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Agenda and minutes

Venue: Council Chamber - Waltham Forest Town Hall. View directions

Contact: Debra Marlow, Acting Democratic Services Team Leader  020 8496 4211 | Email: debra.marlow@walthamforest.gov.uk

Items
No. Item

12.

APOLOGIES FOR ABSENCE AND SUBSTITUTE MEMBERS

Minutes:

Apologies for absence were received from Linzi Roberts-Egan, Deputy Chief Executive, Families and Dr Anwar Khan.

 

13.

DECLARATIONS OF INTEREST

Members are required to declare any pecuniary or non-pecuniary interests they or their spouse/partner may have in any matter which is to be considered at this meeting. Interests are defined on the inside cover of this agenda.

Minutes:

None received.

14.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 101 KB

Minutes:

The minutes of the previous meeting held on 8 December 2015 were approved as a correct record and signed by the Chair.

 

15.

PUBLIC PARTICIPATION

Minutes:

Gail Lovell, Resident from Chapel End Ward addressed the Board and asked that the Council allocate funding to the borough’s GP’s to ensure a continued service with no further reductions.

 

The Chair thanked Ms Lovell for her contribution and offered to meet with her to address her concerns if they were not answered during the meeting.

Terry Huff reassured Ms Lovell that they were not expecting as many cuts as she had quoted and although some practices will potentially see cuts there is still a huge amount of work that will be done. 

The Chair advised Ms Lovell that the Council is not responsible for GP Commissioning and 120,000 residents will not be left without a doctor, as she suggested.

Cllr Rusling added that the decisions are taken by Central Government and that the Council must implement the Secretary of State decisions.

 

 

16.

HEALTH AND WELLBEING FORUM pdf icon PDF 105 KB

The minutes of the Health and Wellbeing Forum held on 23rd February, 2016 are attached. These will be discussed as part of the following substantive agenda items.

Minutes:

The Board noted the minutes of the Health and Wellbeing Forum held onTuesday 23rd February 2016.   The Chair invited Sue Toole, Healthwatch Waltham Forest Chair, to feedback the comments from Healthwatch after each item.

 

17.

HEALTH AND WELLBEING STRATEGY OVERSIGHT PLAN pdf icon PDF 57 KB

Additional documents:

Minutes:

Consideration was given to the report of the Director of Public Health, London Borough of Waltham Forest.

 

Dr Andrew Taylor gave a brief introduction to the report.   He stated that the Oversight Plan is being completed, in order to provide further detail on implementation of the Joint Health and Wellbeing Strategy. Progress against this Oversight Plan will be monitored through quarterly reports to the Board, and it will be updated, and modified if necessary, on an annual basis.  Dr Taylor drew the Board’s attention to the matrix on delivering the strategy.

 

Decision:

The Board noted the structure of the Oversight Plan Template and the proposed procedure for completing the Oversight Plan including the date of the event, Friday 8th April 2016.

 

 

18.

DRAFT ESTATES STRATEGY pdf icon PDF 1 MB

Minutes:

Consideration was given to the report of the Infrastructure Planning Manager.

 

Carl Edmunds, Deputy Director of Strategic Commissioning for Waltham Forest Clinical Commissioning Group (CCG) presented the draft Estates Strategy.

He stated that the key areas the Estates Strategy was trying to address were population growth as more people are moving into borough and how population is changing, i.e. people getting older and living longer. The Board noted that the workforce was also changing as patients now require multidisciplinary teams to deal with their health issues.  Mr Edmunds added that 15% of GP’s had indicated that they wish to retire in the next five years and a similar number of nurses indicated the same.  I.T. was also an issue as some people want to use it and there is pressure to make it work better and there are some communities that see I.T. as a barrier.

 

There are a number of solutions being proposed.   The Board noted that there are currently around 45 practices and the draft strategy proposes around 30 practices working together in hubs. This would enable skills and resources to be shared more easily and would help drive up quality and improve safety

 

The Strategy also proposes new roles such as physician associates and delivering some activity in pharmacies rather than GP surgeries so that GPs can be co-ordinators of care rather than being wholly responsible for all aspects of care. 

A lot of work has been done on developing I.T. so that systems are linked up with with community services and patients are able to both book appointments online and order repeat prescriptions.  This would be promoted more next year.  Trials are also taking place on Skype video conferences with patients.

 

The Draft Strategy proposal is assessing where the hubs might be located as is seeking full engagement from all interested parties. 

 

Lucy Shomali echoed comments made by Mr Edmunds and explained that the Council is working together with the CCG to come up with a strategy document that promotes the pace of growth of Borough and shares plans around growth.

 

Healthwatch Forum feedback:  The report was welcome by Healthwatch and they were excited to see the specific proposals around the hub locations but were concerned that there may be areas where some people have to walk further and requested that consideration be given to good public transport and parking.  The Forum were also pleased to note the bottom up engagement instead of top down.  They requested further clarity on consultation deadlines.

 

Mr Edmunds added that the next version of the strategy would look at travel distances from potential hubs to see if people can get to them within 30 minutes by public transport. 

The Board had the opportunity to ask questions and received the following information:

 

It was explained that Physician Associates have been around a few years.  They have undertaken their first three years at University and then complete a two year course as a Physican Associate.  They train up quicker than  ...  view the full minutes text for item 18.

19.

WHIPPS CROSS CQC UPDATE REPORT pdf icon PDF 56 KB

Additional documents:

Minutes:

Consideration was given to the report of the Managing Director Whipps Cross Hospital

 

Fiona Smith updated the Board on progress with CQC Improvement Plan for Whipps Cross Hospital that has been worked on for the last year. 

The “Safe and Compassionate” Improvement Plan was published by Barts Health in September 2015 and the Board noted that the Plan is being delivered through seven key workstreams with both a corporate and site-based focus, and key governance structures. 

 

The Board noted the most recent update this month as a peer review was undertaken organised by Trust Development Authority (TDA). 

 

Healthwatch Forum feedback:  the Forum requested further statistics on the workforce e.g. percentage of full or part time staff emplayed.  

 

Ms Smith stated that a report on the workforce is coming to the next meeting and will include the statistical details.

Cllr Mark Rusling asked that the spotcheck report be shared with the Board.  Ms Smith agreed to the request.

 

Cllr Rusling further expressed his disappointment that the no-one from Barts Health or the CCG were at the recent Safeguarding Board meeting.  Ms Smith agreed that she would organise representation at future meetings. Dr Myers added that CCG had recently recruited a safeguarding GP who would also be present at the Safeguarding Board meetings. 

Ms Smith reported that Whipps Cross Hospital had a warning notice and they were trying to get that lifted and that Barts Health as whole was in special measures but they are on trajectory to improve
and have the warning notices removed within the next year.

Decision:

The Board noted the update of progress and improvements to date against the Whipps Cross “Safe and Compassionate” improvement plan.

 

 

20.

TRANSFORMING SERVICES STRATEGY AND INVESTMENT CASE pdf icon PDF 76 KB

Additional documents:

Minutes:

Neil Kennett-Brown presented the report which the Board noted is out for formal consultation.  The report highlights the key reasons for change in transforming services.  The Board is working together with Local Authority partners, the Acute Trust and GPs to move to clinical and financial sustainability in the future. 

 

Mr Kennett-Brown explained that there are three documents associated with the report:

First is a summary document which sets out key messages which will also be available in plain English and will be translated if needed.

Second document sets out strategy in detail.

Third document details the high impact changes in 13 key areas, one of which details the future of Whipps Cross Hospital.

 

The committee were informed that Dr Tonia Myers and Terry Huff were involved in drafting the documents and the Board had the opportunity to ask questions and received the following information:

 

Healthwatch Forum feedback:  The Forum was pleased that documents would be prepared in Plain English. Detailed comments were available in the Forum’s report (agenda item 4). Neil Kennett-Brown was happy to accept the invitation to attend a Heathwatch meeting once a plain English document was available.

 

Cllr Rusling also welcomed the plain English version from a Children and Young Person perspective.  He expressed concern that the concept assumes residents will have all their care within three boroughs however it is not unusual to go outside the area. He felt more work needed to be done to transfer people in and out of borough so that the service is not fragmented and patients feel they received a joined up system of care.

 

In response, Mr Neil Kennett-Brown stated that lots of planning was taking place at different levels: across the 3 boroughs and Barts Heath; also working with the seven boroughs in North East London; across all London; and also at a national level.  He agreed that it is important for individuals that services are joined up and that further work was needed.

 

Terry Huff added that digital changes need to be made in the borough so that all systems are linked up. 

 

The Chair remarked that the section of the report around prevention could have been stronger and also asked if discussions had taken place with TfL as residents would have to go to other boroughs to access specialist services.

 

Dr Andrew Taylor stated that the three boroughs are working towards prevention, particularly diabetes and childhood obesity and that there is an opportunity to work effectively with the seven boroughs.

 

Mr Kennett-Brown stated that they are initiating conversations with TfL to ensure connections work better for patients.  The Board noted that it was highly unlikely that patients would need to travel from one hospital to another in a day and therefore better access to all hospitals from all boroughs was needed.  It was also stated that more care would be in the community

 

The Chair thanked Mr Kennett Brown for the comprehensive report. 

 

Decision:

The Board noted the TST Strategy and Investment Case and the  ...  view the full minutes text for item 20.

21.

LONDON AMBULANCE SERVICE RESPONSE TIMES ACTION PLAN AND CQC UPDATE pdf icon PDF 44 KB

Additional documents:

Minutes:

Consideration was given to the report of the London Ambulance Service.

 

The Board noted that the report follows on from a previous report to the Health & Wellbeing Board in December where concerns were expressed about waiting times and asked about the progress that has been made since last time. 

 

James Johnson reported that the LAS is also inspected by CQC and performance is improving although they are still in special measures.  Response times have improved from last year.   The focus has been on staff recruitment and it is anticipated that there will be a full staff complement by June.  The Board noted that there has been an increased use of motorbikes which is also helping with getting better response times and that there are handover delays at hospital.  Mr Johnson concluded that the overall picture is positive and response times are on the increase.

Natasha Willis added that the management restructure had started; there would be more engagement with wider health community; they were working closely with care homes and with rapid response to ensure referrals come directly from the control room.  All these changes would lead towards a positive upwards trajectory.  
 

Healthwatch Forum feedback:  The Forum were interested in the motorcycle aspect and concerned about the 111 service going up to tender. They felt that the actual should response times should be specified so the public know what they are.

The Chair asked that further information on improvements in terms of benchmarking with other boroughs be emailed to him for circulation to the board.

The Chair thanked the LAS for attending the meeting.

 

Decision: The Health & Wellbeing Board noted the report.

 

22.

JOINT COMMISSIONING BOARD OVERSIGHT REPORT pdf icon PDF 89 KB

Minutes:

Consideration was given to the report of the Interim Integrated Commissioning Lead for London Borough of Waltham Forest and Waltham Forest CCG.

 

Sian Therese highlighted four aspects of the report:

She said that in order to get integrated commissioning in the heart of the business, the JCB were looking at the core planning elements of both the Council and the CCG and that the JCB agendas in future will receive a work programme based on two organisations to enable better integration.

The JCB also looked at what integrated commissioning might look like in the future and came to the conclusion that they have a strong foundation.  They also want to test their new styles of commissioning and are launching a project to develop a blueprint on what lead commissioning will look like to generate an active commissioning model.

 

The JCB noted that the Council will work with CCG on “Shaping the Registered Care Market”.  A market position statement will be published at the end of April. When completed, this document will inform future integrated commissioning intensions.

 

The Board was pleased to note that the JCB report stated that integrated equipment procurement had been suspended but discussions are now completed and work had commenced. 

 

Decision

 

The Health and Wellbeing Board noted the discussion and recommendations made by the Joint Commissioning Board.

 

 

23.

BETTER CARE FUND AND BETTER CARE TOGETHER PROGRAMME 2016/17 pdf icon PDF 119 KB

Additional documents:

Minutes:

Consideration was given to the report of the Interim Director of Health and Social Care.

 

Michael Scorer gave a short presentation on the key elements of the 2016/17 Better Care Plan. 

 

Decision

The Board

a)    Endorsed the first submission of the 2016/17 BCF plan in appendix 5 of the report

b)    Endorsed the quarter three BCF submission in appendix 4 of the report

c)    Noted the requirement to enter into a section 75 agreement in line with the national timetable and national regulations

d)    Endorsed the proposal to invest the full £4,720,000 (our share of the national £1bn) that is ringfenced for NHS out-of-hospital commissioned services in the BCF

e)    Endorsed the proposal to incorporate the existing BCT programme tracker (three work streams) and programme risk register into the revised BCF plan for 16/17

f)     Noted the proposals to develop a BCF for children services

g)    Noted the headline interim findings of the BCF self-assessment

h)   Noted the work underway to develop an Accountable Care System in Waltham Forest and to ‘graduate’ from the BCF when national conditions are met.


Vote of Thanks
On behalf of the Board the Chair thanked Michael Scorer for all the work he had done and acknowledged that he is leaving us in a strong position with confidence for the future.