Agenda and minutes

The for the first part of the meeting, members of the board took part in a facilitated workshop on improving mental wellbeing throughout life. In addition to the board members, the workshop was attended by a further 53 individuals including representatives of a variety of related organisations.

The board then briefly adjourned and reconvened at 8.25pm to consider the remaining business on the agenda.

None declared.

The minutes of the previous meeting were not available at the time of publishing and will be circulated separately prior to the meeting.

RESOLVED:-

that the minutes of the previous meeting held on 22 January 2015 be approved as an accurate record of the meeting.

Phil Porter (Strategic Director Adults) provided an update to the board regarding the opportunity to place a bid for the Health and Wellbeing Board (HWB) to work with the Leadership Centre for Local Government. He advised that he and Sarah Mansuralli (Deputy Chief Operating Officer, Clinical Commissioning Group) were in early discussions regarding the proposal. It was intended that two additional meetings of the HWB would be scheduled to review the board’s current ways of working and explore examples of good practice.

A verbal update will be presented to the Board on the outcomes from the Brent Dementia Action Alliance workshop and Brent Children’s Trust workshop.

Danny Maher (Chair, Community Action on Dementia – Brent (CAD-Brent)) provided an update to the meeting on the progress achieved regarding the development of CAD–Brent, following the related workshop held at the meeting of the Health and Wellbeing Board in November 2014. Members of the board were reminded that CAD–Brent had been established to challenge and empower people from local communities, businesses, voluntary sector organisations and the council to support people with dementia; it would act as a central point for information and support and was not intended to be a service provider. 

Outlining some of the successes achieved, Danny Maher reported that CAD–Brent was now a registered charity and this broadened the range of funding opportunities available to the organisation. Work had begun to link CAD–Brent to local business networks, with an initial meeting resulting in a local business agreeing to design a logo for the organisation free of charge. One aim of working with local businesses was to help people with dementia have positive shopping experiences by championing measures such as slow payment lanes and staff awareness training. Ethnographic research was shortly due to commence and this would encompass the training of twenty people in ethnographic research techniques. These individuals would be representative of Brent’s diverse community and would be a valuable resource, enabling additional research to be conducted in Brent’s BAME and faith communities. It was acknowledged that issues of awareness and willingness to talk about dementia could affect support offered to those with the condition in some BAME or faith communities. Attendance at a recent meeting of the Multi Faith Forum had resulted in some very positive outcomes including the intention to develop dementia champions across faith groups.

Danny Maher further advised that CAD-Brent was now represented on the Brent Clinical Commissioning Group Dementia Steering Group. This group took a primarily clinical view of supporting people with dementia and for this reason, CAD-Brent’s efforts to highlight the importance of the community perspective in this work had been well received. CAD-Brent was also working with Brent Council’s Geographical Information System to plot incidences of diagnoses of dementia against service provision to identify areas of need. Moving forward it was intended to obtain funding to support a CAD-Brent Development worker to further assist the charity in achieving its aims.

The board discussed the progress achieved in the development of CAD-Brent and thanked Danny Maher for his contribution to the meeting.  Danny Maher noted the importance of the role of the HWB in the achievements made. Fiona Kivett (Senior Policy Officer, Brent Council) advised that a letter providing an update on some of the key projects underway had been sent to those who had attended the original workshop; CAD-Brent would facilitate further feedback. Dr Ethie Kong (Chair, Brent Clinical Commissioning Group) noted that the CCG had undertaken significant data cleansing, as a result of which the prevalence of dementia diagnoses had increased, and suggested that this information could be used to assist with identifying hotspots of service need.

Gail  ...  view the full minutes text for item 4.

The Health and Social Care Act 2012 conferred the duty for publishing and keeping up to date a statement of the population needs for pharmaceutical services in their area, referred to as a Pharmaceutical Needs Assessment (PNA), onto Health and Wellbeing Boards (HWBs). This paper proposes a process for keeping the PNA up to date and determining if a revision of the PNA is needed within the next three years.

Dr Melanie Smith (Director of Public Health, Brent Council) introduced a report to the committee regarding the duty held by Health and Wellbeing Boards (HWBs) to publish and keep up to date a statement of the population needs for pharmaceutical services, known as the Pharmaceutical Needs Assessment (PNA). Brent HWB had previously established a PNA Steering Group, to which authority had been delegated to conduct, consult on and publish a revised Brent PNA. The HWB has also delegated to the PNA Steering Group the task of reviewing PNAs from neighbouring boroughs and responding to consultation as required.

Updating the Board on the progress achieved by the PNA Steering Group, Dr Melanie Smith advised that a draft PNA had been published and consulted on, with the final PNA due to be published to Brent Council’s website before 1 April 2015. The board’s attention was then drawn to the requirement for HWBs to produce a statement of its revised assessment within three years of publishing a PNA, or sooner should the HWB determine there has been a significant change in pharmaceutical needs in the area. Dr Melanie Smith advised that the proposed process for keeping the PNA up to date was set out in the report for board members’ consideration.

RESOLVED:

    (i)        That the publication of a draft Brent Pharmaceutical Needs Assessment be noted;

  (ii)        That the consultation held on the draft Brent Pharmaceutical Needs Assessment be noted;

 (iii)        That the role of NHS England, the Clinical Commissioning Group and Brent Council in maintaining the Pharmaceutical Needs Assessment be noted;

 (iv)        That the process for the keeping the Brent Pharmaceutical Needs Assessment up to date, as set out in the report from the Director of Public Health, be agreed;

  (v)        That authority be delegated to the Director of Public Health, or the Director of Public Health’s nominee, to decide  whether a revision of the Pharmaceutical Needs Assessment is required.

 (vi)        That authority be delegated to the Director of Public Health, or the Director of Public Health’s nominee, to publish Supplementary Statements to the Pharmaceutical Needs Assessment.

This paper serves to update Brent HWBB on developments in primary care co-commissioning in North West (NW) London up to the end of February 2015, plus next steps for March to April and beyond. Furthermore, this paper is intended to initiate and progress conversations between Brent HWBB and Brent Clinical Commissioning Group on the future role of the HWBB in primary care co-commissioning, to ensure a timely and transparent dialogue as decisions are made about whether to enter into formal co-commissioning arrangements from April 2015.

Rob Larkman (Chief Officer, Brent, Harrow and Hillingdon Clinical Commissioning Group) introduced a report on primary care commissioning in North West London (NWL). It was explained that NHS England currently held sole responsibility for primary care commissioning but had invited CCGs to submit expressions of interest in assuming a heightened role. NHS England had published proposals detailing three potential models for primary care co-commissioning with CCGs; greater involvement, joint commissioning and delegated commissioning. Brent CCG had initially pursued the option of delegated commissioning; however, having identified issues that required further consideration, the NWL CCG Chairs jointly with NHS England (London Region) local area team had deferred the application in favour of a joint co-commissioning arrangement for 2015/16. It was emphasised that, as member led organisations, CCGs would be required to seek the support of their constituent member practices with regard to any decisions to enter into primary care co-commissioning arrangements. 

Dr Chris Cotton (NWL CCGs) explained that the proposed joint commissioning of primary care services in Brent would be conducted via a joint committee between Brent CCG and NHS England. In order to align services across NWL, it was intended that all NWL joint committees would meet in common; this would allow discussions to encompass issues of importance across NWL but ensure that each CCG made an individual decision with NHS England for its respective area. It was intended that the new co-commissioning arrangements would enable Brent CCG to shape primary care in Brent in line with local strategies for integrated and coordinated care. A new contractual offer for General Practice would be pursued to create a foundation for a new model of primary care in Brent; this enhanced role for General Practice would be supported by influencing necessary investment in primary care estates.

In the subsequent discussion, the board sought further details regarding the proposed arrangements for ensuring HWBs and Healthwatch groups were appropriately represented at the joint committee with NHS England. Further queries were raised regarding the frequency of the joint committee meetings, the publication of work programmes and when the views of the Brent CCG members would be known.

Dr Chris Cotton advised that statutory guidance permitted each HWB and Healthwatch to nominate a representative to attend meetings of the joint committee as a non-voting observer. As there was a potential eight CCGs across NWL who could engage in the joint commissioning arrangements, this could result in there being a total of sixteen HWB and Healthwatch representatives. It was currently proposed that this group nominate two of its number to attend meetings of the joint committee; it had been suggested that the nominations comprise one representative for Inner London and one for Outer London.  Rob Larkman confirmed that the joint committee would meet monthly and would publish a forward work programme. The views of Brent’s CCG members would be known by 31 March 2015.

During discussion, members of the board emphasised that Brent was demographically very different from neighbouring boroughs; it was therefore essential that there be  ...  view the full minutes text for item 6.

This report provides an update on progress with the Better Care Fund since the last Health and Wellbeing Board.  It notes the final assurance letter from NHS England at the end of January, outlines the approach and timescales for implementation planning, and sets out proposals for a revised governance structure which has a clear focus on accountability for delivery.

Sarah Mansuralli (Chief Operating Officer, Brent Clinical Commissioning Group) presented an update report regarding the Better Care Fund. Members of the board were asked to note the assurance letter received from NHS England subsequent to the Nationally Consistent Assurance Review (NCAR) process and approve proposed revised governance arrangements for implementation.

Drawing the board’s attention the report, Sarah Mansuralli advised that the Better Care Fund plan, a national programme for health and social care integration, had been reviewed in the summer of 2014 and this had lead to the need to revise and re-submit the Brent Better Care Fund plan in September 2014. This had been followed by a regional and national assurance process with the draft assurance letter presented to the HWB in November 2014. Following continued work on the assurance process, the final assurance letter, attached at appendix 1 to the report, had been issued on 23 January 2015. Sarah Mansuralli further explained that the vision for health and social care integration had not changed significantly since the last update to the HWB and still focussed on four key themes which aimed to reduce dependency on acute hospital care and clinical care. Each of the themes required significant transformation to service delivery and would be underpinned by a new governance structure which would oversee the delivery, management and implementation of the Better Care Fund programme in Brent.

Phil Porter (Director of Adult Social Care, Brent Council) explained that the new governance structure, set out at appendix 2, was designed to clarify responsibility and accountability across the health and social care system and provide clear channels of stakeholder engagement. Members of the board were advised of the membership of the BCF Exec Group and were directed to appendix 3 of the report which detailed the proposed terms of reference for BCF Implementation Board.

RESOLVED:

    (i)        That the assurance letter received from NHS England subsequent to the Nationally Consistent Assurance Review process be noted;

That the revised governance arrangements for implementation as detailed in the report from the Chief Operating Officer, Brent Clinical Commissioning Group and the Strategic Director, Adults, Brent Council, be  approved.

The board noted that the next meeting was scheduled for 2 June 2015 and the subject of the workshop would be social isolation.

None.