Agenda and minutes

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

Apologies for absence were received from the following:

·       Kim Wright (Chief Executive, Brent Council)

·       Councillor Grahl (substituted by Councillor Farah)

·       Rachel Crossley (Brent Council)

·       Basu Lamichane (Nursing and Residential Care)

·       Simon Crawford – joined online (LNWH)

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 22 January 2024, be approved as an accurate record of the meeting.

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

None.

For the Health and Wellbeing Board to receive an update on the acheivements of Healthwatch in 2023-24 and the Work Programme for 2024-25.

Cleo Chalk (Healthwatch Service Manager) introduced the paper which provided an update on the progress of Healthwatch Brent over 2023-24 and an outline of the planned work programme for 2024-25, which aimed to ensure that all residents in the borough could influence the delivery of health and social care in Brent. In introducing the report, she highlighted the following key points:

·       Healthwatch had a statutory responsibility to engage residents and patients as active planners in Healthwatch projects, which was done partly through the Advisory Board, made up of 11 local experts including representatives from community organisations and patients with lived experience, and partly through The Volunteers Programme. Healthwatch had a pool of 25 active volunteers who undertook activities on behalf of Healthwatch and that pool was made up of many different parts of Brent’s communities, including young volunteers. The majority of volunteers also spoke additional languages, allowing them to reach a wider range of residents, which was fundamental for Healthwatch.

·       Crucial to the work of Healthwatch was its work with grassroots community partners, and Healthwatch had 38 community partners who received updates on their work and had the opportunity to collaborate. A recent survey had recently gone out to community partners to better understand what those partners would like from Healthwatch.

·       During 2023-24, Healthwatch had undertaken a project looking at maternity services, comparing the standards of care across North West London (NWL). Cleo Chalk felt that this was a good example of how Healthwatch could work more collaboratively across NWL. The project had looked at in depth testimonials from women who had recently given birth across NWL. Healthwatch had heard from 207 women, 50 of which were from Brent, and the majority of those women, including the women from Brent, had shared positive feedback both about the experience of giving birth and their postnatal care. Healthwatch identified some key areas of improvement, such as a better listening culture, improving the quality of information shared and better support for breast feeding. Healthwatch had been able to present those findings and areas of learning at an Integrated Care System (ICS) collaborative maternity meeting, and the ICS agreed to respond by outlining the actions they would take to move those recommendations further. Healthwatch was also due to meet with the Northwick Park Hospital Maternity Services team to consider the recommendations with into Brent maternity services specifically.

·       Healthwatch’s Advice and Signposting Hub was highlighted, which provided a set of online resources with information about the topics residents most commonly asked about. Healthwatch recognised that online resources were not suitable for everyone but had found them to be a useful tool for those who could access online resources. This also freed up capacity to be directed into helping those without online access through other channels. Cleo Chalk encouraged partners to come forward with any additional areas that they would like to see explored on the online resource hub. The hub had been accessed by 783 residents the previous year, and Healthwatch had the ability to  ...  view the full minutes text for item 5.

For the Health and Wellbeing Board to receive an update on the Integrated Care Partnership (ICP) priorty – improving mental health and wellbeing, and the plan for 2024-25.

Robyn Doran (Director of Transformation, CNWL, and Brent ICP Director) and Sarah Nyandoro (Head of Mental Health, Learning Disabilities and Autism – All Age – NHS NWL) introduced the report, which updated the Health and Wellbeing Board on the Integrated Care Partnership (ICP) priority area for improving mental health and wellbeing. In introducing the report, the following points were highlighted:

• The Board were reminded of the previous discussions in relation to inequalities, levelling up, and the need to have the data to back up the business case for levelling up. In terms of levelling up, Brent had historically been underfunded, and when looking at its data the problem was getting bigger and not smaller. There was disappointment that the case for levelling up had been under discussion for quite some time and despite the inclusion of data to evidence the case, the ICP had still not received an response to the business case that was put forward 6 months previously. The ICP had hoped that Integrated Care System (ICS) partners would be available to answer some of those questions during the meeting but due to the pre-elections period the ICS had not been able to attend. The ICS had committed to attend the next meeting to answer some of those questions.
• There was an ongoing area of concern regarding CAMHS and early intervention and there was now some resource being put in place around neurodiversity which was hoped would see significant progress for children and young people.
• It was highlighted that, when compared with the other 8 NWL boroughs, Brent had the highest number of people registered as having severe mental illness. When looking at those accessing mental health support, such as Talking Therapies, Brent also had the highest number of people accessing services, and the largest numbers being admitted into an inpatient unit. The report aimed to highlight that demand was outstripping capacity.
• The report demonstrated the work done by the priority groups in the Mental Health and Wellbeing ICP Subgroup including employment and housing. Within housing, as well as the support being given to people to access accommodation, there was now the addition of the Rough Sleepers Initiative focused on mental health issues, general health issues, physical health and substance misuse. The ICP were hopefully that this would enable a lot more targeted work with the homeless population. The report also detailed the work being done to improve rehabilitation services.
• Targeted work was taking place in NW2, NW10 and HA9 which the ICP now knew these were the areas with the largest proportion of those experiencing severe mental health issues . Those residents, both children and adults, were accessing services at the point they were experiencing a crisis rather than before they reached crisis point,  the ICP had developed a programme of targeted work in those neighbourhoods which they felt would make an impact to individuals in those areas. One programme was around crisis outreach through Clinical Crisis Workers, who would be reaching into those neighbourhoods  ...  view the full minutes text for item 6.

For the Health and Wellbeing Board to receive an update on the work of the Brent Children’s Trust and a forward look at upcoming work.

Nigel Chapman (Corporate Director Children and Young People, Brent Council) introduced the report, which provided an update of the Brent Children’s Trust (BCT) work programme covering the period July 2023 to March 2024 and set out a proposal to redefine the purpose and vision of BCT for 2024-2026. Some of the key points were highlighted as follows:

• The report covered the progress and challenges of BCT as they related to health matters.
• As well as monitoring by the Health and Wellbeing Board, there was other scrutiny that occurred for the three BCT work programmes. The arrangements for Looked After Children and Care Leavers were reviewed at Corporate Parenting Committee, arrangements for children with SEND were considered at the Community and Wellbeing Scrutiny Committee, and Early Help and Intervention was subject to government oversight through the Supporting Families Programme.
• Time had been spent to develop a refreshed approach over the next 2 years, looking at how BCT operated as a Trust and continuing to focus on those three key work programmes; Looked After Children, SEND, and Early Help. The work would also monitor the effectiveness of the ICP priority workstreams as they affected children, such as the mental health and wellbeing workstream and Brent Health Matters (BHM) and their new remit into children’s work to reduce health inequalities affecting children and families.
• How the Trust worked was underpinned by 3 pillars – shared accountability, better performance information and improved communications and engagement.
• The Trust felt they were in a good place organisationally in a complex landscape to respond in an agile way to issues that arose, and this was thanks to the good relationships between providers, the local authority and Brent Integrated Care Partnership (ICP).
• Robyn Doran added that the Trust had now agreed that it would benefit from having third sector partners around the table, so would begin work to find a way to represent that voice.

In considering the report, the following points were raised:

·       Members felt that the report needed further information on where the challenges were, what the Trust was looking to improve, and what the metrics against those issues were. Nigel Chapman agreed to provide performance information across a range of indicators as they affected Looked After Children, inclusion, and early help for future reports. Those metrics were monitored and reported corporately as part of the Borough Plan Key Performance Indicators and could be drawn into this report. In addition, the Board requested future reports to bring out the voice of the child.

·       The Board were informed that there was now a Clinical Lead within BCT, Dr Anne Murphy, who was working hard and collaborating with partners.

·       The Board asked about the interface with mental health services for young people and SEND and how mental health and SEND interfaced with the criminal justice system. They were advised that there was a close interface between SEND and mental health and wellbeing. The Children and Young People Department was running a programme called ‘Delivering Better Value’, funded through  ...  view the full minutes text for item 7.

Notice of items to be raised under this heading must be given in writing to the Deputy Director of Democratic Services or their representative before the meeting in accordance with Standing Order 60.

The Board was advised that this would be Basu Lamichane’s final meeting as the Nursing and Residential Care Sector Representative on the Board. Members extended thanks for his input on the Board and noted that the ICP was in the process of recruiting a new representative to fill that post.