Agenda item

To provide an update on the joint health and local authority response to winter pressures arising in the shorter-term and outline the Integrated Care Partnership’s (ICP) priorities for children over the medium and longer term.

Councillor Gwen Grahl (Cabinet Member for Children, Young People and Schools, Brent Council) introduced the update, highlighting that she was grateful for the request to update the Board on contingency planning for children’s healthcare and addressing new challenges such as Polio and Strep A.

In further introducing the report, Jonathan Turner (Borough Lead Director – Brent, NWL NHS) advised the Board that the report reviewed the current situation and response to winter pressures with a specific focus on children, and also detailed the Integrated Care Partnership (ICP) priorities to bring together a specific focus on children. In updating the Board on current issues, he highlighted the following points:

·         In the latter part of the summer, routine monitoring of sewage in London showed the presence of the Polio virus,, therefore the Joint Committee for Vaccination and Immunisation (JCVI) had advised that across London the NHSE should offer an inactivated polio vaccine booster for children aged 1 – 9 years. The ICP had moved rapidly to set that up, and the latest figures were that around 13,000 children had received their booster in Brent. This equated to around 32% of the eligible population, which was a strong starting basis.

·         Routine immunisations were ongoing, including an outreach centre with SPIN GPs specifically working around improving childhood immunisation uptake.

·         Strep A clinics had been set up to reduce the pressure on the system and provide extra access for parents and children. As of the week of the meeting, the additional clinics had delivered around 892 additional appointments.

·         Enhanced access hubs were in operation, with joint primary and secondary care clinics set up for paediatrics in the North and South of the borough.

·         Within the ICP, the children’s priorities working group had met to look at where the areas of need were and where partners could collaborate most effectively, which was outlined on pages 12-13 of the report. Focus was on developing a holistic support offer to address the inequalities and prevention agenda, which included specific focus on healthy weight, smoke free homes and a healthy start. Immunisations were also a priority for the ICP

·         In relation to mental health and wellbeing there was a new national Thrive model, and partners were now working together to map out the requirements of that. CAMHS was another area of focus to reduce the substantial waiting list, and there had been work across the system to secure additional non-recurrent funding for the year to reduce the waiting list. Jonathan Turner and Robyn Doran (ICP Director) had been in discussion with NWL ICS to secure additional resources to reduce those waiting lists and keep them down.

·         A new neurodiversity pathway was being implemented, with jointly commissioned speech and language therapy.

·         Work was being done to improve the diagnosis and control of asthma, focusing on inhaler technique, and working with housing teams on mould in houses and the links between air quality and environment on asthma.

·         It was anticipated that these workstreams would report to the ICP exec groups and maintain a close dialogue between ICP leadership, the Corporate Director Children and Young People, and the Borough Lead Director. Jonathan Turner and Robyn Doran were also members of the Brent Children’s Trust so there was close linkage on a governance basis.

The Chair thanked Councillor Grahl and Jonathan Turner for their introductions, and invited contributions from those present. The following issues were raised:

• In relation to the 30-35% increase in out of hours calls, the Board asked whether there were any emerging themes. Jonathan Turner advised that there would need to be further analysis to understand if there were any themes, but envisaged there would be a wide range of themes.
• In response to what outcomes were hoped for in regards to the ICP children’s priority, Jonathan Turner advised that part of the programme of work would be to define those outcomes, but he suggested they would include addressing the issues that appeared each year within the JSNA, such as childhood obesity, asthma admissions and non-elective hospital admissions. The final details would need to be worked through with all representatives from the provider organisations to ensure the right areas were targeted. Nigel Chapman (Corporate Director Children and Young People, Brent Council) added that he would hope to see improvements in progress at school for children with an Education Health and Care Plan and more effective and timely provision of speech and language therapy and occupational therapy.

• The Board asked whether 65% uptake on the health inequalities clinics was expected. Dr Haidar advised the Board that the clinics were organised on weekends to avoid parents and children missing school and to improve access, and the uptake had been very good. As a result of the good practice, other boroughs were looking to learn from the clinics.
• In relation to mental health and the national Thrive model, Robyn Doran advised that this focused on early intervention. Through the work done around the CAMHS waiting list it had been found that having the third sector involved with triage and intervention had made a big difference, and the Thrive model would do more downstream work with families and children to prevent break downs and children ending up in emergency departments.
• Noting the transformation work on speech and language therapy, the Board asked whether this included rehabilitation. For example, they asked whether the work helped children and young people who were partially sighted learn to use a cane or get to school. Nigel Chapman confirmed that there was a specialist SEND pre-school panel where he would expect additional or unmet needs to be supported there, separately from speech and language therapy.

RESOLVED: To note the report. and request that the Health and Wellbeing Board be presented with metrics on CAMHS, particular in relation to the impact of triage, and any updates on investment.