Agenda item

 

1.               Health Improvement Partnership Board

 

The Board received a report from Shahed Ahmad (Director Public Health) updating the Board on the work of the Health Improvement Partnership Board. 

 

Glenn Stewart highlighted the following from the report: 

 

·       There was good news on the Tobacco Control/Smoking Cessation.  The smoking quitters target has been achieved, but the focus would be maintained.  Enfield has the 16^th highest smoking prevalence in London.

 

·       A new Healthy Weight Co-ordinator had started work.

 

·       A final draft of the JSNA was presented to the Board development session on 18 July 2013. 

 

·       The CCG Chief Officer gave the sub board an overview of commissioning and the issues surrounding maternity care.  A review of maternity services is to take place in the Autumn 2013.  

 

·       An update on childhood poverty had been received.

 

·       A consultant is leading work on the Child Death’s Overview Panel. 

 

·       Enfield has come out well on the Public Health England data on prevention of premature deaths.  We were 32^nd out of 150 local authorities and 1 out of 15 in similar authorities. 

 

·       MoreLife(UK) had been providing summer weight loss camps for 8-17 year olds. 

 

AGREED that the Board noted the contents of the report. 

 

2.               Questions/Comments

 

2.1           KPIs were being developed for the Board. 

 

3.               Joint Commissioning Sub Board Update

 

The Board received a report updating them on the work of the Joint Commissioning Sub Board. 

 

Bindi Nagra (Joint Chief Commissioning Officer) highlighted the following from his report: 

 

·       A community interest company had been created, independently of the Council to deliver the Healthwatch functions. 

 

·       Enfield have just been informed that they will not be receiving the Warm Homes funding from the Government which would have been used to cover winter pressures this year.  This is disappointing as last year the voluntary sector had provided an enormous amount of support with this funding.  Other options for funding will be investigated. 

 

4.               Questions and Comments

 

4.1           The section 256 agreement had now been updated and signed.  The Board had received information on the 13/14 allocations.  Bindi Nagra would confirm when this had occurred and provide an audit trail. 

 

4.2           Deborah Fowler invited all to the HealthWatch launch event. 

 

4.3           Clarification of the issue about GPs failing to engage with the bone health nurse would be provided. 

 

4.4           Liz Wise reported that she had written to the Chief Executive of the North Middlesex Hospital about the delays in implementing the paediatric integrated care work stream.  She would keep the board briefed on developments. 

 

4.5           Two learning difficulties nursing posts were in danger of being lost.  Alternatives were being pursued. An update on the situation would be provided to the next meeting. 

 

AGREED that the Board note the contents of the report. 

 

5.               Improving Primary Care Board

 

The Board received an update on the work to date to implement the primary care strategy across Enfield. 

 

Dr Mo Abedi, Chair of the Primary Care Strategy Improvement Board highlighted the following from the report: 

 

·       The money available to deliver the primary care strategy was £11m over 3 years. 

 

·       Thirty eight practices had signed up to the Access Scheme which has created 3,400 additional GP slots per month, a projected 40,000 extra over a whole year, covering 82% of the population.  An evaluation of the effectiveness of the scheme is being undertaken by the Primary Care Foundation. 

 

·       A total of 152 GP reception staff attended training on enhancing communication skills, given by Effective Professional Interactions who are also providing extra support to some of the practices evaluated. 

 

·       The Minor Ailments Scheme has resulted in an extra 3,159 face to face consultations with local pharmacists.  Patient satisfaction data revealed that 95% of patients were seen within 10 minutes and 97% would use the service again.  Evaluations would continue. 

 

·       Enfield Carers Centre had recruited a GP liaison worker and the funding has been made available for a Carers Nurse.  Work was progressing, promoting carers support and developing a clear referral pathway for carers, for GPs and practice staff. 

 

·       The joint initiative with University College London to employ four academic clinical associates is well underway: posts have been advertised, interviews planned and host practices shortlisted.  Once recruited, these extra doctors, will result in an extra 17,000 primary care appointments across Enfield, over 2 years.  They bring in service improvements through research and redesign and raise the profile of Enfield as a borough for newly qualified GPs to settle in, in the long term. 

 

·       Several schemes to improve the patient experience including in blood pressure monitoring, management of childhood obesity and a patient experience tracker have also been introduced.

 

·       A HiLo Initiative in conjunction with Queen Mary University has been set up in two practices to improve the management of Coronary Heart Disease and Blood Pressure. 

 

·       Over 80,000 cancer screening leaflets have been distributed to the over 50’s and two trainers recruited to promote screening. 

 

·       A domestic violence project to work with up to 25 general practices has been set up. 

 

·       IT improvements have been bought in, providing at least half of practices with new hardware and to enable better communication between practices and with other health organisations. 

 

·       This year £3.4m has been allocated to Enfield’s primary care strategy. The business case for a further two years of funding has been put forward. 

 

·       A series of GP networks have been set up and clinical leads identified to engage with practices in each of the different localities across Enfield.

 

2.       Questions/Comments

 

2.1     Vivien Giladi who thanked Dr Mo Abedi for his positive report, expressed some reservations on behalf of the Over 50’s Forum about the minor aliments scheme, but would wait to comment until after an evaluation had taken place in October 2013.

 

2.2     She reported concerns that she had received from visitors, at the Enfield Town Show, about the primary care provision in North East Enfield and referred to the evidence, discussed at the Enfield Health Reference Group, about 5 wards, in North East Enfield, which had been identified as those that would be most adversely affected by the proposed changes at Chase Farm Hospital. 

 

2.3     Some of these concerns may be addressed when the Joint Service Centre planned for North East Enfield became fully operational. 

 

2.4     The GP Network Leads were continuing to work with and engage those practices that had not taken part in the Access Scheme and to develop links, with all practices to enable them to better support each other. 

 

2.5     The four extra University College London doctors would be placed in areas of shortage, but needed to be in practices where they would receive good support and training. 

 

2.6     Access, patient satisfaction and attendance at Accident and Emergency Centres were due to be discussed at the next Improving Primary Care Board Meeting.

 

2.7     Councillor Don MCGowan queried whether the Clincial Commissioning Group (CCG) was happy with the rate of progress in the development of the GP networks.  In response the Board were informed that the first stage had been achieved, to obtain buy in from the practices, but work was continuing on the second stage, to develop them to enable them to work together more effectively.  

 

2.8     Dr Alpesh Patel said that in the past Enfield had not had a culture where GPs worked together and it was difficult to align the different ways of working amongst a large group of GPs who were used to working independently.  It was the CCG’s job to make a case for the clinical and financial advantages to be gained from working together, but this would take time.  Progress was being made. 

 

2.9     Ray James referred to the context of the Barnet, Enfield and Haringey Clinical Strategy in relation to the improvements required in primary care.  He felt that there were some areas of progress but that the report had focussed on the areas where there had been progress and did not give a complete picture of what progress had and had not been made in all areas of the primary care strategy, as had originally been set out, two years ago. 

 

AGREED to note the report.