Agenda and minutes

Facilitated workshop

For the first part of the meeting, members of the board took part in a facilitated workshop on dementia.

The board adjourned for 15 minutes and reconvened at 4:00pm to consider the remaining business on the agenda.

Councillor Perrin has stood down as Lead Member for Environment and Councillor Crane has been appointed in his place. The Leader of the Council has appointed Councillor Crane to the Board in place of Councillor Perrin.

Sarah Mansuralli has been nominated to replace Jo Ohlson as a representative of the Brent CCG on the Board.  This appointment will be made by Full Council on 8 December 2014. 

RESOLVED:

that the appointments of Councillor Crane, in place of Councillor Perrin and Sarah Mansuralli, in place of Jo Ohlson be noted.

None declared.

Minutes of 24 July 2014 attached for confirmation.

RESOLVED:-

that the minutes of the previous meeting held on 24 July 2014 be approved as an accurate record of the meeting.

Whole systems integrated care

Phil Porter referred to resolution (i) and reported that the deadline date of 31 October for submission of the Implementation plan had been extended.

The purpose of this report is to update members on the progress made in respect of the health and social care integration in Brent and specifically ‘Better Care Fund’ (BCF) programme.

Phil Porter (Strategic Director, Adult Social Services) introduced the report which updated the board on the progress made in respect of the health and social care integration in Brent and specifically the ‘Better Care Fund’ (BCF) programme.

He emphasised that the focus of the Brent BCF plan was largely unchanged from the previous presentation to the board but with more detail on what was in the schemes making up the plan.  The schemes remained:

·         Scheme 1 – keeping the most vulnerable well in the community,

·         Scheme 2 – avoiding unnecessary hospital admissions,

·         Scheme 3 – efficient multi-agency hospital discharge,

·         Scheme 4 – improving urgent mental health care.

There had been a fifth scheme in the original submission.  This was focused on the key changes to systems, process and culture which would underpin delivery of the other four schemes. These included co-production with service users and carers, required changes in IT, workforce, and learning and development. Due to the changes in the national criteria and reporting these no longer made up a scheme in themselves, instead they had been integrated into the other four schemes

Work now needed to take place over the next 5/6 months to engage with the community, including with Healthwatch, towards implementation.

In response to a question on what was meant by community engagement, Sarah Mansuralli explained that this would concentrate on the user under each of the scheme headings and key was to work to deliver an improved patient experience.

In addressing the issue of receiving an assurance rating of Approval with Conditions the Board recognised that this was partly as a result of a technical error in one of the financial templates which would be straightforward to correct.  Sarah Mansuralli explained that work would now be undertaken to strengthen and refine the BCF plan template in order to move towards a fully approved status.

Councillor Hirani added that the submission process had been frustrating with a series of changes having to be accommodated but he was confident now that it was moving forward in the right direction.

RESOLVED:

(i)         that the Better Care Fund submission be noted, including:

·         the additional detail in the plans for further developing the schemes and delivery,

·         the revised mental health scheme included in the plan,

·         the approach to implementation and in particular, the planned programme management office involvement, the importance of service user and carer co-production and ongoing governance and oversight;

(ii)        that the assurance letter from NHS England, attached to the report submitted,  be noted.

The attached report considers the health of the people in Brent. It outlines the major causes of mortality and morbidity as well as describing health related behaviours in Brent. It contains a number of examples of how the Council and local people are responding to the health challenges in the borough.

Dr Melanie Smith (Director of Public Health) introduced the report by saying that it had been kept deliberately brief in order that people could retain the main areas it covered which needed leadership and where measurable outcomes could be achieved.

In answer to questions asked, Melanie Smith explained that child obesity rates rose between reception year and year 6 as children continued to eat too much and not get enough exercise; a situation not confined to Brent.  Whilst pleased to report that 38 schools had signed up to the Brent Healthy Schools programme, she hoped more schools would do so.  Gail Tolley (Strategic Director, Children and Young People) stated that this was an issue that had already been identified for discussion with schools and she felt many schools were doing good work in this area but had not necessarily signed up to the programme.

Dr Madhukar Patel welcomed the report as a useful working document for GPs and for outlining how joint working at different levels could tackle the issues identified.

RESOLVED:

that the Annual Report of the Director of Public Health be noted in advance of its publication.

This refresh of Brent’s JSNA provides a detailed analysis of the existing and projected health needs of the local population with the overall aim being to provide the intelligence to inform action to improve outcomes for Brent communities and residents.

Dr Melanie Smith (Director of Public Health) introduced the report which attached the Brent Joint Strategic Needs Assessment (JSNA) 2014 highlight summary report.

Sarah Mansuralli pointed out that the CCG was using the JSNA throughout the development of its commissioning role.  Melanie Smith undertook to get back to Councillor Warren who drew attention to the estimate of 37% of the Brent population who were achieving the target of eating 5 portions of fruit and vegetables a day and asked what the national average was.

Anne O’Neill expressed concern over the absence of reference to people with disabilities and also mental health concerns in the list of information sheets.  Melanie Smith responded that she hoped to see a strengthened focus on these two areas following ongoing work.

RESOLVED:

that the Joint Strategic Needs Assessment be approved prior to publication and dissemination.

The Board is presented with the Action Plan from the Tackling Violence against Women and Girls in Brent Task Group. 

Melanie Smith (Director of Public Health) introduced the report on behalf of Ben Spinks, Assistant Chief Executive who had led the development of the action plan.  Between March 2013 and March 2014, a scrutiny task group was convened to examine the issues of violence against women and girls in Brent, focusing on the issues of Female Genital Mutilation (FGM), Honour Based Violence (HBV) and Forced Marriages (FM).  The report identified a recommendation of the task group which was partly the responsibility of the Health and Wellbeing Board.  Consequently an action plan had been drafted by a wide range of partners which was now before the board for approval.

The Chair stated that members of the Council had received a full briefing on the work of the scrutiny task group and suggested that the board be updated on progress in 6 months time.  It was agreed that the report back should be co-ordinated with a report back from the Children Safeguarding Board.

RESOLVED:

(i)   that the Tackling Violence against Women and Girls in Brent action plan attached to the report submitted be agreed for implementation;

(ii)  that a joint report be submitted to the Children Safeguarding Board and the Health and Wellbeing Board in 6 months time detailing progress on implementing the action plan.

The report outlines responsibilities for responding to consultation requests from neighbouring boroughs.  The Board are asked to consider amendments to the PNA Steering Group terms of reference.

The report submitted proposed an amendment to the Pharmaceutical Needs Assessment (PNA) steering group terms of reference.

RESOLVED:

that the PNA steering group be delegated the task of reviewing PNAs from neighbouring boroughs on behalf of the Health and Wellbeing Board and responding to consultation as required, as detailed in the revisions to the terms of reference for the PNA steering group attached as appendix 1 to the report submitted.

The Board are asked to agree future topics from a draft forward plan to follow.

A draft forward plan for topics to form the basis of workshops at future meetings of the Health and Wellbeing Board was tabled at the meeting. 

It was agreed that the topic on children centres/early years should be revised to be called ‘healthy under fives’.  Dr Melanie Smith (Director of Public Health) emphasised the importance of childhood immunisation to the health and wellbeing of 0 -5 year olds and expressed the hope that those in NHSE responsible for commissioning these services would be able to participate in the event to be planned. Gail Tolley (Strategic Director, Children and Young People) suggested that the currently dormant Children’s Trust be revised and tasked to deal with the issues affecting the health of children on behalf of the board.

Councillor Warren requested that the topic of obesity be timetabled in the plan. 

It was acknowledged that the board’s forward plan would need to take into account the themes running under the Health Partners Forum.

Given the number of issues facing the board it was felt that it would need to meet more than the currently programmed four times a year. 

RESOLVED:

(i)         that the meeting of the Health and Wellbeing Board scheduled for 23 April be moved to a date in March 2015 and that the first meeting of the board in the new municipal year 2015/16 be held in late May;

(ii)        that six meetings of the board be programmed for 2015/16;

(iii)       that subject to the comments made above at the meeting, the board’s forward plan be agreed.

It was reported to the Board that Sarah Mansuralli wished to inform the Board that the independent review of Brent CCG’s arrangements for meeting its statutory duties on equality, diversity and engagement would be made public on 19 November 2014.