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Agenda and draft minutes

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

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Items
No. Item

1.

APOLOGIES FOR ABSENCE AND SUBSTITUTE MEMBERS

Minutes:

Apologies of absence were received from Councillor Hather Ali, Althea Bart, Joseph Lindo, Neil Young, Suzanna Elwick and Linzi Roberts-Egan.

 

2.

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:

There were no declarations of interest.

 

3.

MINUTES OF THE PREVIOUS MEETING pdf icon PDF 332 KB

Minutes:

The Chair asked for an update on the actions from the meeting held on the 18th June 2019.

 

Item 35 - Mr McDonnell said that how respiratory diseases could be considered by the Board would be discussed at the next meeting of the business management group (BMG).

 

Mr Carter said that both Whipps Cross and NELFT had had agreed to sign the Time to Change pledge. He added that the work CCG were also considering signing up to the pledge. Mr Carter said that a plan was in place to organise a joint-signing of the Time to Change pledge in February 2020. Mr Gurney said that Barts Health had originally signed up to the pledge in 2012 but would sign up again.

 

Mr Lobban said that following the discussion around the response to the Health Scrutiny Committee’s recommendations at the last meeting, homelessness would be considered as a priority and would also nominate a homelessness champion and would act as the champion in the interim. The issue would also be raised with the Sustainability and Transformation Partnership (STP)

 

The Board agreed the minutes of the meeting held on the 18th June 2019 as a correct record and the Chair signed the minutes.

 

4.

SCORECARD INDICATORS UPDATE pdf icon PDF 634 KB

Minutes:

Mr McDonnell updated the Board, highlighting that the scorecard indicators were part of the development for the year and would try and create a focused scorecard on the priority areas. He suggested that new indicators would be based on the actions plans in the agenda pack at Item 5 - Health and Wellbeing Priorities for 2019-21.

 

5.

HEALTH AND WELLBEING BOARD PRIORITIES FOR 2019-21 pdf icon PDF 767 KB

Additional documents:

Minutes:

Consideration was given to a report from the Director of Public Health. Mr McDonnell presented the report and explained how each priority would be reported to the Board and how issues would be raised. He added that the proposals for governance on each priority would ensure that the Board would be able to monitor and follow up the work and ensure that one partner is not being overloaded with work on a singular priority.

 

6.

ALCOHOL & DRUGS (SUBSTANCE MISUSE)

Minutes:

Mr McDonnell said that tackling substance misuse had been one of the Board’s priorities over the previous years. Officers had been looking at new collaborations with partners and suggesting new pathways for support. Mr McDonnell said that there had been further progress support for residents with both substance misuse and mental health issues.

 

Mr McDonnell said that the aim of the priority going forward was for more of an integrated care approach for substance misuse and to help partners see this as a health issue, which he added was one of the issues that had been raised. In addition, partnership work, including for young people, the Council’s licensing team, and the criminal justice system, would focus on addressing the root causes of substance misuse and raising awareness. He said that work would be led by the Alcohol and Drugs Steering Group working with the Violence Reduction Steering Group.

 

Ms Flinders suggested that there was a need to demonstrate to the Board what this would look like in action and that there was a need for an evidence base. Mr McDonnell said that the scorecards would lend to this, but many of the indicators had been treatment focused, as these had been seen as easier to measure, but noted that this was still in the discovery phase.

 

The Board agreed the proposals set out in the report.

 

Actions:

 

  • Joe McDonnell to bring completed the Forward Plan to the next meeting of the Board.

 

7.

MENTAL HEALTH FOR ALL

Minutes:

Mr Carter said that this was a new priority for the board which reflected the focus of integrated commissioning.

 

He said that the report proposed that the mental wellbeing sub-group would report back the Board, with other aspects of mental health reporting back via the Better Care Together board. There are several different groups operating in the borough and officers would try and ensure that work was not duplicated. Children’s and Adolescent Mental Health Services (CAMHS) would still report to the Board separately.

 

Mr Carter said that the membership of the group had been officer focused, but this reflected the involvement of the council services within the sub-group.

 

Councillor Williams clarified if CAMHS would sit completely separately from the sub-group in terms of governance. Mr Carter said that the sub-group would look at the wider issues for children. Mr Gurney asked if NELFT were involved with the sub-group. Mr Carter confirmed that they were.

 

Mr Lobban said that the Board should note that the duplication of work needed to be avoided and in areas such as CAMHS that offers need to be looked before approaching the group. He added that he wanted to ensure that conversations were happening at the Board to help join up work.

 

Mr McDonnell said that governance for the CAMHS board sits with the Better Care Together (BCT) fund, but the report indicated that the Board was able to do. Projects had been initiated and officers were now reviewing if the projects had been transformative.

 

The Board agreed the proposals set out in the report.

 

 

8.

HEALTHY LIVING (FOCUS ON HEALTHY WEIGHT, INCLUDING DIABETES IN 2019-20)

Minutes:

Mr McDonnell said that a new strategy was being proposed, after being a priority for two years, particularly looking at tackling areas such as place + environment, food provision and stigma. The Public Health team would continue to chair the sub-group meetings.

 

The Chair asked if Healthy Living was being looked at with other issues, particularly poverty. Mr Carter said that this would come under place + environment. Ms Custance said that this was part of the scope of the Local Plan and would be monitored.

 

The Chair asked if restrictions on fast or unhealthy food could also be put on newsagents and other similar retailers. Mr Carter said that officers were working together with the Mayor of London’s office on a healthy eating plan, which would apply to food retailers of all sizes, but officers would consider the retail sector alongside this.

 

Dr Aswani acknowledged that the sub-group was targeting groups at risk but asked to what extent the sub-group would target those who have long-term illnesses and would GP’s receive any information to help signpost patients to these services. Mr Carter said that officers were providing training for GP’s and had been looking to expand the training to others to help inform them of the services available.

 

The Board agreed the proposals set out in the report.

 

Actions:

 

·         Joe McDonnell to meet with Mark Lobban to confirm who will attend the sub-group to represent commissioning.

 

9.

CHILDREN'S HEALTH & WELLBEING SUB COMMITTEE (CHWBSC) pdf icon PDF 991 KB

Minutes:

Consideration was given to a report from the Director of Public Health. Mr McDonnell presented the report and said that the CHWBSC had started approximately four years ago replacing the ‘Best Start in Life Board’ providing a dedicated place to discuss children’s health and wellbeing issues.

 

Mr McDonnell drew the Board’s attention to the chart in the agenda pack, which showed the what issues the CHWBSC had looked at, highlighting the borough had improved figure for tackling child obesity levels, but there were high levels of need in children’s dental health and summarised the rest of the report to the Board.

 

He noted the challenges that were being faced by the CHWBSC, which included the lack of engagement from schools, the lack of primary care perspective and the lack of organisation buy-in to strategic priorities. Mr McDonnell observed that the CHWBSC had focused on non-clinical issues.

 

Councillor Williams welcomed the opportunity to talk about the priorities in CHWBSC and praised the report as it celebrated the achievements and identified the gaps in the service. She said that it was important for schools to engage and wished to ensure that sub-committee engaged with partners and council programs. Councillor Williams said the sub-committee needed to consider the when the meeting was held to ensure attendance and review the terms of reference. She suggested that that sub-committee is used to look at the wider issues and then technical groups could look at issues such as commissioning. She concluded that bringing partners together will help tackle issues such as immunisation rates and suggested that the children’s commissioner visit the Council’s Corporate Parenting Board.

 

The Board agreed the proposals set out in the report.

 

10.

CHILDREN'S COMMISSIONING pdf icon PDF 699 KB

Minutes:

Consideration was given to the joint report from the Associate Director of Health and Social Care Integration & Better Care Together Programme and the Assistant Director of Commissioning.

 

Mr Newman introduced the report noting that this was part of the Integrated Commissioning System being developed and the paper reflected a scoping exercise which looked at the work happening around children in care, care leavers, SEND and children with mental health needs.

 

He said that the previous focus of commissioning had been centred around the Ofsted improvement plan, so some areas of commissioning had been not been as developed, but the needs and demands were set out in the paper and said that officers were looking at improving practice.

 

Mr Newman added that conversations were taking place on how commissioning would work across North East London as there was no single overarching board for the children and young people landscape.

 

Ms Russell said that the all age approach as difficult as different providers offered different approaches. Officers wanted to ensure that children were represented within these groups and feel that their issues made it to the table. She added that the priorities mirroring each other at the STP level had been helpful.

 

The Chair said that this could be a possibility once leadership for this had been identified within the CCG. Dr Aswani said that new directors and leads were currently being recruited, but the CCG could look internally at ways to support the group.

 

Mr Palfreman said that there was evidence that there were 280 children in the borough living with life threatening illnesses, but the evidence also suggested that this figure could be higher. He said that it was correct to ensure that the right services are provided. He noted that Haven House Children’s Hospital had seen successes and wished share them with partners.

 

The Board agreed the proposals set out in the report. The Board also agreed that the CHWBSC would have oversight of the Children’s Commissioning priorities.

 

11.

LONG TERM PLAN RESPONSE FOR NORTH EAST LONDON pdf icon PDF 854 KB

Minutes:

Mr Scott introduced the report to the Board

 

He said that the East London Health & Care Partnership had been putting together a development plan and involving working groups across North East London. He said that the report outlined the framework and gave case studies. Mr Scott added that North East London had seen one of largest increases in population growth in the UK and there was a need to look at how hospitals operate, and how care is delivered in the borough. He said that there was also a need to focus on the workforce and making the area an attractive place to work and noted that more GP’s were staying in the area after training.

 

Dr Aswani said that it was also important to remember the work that was happening within the borough specifically, particularly the redevelopment of Whipps Cross hospital and the Integrated Care System pathways being developed. He added that he wished to maximise the potential of primary care networks, particularly as they still felt very local.

 

Mr Gurney said that the work being completed would also contribute in preparing for the Whipps Cross hospital redevelopment, which Mr Scott would be part of the submission sent in September 2019. Mr Gurney added that he wanted to ensure that it is all correct with the regulator.

 

12.

JOINT STRATEGIC NEEDS ASSESSMENT pdf icon PDF 639 KB

Minutes:

The Board agreed to vary the order of the agenda, as reporting officers were not present at the time. Item 14 – Joint Strategic Needs Assessment was taken as item 12

 

Consideration was given to a report from the Senior Public Health Analyst. Mr McDonnell presented the report. Ms Jarv and Mr McDonnell provided the Board with a demonstration of the new website, which had been recently soft-launched. He asked the Board to feedback on the information available on the website, to ensure that it was correct and fit for purpose. Mr McDonnell said that the link to the website was in the report and wanted to promote usage of the website. The aim was to have the site fully completed by end of 2020.

 

The Board commented that is was a clear website that was easy to navigate and simple to use. Councillor Williams suggested that it could be used for Connecting Communities. Mr Scott suggested that the section on End of Life care should be moved out of the ‘Elderly’ section.

 

Mr McDonnell said that the site would be useful for decision making in the council and asked the Board if there were any further areas the website could look at.

Mr Lobban said that CCG steering group found the information on the site helpful.

Councillor Williams regarding the poverty figures, if the Life Chances indicators could be used. Ms Flinders said that she would need to see how they would link into the sub-groups and the JSNA.

 

The Board agreed the proposals set out in the report.

 

13.

SEND SELF EVALUATION FRAMEWORK (SEF) pdf icon PDF 874 KB

Additional documents:

Minutes:

Consideration was given to a report from the Interim Director of Disability Enablement Service. Mr Kilgallon presented the report.

 

Mr Kilgallon said that the SEND board would continue. It had been originally focused on addressing the concerns previously raised by Ofsted, but over the autumn it would be redrafted to address wider concerns.

 

Councillor Williams commended that partnership work that had taken place. She said that there was still further work to be completed and there was need to build relationships with schools and families and to stay focused on the current priorities.

 

The Chair said that the Board was happy to assist where they could.

 

The Board agreed the proposals set out in the report.

 

14.

FUEL POVERTY STRATEGY pdf icon PDF 787 KB

Additional documents:

Minutes:

Consideration was given to a report from the Housing Strategy Officer. Ms Revett presented the report, who introduced Mr Ruxton from the HEET Project, which had been working in the borough over the last twenty years. Ms Revett said that the report indicated that there was a need for advocacy and help to identify the support that is available.

 

Mr McDonnell said that he supported the importance of the issue as it had been noted that winter-related deaths in borough were higher than the national average. He added that this fitted into the work of the Promoting Wellbeing sub-group and suggested that the issue could be considered by the BMG, as the issue needed governance at the Health and Wellbeing Board level. Mr Lobban agreed and said that he would take it to the next BMG meeting.

 

Mr Carter said that was also some overlap with air quality and food poverty strategies and suggested that he could work together with Ms Revett.

 

Mr Ruxton said that the main cause of death has been cardio-vascular and respiratory related and said that he wanted to link in people with chronic obstructive pulmonary disease (COPD) and heart failure classes. Mr McDonnell said that the Promoting Wellbeing sub-group considers holistic support needs especially for those with long-term conditions.

 

Mr McDonnell said that tackling poverty in the borough will be on the Council’s priorities in the future and asked Mr Coker if there were other strategies and the reports in the pipeline. Mr Coker said that the fuel poverty strategy was planned to go the Cabinet in December 2019 but was currently unaware of any other reports that would come to the Board in the near future. Councillor Williams said there was a need to look at how the strategy could link in with other existing priorities.

 

The Board agreed the proposals set out in the report.

 

Actions:

 

·         Promoting Wellbeing sub-group to consider the issue of fuel poverty as part of its work

·         Joe McDonnell and Mark Lobban to raise the issue of fuel poverty to be looked at the next BMG meeting.

 

15.

UPDATE: CROSS-CUTTING WORK

Minutes:

None.

16.

WALTHAM FOREST CHILD DEATH OVERVIEW PANEL (WF-CDOP) SUMMARY 2018-19 pdf icon PDF 795 KB

Minutes:

Mr McDonnell indicated to Board that this item was for information only and presented the report.

 

He noted that there had been thirty-one deaths in the borough in 2018-19, half of these had been within Bart’s Health trust. ten deaths had been recorded as coming from consanguineous families and in total three quarters of deaths recorded were attributed to genetic anomalies. Five deaths had related to the child’s access to healthcare and four deaths had related to the mother smoking during pregnancy.

 

Mr McDonnell said that it was difficult to identify trends from just a borough perspective, but in future information will be incorporate from other London Boroughs in North East London to get a better picture.

 

Mr McDonnell also commended the fantastic work of Haven House Children’s Hospice.

 

The Chair asked if faith communities had been approached on the issue of consanguineous marriages. Mr McDonnell said that it occurred in several communities which was being looked at on the STP level. He said that it had been difficult as the focus had been on genetic counselling and not on relationships. But officers ensured that advice was available.

 

Councillor Williams noted that in 2018 that some of the deaths had been caused by violence and suggested that there also needed to be a focus on violence reduction as part of the analysis.

 

Ms White suggested that it was important to narrow down the expected deaths to ensure that parents can have a choice in the location of death of their child.

 

The Board noted the report.

 

17.

ITEMS FOR THE NEXT MEETING

Minutes:

The Chair asked the Board for suggestions of items for the next meeting.

 

Councillor Williams suggested that it would be good to look at poverty and deprivation in the borough.

 

Mr McDonnell suggested that the Board look at Integrated Care strategy, which will be completed by the next board. Mr Lobban said that there were also related items that he could bring to the Board in advance of looking at ICS.

 

Mr Carter suggested that the consultation for the Local Plan could be brought to the Board.

 

Mr Gurney suggested an item on HIV Strategy in Waltham Forest, following attending a seminar on the subject. Mr McDonnell agreed and said that there was no governance around sexual health above the sexual health steering group.

 

18.

MESSAGE FROM THE BOARD