Agenda and draft minutes

To note the following membership changes for the 2024/25 municipal year:

·       Replace Councillor Ben Coleman with Councillor Bora Kwon

·       Replace Philippa Johnson with Caroline Farrar, HCP Managing Director

·       Replace Linda Jackson with Katharine Willmette, Interim Director of Adult Social Care

To agree the following addition to the membership:

·       Add Sarah Bright, Director of People’s Commissioning, Transformation and Partnerships as a non-voting member

RESOLVED

1. That the Health & Wellbeing Board noted the following membership changes for the 2024/25 municipal year:

·       Replace Councillor Ben Coleman with Councillor Bora Kwon

·       Replace Philippa Johnson with Caroline Farrar (HCP Managing Director)

·       Replace Linda Jackson with Katharine Willmette (Director of Adult Social Care)

2. That the Health & Wellbeing Board agreed the following addition to its membership:

·       Sarah Bright, Director of People’s Commissioning, Transformation and Partnerships as a non-voting member

Apologies for absence were received from Councillor Bora Kwon, Caroline Farrar, and Detective Chief Inspector Mark Staples.

Apologies for lateness were received from Councillor Rowbottom (who entered the meeting at 6.58pm).

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 Standards Committee.

There were no declarations of interest.

To approve the minutes of the previous meeting as an accurate record and note any outstanding actions.

RESOLVED

That the minutes of the meeting held on 12 March 2024 were agreed as an accurate record.

This item presents the Health and Wellbeing Strategy 2024-2029 for approval.

Dr Nicola Lang (Director of Public Health) presented the Health and Wellbeing Strategy 2024-2029 for approval. Dr Lang explained that producing a Health and Wellbeing Strategy was a key function of the Director of Public Health and a statutory duty for the local authority. She talked about the work undertaken to ensure the strategy was informed by the latest data and residents – including oversampling groups that didn’t normally have a voice like new immigrant communities.

Dr Lang highlighted the Strategy’s four priorities:

• Address key health issues innovatively and proactively so that people stay as healthy as possible for as long as possible
• Amplify community strengths and capabilities to tackle health inequities
• Cultivate the conditions necessary for people to flourish and build their resilience
• Eliminate the barriers to information and mitigate misinformation

Councillor Alex Sanderson thanked Dr Lang and commended the strategy.

Councillor Natalia Perez thanked officers for the report. She then asked if officers were satisfied by the level of community engagement achieved, or if there were areas to improve on. Dr Lang said the work done for the Strategy was the start of a continuous process of engagement and listening to communities across the borough. She gave the example of two recent awards of NHS inequalities funding of £30,000 for conversations with Muslim groups to lead their own work around awareness of immunisations and cancer screening and £10,000 for gym memberships for care experienced children.

Councillor Perez asked if children’s mental health was a priority, particularly the negative impact of social media. Dr Lang said it was a key issue and Public Health worked closely with colleagues in Education on this issue. Jacqui McShannon noted that this was one of the advantages of a unified People’s department that combined Children’s Services, Adult Social Care, and Public Health. Councillor Sanderson noted that Fulham Boys School had recently banned smart phones for younger pupils and was interested to see the impact.

Sue Spiller praised the Strategy and asked if thought had been given to how to publicise the strategy and reach the people that needed it. Dr Lang said that the department had learned a lot about engaging different communities during the Covid-19 pandemic. For example, some groups preferred to receive messages via WhatsApp rather than Facebook or other platforms. The team were also trying new things such as producing a video on the MMR (measles, mumps and rubella) vaccine in various community languages that was directly shared with mothers. They listened to groups and tried to do what they said was most effective.

Councillor Sanderson asked what the next steps were for the Strategy. Dr Lang explained that once it had been agreed, it would be published, then work would continue on the priority areas.

Councillor Perez asked about the timeline for reviewing priorities and if emerging needs could be incorporated. Dr Lang said the team would come back to report on progress against the action plan annually. She ensured the Board that emerging issues could be incorporated in-year.  ...  view the full minutes text for item 5.

Katharine Willmette to provide a verbal update on the Social Care Position Statement and CQC inspection.

Katharine Willmette (Director of Adult Social Care) provided a verbal update on the Social Care Position Statement and Care Quality Commission (CQC) inspection.

Katherine Willmette gave a summary of changes in Adult Social Care over the past few months and noted that following a corporate reorganisation, Adult Social Care and Public Health had joined with Children’s Services to form the new People department led by Jacqui McShannon. This new department had a unified leadership team with shared governance arrangements and enabled closer working around key areas such as special educational needs and disabilities (SEND).

The department’s top priority in the short term was the upcoming CQC inspection of Adult Social Care. She explained that it was a new inspection process that had only been running since December 2023. The inspection covered all Adult Social Care teams. The inspection was in two parts - the first was a self-assessment and information gathering which started in May, then a site visit which had been scheduled for 21 October. The inspectors would meet with frontline staff, residents, carers, and partners including the NHS and the voluntary sector. It was a comprehensive process that would result in an Ofsted-style grade of outstanding, good, requires improvement etc. She added that the CQC process was new and evolving, and so each local authority had a slightly different experience – so it was harder to prepare for. There was a lot of work involved but staff were reasonably confident.

Nadia Taylor asked if the Council had a say in which partners the inspectors spoke to. Katherine Wilmette said the inspectors decided who to speak to.

Nadia Taylor asked how confident officers were going into the inspection. Katherine Wilmette said staff were confident, but it was new for many of them. Jacqui McShannon noted that inspections always provided useful insights and direction.

Sue Spiller asked if the self-assessment had highlighted any areas that required further work. Katherine Wilmette said their focus was ensuring that learning from partners and internally was embedded in all areas of their work. She gave the example of the co-production strategy and the importance of ensuring that it feed through to frontline staff. She also noted the importance of working with partners to build on existing positive relationships.

Sue Spiller noted that the Council used to have an internal quality assurance team and worried that with the turnover of staff in recent years she worried that some of that learning would be lost. She also said it was important to keep external partners updated with changes to systems and processes. Katherine Wilmette agreed that staff turnover meant the department had to work harder to retain learning. She added that there was still a quality assurance team, and they were a key part of ensuring teams responded to feedback and learning.

Councillor Alex Sanderson said she had been reading several CQC reports in preparation for the inspection and noted there was volatility in the grades given, despite similar write-ups. She said there was a lot  ...  view the full minutes text for item 6.

This Better Care Fund (BCF) paper sets out the London Borough of Hammersmith & Fulham and the H&F Integrated Care Board’s proposed plan for 2024 – 2025 and the BCF quarter 1 report which were submitted to NHS England on 5 July 2024 and 29 August 2024 respectively.

Julius Olu (Assistant Director for Independent Living, Commissioning & Partnerships) presented the paper which set out the Council and the H&F Integrated Care Board’s proposed plan for 2024 – 2025 and the BCF quarter 1 report which were submitted to NHS England on 5 July 2024 and 29 August 2024 respectively. He explained that the Better Care Fund supported community health and social care resources to reduce the number of people who needed to be admitted to hospital. Residents that did require admission to hospital were supported to get home as soon as they are well. He added that the plan had been signed off by Chair’s action in June and had come to the Board to be ratified.

Councillor Rowbottom noted that at the Board meeting on 20 September 2023, there had been a discussion^[1] about the discrepancy between delayed transfers of care statistics from the Council and the NHS and asked if this had been resolved. Sue Roostan said they had regular escalation meetings with Imperial College Healthcare NHS Trust but noted that there could be discrepancies due to differences in data collection. She said she could share information on this with Board members.

ACTION: Sue Roostan

Councillor Natalia Perez asked if there were any areas of concern at this stage of the reporting. Julius Olu said there were no areas of concern at present.

Councillor Rowbottom asked if there had been any negative impacts from the reduced capacity of the Police to issue section 136 orders. Katherine Willmette said it was her understanding that the impact had been mostly felt by the NHS. She clarified that the issue was that the Police were not attending sectioning and welfare visits unless there was an immediate risk to a person. She said more work was needed to understand the impact. Councillor Perez asked to look at this issue in more detail at the Health and Adult Social Care Policy and Accountability Committee meeting in November.

ACTION: Katherine Wilmette

Sue Spiller asked if it was possible to flex money to support additional capacity in high pressure areas. Sue Roostan said funding was usually allocated for specific purposes and was difficult to move in-year.

RESOLVED

1. That the Health & Wellbeing Board, ratified the planned total expenditure and the proposed schemes in the plan for 2024-2025 (Appendix 1).

2. That the Health and Wellbeing Board ratified the BCF quarter 1 report for 2024- 2025 (Appendix 2).

3. That the Health and Wellbeing Board receive an end of year report outlining the outcomes of each scheme and the difference it has made for residents of H&F.

Susan Roostan to provide a verbal update on the work of the Integrated Care Board.

Susan Roostan (H&F ICB Borough Director) provided a verbal update on the work of the Integrated Care Board (ICB). She noted that the ICB covered eight London boroughs: Brent, Ealing, Hammersmith & Fulham, Hillingdon, Harrow, Kensington & Chelsea, and Westminster. NHS North West London had a budget of £6 billion serving 2.1 million residents. Their goal was to help local people live healthier lives, improve the quality of healthcare, tackle inequalities and make sure the NHS makes best use of resources.

Susan Roostan discussed the ICBs new organisation structure, ways of working, and values of inclusivity, respect, innovation, and empowerment. She also highlighted the Joint Forward Plan and its nine priorities for the next five years:

• Reduce inequalities and improve health outcomes through population health management
• Improve children and young people’s mental health and community care
• Establish Integrated Neighbourhood Teams (INTs) with general practice at their heart
• Improve mental health services in the community and for people in crisis
• Embed access to a consistent, high quality set of community services by maximising productivity
• Optimise ease of movement for patients across the system throughout their care – right care, right place
• Transform maternity care
• Increase cancer detection rates and deliver faster access to treatment
• Transform the way planned care works

Jacqui McShannon thanked Susan Roostan for the update and added that the Council had also undertaken a restructure, with a new People department that comprised Children’s Services, Adult Social Care, and Public Health. A new post had been created – Director of People’s Commissioning, Transformation and Partnerships – to give more capacity to work with health partners in a responsive and flexible way. Jacqui McShannon then reiterated the Council’s commitment to work in partnership with the ICB for the benefit of the borough’s residents.

To suggest items for the Board’s work programme.

Members made the following suggestions for the work programme:

• Update on vaccines
• Review of suicide prevention (following commissioning in 2025)
• A regular Healthwatch update at future meetings
• Community mental health services – including capacity, what support is available, engagement and access for different communities

To note the following dates of future meetings:

·       11 December 2024

·       19 March 2025

The following dates of future meetings were noted:

• 11 December 2024
• 19 March 2025