Agenda and minutes

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

Apologies for absence were received from:

(i)         Councillor McLennan, with Councillor Farah present as substitute;

(ii)        Councillor Butt;

(iii)       Councillor Colwill; and

(iv)       Dr Ethie Kong (Vice-Chair of the Health and Wellbeing Board; Chair and Co-Clinical Director, Brent Clinical Commissioning Group).

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

There were no declarations of interest.

To approve the attached minutes of the previous meeting on 24 January 2018 as a correct record.

It was RESOLVED that the minutes of the previous meeting held on 24 January 2018 be approved as an accurate record of the meeting.

To note any matters arising from the previous minutes, if any.

There were no matters arising.

To hear any deputations received from members of the public which comply with the Council’s Standing Orders.

There were no deputations.

This report provides a summary of the Health and Wellbeing Board public engagement roadshow events and the health and care issues that Brent’s communities felt were important. The Board is asked to note, discuss the emerging themes and agree how the findings can be used to feed into the Brent Health and Care plan workstreams.

Zac Arif (Director of Integration, Brent Council/Brent Clinical Commissioning Group) introduced the report which provided Members with a summary of the three Health and Wellbeing Board roadshow events which had taken place in mid-March 2018.

Members heard that the events had followed on from a previous series of events in 2016, and had been a successful method of engagement with the public to reinforce the themes within the Brent Health and Care Plan and to also establish the current issues that residents felt strongly about. Zac Arif specified the key issues which had arisen through interaction with the public, which had centred on: how to achieve a balanced lifestyle; pre-diabetes; the difference between type one and type two diabetes; tackling social isolation; different ways to access services (such as through the ‘Health Help Now’ NHS app); and the role of Brent Healthwatch. Mr Arif thanked colleagues who had assisted the successful organisation and delivery of the events.

In the ensuing discussion, the Chair, having been present at all three events, outlined that the event held at Tesco Extra Supermarket in Brent Park had provided the best opportunity to speak to residents due to the high volume of footfall. Both he and Zac Arif also encouraged Board members to attend the Community Hub at Central Middlesex Hospital which was running into its second week at the time of the meeting, and praised the work of the hub thus far.

A member of the Board raised that Ramadan would take place in the near future and questioned what health and wellbeing advice was due to be given to Brent residents who observed Ramadan. The Chair outlined that the existing resources which provided information on fasting during Ramadan would likely be utilised, and that it would be useful to have partners’ communications teams promote these accordingly as the month drew closer. Members felt that health and wellbeing guidance for those with diabetes who observed Ramadan would be particularly important. 

It was RESOLVED that the report and emerging themes be noted.

This reports provides Health and Wellbeing Board with an overview of the new framework for the Inspection of Local Authority Children’s Services (ILACS), Brent’s progress since the previous inspection and preparation for the new arrangements. The Board is asked to note this report and comment on partnership contributions to preparation.            

Gail Tolley (Strategic Director of Children and Young People, Brent Council) introduced the report which provided the Board with an overview of the new framework for Inspection of Local Authority Children’s Services (ILACS). The report also noted Brent’s progress since the previous inspection and preparation for the new arrangements.

Gail Tolley stated that the provisions within the new framework had been scrupulously reviewed by key stakeholders at a number of different meetings, including the Brent Children’s Trust. The Board heard that the new framework no longer included an inspection of the partnership working of local safeguarding boards and that there was a key focus on local authority social work services and the quality of professional practice. Gail Tolley explained that the report provided detail and assurance on partners being engaged and sighted on the changes. She also mentioned that the key transition points between the Children and Young People and Community Wellbeing Departments at the Council were being discussed by Strategic and Operational Directors.

It was RESOLVED that the report be noted.

The purpose of this report is to provide the Health and Wellbeing Board (HWB) with a summary of progress on the delivery of the Older People’s workstream, identifies challenges and priorities for 2018/19. This major workstream forms part of Brent’s Health and Care Plan.

Helen Woodland (Operational Director of Social Care, Brent Council) introduced the report which provided the Board with a summary of progress on the delivery of the Frailty work stream within the Brent Health and Care Plan. She explained that the report highlighted the achievements in this area over the past year, and the learning from these which could be fed into the priorities for 2018-19. She provided a top-line overview of the different sections within the report, which were: Delivery of Home First; Step-Down Beds; Delayed Transfers of Care (DTOC); Acute Frailty Service (AFS); Integrated Rehab and Reablement Service (IRRS); and emerging issues.

Simon Crawford (Director of Strategy, London North West Healthcare NHS Trust) emphasised that, from an NHS Trust perspective, the interventions specified within the report had been very positive. He added that each initiative provided opportunities for additional learning and scope for further effectiveness, particularly on optimising care pathways and long-term approaches to staffing, but that the partnership working so far had been invaluable. Sheikh Auladin (Chief Operating Officer, Brent Clinical Commissioning Group) agreed that lessons could continue to be drawn from the work, such as improving Home First provisions to ensure a single point of access.

A question arose on the different versions of the Home First programme which ran out of Northwick Park Hospital (as referenced within paragraph 5.17 of the report), and whether this had resulted in a difference in service for residents across Brent, Harrow or Ealing. Simon Crawford acknowledged that staff working differently across sites had proved to be a challenge, which could manifest in delayed transfers of care, but that the service had been become more joined-up in its operation over the last year. Phil Porter (Strategic Director of Community Wellbeing, Brent Council) expanded on this and noted that work was underway to align social care discharges across the area. Sheikh Auladin added that there were multiple discharge pathways within the system as things stood and Hunter Healthcare had also undertaken work at Northwick Park Hospital to streamline these in order to make discharges easier for staff to coordinate.

It was also questioned how momentum could be maintained for the work stream in the future. Simon Crawford indicated that the continued support of partner organisations would be very important and that the schemes needed to continue to be monitored in order identify where further improvements could be made. He also noted that the financial implications and funding streams needed to be considered going forward. Members agreed that the desire remained to keep up the work particularly whilst funding could be accessed via the Improved Better Care Fund (iBCF), but it was acknowledged that the uncertainty of long-term funding remained an issue. On the whole, Members felt that progress had been positive over the past year and that the low re-admittance rates after discharge across the area reflected this.

It was RESOLVED that the report be noted. 

At the June 2017 meeting the Board agreed to establish a PNA Steering Group to which it delegated the task of overseeing the conduct, consultation and publication of the revised Brent Pharmaceutical Needs Assessment (PNA). The report informs the Health and Wellbeing Board on progress with the Brent PNA.

Dr Melanie Smith (Director of Public Health, Brent Council) introduced the report which provided the Health and Wellbeing with a progress update on the publication of Brent's Pharmaceutical Needs Assessment (PNA).

She explained that statutory regulations stipulated that Health and Wellbeing Boards were required to publish a revised assessment within three years, which for Brent was by 1 April 2018. She reminded the Board that at its June 2017 meeting it had been agreed to establish a PNA steering group to assist with the organisation, consultation and final publication of the revised assessment and that the report detailed this work. She concluded and drew the Board’s attention to the recommendations which requested delegated authority for the decision as to whether a revision of the PNA was required or whether the publication of a Supplementary Statement would suffice.

It was RESOLVED:

(i)         That the publication and consultation of the draft Brent PNA, be noted;

(ii)        That the intention of the Brent PNA Steering Group to publish the final Brent PNA before 1 April 2018, be noted;

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

(iv)       That authority be delegated to the Director of Public Health (“DPH”) or the DPH’s nominee as to whether a revision of the PNA was required, or whether the publication of a Supplementary Statement would suffice.

The date of the next Health and Wellbeing Board meeting will be confirmed upon the publication and agreement of the Council’s municipal calendar for 2018/19 at the Council’s Annual General Meeting on 14 May 2018.

It was noted that the date of the next Health and Wellbeing Board meeting would be confirmed upon the publication and agreement of the Council’s municipal calendar for 2018/19 at the Council’s Annual General Meeting on 14 May 2018.

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.

There was no other urgent business to transact.

Before the meeting was formally declared closed, the Chair placed on record the Board’s thanks to Dr Sarah Basham (Vice Chair and Co-Clinical Director of Brent Clinical Commissioning Group) for all of her hard work as she was soon to leave her current role.