Agenda item

The Chair introduced Mr Dan Heller, Neighbourhood Programme Lead, North Central London Integrated Care Board (NCL ICB) to speak to his slides which were published with the agenda.

Mr Heller reported that the decision to develop a Neighbourhood Programme with dedicated resources was made by the Barnet Borough Partnership Executive Board in October 2022.

Mr Heller noted that he was appointed to his role in March 2023, and works in partnership with colleagues from Barnet Council, Barnet, Enfield and Haringey Mental Health Trust, Central London Community Healthcare NHS Trust, Primary Care colleagues, the voluntary sector and others. In February 2023 a neighbourhood workshop event had been held including 80 system leaders from settings across the Borough to hear about the excellent work going on at the local level.

It was agreed to use a pragmatic approach by following the infrastructure of the Primary Care Networks (PCN) for neighbourhood working, as well as a hyperlocal approach to developing initiatives to address health and wellbeing challenges in an area. In addition non-geographically bound projects were being undertaken to identify local health challenges and bring together colleagues to address these.

In October 2023 a second workshop was held with clinical directors from all seven PCNs to take the ideas further into the planning stage. A small funding pot has been made available from the ICB to use for pilots to test out initiatives within PCNs. One of the conditions of being granted funding is that the work is in partnership with another organisation. Several PCNs are currently putting pilots together in Barnet.

Mr Heller noted that Grahame Park is the test site for the hyperlocal approach, in partnership with the Grahame Park Strategic Group. He added that he is working with Rachel Wells (Barnet Public Health) and he is also Co-chair of Grahame Park Estate Adults, Health and Wellbeing Working Group to lead this initiative. The group will review what is already available for residents, consider the health challenges and possible solutions. Housing comes up as a big issue in the area and a meeting has been set up between housing and health colleagues to talk at a strategic level on this. Mental health is also a big theme, as is communication. There are many interventions available for Grahame Park residents but language barriers and digital exclusion often prevent residents from access. Effective communication can help to solve this.

The Chair asked what the main difference is with this approach, to other models of care and what the implications for Barnet council might be. Mr Heller responded that the joint working between Primary Care and the voluntary sector is largely new, as is the opportunity to receive funding, and the funding models that will make the work sustainable. The current work from NCL ICB around Long Term Conditions, which is locally commissioned, is the first time Primary Care has been required to provide funding initiatives in the voluntary sector and this is potentially transformative. The Executive Director, Communities, Adults and Health added that trials on bringing healthcare out of hospitals and into the community have had varying degrees of success – this has been driven by the Fuller Stocktake on Primary Care and some aspects of this are well embedded in Barnet for the first time, such as the Ageing Well Multidisciplinary Team across the Borough. Patients meet with Consultants in Geriatric Medicine, Specialist Frailty Nurses, Dementia Nurses,  Social Prescribers and others to consider a resident with complex needs or their carer, and then put plans in place. The new structure also provides an opportunity to ensure that across the Borough different organisations receive a more rapid and community-specific response. For example this is happening with the Colindale Communities Trust in Grahame Park, with a weekly onsite service. It also provides an opportunity to address prevention earlier on and deal with issues such as social isolation, housing and finding work. The approach offers many opportunities across a range of council services. 

Cllr Rose enquired what plans are in place given that the funding is non-recurrent and given the pressure on the council’s budget. Mr Heller responded that one of the questions asked when expressions of interest are invited, is around other pots of funding that the proposed work will be linked to, as part of trying to ensure sustainability. The Executive Director, Communities, Adults and Health noted that there is no dedicated funding through NHS commissioning and no additional funding for services at a neighbourhood level, but the initiatives detailed on the slides continue to be funded.  She added that there is a potential for this work to identify more need for social care and increase demand, but also it could prevent more complex conditions developing due to earlier intervention.

Cllr Sargeant asked whether some of the co-located services will be in the new health centre on Aerodrome Road. Mr Heller responded that some of them will be there (the Integrated Hub). There will also be services in the community such as health and wellbeing drop-in for parents in a school, and other places where a relationship of trust has already been built with residents.

Mr Heller noted that the pilots will start in early 2024, with up to one year to carry them out. The learning from the Grahame Park pilot would help to inform the next projects in other wards where needed. He noted that the Grahame Park Adults Health and Wellbeing Group and the Strategic Group will take some time to undertake the project – at their meeting the following week they will discuss housing and health and support for tenants, as well as information sharing with health providers.

Cllr Stock enquired about isolated residents and how these would be reached, particularly some who may not speak English and that services may not be aware of. Mr Heller responded that the several PCNs have highlighted housebound and frail residents who live alone as a priority. Pilots may be proposed around these, and the Neighbourhoods Programme works alongside other council programmes such as Ageing Well. The Executive Director, Communities, Adults and Health noted that GPs usually know which patients are housebound and the council is aware of many from the childhood vaccination programme. This could be an opportunity to connect people with others. Mr Heller added that the social prescribers in Barnet have an excellent data capture system to record the learning from their interventions to feed back to GPs. Also he noted that there are organisations in Grahame Park that do lot of translation already and one of the benefits of connecting those organisations with Primary Care is that you enhance the opportunity to include those residents who may be isolated.

The Chair asked how housing-related health problems were being tackled. Mr Heller noted that this is at an early stage with getting to know new tenants through visits, with health colleagues involved in the process. Also one of the suggestions for a co-location project for Grahame Park is a space where the housing team and the Mental Health Trust can come together for a drop-in session. Also social prescribers are speaking to residents and sharing information about damp and mould.

The Director for Public Health noted that one of the challenges is getting engagement from residents who are suffering mental ill health and for example substance abuse, but it is positive to have involvement from Primary Care. The Integrated Hub in Colindale will be a positive step.

Mr Heller agreed to report back to the Committee when some of the pilots have been up and running.

Action: Scrutiny Officer

RESOLVED that the Committee noted the Neighbourhood Model Programme in Barnet.