Agenda and minutes

Councillor Helena Hart, Chairman of the Health and Wellbeing Board welcomed all attendees to the meeting and noted that the actions arising from the previous minutes have been taken forward and covered under the business items of this agenda.

RESOLVED that the minutes of the previous meeting of the Health and Wellbeing Board held on 21^st July 2016 be agreed as a correct record. 

Apologies for absence were received from Mr Chris Miller, Dr Clare Stephens who was substituted by Dr Ahmer Farooqui and Ms Ceri Jacob who was substituted by Ms Elizabeth Comley.

Dr Debbie Frost, Dr Charlotte Benjamin 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.

None.

None were received.

The Chairman and Board Members commended the efforts of Dr Charlotte Benjamin for her work towards initiating various innovative projects to transform mental health services in Barnet with a focus on direct involvement of patients. Dr Benjamin’s initiatives have also been recognised by Pulse Magazine who named her a “Local Hero” following her work on the Reimagining Mental Health Programme to transform the way mental health services are delivered in the Borough.

Dr Debbie Frost, Vice-Chairman, introduced the Patient’s Story and the Chairman invited a local resident to join the meeting and tell the Board about her experience The Board heard about the speaker’s experiences of the tissue viability service and the support received from staff. The Chairman thanked the speaker for sharing her story with the Board and noted the importance of specialist training for nursing staff.

The Chairman welcomed the Primary Care progress report and the regular updates that had previously been brought to the Board regarding Primary Care.  She said this truly reflected a real desire to work together across the CCG and Barnet Council. She particularly welcomed the commitment to improve the Service Specification for Looked After Children following previous discussion by the Board. She also drew attention to the the patient leaflet regarding Health Records at Appendix 1 of the report which is currently being put out by Islington Council. Barnet CCG’S version would be broadly similar but updated and specifically tailored for Barnet and under the Barnet CCG logo. Mr Leigh Griffin, Interim Director of Strategic Development and Mr Neil Snee, Interim Director of Commissioning, Barnet CCG joined the meeting to present the paper.    

In reference to the Practices inspected by the Care Quality Commission referenced at section 1.19 of the report, Dr Ahmer Farooqui informed the Board that a future update will be reported to the Board following release of further information.

Mr Michael Rich, Head of Barnet Healthwatch welcomed the progress update report and noted the service improvements delivered as evidenced through patient feedback.

The Board noted the importance of the continued improvement of services around Looked After Children.

It was RESOLVED:

1.    That the Health and Wellbeing Board noted the progress made by Barnet CCG on Primary Care issues related to the Strategic Framework.

2.    That the Health and Wellbeing Board noted the planned programme for delivery on future aspects of the Strategic Framework for Primary Care, including the initial considerations for reducing acute activity and re-provision within the community.

3.    That the Health and Wellbeing Board noted the additional activity related to the Sustainability and Transformation Plan across North Central London CCGs.

The Chairman welcomed the report which she said patently demonstrated the willingness and ability of the Council and the CCG to work together so closely to improve this vital service for children and young people in Barnet. The joint approach taken by LBB and the CCG towards the commissioning of CAMHS services will ensure that the CAMHS service is specifically tailored to the mental health and wellbeing needs of Barnet children. The Chairman also mentioned Hendon School’s very successful and well attended Stamp Out Stigma Day on the problems experienced by young people regarding mental ill health and the many and various ways of combatting them.The Board also noted the positive achievements delivered through the Crisis Service and CAMHS provision in schools.

Ms Collette McCarthy, Head of Children’s Joint Commissioning, Mr Eamann Devlin, CAMHS Joint Commissioning Manager and Mr Neil Snee, Interim Director of Commissioning, Barnet CCG joined the table.

The Commissioning Director for Children and Young People, Chris Munday, presented the report and informed the Board that the purpose of the approach set out in the paper is to enable further joined up commissioning of integrated services. This includes the opportunity to develop further joined up working outside of clinical settings.

Board Members welcomed the approach and the opportunity for further partnership working with a focus on engagement with children and young people in community and social media settings.

In response to a query from the Board, Mr Munday noted that an update report will be brought to a future HWBB meeting in addition to regular reporting through the Joint Health and Wellbeing Strategy Implementation Plan.

The Chairman thanked the Board for the discussions, it was RESOLVED:

That the Health and Wellbeing Board approved the continuing work outlined in the report to transform CAMHS including

·         LB Barnet to extend the CAMHS contract for 6 months and bring into alignment with BCCG contract

·         LB Barnet and Barnet CCG to jointly commission on a whole system basis led by LB Barnet

·         This will be a Barnet specific process for Community CAMHS starting Autumn 2016 for implementation by 1 October 2017

·         Commissioning intentions letter to providers September 2016

·         LB Barnet maintain current funding for the 6 month extension subject to approval by the board

·         Implementation of a Section 75 agreement including pooled budget arrangement and governance board

The Chairman welcomed the report which sets out a communication campaign to inform residents about the health risks associated with Shisha smoking, following the formation of a Task and Finish group. She pointed out that this communication campaign was part of the Action Plan for tackling the growing problem of Shisha which had been approved by the Board in March.

The Chairman again re-iterated that this Campaign was not about banning Shisha but rather ensuring that all Barnet residents - of all ages - were made aware of the health implications of smoking Shisha and that the Council was doing everything it could to minimise the health risks, including the stringent application of the smoking legislation as it applies to Shisha.

The Director of Public Health, Dr Andrew Howe presented the report and briefed Board Members about the consultation and engagement that has taken place with young people and other community and stakeholder groups about Shisha smoking.

Ms Chimeme Egbutah, Public Health Strategist joined the meeting and informed the Board about the dialogue taking place through visits to Shisha outlets. The Board also noted the plans for a comprehensive Survey on Shisha which will be developed in consultation with the Chairman and circulated to schools and colleges. The results and review of the Survey will be shared with partners and reported to the Board.

The Board noted the posters attached at Appendix 1, 2 and 3 of the report. In response to a query about distribution of the posters, Ms Egbutah noted that these will be promoted through social media and placed around approximately 250 sites across the Borough including colleges, libraries and bus shelters to reach as many people as possible.

Ms Gritzner requested that information about the health risks associated with Shisha smoking could be disseminated to A&E staff. Dr Farooqui also asked whether GP’s could be instructed to pro-actively discuss shisha smoking with patients in respect of patients’ smoking history.

In response, Dr Howe stated that both initiatives could be supported.

The Chairman commended the efforts by all those involved to minimise the health risks to residents as much as possible. 

RESOLVED:

1.    The Board approved the Shisha Communication Campaign highlighted in this report led by the communications team. This includes further engagement with shisha businesses within Barnet.

2.    The Board approved and supported the art work and health messages related to the campaign as part of the communications campaign.

3.    The Board approved the distribution of campaign materials to relevant and appropriate sites.

4.    The Board approved that the communications campaign is launched in October 2016 .

The Chairman welcomed the report which sets out the annual performance for Public Health for 2015-16. Ms Rachel Wells, Consultant in Public Health, Ms Audrey Salmon, Head of Public Health Commissioning and Ms Bridget O’Dwyer, Senior Commissioning Manager joined the meeting.

The Board received a presentation highlighting the key achievements delivered and changes which have taken place, in particular the ‘Healthy places’ approach, a public health intelligence team and a successful recruitment programme.

Ms Salmon provided an update in relation to smoking cessation. She informed the Board about the social media communication campaigns taking place across London and noted the newly created post for a joint Smoking Cessation/Health Checks Coordinator.  

The Chairman expressed concerns over lack of intervention and prevention with reference to excess consumption of alcohol. A request was made to consider options for disseminating information about the health risks of excessive social drinking.

Ms O’Dwyer welcomed the comment and informed the Board about the intention to deliver a training programme and highlighted the importance of involvement of Family and Children’s Service.

The Chairman of the Children, Education, Libraries and Safeguarding Committee, Councillor Reuben Thompstone welcomed the report and requested that the data from the Mayor’s Programme is included within the Public Health Commissioning Plan and KPI information sheet.

The Board noted that this information will be included within the Public Health Commissioning Intention PH2 and PH3 (Children and adults who are overweight and obese are encouraged and supported to lose weight) for 2016-17. (Action)

Following discussion, the Chairman moved a motion which was seconded and agreed as an additional recommendation to read:

That the Health and Wellbeing Board agrees that the Barnet CCG, London Borough of Barnet including Adult Social Care and Children’ Social Care Services and Public Health develop a shared approach to care closer to home, that incorporates health prevention work that includes services such as Stopping Smoking and substance misuse services.

The motion was agreed and became the substantive motion.

It was therefore RESOLVED:

1.    That the Health and Wellbeing Board noted and commented as above on the report and its appendices.

2.    That the Health and Wellbeing Board agreed that the Barnet CCG, London Borough of Barnet (including Adult and Children’s Social Care Services) and Public Health develop a shared approach to care closer to home, that incorporates health prevention work including services such as smoking cessation and substance misuse services.

The Chairman introduced the item which provides an update on discharge of a cohort of patients from hospital, subject to the Winterbourne View Concordat and the progress made by the NCL Transforming Care Partnership. Mr Snee and Ms Sue Tomlin, Joint Commissioning Manager Learning Disabilities informed the Board about the contents of the paper.

The Commissioning Director for Adults and Health, Dawn Wakeling briefed the Board about the update report. She noted that the cohort of patients is currently 10 which is the lowest it has been.

It was RESOLVED:

That the Board noted the contents of the report and progress being made by the North Central London Transforming Care Partnership, patient discharges and the update on patients subject to the Winterbourne View Concordat.

The Chairman noted the update report which sets out the progress of the North Central London - including the London Borough of Barnet - Sustainability and Transformation Plan.

Ms Gritzner noted the contents of the report and highlighted the importance of transformation of health and social care services towards a sustainable system for the benefit of service users and tax payers. The Board also noted that the Sustainability and Transformation Fund can be accessed following the submission of an effective and credible Sustainability and Transformation Plan.

The Chairman asked about plans to ensure that there is no shortfall of services between cross-running community and hospital services. Mr Leigh Griffin, Interim Director of Strategic Development noted the challenges around minimising the limitations and risks involved with the transfer from hospital to community care services.

The Head of Healthwatch Barnet, Michael Rich’s request for engagement with resident and patient groups was welcomed by the Board. Ms Wakeling informed the Board about the importance of engagement with harder to reach community and patient groups and to utilise the opportunities for input from service users about the future of health and social care services.

The Chairman informed the Board about a public meeting to discuss the development of the Sustainability and Transformation Plan in Barnet, being held on 27^th September 2016, 6pm-8pm, at St Paul’s Centre in Finchley Long Lane N3 2PU.

RESOLVED:

That the Health and Wellbeing Board noted and commented as above on the summary Update Presentation for North Central London Sustainability and Transformation Plan.

The Chairman introduced the report which provides a progress update against the JHWB Strategy Implementation Plan which was approved by the Board in January 2016.

The Board noted the key highlights as set out under section 1.2.3 of the report and Ms Wakeling briefed the Board on the efforts to improve mental health and wellbeing – she noted that the Barnet Wellbeing Centre is to open in early October 2016 at the Meritage Centre which will help to improve and expand the Barnet mental health network.

Dr Benjamin welcomed the progress and noted the importance of involvement of social workers. She noted that the Voluntary and Community sector’s involvement will play a key role alongside social workers who could be best placed in different settings to be most accessible to residents.

Mr Munday requested that future progress reports on the JHWB Strategy Implementation Plan include information about the direction of travel against the key actions, marked with arrows for ease of reference. (Action)

Mr Munday noted the progress made to increase the percentage of children in care in Barnet with a focus on making more placements available locally. It was further noted that the report states that 60% of placements are made locally, although there has been a shift to making more local placements, 60% refers only to new placements that have been made. For the whole cohort local placements is at 43.3%. He also noted the importance of clear agreement about the way data is collected and the impact on the cohort as a whole.

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

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

The Board noted the standing item on the minutes of the JCEG as set out in the appendix to the report. It was noted that the Group is due to receive regular finance reports on the BCF and that actions in response to the S75 agreements have been taken forward. Ms Wakeling provided an update noting that the JCEG didn’t receive a finance report for the BCF but that she and Mr Neil Snee had been provided with one and that following the signing of the overarching deed, all of the actions from the Section 75 audit report have been completed.

It was RESOLVED that:

That the Health and Wellbeing Board commented on and approved the minutes of the Joint Commissioning Executive Group meeting of 23 August.

The Board noted the Forward Work Programme which is a standing item on the agenda and lists the business items for the period 2016-2017.

The Board agreed to receive an update item on ‘Care Closer to Home’ and an update report on CAMHS at its future meeting.

It was 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).

There were none.