Agenda and draft minutes

Welcome from the Chair and introductions

Cllr Alev Cazimoglu, Chair, welcomed everyone to the virtual meeting and invited attendees to introduce themselves.

Apologies for absence were received from Mark Tickner, Health and Wellbeing Board Partnership Manager.

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.

Doug Wilson, Director of Adult Social Care, London Borough of Enfield, for noting.

To include brief detail of preparations and possible timelines.

RECEIVED a verbal update from Doug Wilson, Director of Adult Social Care.

1.  The update further to the last Board meeting was a reminder that Care Quality Commission (CQC) inspections were returning after a long absence and would be a different process.

2.  The Adult Social Care Service in Enfield had submitted its self-assessment.

3.  The CQC’s second letter was expected shortly, and it was anticipated the inspectors would be on site around late November / early December.

4.  The Adult Social Care Service had made good progress in its preparations and welcomed the inspection. Acknowledgement was noted to VCS and NHS partners and confirmation that there would be pre-engagement with key partners and sharing of key messages.

IN RESPONSE

5.  The Chair expressed thanks for officers’ work in preparation for the inspection, and looked forward showing the good services provided in Enfield.

6.  In respect of learning from boroughs already inspected, it was known that inspectors tended to be physically on site between three to five days depending on the key lines of enquiry.

7.  The self-assessment had set out the service’s successes and challenges. The CQC would be interested in how challenges were being dealt with, evidence of a plan, and progress against the plan.

8.  The CQC would want to speak to various groups on a structured basis, and in less formal drop-in sessions.

Presenters for the NHS North Central London ICB:

Clare Henderson, Director of Place, East: covering Enfield, Haringey and Islington

Paul Allen, Assistant Director – Strategy, Communities & Inequalities

And

Dudu Sher-Arami, Director of Public Health, Public Health Department LB Enfield, and Victoria Adnan, Policy and Performance Manager, People’s Department LB Enfield.

(Paper attached.)

RECEIVED a presentation introduced by Clare Henderson, Director of Place, East and Paul Allen, Assistant Director – Strategy, Communities & Inequalities, NHS North Central London ICB.

1.  The NCL Population Health & Integrated Care (PH&IC) Strategy was endorsed in April 2023 following significant work with partners and residents, and outlined the ambition to tackle health inequalities by a shared emphasis on early intervention, prevention and proactive care, via the NCL Delivery Plan.

2.  The Strategy aligned to the life course approach of Start Well, Live Well and Age Well. Delivery would be monitored using the NCL Outcomes Framework.

3.  There had been some progress made, but there was a lot of work ahead, with particular focus on the five population health risks identified in the PH&IC and the background behind them, as summarised on the presentation slides.

4.  The roles and responsibilities of all partners’ contributions would be clarified. Tangible improvements in population health over the next 18 months would be demonstrated.

5.  Peppa Aubyn, Assistant Director of Place, Integration, Transformation & Delivery, NHS NCL ICB, highlighted successful integrated working in Enfield, and the taking forward of projects as a system. There was consideration of how to work together most effectively to assure delivery of joint population aims and ambitions.

6.  Dudu Sher-Arami, Director of Public Health, noted the integrated process in completing the Joint Local Health and Wellbeing Strategy (JHWS) and sought Board approval of the main Strategy. There would be work to further develop the action plans, with the development workshop confirmed for 23/10/24 at Enfield Civic Centre. The three priorities to be taken forward (one for each life course stage) had been agreed, based on local evidence of need.

IN RESPONSE

7.  The Chair thanked everyone for their contributions to completing the JHWS, noting that the ICS structure allowed better working together with alignment of policies, aims and strategies. Tracking of outcomes would allow achievements to be demonstrated to Enfield’s residents.

8.  Dr Nnenna Osuji, Chief Executive, NMUH NHS Trust, highlighted points ahead of the workshop in respect of demonstrable benefits to residents of Enfield, effects of non-health elements, and importance of prevention and proactivity.

9.  In response to Cllr Supple’s queries, it was confirmed that the action plans would be based on local health intelligence and would have an inequalities focus throughout their core, for example prioritising work with communities where conditions were known to be at a higher rate.

AGREED that Health and Wellbeing Board approved the Joint Local Health and Wellbeing Strategy to be recommended to full Council for approval.

Matthew Cagnetta,  National Management Trainee, People Department, Public Health LB Enfield.

(Papers attached.)

RECEIVED a presentation introduced by Matthew Cagnetta, National Management Trainee, People Department, Public Health LB Enfield.

1.  The review and mapping of all the Health and Wellbeing Board and the Borough Partnership sub-groups would identify opportunities to improve collaboration and joint working.

2.  The four key objectives of the project and the three expected outputs were confirmed, with the project findings proposed to be presented to the Board in March 2025.

IN RESPONSE

3.  The Chair welcomed the project as another way to focus on improved outcomes for Enfield residents.

4.  Board members were requested to advise Matthew Cagnetta of other sub-groups not yet identified on the Appendix 1 : Governance Map.

5.  It was confirmed that Matthew Cagnetta would also be liaising with chairs of sub-groups to gather further detailed information, including on memberships and terms of reference.

Trauma Informed Practice and its place within the Successor Health and Wellbeing Strategy, and activity across LB Enfield - Dr Leylla Mulisa, Senior Lead Educational Psychologist for Emotional Wellbeing and Mental Health/ E-TIPPS Programme Lead.

RECEIVED a presentation (slides appended to the minutes) from:

Suzy Francis, Principal Educational Psychologist, Strategic Lead for Children and Young People’s Emotional Wellbeing & Mental Health

Dr Leylla Mulisa, Senior Lead Educational Psychologist for Emotional Wellbeing & Mental Health

Mark Maidens, Head of SWERRL / Enfield Primary Behaviour Support Service.

1.  An explanation was given of Trauma Informed Practice in Schools (TIPS): a training and implementation programme to help schools and wider educational settings to integrate this approach into their policies and practices.

2.  In Enfield, 70 schools out of 97 were engaged with the E-TIPSS programme.

3.  The Attachment Regulation and Competency (ARC) Framework was described as the vehicle to embed this approach in practice.

4.  The SWERRL Team worked with schools to become trauma informed.

5.  Further information could be found at

https://www.enfield.gov.uk/educationalpsychologyservice/enfield-trauma-informed-practice-in-schools-and-settings

or by emailing e-tipss@enfield.gov.uk

IN RESPONSE

6.  The Chair thanked the officers for their attendance and the information, and requested the slides be circulated to the Board members.

Rachel Stephen NCL iThrive Manager, Tavistock and Portman NHS Foundation Trust.

(Paper attached.)

RECEIVED a presentation introduced by Rachel Stephen, NCL iTHRIVE Manager, Tavistock and Portman NHS Foundation Trust.

1.  The iTHRIVE process was a framework for whole system change, designed to transform mental health and wellbeing support for children and young people and their families that are shaped by their needs and the ways in which they would like to receive help and support.

2.  The NCL ICB had commissioned the national iTHRIVE programme under the Tavistock and Portman NHS Foundation Trust.

3.  The NCL ICB was using the framework to simplify the language and improve timely, accessible and local advice and assistance.

IN RESPONSE

4.  The Chair expressed thanks for the information. Any questions from Board members should be sent to Dudu Sher-Arami to forward to Rachel Stephen.

Gayan Perera, Public Health Intelligence Manager – Public Health Department, LB Enfield. (Papers to follow.)

RECEIVED the slide presentation regarding vaccine uptake and coverage, introduced by Gayan Perera, Public Health Intelligence Manager and Dudu Sher-Arami, Director of Public Health.

1.  Flu vaccination uptake was highlighted, with comparisons from 2023. There were some large variations among cohorts, and some concern in respect of rates for older care home residents. It was confirmed that work continued via the Immunisation and Screening Working Group, and that there may not be complete recording of vaccinations administered.

2.  In respect of vaccine coverage among 1-year olds and among 5-year olds in Enfield, rates were slightly below the NCL average, and were noted to be lower in particular areas and in some ethnic groups.

IN RESPONSE

3.  In response to the Chair’s queries, it was advised there had been a significant rise in measles cases, mainly amongst children of primary school age and mainly in those unvaccinated, or having had only one of the two MMR doses. Measles was being closely monitored, and work continued with our school vaccination provider.

4.  It was confirmed that the immunisation project at North Mid Hospital maternity services was continuing.

i.  Board suggested items.

ii. Development session on Wednesday 23 October 2024.

1.  Board members should please send on email any suggested items for future meetings.

2.  Board members were reminded about the Health and Wellbeing Strategy Action Plan Development Event at 4.00pm, Wednesday 23 October 2024.

Any queries in respect of the report sent out with papers for the Board’s information should be sent to Doug Wilson, Director of Adult Social Care.

To receive and agree the minutes of the meeting held on 11 June 2024.

AGREED the minutes of the meeting held on 11 June 2024.

In response to Cllr Supple’s queries in respect of voluntary sector organisations’ concerns for their future, it was reiterated that discussions would take place between the Council and the organisations involved, outside of the Board’s remit.

Proposed dates of the next meetings of Enfield Health and Wellbeing Board:

Tuesday 3 December 2024

Wednesday 5 March 2025

Formal Board meetings proposed to commence at 6:30 pm to 8:00 pm.

NOTED the next Board meeting date: Tuesday 3 December 2024, 6:30pm on Teams.