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Agenda and minutes

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No. Item




Apologies for absence were received from Councillor Angie Bean (LBWF), Terry Huff (WFCCG), Dr Anwar Khan (WFCCG), Linzi Roberts-Egan (LBWF), Councillor Grace Williams (LBWF) and Jaime Walsh (Healthwatch)


The following substitution arrangements were in place:

Rebecca Waters for Jaime Walsh

Heather Flinders for Linzi Roberts-Egan

Helen Davenport for Terry Huff




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.


There were no declarations of interest.




The minutes of the previous meeting held on 14 June 2016 were approved as a correct record and signed by the Chair.


The Chair updated the Board on events since the last meeting and stated that a meeting had been organised for the following day with Save our NHS, Barts Health NHS Trust, WFCCG and lead officers of the Transforming Services Together (TST) strategy to discuss the concerns raised by SAVE Our NHS campaign regarding the TST (appended to the minutes of 14 June 2016).


The Chair also advised that a Strategic Partnership Unit had been developed to work across the different boards at the Council; two safeguarding boards, SafetyNet and the Health and Wellbeing Board. All Boards are being supported by their own Business Management Group (BMG) to help with agenda setting, business plans and to ensure close working on priorities across the other Boards.


The Board noted that Terry Huff chairs the Health and Wellbeing Board BMG. The BMG has put together a new way of working for Board meetings, includes report authors having to answer ‘challenge’ questions in their report and presentation that focus on key issues identified by the BMG.





The minutes of the Health and Wellbeing Forum held on 2nd June, 2016 are attached. These will be discussed as part of the following substantive agenda items as they are reached through the meeting.



The Board noted the key points of the Health and Wellbeing Forum held on Thursday, 1 September 2016.  The Chair invited Rebecca Waters, Healthwatch, to feedback comments from Healthwatch after each item.



Additional documents:


Consideration was given to the report of Joyce Guthrie, Head of Parks and Leisure.


Focus was given to the challenge question put forward by the BMG:

How do we address wellbeing in the widest sense – including mental health and wellbeing – and not just attract people who already participate in sport/physical activity?


Joyce Guthrie presented her report and stated that the Council has made a commitment to supporting residents to have a good quality of life, highlighting the investment and leisure opportunities available in the Borough.


The Board noted that the Physical Activity and Sport Strategy 2016-20 had been produced to ensure all residents increase their physical activity, no matter what their fitness levels. The Board was advised that the Feel Good Campaign had recently been launched as a month of activities and engagement focused on health and wellbeing in the borough. A rewards app has also been launched to encourage residents to get more active.


The Board was also made aware that:

·         Work was underway with Motability East to help fund disability groups

·         The Our Parks programme has helped to attract new people to exercise – including those that would not join a gym - and, created social groups

·         The schools-based programmes have seen engagement levels of young people higher than the London average

The new Feel Good Centre (formerly the Waltham Forest Pool and Track) is opening in October 2016 and will be a health and wellbeing centre,


The Chair added that the Council had made a lot of financial investment in sports and leisure and welcomed comments from the Board.   


Joe McDonnell advised that Public Health had been working with Parks and Leisure on the strategy as it important for residents’ health and wellbeing. The biggest benefit would be in increasing activity in people who do not currently exercise. He asked that the strategy include more detail on how to attract and provide services for people across the diverse communities of Waltham Forest who are less likely to exercise.


Lucy Shomali felt the strategy did not include an analysis of, and response to, current and future population growth and other demographic changes in the borough and how this will be responded to through the delivery of sports and leisure facilities. 


In response to a question from Rebecca Waters, the Board was advised that disability groups could obtain funding for special provision through Motivate East, which is a programme funded by Sport England. 


Dr Tonia Myers stated the strategy was very positive but felt we needed to ensure Obesity was a priority.


The Board then discussed the increase in obesity levels in the borough and wanted to ensure that this strategy reflected the focus of the obesity strategy.


The Chair thanked Joyce Guthrie for her report and asked that the final strategy come back to the Board for noting.



The Board noted the report




Additional documents:


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


Challenge question:

What is London Ambulance Service doing to improve poor response times? and:

What can partner agencies do to support change including reducing demand and waiting times?


Nick Osborne and Natasha Wills presented their report and gave background information regarding issues that affect performance - 

·         In search of best patient care: patients are taken to specialist hospitals if they have specific needs such as strokes and these hospitals are often out of the borough.

·         Increase in demand: the LAS had the busiest month in history in the first quarter of 2016.

·         Handover at hospital: hospital targets are to take patients within 15 minutes, however, during the first quarter this year it took longer - over 450 hours of time were lost by LAS at Whipps Cross hospital.

·         Staffing: there is a shortage of paramedics. Recruitment is improving and in the short term the LAS had recruited from Australia. Ongoing and longer-term plans include work with universities increasing the number of paramedic places and courses available.


The Board was also given information on the LAS response to these response time problems, which included: improving pathways to help deal with demand so calls can be referred rather than treated on scene; working closely with hospitals to increase efficiencies and improve handover processes; and working closely with out of hours GPs teams, care homes and rapid response teams.


The Board received the following information relating to the challenge question on what partner agencies can do to support change including reducing demand and waiting times.


Bernice Solvey advised that a great deal of work had taken place jointly with Adult Social Care, NEFLT and the CCG. The Waltham Forest Direct contact centre advises people to use walk-in centres and does not default to calling an ambulance, as used to be the case. Other opportunities included working with rapid response. It was acknowledged that more work needed to be done with out of hours’ re-enablement.


Sue Boon reported that work had taken place to see how calls could be diverted to rapid response units, using community nursing and working to improve pathways for patients. More work was needed to improve transfer of patients and when non-Waltham Forest crews are called in to help, as they are not familiar with the systems.

More could also be done in care homes and with people in the community not to use 999 but use other alternatives. 


Enrico Panizzo advised that the CCG had been focusing on how to reduce the demand so that a rapid response is an alternative to 999. The CCG is working closely with NELFT to identify high intensity users to get lists of patients in order to manage them through better coordination. Alternatives include enhanced GP support piloting with care homes.


Healthwatch Forum feedback: there needs to be better communication with the public about when to call 111 and 999. Terminology used by LAS was not always understood  ...  view the full minutes text for item 20.



Additional documents:


Consideration was given to the report of the Acting Director of Public Health.


Joe McDonnell asked the Board to approve the final version of the Board’s scorecard, whose indicators have been selected to provide evidence of progress against the Health and Wellbeing Strategy.


In response to the challenge question relating to the formation and prior approval of the indicators, the Board was advised that the scorecard had been developed and reviewed by the Joint Commissioning Sub-Committee as well as other senior local authority and CCG officers.


Rebecca Waters asked how the information would be made accessible to the public so that they can be reassured that targets are being met. Joe McDonnell advised that the scorecard and its indicators would be presented to the Joint Strategic Needs Assessment (JSNA) working group who would explore ways of making them more publicly available. The Board discussed and agreed that the indicators should be aspirational and asked for national and pan-London figures and targets to be added for comparison.



The Board approved the indicators selected for the Health and Wellbeing Scorecard and agreed to monitor progress against these indicators.




Additional documents:


Consideration was given to the report of the Acting Director of Public Health.


Lucy Shomali clarified that the Board can make a recommendation about health-related Section 106 spending, however the final decision is with the Section 106 Board. Lucy Shomali noted that business cases to the Section 106 Board must focus on service, project or infrastructure development rather than general repairs.


The Board felt a strategy setting out priorities and principles around current S106 and future Community Infrastructure Levy (CIL) monies needs to be developed. This would help in enabling the Board to make recommendations to the S106 board. The Chair asked that this is discussed further at the BMG.



The Board agreed that Section 106 business cases and recommendations are to be submitted to the Section 106 Board for final decision and approval.




Consideration was given to the report of Healthwatch Waltham Forest (HWWF).


The Board noted that Healthwatch would be working more closely with an NEFLT in planning their programmes.


The Board also noted that Healthwatch are waiting to hear about their future funding because the Council Contracts team has still to timetable in this procurement. This situation, with future funding unconfirmed, is making it difficult for Healthwatch to plan for the financial year 2017/18.


Decision: The Board:


Agreed that as per the statutory function HWWF continues to have a place on the Health & Wellbeing Board.

Recognised that HWWF are administrating the Health & Wellbeing Forum (HWBF) and that the views of the HWBF members are not those of HWWF.

Noted that the HWWF will continue to analyse multiple data sources, as per the core work and use this in partnership with Health and Wellbeing Board members inside and outside the board to improve the standards of health and social care in Waltham Forest.

Agreed to read the Healthwatch annual report available on its website:



Mental Health Scrutiny Committee Report pdf icon PDF 120 KB

Additional documents:


Consideration was given to the report of the Health Scrutiny Committee.


Councillor Anna Mbachu, Chair of the Health Scrutiny Committee presented the report, which set out the Committee’s findings and recommendations on mental health.


The Chair thanked Cllr Mbachu for her presentation.



The Board noted the findings of the Health Scrutiny Committee.



Joint Commissioning Sub-Committee update pdf icon PDF 129 KB


Consideration was given to the report of the Lead for Integrated Commissioning.



The Board noted the discussion and recommendations made by the Joint Commissioning Sub-Committee at their meetings on 7 June 2016 and 12 July 2016.



Sustainability & Transformation Plan (STP) update pdf icon PDF 106 KB

Additional documents:


The Board noted that NHS England had made a decision to stop any public discussion of all Sustainability and Transformation Plans (STPs).


As a consequence of this decision, the Board passed a resolution to exclude the press and public from the meeting during consideration of this item in accordance with the Section 100(A) of the Local Government Act 1972 as amended, on the grounds that it would involve the disclosure of exempt information as defined in the relevant paragraphs of Schedule 12A of the Act.


Helen Davenport, WFCCG presented the report.  Partners expressed their commitment to the ongoing STP process and the need for communication and engagement with residents about its content and impact.



The Board noted the update on STP activity and preparations.