Agenda and draft minutes

Welcome from the Chair and introductions

Cllr Abdul Abdullahi, as Chair in the absence of Cllr Alev Cazimoglu,  welcomed everyone to the virtual meeting and invited attendees to introduce themselves.

Apologies for absence were received from Cllr Nesil Caliskan, Cllr Alev Cazimoglu, Dr Shakil Alam, Dr Alpesh Patel, and Glenn Stewart.

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.

Mark Tickner, Infection Control Lead, and Gayan Perera, Public Health Intelligence Manager – Public Health Department London Borough of Enfield.

(PAPERS ATTACHED)

Verbal update from Dr Nnenna Osuji, Chief Executive, North Middlesex University Hospital NHS Trust.

RECEIVED the slide presentation, introduced by Gayan Perera, Public Health Intelligence Manager, and Mark Tickner, Infection Control Lead.

NOTED

1. The number of infectious disease notifications was low and normal.

2. The number of Covid-19 cases was small at the moment.

3.  Latest Covid Autumn booster and flu vaccination numbers were shown.

4.  Latest childhood immunisations uptake data was reported.

5.  Reassurance was provided regarding recent detection of swine flu in the north of England, which was of natural occurrence and not spreading, and respiratory disorders reported from China and USA which were linked to ‘immunity debt’ and not to new pathogens.

6.  A multi-agency table top exercise had been run in November in respect of measles planning. A resulting report would be circulated to Board members.

RECEIVED a verbal update in respect of winter preparation from Dr Nnenna Osuji, Chief Executive, North Middlesex Hospital.

7.  The number of Covid-19 and flu cases were low, but there remained a quite significant operational impact due to affected patients and staff.

8.  There had been increasing numbers of children attending the hospital with respiratory syncytial virus (RSV).

9.  Lower vaccination uptake and ‘vaccination fatigue’ was also manifested in numbers of vaccinated staff, despite a promotional campaign.

10.  In emergency departments, pressures and high attendance volumes were present throughout the year. A number of contingency plans had needed to be used.

11.  Work was ongoing with London Ambulance Service (LAS) in respect of response times. A pilot scheme to release LAS crews after 45 minutes had been introduced, with improvements to patient flow.

12.  Flow had also been improved in emergency services. The front door GP provision had been doubled in capacity.

13.  The hospital was intensely busy, and getting busier as the weather got colder. She wished to record gratitude to staff for their hard work.

Doug Wilson, Director of Health and Adult Social Care, London Borough of Enfield and Matt Casey, Head of Strategy and Service Development, People Department London Borough of Enfield.

(PAPERS ATTACHED)

RECEIVED the slide presentation, introduced by Doug Wilson, Director of Health and Adult Social Care, providing an update on the Better Care Fund (BCF).

The BCF supported joined up working across health and social care. The BCF policy objectives related to enabling people to be living safely and independently at home for longer, and providing the right care, at the right place, at the right time. Partnership working in Enfield had been particularly successful. Preparations were in place for services to be busier as the weather got colder: staff were ready and plans had been made.

IN RESPONSE

In response to the Chair’s queries around delayed discharges from hospital, it was advised that there could be a number of reasons for delays, usually due to complexity. It was also noted there had been an increase in numbers of people admitted with strokes who needed rehabilitation before leaving hospital. Partners did work together genuinely well.

Stephen Wells, Head of Borough Partnership Programme, Enfield Borough Directorate, NHS North Central London. Deborah McBeal Director of Integration Enfield Borough Directorate NHS North Central London Integrated Care Board.

(PAPERS ATTACHED)

RECEIVED the slide presentation, introduced by Deborah McBeal, Director of Integration, North Central London Integrated Care Board (NCL ICB) and Stephen Wells, Head of the Enfield Borough Partnership Programme.

1.  The governance and leadership of the Enfield Borough Partnership was set out.

2.  The work programme was outlined. Summaries of the work of the key working groups were highlighted, including the Inequalities Delivery Group.

3.  There had been mapping across the five NCL boroughs and programmes of work would address the biggest gaps and challenges.

4.  Working together going forward was emphasized, with best use of resources and reduced duplication, and alignment with the Joint Local Health and Wellbeing Strategy.

5.  A further update would be brought in the new year, when the delivery plan would be in place.

IN RESPONSE

6.  Pamela Burke, voluntary sector representative, wished to encourage a joint strategic approach to supporting young carers and adult carers as a group. Involvement of carers led to savings to hospitals and social care costs. Stephen Wells advised that there was a lot of support for this work and he would make contact the following day via email. Dr Nnenna Osuji also advised she would be happy to have further conversations outside the meeting.

Dudu Sher-Arami, Director of Public Health LB Enfield, Chad Byworth ST1 Registrar – Public Health Department, LB Enfield, Victoria Adnan, Policy and Performance Manager, Chief Executive’s Department, LB Enfield, Mark Tickner, Senior Public Health Strategist, Public Health Department, LB Enfield.

(PAPERS ATTACHED)

RECEIVED the draft Enfield Joint Local Health and Wellbeing Strategy 2024-2030, introduced by Dudu Sher-Arami, Director of Public Health, and Victoria Adnan, Policy and Performance Manager.

1.  Board members were requested to send their own feedback and to circulate the draft document and questionnaire link to their networks during the current consultation period. Officers would also be pleased to attend meetings of groups to continue the engagement programme. The online consultation would run until 29 January 2024.

2.  A special meeting between the Health and Wellbeing Board and the Borough Partnership was proposed around mid-February 2024 for presentation of the consultation feedback and any amendments to the strategy.

IN RESPONSE

3.  In response to the Chair’s queries regarding success of consultation, this would be by ensuring good quality conversations and speaking with a broad range of types of Enfield residents and stakeholders in organisations across the health and care sector.

4.  Cllr Milne had concerns that the strategy was aspirational but did not specify what success would look like or how it would be measured. Officers advised that these concerns, also raised at Health and Adult Social Care Scrutiny Panel, were being addressed. It was confirmed there would be a monitoring framework that would also link to key strategies already in place such as the corporate plan and population health strategy. The action plans in the JLHWS would also be developed during the life of the strategy.

5.  Pamela Burke would like for young carers and adult carers to be noted specifically in the strategy. Officers agreed to review the text, and would incorporate carers networks into the actions planning. Dudu Sher-Arami would liaise further outside the meeting regarding engagement with the carers’ community before the end of the consultation period.

Andrew Lawrence, Head of Commissioning – Children and Young People, Public Health Department LB Enfield and Francesca Falcini, Schools and Early Years Data Manager, People Department, LB Enfield.

(PAPERS ATTACHED)

RECEIVED the Early Years Partnership Board data set and introduction by Peter Nathan, Director of Education, providing an update on Early Years services.

1.  The profile of early years provision had been raised by the government’s proposals regarding expanded childcare provision, and expected funding. The changes would require a lot of preparation. Further details would be provided to the Board in the new year.

2.  The detailed data set informed planning going forward. It was noted that the birth rate in Enfield had fallen and was already impacting schools.

3.  Early Years Foundation Stage Profile data was highlighted: Enfield’s Good Level of Development rates were below the London and national averages. Children Obese percentages, and dental decay levels, were higher than London and national averages. Children’s MMR immunisation rates were also lower in Enfield than average.

4.  Attention was drawn to good results in respect of Health Visiting data. There had been a lot of work to ensure people were seen in a timely way and an increase in the number of drop-in clinics.

5.  Of the referrals for family support work, domestic abuse as a presenting issue was significant.

6.  In respect of Joint Service for Disabled Children’s Referrals, the top presenting need was social communications difficulties.

To receive and agree the minutes of the meeting held on 2 October 2023.

AGREED the minutes of the meeting held on 2 October 2023.

Proposed date of the next meeting of Enfield Health and Wellbeing Board:

Tuesday 5 March 2024.

Formal Board meetings proposed to commence at time to be confirmed.

NOTED the next Board meeting date: Tuesday 5 March 2024 on Teams.

Councillor Abdullahi suggested future agenda items including Inspections, and accessing Child & Adolescent Mental Health Service and autism diagnosis.