Agenda and minutes

Apologies for absence were received from Toby Hyde, Dr Nicola Lang, Councillor Lucy Richardson and Glendine Shepherd. Apologies for lateness were received from Janet Cree and Nadia Taylor.

The Chair will carry out a roll call to confirm attendance. Members also have the opportunity to declare any relevant interests.

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. 

The Chair confirmed members in attendance and there were no declarations of interest reported.

(a)   To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health & Wellbeing Board held on 24 March 2021; and

(b)   To note the outstanding actions.

A minor correction to the minutes was noted, where a resident attendee was recorded twice. 

RESOLVED

That the minutes of the meeting held on 24 March 2021 were agreed as an accurate record.

Matters Arising – Vaccination Update

Linda Jackson provided the Board with an update about the progress of vaccinations in the borough which recorded the lowest uptake across the borough within North West London. A successful vaccination event at Chelsea Football Club, ‘Super Saturday’ had administered 6200 vaccinations with 45% of those being residents of the borough.  There had been a positive response to pop up sites on local estates primarily using the AstraZeneca vaccine due to storage requirements. The Novotel site delivered Pfizer and AstraZeneca vaccines but not all the slots had been fully utilised. Weekly meetings continued with CCG colleagues and discussed plans for example to increase the number of pharmacists approved to administer vaccines.  This was also an issue being followed up with the strategic North West London Board.

Sue Roostan continued that they were keen to mirror pop up events and a five week plan was in place leading up to 19 July.  The Borough Vaccination Plan was a joint team effort between the local authority, CCG, GPs, and primary care and remained a live and iterative document.  The latest pop up had been more successful than previously, and another Super Saturday was arranged for 17 July.

Jane Wilmot asked if engagement with community groups had been co-produced to improve uptake and in addition, also asked about vaccines being administered to school children. Linda Jackson confirmed that there had been community engagement, but that this had not been co-produced, by H&F definition.  Community engagement resident groups and work with community champions had informed and influenced the borough’s approach.  There was now a sense that people felt that it was time to focus on delivering the vaccine and allow people to make their own, informed decisions about vaccination.

Jane Wilmot referenced the virtual Co-production Huddle workshops facilitated by Imperial College NHS Healthcare Trust. There had been a recommendation to support GP practices with conversations about co-production and how they could provide better support. Sue Roostan stated that advice had been provided to GP practices.  In response to the question about vaccinating children the Department of Health had not issued approval for this to date. Delivery of the vaccine continued to align with Joint Committee for Vaccination and Immunisation (JCVI) national eligibility criteria.

There had been huge challenges in gaining approval from National Health Service England (NHSE) for pop up sites and H&F were behind many other boroughs in North West London (NWL). The Board was assured that that health colleagues were working hard to lobby NHSE to support residents and NHS workers of the borough. 

Sue Spiller observed that efforts to co-produce had been hindered by a huge reluctance by groups to be seen to be advocating for vaccination, given the level of reluctance within communities. DI Luxan Thurairatnasingam commented that a lower  ...  view the full minutes text for item 3.

Members of the Board are invited to agree the appointments of two new members:

1.       Mrs Philippa Johnson, Director of Operations, North West Division

Central London Community Healthcare NHS Trust; and

2.     Detective Inspector Luxan Thurairatnasingam, Metropolitan Police (replacing the previous Metropolitan Police representative).

Councillor Coleman welcomed Philippa Johnson, a pharmacist by profession and currently Director of Operations for Central London Community Healthcare Trust (CLCH)and currently responsible for delivering Adult community services in 4 boroughs of NW London.  She currently led the Integrated Care Partnership (ICP) as co-chair. DI Luxan Thurairatnasingam, Metropolitan Police, was also welcomed to the Board.  An officer within the Public Protection Hub, he had oversight of the Predatory Offender Unit, Multi Agency Safeguarding Hub (MASH), Police Conference Liaisons Team and the Mental Health Team.

RESOLVED

That Philippa Johnson and Detective Inspector Luxan Thurairatnasingam be appointed to the Board.

This report sets out the work of H&F Youth Offending Service and The Youth Crime Prevention Partnership (YCPP).  It also seeks to highlight measures that might address the disproportionate representation of black and Asian minority ethnic communities within the criminal justice system, and those in the ‘not in education or employment’ cohort.

Councillor Coleman welcomed Alison Sabaroche from the Youth Offending Service (YOS) and Children’s Services colleagues who led a presentation about the service. The aims, objectives and outcomes were framed by four key performance indicators (KPIs) which were: to reduce first time entrants to the youth justice system; reduce reoffending; minimise the use of custody suites in H&F; and a fourth key focus was to reduce the disproportionate and over representation of black and Asian minority groups within the youth justice system.  

Headline figures setting out the overall health outcomes for such groups indicated that they were likely to have experienced either one or a combination of factors including low income, hidden disabilities, and poor housing. Approximately 19% of the YOT cohort were identified as having special educational needs or disabilities, and 37% had speech and language concerns.   47% of young people had some form of contact with children and adolescent mental health services.  YOS worked with partners to achieve better outcomes focusing on KPIs to deliver initiatives such as Street Doctors training and working with a 7-borough disproportionality group.

Mandy Lawson continued that there was a broad, partnership approach to prevent H&F young people from entering the YOS.  The council was working with H&F clinical commissioning group (CCG) in undertaking a whole system review of mental health children’s services, with funding from NHS England and input from the West London NHS Trust.  This was a significant area of work with a key focus on ensuring the mental health needs of young people were fully met.  It was reported that fifteen H&F schools had access to the mental health trailblazer program.  The council was currently investing in and recruiting for a speech and language support service for school aged children without educational healthcare plans and a brief outline was provided about the diagnostic pathway for early ASD (autistic spectrum disorder) intervention.  The partnership approach included work with colleagues across the council to ensure that post-school provision and pathways were in place and signposted to help meet the aspirations of young people. 

Sue spiller commented that fear from within black and Asian minority ethnic communities indicated a huge reluctance to engage with statutory services and sought details about engagement. Alison Sabaroche responded that most staff YOS chose to work with adolescents and naturally had a skillset that allowed them to work well with families that struggled to engage.  YOS also worked with community organisations so there was a focused and hyperlocal approach to support children, who benefitted from feeling rooted within their communities.  Lisa Redfern provided an ICP perspective and how this could help support a mental health pathway which was currently underdeveloped. Jacqui McShannon concurred and stated that this had been recognised by the whole system review, including low level access to mental health support out of hours and at weekends, and the referenced trailblazer programme. Increasingly, children and young people preferred the term “emotional health and wellbeing”, rather than ‘mental health’ due to the associated stigma.  ...  view the full minutes text for item 5.

This report provides a general update on how the ICP is working and an update on the progress made in each health campaign over the last 3 months. The progress reports are set in the context of our continued efforts to manage through the pandemic and the recognition that all parts of the ICP face significant challenges.

Philippa Johnson and Lisa Redfern provided a joint presentation as co-chairs of the ICP board. There are four campaign groups: Health & Wellbeing, Frailty, Mental Health and Diabetes. It was recognised that certain parts of the health and social care system were still experiencing sustained pressure. A key focus was the inclusion of and engagement with patient voices. The general direction of travel was good with work being undertaken using scarce resources, however, new funding was coming into the primary care and this was the starting point of a long journey of change.

Merril Hammer commented that despite the involvement of HAFSON, there was no reference to the organisation within the report regarding engagement work, and a notable absence of the “patient voice” and the involvement of local people.  Jane Wilmot highlighted the focus on co-production and sought details (to be provided outside the meeting) about how seriously this was being considered by the ICP and Lisa Redfern assured her that this would be provided. Using the example of the vaccine bus, Jim Grealy pointed out that this had served the dual purpose of delivering information about the vaccine and administering the vaccine itself, and, offered reassurance, creating trust. 

Deploying buses as a way of signposting services and sharing information about patient pathways offered a creative and innovative solution to reach not convinced groups. Philippa Johnson welcomed the oversight provided by HAFSON and Healthwatch and was committed to getting engagement right.

Councillor Coleman observed that there was a genuine commitment to collective, partnership working and to deliver innovative services creatively, illustrating this point with the work on dementia as an excellent example.

RESOLVED

1.     That the ICP provide an update to the Board regarding the development of engagement with residents, as a theme for the next board meeting; and

2.     That the report be noted.

The Board is requested to consider items for inclusion in the work programme.

The Board noted the work programme and suggestions arising from under Agenda Items 3, 5 and 6, for inclusion at future meetings.

-        Progress update on the draft Dementia Strategy

Councillor Coleman welcomed Stuart Downey, a local H&F solicitor and chair of the Dementia Action Alliance (DAA). The DAA brought together representatives from agencies and organisations from across the community including police, fire, health, and carers.  A report had previously been provided to the Board and the intention now was to finalise a report setting out a dementia strategy.  The report, which was almost complete, would be presented at the next meeting of the Board and would offer recommendations that could be taken to the ICP, co-produced between the community and service providers.  Stuart Downey thanked colleagues who had contributed to the development of the report and its recommendations, which would be the first residents report to make joint recommendations to both the local authority and the NHS.

The Board is asked to note the meeting dates scheduled for the remainder of the current municipal year 2021/22 which are as follows:

Tuesday, 29 June 2021

Monday, 13 September 2021

Monday, 13 December 2021

The date of the next meeting of the Board was noted as Tuesday, 21 September 2021.