Agenda and minutes

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

Matters arising:

·         Councillor Hart welcomed Mr Andrew Fraser, Chairman of the Children’s Safeguarding Partnership to his first meeting as an Observer Member following his appointment to the Board.

·         Actions have been taken forward and there were no further actions from the previous meeting.

·         The Board noted that Ms Fiona Bateman has been appointed as the Chairman of the Barnet Safeguarding Adults Board and it was agreed that she will be invited to join the Board as an Observer Member with speaking but not voting rights.

·         The Chairman drew the Board’s attention to the International Zero Tolerance to FGM Day which will be held on 6^th February this year.  As discussed on numerous occasions at Board meetings and speaking on behalf of the HWB, the Chairman expressed unequivocal opposition to FGM and highlighted the physical and mental harm caused as a result of it. Dr Clare Stephens noted that training on FGM will continue to be rolled out across the CCG in all appropriate forms.

Apologies for absence were received from:

·         Dr Andrew Howe, Public Health who was substituted by Dr Jeff Lake.

Dr Debbie Frost made a joint non-pecuniary declaration on behalf of Barnet CCG Board members; Dr Clare Stephens, Dr Charlotte Benjamin and herself, in relation to Agenda Items 7 and 8 which refer to GP practices, by virtue of being impacted through their respective GP practices.

Councillor Helena Hart declared a non-pecuniary interest in relation to Care Closer to Home - which is referred to under Item 8 and includes reforms to secondary care - by virtue of her son being a Consultant at the Royal Free Hospital which could be affected in the future by any such reforms.

None.

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The Chairman introduced the Report which sets out research on how the built environment can help to improve health and wellbeing, along with the work already being done in Barnet by the Council and partners to develop and enhance the built environment together with some recommendations for further action.

Rachel Wells, Consultant in Public Health joined the meeting and presented the Report to the Board. The Chairman noted how much was already being done to further the aspirations set out in the Report and highlighted the work already underway through the Borough’s regeneration schemes and building programmes.

In response to issues raised within the Report, the Chairman informed the Board that £50m has been already been committed towards improving roads and pavements.

Referring to parks and open spaces, the Chairman drew attention to the fact that the comments had been based on information from 2009 and gave several examples of how matters had advanced since then. These included a most significant investment in outdoor play facilities and Outdoor Gyms and Marked and Measured Routes in Parks - as well as the ‘Our Parks’ and Barnet Health Walks programmes. Further developments will see Re working in partnership with others including local traders, residents groups, community safety, highways and transport colleagues to develop Town Centre Strategies based on health and wellbeing and seeking to keep town centres clean and safe.

A key theme is working with traders on initiatives such as the healthier catering commitment which includes using colour-coded systems for all vending and catering products, to educate customers to choose healthy food options.

In respect of physical activity, the Chairman very much welcomed the achievements and increase to over 77% in the percentage of the 16+ population taking part in sport and physical activity. She envisaged even greater improvements once the new Fit and Active Barnet Campaign was launched in May.

Dr Debbie Frost Chairman of Barnet CCG queried whether consideration was being given to Primary Care and access to services in the light of future regeneration. Dawn Wakeling, Strategic Director for Adults, Communities and Health noted that a team has been set up to take this issue into consideration as well as looking at wider health facilities.

In relation to clinical input, Dr Clare Stephens of Barnet CCG requested that early engagement and input be sought with Barnet CCG in advance of future development and planning. (Action: Planning/ Assets, Regeneration and Growth)

It was RESOLVED that:

1.    That the Health and Wellbeing Board considered the Annual Report of the Director of Public Health 2017: The Built Environment and Health (Appendix 1).

2.    That the Health and Wellbeing Board considered and commented as above on the recommendations contained in the Annual Report.

The Chairman welcomed the joint report on the progress made towards delivery of a new service delivery model. Mr Chris Munday, Strategic Director Children and Young People and Ms Kay Matthews, Chief Operating Officer Barnet CCG introduced the report.

Ms Matthews spoke about the work delivered and noted that it will continue to be scrutinised by the CCG Governing Body. Mr Munday highlighted the progress made in reducing the community CAMHS average waiting times and the specialist Eating Disorder Service waiting times.

The Chairman invited Ms Collette McCarthy, Head of Children’s Joint Commissioning to the meeting. Ms McCarthy noted that additional children and young people have been engaged with and that work will continue to be carried out with schools. She further noted that for the past quarter the response rate has been increased in relation to users recommending to a friend.

Following a query from the Board about areas of improvement, Ms McCarthy noted that counselling is being delivered on weekends by Raphael House for additional people.

Dr Charlotte Benjamin spoke about the complexities involved with a wide model and noted the importance of due diligence to ensure that mental health and emotional wellbeing of children and young people are continuing to be addressed. She also noted the importance of exploring use of technology and other methodology.

The Head of Barnet Healthwatch Ms Selina Rodrigues welcomed the report and the reduction in waiting times. She noted the concerns about the support whilst awaiting the first appointment. It was noted that this would continue to be addressed taking a wider approach involving the family and school. 

The Chairman thanked the Board for the discussion. It was RESOLVED:

1.    That the Board noted the proposed way forward to further develop the Transformation of services relating to children and young people’s emotional health and wellbeing.

2.    That the Board noted progress to date towards establishing a new integrated model of services to address children and young people’s mental health and wellbeing.

3.    That a progress report be taken to the Board in 6 months’ time. (Action: Forward Work Programme)

The Chairman introduced the report which sets out the progress towards establishing CHINs in Barnet. She commended the joint partnership working between the Council and the CCG towards this important programme.

Ms Courtney Davis, Adults and Health Programme Lead and Ms Collette Wood, Director of Care Closer to Home at Barnet CCG joined the Meeting and presented this item. Ms Wood spoke about the progress made towards extended access provided from 3 community hubs with 6 satellite sites. Monitoring will continue through monthly contract meetings between the CCG and the GP Federation to assure progress.

Ms Davis spoke about the aims which includes reducing clinical variation and enhancing the quality of life for people with long-term conditions. She noted that as part of improving patient satisfaction patients can access consultations with Primary Care professionals in their local area from 8am-8pm seven days a week.

Ms Dawn Wakeling requested that a list is compiled of CHINs and GP practices across the borough to be circulated to the Board and all Members. (Action)

Ms Matthews welcomed the report and noted the significant transformation programme which involves community services as well as sharing resources and reducing unnecessary pressures on services.

Councillor Sachin Rajput asked about the locations of future CHINs within the borough. Ms Wood noted that the aim is to achieve full coverage across the borough and that lessons learnt will be shared in order to shape services.

It was requested that an update is provided to the Board setting out CHINs coverage plans including future CHINs and overview mapping of other hubs, Police, School catchment areas and other partnerships. (Action: Forward Work Programme)

It was RESOLVED:

That the Health and Wellbeing Board noted and commented as above on the progress of Care Closer to Home Integrated Networks in Barnet.

The Chairman welcomed the report setting out the Smoking Cessation Strategy and its aim to increase access to smoking cessation support through a new hub model and digital services.

Dr Lake presented the report. He highlighted the importance of working differently to reach a greater number of people through working closely with smaller providers across the borough. He spoke about encouraging use and access to the digital platform being developed.

In response to reaching people with mental health issues, Dr Lake noted that work will continue to sign post people to receive relevant support where needed.

The Chairman questioned both Public Health and CCG colleagues as to the safety of e-cigarettes and to the advisability of actively promoting them. She felt in some cases this could even be encouraging people to start smoking. Dr Stephens drew attention to the unknown health disadvantages as a result of e-cigarette usage and requested that the wording of paragraph 3.6 Harm Reduction on p.44 be revised. (Action: Public Health)

Mr Munday highlighted that a multi-facetted approach was much needed to engage with children and young people both at school and outside the school environment.

The Board requested that further partnership working is undertaken to engage with children and young people, as well as with people who are out of work and with pregnant women. (Action: Public Health)

It was agreed to amend the first recommendation to read:

That the Board agrees the smoking cessation strategy, subject to further details being added about engaging with children and young people on smoking cessation.

It was therefore RESOLVED:

1.    That the Board agreed the smoking cessation strategy, subject to further details being added about engaging with children and young people on smoking cessation.

2.    That the Board agreed the implementation actions outlined in this cover sheet.

The Chairman welcomed the Report and noted that Prevent is a statutory duty for both the Council and partners. This report sets out local progress on delivery of the Prevent agenda and highlights aspects particularly relevant to health and social care.

Mr Sam Rosengard, Barnet Prevent Coordinator presented the report. Mr Fraser welcomed the report and noted the Community Safety Committee’s close involvement with the Children’s Safeguarding Partnership.

The Board agreed to amend the wording of both the first and second recommendation to read:

-That the Board comments and supports the actions identified following the recent publication of the Counter Terrorism Local Profile (CTLP) and having had due regard to the need to prevent people from being radicalised or drawn into terrorist activities.

- That the Board endorses the proposed method of training delivery set out in this report to ensure that the Barnet workforce is trained and skilled in identifying, recording and referring children, young people and adults who are vulnerable to radicalisation or are suspected of having been radicalised.

It was therefore RESOLVED that:

1.    That the Board commented as above and supported the actions identified following the recent publication of the Counter Terrorism Local Profile (CTLP) and having had due regard to the need to prevent people from being radicalised or drawn into terrorist activities.

2.    That the Board endorsed the proposed method of training delivery set out in this report to ensure that the Barnet workforce is trained and skilled in identifying, recording and referring children, young people and adults who are vulnerable to radicalisation or are suspected of having been radicalised.

The Chairman introduced the item which was considered by the Children, Education, Libraries and Safeguarding Committee on 16^th January 2018. She welcomed the improvements noted by Ofsted in their letter following their recent monitoring visit particularly the 2^nd paragraph on page 91 which said the Local Authority was starting to make progress to improve services for children and young people and the 4^th paragraph on page 92 which said that the pace of improvement and change is appropriate and commensurate with the task at hand.

Mr Munday Strategic Director of Children and Young People presented the report. He noted the progress made in improving services for children and young people in line with the Ofsted monitoring visit feedback letter. Mr Munday also informed the Board that the second monitoring visit will take place at the end of the month.

In respect of GP involvement, the Board noted that discussions will be held going forward involving partners to consider what has been working well and adopt lessons learnt from other areas.

RESOLVED that:

1.    That the Board noted the progress of the Barnet Children's Services Improvement Action Plan as set out in paragraphs 1.8 to 1.71.

2.    That the Board noted details of Ofsted’s monitoring visit set out in paragraphs 1.11 to 1.14 and the monitoring visit feedback letter received from Ofsted attached in Appendix 1.

3.    That the Board noted the performance information provided in paragraphs 1.72 to 1.85 and Barnet Children’s Services Improvement Plan Data Dashboard attached in Appendix 2.

The Chairman introduced the PNA report which presents the findings of our recent assessment prior to further public consultation.

It was noted that the production of a local Pharmaceutical Needs Assessment is a statutory requirement for the Board, which must be reassessed every three years.

The Chairman commended the findings and noted that the assessment has found no gaps in pharmacy provision – in essential, advanced or enhanced services in Barnet.

Ms Wells joined the table to present the report. Ms Wakeling noted that following conclusion of the consultation the final PNA will be shared with the Board and published.

It was RESOLVED that:

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

2.    That the Health and Wellbeing Board delegated authority to the Director of Public Health to finalise the PNA and its publication.

The Board noted the standing item on the agenda which provides the minutes of the Care Closer to Home Programme Board and the Joint Commissioning Executive Group for approval.

It was RESOLVED:

That the Health and Wellbeing Board approved the minutes of the Care Closer to Home Programme Board and the Joint Commissioning Executive Group of 19 October 2017.

Ms Wakeling noted the standing item on the agenda which lists the reports to future Board meetings. It was noted that the items agreed during this meeting will be added to the Forward Work Plan.

It was RESOLVED:

That the Health and Wellbeing Board considered and commented as above on the items included in the Forward Work Programme (see Appendix 1).

None.