Agenda and minutes

Health & Wellbeing Board - Wednesday, 21st September, 2016 1.00 pm

Venue: Committee Room 3B - Town Hall. View directions

Contact: Anthony Clements  Email: 01708 433065

No. Item



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.


Councillor Brice-Thompson


Start time: 13:00


The Chairman announced details of the arrangements in case of fire or other event that might require evacuation of the building.




(If any) – receive.


Apologies have been received from Tim Aldridge, Director of Children’s Services.  



Apologies were received from Susan Milner, Interim Director of Public Health (Elaine Greenway substituting) Tim Aldridge, Director of Children’s Services, Conor Burke, BHR CCGS and Matthew Hopkins, BHRUT (Fiona Peskett substituting).




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


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


There were no disclosures of interest.



MINUTES pdf icon PDF 184 KB

To approve as a correct record the minutes of the Committee held on 20 July 2016 (attached) and to authorise the Chairman to sign them. To also conider any matters arising not on the action log or agenda.


Councillor Brice-Thompson


Start time: 13:05


The minutes of the meeting held on 20 July 2016 were agreed as a correct record and signed by the Chairman. There were no matters arising not covered elsewhere on the agenda.



ACTION LOG pdf icon PDF 177 KB

To consider the Board’s action log (attached).


Councillor Brice-Thompson.


Start time: 13.10


It was noted that the finalised Board terms of reference had been circulated to Board members as agreed.


The draft of the refreshed Joint Health and Wellbeing Strategy would be circulated after the meeting and comments invited.




Report attached.


Conor Burke/Alan Steward/Andrew Blake-Herbert


Start time: 13.15


The local Sustainability and Transformation Plan (STP) was at framework level and covered the whole of North East LondonThe STP is the mechanism for delivering the NHS 5 year Forward View and a draft business case had been submitted at the end of June. A further submission was due by 21 October which would address, as requested, the impact of the plans on quality of care.


Havering was involved with a Democratic Oversight Group looking at governance issues regarding the STP. AS added that a number of different workstreams had been set up in order to deliver the plan covering areas such as A & E, planned care, prevention and IT issues. A successful three-borough workshop had been held on how improvement could be delivered and it was emphasised that Councils had a key role to play in this. 


Support had been received from the Local Government Association to deliver a major workshop covering readiness of all relevant parties for the proposals. BN added that updates on governance issues would be brought to both the CCG and the Council. Priorities for Havering under the STP included work with children and families and frailty issues.


AS added that engagement was planned with local people and communities. It was necessary to develop however how this would be carried out. Councillor Ford felt that social media could assist with this. AMD felt that it was important that local messages from the STP were also focussed upon. A wider meeting was planned in the next 2-3 weeks to discuss how best communities could be engaged with.


It was noted that the reference to Redbridge in paragraph 1.1 of the report should have referred to Havering. It was uncertain at this stage if there were any conflicts between the plans for the STP and the proposals around the work of the Accountable Care Organisation (ACO).


It was accepted that there was a lack of knowledge around the STP outside of the local Councils. Councillor Ramsey felt that public engagement should focus on succinct messages and a summarised version of the STP should be developed for the public. AS agreed to note this.




Report attached.


Mary Phillips/Sue Elliott


Start time: 13.40

Additional documents:


MP explained that Children and Families services were preparing for a future inspection by Care Quality Commission and OFSTED. The inspection had a wide-ranging scope covering SEND outcomes from 0-25 and included such topics as understanding local need, education, health and care plans, and joint commissioning. The scope of the inspection covered all children with an identified special need and was not restricted to those with Education, Health and Care Plans etc.  The organisations that anticipate being inspected include the local authority, those in the youth justice system, CCG, NHS England, health providers, early years settings, schools and further education colleagues


Reports of most previous inspections in other areas were available and five days’ notice of the start of the inspection would be given to the Council and CCG. Inspectors would expect evidence-based information, including sharing of information. The inspectors would meet with providers and commissioners as well as parents, carers and children & young people themselves. Officers had put in a great deal of work in order to be ready for the inspection and the implementation of the Children and Families Act.


It was emphasised that the Children and Families Act aimed for children to be prepared for an independent adulthood. All working was required to be joint between education, health and social care. The Local Offer for Havering would therefore be closely inspected.


Associated risks included a need to articulate funding challenges and low numbers of personal budget holders, although the Council wished to increase this. Other risk areas included the transition process, a lack of evidence of joint commissioning taking place and not having a live system of tracking from pre-birth onwards. It was recognised that integration could be improved, including for example integration between early years providers and health visitors.


Joint working for commissioning, assessments and an integrated 16-25 provision also needed to be addressed. ICT needed to be used as part of the solution around joint assessments given the limited time and other resources available to GPs, physios etc. MP felt there was a full commitment to addressing these issues. Next steps included the appointment of an officer to support inspection preparation. 


MP felt that other inspected authorities had received similar results around joint working and the inspection team would not be expecting all issues around Children and Families to be fully resolved at this stage.


Councillor Ramsey felt it was important to show if Havering was making similar progress to other Local Authorities. MP felt Havering was in a similar position to other Council areas. The inspection report would identify areas where progress needed to be made, rather than make judgements.


MP would bring to a future meeting of the Board the self-evaluation that had been worked on with the CCG. It was confirmed that there was a list of services commissioned for children and the delivery plan was being written at the same time.   


Data sharing was difficult to implement fully at present due to there being a number of different ICT systems across  ...  view the full minutes text for item 18.



Report attached.


Barbara Nicholls


Start time: 14.05

Additional documents:


BN explained that this was a national initiative supported by the Local Government Association and the Association of Directors of Adult Social Services , following the Winterbourne View review of incidents of abuse at a care home. The programme had led to the establishing of Transforming Care Partnerships (TCPs) in local areas.


Havering’s TCP includes partnership working between the Council, NELFT, and NHS England which is responsible for specialist commissioning.


Locally, this work aimed to make respite care more readily available and provision across Havering, Barking & Dagenham and Redbridge would be looked at in order to get the maximum from community services.


It was noted that, as of March 2016, there were a total of 26 people receiving in-patient care services with 8 of these from Havering. These figures had increased slightly during 2016-17 but remained low overall. The aim of the TCP was to introduce facilities that would allow people to be discharged sooner and be supported in the community. The new Havering facilities at Great Charter Close were an example of this. It was uncertain at this stage why more people from Redbridge were placed in secure settings but this was being investigated in conjunction with NELFT. In-patient services consisted of 11 beds at Goodmayes Hospital. Private secure in-patient facilities were also used although these could be very expensive.


The TCP would have governance links to the three local CCGs as well as relevant partnership boards. The TCP work also sat within that of the STP but work would only be carried out at a regional or London-wide level where it was felt it would be advantageous to do so.


The TCP programme plan had several key domains including co-production and it was accepted that fuller engagement with service users was required. An organisation that was experienced with working with people with learning disabilities had been engaged to ascertain what service users required.


The programme also aimed to keep people out of hospital settings and the reduction in the number of beds required would fund the work of the TCP itself. Some specialist units would still be needed although work was in progress with NELFT to remodel the way beds were used and hence reduce the amount of out of borough placements that were needed.


The new 16-25 provision at the Avelon Centre would be used more and a Cabinet report had been drafted concerning a proposed special school for very high needs autistic children. This would be a unit for 20-25 children that would lead to better outcomes.


An estates workshop for Barking & Dagenham, Havering and Redbridge was due to be held shortly in order to consider what facilities would be needed in the future.



The Board:


1.    Received the final TCP plan submitted to NHS England on 11th April 2016 (now assured by NHS England).

2.    Noted the programme plan now underway to deliver the TCP plan.

3.    Agreed to receive an update in six months on ongoing progress against the delivery of the programme.  ...  view the full minutes text for item 19.



Report attached.


Conor Burke/Alan Steward


Start time: 14.25



 AS explained that Havering CCG’s assessment had been downgraded from ‘good’ to ‘inadequate’ due to the referral to treatment (RTT) issues. The issuing of legal directions to the CCG regarding RTT had led to a new assessment. The CCG was developing a plan for ensuring that the 18 week RTT target would be met and this was due to be finalised by the end of September 2016.The 1,000 people who had been waiting in excess of 52 weeks for treatment had reduced to approximately 200.


The assessment had indicated that the CCG was excellent in other areas such as primary care. The new assessment framework, which was related to work on the STP and Five Year Forward View had prioritised three areas – dementia, learning disabilities and diabetes. The assessment had said that the CCG was performing well on dementia but that improved outcomes were needed for diabetes. Work on this was in progress across the three local CCGs and it was hoped this would lead to a better quality of life for people with diabetes  as well as increased funding. AS would bring an update on this to a future meeting of the Board.


It was agreed that the Board should receive regular updates from AS and FP on waiting times for treatment, particularly those people who had been waiting more than 52 weeks. It was noted that the Health Overview and Scrutiny Sub-Committee was currently reviewing this issue in conjunction with Healthwatch Havering.




Elaine Greenway on behalf of Susan Milner


Start time: 14:45


It was agreed that the following items should be added to the Board’s Forward Plan:


Area Inspection of SENDJoint Self-Evaluation.

TCP six monthly update.

Update on Looked After Children.

STP/ACO update

An update on Referral to Treatment delays





16 November 2016


The next meeting of the Board would be on Wednesday 16 November at 1 pm at Havering Town Hall.



To consider whether the public should now be excluded from the remainder of the meeting on the grounds that it is likely that, in view of the nature of the business to be transacted or the nature of the proceedings, if members of the public were present during those items there would be disclosure to them of exempt information within the meaning of paragraph 3 of Schedule 12A to the Local Government Act 1972; and, if it is decided to exclude the public on those grounds, the Committee to resolve accordingly on the motion of the Chairman.


(Meeting close time – 15.00).


It was agreed that the public should be excluded from the remainder of the meeting on the grounds that it was likely that, in view of the nature of the business to be transacted or the nature of the proceedings, if members of the public were present during those items there would be disclosure to them of exempt information within the meaning of paragraph 3 of Schedule 12A to the Local Government Act 1972.




The Board was informed that NHS England had recently advised that draft STPs could now be made publicly available. BN would confirm if there was any consultation or engagement on the STP document currently planned. This also included the ACO work that had been undertaken.


The revised STP document would have the same priorities and BN would seek to share a draft of this with the Board for comment.