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)

·       Robyn Doran (Director of Transformation, CNWL, and Brent ICP Director))

·       Cleo Chalk (Healthwatch)

The Chair welcomed those present to the meeting and advised members that Rammya Mathew would be taking up the role of Vice Chair of the Health and Wellbeing Board, highlighting that the Board looked forward to working with her. He also confirmed that Cleo Chalk had now left her role as manager of Healthwatch and thanked her for her contribution in driving forward progress with Healthwatch in Brent. Patricia Zebiri was present to represent Healthwatch at the meeting.

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.

Personal interests were declared as follows:

·       Councillor Nerva – Councillor Member of the North West London Integrated Care Board (NWL ICB)

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

RESOLVED: That the minutes of the previous meeting, held on 28 October 2024, be approved as an accurate record of the meeting.

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

None.

To outline the work of Age Friendly Brent in relation to creating an age-friendly borough where people can live healthy and active later lives.

The Chair welcomed Tony Burch and Florence Njoku to present the work being done to achieve Age Friendly status in Brent. In introducing the presentation, Tony Burch explained that he had previously been a GP for 30 years, and a clinical interest in medicine for older people became an interest in service development, particularly integrated care. He had become involved locally in Age UK and was recently elected Chair of Age UK London. Florence Njoku was introduced as the Chair of the Brent Pensioner’s Forum. The Age Friendly Brent campaign had been launched through the Brent Pensioners Forum as a way of ensuring as many older people as possible were involved in the campaign. The following key points were then highlighted:

·       The aim of Age Friendly Brent was to create an age friendly borough where people could live healthy and active later lives where the environment, activities and services enabled older people to enjoy life, participate in society and be valued for their contributions.

·       The slides linked to resources outlining what was happening in the UK Network of Age Friendly communities.

·       There were 8 areas of focus for the Age Friendly Group; outdoor spaces and buildings; transport; housing; social participation; respect and social inclusion; civic participation and employment; communications and information; community support and health services.

·       A steering group had been established with representatives from the Pensioners Forum, Brent Council staff, Age UK, Elders Voice and Ashford Place.

·       Age Friendly Brent had met with Barnet Council who had already achieved Age Friendly status to learn best practice from them, who had provided some useful advice.

·       Focus groups had been set up with WISE, Elders Voice and the Pensioners Forum to drive the work forward. One focus group was made up of participants in receipt of Adult Social Care, another focus group had participants who had been taking part in a Zumba class, so there were a wide range of voices in the focus groups with strong enthusiasm which he hoped to pull together into a big meeting.

·       An application for funding had been made to help resource a dedicated co-ordinator to support the work being done to achieve Age Friendly status.

·       Age Friendly Brent was looking to work with the Council to see whether there was resource that could be provided to help these ambitions, similar to what has been provided in other boroughs that had achieved Age Friendly status. They acknowledged that any resource offered would need to work with the Council’s budget constraints and fit with the Council’s objectives.

·       Tony Burch emphasised that evidence showed that working further downstream on prevention saved significant amounts of money further down the line on acute and clinical care. He hoped that every conversation that took place in the borough considered older people and the positive contribution older people made to society, as well as older people’s needs outside of frailty.

·       The importance of getting buy-in from the Council and partner organisations was highlighted. Other boroughs that had achieved Age Friendly status  ...  view the full minutes text for item 5.

To set out the NHS’ Joint Forward Plan for 2025/26 to 2029/30 and receive feedback from the Health and Wellbeing Board.

The Chair welcomed Toby Lambert (Executive Director of Strategy and Population Health, NWL ICB) to the Board meeting, explaining that he would be presenting the 5-year Joint Forward Plan that the ICB was required to produce every year and present to all 8 NWL Health and Wellbeing Boards.

Toby Lambert began by highlighting that the ‘joint’ part of the Forward Plan referred to ‘joint’ between NHS organisations and not between the NHS and local authorities and other partners. He advised that this did not mean ICBs did not value the opinion of local authority colleagues in relation to the content of the plan or that it could not work with the local authority in developing it, but was purely what was required by legislation. The Health and Wellbeing Board had a statutory duty to provide an opinion to the ICB on whether it believed the plan adequately met the needs of Brent residents as laid out in the Joint Health and Wellbeing Strategy and Joint Strategic Needs Assessment (JSNA). He also welcomed comments from Board members about how the ICB could improve the process of developing the plan and work together with partners to implement the plan, and how the ICB could support the Council as a local system to achieve its priorities within the context of the Plan. He added that the ICB had prepared a ‘light touch’ refresh this year due to the upcoming 10-year plan for the health service due in Spring, which would act as a trigger for a more in-depth refresh for the next iteration of the Joint Forward Plan. He then highlighted the following key points:

• The ICB had aimed to be more rigorous in terms of prioritisation for this iteration of the plan, concentrating on a few priorities in year one, moving to another set of priorities in year two, and so on, so that cumulatively more could be done by putting larger effort behind a smaller number of priorities each year. He added that this did not mean those priorities appearing in later years were less important.
• The Plan tried to draw a link to the NWL Shared Needs Assessment, which had been produced using each of the 8 boroughs’ local JSNAs. The Plan highlighted the links to how particular actions supported the needs of NWL residents.
• The ICB had also tried to work better on how it developed the plan, and he felt that the ICB had been better at inviting colleagues to the key meetings in relation to the plan and attended Health and Wellbeing Boards earlier in the process.
• The same 9 overall priorities had been retained, outlined in section 3.4 of the cover paper, which were; to establish neighbourhood teams with primary care at their heart; to continue to reduce inequalities and improve health outcomes, particularly using population health management; to optimise the ease of movement for patients throughout their care; to embed access to consistent high quality community services by maximizing opportunity, which referred to a core  ...  view the full minutes text for item 6.

To provide an update on the challenges and responses related to winter pressures as faced by local healthcare partners.

The Chair opened the item by acknowledging the pressure services were under to deliver care across NWL and in Brent. He had requested a brief report from partners on how they were working in Brent to address those winter pressures, and invited Steve Vo (Assistant Director of Place – Brent Borough, NWL ICS) to introduce the report.

Steve Vo highlighted the following key points in relation to the report:

• The current challenge for the local health and social care system, adult social care, and the Brent Borough Based team was the discharge delays being faced, which had increased during the holiday period.
• Workforce challenges remained, with a lack of social workers impacting the overall discharge rates.
• Care homes were more reluctant to accept patients with complex needs which was also driving the delays in discharge.
• There were also challenges in finding temporary accommodation following discharge for patients who required it.
• Actions being taken locally to address those discharge delays were:
  • The offer of weekend coverage for non-complex discharges.
  • Hospital teams having direct access to care providers to facilitate discharges over the weekend.
  • Close working with CLCH to commission a provider to support patients with Stomas and feeding tubes, although further work was needed to address long term care for those patients as that pathway was only for 6 weeks.
  • The team had learned form best practice in other boroughs across NWL and implemented some of that learning in Brent, particularly the model for in-reaching patients with dementia.
• To further address the challenges with discharge, the team was moving to a more preventative approach, focused on hospital admission avoidance with care homes by equipping staff with the skills and tools to manage more complex patients.
• Work was being done with CLCH’s Enhanced Care Home Team to provide training and advice to care homes, ensuring the Enhanced Care Home Team was well utilised so that patients were managed well within the home rather than being admitted to hospital.
• There were many pathways for admission and discharge in Brent, and colleagues would be reviewing those pathways over the next few weeks to ensure a cohesive approach was being taken and those pathways were right for Brent’s patients.
• A Frailty Management Service in Brent was being provided by 3 GP Federations who worked closely with CLCH to ensure that patients with a rising risk of frailty were well looked after in the community to avoid admittance to hospital.

The Chair then opened up the discussion to those present to explain what they were doing to address winter pressures in their own organisations. The following points were raised:

·       Claudia Brown (Director of Adult Social Care, Brent Council) informed the Board that there was a lack of social workers currently, with specific challenges in asking social workers to work in a hospital setting. That work was seen to be fast paced and had challenges relating to professionalism and how health professionals related with social workers, so social workers did not stay in the hospital setting long  ...  view the full minutes text for item 7.

To discuss and agree any future agenda items for the Health and Wellbeing Board.

The Chair gave members the opportunity to highlight any items they would like to see the Health and Wellbeing Board consider in the future.

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

None.