Agenda and draft minutes

Health and Wellbeing Board
Thursday, 26th July, 2018 4.30 pm

Venue: Room 1, Civic Centre, Silver Street, Enfield, EN1 3XA. View directions

Contact: Jane Creer 020 8379 4093 Email: jane.creer@enfield.gov.uk 

Items
No. Item

12.

Welcome and Apologies

Minutes:

Councillor Cazimoglu (Chair) welcomed everyone to the meeting. Apologies for absence were received from Ian Davis (Chief Executive), Dr Helene Brown, Councillor Georgiou, Tony Theodoulou, Maria Kane and Councillor Caliskan (Leader).

 

The Chair suggested to the board to hold the next meeting at a different venue (Outside Enfield Town) to aid public awareness of the Board.

 

The Board AGREED this would be a good idea.

 

 

13.

Declaration of Interests

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

Minutes:

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

14.

NORTH MIDDLESEX UNIVERSITY HOSPITAL NHS TRUST (NMUH) CASE FOR CHANGE pdf icon PDF 446 KB

A slide presentation to be delivered by Richard Gourlay, Director of Strategic Development, NMUH.

 

NMUH are currently a clinical partner in the Royal Free London (RFL) Group and have committed to developing the case for change which will determine whether there is a decision to proceed to closer partnership with RFL and that such a change best serves the needs of NMUH’s patients and community. NMUH want to engage all stakeholders about the broad range of challenges they face, and whether RFL group provide the best option for NMUH into the future.

Minutes:

 RECEIVED a presentation by Richard Gourlay, Director of Strategic Development, NMUH.

 

NOTED

Richard Gourlay introduced the report, highlighting the following:

·         North Middlesex University Hospital (NMUH) primarily looking at how to provide a sustainable service

·         NMUH trying to digitalise pathways and make decisions in closer collaboration

·         Provide essential care for a needy population

·         It was highlighted that the current pressure on the A&E department is significant

·         Issues raised were Retention and Recruitment regarding staff, improving the culture in the workforce and implementing Governance Arrangements

·         It was noted that arrangements will be drafted in August 2018 and engagements with stakeholders to commence in September 2018.

 

IN RESPONSE comments and questions were received, including:

 

 

1.    The Chair raised issues regarding Public Transport to and from hospitals, and if anything is being done in connection with this?

 

Richard Gourlay advised that he has a specialist team (Estates team) working on this issue and that NMUH representatives sit on that group.

 

 

2.    Congratulations were passed onto the North Middlesex on how well they did during the Winter crisis. A question was asked regarding the amount of deficit the Royal Free have?

 

It was advised that the deficit at the start was 29 Million and is projected to be 18 Million (end of the year), it was also highlighted that integration within the organisations (NMUH & RFL) will improve current deficits. 

 

 

3.    A question was asked for better clarification on the managerial structure with a Royal Free London (RLF) integration.

 

Similar management structure as Barnet Royal Free. Royal free to be strategic decision makers.

 

4.    Dr Mo Abedi (Vice-Chair) also made a comment regarding the improved stability the association have brought.

 

5.    Bindi Nagra (Director of Adult Social Care) commented that the Board needed to look at all options not just one, Bindi also advised that Maria Kane’s (North Middlesex University Hospital NHS Trust) approach regarding quality improvement has been excellent. It was also highlighted by Bindi that there was a lack of evidence regarding the benefits the Royal Free would bring to guide decision making.

 

Other questions received:

 

6.    Why can’t you go it alone, without any integration with RFL?

 

Some services are small and fragile, A&E department demonstrated this with issues around retainment and recruitment in the sector this year.

 

 

7.    Do you understand why you struggle to recruit/retain staff?

 

Inner London waiting is more appealing to potential/current staff and the culture within organisation needs improving.

 

8.    Parin Bahl (Healthwatch Representative) mentioned that she has previously highlighted her disappointment if another crisis happened, residents’ value their local hospital and welcome the idea for change.

 

.

9.    Stuart Lines (Director of Public health) asked what is the role of the Royal Free in prevention?

 

Stop smoking services, maintaining care outside hospitals. A bid was recently submitted to CCG looking at other prevention action plans.

15.

INTEGRATION AND BETTER CARE FUND (BCF) pdf icon PDF 287 KB

To receive the report of Bindi Nagra (Director, Adult Social Care, LB Enfield) and Graham MacDougall (Director of Commissioning, NHS Enfield CCG) setting out the delivery of the BCF for Quarter 4 2017-2018, alongside the noted changes for the 2018-2019 BCF plan.

Minutes:

RECEIVED the report of Bindi Nagra, Director, Adult Social Care Enfield Council and Graham MacDougall, Director of Strategy and Partnerships Enfield CCG

 

NOTED

Graham MacDougall introduced the report, highlighting the following:

·         The year-end financial position for the BCF’s performance was good

·         It is confirmed that both the CCG and Council have achieved the required savings to provide a balance position (End of year)

·         The Better Care Fund allocation was agreed as part of a two-year plan 2017-2019, this was ratified by the Health and Wellbeing Board in August 17 and submitted to NHS England with the plan formally agreed in October 17

·         The improved better care funding for 18-19 has been allocated to meet the following grant conditions; Adult Social Care needs, reducing pressures on NHS and to support the local social care provider market.

 

 

16.

PROGRESS UPDATE ON JOINT HEALTH AND WELLBEING STRATEGY (JHWS) pdf icon PDF 462 KB

To receive the report of Stuart Lines, Director of Public Health.

Minutes:

RECEIVED the report of Stuart Lines Director of Public Health, on progress on Health and Wellbeing Board Monitoring areas for 2017-19 and the Annual Review of key indicators.

 

NOTED

Stuart Lines introduction of the report highlighted:

·         This is a regular item within the Board Meetings, with the priority areas being Best start in Life, Healthy Weight and Mental Health resilience

·         Continue to support ongoing partnership with Thrive LDN in mental health resilience

·         Awareness of emotional health and wellbeing resilience to other HWB priorities

·         HWB member organisations to sign up to Sugar Smart Enfield and Enfield CCG and LBE to offer more accessible places locally for initial assessments, and group intervention sessions regarding diabetes prevention

·         Continue to progress the Best Start in Life Action Plan

·         Monitoring the VAWG Strategy Action Plan

·         Progressing an audit of how Enfield is meeting NICE guidelines on domestic abuse

·         Supporting future cancer awareness campaigns and to facilitate/encourage bowel scope launches for Enfield residents

·         Season Flu vaccination performance have improved in 17/18 across all NHS providers and will continue to support flu vaccination uptake and campaigns

 

17.

MENTAL HEALTH - PRIORITY UPDATE REPORT pdf icon PDF 135 KB

To receive the report of Mark Tickner, Senior Public Health Strategist, providing an update on emotional and mental health resilience activity and progress thus far and proposals for additional activity moving forward.

Minutes:

RECEIVED the report of Stuart Lines, Director of Public Health on Mental Health.

 

NOTED

Mark Tickner (Senior Public Health Strategist) introduced the report, highlighting the following:

·         Proposals will be in place soon for additional activity moving forward

·         Mark advised 2 flowcharts will be developed relating to “Making Every Contact Count” [MECC] and “Mental Health First Aid” [MHFA] at the Council

·         The first to display how we might introduce MECC and MHFA across LBE, and for whom and to define what additional skills would be delivered. This would include timeframes and optional arrangements including potential partners locally

·         The second to show how the referral mechanisms for MECC and MHFA after introduction

·         Mental Health resilience is a priority identified by the Health and Wellbeing Board

·         Flowcharts are due to be submitted by the 3rd September 2018

 

18.

BEST START IN LIFE - PRIORITY UPDATE REPORT pdf icon PDF 384 KB

To receive the update from Andrew Lawrence, Service Development Manager – Early Years and Early Help, on the area of focus Giving Every Child in Enfield the Best Possible Start in Life through improving school readiness, and action plan.

Additional documents:

Minutes:

RECEIVED the background papers on Giving Every Child the Best Possible Start in Life through improving school readiness

 

NOTED

Andrew Lawrence introduced the report, highlighting the following:

·         In Enfield, for a cohort of 4,634 children the data shows an improvement of 1.6% to have a good level of development (GLD) from 66% in 2016, to 67.8% in 2017. The National GLD had also risen from 69% to 70.7%.

·         Enfield have consistently improved in line with other authorities, it has not yet however narrowed the gap in school readiness measures in terms if nation/regional comparators.

·         Some Enfield Schools, who have a high percentage of children from families with complex issues, can ensure that 66+% of children do achieve a GLD while others it is still only 55+%

·         Schools are also reporting higher mobility within the year group. During reception year 160 children (4%) left whilst another 80 transferred to another Enfield school.

·         In response programmes such as empowering parents and empowering communities are taking place.

·         Healthy early year schemes are also in place in private, voluntary and independent nurseries , early learning/day care in children’s centres, schools, nursery schools and childminders.

19.

HEALTHY WEIGHT - PRIORITY UPDATE REPORT pdf icon PDF 250 KB

To receive the report of Dr Glenn Stewart, Assistant Director of Public Health providing an update on the Healthy Weight Partnership and the draft Healthy Weight Strategy and action plan, in addition to highlighting an opportunity to participate in the School Superzones pilot project.

Minutes:

RECEIVED the report of Dr Glenn Stewart, Assistant Director of Public Health

 

NOTED

Dr Glenn Stewart introduced the report, highlighting the following:

·         Report encourages their organisations to responds to the Healthy Weight Strategy consultation and consider what actions to take

·         Support Enfield Councils efforts to participate in School Superzones pilot project that target unhealthy food and drink sales, advertisements, alcohol, smoking, gambling, air quality and physical inactivity

·         Obesity still a priority for the Health and Wellbeing Board for 2017 -2019

 

 

20.

KEY MESSAGES FROM THE JOINT STRATEGIC NEEDS ASSESSMENT (JSNA) pdf icon PDF 2 MB

JSNA summary information pack to follow.

TO FOLLOW

Additional documents:

Minutes:

RECIEVED the presentation on the Key Messages from the Joint Strategic Needs Assessment (JSNA) sent to follow.

 

NOTED

·         Population Structures in Enfield;

·         331,395 people in Enfield, 5th largest population in Enfield, Larger proportion of 0-19 year olds compared to London/England average and Enfield population to increase to 354,300 by 2023

·         Deprivation;

·         Highest deprivation in East of Enfield, 22% of Enfield children (around 19,00) lives in poverty (Tenth highest in Enfield

·         Ethnicity is ethnically diverse borough

·         Life expectancy in Enfield is 80.1 years (Male) and 84.5 years (Female)

·         There are still wide inequalities in health outcomes in the Borough

·         Obesity also a serious issue in the Borough.

 

 

21.

HEALTH AND WELLBEING BOARD TERMS OF REFERENCE pdf icon PDF 392 KB

To note the updated terms of reference further to submission to Council on 19 July 2018.

TO FOLLOW

Minutes:

RECEIVED the report of Tony Theodoulou (Executive Director of People’s Services) sent to follow.

 

NOTED

·         The amended Terms of Reference were agreed at full Council on the 19th July 2018

·         Key amendments include;

·         The frequency of Board meetings and Development Sessions

·         Revised structure and Governance Arrangements

22.

VOLUNTARY REPRESENTATION AT THE HEALTH AND WELLBEING BOARD pdf icon PDF 136 KB

Democratic requirement to hold an election for Voluntary Sector (Attached)

Minutes:

RECEIVED the report of Dr Glenn Stewart, Assistant Director of Public Health, sent to follow

 

NOTED

Dr Glenn Stewart introduced the report, highlighting the following:

·         The current Terms of Reference include provision for the election of a representative from the Third Sector for a term of office of 3 years. The current representatives have been on the Board since 2013.

·         The revised terms of reference state that there will be one representative from Enfield Voluntary Action (EVA) and another elected representative.

·         There is therefore a need to hold a formal, open, transparent and democratic election to secure voluntary sector representation to assist the HWB in fulfilling its health leadership role for the borough.

·         Democratic Services have confirmed that the current voluntary sector representatives will remain in place until new voluntary sector representatives have been elected (or re-elected). 

 

PROPOSAL

1.    To achieve the above, it is anticipated that engagement with the VCS will start immediately with a view to holding elections in September with the result reported to the HWB on 27th September 2018.

 

The Board considered that the proposal was satisfactory

 

IN RESPONSE comments and questions were received, including:

 

1.    An ECS representatives term of office is three years, with new representatives to be in place by 27th September 2018.

2.    It was advised to include as many people as we can to have the best Health and Social Care experience.

23.

HEALTH AND WELLBEING BOARD FORWARD PLAN pdf icon PDF 152 KB

To discuss and update the Forward Plan.

Additional documents:

Minutes:

RECEIVED the report of Stuart Lines, Director of Public Health

 

NOTED the proposed forward plan.

 

AGREED

1.    That the Health and Wellbeing Board agreed the proposed forward plan.

 

24.

INFORMATION BULLETIN pdf icon PDF 306 KB

Minutes:

NOTED the Information Bulletin items.

25.

MINUTES OF THE MEETING HELD ON 17 APRIL 2018 pdf icon PDF 90 KB

To receive and agree the minutes of the meeting held on 17 April 2018.

Minutes:

AGREED the minutes of the meeting held on 8 February 2018.

26.

Dates of Future Meetings

Members are asked to note the dates of meetings for the 2018/19 municipal year:

 

?  Thursday 27 September 2018

– 4:30pm Development Session & 6:30pm HWB Board

 

?  Wednesday 31 October 2018 – additional Development Session if required

 

?  Thursday 6 December 2018

– 4:30pm Development Session & 6:30pm HWB Board

 

?  Wednesday 16 January 2019 – additional Development Session if required

 

?  Wednesday 20 March 2019

– 4:30pm Development Session & 6:30pm HWB Board

Minutes:

NOTED the dates of future meetings of the Health and Wellbeing Board and dates of future development sessions.