Agenda and minutes

To approve as an accurate record and the Chairman to sign the minutes of the meeting of the Health & Wellbeing Board held on 9 September 2013.

RESOLVED THAT:

(1)   The minutes of the Health & Wellbeing Board held on 9 September 2013 be approved and signed as a correct record of the proceedings.

(2)   The HWB would recommend to the Council that two additional members of the Hammersmith & Fulham Clinical Commissioning Group (CCG) should be appointed to the HWB and that all members should be entitled to vote.

Apologies were received from Trish Pashley.

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. 

There were no declarations of interest.

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.

RESOLVED THAT:

The work programme be noted.

This report sets out the draft H&F CCG Commissioning Intentions for 2014/15.

Dr Tim Spicer tabled a summary of the key areas of intent from the H&F CCG Commissioning Intentions for 2014/2015. There would be further changes to the document during the following week, but substantial alterations to the majority of intentions were not anticipated.

Dr Spicer referred to the graphic representation of the process, which indicated that the CCG was currently refining/developing commissioning intentions, which were summarised by joint CCG and local authority (LA) and CCG specific intentions, subsequently split to indicate health only intentions.

In respect of Children’s services, it was agreed that the work with LA social care and education partners to develop robust plans for delivering the new Children and Families Legislation (statute September 2014),  which was included in the detail of the report should also be brought forward as a headline.

Keith Mallinson referred to community dressing services and the high number of patients presenting to Urgent Care Centres (UCC). Dr Spicer responded that there were different models of tissue viability services across the country. H&F CCG was currently redrafting the details of the provider statement. Whilst there would always be a requirement for some home visits, patient experience and outcomes seemed to be better by centralising services, maybe at a local hospital.

Liz Bruce referred to anxieties around joint commissioning and specifically the Tri-Borough Community Intelligence Service specification and learning disabilities essential activity. There were cross cutting issues in respect of for example transition from children’s to adult services, including specialised educational needs.  Dr Spicer responded that transition this was clearly a risk area from a clinical aspect.

Councillor Georgie Cooney queried the continued use of the hydro-therapy pool. Dr Spicer responded that  this would be dependent on  which therapies the providers considered to be best. 

Eva Hrobonova queried whether the commissioning intentions could alter spending patterns in terms of care and age groups. Dr Spicer responded that whilst the commissioning process made it difficult to give a definite answer,  it was intended to shift resources away from unplanned to planned care.

Andrew Christie commented that the forward plan for the Local Safeguarding Children’s Board might overlap with that of the HWB, and there were a number of serious case reviews where issues might be relevant to the HWB, such as the CCG and LA working together, particularly in respect of information sharing. A report could be brought to a future meeting as the basis for a discussion on how the two boards could ensure that vulnerable people were being supported. Ms Bruce stated that these issues linked with the HWB’s responsibility for the implementation of the learning from the Winterbourne View Inquiry.

Mr Mallinson commented that education should also be included. There were specific issues in respect of children in bed and breakfast accommodation and encouraging parents to avail themselves  of services.

Action:

A report/discussion on support to vulnerable children and adults to be added to the work programme.

Action: Sue Perrin

Dr Spicer responded to a comment in  ...  view the full minutes text for item 26.

The consultation draft sets out a new shared vision for the development of Hammersmith & Fulham over the next eight years.

Peter Smith presented the strategy document, which had been drafted by Council officers and key partners, to present an overarching vision for the future of the borough. There was currently a public consultation, with a deadline of 16 December 2013.

The forward by the Leader of the Council set out the seven key priorities for delivering the Council’s vision for the borough.

The section ‘Improving Health and Wellbeing’ had been drawn from the draft HWB strategy.

It was proposed that should be specific priorities be added in respect of children and young people and adult health and social care.  The priorities needed to be developed into desired outcomes.

It was agreed that reference should be made to the substantial changes which will be brought about by the new Children and Families Legislation.

Action: Peter Smith

In response to a query in respect of the difference in life expectancy, Dr Spicer outlined one approach whereby an individual’s risk was assessed and resources supplied to mitigate. Frequently, there were other factors such as housing and access to work. Ms Hrobonova added that it was not possible to say how great a difference could be made, but by better understanding the elements, it was possible to change behaviour and to put in place interventions. Access and better knowledge of data was essential, for example in respect of the biggest causes of preventable deaths.

RESOLVED THAT:

The strategy document be noted.

This report updates on progress against health and wellbeing priorities.

David Evans presented the strategy, which was being consulted upon in parallel with the Community Strategy. Members considered priority 6, ‘to develop better access to suitable housing for vulnerable older people’.

Members considered the role of the HWB , including the governance arrangements and the value added by the HWB. It was agreed that both the integrated health and social care services and  the White City Collaborative Care Centre (Park View) would have happened without the HWB, but other priorities might not have happened without the HWB.

Members commented that the objectives, and specifically ‘every child has the best start in life’  were too broad.

Ms Bruce commented that the HWB had an important role in bringing together a range of partners to work collaboratively.

Ms Hrobonova confirmed that the priorities were broadly aligned with the CCG Commissioning Intentions.

RESOLVED THAT:

(i)                  The Cabinet Member for Housing and Executive Director for Housing be invited to the next meeting to discuss better access for vulnerable people to sheltered housing.

(ii)                The HWB priorities should be amended to be more focused, with specific outcomes..

(iii)               In respect of Governance Arrangements, the value added by the HWB should be linked into the consultative document.

(iv)              An update on the priorities, with an additional column to indicate the value added by the HWB,  should be a standard agenda item.

This report updates on child oral health improvement initiatives delivered in the London Borough of Hammersmith & Fulham since 2011, including an overview of the ‘Keep Smiling Programme,’ a school-based outreach programme.

Dr Claire Robertson presented the update on child oral health improvement initiatives, including an overview of the ‘Keep Smiling Programme’, a school-based outreach programme.

A child health day was planned for younger children.

Dr Robertson requested that the HWB recommended how the programme could engage with GPs. Dr Spicer responded that the programme could be promoted through the GP networks. It could also be a contractual issue in respect of provider expectations. It was agreed that Dr Robertson would meet with the CCG, and provide a brief update to the January HWB.

Action: Claire Robertson/Tim Spicer

Councillor Binmore requested that the original statistics be revisited, with a view to demonstrating the impact of the programme.

Mr Mallinson queried emergency provision for children who were not registered with a GP. Dr Robertson responded that the nurse led triage and those in immediate need would be allocated an urgent care slot with  a clinician on the following day.

RESOLVED THAT:

The ongoing work be noted.

This report updates on the first meeting of the JSNA Steering Group and current progress on the JSNA work programme.

Ms Hrobonova presented the report and highlighted that: the first meeting of the Tri-borough JSNA Steering group had taken place; the post of JSNA Manager had been advertised; there had been no new applications for JSNA ‘Deep Dives’ for the three boroughs; and the JSNA highlight report had been drafted.

Councillor Binmore proposed that a female genital mutilation deep dive.

In respect of the highlights report, Councillor Binmore queried:

·        the source and back up data of the report that the number of children reaching school readiness had dropped;

·        the data in respect of education attainment.

Action: Eva Hrobonova

RESOLVED THAT:

The report be noted.

Ms Bruce stated that information in respect of Integration Transformation Fund allocations was expected in the Autumn statements for both health and local authorities.

North West London had been successful in becoming a pioneer site to showcase innovative ways of creating change in the health service across the eight London boroughs.  

The initiatives would include: prevention and early intervention to reduce the number of unplanned emergency admissions to hospitals, with better outcomes for patients and better experiences of care. Financial savings were also expected.

The plan would be submitted to the January meeting for approval and submission on 15 February.

RESOLVED THAT:

(i)                  The oral update be noted.

(ii)                A report on the North West London site be added to the work programme.

The Board is asked to note that the dates of the meetings scheduled for the municipal year 2013/2014 are as follows:

13 January 2014

24 March 2014