Agenda and minutes

If a Member of the Board, or any other member present in the meeting has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.

At meetings where members of the public are allowed to be in attendance and speak, any Member with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter.  The Member must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where members of the public are not allowed to be in attendance and speak, then the Member with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Members who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Members are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Audit, Pensions and Standards Committee. 

Steve Buckerfield introduced the report of The Children, Young People and Mental Health (CYPMH) Task and Finish Group, which presented a series of recommendations, aimed at improving services for children and young people in the short to medium term.

The report also framed the discussion for the HWB around the development of a new long-term vision for how children and young people accessed support for mental illness across the borough.

In  addition, following concerns raised about inappropriate care and bed shortages nationally, a CAMHS Taskforce was looking at overhauling the way CAMHS are commissioned. It was expected that the Taskforce would report in Spring 2015.

The experience of users of local Children and Adolescent Mental Health Services had been captured in the report, through the mental health charity Rethink.

The Task and Finish Group had agreed to focus on the following three particular areas, where it was agreed that more could be done to improve the outcomes for children and young people:

·         Ensuring early intervention and prevention in relation to children and young peoples’ mental health and wellbeing

·         Reducing the impact of parental mental health disorders on children and young people

·         The transition from Children’s to Adult mental health services.

The report set out 12 recommendations.

Mr Buckerfield stated that the key messages were in respect of:

·         Access: location of services and how delivered.

·         A ‘Whole Family’ approach being adopted in adult mental services, .

·        Parental mental health and the potential impact of any mental health problems on the children for whom they are responsible.

Mr Buckerfield stated that the Rethink project had looked at the experiences of young people from Hammersmith & Fulham of mental health services in the borough, by means of focus groups and surveys, in person and on line. The research had identified a number of key issues.

There were concerns in respect of training for professionals who were not mental health professionals, for example social workers and GPs, and how this could be developed. Hammersmith & Fulham’s Looked After Children CAMHS service had collaborated with Rethink’s Co-production Project and devised a training package for front line staff.  Young people supported by Rethink had successfully delivered a pilot training package for social work staff, which had been well received.  It was intended to extend the training to all workers.

The research had found that young people wanted to raise their mental health concerns with professionals that they knew or were close to. This was particularly the case for ‘looked after’ young people.

Young people would like to self-refer, rather than through A&E and go to a safer place, isolated from A&E.

Co-production brought together young people with commissioners, to work together as equal partners in decision-making around planning, design and the review of mental health services. Champion facilitators and commissioners were trained and empowered to enable them to work effectively together to co-design services.

Members queried the pilot training, how this had been organised, how it could be rolled out, with a  ...  view the full minutes text for item 32.

Julia Mason introduced the report on the School Nursing (SN) Review and Service Redesign. The tri-borough review had found that services in Hammersmith & Fulham were effectively delivering the core requirements of the Healthy Child Programme 5 – 19 years (vision and hearing screening and health assessments), the national child measurement programme, immunisations and safeguarding, but had insufficient capacity to provide a comprehensive preventative and early help service to schools. The SN service needed to be part of an integrated school health model to address changing priorities and new technologies.

The report proposed options for a new service model, within the current financial envelope, which made best use of SN resources and skills. Nationally there was only a small pool of registered school nurses, and the workforce would need to be supplemented by staff nurses, nursery nurses and school nurse assistants.

As NHS England was the responsible commissioner for school aged immunisation, additional capacity would be released when the new service was in place (scheduled to be in place by September 2015).

The report set out the components of the service model, together with two workforce options. Option 1 included a number of lead or specialist roles, and option 2 deployed qualified SNs where they were most needed.

Councillor Vaughan queried how the immunisation service would be monitored. Ms Mason responded that NHSE would have access to the Child Health information system for collation of the data. Performance would be monitored and any variances in uptake would be taken seriously. Public Health would work with NHSE when arising. SNs would continue to have a role in promoting immunisation. There would also be a follow up as part of the review of commissioned services.

Stuart Lines stated that the MMR vaccination was of particular concern. Public Health intended to set up a task and finish group of key players across the whole system, including the CCG to encourage uptake.

It was noted that, in respect of Child Protection Conferences, SNs were, by default, asked to attend, and this was a considerable onus.

Dr Susan McGoldrick queried whether the sharing of SN information with other health bodies had been considered. Ms  Mason responded that SNs did identify relationships and  information sharing. Paediatric hubs had been developed. It worked better where specific issues had been identified and professionals came together in a multi-disciplinary way.  

The consultation had indicated that children and young people wanted a wide range of SN services, from confidential advice and support to the provision of health information. They had stated a preference for individual face to face consultations, but also text and web based information.

Councillor Holder queried the equality implications and work with different communities. Ms Mason responded that clearly there were equality implications, and that it would be possible to bring a full report  as the model and specification developed. The workforce was not large enough to undertake work with different communities. Equality implications could be addressed through better support and access in schools.

Members considered  ...  view the full minutes text for item 33.

The Board received the Healthwatch Central West London Sex and Relationship Education report, which assessed young people’s experiences of sex and relationship education, their ideas of how they wanted sex and relationship education to be delivered and their knowledge of sexual health services.

Mr Lines noted that the report contained key information in respect of commissioning decisions.

Ms Pashley noted the ongoing discussions in adult health services with providers and stakeholders in relation to developing procurement plans and the key message that young people were not getting information as readily as was expected. There appeared to be  a lack of basic information, no clear pathways and no standard for what was delivered in schools in respect of sex and relationship education.

Mrs Bruce stated that Public Health commissioned services across the three boroughs and some approaches were outdated and not meeting needs. This was being reviewed to modernise the offer. There was a clear message that most young people thought that sex and relationship education should be delivered by their peers, not older people.

Mrs Bruce noted that young people should be involved when procuring services.

Mr Christie stated that the money from the Local Authority to fund this work had been cut back. However, schools were keen to bring in help, and there was an opportunity for re-engineering  how the money was spent.

RESOLVED THAT:

1. The HWB supported the recommendations made by Healthwatch.

Action:

Mrs Bruce and Mr Christie to follow up the recommendations.

The HWB received the Annual Report of the Independent  Chair of the Local Safeguarding Children Board (LSCB) 2013/2014, which: set out the achievements against its four key priorities; evaluated the effectiveness of the LSCB overall, described its activities and future priorities; and commented on the linkage to the HWB.

The report highlighted three priorities:

·         Neglect remained a source of concern.

·         Child sexual exploitation, gangs, missing young people, suicide risk were linked further high priorities.

·         Responding to national issues at a local level such as female genital mutilation (FGM) was also a high priority.

RESOLVED THAT:

The report be noted.

The  HWB received a summary of the London Health Commission Report ‘Better Health for London’, which gave a brief overview of the main recommendations of interest to the Hammersmith & Fulham HWB.  

The HWB received the briefing on the Learning and Development Sessions, which set out for members the benefits of participating in these session.

The Board’s proposed work programme for the municipal year is set out as Appendix 1 to this report.

The Board is requested to consider the items within the proposed work programme and suggest any amendments or additional topics to be included in the future.

19 January 2015

23 March 2015