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

(b)  To note the outstanding actions.

RESOLVED

That the minutes of the meeting of the Health and Wellbeing Board, held on 9 February 2016, be agreed and signed as an accurate record by the Chair, Councillor Vivienne Lukey.

Apologies for absence were received from Liz Bruce, Executive Director of Adult Social Care, Mike Robinson, Director of Public Health, Ian Lawry from Sobus, Andrew Christie, Director of Children’s Services and Harley Collins, Health and Wellbeing Manager.

There were none.

Professor Chris Ham (King’s Fund) has kindly agreed to attend the meeting and the Board is requested to discuss place based systems of care and the solution they potentially offer to the challenges facing the local health and care system.

Professor Chris Ham gave a presentation to the board on ‘Place-based systems of care’. The full presentation can be found on pages 61-75 of the agenda. Chris Ham talked about three versions of place based systems and how the NHS was taking the idea forward. He also explained health and social care integration under the aegis of the health and wellbeing boards (HWBs) and outlined the purpose and scope of the sustainability and transformation plans (STPs). He then identified the emerging issues which included the size and complexity of the task and the deadlines, as well as, leadership, management capacity and the role of the local authority. 

He outlined the local government version of place based systems and gave the examples of Greater Manchester’s devolution plan and the integrated care pioneering which had taken place in Leeds. He explained that the focus was on whole populations and public service and community budgets. He also talked about the bold vision for the ‘northern powerhouse’. 

Chris Ham then summarised health and social care integration and talked about the Isle of Wight, Torbay and West London and new care models under the NHS. With regard to the Isle of Wight he explained that working under the health and wellbeing board had already been established and provided overall leadership for the transformation programme. He went on to talk about relationships with STP’s and the behaviours of leaders and concluded that system leadership was needed at all levels to realise the benefits; and, that HWB’s had a role in providing that leadership. 

Chris Ham moved onto the implications for Hammersmith and Fultham and across NW London in specialised health services. He talked further on local acute services across the Borough and about community, primary and social care as well as population health at all levels. He explained that there was a broader shift in the focus for individuals and populations and that improving population health and outcomes was the overall goal. He then talked through the challenges and how to ensure progress in Hammersmith and Fulham and posed four questions for the Board which were;

1. What part should the Board play in providing place based leadership?
2. Were the right people sitting around the table?
3. Did the board have the support it needed?
4. Was there an appetite for taking on the role that was emerging for the HWB in the Isle of Wight and was under discussion elsewhere?

Steve Miley asked how the Isle of Wight model worked and Chris Ham stated that they had a broad vision and an overarching board. That they had split provision and partnering enabled them to provide services effectively. 

Keith Mallinson commented that public input was important and that he would like to see more members of the public involved in the future governance arrangements. He also felt it would be useful to have the health unions support for future plans. 

Stuart Lines asked if there were any examples of public health input into population health improvement  ...  view the full minutes text for item 44.

This report considers research into the effectiveness of Health and Wellbeing Boards across the country, outlines the changing needs of the Hammersmith & Fulham population and sets out a framework for the refresh of the Joint Health and Wellbeing Strategy in 2016.

Stuart Lines gave a presentation on the Health and Wellbeing Strategy supporting information for Hammersmith and Fulham. The full presentation can be found on pages 90 - 126 of the agenda. 

In summary Stuart Lines talked through the characteristics and demographics of the local population. He also touched on life expectancy, age, child and adult health, gender, family breakdown, disability, sexual orientation and deprivation. He went on to present information on health inequality trends and ethnicity health inequalities, housing, patterns of health and vulnerable groups in the Hammersmith and Fulham area. There was also research on mental illness, HIV, problem drug users, changing patterns of need and projections of the prevalence of selected diseases in the area. 

In response to a question from the Chair about breaking the information down by ward it was confirmed by Stuart Lines that this would be possible for some of the slides but not all of them. He also confirmed in response to a question from Steve Miley about rising alcohol abuse that identifying parents from hospital admissions was not in line with current practice. Dr Tim Spicer commented that with alcohol abuse there was no age limit when it stopped and that Hammersmith and Fulham were currently providing data in this area which was being utilised across London. 

Vanessa Andreae commented that with regard to prevalence of selected diseases in Hammersmith and Fulham there was work to be done on cancer. Stuart Lines added that what was preventable was the key. Councillor Lukey commented that increased monitoring information was useful and Councillor Vaughan asked the CCG what were the key messages for smokers. Councillor Sue Macmillan commented that alcohol abuse was a good area of focus for a future report. 

Councillor Lukey stated that community grants were a positive area that the board could influence and join up processes to use finances to improve health outcomes. Vanessa Andreae agreed that it would also be beneficial in terms of governance arrangements. Dr Tim Spencer stated that social isolation and long-term conditions were also areas that the board could work together on. Stuart Lines added that smoking cessation was the best way to improve health and the issue was how to target particular groups. 

Councillor Lukey reminded Members of the upcoming community event with a focus on poverty, diet and healthy eating. 

ACTION - Chris Neil

Chris Neil discussed arranging a half day development session with Members to discuss the care budgets 5 to 10-year deficit and long term financial planning. 

RESOLVED

i)             That the position of the Health and Wellbeing Boards across the country and progress made to date, be noted.

ii)            That population health need in the borough, how needs and demography have changed and how they are expected to change in the future, be noted.

iii)           That recent policy announcements and how the board will need to dapt to offer system leadership in the future, be noted.

iv)           That early thinking about what the new Health and Wellbeing strategies could cover,  ...  view the full minutes text for item 45.

This report provides an update to the Health and Wellbeing Board on progress made to date within the North West London ‘Transforming Care Partnership Plan’.

It was stated that a NW London plan was being developed to avoid people moving out of the area. She added that it was an all ages plan and that the first draft was in the report on pages 138 - 174. She also stated that they were in collaboration and working on its development with Mary Dalton. 

Councillor Lukey asked about the transition task force and Steve Miley confirmed that this was still in the forming stage. There was further discussion amongst Members on what could be included in the final report.

Janet Cree commented that the timeframe ensuring the final plan was reviewed in more detail needed to be signed off in June 2016.

Councillor Lukey concluded that the draft report was impressive.

RESOLVED

i)             That the first draft North West London Transforming Care Partnership plan noting that further updates will be made to address the areas of underdevlopment, be endorsed.

ii)            That delegated authority to the relevant committee to approve the final local and NW London Transforming Care Partnership plan in order for this to be submitted to NHS England on 11 April 2016, be endorsed.

iii)           That the final plans will be reviewed by the HWBB in May. The plan will then be implemented from April 2016, and be reviewed in 2019/20, be endorsed.

This report presents the quarter 3 Better Care Fund performance.

Chris Neil commented that there was a £200 million budget for the Better Care Fund locally. He also confirmed that there was additional information to go with the report which he would circulate outside of the meeting. He apologised the information was not included in the agenda. 

ACTION - Chris Neil

RESOLVED 

That the Health and Wellbeing Board commented on progress to date and on the Quarter 3 Better Care Fund submission, be noted.

This report summarises the work and findings of the JSNA on End of Life Care, including the recommendations for key partners.

Stuart Lines stated that multi-agency JSNA informed strategy priorities and affected all services. He also added that there were five key recommendations and that the one which was of particular interest to the HWB was strategic leadership for end of life care. 

Councillor Lukey proposed that it could be a role for the Board and requested it be added to the forward plan and a report be scheduled for a future meeting. This was seconded by Councillor Vaughan. Dr Tim Spicer talked about the NW London footprint and stated that it would bring together formal providers and the voluntary sector. He added that the JSNA was likely to be acted upon and would build good practice. 

An additional item was circulated by Janet Cree which was the 2016/17 Operating Plan - Quality Premium Guidance.

There was a discussion amongst members regarding the forward plan and delegated authority for the June 2016 meeting. Chris Neil agreed to update the forward plan.

Action - Chris Neil

RESOLVED 

i)             That the Health and Wellbeing Board approved the End of Life Care JSNA for publication, and how the JSNA will be used to inform local strategic approaches to end of life care, be approved and noted.

ii)            That the Health and Wellbeing Board considered the recommendations arising from End of Life Care JSNA, in particular Recommendation 3, and provided a steer on how this should be implemented locally, be noted.

iii)           That the recommendation that the Health and Wellbeing Board review progress against recommendation in 1 year from publication, be noted.

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.

Steve Miley requested that where there was an overlap of agenda items that reports on children services be prioritised. 

Councillor Macmillan stated it would be good to have reports on education health and care plans soon.

Councillor Lukey agreed to juggle the future work programme where possible at the half day development session in May 2016.

RESOLVED

That the report be noted.

The Board is asked to note that the dates of the meetings scheduled for the municipal year 2016/2017 are as follows:

20 June 2016

7 September 2016

14 November 2016

13 February 2017

20 March 2017

20 June 2016.