Agenda and minutes

Apologies for absence were received from Dr James Cavanagh, Councillor Larry Culhane, Philippa Johnson and Sue Spiller.

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. 

None.

(a)   To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health & Wellbeing Board held on 29 September 2021

(b)   To note the outstanding actions.

The Chair confirmed that the actions from the previous meeting would be addressed within the order of business.

This meeting is being held remotely. If you would like to ask a question about any of the items on the agenda please contact: bathsheba.mall@lbhf.gov.uk

You can watch the meeting live on the Council’s YouTube channel:

Watch the meeting live on YouTube

None.

This report will include an update from the Director of Public Health and the Director of Covid (Lead for Afghan Refugees) on the boroughs Covid response, and health partners, with particular reference to the support provide to residents experiencing long covid symptoms:

-        Flu vaccine uptake

-        Covid vaccine uptake

-        Support for those with long Covid symptons

5.1           Councillor Ben Coleman welcomed NHW health colleagues who provided a Covid update against the background of the government response on the emergence of the highly transmissible Omicron variant of Covid-19.

5.2           Sue Roostan explained that the timing of the meeting was welcome given the Prime Minster’s announcement on 12 December 2021 to offer vaccinations to all by the end of December.  Logistically a range of measures would need to be implemented to support the additional requirement.  A group of health and local authority officers would work within the borough partnership to deliver the offer and manage the vaccine roll out. The speed of the announcement presented difficulties in mobilising resources to deliver the expected increase in excess of 200k vaccines per week by the end of the year. 

5.3           This was a huge task and require considerable resources utilising a mixed local delivery model with four borough hubs, clinics and pop ups, and 10 community pharmacies. It would be supported by focused communication messaging and engagement. Sue Roostan clarified that some clinical and administrative changes were currently being considered by government which would support a rapid delivery of the programme, some of which concerned vaccine supply and the removal of the Pfizer, 15 minute wait time, post vaccination. This would enhance the through flow of people, speed up the process and increase capacity.  In terms of capacity, it was reported that pharmacies at this time could offer 8-10 slots per day.  It was anticipated that this would be used to capacity soon and lifting the cap on pharmacies was an additional option to consider (it was later confirmed that it was highly unlikely any more pharmacies will be approved).

5.4           There would a focus on vaccinating those in care homes and who were house bound, and progress on this had been positive. House bound vaccinations had routinely continued, supported by primary care district nurses, although this could be speeded up if the 15 minute time was lifted.  Non-essential CCG down would be stepped down from their current roles and redeployed to support vaccination delivery sites and military support would also be mobilised.  In the context of military support, Lisa Redfern highlighted the size of the Northwest London Integrated Care System (ICS) footprint supporting 2.3 million people across the region, making it one of the largest ICS programmes nationally.

5.5           Councillor Patricia Quigley received an assurance from Sue Roostan that the decision to remove the requirement for a 15 minute waiting time would be a clinical decision taken by the Chief Medical Officer balanced against the need to locally deliver over 200k vaccine doses weekly.  In response to a follow up question from Councillor Coleman, Vanessa Andreae briefly explained that in her clinical experience there was a very low probability of a person having either an anaphylactic or vasovagal (fainting) reaction.  The 15 minute wait time would not be removed if it was not safe or in the best interests to do so.

5.6           Jim Grealy referenced the significant figure  ...  view the full minutes text for item 5.

This report will consider a progress update on the transition, governance arrangements and priorities for the Integrated Care System which will be implemented in April 2022.

6.1          Councillor Coleman provided a brief overview of the move towards a health administrative system which would see the decommissioning of clinical commissioning groups (CCGs) and the creation of a new integrated care partnership board to support an integrated care system (ICS).  The ICS would co-ordinate the delivery of local health services to 8 north west London boroughs and represented the coming together of different parts of the NHS. 

6.2          Jo Ohlson explained that the current system of CCGs would be disbanded in February 2022 subject to parliamentary approval of the legislation and any delay would see the CCGs continue as a statutory body.  The terminology was also in the process of being agreed but it was anticipated that there would be two statutory bodies established.  Robert Hurd had been appointed as the chief executive officer of the ICS and would replace the interim CEO, Lesley Watts, and he had already begun to meet with colleagues ahead of his start date on 6January 2022. The ICS anticipated the appointment of a chief nurse and a draft constitution had been prepared which specified a constitutional membership governance mandate, as specified by NHS England.  In terms of ICS priorities, it was reported that delivering the areas Covid response was key.  Numbers of Covid cases were increasing exponentially and this coincided with winter pressures, exacerbating concerns about increased susceptibility to flu caused by low immunity.

6.3          Councillor Coleman observed that the ICP had made successful progress, beginning slowly at a senior level and had gathered momentum with signs of improved communication on multiple levels. At the same time the disproportionate impact of health inequalities minority ethnic communities, had been recognised.  The NHS, and NWL in particular had acknowledged that structural racism existed and was endeavouring to working directly with black communities, a bold decision which was commended. Exploring the configuration of the ICP board, Jo Ohlson confirmed that there would be improved local authority representation on the board and recognised that the integration of partners and the integration of component parts of the NHS were both equally challenging. 

6.4          Part of the change process would involve the development of provider collaboratives and this would be considered both in acute mental health services and community collaboratives to ensure a greater convergence in service standards and delivery.  This would not necessarily dilute services and Jo Ohlson described a detailed piece of work in community nursing and the delivery of intravenous fluids where small refinements had allowed people to remain in their homes whilst being treated.  Other refinements included improved rapid response times to urgent care cases which had helped to alleviate pressure on the London Ambulance Service.

6.5          Jacqui McShannon confirmed that despite challenges in Children’s Service, there had been improved partnership collaboration at a local, placed based borough level.  There had been a greater inclusion of local authorities and this would continue to evolve despite some false starts and challenges to overcome. There had been a welcome commitment from health colleagues which indicated  ...  view the full minutes text for item 6.

Councillor Coleman reminded members to review the Better Care Fund report for 2022 (circulated). This had been agreed in principle but would require collective formal approval from the Board at an in person or hybrid meeting on 14 March 2022 (subject to any further temporary Covid regulations to facilitate statutory decision making at virtual meetings).  It was noted that the palliative care response would be considered and prepared by the Health, Inclusion and Social Care Policy and Accountability Committee. The following items were agreed:

-        Long covid support

-        GP surgeries

-        Better Care Fund (approval)

Vanessa Andreae reported on a piece of work on improving access to primary care and how positive and helpful it had been to have input from a social worker to support the work of the frailty multi-disciplinary team.  This was welcomed as an approach and it was hoped that it could be replicated with other areas of work within the PCN.

Monday, 28 March 2022

Monday, 14 March 2022.