Agenda and 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 6 March. 

Items
No. Item

1.

Minutes of the Previous Meeting pdf icon PDF 106 KB

    Minutes:

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

     

    Mr Michael Rich has now left his role at HealthWatch Barnet for a new role as Chief Executive at Epilepsy Research UK. The Chairman, on behalf of the Health and Wellbeing Board, congratulated Mr Rich on his new appointment and extended her sincere gratitude and appreciation of all the sterling work that he had done both as Head of Healthwatch Barnet and as an extremely active and committed Member of the Health and Wellbeing Board.

     

    It was noted that Ms Julie Pal was attending the Health and Wellbeing Board, representing Healthwatch Barnet.

     

    RESOLVED that the minutes of the previous meeting held on 19th January 2017 be agreed as a correct record with all necessary actions having been taken forward.

     

2.

Absence of Members

3.

Declaration of Members' Interests

    Minutes:

    Dr Debbie Frost made a joint declaration on behalf of Barnet CCG Board members, Dr Clare Stephens, Dr Charlotte Benjamin and herself, in relation to agenda item 7 by virtue of being impacted by proposals through their respective GP practices and as part of a GP Federation.

     

    Councillor Helena Hart declared a personal non-pecuniary interest in relation to agenda item 7 by virtue of her son being a Consultant at the Royal Free Hospital which in the future could be affected by any reforms.

     

4.

Report of the Monitoring Officer (if any)

5.

Public Questions and Comments (if any)

6.

Motion from Full Council - Volunteering in Care Homes pdf icon PDF 128 KB

    Additional documents:

    Minutes:

    The Chairman introduced the Report which informed the HWBB of a Motion on Volunteering in Care Homes which was referred from Full Council on 31 January 2017. The Chairman referred to the Report and expressed her own personal support for the sentiments expressed in the Motion.  She noted the importance of effective communication between staff and residents at care homes, especially those residents suffering from Dementia very often reverting to their native tongues.

     

    The Commissioning Director for Adults and Health, Dawn Wakeling informed the Board that the Motion and amendment were initially reported to Full Council on 31st January 2017 and referred to the Health and Wellbeing Board in accordance with Council Procedure Rule 23.5.

     

    Ms Wakeling informed the Board about the various volunteering activities taking place in care homes across the Borough. These are organised through a number of community, voluntary and charitable bodies such as Barnet Mencap, Dementia Club UK, Jewish Care, Vintage Volunteering, Advocacy in Barnet and other organisations.

     

    In response to the item, Ms Wakeling briefed the Board about Groundwork, which provides the Council funded volunteering brokerage service between volunteers and organisations. The service is called Volunteering Barnet. She stated that Volunteering Barnet have now been asked to expand the current application form to capture additional information about individual applicants’ language skills. This would allow for specific language skills to be recorded by Groundwork and to be considered by care organisations when seeking to recruit volunteers. The Council also provides a Care Quality team which offers advice, guidance, training and support to care and nursing homes. The Volunteering Barnet service will be promoted to local care homes by the Care Quality team.

     

    Dr Debbie Frost, Chairman of Barnet CCG made a request which was supported by the Board to invite a speaker at a future HWBB meeting to provide a verbal update on volunteering in care homes. (Action: FWP)

     

    The following motion was seconded and agreed by the Board:

     

    That the Board agrees with the actions noted above, namely that language skills are captured on volunteering application forms and that volunteers are signposted to relevant care homes. 

     

    It was therefore RESOLVED:

     

    That the Health and Wellbeing Board’s instructions in relation to this item are that - the Board agreed with the actions noted above, namely that language skills are captured on volunteering application forms and that volunteers are signposted to relevant care homes. 

     

7.

Care Closer to Home pdf icon PDF 749 KB

    Additional documents:

    Minutes:

    The Chairman welcomed the report which provides an update on the Care Closer to Home (CC2H) proposals and its aims to improve services in Barnet.

     

    She noted that the Council and CCG have for some time been working on bringing “Care Closer to Home” with the emphasis being re-positioned from patients receiving defined and rigid in-hospital treatment and services to more individually tailored out of hospital health care provision. She re-iterated the HWBB’s focus on trying to prevent people from becoming ill in the first place and where that was not possible then preventing them from becoming more unwell.  Progress along these lines so far had been through the Better Care Fund plan, the Joint Health and Wellbeing Strategy and a range of joint commissioning works, such as stroke rehabilitation and the community dementia pathway. The North Central London Sustainability and Transformation Plan (NCL STP) has developed a model for Care Closer to Home and this paper outlines the ambitions for Barnet in line with the NCL STP.

     

    Upon invitation from the Chairman, John Ferguson Head of Primary Care Transformation / CC2H lead, Barnet CCG joined the table and presented the report. Mr Ferguson briefed the Board about the key areas of focus and developments so far.

     

    In response to a query from the Board, Mr Ferguson stated that Care Closer to Home is driven by the principle of right care and the right place for patients. The Board heard about the importance of tailoring services around patients and patients’ needs.

     

    Dr Frost welcomed the paper and requested that an addition be made to include references to Reimagining Mental Health. (Action)

     

    Dr Charlotte Benjamin highlighted the need to focus on needs at a local level. Ms Wakeling also welcomed the proposals and informed the Board about the framework which will be shaped based on local area needs in collaboration with other NCL areas.

     

    Ms Wakeling stated that consideration will also need to be given about the impact of the proposals for all communities and age groups.

     

    Julie Pal, CEO of CommUnity Barnet and representing Healthwatch Barnet, welcomed the proposals and noted the need for effective engagement with service users. Ms Pal  requested that  communication with residents be undertaken to develop informed and succinct understanding about CC2H proposals. (Action)

     

    Cathy Gritzner, Accountable Officer CCG, requested that consideration be given to the way modern technology can be used as part of the development of the CC2H.

     

    Mr Ferguson welcomed the comments  and thanked the Board for their contributions.

     

    RESOLVED :

     

    1.    That the Health and Wellbeing Board noted and commented as above on the plans to implement Care Closer to Home.

    2.    That the Health and Wellbeing Board endorsed a shared approach between health and social care commissioners and providers to implement Care Closer to Home.

     

8.

Public Health and Wellbeing Commissioning Plan 2015 - 2020 addendum and targets pdf icon PDF 279 KB

    Additional documents:

    Minutes:

    The Chairman introduced the report which sets out the Public Health and Wellbeing Commissioning Plan 2015-2020 and a detailed plan for delivery of the targets in 2017/18.

     

    The Chairman noted that Public Health continues to deliver vital projects and activity supporting the delivery of the Joint Health and Wellbeing (JHWB) Strategy. She welcomed this report as an opportunity for the Board to discuss the delivery of Public Health services in the Borough. The Chairman particularly welcomed the fact that   Barnet will be able to continue to provide services beyond the statutory requirements in 2018/19 and thanked both Dr Howe and the rest of the Public Health team for all their efforts in securing this result.   

     

    The Board noted that many of the indicators reported are showing as green meaning that they are either on or above target.

     

    Dr Andrew Howe, Director of Public Health presented the report. Dr Jeff Lake, Consultant in Public Health joined the table.

     

    The Chairman stated that she was particularly pleased at the positive impacts of the Shisha campaign as highlighted in the Key Successes on page 9 of the appendix.

     

    In relation to the indicators for PH/S3 and PH/S11 regarding excess weight, the Chairman expressed her disappointment on the very high proportion of both 10-11 year olds and adults who were overweight and asked for an update on the progress of the Obesity Plan.

     

    In response, Dr Andrew Howe, acknowledged the challenges around tackling obesity and setting realistic and ambitious targets. Dr Howe noted that this was a national issue and that work has been undertaken to improve food labelling and encourage physical activity.

     

    He updated the Board on two projects which centre around obesity in families and schools. It was noted that outcomes show that there have been positive changes as part of the referrals to the excess weight support service for children and their families. However, Dr Howe also recognised that further work is needed to tackle this important issue in a sustainable way, involving partner agencies and engaging with local residents.

     

    Dr Lake provided an update to the Board about the NHS Diabetes Prevention Programme which aims to educate residents about lifestyle choices to reduce the risk of developing Type 2 diabetes.   

     

    Councillor Reuben Thompstone informed the Board about the success of the Mayor of Barnet’s Golden Kilometre initiative – which encourages primary schools in Barnet to help their pupils take part in a daily 1km walk, jog or run around their school or local green space.

     

    The Chairman thanked  Board Members for their comments.

     

    It was RESOLVED:

     

    That the Health and Wellbeing Board reviewed and approved the addendum to the Public Health & Wellbeing Commissioning Plan for 2017/18 (Appendix A).

     

9.

Screening Update pdf icon PDF 262 KB

    Additional documents:

    Minutes:

    The Chairman introduced the report and noted that screening has been a priority area for improvement in  the Joint Health and Wellbeing Strategy since its refresh in 2015.

     

    NHS England were not present at this meeting, which the  Chairman regretted as she stated that attendance by NHSE would have been most valuable particularly in light of the ongoing grave concerns around low screening uptake and inconsistent reporting. The Chairman expressed her own deep concern regarding this in the light of effect it could have on the vitally important early cancer diagnosis necessary for successful cancer treatment.

     

    The Chairman indicated the need to escalate the HWBB’s concern over ongoing failures to establish clear reporting arrangements and the need to address low cancer screening uptake.

     

    Dr Lake updated the Board regarding the delay in a screening report returning to the HWBB awaiting an annual report from NHS England. An annual report was produced and shared with the Joint Health Overview and Scrutiny Committee in February but concerns remained both over its format and plans to address areas of poor performance. Dr Lake noted that the Committee has asked for an update to be reported back in six months’ time.

     

    It was noted that in summary, good performance was shown for some areas of screening, particularly diabetic eye screening and screening for Abdominal Aortic Aneurysm. However there were ongoing concerns about low uptake for breast, cervical and bowel screening.

     

    To help improve support to NHSE in producing a report to address Local Authority needs, an NCL adult screening assurance group has been set up and is chaired by Dr Lake. Efforts are underway to establish how it can best operate to support NHSE. Ms Julie Pal also expressed interest in joining the group.

     

    Dr Frost noted the importance of closer working between partners and GP’s to help improve uptake and potentially exploring the use of IT technology and mobile apps.

     

    Dr Benjamin welcomed the report and noted that inclusion of partners is key to encourage more screening. In order to identify the groups where uptake was low, Dr Lake noted that further scrutiny of the data would need to be undertaken.

     

    In order to improve screening uptake, Dr Stephens requested that the Board join the national call for lowering the screening age for bowel cancer from 60 to 50. She noted the importance of early screening for bowel cancer particularly for the age group 50-60.

     

    Ms Wakeling welcomed the comments and proposed to move two additional recommendations (numbered 4 and 5) which were seconded and agreed.

     

    4- That the Health and Wellbeing Board asks the Communities Together Network to consider the need for and develop proposals accordingly for increased screening uptake (including amongst BME communities and faith groups in Barnet).

    5- That the Health and Wellbeing Board asks Council Officers and CCG colleagues to develop proposals for a local communication campaign with an aim to increase screening uptake in Barnet.

     

     

    It was therefore RESOLVED:

     

    1.    That the Health and Wellbeing Board noted the  ...  view the full minutes text for item 9.

10.

Joint Health and Wellbeing Strategy Implementation Plan performance report including CAMHS transformation plan pdf icon PDF 296 KB

    Additional documents:

    Minutes:

    The Chairman introduced the report which sets out the progress delivered against the set priorities as agreed by the Board in November 2016. She noted that following the agreement of the JHWBS in November 2015, colleagues across the partnership have been working to deliver the actions set out in the Strategy’s implementation plan. 

     

    Ms Dawn Wakeling presented the report and Mr Eamann Devlin, CAMHS Joint Commissioning Manager (interim) joined the table. Ms Wakeling updated the Board on the progress made against each of the four themes within the Strategy. The Board noted the development of the Reimagining Mental Health Programme as part of the progress update since November 2016.

     

    Mr Munday noted that good progress has been made in respect of the CAMHS Transformation Plan to improve children’s health services. He also noted that further work is needed to increase capacity and reduce waiting times which will help to improve CAMHS Tier 4 and Early Years standards.

     

    The Chairman welcomed the discussion and commended the joint working on behalf of children in Barnet.

     

    It was RESOLVED:

     

    1.    That the Health and Wellbeing Board noted and commented as above on progress to deliver the Joint Health and Wellbeing Strategy (2015-2020). (Appendix 1)

    2.    That the Board approved the refreshed CAMHS Transformation Plan (2015 – 2020) part 1 (Appendix 2) and noted the refreshed Plan for NCL, part 2 (Appendix 3).

     

11.

Minutes of the Health and Wellbeing Board Working Groups - JCEG pdf icon PDF 232 KB

12.

Forward Work Programme pdf icon PDF 245 KB

13.

Any Items the Chairman decides are urgent

    Minutes:

    The Chairman and Vice-Chairman invited Mr Adrian Phelan and Ms Robyn Sandler to join the Board. Mr Phelan provided an update on the progress of the CCG Annual Report and Accounts.

     

    Mr Phelan invited the Board to submit their comments and suggestions for areas of focus which can also be made outside of the meeting. It was noted that the final draft of the Annual Report will be submitted to NHSE on 31st May. Mr Phelan noted that the Board will be updated on the final draft prior to submission and on the final version following submission to NHSE.

     

    Following discussion the Board made the following requests for reference and inclusion within the Annual Report:

     

    ·         CAMHS Transformation Plans and consultation feedback from children and young people

    ·         Children’s Continuing Care and collaborative working towards a shared pathway for vulnerable children and young people

    ·         Childhood Immunisations and initial health assessments for Looked After Children

    ·         The Mayor of Barnet’s Golden Kilometre Award

    ·         Community Dementia Services and the joint working arrangements

    ·         Acute admission and continued pressures in health and social care system

    ·         Shisha communication campaign

    ·         Councillor Hugh Rayner and Councillor Agnes Slocombe have been appointed as joint Diabetes Champions.

    ·         Concerns about low level of funding for Primary Care.

     

    Ms Julie Pal indicated that she had submitted her comments on behalf of Healthwatch Barnet.

     

    The Chairman welcomed all the submissions made by Board Members and requested that further issues and comments be sent directly to Mr Adrian Phelan.

     

    In response to a query from the Chairman, Dr Andrew Howe confirmed that the budget for Public Health was ring-fenced for 2018/2019.