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 of arrangements in case of fire or other event that would require evacuation from the meeting room.

(If any) – receive

Apologies for absence were received from:

Dr Atul Aggarwal, Chair, Havering CCG

Alan Steward, Chief Operating Officer, Havering CCG (representative Clare Burns)

Connor Burke, Accountable Officer, Barking & Dagenham, Havering and Redbridge CCGs

Susan Milner, Interim Director of Public Health LBH (representative Elaine Greenway)

John Atherton, Head of Assurance North Central and East London, NHS England

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.

No pecuniary or personal interests were disclosed.

The minutes of the meeting held on 19 August 2015 were agreed as a correct record and signed by the Chairman.

The minutes of the meeting held on 19^th August 2015 were agreed as a correct record and signed by the Chairman.

To consider any matters arising.

There were no matters arising. It was agreed to vary the order of the agenda items.

Reports attached.

The Chair of the Safeguarding Adults and Children’s Boards, BB, presented his reports (previously circulated).

Clarifications were sought on the following content of the Adult Safeguarding Report:

IC expressed concerns regarding why there had been a marked increase in domestic violence offences, and what actions were being taken to address the increase.  PB explained that the eligibility definition had changed, and now includes 16 and 17 year olds, and that safeguarding also now includes emotional abuse. However the projected activity had not been increased accordingly.  Havering partners continue to address the issues, with action that includes delivering a multi-agency Violence Against Women and Girls Strategy, which reports to the Safeguarding Board. A conference on Safeguarding was due to take place in November, which will include the topic of domestic violence, and will result in a multi-agency action plan.

Action:  Following the conference, BB will circulate the action plan to Health and Wellbeing Board members

SK raised general concern as to how the Safeguarding Boards will meet their statutory duties in relation to prevention of abuse, raising awareness, and involving the community.  BB advised that:

·         A group comprising communities and voluntary sector has been established that will contribute to raising awareness and involve the community.  A community development day is planned,

Action:  BB will circulate information to HWB members in December on outcomes from the Development Day

There continued further discussions on matters contained in the Safeguarding Adults report

·         There had been a strengthening of arrangements, such as working with the Council Housing Service

·         Learning from Serious Case Reviews (Adults) will support a greater understanding of risks and how to improve the local response.

There was a discussion about the Multi-agency Safeguarding Hub (MASH) for adults:

·         That there was to be a review of the MASH processes, which will consider

improvement in the quality of information included in the referrals

·         That Probation Services had withdrawn from the MASH

Actions:

·           BB to share the SACB action plan with the board to ensure that all partners are delivering the agreed actions.

·           BB to raise with London Safeguarding Boards Chairs Group that Probation Services are withdrawing from local MASH

·           IC to raise the issue of Probation Services and MASH with the Directors Group

·           CC to raise the issue of Probation Services and MASH with London Councils

The following were highlighted from the Safeguarding Children’s Report:

·         Havering was one of the most effective boroughs for identifying Child Sexual Exploitation.

·         There could be improvement in the quality of information included in the referrals

·         There had been an increase in numbers of child protection conferences

·         The demographic changes in the borough had contributed to the increasing numbers of Looked After Children

CC highlighted increased demographic pressures. There is an overspend of £1m on Children’s Services.

It was noted that both IC and TA were currently undertaking a review of children services to gain a better understanding of the pressures experienced by the services, and assurance that these of being managed.

The Board noted the reports.

Report attached.

AMD presented highlights from the report (previously circulated with the agenda papers).  The report was noted.

Action: presentation slides to be circulated

CB gave a presentation, and highlighted that the CCG had two main priorities:  Looked After Children health checks (assessments), and equipment for children with special needs.

There was a discussion on Looked After Children’s health checks. CB explained that late delivery of health assessments was a major issue, and that a written plan was being prepared describing how the backlog of health assessments will be cleared by end December and on-going assessments will be delivered on time. It was noted by the Board that the same pressures experienced by MASH and increased child protection cases were also affecting arrangements for Looked After Children health checks, with an increase in numbers of Looked After Children.

Clarification was sought on whether the plan will include consideration of Looked After Children placed in the Borough from outside the Borough.  CB confirmed that the plan would include this information.

Clarification was sought on the quality of the health checks.  CB explained that CCG now has a lead doctor for Looked After Children who ensures standards of quality, and that some GPs also specialise in paediatrics.

The Board noted the presentation.

Action

·          CB to circulate the written plan to HWB members during week ending 20 November

·          CB to circulate Children’s Equipment Plan

·          Presentation slides to be circulated

Report attached.

DR presented highlights from a report (previously circulated with the agenda papers).

Actions:

·            DR to consider the CCG Looked After Children Health Check Plan, and identify any recommendations from her report that have not been taken into account by CCG Plan, and assess the significance of any not included

·            TA / DR to feedback to the next Health and Wellbeing Board Meeting regarding the backlog for Initial Checks of Health Assessments being on track to be cleared.

Report attached.

MA presented highlights from a report (previously circulated with the agenda papers).

The Chair and members of the Board raised serious concerns about funding and transfer arrangements of the health visitor service, including the implications for effective safeguarding of under 5s:

·        The reduction in Public Health Grant, which means that the mandated health visitor service cannot be delivered.

·        Whereas inner London local authorities are experiencing a reduction in numbers of Looked After Children, local authorities such as Havering are experiencing increases in numbers, and yet there is no scope for readjustment of the funding formula

·        Although the government had aimed for a rapid growth in health visitor numbers, NELFT had not been able to recruit sufficient despite best attempts.  This meant that health visitors caseloads were even higher, and far above national recommendations

·        There remains a query about succession planning for health visitors, including responsibilities for training new health visitors.

·        That the service specification transferred to the Council in October did not reflect latest practice (Ages and Stages Questionnaire) – adoption of best practice would reduce performance against mandated elements of the service specification

·        That the extra numbers of Looked After Children have created additional pressures on the health visitor service, including participation in case conferences, and undertaking follow up health reviews etc

In the light of these serious issues, the Board agreed that Havering should seek advice on a Judicial Review of the Department of Health’s decision to reduce public health grant funding.

Actions

·          BB, DR, TA and MA to write a technical report of the issues and submit to IC by 20 November

·          IC to request that LBH Legal Team engage specialist counsel by Christmas

Report attached.

CC presented highlights from a previously circulated presentation and informed the meeting that Confirmation on the outcome for the Accountable Care Organisation Pilot applications would be formally announced by the end of 2015.

MP presented highlights from a report previously circulated with the agenda and MP highlighted that the inspection would focus on how the area meets local needs according to the requirements of the Children and Families Act, not an individual agency.

The Chair thanked all presenters for their reports.

Dates of future Health and Wellbeing Board meetings:

          27 January 2016

          23 March 2016

27^th January 2016