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Agenda and minutes

Venue: Committee Room 3 - Waltham Forest Town Hall. View directions

Contact: Rushena Miah, Democratic Services Officer  020 8496 4211 | Email: rushena.miah@walthamforest.gov.uk

Items
No. Item

13.

APOLOGIES FOR ABSENCE AND SUBSTITUTE MEMBERS

Minutes:

Apologies were received from:

 

Board members:

Dr Ken Aswani, Clinical Director, WFCCG

Dr Anwar Khan, Clinical Director, WFCCG

Dr Tonia Myers, Clinical Director, WFCCG

 

Substitute members and other officers:

Dr Dinesh Kapoor, Clinical Director, WFCCG

Kelvin Hankins, Assistant Director of Contracting, WFCCG

Brenda Pratt, Associate Director of Health and Social Care Integration & Joint Lead Better Care Together Programme, WFCCG & LBWF

Dr Mayank Shah, Clinical Director, WFCCG

Sharon Yepes, Associate Director Strategic Planning, WFCCG

Neil Young, Health and Wellbeing Board Coordinator, LBWF

 

It was noted that there were no substitutes present to cover for Dr Anwar Khan, Dr Tonia Myers and Dr Ken Aswani.

 

Decision:

 

(a)  the Chair asked for the board co-ordinator to write to Dr Khan, Dr Myers and Dr Aswani to remind them to send substitutes if they cannot attend a meeting. Angela Cater and Mark Ingers (PA to Leader) are to be copied in. 

 

(b)  It was decided meetings should be rearranged if clinical leads cannot attend.

 

14.         DECLARATIONS OF INTEREST

 

None declared.

 

14.

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 declared.

15.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 78 KB

Minutes:

The minutes of the meeting for 21 June 2017 were approved as a correct record and signed by the Chair.

16.

COMMUNITY STATEMENT ON EAST LONDON HEALTH & CARE PARTNERSHIP (ELHCP) AND NORTH EAST LONDON SUSTAINABILITY AND TRANSFORMATION PLAN (NELSTP): SAVE OUR NHS WITH BOARD RESPONSE

Minutes:

King George Hospital: The Board heard a statement from Mary Logan from Waltham Forest Save our NHS. Ms Logan urged the board to support Redbridge Council in opposing the plan to downgrade King George Hospital in 2019, as this would have a negative knock on effect on Whipps Cross Hospital such as reducing the number of available beds. Ms Logan also raised concerns about the proposal to reform the governance arrangements of Clinical Commissioning Groups (CCGs) within Sustainability and Transformation Partnerships (STPs).

 

Ms Logan invited the Health and Wellbeing Board to attend a rally on the 14th October 2017 which will address these issues.

 

Terry Huff, Chief Officer WFCCG, responded to Ms Logan’s presentation. He explained that there has been a recent update about King George Hospital. A review of the proposals found them not to be realistic as they had been based on figures that did not take into account how consultants would work with patients across geographical areas. Moreover, the cost of the change would amount to approximately £100 million, which is unaffordable. In light of this, it has been agreed that there will be a further review of the proposal due to be completed in 2019. As a result the hospital will not be closing in 2019.

 

Engagement: Althea Bart, representing Healthwatch Waltham Forest, raised a concern about the lack of engagement with patients within the creation of   STPs. The Chair asked what effective engagement looked like. Althea responded by saying that patients should be involved at every step of the process when developing new structures and that there needed to be a better processes for patients to express their views, for example, Patient Participated Groups (PPGs) need to be introduced and effectively managed in all GP surgeries. The Lime Tree GP surgery patient away day was highlighted as an effective engagement session.

 

Accountable Care Systems: Ms Logan informed the group that Waltham Forest, Tower Hamlets and Newham have been grouped together to deliver an Accountable Care System. The Board were in agreement that the Accountable Care System should be sourced locally and integrated with other local services. Both Terry Huff and Linzi Roberts-Egan confirmed that they would advocate for this solution. There will be a report going to Cabinet this month on this issue.

 

Mary Burnett, Save Our NHS Waltham Forest, alerted the group to an article in the Independent newspaper, which reported that up to 40% of NHS beds, could be reserved for private patients. She emphasised that NHS beds were a public asset and was concerned there may be a masking of private involvement. Heather Noble, Medical Director for Whipps Cross, confirmed there were no private beds reserved for private patients at Whipps Cross.

 

Bed Audit Group: Terry Huff informed the group of a working group called the Bed Audit Group. This group falls under the Better Care Together Board which reports to the Health and Wellbeing and CCG Boards. Health and Wellbeing Board members requested to see the bed audit group report.  ...  view the full minutes text for item 16.

17.

HEALTHWATCH FORUM MINUTES pdf icon PDF 51 KB

Minutes:

Due to time constraints, the minutes were noted and it was agreed any questions or comments should be directed to Althea Bart, Healthwatch.

18.

ANNUAL REPORT pdf icon PDF 3 MB

Minutes:

The Annual Report was presented by Joe McDonnell, Director of Public Health. Questions and comments were taken after his presentation.

 

The group broadly discussed key priorities and challenges. Linzi Roberts-Egan said that the real challenge for this Board is measuring value and determining how they are making a difference.

 

The Chair commented that the breadth and range of issues that require attention is an issue but she is looking forward to working with the Board as a critical friend.

 

Terry Huff raised the importance of seeing performance reports over the course of the year so issues can be addressed earlier. Performance data is on this group’s forward plan for the year.

 

Councillor Grace Williams noted the achievements of cross partnership working between the Board and the Children’s Health and Wellbeing Sub Committee. She said the immunisation focus at today’s meeting is due to a link made at the Children’s Health and Wellbeing Sub Committee.

 

Board Members requested to see the infrastructure plan and borough demographics report. Lucy Shomali, Director of Regeneration and Growth said she could provide this information. Althea Bart requested that the report be in a summarised format and accessible language is used so patients can easily digest the information.

 

The Board Noted the report and the Chair thanked the Director of Public Health for his presentation.

 

Actions:

 

(a)  Lucy Shomali to circulate the Infrastructure Plan and Borough Demographics Report for discussion at this Board within a wider agenda item re One Public Estate work. This report will go to the Board’s Business Management Group (BMG) in January 2018 and then come to the Board in March 2018.

 

19.

SCORECARD UPDATE, INCLUDING ACTION PLANS FOR INDICATORS pdf icon PDF 305 KB

Minutes:

Joe McDonnell presented the item. The Scorecard was launched in early 2017 and measures the level of performance against health targets. The National and London average are used for benchmarking.

 

Lucy Shomali asked whether there was scope to re-examine Scorecard indicators, including housing-focused ones, Joe McDonnell stated that this would be discussed at the January 2018 Business Management Group. 

 

Terry Huff Chief Officer at WFCCG explained that the Scorecard does not include all health targets, it is a list of areas this Board could work better together on.

 

Councillor Naheed Asghar asked the Director of Public Health about young people’s mental health referrals. The Director responded by saying that referrals from schools for young people’s mental health tend to be seasonal, with a drop during exam periods and school holidays, explaining the fall from previous quarter. He said the CAMHS partnership plans to work closely with schools to increase referral numbers.

 

The Board noted the Annual Report.

 

20.

STRATEGIC PRIORITIES - UPDATED ACTION PLANS pdf icon PDF 194 KB

Additional documents:

Minutes:

Due to time constraints this item was not discussed in detail. The Chair advised any member who has a question or comments regarding the item, to write to Suzanne Elwick, Head of Strategic Partnerships and Joe McDonnell, Director of Public Health, who will report back at a later meeting.

 

21.

IMMUNISATION DEEP DIVE pdf icon PDF 343 KB

o   What happens to children, including those with additional needs e.g. looked-after children, those with learning and physical disabilities – who cannot easily access immunisations through school?

o   Why does NHSE only commission an immunisation service for babies born within the NHS Trust up to 28 days old, which excludes  ...  view the full agenda text for item 21.

Additional documents:

Minutes:

This item was presented by Dr Catherine Heffernan, Principle Advisor for Commissioning Immunisation and Vaccine Services, Public Health England/NHS England.

 

Key points made by Dr Heffernan:

 

  • London’s immunisation performance is lower than the national average because the population is two or three times larger than other areas, which skews the figures. London also tends to have transitional populations.
  • There is a shortage of Practice Nurses because London is an expensive city to live in.
  • Additional immunisations have been introduced that have increased the workload.
  • The London Immunisation Plan is a 2-year commitment document.
  • BCG is not a universal programme. BCG is a TB vaccine which is given to babies to protect them from getting TB meningitis. It does not prevent acquiring TB.
  • There is a universal offer given in maternity wards, with follow-up only for babies in a high risk group.
  • There are stock shortages globally for BCG vaccine. Public Health England has sourced an unlicensed vaccine that needs to be prepared in bulk for up to six babies. If babies don’t attend the appointment the vaccine is wasted.
  • 40 cases per 100,000 is considered high risk. It was noted by Joe McDonnell that the rate in Waltham Forest was 38 cases per 100,000, very close to high risk levels.

 

High risk: Councillor Grace Williams was concerned that although Waltham Forest was a high risk area, there was little research into the rate of infection in the borough. She felt the issue was not being adequately addressed. Councillor Williams asked Dr Heffernan if there would be catch up immunisations when new vaccine stock was procured.

 

Dr Heffernan explained that there would not be catch up immunisations as the NHS only provides the vaccinations to children up to 12 months old. The baby’s natural immune system should start to work after this time. She reminded the group that the vaccine was not a cure to TB meningitis it is a preventative measure. 

 

The Deputy Chief Executive of Waltham Forest Council, Linzi Roberts-Egan, said the Board should be concerned about why there is a gap in risk between Waltham Forest and neighbouring boroughs. She said health inequalities play a large role in the rate of infection and it was the responsibility of all members of this Board to deliver on the Action Plan. GPs also need to be proactive about immunisation.

 

The Chair acknowledged there was an issue of vaccine uptake varying from practice to practice. She asked for suggestions on how to improve uptake.

 

Dr Heffernan suggested Action Plans to be drawn up for GP practices to increase immunisation uptake. With regard to the Child Flu Programme, she found some GPs thought this was voluntary and did not do re-calls for parents who missed appointments. Parents and the general population need to be better educated on immunisation.

 

Dr Heffernan also publicised a pilot vaccine called MenACWY which prevents meningitis and septicaemia. It will be administered to 18-25 year olds.

 

Dr Heffernan reported that she is an administrator on the global immunisation  ...  view the full minutes text for item 21.

22.

WHIPPS CROSS - END OF LIFE CARE pdf icon PDF 283 KB

How is Whipps Cross working with partners to increase the choices people have for End of Life Care?

Minutes:

Due to time constraints, the Chair requested any questions or comments on this item should be directed to heather.noble@bartshealth.nhs.uk . Heather is to email democratic services with any questions she received and the response she gave, to be circulated for information at the next meeting.

 

Action:

 

(a)  Board to contact Heather Noble if they have any questions in relation to this item. Heather Noble to send any feedback to the democratic services officer to circulate at the next meeting.

 

23.

SUBSTANCE MISUSE NEEDS ASSESSMENT pdf icon PDF 235 KB

Minutes:

The Board noted the report.

24.

SECTION 106 GOOD GYM PROPOSAL (FOR INFORMATION) pdf icon PDF 272 KB

Minutes:

The Board noted the report, with no objections.

25.

ANY OTHER BUSINESS

Minutes:

James Partis, Head of Transformation, notified the Chair that the Better Care Implementation Plan will be ready for the next Health and Wellbeing Board Meeting.