Agenda and minutes

None declared.

RESOLVED:-

That the minutes of the previous meeting held on 3 July 2013 be approved as an accurate record of the meeting.

Item 4, Matters arising

It was confirmed that the adequate Ofsted rating referred to a joint inspection of LAC and safeguarding.

Item 5, Health and Wellbeing Board Governance

The Chair informed the Board that a report would be received by Full Council in two weeks time to confirm the governance arrangements of the Board.  The report intended to recommend all members of the Board being allocated voting rights except Council officers.

Item 9, Shaping a Healthier Future, - Implementation Update

Rob Larkman informed the Board that the Secretary of State for Health had confirmed his support for the Independent Reconfiguration Panel’s recommendations on Shaping a Healthier Future. Work was still to be done to confirm the services retained at Ealing and Charing Cross Hospitals. Changes at Central Middlesex Hospital, such as the closure of A&E, would take place as soon as it was safe to proceed. 

The Health and Wellbeing Board held a development session on 11^th September, where it was agreed that the Health and Wellbeing Strategy needed amending if it was to accurately set out the ambitions for the Health and Wellbeing Board. This work has started and this report updates the Board on the progress made since the development event.

Andrew Davies, Policy and Performance Officer explained following the development session held in September 2013 the Board had agreed that the Health and Wellbeing Strategy needed a refresh.  The report asked the Board to confirm the principles for the Strategy, objectives for each priority, a RAG rating for each objective and to task officers with preparing a final Health and Wellbeing Strategy with an action plan for the next meeting.  In response to agreeing the principles, the Board queried how they would be delivered and how it linked to the CCG clinical commissioning intentions.  It was clarified that the objectives within each priority would enable the delivery of each principle, with an action plan being developed to facilitate delivery.  Rob Larkman explained that similar principles underpinned the CCGs clinical commissioning intentions and it was intended that they would fit together to support wider health ambitions.  Members of the Board queried the term ‘single point of access’ highlighting that terminology needed to be meaningful to residents and it was agreed that a form of wording would be developed. 

Andrew Davies drew the Board’s attention to the rationale behind the RAG rating, highlighting that a red action did not necessarily mean that no work had been undertaken or that a service was failing in some way.  .  Sara Williams explained that parenting programmes were currently being evaluated and the RAG rating and should be set at amber with further work to be undertaken.  The Policy and Performance Officer acknowledged there were gaps in relation to the current position and that further information would be required for the action plan to ensure that actions carried out would add value.  The Board noted concerns regarding poor dental health in children as well as obesity in children and noted the need to work collaboratively on an education programme to address issues proactively. 

Andrew Davies highlighted the removal of objectives in priority two surrounding employment and housing however on reflection felt that the objective regarding employment should be made specific and achievable.  Councillor Hirani felt that the objective concerning housing should remain, but focus on issues such as energy solutions and minor adaptations to improve health.  It was noted that any work in relation to housing would need to be consistent with the housing strategy.

The Board noted the changes to priority three, endorsing the focus on tobacco control and were pleased to learn a declaration had been signed by Brent Council confirming its commitment to tobacco control   The Policy and Performance Officer drew the Board’s attention to changes within priority four and noted that the New Economic Foundation approach to good mental health had not yet been adopted  although Bristol City Council had undertaken the approach successfully.  The approach looked at reframing activities rather than commissioning new services to improve mental wellbeing.  The Board provided information relating to each objective including issues surrounding dual diagnosis, gaps in services and the requirement for a joined up approach to meet individuals various needs.  Concern was expressed regarding  ...  view the full minutes text for item 4.

This paper sets out a broad plan for the Board’s time up to and beyond April 2014.

Andrew Davies, Policy and Performance Officer echoed the intentions of the Board following the development session to be an interactive Board, working proactively and productively around set themes.  It was felt that this would be best achieved through an informal setting although it was recognised that some aspects of the Board’s statutory duties would required a formal meeting.

RESOLVED:

That an informal meeting approach be undertaken where appropriate.

Brent Clinical Commissioning Group has been preparing its commissioning intentions for 2014/15. It has a duty to involve the Health and Wellbeing Board in this work, for the Board to comment and give its views on the proposals.

Rob Larkman, Chief Executive CCG, informed the Board of the work that had been undertaken to date and the future timetable of the CCG’s clinical commissioning intentions.  He noted that the principles underpinning the intentions were similar to those in the Health and Wellbeing Strategy and intended to improve preventative services, working with partners to reduce inappropriate A&E attendance.  Rob Larkman continued to explain that there would be numerous challenges such as meeting an increasing demand with lower resources, meeting and exceeding performance standards such as the 18 week referral to treatment targets as well as the impending merger of acute and community care providers.  Additionally the demographics of Brent were highlighted as a challenging factor due to the high levels of deprivation as well as a high level of young and elderly persons living in the borough.  Rob Larkman drew the Board’s attention to the QIPP requirements whilst commissioning and highlighted that although the CCG were currently in a stable financial position, it was anticipated that annual savings of 4% would be required to meet changes in funding. 

In response to queries regarding the level of consultation and discussion with patients on the commissioning intentions, Rob Larkman explained that in principle it was articulated within the document although recognised it needed to be made explicitly clear. 

Rob Larkman drew the Board’s attention to the various areas that required commissioning including; acute care, community health services, mental health, children’s services and developing primary care.  He continued to explain the intention to improve each pathway of care with the hope to reduce unnecessary emergency admissions and to ensure that the appropriate care was received in a community setting.  It was hoped that the commissioning of urgent services would help deliver the CareUK model as well as improving the 18 week target and improve integration of care to provide a seamless service. 

During discussion, the rationale behind the commissioning intentions was queried.  Rob Larkman explained that although financial challenges were a factor in the decision to commission services, service improvement was the main driver behind plans for new services. .  It was noted that there were few savings that could be achieved through realigning back office support, with services being commissioned through balancing QIPP and ensuring quality for patients.  The Board queried the level of joined up working and whether opportunities to offer support in numerous venues such as children centres were being explored.  Rob Larkman acknowledged that a greater integrated approach was required to release efficiencies and to avoid duplication of resources.  The Board queried whether the extension of GP hour’s pilot had been commissioned.  It was clarified that it had been on a pilot basis from practices in each of the five locality areas. Some were already operating extended hours, whilst others would be starting soon.

In response to queries regarding the need to re-commission Local Enhance Services, the CCG explained that the LES contract could not be used from April 2014 and so the CCG was required to  ...  view the full minutes text for item 6.

None.