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.

Councillor Brice-Thompson

Start time: 13:00

The Chairman gave dcetails of the arrangements in case of fire or other event that might require theevacuation of the building.

-       receive.

Apologies for absence were received from Matthew Hopkins, BHRUT (Piers Young substituting) Jacqui van Rossum. NELFT (Carol White substituting) and from Conor Burke, BHR CCGs.

Apologies were also received from Philippa Brent-Isherwood, London Borough of Havering.

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.

Councillor Gillian Ford disclosed a personal interest in item 17 (update on integrated care partnership (previously ACO) locality boundaries and STP) due to a family relationship with a presenter of the item.

To approve as a correct record the notes (attached) of the inquorate meeting of the Board held on 16 November 2016.

Councillor Brice-Thompson

Start time: 13:05

The notes of the inquorate meeting of the Board held on 10 November 2016 were agreed as a correct record.

NOTE: Due to the meeting of 16 November 2016, items 5 - 13 are resubmitted from that meeting in order to take any comments in addition to those shown in the notes of the meeting.

Please could members bring with them the agenda papers from the 16 November meeting.

Cllr Brice-Thompson

13:05

Note: Due to the previous meeting of the Board held on 16 November 2016, being inquorate, agenda items 5-13 were resubmitted in order to take any comments in addition to those shown in the notes of the meeting. The notes of the inquorate meeting are appended to these minutes for information.

The Board made no further comments on the draft Health and Wellbeing Strategy as this was being considered later in the agenda.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

The Board made no further comments on this issue other than those shown in the notes of the previous meeting.

Report attached.

Anthony Clements

Start time: 13:30.

The Board considered a report which recommended a slight amendment to the Board’s terms of reference in order that named substitutes for Board members be allowed at Board meetings. Named substitutes would also have voting rights.

The report was agreed without division and it was resolved:

1. That the Health and Wellbeing Board agree that named substitutes be permitted for members in the event members are unable to attend meetings of the Board. These substitute members to have voting rights on issues where a vote is required.

2. That the following wording is added to the ‘Reporting and Governance’ section of the Board’s Terms of Reference:

·           Named substitutes for Health and Wellbeing Board Members are permitted if advised prior to the start of a meeting. Named substitute members will have voting rights.

Report attached.

Oge Chesa/Susan Milner

13:35

 A representative of Barking & Dagenham, Havering and Redbridge Clinical Commissioning Groups (BHR CCGs) advised the Board that a Pharmacy Intervention Fund had been announced by NHS England in October 2016. This would allow NHS 111 to contract pharmacists to whom people could be referred for the administration of urgent repeat prescriptions. This would run on a pilot basis until April 2018. Pharmacists would also be trained to carry out enhanced services within care homes.

There were no pilots running currently in Havering and so there were unlikely to be any changes to local pharmacy services until 2018. More details on the care home elements were expected to be released later in 2017. A written summary of which Havering pharmacists could currently take referrals from NHS 111 could be provided to the Board.

Officers from Havering CCG added that a new NHS 111 service was in the process of being procured and this would divert people to pharmacists if they simply required a repeat prescription. A small number of local GP practices already employed pharmacists and the CCG also ran a programme to train pharmacists in chronic disease management such as Chronic Obstructive Pulmonary Disease.

The Board noted the position.

Report to follow.

Susan Milner

13:50

The Interim Director of Public Health advised that feedback from the Board had been taken into account in the mid-period refresh of the strategy. Members of the Board were invited to select performance indicators that could be put into a dashboard that would be brought regularly to the Board. It was planned to bring a dashboard to the Board in May 2017. The redraft of the strategy for the next period would commence in autumn 2017.

It would also be necessary to consider the governance structure of the Board and how this related to developments across North East London. Board members were therefore invited to submit any comments on the Board’s governance and which other groups reported into the Board. It was confirmed that the Chairs of local Health and Wellbeing Boards did meet as part of a wider group but it had been decided not to formally combine local Health and Wellbeing Boards.

The Board approved the refreshed Health and Wellbeing Strategy.

Report attached.

Alan Steward/Barbara Nicholls/Ade Abitoye/Ian Tompkins

14:10

A representative of the Sustainability and Transformation Plan (STP) team confirmed that a more simple and transparent narrative explaining the proposals was in the process of being developed. A meeting of communications leads from all organisations involved with the STP (including the Council) had been arranged for 26 January. A memorandum of understanding re STP governance had also been circulated. The STP had started working on establishing a community council and had also developed linkages with the Healthwatch organisations. A political leadership group was also being considered.

The Director of Communications and Engagement indicated he would like to attend the Board regularly and was also happy for his contact details to be circulated to the Board.

It was hoped that governance arrangements for the STP would be confirmed by April 2017 and that the focus would be on partnership working and local control from partner bodies. The STP was linked to the procurement of NHS 111 services across North East London and work was also in progress with the London Ambulance Service.

Councillor Ramsey felt that there may not be enough governance involvement from Councils with for example only one Local Authority representative on the STP Board. A Leader’s Committee had been suggested but Councillor Ramsey felt that there was less understanding of the STP amongst Leaders of Boroughs not involved in the Integrated Care Partnership (ICP) work. The STP representative noted these concerns.

It was accepted that more detail was needed in the STP documents of work in the non-ICP areas covered by the plans. The Council Chief Executive felt there were some common themes across all the ICP boroughs but that Havering was further ahead in a number of areas. A report on STP governance would be brought to the next meeting of the Board.

The Healthwatch Chair added that local residents wished to be certain that people running services would still be in control of these under the STP. It was also felt that changes of names such as the ICP were confusing for members of the public. It was also accepted that the branding of the STP needed more work and that stronger linkages should be established with areas such as Essex, Epping Forest and the City of London.

The Board of the Integrated Care Partnership was chaired by the Cabinet Member for Health in Barking & Dagenham. Councillor Brice-Thompson also attended these meetings and a representative of Healthwatch was also present. The locality boundaries had been drafted and the Health and Wellbeing Board would be invited to agree these at a future meeting. Priorities for the locality areas included children’s health & social care and urgent & emergency care. The benefits and challenges of each locality area were currently being investigated and it was hoped challenges could be solved at the locality level where possible. Progress in Havering would be reported on at the next ICP board meeting.

An Integrated Commissioning Board had been established and the Transforming Care Partnership Board could be used to test out joint  ...  view the full minutes text for item 16.

Attached.

Carol White/Russell Razzaque.

14:35

 The Associate Medical Director of NELFT explained that the Open Dialogue method of mental health care saw service users with their network of family or friends rather than just individually. The technique had originated in Finland and had resulted in a 72% discharge rate from mental health services after two years and good outcomes had also been seen when the technique was introduced in the USA.

NELFT had organised the first training in the UK for Open Dialogue and it was aimed to launch a pilot of the treatment in late 2017. An academic board had been formed with University College London and Kings College and a bid had been submitted for £2.4 million of funding for a trial of Open Dialogue. It was hoped to announce in March if this funding had been received. Trial areas for the technique would be in Havering and Waltham Forest.

The Open Dialogue model could be used to deliver other types of care such as Cognitive Behavioural Therapy. The trial of the service would focus on adults in the 18-65 age range although it was possible Open Dialogue could be applied to mental health services for younger people in the future.

The technique was patient centred and no negative feedback had been received from service users. It was accepted that there was a link between Open Dialogue and physical healthcare and that this area needed to be explored more in the future. It was noted that there were also linkages between Open Dialogue and the training in systemic family therapy that the Council’s social workers were currently undertaking.

Attached.

Mark Ansell

15:00

The Board was advised that Havering performed at an average or better level for most sexual health services although abortion rates were relatively high. HIV rates for Havering had also increased slightly.

The redesign of Havering’s sexual health services was now live and the London e-Service would start in May 2017. This would allow residents to order self-sampling kits to their homes. Inner North East London boroughs were looking to procure a new site for their services in the Stratford area which was likely to be more accessible for some Havering residents.

The ICP approach could lead to a change in the family planning  pathway at locality level and it was planned to procure new contracts for the BHR area for sexual health by October 2018.

. There were no figures available for abortion rates at borough level and this would need to be looked at on a wider level. All abortions were carried out, by law, on health grounds so it was not possible to produce information on more detailed reasons for abortions. Sexual health services were also provided anonymously so there was no data on for example what proportion of Looked After Children were accessing services.

It was confirmed that Havering’s family planning spokes had closed last year following a consultation. Family planning services were however still available at Queen’s Hospital or via GPs. The GUM service had moved from Queen’s to Barking Hospital. The morning after pill and long acting reversible contraception was still commissioned from GPs. It was confirmed that all existing clients had been advised where new services would be provided from and the e-service would offer a further option, once this commenced.

Pharmacists were not able to prescribe the contraceptive pill in Havering and the Director of Public Health added that 80% of Havering women accessed contraception via their GP. The Havering CCG Chair added however that there were capacity issues re this as there may not be not enough GPs to provide contraceptive services. It was felt that this was an issue that the ICP could look at.

The Board noted the report.

Alan Steward/Matthew Hopkins

15:20

The Deputy Chief Operating Officer of BHRUT reminded the Board that the Trust had suspended reporting figures on referral to treatment waits in September 2014. Havering CCG had supported BHRUT in its recovery of the long waiting times for patients to receive treatment. BHRUT had also worked closely with the local CCGs on validation of data around this issue.

Nineteen new consultant posts had been funded, with most now filled, which would increase BHRUT’s capacity to treat patients. In addition, some 17,500 patients had been diverted for treatment elsewhere as part of a wider demand management scheme. Reviews were also carried out on patients who had been waiting a long time for treatment.

Some 76.3% of BHRUT patients were now being treated within 18 weeks. This was below the target of 92% but ahead of the Trust’s trajectory at this point. Referral to treatment was now subject to a robust governance framework with regular meetings between BHRUT and the local CCGs. It was felt that the Trust had made significant steps forward towards delivering a consistent standard for patients on this issue.

The Chair of Healthwatch Havering congratulated BHRUT on the progress it had made and valued the Trust’s openness on this matter.

Attached.

Susan Milner.

The Board noted the contents of a letter received from the Home Office concerning the benefits to be realised through closer collaboration between policing and health partners.

Attached.

Susan Milner.

The Board noted the contents of a letter from the Department of Health concerning the General Practice Forward View and the relationship that primary care had with the delivery of local health and wellbeing strategies.

To be tabled.

Susan Milner.

15:25

It was noted that dates for meetings of the Board in the next municipal year were hoped to be announced in March 2017 and efforts would be made to avoid clashes with other meetings, as far as these were known.

It was agreed that the item on the Transforming Care Partnership would be moved to the May 2017 meeting of the Board, It was also suggested that a discussion on financial recovery and budget issues should be held, in private session, at the May meeting.

The Board noted with concern that Havering was not getting any extra funding under the needs assessment, despite the population of Havering being expected to rise to 270,000 by 2026. The Leader of the Council felt it was essential that health provision was factored into population growth.

The Forward Plan for the Board is attached to the minutes for information.

15 March 2016.

The next meeting of the Board would be held on 15 March 2017 at 1 pm at Havering Town Hall.