Agenda and minutes

The Chair welcomed everyone to the meeting particularly the new voluntary sector representatives: Vivien Gildadi and Litsa Worrall. 

Apologies for absence were received from Councillor Bond, Ian Davis, Andrea Clemmons and Dr Mo Abedi. 

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

All members of the Health and Wellbeing Board are reminded that they are required to comply with the Council’s Code of Conduct.   

There were no declarations of interest.

Board members were reminded of the need to complete their declaration of office and registration of interests’ forms which had been sent out separately. 

To receive a report on the establishment of the Enfield Health and Wellbeing Board and to endorse the terms of reference as agreed at Council on 27 March 2013. 

The Board received a report on the establishment of the Health and Wellbeing Board. 

NOTED that

1.                  Council had approved the establishment of the Board and the terms of reference at its meeting on 27 March 2013.

2.                  The Chair highlighted a proposed minor change to the terms of reference to include that membership of non statutory members should be reviewed annually.

3.                  Councillor Hamilton corrected the impression in Para 3.4.3 that the Cabinet Member for Environment, and not as was the case, the Cabinet Member for Community Wellbeing and Public Health was responsible for community safety. 

AGREED

1.                  To note and endorse the terms of reference as set out in Appendix A to the report.

2.                  To note that the Council’s Code of Conduct will apply to all Board members.  Para 3.6 of the report.

3.                  To approve a change to the terms of reference, agreed at Council, that “membership of all non statutory board members be reviewed annually in line with the Council representations”. 

4.                  To agree to the continuation of the three sub committees that previously operated under the shadow board arrangements.  These were the Health Improvement Partnership Board, the Joint Commissioning Partnership Board, and the Improving Primary Care Partnership Board.  

To receive a report from Richard Quinton (Director of Finance - Enfield Clinical Commissioning Group) on the transition between Enfield NHS and Enfield CCG. 

The Board received an update report from Liz Wise (Chief Officer – Enfield Clinical Commissioning Group) on the overall position on the authorisation, transition and handover processes of the CCG. 

4.1       Presentation of the Report

Richard Quinton, Director of Finance - Enfield CCG, presented the report to the Board highlighting that: 

• The Enfield CCG was authorised by NHS England as a legally established organisation with only 7 conditions out of 119 criteria and one legal direction.

• The CCG is producing a plan as to how to address these conditions which is due to be approved by the CCG Governing Body at a meeting on 24 April 2013. 

• It is hoped that all conditions will be resolved by June and the CCG will then be able to take on responsibility for all the relevant health services in Enfield. 

• There are likely to be monthly, assurance reviews until all the conditions are resolved. 

• By the end of the year the CCG should have a balanced financial position.

• On 4 April NHS Enfield CCG held its first public event, attended by over 80 people.  Presentations were made by Dr Alpesh Patel, Liz Wise, Dr Shahed Ahmad and Richard Quinton.  Following questions a series of workshops were held on Unscheduled Care, the Barnet Enfield and Haringey Clinical Strategy, Integrated and Primary Care.  Positive feedback was received. 

4.2       Questions/Comments

4.2.1   A summary of the plan will be produced and will be circulated to Board members. 

4.2.2   It is not anticipated that the 7 remaining conditions will impact upon patient care. 

4.2.3   The contracts with the major providers Barnet and Chase Farm and North Middlesex Hospitals are within days of being finalised, although there are still some points of difference but these should not cause problems. 

4.2.4   The CCG development plan is being reviewed in the light of the locality based working.  Enfield will be divided up into 4 areas and work will continue as to how best to deliver the locality based services. 

AGREED to note the contents of the report in particular that

1.                  To receive and note the briefing about the authorisation, transition and handover processes.

2.                  To receive and note the update to the CCG introduction event on 6 April 2013. 

To receive an report from Bindi Nagra (Chief Commissioning Officer) and Deborah Fowler (HealthWatch Chair) updating the Board on the new Enfield HealthWatch organisation. 

The Board received a report updating the board on the development of the HealthWatch function from Michael Sprosson, Service Manager Procurement.

1.         Presentation of the Report

Bindi Nagra, Joint Director of Commissioning, highlighted the following from the report: 

• A reference group had been established in March 2013 and Deborah Fowler recently appointed Chair of the organisation. 

• The process of selecting board members had begun: twenty eight expressions of interest received from a wide range of people with a variety of skills and experience.  Interviews were due to take place on 7 and 8 May 2013. 

• An advertisement for the Chief Executive Officer post had been placed in the Guardian. 

• A dedicated individual and phone number had been identified within the council.  This had been publicised and some phone calls received. 

Deborah Fowler, HealthWatch Chair, added:

• The immediate focus of the group had been on recruitment and it was hoped that trustees and a chief executive would soon be in place.  Two other staff members were also to be taken on. 

• The initial development phases had received good support from Commissioning Staff and the reference group.

• HealthWatch were keen to work with existing groups and to build on work that had already been carried out.

• Work had begun on creating a website and linking to the national body HealthWatch England. 

• A letter had been sent to all Links members welcoming their involvement in the new organisation. 

• A search for suitable premises had begun. 

• She, as Chair, had attended a national launch event in London. 

• Expectations management would be essential. 

• Although Enfield was not as far advanced in this area as other boroughs, everything was now in place to create a good solid organisation

2.         Questions/Comments

2.1             Andrew Fraser advised that he would be keen to assist through the engagement of children and young people in the youth parliament.  Also the Parent Engagement Panel could be used as a forum to support engagement with communities. 

2.2             Concern was expressed as to how to reach seldom heard people.  Deborah Fowler responded that HealthWatch had been set up as a new organisation by Government and this was one area where work would be carried out.

2.3             Although the organisation had been set up by the Council, it would be working independently.  Accountability was ultimately to the people of Enfield. 

2.4             The reference group which had been set up to set up to advise Health Watch was representative of a wide spectrum of the voluntary sector.

2.5             HealthWatch was anxious not to lose the knowledge and experience gained by the Links organisations. 

2.6             It was not anticipated that councillors would be involved directly in HealthWatch.  A protocol for councillor involvement would be drawn up by officers.

2.7             Councillor McGowan acknowledged that the organisation had been formed quite late in the process, but this had been after extensive consultation.  Final decisions on establishment would be made by the reference group and the Chair.

AGREED that the Board note the contents  ...  view the full minutes text for item 5.

To receive a report from Andrew Fraser (Director of Schools and Children’s Services) setting out the next steps for taking forward the Family Nurse Partnership Bid. 

The Board is asked to formally endorse this bidding process. 

The Board received a report from Andrew Fraser, Director of Schools and Children’s Services, on the Family Nurse Partnership Programme. 

1.         Presentation of Report

Eve Stickler presented the report to board members.  She highlighted the following:

·        The report updated members on progress, since the presentation received by the board at their development session in March. 

·        The scheme was something that the department had wanted to participate in for some time and this was an opportunity to engage.

·        The scheme was licensed, as such it had a clear structure and was very prescriptive to enable outcomes to be maintained. 

·        Participation was limited to first time mothers, aged 19 and under, entering no later than the 28^th week of pregnancy; 60% to be enrolled by the 16^th week. 

·        This was an opportunity to access a free resource which would be fully funded for the first two years.  It would act along side the wider children and young people and health visitor services.  

·        The partnership scheme involved highly skilled practitioners working intensively with small case loads with clear outcomes including reducing low birth rates, increasing breast feeding, improving immunisation rates, enabling parents, increased maternal and paternal employment.

·        Participants would leave the scheme after two years as the aim was to avoid dependency and enable the families to function more effectively becoming self supportive. 

·        A Local Advisory Board will be set up to drive and oversee the project, in operation. 

·        Initially the team of 4 with one supervisor will have a caseload of 104 young mothers

2.         Questions/Comments

2.1             Ray James advised that the scheme would be funded by the Department of Health for the first two years and then be included as part of baseline funding.  

2.2             Eve Stickler would provide information on where scheme workers would be based. 

2.3             Avoiding creating silos and ensuring the scheme worked in co-operation with other services would be key to success and should help ensure that the working is embedded once the initial scheme ends.  Duplication should also be avoided to ensure that what the nurse partnership nurses do is apart from what is being done by regular health visitors.    

2.4             The Health and Wellbeing Board will have oversight and should receive regular 3-6 monthly updates to enable them to help resolve any problems and to see where lessons learned could be utilised by other services. 

AGREED

1.                  To note the aims of the Family Nurse Partnership and the progress in implementing it to date.

2.                  To support the development of the Family Nurse Partnership across Enfield. 

To receive updates from the following: 

1.         Health Improvement Partnership

2.         Joint Commissioning Partnership Board

3.         Improving Primary Care Board (To Follow)

4.         Children’s Services Update

4.1       Change and Challenge Programme

4.2       Fulfilling Lives Big Lottery Bid

7.1             Joint Commissioning Board Report

7.1.1   The Board received a report from Bindi Nagra, Joint Chief Commissioning Officer.

He highlighted the following: 

• The Voluntary and Community Strategy had been agreed by Cabinet.  Implementation would be phased in. 

• The Council has been successful in its application to be part of a pilot programme for the implementation of direct payments in residential care.  Details on how the pilot will operate have not yet been received. 

• A response to the Joint Commissioning Board on the roll out of direct payments in healthcare is being prepared. 

• The Quality Checker Programme have recruited and trained over 50 quality checkers.  They have already undertaken 191 visits to 57 sites.  Visits are made with a view to look at what is being done well, as well as what could be improved.  Further information will be provided to the Board at a later meeting. 

• A network multidisciplinary team had been established in the North West area of the borough as part of the Integrated Care Programme for Older People.  This will also be rolled out to the other parts of the Borough. 

7.1.2   Questions/Comments

7.1.2.1      The Quality Checker Scheme is unique to Enfield.  All volunteers are thoroughly trained and take part in an induction process.  This will not take the place of regulatory or inspection visits but has been designed to complement them.  The Care Quality Commission is aware of the scheme and has expressed support.  Enfield has been invited to share the model with other authorities. 

7.1.2.2      A review of all grant funded voluntary sector organisations is being undertaken over a period of 18 months. 

7.1.2.3      The consultation on direct payments for healthcare is a national consultation exercise.  The scheme promotes choice and enables patients to have greater control over their own care.  It is in the interests of both patients and the council that it can work well.  .

7.1.2.4      The use of overt and covert surveillance to deter and detect abuse of adults at risk is a national issue.  It was felt that the Council had a moral duty to explore its use in care settings, as the technology was now readily available and it was a way of protecting service users.  Some felt that it was not the Local Authority’s job to act as snoopers and that human rights issues were involved.  The Council had recently received two safeguarding alerts, for which the public had gathered evidence covertly.  This was an issue which would be subject to further discussion. 

7.1.2.5      The network multidisciplinary team was to be rolled out to the South East and North East of the borough soon. 

7.1.2.6            Andrew Fraser was awaiting further information from Derby on the recent safeguarding case involving the Philpot family, where parents had been found guilty of killing their own children.  He would be looking to learn from the information provided to apply in Enfield.  Tony Theodoulou, Assistant Director Children’s Services, could be asked to provide a report for the board on  ...  view the full minutes text for item 7.

To receive and agree the minutes of the meeting held on 14 February 2013. 

AGREED the minutes of the meeting held on 14 February 2013 as a correct record.   

To note the dates provisionally set aside for future meetings of the Board: 

• Thursday 20 June 2013
• Thursday 19 September 2013
• Thursday 12 December 2013
• Thursday 13 February 2014
• Thursday 24 April 2014

These may change following agreement on the whole Council Calendar at Council on 8 May 2013. 

NOTED the dates put forward for future meetings of the Board: 

• Thursday 20 June 2013
• Thursday 19 September 2013
• Thursday 12 December 2013
• Thursday 13 February 2014
• Thursday 24 April 2014

If necessary, to consider passing a resolution under Section 100A(4) of the Local Government Act 1972 excluding the press and public from the meeting for any items of business moved to part 2 of the agenda on the grounds that they involve the likely disclosure of exempt information as defined in those paragraphs of Part 1 of Schedule 12A to the Act (as amended by the Local Government (Access to Information) (Variation) Order 2006).

(There is no part 2 agenda)