Agenda and draft minutes

Apologies were received from Councillor Alex Sanderson and Jacqui McShannon.

Nadia Taylor joined the meeting remotely.

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 Standards Committee.

There were no declarations of interest.

To approve the minutes of the previous meeting as an accurate record and note any outstanding actions.

The Board agreed the minutes of the meeting held on 20 September 2023 as an accurate record.

This report sets out Hammersmith & Fulham Council and the H&F Integrated Care Board’s Better Care Fund quarter 3 submission 2023 - 2025 to NHS England detailing planned and actual expenditure and outputs delivered to date.

Julius Olu (Assistant Director for Independent Living, Commissioning & Partnerships) presented the item which set out Hammersmith & Fulham Council and the H&F Integrated Care Board’s Better Care Fund quarter 3 submission 2023 - 2025 to NHS England detailing expenditure and outputs.He noted that the document had been submitted on the 9^th of February with the agreement of Councillor Coleman and it was being presented to the Board for formal ratification.

Councillor Natalia Perez asked how performance was measured. Julius Olu noted that the quarterly submissions to NHS England followed a standard template that covered planned and actual activity. He added that there were regular service review meetings to track performance and give partners an opportunity to raise issues. Linda Jackson gave the example of reablement and some of the metrics that were tracked, including time spent at home.

The Chair noted that the submission said data was not available in three areas and two areas were marked as not on track to meet their target. He asked how that fit with the assessment that we were meeting the national requirements. Julius Olu said there were some quality issues with the data and assured the Board they had met the requirements.

The Chair noted that flu vaccine uptake in the borough had been low and asked why it was given a tick if the outcome was poor. Julius Olu said the tick suggested a service was in place. He said any queries about performance could be fed back to the ICB.

Nadia Taylor asked what mechanisms there were for hospitals when discharging patients to ensure there was adequate provision in place for patients at home. She gave the example of an elderly patient who may have a carer and asked how they would be assessed. Linda Jackson said it was outside of the scope of the Better Care Fund but acknowledged the Discharge Hub had identified areas for improvement. The Chair requested an item for a future meeting on the discharge arrangements from hospital, with a particular view to the patient experience. Councillor Perez asked that the item include a section on how patients with additional needs were supported through discharge process. The Board agreed the item for inclusion on the work programme.

ACTION: Linda Jackson

RESOLVED

1. That the Health & Wellbeing Board retrospectively agreed the BCF quarter 3 report that enabled submission to NHS England by the 9 February 2024 deadline.

2. That the Health and Wellbeing Board receive an end of year report outlining the outcomes of each scheme and the difference it has made for residents of H&F.

This report provides a summary on the oral health of the borough’s population and access to NHS dental services. It uses data to profile the oral health of Hammersmith and Fulham residents, describes the provision and use of NHS services, in addition to how the services are commissioned.

Helen Byrne (Head of Commissioning, Public Health) and Hilary Tovey (ICP Health Equity team) presented the report which gave a summary of the borough’s plan for oral health and access to NHS dental services.

Helen Byrne said the plan aimed to reduce tooth decay and increase access to dentistry. She noted that within Hammersmith & Fulham, only 40% of children and 44% of adults had access to dentistry. The Chair asked what lack of access meant in this context. Helen Byrne said there were 30 dentists in the borough, but officers didn’t have data on how many NHS places were available. She said services were not promoting oral health early enough to young families and dentistry was not embedded into the early life health checks. She said officers wanted to work across the system to build a consistent oral health offer. Hilary Tovey said there needed to be a whole system response including better access to dentists and improved oral health promotion. Helen Byrne added that oral health was also an issue for adults, particularly in vulnerable populations like refugees, asylum seekers, and the homeless.

Councillor Natalia Perez asked if the solutions to these problems would involve the voluntary sector as she felt they were well placed to reach the groups we needed to engage. Helen Byrne said charities and the voluntary sector would be consulted on how best to communicate with different communities.

Shad Haibatan (SOBUS) felt there was a need for more granular data because different communities had different levels of poverty, distrust, and exclusion. He noted that SOBUS worked closely with diverse communities and health was a key area of focus for them.

Hilary Tovey said one of the challenges was that dentists could choose to offer either NHS or private places. The Chair said the dentists’ contract was the key factor because currently it paid less to offer NHS places.

The Chair asked if the ICB could directly commission more dentists.Hilary Tovey said the ICB could not grant licenses for new dentists, but it had looked at using delegated commissioning to provide incentives for existing dentists. In 2024 the ICB had allocated £2.7m for enhanced Unique Dental Activities (UDAs) for new patients to get people back to regularly seeing a dentist. She noted that since starting the programme there had been an increase in the number of new patients.

Nadia Taylor said it was a complex problem with many factors contributing to the current crisis. She noted that in her role as a School Governor she had seen the impact of the reduction in funding and services, and the cost-of-living crisis also had a big impact. She added that Healthwatch had produced a detailed report on the impact of the cost-of-living crisis and dental treatment was shown to be one of the most difficult services to access.

Carleen Duffy said residents regularly called Healthwatch to ask which dentists took NHS patients. There was an online list, but dentists were responsible for updating it and it was  ...  view the full minutes text for item 5.

This report provides an update on the incidence of deaths by suicide in Hammersmith and Fulham and the work at both strategic and operational levels in the Council to examine the context and develop learnings to inform targeted and universal approaches for reducing the rate and preventing further occurrences.

This item includes an appendix that contains exempt information. Discussion of the contents of the appendix will require passing the proposed resolution at the end of the agenda to exclude members of the public and press.

Helen Byrne (Head of Commissioning, Public Health) introduced the report that provided an update on the incidence of deaths by suicide in Hammersmith and Fulham and the work at both strategic and operational levels in the Council to examine the context and develop learnings to inform targeted and universal approaches for reducing the rate and preventing further occurrences.

Helen Byrne was joined by Eve Penman (Public Health Officer) who was beginning a contract to focus specifically on suicide prevention in the borough. She addressed the board and noted the following points:

• Hammersmith & Fulham had the highest suicide rate in London.
• The majority were male aged between 25 and 35, many with known mental health problems and drug and alcohol problems.
• Officers were working with partners to collect data and information on suicide attempts and incidents of self-harm to build a fuller picture of the problem.
• The Council was supported by the Listening Place, an award-winning volunteer-led suicide prevention organisation.
• Officers were working with partners to update the prevention strategy from 2020. They were also working with families who had lost loved ones to suicide.
• Key risk factors included contact with the criminal justice system, housing need, unemployment, and bereavement.

Helen Byrne noted that officers intended to bring the draft action plan to the Board in June 2024.

ACTION: Helen Byrne

Shad Haibatan (SOBUS) said it was sad that Hammersmith & Fulham had the highest suicide rate in London. He noted that mental health was a big factor, along with isolation, and early intervention was key. He wanted partners and communities to work together to tackle this issue. He also raised concerns about the promotion of suicide amongst certain groups of young people online.

Councillor Natalia Perez expressed her condolences to families who had lost someone from suicide. She noted that the risk factors included housing need and employment status – and asked about the role of the advice sector and if there was any preventative support they could give.

Helen Byrne said there was a lot of support available to people, but it was usually only accessed at the point of crisis. The Council wanted to take a more holistic approach and ensure people were aware of help and support earlier to prevent people getting to crisis point. Officers planned to work on this issue with partners like the Listening Place, H&F Law, Citizen’s Advice Bureau, and housing providers.

The Chair asked about the work with housing providers. Eve Penman said work was being initiated with Council housing officers to offer suicide prevention training and promote wellbeing services through them. Helen Byrne said the goal was that all frontline staff would get access to training.

Nadia Taylor asked why Hammersmith & Fulham had the highest suicide rate. Eve Penman said there were a range of factors and that more analysis needed to be done before coming to a robust conclusion.

The Chair noted that from September 2023, the police in England had stopped responding to metal health calls if there was  ...  view the full minutes text for item 6.

To suggest items for the Board’s work programme.

The following items were requested and agreed in the meeting:

• An item on discharge arrangements from hospital, with a particular view to the patient experience. To a section on how patients with additional needs were supported through discharge process.
• Dentistry and Oral Health – a detailed plan with clear measures and success outcomes. Should also highlight areas that were outside of local control and needed to be raised at a national level.
• Suicide prevention draft action plan in June 2024.

To note the following dates of future meetings:

·       26 June 2024

·       11 September 2024

·       11 December 2024

·       19 March 2025

The following dates of future meetings were noted:

• 26 June 2024
• 11 September 2024
• 11 December 2024
• 19 March 2025

LOCAL GOVERNMENT ACT 1972 - ACCESS TO INFORMATION

Proposed resolution

Under Section 100A (4) of the Local Government Act 1972, that the public and press be excluded from the meeting during the consideration of an item of business, on the grounds that it contains the likely disclosure of exempt information, as defined in paragraph 3 of Schedule 12A of the said Act, and that the public interest in maintaining the exemption currently outweighs the public interest in disclosing the information.

Not required.