Agenda and minutes

(a)  To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health & Wellbeing Board held on 9 November 2015.

(b)  To note the outstanding actions.

Councillor Vivienne Lukey introduced Mike Robinson (Director of Public Health) and Keith Mallinson (H&F Healthwatch Representative) who had been recently appointed to the Health and Wellbeing Board.

RESOLVED –

THAT, the minutes of the meeting held on 9 November 2015 were approved as an accurate record and signed by the Chair.

THAT, Mike Robinson and Keith Mallinson were appointed to the Health and Wellbeing Board.

Apologies for absence were received from Vanessa Andreae (H&F CCG), Liz Bruce (Executive Director of Adult Social Care) and Ian Lawry (SOBUS).

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 received an update on the progress made in improving partnership and integration in relation to Child Health and Wellbeing. Sarah Bright reported that Early Help and Children’s Centres have been working together to develop an approach for an integrated 0-18 Children and Families Partnership model. It was additionally reported that work was continuing on the design of this approach that would be ready for implementation by 2017.

Andrew Christie drew Members attention to page 14; appendix 1 of the report, which set out the ‘Best Start in Life Care Pathway’. The Best Start in Life (BSiL) was a partnership programme of work across Children’s Centres, CCGs, GPs and midwifery to develop a systematic pathway of care for families from pregnancy to age 5 in order to improve outcomes for children, families and communities, as well as creating services that provide better access and experience.

It was noted that the programme of work had achieved the following:

·           Improved partnership between Children’s Services and key health professionals such as Health Visiting, Midwifery, Family Nurse Partnership (FNP)

·           Early identification and support offer for vulnerable families as a direct result of health and early help staff attendances at Connected Care, Team Around Children’s Centres and BSiL meetings

·           Joint delivery of services from local community sites such as targeted NSPCC Baby Steps, universal antenatal parent education class, midwifery and health clinics.

·           Joint development and understanding of care pathway between professionals working with families with children 0-5 years.

·           Co-location of provision in one site/locality has significantly improved professional understanding and partnership working between children services and health resulting in joined up delivery of support to families

Keith Mallinson referred to the issue of early identification and support offer for vulnerable families, as it was felt that there was a lack of provision in the north of Hammersmith and Fulham. Sarah Bright commented that there were two key children’s centres in the North of the Borough; Old Oak Children’s Centre and Randolph Beresford Children’s Centre and they both had strong links with partners.

Councillor Vaughan queried the number of schools involved in the Healthy School Partnership as there had been an increasing number of schools taking part. Sarah Bright and Sarah Wallace agreed to provide information on the schools that were taking part and what they were doing in this area either on their own or in conjunction with partners.

ACTION: Sarah Bright and Sarah Wallace

Councillor Lukey referred to the number of families that were not registered with GPs and what could be done to encourage registration of new families moving into Hammersmith and Fulham. Sarah Bright commented that this was being monitored continuously at children’s centre who were working towards signing families up. In addition, it was reported that officers were looking to implement a streamlined service to encourage registration through the use of online forms by moving away from traditional and outdated paper forms.

Sarah Bright drew Members attention to the next steps on pages 12 – 13 of the report and  ...  view the full minutes text for item 34.

Ian Elliott provided the Board an update on the emerging Child Poverty strategy for Hammersmith and Fulham. It was noted that Hammersmith and Fulham committed to produce its first child poverty strategy, following the JSNA in 2013 on child poverty and the development of a strategy on Early Help in 2015. It was proposed to return to the Board with a final version of the completed strategy in the summer, following wider consultation in the spring of 2016.

Ian Elliott drew Members attention to pages 18 – 19 of the report, which set out the draft strategy that had been arranged into four themes, which were Housing, Work and Pay, Children’s Services and Health. It was noted that each theme was covered in detail in the strategy, with proposed actions and activity to alleviate child poverty locally.

Keith Mallinson welcomed the report and offered his support during the consultation process as it was noted that Healthwatch had a greater reach in many areas. It was felt that the strategy should consider the mental health of parents and its impact on children and child poverty. In addition, Tim Spicer commented that there was an opportunity for partners such as GPs to offer patients information on financial advice, debt advice and foodbanks to help to alleviate child poverty. It was felt that there was an opportunity to collate information for patients in order to provide a readily available service or offer.

RESOLVED –

THAT, the Board approved the consultation process.

THAT, the report be noted.

Mike Robinson introduced the report on Joint Strategic Needs Assessment Childhood Obesity. This forms a common foundation and shared understanding across partners on the needs for health improvement to provide an evidence base on the causes and consequences of childhood obesity in Hammersmith and Fulham. It was noted that the JSNA would inform the next phase of the Tackling Childhood Obesity Programme.

Councillor Macmillan queried the table data (table 7) on page 41; appendix 1 of the report, as the prevalence of childhood obesity in Reception and Year 6 from a ward level perspective was different. In reply, Mike Robinson commented that this was an area of research as there was no obvious pattern and data was being collected every year in order to provide a better understanding. In addition, Councillor Macmillan referred to figure 15 on page 46, appendix 1 of the report, as the number of children participating in two hours of high quality PE or school sport was lower than the London average. Mike Robinson agreed to examine this in further detail and then provide the Health and Wellbeing Board an update.

ACTION: Mike Robinson

Mike Robinson noted the current work being undertaken by Westminster City Council (WCC)regarding the Healthy Catering Commitment as Members felt it would be useful to understand the learning outcomes from this area of work. The pilot at would involve WCC working with 20 fast food providers to improve the nutritional content and quality of their food offer.

ACTION: Mike Robinson

Members noted that the information on children’s centres on page 45 of the report was incorrect and Mike Robinson agreed to the information in the report accordingly.

ACTION: Mike Robinson

Keith Mallinson referred to the high cost of transport and lack of access to sports/outdoor facilities, which can impact on children obesity. In addition, many schools no longer run short outdoor breaks to places like the Isle of Wight due to budgetary constraints, which was considered an opportunity for many children to experience outdoor activities. Councillor Lukey noted that officers were closely with schools to encourage children to take part in sports outside of school time.

Andrew Christie and Mike Robinson drew Members attentions to the recommendations on page 71; appendix 1 of the report. It was agreed that they would present the paper to Hammersmith and Fulham Business Board to gather support as it was felt that every Council  department had a role to play in creating and supporting increasingly healthier environments to make healthy choices easy choices.

ACTION: Andrew Christie and Mike Robinson

RESOLVED –

THAT, the Board approved the JSNA for publication.

THAT, the Board agreed to monitor the progress of the implementation on the recommendations, holding to account the parties involved.

THAT, the Board continues to support and to actively promote the whole council partnership initiative to tackle childhood obesity

Janet Cree introduced the report, which provided an update on the key planning tasks Hammersmith and Fulham CCG were engaged in for financial year 2016/17. It was noted that the Government announced in the Comprehensive Spending Review (CSR) on 25 November 2015 a plan for health and social care to be fully integrated across the country by 2020 and for every part of the country to have a plan for this in 2017. In order to achieve this, all NHS organisations had been asked to produce two separate but interconnected plans:

1.    Local place-based health and care system Sustainability and Transformation Plans (STP), for the period October 2016 to March 2021.

2.    One year organisation based operational plans for 2016/17

Janet Cree drew Members attention to page 82 of the report, which set out the timetable for the development of local STPs:

·           29^th January - submit proposals for STP footprints

·           8^th February – first submission of full draft 2016/17 operational plans

·           31^st March – boards of commissioners and providers approve budgets and final plans

·           11^th April – submission of final 2016/17 operational plans, aligned with contracts

·           20^th – 22^nd April – stock-take

·           End June 2016 – submission of full STPs

·           End July 2016 – assessment and review of STPs

The Spending Review provided additional dedicated funding streams for transformational change, building up over the next five years. This protected funding is for initiatives such as the spread of new care models through and beyond the vanguards, primary care access and infrastructure, technology roll-out, and to drive clinical priorities such as diabetes prevention, learning disability, cancer and mental health. Members commented on the Like Minded Programme and highlighted the Board’s focus on mental health, particularly in respect of children and young people. In response to issues raised by the Board, Andrew Christie advised that the Future In Mind programme had been created to tackle issues concerning children and young people’s mental health and that he would be happy for a report on the Future In Mind programme to be considered at a future Board meeting. Andrew Christie added that the Like Minded Programme offered a good opportunity to involve a number of organisations in tackling mental health.

Janet Cree reported that the STP production will be developed alongside the refresh of the HWBB strategy. In addition, the Health and Wellbeing Board would be updated on the first stage of the assurance process and would continue to receive regular updates moving forward.

ACTION: Janet Cree

RESOLVED –

THAT, the report be noted.

Sarah Wallace provided the Board an update report on flu immunisations in Hammersmith and Fulham.

Sarah Wallace drew Members attention to page 136 of the report, which set out the immunisation data for the period September – December 2014 and September – December 2015 for 2 years, 3 years, 4 years, over 65s, under 65s ‘at risk’ and pregnant women. Members felt that the numbers were encouraging compared to London averages. It was reported that Public Health, CCG, NHSE and Children’s Services worked together to deliver a flu pilot based in 2 Children’s centres in Hammersmith and Fulham. The pilot was delivered in four clinics and 71 children were immunised in total.

There were three practices in Hammersmith and Fulham that were commissioned to provide extended hours services to all Hammersmith and Fulham registered patients and the commissioned service includes a requirement to immunise eligible patients for flu. It was reported that a total of 217 flu immunisations had been administered to patients at ‘weekend plus’ hubs this season. The immunisation campaign will continue during February until the end of the vaccine availability. It was additionally reported that the final uptake data for the 2015/16 season will be published in March 2016.

Keith Mallinson commented that the voluntary sector provides a good opportunity to offer immunisations. Sarah Wallace noted that officers work closely with SOBUS, Carers Network and Age UK.

Sarah Wallace commented that a ‘wash up’ session would take place once the final data had been received to take away the learning outcomes. It was noted that the timetable for the flu season 2016/17 already being put in place and the first meeting had been planned for June 2016, to begin activities for next year’s flu season. Councillor Lukey welcomed the data made available to the Board and future planning and requested an update following the ‘wash up’ session.

ACTION: Sarah Wallace

RESOLVED –

THAT, the report be noted.

To note the minutes of the meeting held on 26 January 2016.

RESOLVED –

THAT, the Board noted the minutes of the meeting held on 26 January 2016.

The Board is asked to note that the dates of the meetings scheduled for the municipal year 2015/2016 are as follows:

21 March 2016

21 March 2016.