Welcome from the Chair

Councillor Nesil Caliskan, Chair, welcomed everyone to the virtual meeting.

Apologies for absence were received from Dr Helene Brown, Tony Theodoulou, Pamela Burke and Doug Wilson. Apologies for lateness were received from Councillor Rick Jewell.

Members are asked to declare any pecuniary, other pecuniary or non-pecuniary interests relating to items on the agenda. 

There were no declarations of interest in respect of any items on the agenda.

Verbal Update from Doug Wilson Head of Strategy & Service Development, Health Housing and Social Care London Borough of Enfield.

RECEIVED a verbal update from Bindi Nagra, Director of Adult Social Care, LBE.

NOTED

1.    This was an annual agreement to pool money between the CCG and the Council, to support the NHS.

2.    The Government had yet to issue formal guidance for this year, but there was agreement with the CCG to roll forward the schemes and money for last year to this year, pending guidance.

3.    It was confirmed that there had been no request for changes relating to the merger of CCGs and at this stage it was a local plan delivered and agreed locally.

Deborah McBeal, Director of Integration Enfield Directorate NHS North Central London Clinical Commissioning Group (CCG) and LBE Representative to be confirmed – Slides Attached

RECEIVED the presentation on Enfield Integrated Care Partnership (ICP).

NOTED

1.    Introduction by Deborah McBeal, Director of Integration, NHS North Central London CCG, noting the progress made. The partnership was an opportunity to collectively work on a number of initiatives to help the health and wellbeing of Enfield residents. The three key initiatives were (1) achieving uptake of screening and immunisation; (2) identifying and addressing health and wellbeing inequalities in BAME communities; and (3) improving mental health and wellbeing among residents.

2.    Bindi Nagra highlighted the importance of governance arrangements and coherent and consistent reporting back to partnership bodies, and of the patient voice.

3.    Dr Hetul Shah, clinical lead, highlighted the involvement of many partners working together, and current focus on flu vaccination.

IN RESPONSE

4.    Members raised the concerns of patients regarding access to primary care/digital exclusion in respect of e-consult, and in navigating secondary healthcare online systems. It was acknowledged that a proportion of patients found online services complex and sub-optimal, and practices were being supported to increase confidence in seeing patients in person for examination. There was now confidence in availability and supply of PPE, and training on how to keep premises, staff and patients safe. There was also work being done to improve communication from hospitals.

5.    In respect of health and wellbeing inequalities in BAME communities, the Chair raised that the focus needed to be on Edmonton. The importance of community research and engagement was emphasised by CCG representatives.

6.    Assurances were sought that Enfield would have adequate representation in North Central London CCG, and there would be equitable distribution of resources. It was confirmed that Enfield would have extra management support, and that part of the rationale for the CCG merger was to ensure best use of funding across boroughs and more equity of funding across North Central London.

AGREED that Health and Wellbeing Board noted and endorsed the ICP progress update.

Verbal Update from Sharon Burgess, Head of Safeguarding, Adults and People Department and Elspeth Smith, Team Manager Safeguarding, London Borough of Enfield – To Note

RECEIVED a verbal update from Sharon Burgess, Head of Safeguarding, and Elspeth Smith, Team Manager Safeguarding, LBE.

NOTED

1.    The Council had not used Care Act easements, and was not intending to do so at the moment.

2.    The Mental Health Act also had some easements, also not used by LB Enfield.

3.    Any issue around not meeting obligations under the Care Act was taken very seriously. There was careful monitoring of demand on services, staff and providers.

4.    Appropriate communication and transparency was important. A Care Act easement framework would be published soon, and there was an online pamphlet.

5.    Bindi Nagra raised that there had been some interest expressed as to whether the Council would ever introduce easements, but it had not been necessary so far. Enfield’s social care services were well run. He wanted to give reassurance that officers wanted to do the right thing by local people, to assess and to meet needs.

Teresa Cullip, PHE Registrar in Public Health, Ivana Price – Head of Service, Young People and Community Safety, Andrea Clemons – Head of Community Safety, Environment.

RECEIVED the presentation sent to follow.

NOTED

1.    Introduction by Theresa Cullip, Registrar in Public Health, and Andrea Clemons, Head of Community Safety, LBE, that there were high numbers of serious youth violence in Enfield, and that the borough had a large youth population.

2.    Serious youth violence had reduced during the Covid lockdown, but less than other areas, and there were now increases in anti-social behaviour reports, which had been a precursor to youth violence.

3.    A public health approach was proposed. Existing work and activities in Enfield were being mapped to produce an overall plan to cover all Council service areas. Main oversight would be provided by the Stronger Safer Communities Board.

NOTED

4.    The Chair highlighted connections to levels of deprivation and inequalities, and the need for committed Police resourcing in affected areas.

5.    Members welcomed the public health approach.

6.    A future update was requested to the Board to report progress made.

Gayan Perera, Darya Bordbar and Roseanna Kennedy-Smith of the Enfield PH Intelligence Team – presentation to follow.

London Borough of Enfield COVID19 Dashboard and Update on local and regional trends.

RECEIVED the presentation sent to follow providing an update and analysis of Covid-19 related data in Enfield from LBE Public Health Intelligence.

NOTED

1.    Introduction by Roseanna Kennedy-Smith, LBE Public Health Intelligence Team, on the latest case numbers in Enfield and rate per 100,000 people, which was in line with North Central London over the last few weeks.

2.    Calls to 111 and 999 had been increasing, but were still significantly below numbers seen in March and April.

3.    There had been increasing cases since August, the majority in the community, identified through swab testing, and a larger percentage in younger populations.

4.    Distribution of cases across the borough was shown. There was correlation of more deprived areas having more cases.

5.    Progress on locally supported contact tracing in Enfield was illustrated.

6.    Gayan Perera, LBE Public Health Intelligence Team, highlighted analysis of testing.

IN RESPONSE

7.    The Chair expressed concern over spread of the virus in a second wave, and recent reduction of testing capacity in London.

8.    Improvements to receipt of data in a more systematic way was welcomed.

Dudu-Sher Arami, Consultant in Public Health, London Borough of Enfield and Sarah Fryer Head of Schools Personnel Service, Chief Executive’s Department, London Borough of Enfield.

RECEIVED the presentation sent to follow providing an update on the impact Covid-19 cases were having on Enfield schools

NOTED

1.    Introduction by Dudu Sher Arami, Consultant in Public Health, and Sarah Fryer, Head of Schools Personnel Service, LBE, highlighting the work done over the summer to prepare schools to welcome all students back safely in September, and ongoing support and advice since their return.

2.    An update was provided on the impact of Covid-19 cases on affected school settings since the beginning of term.

IN RESPONSE

3.    Councillor Rick Jewell, Cabinet Member for Children’s Services, put on record his thanks to everyone working so hard to keep pupils and staff safe.

Doug Wilkinson Director of Environment and Operational Services Place Department, London Borough of Enfield and Stuart Lines – Director of Public Health London Borough of Enfield.

Presentation and review of current situation. Description of new powers and fines. Subsistence funding and enforcement in hospitality sector.

RECEIVED the presentation providing a review of the current situation.

NOTED

1.    Introduction by Doug Wilkinson, Director of Environment and Operational Services, and Sue McDaid, Head of Regulatory Services, LBE, in respect of the activities around new regulations, and enforcement actions.

2.    Environmental Health were assisting with local contact tracing.

3.    Financial support would be distributed through the local authority.

4.    There was co-ordination across a sub-regional enforcement group.

IN RESPONSE

5.    Members queried the operation of the contact-tracing app, which logged the venue visited, but not the length of time spent there.

6.    The Chair’s view that over coming weeks and potential introduction of further restrictions it was important there was a collective approach across all of London; and that self-isolation financial support was a crucial element in encouraging Covid-19 testing.

Dudu Sher Arami Consultant in Public Health, London Borough of Enfield. Dr Catherine Heffernan, Principal Advisor for Commissioning Early Years, Immunisations and Vaccination Services, Hon. Associate Professor for Public Health (LSHTM), Public Health England) and NCL CCG Representative.

To note the recent letters sent by The Leader to the Secretary of State for Health and NCL CCG requesting details of activity to ensure provision of influenza vaccination in Enfield. Discussion of current activity around influenza vaccination issues at national and local level.

RECEIVED the presentation introduced by Dudu Sher-Arami, Consultant in Public Health.

NOTED

1.    Following the last Board meeting, the Leader of the Council had written to NCL CCG and to the Secretary of State for Health requesting details of activity to ensure provision of flu vaccine in Enfield.

2.    Since the last meeting, there had been collaboration with the CCG and a huge amount of work had taken place involving joint working with the Council, CCG, voluntary sector partners and others, which it was hoped would result in a high vaccine uptake.

3.    Peter Lathlean, Deputy Head of Primary Care Commissioning, NCL CCG, provided an operational update. A flu working group met fortnightly. He confirmed that nationally there was enough vaccine stock to meet patient demand. There was a more targeted approach this year, and detection around clinical risk groups.

4.    Vee Scott, NCL CCG provided a communications and engagement update.

IN RESPONSE

5.    In response to queries regarding availability of vaccine, its roll out over different time periods for different groups and the logistics may have led to some confusion for patients, and there was a need for clear communication. It was confirmed that NCL CCG to date had delivered 51,000 flu vaccinations in four weeks. In respect of the over 65’s, flu vaccine was ordered sufficient for 80% of the eligible population; which was a good position. There was a slight shortage for the under 65’s, but work was being done to secure additional vaccines. Ambitions had grown for vaccination uptake this year, and the pace of the delivery of the flu vaccination programme was accelerated.

6.    There was a plan in place in Enfield for 100% vaccination of staff and residents of care homes.

7.    Provision and access to data day by day was key.

8.    GPs were using innovative ways to deliver vaccinations this year, including drive-through, out of hours service, and outdoor marquees, and had seen increased take-up by patients.

Dudu Sher-Arami, Consultant in Public Health London Borough of Enfield, Stuart Lines, Director of Public Health London Borough of Enfield, Ruth Donaldson Enfield CCG.

AGREED that due to lack of time for a full discussion, this item be deferred to the next meeting of Health and Wellbeing Board.

ACTION: Mark Tickner, Health and Wellbeing Board Partnership Manager

To receive and agree the minutes of the meeting held on 16 July 2020.

AGREED the minutes of the meeting held on 16 July 2020.

Dates of meetings for the 2020/21 municipal year:

Thursday 3 December 2020

Thursday 18 March 2021

Development Session to commence at 4:30pm.

Formal Board meeting to commence at 6:30pm.

Unless otherwise advised.

Venues to be confirmed.

NOTED the dates scheduled for future meetings for the 2020/21 municipal year, and potential for an additional meeting if required. The next Board meeting was scheduled for Thursday 3 December 2020.