Agenda and minutes

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

Apologies for absence were received from:

(i)         Councillor McLennan with Councillor Farah substituting on her behalf;

(ii)        Dr Ethie Kong (Vice Chair of the Health and Wellbeing Board; Co-Clinical Director, Brent Clinical Commissioning Group) with Sheikh Auladin attending on her behalf;

(iii)       Phil Porter (Strategic Director, Community Wellbeing, Brent Council), with Helen Woodland (Operational Director, Social Care, Brent Council) attending on his behalf; and

(iv)       Rob Larkman (Chief Officer, Brent, Harrow and Hillingdon Clinical Commissioning Groups).

Members are invited to declare at this stage of the meeting, any relevant personal and prejudicial interests and discloseable pecuniary interests in any matter to be considered at this meeting.

There were no declarations of interest from Members.

To approve the attached minutes of the previous meeting on 28 March 2017 as a correct record.

It was RESOLVED that the minutes of the previous meeting held on 28 March 2017 be approved as an accurate record of the meeting.

To address any matters arising from the minutes.

There were no matters arising.

The purpose of this report is to provide the Health and Wellbeing Board (HWB) with a further update on the progress of the delivery of the Brent Health and Care Plan following the first update report in January 2017.

Helen Woodland (the Council’s Operational Director, Social Care) introduced the report which provided the Health and Wellbeing Board with a progress update on the delivery of the Brent Health and Care Plan. She ran through the detail of what underpinned the delivery of the plan, including: the governance arrangements; the ongoing systems development work; and the need for effective systems leadership across both health and social care organisations. She directed Members’ attention to the leadership and change management programmes which had been commissioned under the Change Academy umbrella (paragraph 3.9 of the report) and noted that Professor Rebecca Malby (London Southbank University) had been leading on these. The Board heard that two other change management programmes had also been applied to in order to assist delivery of the plan. She concluded by offering some brief updates on the progress of each of the six big ticket items, as specified within the report.

Dr Melanie Smith commented that it was positive that Brent’s localised plan was making progress under the wider NWL STP umbrella. She noted that there had been a clear alignment at both the local and regional level in particular on prevention of alcohol related A&E admissions and that Brent had been leading on a pilot with London North West Healthcare aimed specifically at reducing this type of admission.

It was RESOLVED that the progress report on the delivery of the Brent Health and Care Plan be noted.

The purpose of this report is to provide the Health and Wellbeing Board

(HWB) with an update on progress on the Older People’s Acute Liaison

Service (OPALS) business case for Northwick Park Hospital.

This is one component of the Unified Frailty Pathway and part of Delivery

Area (DA) 3 - the Older People’s services workstream of the Northwest

London Sustainability and Transformation Plan (NWL STP). It also forms a

key workstream of the Brent Health and Care Plan (the Brent Plan).

Helen Woodland introduced the report which provided Members with an update on the United Frailty Pathway and progress on the Older People’s Acute Liaison Service (OPALS) business case for Northwick Park Hospital, which had been discussed at the last meeting of the Board. She noted that this formed part of the extensive ‘Older People’s Services’ work stream within Brent’s Health and Care Plan.

James Walters (Divisional General Manager, London North West Healthcare NHS Trust) explained that the first part of the report detailed the systems approach to preventing unnecessary admissions and maintaining care outside of the hospital setting. He noted that admissions numbers had been rising for older age groups and that frailty often exacerbated existing health conditions, which in turn had the unwanted consequence of seeing people stay in hospital for longer periods. The Board heard that the aim of OPALS was to provide a model of care which sought to address frail patients once they had entered the emergency department in order to substantially reduce any potential length of stay in hospital. Mr Walters mentioned how OPALS linked with the Short-Term Assessment Rehabilitation and Reablement Service (STARRS) programme once the patient had been moved to a community setting. He concluded by detailing the proposals within the business case and the potential for significant savings if the patient had a reduced length of stay in an acute setting.  

Members asked for clarification on the proposed timeline for putting OPALS into operation. Helen Woodland outlined that the aim was to ultimately have the full frailty pathway in place in Brent by 2020/2021, however there were aspects of the pathway within this that were already operational. Members commented that there was a need to be clear on the incremental steps which needed to be taken and which of these had been making progress.

A Member of the Board questioned whether OPALS would provide a community ophthalmology service to deal with any eye-related emergencies. James Walters agreed to arrange a briefing to Members on what specific services were provided in this area and how they linked to the OPALS model.

Questions also arose on the working arrangements with other neighbouring boroughs and whether there had been any collaborative working on the proposals. James Walters responded that there was a willingness to have this service operate effectively across boroughs. He noted that there had been positive in-depth conversations with the London Borough of Harrow on moving ahead with this model and on what each borough could specifically do to support the concept. It was also mentioned that OPALS built on the hospital discharge project work being undertaken by the West London Alliance and that there were also plans for a similar model to be undertaken on an appropriate site in Ealing.

Discussions moved to the proposed finance arrangements for the model and which budget the plans were being derived from. Members heard that that there was a need to work out what was proportionate for each Clinical Commissioning Group which would be  ...  view the full minutes text for item 6.

The Brent Health and Wellbeing Board published its first PNA by April 2015 in

accordance with the NHS (Pharmaceutical Services and Local Pharmaceutical

Services) Regulations 2013 (the Regulations). The Regulations stipulate that

HWBs will need to publish a revised assessment within three years, which is by

01 April 2018.This paper proposes how this responsibility should be

discharged.

Dr Melanie Smith (the Council’s Director of Public Health) introduced the report which detailed the statutory duty for Health and Wellbeing Boards to update and publish a Pharmaceutical Needs Assessment (PNA) for the local area, and proposals on how this responsibility should be discharged. She stated that the Board published its first PNA in April 2015 and was required to publish a revised assessment by 1 April 2018. She noted that the process for drawing up the PNA remained the same from the previous publication. Members heard that PNAs were a very particular type of assessment and focused on what should be dispensed at community pharmacies to meet the needs of the local population.

The Board agreed that the process had worked well for the previous PNA publication and that there was no need to differ from this approach.  

It was RESOLVED that:

(i)         The establishment of a task and finish PNA Steering Group be agreed;

(ii)        The terms of reference for the PNA Steering Group, attached as appendix 1 to the report, be agreed; and

(iii)       That the task of overseeing the conduct, consultation and publication of the revised Brent PNA be delegated to the PNA Steering Group.

The next scheduled meeting of the Health and Wellbeing Board is on

The date of the next meeting was noted as being 5 October 2017. 

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 64.

There was no other urgent business to be transacted.