnership Plan has been developed together with CCG. Mr Munday briefed the Board about the CYPP 2016-2020 and requested that the plan be noted as an important opportunity to improve outcomes for children and young people through a dynamic vision for creating a Family Friendly Barnet, a vision that has resonated with children, young people, their families and partners.

 

Dr Frost welcomed the item and the CYPP and queried the amount of feedback received as part of the consultation. Mr Munday informed the Board about the consultation at the Youth Convention which was attended by over 200 children and young people followed by consultation in children’s centres with parents and through various forums for young people and their families.

 

Dr Frost and Ceri Jacob, Director of Commissioning Operations for NCEL, NHSE welcomed the paper and commended the actions planned, particularly in relation to employment support programs and coaching. Mr Munday welcomed involvement from public sector partners to improve the offer of employment and youth coaching programs.

 

Ms Cathy Gritzner, Barnet CCG Accountable Officer informed the Board that the Commissioning Director for Children and Young People, will be invited to present the revised the CYPP 2016-2020 to the CCG’s Governing Body.

 

It was RESOLVED:

 

1.    That the Health and Wellbeing Board endorsed the revised Children and Young People’s Plan 2016-20 as summarised in 1.1 to 1.11 and contained in Appendix 1.

2.    That the Health and Wellbeing Board noted that authority has been delegated to the Commissioning Director for Children and Young People, from Children’s, Education, Libraries and Safeguarding Committee, to work with partners to develop an action plan and implement the new Children and Young People’s Plan.

 

8.

Finchley Memorial Hospital Transformation project pdf icon PDF 198 KB

Additional documents:

Minutes:

The Chairman introduced the report and welcomed Alan Gavurin, Strategic Estates Director (Interim) Barnet CCG, to join the table and present the item. Councillor Hart noted that this item had recently been the subject of a discussion at the Health Overview and Scrutiny Committee. She noted that whilst the HWBB had been most heartened and enthusiastic following previous discussions around the developments on the site, both Members of the HOSC and the HWBB were concerned about the lack of progress. 

 

Mr Gavurin briefed the Board about the contents of the paper and the plans for the development of the Finchley Memorial Hospital site. He stated continuous assessment procedures are in place as to what is needed and that for example, discussions are being held about setting up discharge wards with further comprehensive assessment in advance of winter pressures.

 

The Chairman welcomed Neil Snee, Interim Director of Clinical Commissioning CCG, who joined the meeting. Mr Snee noted that the Board would receive an update in three months about the progress of development at Finchley Memorial Hospital site.

 

The Chairman queried whether the procurement of the assessment service had commenced. Mr Snee informed the Board of the two options available and noted that the criteria for quality assessment will be developed before the end of July.

 

In relation to a query from the Board about the empty inpatient ward, Mr Snee noted that this will present an opportunity for the benefit of patients and that this process will be monitored for improvements. 

 

Following a comment from the Board, Mr Snee noted that the blood taking service was not initially identified as a major service priority but following discussion with CLCH, it was identified that an additional room can be used for this facility.

 

Michael Rich, Head of Healthwatch Barnet, noted the previous negotiation with GP practices with regards to the space to rent but this had not been taken forward due to high rent and asked what had changed to reopen the discussion. Healthwatch Barnet and other voluntary and community sector organisations had also declined space due to the high rent. Mr Snee explained that the building is of very high quality and would expect clinical tenants to pay the core rent which would allow for subsidised rents for voluntary and community sector.

 

Dr Frost welcomed the update on the action plans and the developments on the site.

 

The Chairman thanked the Board for the discussion and noted the update report due back in 3 months as an update on progression to the Health and Wellbeing Board. (Action: for inclusion on the Board’s Forward Work Programme)

 

RESOLVED:

 

1.    The Health and Wellbeing Board noted and provided feedback on the plans and development activities set out in this report.

 

9.

Barnet CCG's Improved Financial Position pdf icon PDF 285 KB

Additional documents:

Minutes:

The Chairman welcomed the update report which sets out the Barnet CCG’s improved financial position and commended the efforts made towards achieving financial stability. Ms Wakeling also welcomed the report as good news and the update on the financial position, noting the increase in national allocation.

 

The Chairman asked for an update about progress towards reaching the fair share allocation. Ms Jacob stated that it will difficult to say but that it will become clearer nearer the end of the five year projection plans.

 

Ms Jacob noted the information set out in the table under section 4.2. It was also noted that the CCG is expected to remain 1% under its Fair Share target for the next four years.

 

Councillor Thompstone asked how much the portion of the increased allocation is towards the support of children and the impact of underperforming health functions for children. Ms Gritzner informed the Board that an update can be provided to the Board about what percentage of the allocation is used towards the support of children. (Action)

 

It was RESOLVED:

 

1.    That the Health and Wellbeing Board noted the improved financial position of the Barnet CCG and actions taken to achieve this.

 

10.

Primary Care Co-Commissioning Options pdf icon PDF 201 KB

Additional documents:

Minutes:

Beverley Wilding, Head of Primary Care Commissioning, Barnet CCG was welcomed to join the table. Ms Wilding presented the item which sets out the opportunity to apply for Delegated Commissioning of Primary Care Services.

 

In relation to a query from the Board, Ms Wilding noted that if it is agreed to apply for Delegated Commissioning, each CCG would still retain its own local Primary Care Commissioning Committee and it is proposed that NCL CCG’s would establish a Committee in Common.

 

Following a query from the Board about management of conflicts of interests, Ms Wilding gave assurances to the Board about the constitutional and governance procedures that have been put in place for the purposes of avoidance of conflicts of interests.

 

The Commissioning Director for Adults and Health noted that there is an expectation that all CCGs become delegated commissioners at some point in the future. She stated that in turn, this will be beneficial by way of enabling NCL as a system to work collaboratively and review issues across NCL as a whole.

 

The Vice-Chairman, Dr Frost noted that the Governing Body of the CCG had expressed support towards moving to level 3 delegated commissioning of Primary Care Services.

 

The Head of Barnet Healthwatch, Michael Rich informed the Board that following consideration of the proposed governance structure, he would also be in support of moving to level 3 delegated commissioning. However, Mr Rich also noted the importance of engagement about delegated commissioning with stakeholders, service users and patients providing transparent information about the governance structures and conflict of interests. 

 

The Chairman thanked the Board for the feedback. In relation to the three key questions put to the Board, it was noted that the Board

-       endorse the move to level 3 commissioning;

-       that the Board expressed views on the importance of consulting with stakeholders about the proposed move to level 3 commissioning and that;

-       the Board is satisfied with the information contained in the report and the Stakeholder Engagement Pack.

 

It was therefore RESOLVED:

 

1.    That the Health and Wellbeing Board considered and commented on the enclosed Engagement pack and on the opportunity for Barnet CCG and the other North Central London CCGs to apply for Delegated Commissioning of Primary Care Services.

 

2.    That the Health and Wellbeing Board considered and commented on the key questions set out in the Stakeholder Engagement Pack and provided feedback to Barnet CCG as set out above:

·         Do you think NCL CCGs should move to level 3 delegated commissioning to help achieve primary care transformation?

·         Do you have any comments about the proposed governance structure?

·         Is there additional information that you need to better inform your understanding?

 

11.

Joint Health and Wellbeing Strategy Implementation plan (2015 - 2020) progress update pdf icon PDF 306 KB

Additional documents:

Minutes:

The Chairman introduced the report and noted that the Joint Health and Wellbeing Strategy Implementation Plan 2015-2020 was received by the Board at its meeting in January 2016. The Board had also agreed to receive progress report updates at each meeting.

 

Mr Munday noted the progress achieved, particularly in respect of the initial health assessments for Looked After Children (LAC) which have been completed within the statutory timeframe of 28 days. However Mr Munday also noted that progress has been made but it is important to continue to monitor progression.

 

With regards to supporting people with mental health problems into employment, Ms Wakeling explained the issues with the indicator as this is a restricted national definition to allow for benchmarking. Ms Wakeling went on to explain the positive impact of a number of employment support services in the borough such as The Network, BOOST, and Twining.  

 

Dr Frost asked for information to be provided to GPs which details the services that can support people into employment, who is eligible for support and the referral routes. (Action)

 

The Board received a short video clip presentation about the Barnet Integrated Locality Team (BILT) which coordinates care for older adult residents with complex medical and social care needs, as well as providing support to carers in the west of the borough. The Board heard about the BILT’s coordinated approach towards supporting service users and carers and enabling people to live more independently. BILT was developed as part of the borough’s Better Care Fund and is currently being rolled out across the borough.

 

It was RESOLVED:

 

1.    That the Health and Wellbeing Board noted and commented as above on the progress to deliver the Joint Health and Wellbeing Strategy (2015-2020) and agreed further action where necessary.

 

 

12.

Minutes of the Joint Commissioning Executive Group pdf icon PDF 232 KB

Additional documents:

Minutes:

The Board noted the standing item on the agenda which sets out the minutes of the Joint Commissioning Executive Group meeting held on 20th June 2016.

 

It was RESOLVED:

1.    That the Health and Wellbeing Board approved the minutes of the Joint Commissioning Executive Group meeting of 20 June 2016.

 

13.

NCL Sustainability and Transformation Plan pdf icon PDF 198 KB

Additional documents:

Minutes:

The Chairman introduced the report. The Board noted that the plan for a plan was submitted to NHS England on the 30 June. 

 

Following a query from the Board, Cathy Gritzner noted that the September submission will address the focus on prevention in the system through joint collaboration between the Local Authority, Barnet CCG and NHSE.

 

RESOLVED:

 

1.    That the Health and Wellbeing Board reviewed and commented on the NCL Sustainability and Transformation plan.

 

14.

Forward Work Programme pdf icon PDF 303 KB

Additional documents:

Minutes:

The Board noted the standing item on the agenda which sets out the Forward Work Programme for 2016/2017. The Board noted that the November agenda will include items on Finchley Memorial Hospital and a further update on childhood immunisation.

 

RESOLVED:

 

1.    That the Health and Wellbeing Board noted the Forward Work Programme and proposes any necessary additions and amendments as above 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 continues 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).

 

15.

Any Items the Chairman decides are urgent

Minutes:

None.

16.

Motion to Exclude the Press and Public

Minutes:

The Chairman moved a motion which was seconded and agreed to exclude the press and public from the meeting on the grounds that the discussion will involve information relating to the financial or business affairs of any particular person (including the authority holding that information) in line with paragraph 3 to Schedule 12A of Local Government Act 1972.

 

The public gallery was cleared of the public and press.

17.

NCL Sustainability and Transformation Plan (exempt)

Minutes:

The Board noted the contents of the exempt item.

 

RESOLVED:

 

1.    That the Health and Wellbeing Board noted the exempt report.

18.

Any other exempt item(s) the Chairman decides are urgent

Minutes:

None.