Agenda and minutes

For Members of the Board to note any apologies for absence.

Apologies for absence were received from the following:

·         Carolyn Downs (Chief Executive, Brent Council)

Members are invited to declare at this stage of the meeting, the nature and existence of any relevant disclosable pecuniary or personal interests in the items on this agenda and to specify the item(s) to which they relate.

None declared.

To approve the minutes of the previous meeting as a correct record.

RESOLVED: That the minutes of the meeting held on 6 April 2021 be approved as an accurate record of the meeting, subject to ratification at the next quorate Board meeting.

To consider any matters arising from the minutes of the previous meeting.

The Board sought clarification that the STARR service would be transferred as part of the transfer of community services from NWL hospitals to Central London Community Healthcare Trust (CLCH), and would be available to all people with a Brent GP. Jonathan Turner (Borough Lead Director – Brent, NWL CCG) advised that there would be no change in the service specification or who it was offered to and the service would form part of the transfer, continuing to provide services to all registered Brent patients. Janet Lewis (CLCH) added that STARR would continue to operate as it did currently, taking referrals from Imperial College London, Royal Free Hospital and Brent, and that the team would be based at Sudbury Centre for Health and Care instead of Northwick Park. The transfer to the new site would take place the weekend prior to the 1 August 2021 and there would be no disruption to service during the transfer.

This report presents to the Brent Health and Wellbeing Board the Brent Health and Wellbeing Board governance arrangements, the Health and Wellbeing Board work plan and the changed health and care landscape.

Phil Porter (Strategic Director Community Wellbeing, Brent Council) introduced the item relating to the Governance of the Health and Wellbeing Board and wider health system. The item had been discussed at the previous Board meeting, but brought back to Board as there had been significant changes to the governance arrangements, which brought together all key stakeholders to ensure overall accountability. The paper set out this new structure and gave clarity on where partners had built on existing good practice governance, such as the Brent Children’s Trust which would be included in the Integrated Care Partnership (ICP) Executive Board. Phil Porter highlighted that, for adults, the ICP would be where everyone came together to solve problems and have joint accountability, but it would not replace existing governance structures such as Cabinet and the individual governance of each organisation. It was believed the ICP would complement those existing structures, ensuring those groups worked together. The Board were directed to section 3.6 of the report which confirmed the Health and Wellbeing Board would still have a statutory role under the new Health and Social Care Act being introduced, but there was a need to wait to see exactly how that would work as details of the legislation came through. Referring to the priorities laid out in section 3.24, Phil Porter confirmed they were interim to ensure that, as a system, partners were making a difference in the short term, while the long term strategy was in progress.

Robyn Doran (Chief Operating Officer, CNWL and ICP Director) reinforced the comments regarding the structures proposed, explaining the ICP had tried to work with the grain on what was already in Brent. The aim was to work together, with the voice of residents in Brent very much at the core. She advised that there was still more to do working with residents, and Healthwatch was working alongside them on this and would form part of the group. In relation to timescales, Robyn Doran informed the Board that the statutory changes around the Integrated Care System (ICS) would take place in March 2022 and likely evolve again, and in the meantime partners would focus on practical joint work within the current governance structures and with Brent residents.

Gail Tolley (Strategic Director Children and Young People, Brent Council) reinforced the importance of the inclusion of the Brent Children’s Trust on the ICP Executive Board, which she highlighted was a strength in Brent, and thanked ICP colleagues for arranging the inclusion. She pointed out that the inclusion of the Strategic Director for Children’s Services on the ICP Board was not the case in many other areas, in comparison to Brent, where the Trust was automatically a part of the Partnership Board. She felt this showed Brent leading the way in putting children and young people first.

The Chair thanked colleagues for introducing the item, and invited comments and questions from those present, with the following raised:

·         The Board welcomed the involvement of the Brent Children’s Trust in the governance  ...  view the full minutes text for item 5.

To update the Health and Wellbeing Board on the COVID-19vaccination programme.

Jonathan Turner (Borough Lead Director – Brent, NWL CCG) introduced the vaccination programme update, highlighting that the positive working relationship with partners was in place, and he hoped this could be taken forward for other programmes. A weekly meeting took place with all partners involved in delivering the vaccination programme, with very close working between health and social care. Health colleagues had depended on the Council for the logistics and communications of organising the pop-up vaccination clinics and working with the voluntary sector. Jonathan Turner highlighted that the figures within the report presented to the Board were now around a week out of date from when the paper was submitted.

Vaccination had now moved to 18+ groups, in line with national programmes. The biggest challenge in relation to Covid-19 was thought to be the reopening and lifting of restrictions on 19 July 2021, and partners were being pressed to increase the rate of vaccination of people in 18+ ages to be ready for that. Nationally, cases of Covid-19 were rising, so there was a need to vaccinate many people as quickly as possible.

The Board were advised that the programme was focusing on the South of the Borough, as throughout the programme the rates of vaccination in the South of Brent had been lower, and there appeared to be more vaccination hesitancy in some parts of the borough. There was also work being done to host a mass vaccination event at Wembley stadium on 24 July 2021, but that was yet to be confirmed. A big communications push had been done with leaflets, social media campaigns and there was potential for celebrity endorsements.

The Board were informed that further information was coming out from NHS England about phase 3 of the national vaccination programme, where a booster campaign would start in September, most likely delivered by GPs. This would start with the higher risk groups, as the original programme had.

The Chair thanked Jonathan for the introduction and invited comments and questions from those present, with the following issues raised:

Vaccination figures and data:

·         In relation to the vaccination figures from the vaccination bus situated in Church End and Harlesden, the Board queried whether the figure of 44 vaccinations was for one week. Jonathan Turner confirmed it was a weekly figure that showed only vaccinations that had been done on the bus, and highlighted that the system was not dependent on just the bus for vaccinations as there were pop-up clinics, large vaccination sites and mass sites. The bus was only one way of reaching people. He added that to some extent the bus acted as an awareness raising piece.

·         The take-up for under 30s was moving, but Jonathan Turner highlighted there was some hesitancy within that cohort depending on the population. Some young people wanted to be vaccinated so that they could travel or go on holiday, but there was some complacency amongst other young people feeling that they were not affected by Covid-19. There were differing views but  ...  view the full minutes text for item 6.

This report presents the Brent Health and Wellbeing Board an update on the Brent Health Matters programme including additional areas of focus.

Tom Shakespeare (Director of Health and Social Care Integration, Brent Council) introduced the update on the Brent Health Matters Programme, which he explained was the Brent system response to the challenges of health inequalities within the Borough. It had been 9 months in delivery and development, and 6 months since additional funding had been received from central government for the programme. He highlighted the following key points in relation to the update:

· The programme had 5 main strategic aims; to reduce the impact of Covid-19; to increase the uptake of vaccinations and health screenings; to reduce variation in life expectancy for those with long term conditions; to increase community awareness of existing support and services within the community and; to increase engagement with GPs and the number of people with a registered GP. This would be done through listening to communities and working with them to address the main aims.

· The workstreams of the clinical service had focused on improving health assessments and the uptake of particular services such as flu vaccinations, health checks and blood checks. There was a dedicated phone line for Brent residents to call for help and advice, staffed 5 days a week by clinicians within the clinical team. The team had also focused on Covid-19 over the last few months, supporting some of the vaccination pop-ups alongside the community team, community champions and volunteers.

· The community element of the service now had 27 Health and Wellbeing

Community Champions and 7 Community Co-ordinators across the 5 Brent

Connects areas. Page 57 of the agenda pack gave an overview of the £250k grants programme organisations had bid to and the types of impact those grants would deliver.

· The programme had contracted with a consortium of volunteer organisations for the recruitment of a number of health educators across the Borough working as a voice and bringing people towards health services, improving the awareness of health and clinical conditions.

· Communications work had been done around vaccination, including with younger people and there had been positive coverage in the guardian about the work of the Brent Health Matters programme.

· The next phase of the programme was to bring together the work by primary care colleagues on the development of a diabetes model alongside community engagement and health educators to promote those services and tackle those challenges.

· Community co-ordinators were working across the patch with housing associations such as Catalyst, using the Unity Centre to help promote the programme.

The Chair thanked Tom Shakespeare for the update and invited members to comment, with the following issues raised:

·         Dr M C Patel (NWL CCG) advised that, working with Imperial College London, North West London would be looking for the first time to put blood pressure results, glucose levels, BMI, age and ethnicity together to give individual profiles to practices about their patients. The piece of work would be presented in a few days’ time to NWL and could be presented in 3-4 months’ time at the Health and Wellbeing Board. He advised  ...  view the full minutes text for item 7.

This report provides a progress update from the development group on activities so far and notes the emerging interim priorities.

Dr Melanie Smith (Director of Public Health, Brent Council) introduced the update on the progress of the Joint Health and Wellbeing Strategy. She reminded the Board they had previously agreed that, recognising the light Covid-19 had shone on health inequalities and the disproportionate impact of Covid-19 on Brent’s Communities, the Strategy would focus on inequalities. She advised that from that came a focus on the social determinants of health.

The Board heard that, since the last update, work had been done with the assistance of Healthwatch and other community groups to consult with local communities about what they felt was important about their health. The outcome of those conversations had shown that the focus on social determinants of health was what communities expected to see from the Council and NHS. Dr Melanie Smith advised that there were particularly concerns about the impact of the pandemic on young people and people with disabilities. There was a desire from communities for the strategy to recognise the assets, such as community organisations, that existed within Brent and how those assets could be mobilised. Language was also discussed. For example, when the team had spoken about obesity, communities had not spoken to the team about obesity, but instead about the desire to be able to eat healthily, for a healthy diet to be easier and more accessible, and for children to be more physically active.

Dr Melanie Smith drew the Board’s attention to paragraph 3.15 of the report which detailed the areas of focus agreed at the last Board meeting, and 3.17 which described those priorities in a way it was hoped would resonate with communities. The Appendix to the report included some infographics which would form the basis of the next stage of consultation. The next stage involved going back to the communities that had been engaged and expanding the conversation to ensure that what had been heard had been heard correctly, that priorities and actions were being described in a way that resonated, and asking what should be done about those actions by the Council, NHS, individual families and communities.

Councillor Nerva (Lead Member for Public Health, Culture and Leisure) emphasised the need for a strategy which, for the first time, recognised the need to address inequalities to keep people healthy. He added that the document should be seen as integral to the authority’s current strategies such as the Climate Emergency Strategy, the Black Community Action Plan, the Poverty Commission and the overall Borough Plan. The Strategy had been taken through the Community and Wellbeing Scrutiny Committee and a useful member development session, which had raised points around active travel and school streets. Both the Community and Wellbeing Scrutiny Committee and the Resources and Public Realm Scrutiny Committee had done pieces of work that Councillor Nerva felt were useful to benchmark to see how they could be embedded into the strategy, such as the Poverty Task Group, Air Quality Task Group and Access to GP and Primary Care Task Group. On a  ...  view the full minutes text for item 8.

For the Health and Wellbeing Board to note the work plan of the new commissioned service.

Judith Davey (CEO, Healthwatch Brent) introduced the report detailing the Healthwatch workplan. She advised that the period from April to June 2021 had been the mobilisation period for the service and they had worked hard to ensure a smooth and effective handover. The challenges she raised included the need to put in place temporary staff, as well as hire a permanent staff team, and ensuring they had the relevant information on connections and strategic priorities. Despite the challenges during mobilisation, Judith Davey expressed that Healthwatch had a good first quarter and were delivering the service with a robust governance arrangement in place. The grassroots steering group had started, and engagement strategies and prioritisation policies had been developed. Healthwatch had also met with residents, patients and volunteers, gathering local intelligence to take to the advisory group to agree the issues which would be confirmed as priorities for the year’s workplan. She detailed the types of issues identified by Healthwatch through engagement with residents, service users, volunteers and councillors as; safeguarding reporting and working with the head of safeguarding to understand whether certain groups were over or under-represented in safeguarding data; GP access; and access to mental health services for adults and children. It was felt these emerging priorities sat squarely within the priorities of the Health and Wellbeing Strategy. She added that they were grateful to stakeholders for the help and support in getting the new Healthwatch service launched.

Councillors present at the Board meeting welcomed a discussion outside of the Board meeting within their formal Cabinet roles to discuss the workplan.

RESOLVED: To note the progress in implementing the new Healthwatch service, and the development of the draft work plan 2021-22.

Notice of items to be raised under this heading must be given in writing to the Head of Executive and Member Services or his representative before the meeting in accordance with Standing Order 60.

None.