Agenda item

Update on the work and future plans of the Health and Wellbeing Board.

The Chairman of the Health and Wellbeing Board (Cllr. Kelly) explained that the Board’s overall aim was to ensure an across the borough approach to both health and social care. The Board membership numbered twelve people including four Councillors, the Group Director for Social Services and the Director of Public Health. A representative of the Local Healthwatch for Havering would also join in April. This representative would be appointed by Local Healthwatch themselves and not by the Council. The Clinical Commissioning Group (CCG) was also represented.

No Government funding had been received to set up the Health and Wellbeing Board and other funding had been used to run 19 projects. These covered areas such as the number of rehab beds, falls, telecare, strokes and COPD. Each project was run jointly between the Council and health partners.

The Board also wished to have GP surgeries open, on a rota basis, on Saturdays and Sundays. The CCG would check that savings generated by the projects were reinvested into the brought. Another role of the Health and Wellbeding Board would be to agree the final budget of the CCG although this would be undertaken in partnership with the CCG itself.

The Health and Wellbeing Board also produced the Joint Strategic Needs Assessment and it was hoped to produce local health statistics as this would allow effective pre-emption of health problems in Havering. It was hoped this would reduce both numbers of people going into hospital and rates of readmission.

There were seven priorities for the Health and Wellbeing Board:

1. Early help for vulnerable people to live independently. The Board felt that more work on long-term conditions of the elderly could reduce their need to attend or be admitted to hospital. The development of telehealth would reduce hospital admission and the Board also wished to tackle the isolation of elderly people.

There would be more community based and provision of reablement. Fifteen more beds were opening in Royal Jubilee Court. There would also be a move to allow more initial reablement to take place in people’s homes.

2. Dementia identification and support – It was agreed that this was a growing problem in Havering and the Board wished to change attitudes and ensure that dementia was seen as an acceptable illness. An aim was to reduce the number of people on anti-depressants as this may increase dementia. The Health and Wellbeing Board could direct strategy on this. Better recognition of dementia was also needed by professionals to reduce instances of e.g. urinary tract infections being mistaken for dementia. The Board had also agreed to adapt some allotments units to be used by people with dementia.

3. Early detection of cancer – Early cancer detection rates in Havering were very low. If diagnosed barky, survival rates were good but there was a need to have doctors recognise the symptoms. The cancer department at Queen’s was good but the Board felt the screening programme needed to be better.

4. Tackling obesity – A priority was to increase support levels such as exercise programmes in order to reduce levels of obesity, particularly in children.

5. Better integrated care for the frail and elderly – A new Integrated Care Coalition had been developed which would allow all major stakeholders to look at patient discharge. Issues such as doctors having to give a new prescription to allow drugs to be dispensed in care homes could be considered by this new body. A further aim of the Coalition was to increase the numbers of people able to die at home rather than in hospital etc. The Coalition was chaired by Cheryl Coppell.

6. Better integrated care for vulnerable children – A total of 470 cases were now specifically targeted by Children’s Services with targeted social work support and other assistance.

7. Reducing avoidable hospital admissions – The Board felt it was essential to decide who needed to go into hospital. One option was to use a consultant stationed on the door of A&E to reduce admissions but opening GP surgeries at weekends would reduce A&E attendees. The Board also wanted to reduce waiting times for GP appointments and introduce more safeguarding controls for care agencies to stop people being admitted to hospital. It was also important to find out about the quality of service and patient experience received.

Enter and view visits would be undertaken by Healthwatch. The Chairman of the Health and Wellbeing Board felt that it was important that such visits were undertaken by skilled and trained people something that, in his view, had not always been the case under Havering LINk. A LINk representative responded that all LINk members were required to undergo a full day’s training course and have a Criminal Records Bureau check before they were allowed to undertake any visits. Quality assurance of enter and view visits would be the responsibility of the Healthwatch board.

Communication of the health strategy would, in some instances, be the responsibility of bodies such as the NHS Commissioning Board or the Public Health Board. Locally, Living Magazine etc. could also be used.

The Health and Wellbeing Board Chairman felt that the capacity of GPs would need to be considered. There was no obligation on the CCG to fund Queen’s Hospital and more money should be retained to be put into local primary care.

The Data Protection Act was a problem in attempts tom help vulnerable older people as it was not possible to obtain information on local people above certain ages. Work was in progress with the NHS to try and improve this. The numbers of people in non-acute beds who lived alone was monitored and people on over 65 medical checks were also signposted to Council activities.

The Board chairman agreed that it was important that all potentially vulnerable older people were seen. The Activate Havering project aimed to contact isolated people and it was also being investigated how people not on benefits or funded social care could be contacted.

The Committee noted the update on the Health and Wellbeing Board.