Agenda and minutes

The Chairman will announce details of the arrangements in case of fire or other events that might require the meeting room or building’s evacuation.

The Chairman advised the meeting of the arrangements in case of fire or other event that may require evacuation of the meeting room.

(If any) – receive

There were no apologies for absence.

Members are invited to disclose any pecuniary interest in any of the items on the agenda at this point of the meeting.

Members may still disclose any pecuniary interest in any item at any time prior to the consideration of the matter.

There were no disclosures of interest.

To approve as a correct record the minutes of the Committee held on 15^th October 2014 attached, and to authorise the Chairman to sign them.

The minutes of the meeting held on 15 October were agreed as a correct record and signed by the Chairman.

To consider the Board’s Action Log

Life Study – The Board expressed some concern that the study was only initially funded for one year.

Complex care – Conor Burke would update on this area at the next meeting of the Board.

End of life care – It was felt that good progress had been made although there was still an issue people dying at home. St Francis Hospice did excellent work but there were waiting lists for care at the facility. It was noted that the Hospice remit than just cancer services. Dr Saini felt it was important that a dying person got the best care. People were now talking about death on a regular basis and a regular series of sessions discussing end of life care would commence from January 2015. It was noted with pleasure that there were now 50% less people being moved out of care homes to die in hospital.

Delivered by Brian Boxall. Report attached

The Independent Chair of both Safeguarding Boards presented the Boards’ annual reports. The Children’s Board had been statutory since 2006 and the Adults Board would become statutory under the Care Act. Both Boards sought to look at the safeguarding practices of individual agencies and discuss or challenge these.

The Children’s Board had changed what safeguarding in Havering looked like. A lot of work had been undertaken on child sexual exploitation and identifying children subject to abuse. It was accepted that gangs were starting to be an issue in Havering although this was very much in its early stage. There were also issues with female genital mutilation in Havering although not in large numbers. The Chair felt that any new Joint Strategic Needs Assessment should reflect these issues.

Levels of mental health support had been an issue under child sexual exploitation as well as in cases of children self-harming, including in junior schools. Schools were currently undertaking work for the Children’s Safeguarding Board on this area.

The Board Chair felt that all commissioners should consider safeguarding of children and adults and that it was essential to ensure commissioned services were safe into the future. Most safeguarding problems had resulted not from a lack of staff ability but were due to staff not coping with workloads. It was therefore essential to establish long-term staffing plans. The Board agreed that staffing levels were issues in areas such as health visiting and school nursing and that this could impact on safeguarding.

It was important that individual agencies understood the impact of the Adults Safeguarding Board having statutory status.

The Board agreed that child sexual exploitation was an important issue nationally and it was important that victims were supported and that early intervention took place. The Safeguarding Board worked closely with the Children’s Society. The Board had challenged the Police on the level of their investigation teams but this was more an operational issue for community safety. The numbers of convicted paedophiles resident in Havering were not known. The Police special child investigation team was shared with Barking & Dagenham. The Police had agreed that this team was under-resourced but there had been no changes as yet. This would be followed up before the end of the calendar year.

A transitional group was looking at the transition from children’s to adult services. This included mental health services for teenagers which was a national issue. Schools had good input into both Safeguarding Boards.   

A peer review of work on serious youth violence was currently in progress. This was being undertaken by the Home Office and £96,000 of community safety funding had been reallocated to deal with this issue in schools. Mentoring schemes were used for troubled teenagers and anti-social behaviour orders were also used to prevent at risk adolescents from entering the town centre.

The Safeguarding Boards worked closely with community safety agencies. This allowed the agencies to explain what they felt were current risks and long-term challenges.

It was noted that the Adult Board, once it  ...  view the full minutes text for item 49.

Presented by Caroline O’Donnell

Officers from North East London NHS Foundation Trust (NELFT) explained that they wished to continue to widen the service portfolio of NELFT by moving into areas such as community nursing.

NELFT owned many buildings and estate in different stages of repair and wished to divest from properties where they had no control over infrastructure. There had also been investment into new properties such as the London Road Child Development Centre.

The Chairman felt that there were too many wasted facilities within Havering and that NELFT should talk more to organisations such as NHS England and NHS Property Services who were responsible for many local health buildings. There was currently no list of all health and social care properties within Havering although the CCG confirmed that this was being compiled.

NELFT officers felt that the London Road development was a good example of the different agencies working together. The building would be handed over to NELFT in December 2014. Services in the building would be based on engagement sessions that had taken place with stakeholders and the building would serve as a single access point for children’s mental health services. The CCG and Social Care were looking at ways to avoid duplication of work by voluntary groups.

There were a total of 120 extra health visitors recruited for the Outer North East London area. NELFT had programmes in place to support new health visitors and had also looked at its retention model. A ministerial visit had taken place to showcase the work done and a second visit was planned.

The Council chief executive explained that attempts were in progress to reach agreement across London on the transfer of early years commissioning which was due next year. Specific health visiting elements had been written into a much larger contract and the suggestion of the transfer of health visiting services to the Council without any funding for overheads was not acceptable. The Department of Health was therefore being lobbied to give Havering £432,000 for health visitor overheads and, while this had been agreed a  figure by the Department’s area team, a meeting was due to be held with the Department of Health later that week in order to discuss the issue further.

It was also felt that some boroughs did not have sufficient health visitors for their 0-5 population. The caseload for health visitors also varied widely across London and was very heavy in Havering. NELFT officers agreed that it was difficult to recruit health visitors to Havering due to the high number of cases per health visitor. The Chief Executive added that the matter could be escalated to Members at London Councils if necessary.

The three local boroughs were underfunded for health visiting compared to Inner London boroughs and local CCGs were also under capitation generally. It was necessary to try to use political levers to get funding for the Outer London boroughs. The Board Chairman suggested this matter could be discussed at a planned meeting with the Health and Wellbeing Board  ...  view the full minutes text for item 50.

Verbal update from Alan Steward

The CCG wished to mainstream the Community Treatment Team and Intensive Rehabilitation Services across the three local boroughs. There had been a lot of feedback given to the consultation and the CCG was currently considering its response to this, A paper would therefore be taken to the CCG governing bodies on 11 December.

The Board indicated it would be very disappointed if the Community Treatment Teams and Intensive rehabilitation Services were to be lost in Havering. It was uncertain if there was any appeal process if any of the CCGs decided this.

The Board NOTED the update.   

This item was deferred to a future meeting.

Verbal update from Alan Steward

It was explained that the new access hub run by the GP Federation had commenced in September 2014 with a phased introduction. Fifty per cent of the access slots were now being used and this was expected to increase in the future. Appointments were currently available from 6 – 10 pm on weekdays and it was planned to extend this to weekends over the winter period.

The Board felt that if the access hub was running properly, this would reduce numbers of people needing to attend A & E. It would be necessary however to instil confidence in local residents that that the hum would remain as a facility.   

Shared care records would be introduced with GPs in December 2014 and for other providers such as BHRUT, NELFT and social care in the new year. It was agreed to take an update on this issue at the March meeting of the Board.

Verbal update from Cheryl Coppell

The Council Chief Executive explained that accommodation was an issue across both Inner and Outer North East London health services. Work on mapping of accommodation was under way and a report on this would be brought to the Board once the work was complete.

Report by Joy Hollister

This item was deferred to a future meeting.

Report from Joy Hollister

This report would be submitted at the next meeting of the Board.

JAD performance report one page summary to follow if available.

There had been a reduction in the number of permanent admissions to residential and discharge teams. The number of delayed transfers of care across the system was on target and performance against the reablement target was also good. Spending on homecare had however compared to last year with increases in both numbers of service users and the hours of care received. The reasons for this rise were being investigated.

It was felt that the Joint Assessment and Discharge Team should be pushed to start work on discharge at an earlier point in a patient’s hospital stay. A report on this would be brought to a future meeting of the Board. The Chairman felt that the length of people’s stay in hospital should be considered with perhaps the use of larger private houses being considered as a location for shared social care.

The Group Director for Children, Adults and Housing felt that the overall performance of the Joint Assessment and Discharge team remained to plan and it was important not to get distracted by short term increases in certain indicators.     

There were no other business items raised.

The next meeting would be held on held on Wednesday 10 December at 1.30 pm in Havering Town Hall, committee room 2.