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 7^th September 2016.

(b)  To note the outstanding actions.

The minutes of the meeting held on 7^th September were agreed as a correct record.

Apologies for absence were received from Councillor Sue Fennimore, Liz Bruce, Stuart Lines, Tim Spicer and Ian Lawry.

The draft annual report for 2015/16 includes key details about the demographics of local children, safeguarding responsibilities and activities of agencies which are represented on the LSCB, an overview of the LSCB priorities, activities and details of its budget; a review of the outcomes of Serious Case Reviews and learning that has resulted from these.

Councillor Vivienne Lukey welcomed Jean Daintith, Independent Chair of the Local Safeguarding Children’s Board (LSCB), accompanied by Emma Biskupski, LSCB Business Manager.  Detailing the background to the draft annual report, it was explained that there was a requirement for it to be submitted to several agency and organisational lead officers including the Chief Executive and the Health and Wellbeing Board (HWB).  This was the 4th Annual Report of the LSCB, covering LBHF, RBKC and WCC.  It was explained that the LSCB oversees a partnership arrangement, comprising of sub-groups and individual boards for each borough.

This year they had undertaken a range of activities including two task and finish short life working groups, one focusing on neglect, and a second on parental mental health, with lead officers from Children’s Services and mental health colleagues working collaboratively to support the process.  It had been a busy year, with 5 serious case work reviews being undertaken, together with a n inspection of children’s services in the three boroughs and the LSCB received a “good” rating and given five recommendations.  A different approach had been taken to producing the Annual Report for 2015/16 and partner organisations had each been invited to draft their own sections and account for themselves.  The report also set out what has been achieved in the past year and future direction of travel in the context of the significant changes planned by government and the introduction of the children and social work bill, currently going through Parliament. These changes were not anticipated to be implemented prior to 2018 but police, local authorities and health agencies to would positioned to lead on child safeguarding.

Ms Daintith explained that this was her fifth year of chairing the LSCB and that she had taken a decision to step down.  Interim arrangements had been made to begin the process of appointing a new independent chair. 

Janet Cree commented that she would have had sight of the Annual Report through the CCG Quality Committee, as well as through the HWB, welcomed the report.  However, she also recommended that the section on Ofsted recommendations be set out more clearly in a separate box, making them more accessible.  Ms Daintith explained that prior to the inspection, she had been concerned about demonstrating a clear link both through the governance arrangement with the HWB but also a shared agenda.  Going forward, they aimed to reduce the bureaucracy around having multiple meetings with the same individuals, a process which was already happening organically as they now worked across the partnership groups within the three boroughs, focusing on areas of local concern.  Examples of reporting arrangements in other parts of the country had shown great synergy between the LSCB and HWB in term of taking forward key concerns.   Ms Daintith felt that the LSCB was effective and benefitted from strong partnership arrangements, a sharing of good practice and an ability to work well together. 

Councillor Rory Vaughan expressed interest in the case review and commented that it was helpful to  ...  view the full minutes text for item 75.

This report updates Hammersmith and Fulham Health and Wellbeing Board on transforming mental health services for young people.  It has been previously presented and considered at the Children and Education Policy and Accountability Committee (June 2016) and the more recent Health, Adult Social Care and Social Inclusion Policy and Accountability Committee (October 2016).

 Councillor Lukey welcomed Angela Caulder, Joint Commissioning Manager, and, Dr Meenal Sohani, Consultant Child Psychiatrist, Hammersmith and Fulham CAMHs, West London Mental Health Trust.  The report integrates the findings of Councillor Alan D’Aths Child and Adolescent Mental Health Taskforce Report 2016 (Appendix 1) and the development of the CAMHS transformation plan.  In 2015, the CCGs in collaboration with local authorities, agreed proposals to improve mental health services for young people, which included establishing a community eating disorder service for under 18s, and, to ‘transform’ local mental health services for young people in line with the recommendations made in ‘Future In Mind’.  Angela Caulder highlighted the following 3 achievements and three next steps:

·         The eating disorders service, established on 1st April 2016, in collaboration with Ealing and Hounslow CCGs, as a hub (Ealing) and spoke (Glenthorne Road, LBHF) model.  This was as self-referral service, with cases being seen within four weeks, and, a one week wait for urgent cases and linked to the CAMHS national specifications for eating disorders.  This was a national incentive with the CAMHs transformation money to develop services for children with eating disorders such as anorexia nervosa;

·         Out of hours’ service, working with 8 CCGs across North West London, involving both Central and North West London Foundation Trust (CNWLFT) and the West London Mental Health Trust (WLMHT).  The service had recently been reviewed and evaluated by both the trusts and LBHF children and young people champions, and received positive feedback.  Both services were now embedded and would be available across all 8 collaborative CCGs in 2017/19;

·         The H&F schools pilot, a successful bid to become one of fifteen national sites.  This linked ten schools together with CAMHS provision from the West London Mental Health Trust, with two hours per week in school (with a specially trained mental health lead in each school) and several young people seen in school, with a further four schools added to the programme, now extended to March 2017.

A related or linked achievement was the co-production work with local children and young people champions (aged between 16-20).  These were young people who had either direct or indirect personal experience of living with mental health problems.  They had been evaluating the services, delivering training with colleagues from WLMHT, in the successful LBHF schools pilot in 2016.   In addition, Ms Caulder reported that a young peoples conference had been held at RBKC Town Hall, attended by children from LBHF with an opportunity to share experiences and meet young social media stars.  Dr Meenal Sohani explained that as part of the national school links pilot project, H&F CCG were successful in their bid to work with WLMHT in developing links with 14 schools in the borough, both primary, secondary and alternative provision.  Linking with the lead in each school, clinicians offered training and consultation to the staff, organising drop in sessions for pupils or guidance for parents.  Feedback to date has been positive and  ...  view the full minutes text for item 76.

This is the third Annual Report of the Safeguarding Adult Executive Board (SAEB). The multi-agency Board provides leadership of adult safeguarding across the London Borough of Hammersmith & Fulham; the Royal Borough of Kensington and Chelsea; and the City of Westminster.

Councillor Lukey welcomed Helen Banham, Strategic Lead, Professional Standards and Safeguarding, Westminster City Council, who presented the third annual report of the SAEB, working across the three boroughs.  Ms Banham explained that the report set out the operational arrangements for working with the key statutory agencies involved were: the local authority, police and health professionals including directors of public health, NHS trusts, including The Royal Marsden, Imperial, West London Mental Health Trust, Central and North West London and Central London Community Healthcare. 

Thirteen cases serious (death or harm to an adult) safeguarding case reviews (Care Act 2014, S.45) had been conducted (with one predating 1st April 2016).  Ms Banham explained that this was one of most important areas of work undertaken.  This would not be possible without out the willingness of agencies to share information and there had not been a need to force compliance with S.45, which was well evidenced across the partnership. 

The report focused on the accountability of health organisations and patient safety, and Ms Banham explained that residents were at the very heart of safeguarding.  To illustrate, two consultation events were held (November 2015), with feedback used to inform and develop the House Strategy.   The role of community champions was also essential to ensure local input.  Whilst the role of community champion, it was important to be aware of how issues such as domestic violence and mental health concern, had a significant impact on the individuals who took on such roles.  The SAEB has also focused on financial abuse and the scamming of older or vulnerable adults. Valerie Simpson from Trading Standards had recently been appointed to the SAEB.

Keith Mallinson expressed concern about safeguarding issues arising in Wormwood Scrubs prison.  He commented that the conditions within the prison were disgraceful and that prisoners experiencing abuse and neglect were reluctant to come forward.  He hoped that agencies that represented them such as the prison and the probationary services would be challenged.  Ms Banham responded that this had been a priority for Mike Howard, Independent Chair of the SAEB.  He had attended Wormwood Scrubs in order to secure representation from the prison on the SAEB, and whilst he was mindful of the seriousness of the concerns raised, there was currently no easy solution.

Councillor Vaughan commented that he had been impressed by the report when it had recently been presented to the Health, Adult Social Care and Social Inclusion Policy and Accountability Committee (HASCSIPAC, 20th October 2016) and welcomed the approach of focusing on a single theme throughout the year, which in this case had been financial scams and fraud.  Councillor Lukey added that it would be helpful if there could be further exploration of cases of hoarding, as these had resulted in the case of two (unrelated) deaths in Earls Court.  Ms Banham observed that adult safeguarding was a vast area of work and the report could only offer brief insight into the work undertaken.  The focus this past year had been on those issues highlighted  ...  view the full minutes text for item 77.

This report updates on progress with developing the Health and Wellbeing Board’s Joint Health and Wellbeing Strategy 2016-2021 (JHWS) and the outcomes of the period of public consultation which have been used to inform the next draft of the plan

Councillor Lukey welcomed Harley Collins, Health and Wellbeing Manager, who presented the report. This was a joint report between the Council and the CCG and set out the development details of the Joint Health and Wellbeing Strategy, 2016-21 and emerging priority areas including mental health, children, young people and families and long term conditions.  The development process had been structured in three phases: The first, from January to March, involved a large scale review of the evidence of need; the second phase, covering April-May, included a series of workshops with patients and stakeholders; the third phase has included a fourteen-week period of public consultation during July-October. 

It was explained that consultation and engagement has been a key principle throughout all stages of the work. During the public consultation, an online questionnaire was set up and sent to over 500 local organisations.  40 responses had been received from a mixture of businesses and individual residents. Responses indicated strong support for the four draft priority areas and for a preventative approach that sought to proactively keep people well rather than reactively treat people who are sick. 

Feedback had been received as the report had navigated governance processes from within the Council.  The report had been considered by the Business Development Team, which had sought greater reference in the report to the link with social inclusion, the Worklessness and Poverty Commission report and reference to the regeneration work undertaken in Children’s Services and across the Council.  HASCSIPAC (20^th October 2016) had highlighted the lack of reference to older people as a separate, 5^th priority, which was currently being considered.  Further comments from the Committee included references to welfare reform and the need to formulate a communications strategy and implementation plan. 

Vanessa Andreae commented that the strategy would require monitoring in terms of measuring precisely how it would impact on outcomes and make a difference.  Councillor Lukey explained that this would be the next phase of work, to develop detailed operational and implementation plans, with examples of how we might deliver, key performance indicators and with more information about outcomes. Vanessa Andreae responded that the strategy was detailed and outward facing but that it was important to recognised that it should not be promising to deliver outcomes that had not been considered.  Any statements would need to be clearly evidence based and benchmarked.  Mr Collins confirmed that the next phase would more closely involve Public Health and commissioning colleagues in developing a ‘dashboard’ which would guide the work of the Board.   Councillor Lukey added that this was intended to be a high level documents, with the next step being to translate it into a delivery plan. 

Commenting on the governance arrangements, Ms Andreae highlighted the need to consider to properly signpost the reporting arrangements.  Sarah McBride responded that it was important to note that HWB was not the delivery vehicle for the JHWS, it’s role was to monitor and ensure proper governance. 

Councillor Vaughan recapped some of the points of the discussion  ...  view the full minutes text for item 78.

The Board noted that the date of the next meeting had been brought forward and would take place on 8^th February and not 13^th February.  Harley Collins informed the Board that some updates to the forward plan would be required and that a date for a development session to discuss the JWBS would be scheduled.

RESOLVED

That the reported be noted.

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

Wednesday, 8^th February 2017

Monday, 20^th March 2017