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 30 January 2019

(b)  To note the outstanding actions.

Janet Cree clarified with reference to the comment on establishing a citizen’s panel, this was in the early stages of being developed and they had not reached the point at which the panel could be established and that she would share the details when they were ready.  She also clarified that the proposed change to UCC would be determined by the outcome of the consultation, which was yet to be undertaken.  Finally, it was confirmed that Vanessa Andreae had discussed the idea of holding a “thinkathon” event and that the governing body were happy to support this, provided that it utilised existing collaborative networks.

NHS England had allocated funding to Central London CCG, to facilitate the work of Healthwatch on co-production, to deliver two consultation events per borough.  This aligned with the Long-Term NHS Term Plan and there were many other engagement events also taking place, details of which would be shared when available.

Councillor Coleman reported that he would work more closely with other boroughs to address increased concerns regarding the combing of the CCGs and that further updates would be provided.

Discussing the changing aspects of delivering local, strategic healthcare Dr Spicer commented that local provision could in future be determined by residents and that it was important to prioritise the needs of the community.  Keith Mallinson observed that it was essential that the views of residents were critical in shaping future provision. 

With reference to the CCG financial deficit, Councillor Coleman found it difficult to understand how the development of new, emerging networks would be better for H&F residents.  He asked whether any funds from the other CCG’s could be distributed to address the H&F CCG deficit.  Dr Spicer confirmed that this had been discussed but Janet Cree cautioned that seven out of eight of the CCG’s were experiencing significant financial difficulties. 

ACTION: The CCG to develop a piece of work around the primary configuration of the new and emerging networks, for either June or September HWB.

RESOLVED

That the minutes of the previous meeting be agreed.

Apologies for absence were received from Councillor Connell, Councillor Patricia Quigley, Lisa Redfern and Vanessa Andreae.

None.

Presentation by Opening Doors London (ODL), a charity providing information and support services specifically for older Lesbian, Gay, Bisexual and Trans (LGBT+). 

Councillor Coleman welcomed Jim Glennon, Richard Jackson and Maggie Jones from Opening Doors London.  Explaining their interest and involvement with LGBT+ (Lesbian, Gay, Bisexual or Transgender) issues.  Both Richard Jackson and Maggie Jones shared their personal stories which had eventually led to their association and work with Opening Doors London ODL.  As volunteer ambassadors for ODL, they had worked with older LGBT+, people, providing support, friendship and help in navigating local health and social services.  They had helped facilitate workshop events for older, LGBT+ people, fundraising and raising awareness at corporate training events.

Jim Glennon provided a detailed presentation regarding the work of ODL.  Support was provided to over 2000 members, facilitating social groups across London in safe places.  An outreach and befriending programme that complied with international equality standards ensured that support was available to a generation of older LGBT+ who had previously experienced abuse and rejection, during a time when had not been possible to be open about sexuality or gender within a hostile climate.  Jim Glennon outlined the extensive range of activities supported and facilitated by ODL, which offered a safe and tolerant environment in which older LGBT+ people could share experiences and support others.

Richard Jackson recounted how electro medical treatment had been intended to “cure” LGBT+ and had been developed by the Maudsley hospital. It was removed after twenty years, having been recognised as ineffective.  This controversial, conversion treatment had been delivered without aesthetic and aimed to make people feel repulsed by other gay people.    Homosexuality was a punishable offence, and those found guilty were given the option of imprisonment or medical treatment. Side effects included scarring and memory loss, and many people either self-harmed or were suicidal. 

Maggie Jones explained that many people from the older generation were subjected to abuse, and that this impacted on those in care homes as some individuals of that generation harboured homophobic attitudes. The issue was to ensure equity for LGBT+ groups, as distinct from equality, and therefore parity in treatment. It was explained that there was evidence to indicate that people were being treated differently and that CQC inspectors where aware of the issue.  Care homes had improved their awareness and better increasingly better at understanding experience of LGBT+ older people through training.

Social isolation and loneliness were key issues for many older LGBT+ people, who did not have children, or had become estranged from their families. They might have moved from away from where they once had lived and were likely to live alone. They were also more likely to have experienced mental health problems, had higher rates of suicide, alcohol or drugs abuse, compared to heterosexuals.  There was no suggestion that to be LGBT+ was to be mentally ill, but that this had resulted from the impact of the pressure, abuse and treatment experienced by LGBT+ people.  There was a fear of going out into the community and an individual who was not robust, would find it difficult to support themselves and became quickly isolated.  ...  view the full minutes text for item 175.

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.

None.

Consultation on Urgent Care Centres (UCC) and Extended Hours

Janet Cree provided a short update to the consultation on UCC and extended hours. The NHS Long-Term Plan indicated long-term investment in extended opening hours.  It was explained that the intention was that from July 2019, extended hours would be delivered through direct enhanced services (DES) with the expectation that the CCG continued to commission that provision through the GP primary care network.  The CCG will continue to commission local hours for the first quarter of 2020. 

Further guidance from the NHS was expected however, the DES was expected to further develop and this had necessitated the need to change the scope of the GP contract.  Janet Cree explained that it was not possible to include consultation on DES but that the consultation would still look at extended care and that this had been the reason in part for the delay to the commencement of the consultation. 

Healthwatch had been very helpful in reviewing the consultation materials and work on developing this had progressed well.  This had been a large, joint piece of work and following discussions, the layout and content had been refined.  Final adjustments were required and then content would be available in a variety of formats online.  The documents would be in plain English and included a short, A5 leaflet, a brief overview, an easy read version of the consultation document, a poster, adverts and social media activity. It was anticipated that the launch could take place the following week, once formal assurance had been provided by NHS England. The CCG had also been in contact with the Councils communications team for guidance on how best to reach residents.  It was thought that it would not be possible to send text alerts or information by text message due to both potential legal and financial constraints.

Councillor Coleman enquired about the methods by which residents might be informed of the consultation.  Janet Cree explained that the consultation would last approximately seven weeks and had been slightly extended due to the Easter holiday period.  Details as to the location of posters could be provided but these currently included libraries, GP practices and UCCs to ensure that service users would be aware of the proposed changes.

Councillor Coleman queried the anticipated savings, that might follow the implementation of service changes.  Janet Cree indicated that this could amount approximately £600,000 each, for both changes to UCCs and GP extended hours if the proposed changes were accepted, so potentially £1.2 million.   Discussing the possible cost of the consultation, it was noted that this was limited to the cost of printed materials.  Janet Cree explained that the CCG had taken advice on how to raise awareness with residents as well as to ensure that the consultation document was accurate.

Referring to the length and range of any consultation, Councillor Coleman highlighted two concerns. The first, was about the consultation itself and what it was nature of the consultation, with the intention to make savings,  ...  view the full minutes text for item 177.

The Board is asked to note the date of the next meeting scheduled for the municipal year 2019/2020 as 25 June 2019

The date of the next meeting was noted as 25 June 2019.