Agenda item

To receive the following updates from the Board’s Sub Boards:

 

a.     Health Improvement Partnership Board

b.     Joint Commissioning Board

c.     Improving Primary Care Board

1.               Health Improvement Partnership Board

 

The Board received an update report from Dr Shahed Ahmad, Director of Public Health, on the work of the Health Improvement Partnership Board. 

 

Glenn Stewart, Assistant Director of Public Health, presented the report to the Board, highlighting the following: 

 

·       The smoking target for four week quitters for 2013/14 was exceeded.

 

·       In the latest Active People Survey, Enfield came out as the fifth most obese borough in London. 

 

·       A workshop was held on 26 June 2014 to develop an obesity pathway. 

 

·       The obesity strategy will be updated in the summer. 

 

·       Public Health is working with University College London to implement behaviour change models at a population level.

 

·       The data for the National Childhood Measurement Programme (NCMP) will be submitted in mid-august. 

 

·       A steering group has been set up to develop the Cycle Enfield proposals. 

 

·       In Upper Edmonton a diabetes social marketing campaign was implemented at the start of the year and an enhanced diabetes patients’ pathway developed with the CCG.

 

·       Latest life expectancy figures indicate that there has been an increase in life expectancy of 1.3 and 1.1 years for males and females in Upper Edmonton. 

 

·       Mental health involvement has included work with mosques, job centres, Council departments, the NHS and community organisations.

 

·       In child health a school nursing needs assessment has been completed in draft, work has begun on female genital mutilation needs assessment, smoking in young people in the Turkish community, a breast feeding friendly initiative introduced  and 12 parent engagement champions are to be trained to work with the community. 

 

·       The health check targets for 2013-14 were exceeded as well as the offer targets. 

 

·       The Annual Public Health report is nearly complete.

 

·       Information has been uploaded to the public health webpages. 

 

Questions/Comments

 

1.               Life expectancy is lower among both males and females in wards in the east of the borough, including Ponders End.  New data from Enfield Chase, Enfield Lock, Ponders End and Jubilee is just out. 

 

2.               The schemes for increasing life expectancy have not been running for long and the work being done is based on good practice which should have an impact in the long term.  Hypertension and smoking levels are key.  In future focus will be placed on certain at risk populations such as the Turkish smokers. 

 

3.               One of the benefits of the transfer of public health services to the authority is the ability to target resources more effectively in areas of greatest need.  With a better recall system those who need the most help can be more accurately identified. 

 

AGREED to note the contents of the report and the appendix. 

 

2.               Joint Commissioning Board

 

The Board received the report from Ray James (Director of Health, Housing and Adult Social Care) updating them on the work of the Joint Commissioning Board.

 

Bindi Nagra (Assistant Director Strategy and Resources – Health, Housing and Adult Social Care) and Graham McDougal (Head of Commissioning, Integrated and Acute Care at the CCG) presented the report to the board, highlighting the following:  

 

·       Work is continuing on primary care case management and risk stratification for older people.  The risk model enables the patients with the highest risk of hospitalisation to be identified.  45 out of the 52 GP practices have signed up to the tool.  Those patients judged to be at high risk will be subject to multidisciplinary conferences.

 

·       Chase Farm Hospital’s Older People Assessment Unit is operating at full capacity, although the unit at North Middlesex is less well used.  Chase Farm is nurse led more focussed on social circumstances: North Middlesex is consultant led and more medically orientated.  There are benefits to both approaches but both could benefit by adopting some of the approach of the other.  The scope of the service is being reviewed and a report due in September 2014. 

 

·       The community services contract with Barnet, Enfield and Haringey Mental Health Trust expires next year.  A new procurement process has started.  The council is working with the CCG on the tendering process.  This will be referred to the Board later in the year. 

 

·       Work is continuing with the Learning Disabilities Self-Assessment Framework and the action plan produced in response to the Winterbourne View Concordat.  Most people have now been bought back to Enfield with only one person now remaining in a placement outside the borough. 

 

·       Savings from reducing the numbers of assessment and treatment beds have been reinvested in community support. 

 

·       There are now 2558 carers on the Carers’ Register.  Recruitment to the Carers’ Nurse position has been delayed as we are looking for a GP practice host. 

 

Questions/Comments

 

1.               Cross borough discussions are continuing on the joint mental health strategy which will now be considered at Cabinet later in the year. 

 

2.               Responsibility for school nursing and health visitors will transfer to the Council next year.  Discussions are continuing.

 

3.               The draft CAMHS (Children and Adolescent Mental Health Service) strategy is being put together with consultation due to take place in July and August 2014.  The intention is to have a whole systems approach covering children and young people on a continuum. 

 

4.               A recent Care Quality Commission (CQC) inspection had highlighted the existence of a device that can be fitted that will monitor the smell of gas and turn it off automatically which would help where requests had been made to switch off the gas of a customer suffering from dementia.

 

5.               Since GPs had been paid specifically for services, referrals had gone down. 

 

6.               Some GP’s had not signed up to the Risk Stratification Programme in some cases because the surgeries were being staffed by locums.

 

7.               As the network system develops there will be less dependence on individual practices for the take up of new services. 

 

8.               If the GP practice does not have a partner then arrangements for cover should be possible.  Henrietta Hughes agreed to take this matter up at NHS England. 

 

9.               The Barnet, Enfield and Haringey Mental Health Strategy will focus on prevention rather than treatment in people known to have the most need.  Bindi Nagra will feed in comments to the consultation regarding working with the prison services and the minority ethnic communities.  Bridging the gap, making good transition arrangements for those aged between 18 and 25 was also an issue that needed addressing. 

 

10.           The community safety tap it ap was praised by Henrietta Hughes.

 

AGREED to note the contents of the report. 

 

Improving Primary Care Board

 

The Board received a report from Dr Mo Abedi, Medical Director NHS Enfield CCG updating them on the work of the Primary Care Sub Board. 

 

Graham McDougal (Head of Commissioning, Integrated and Acute Care at the CCG) presented the report to the Board highlighting the following: 

 

·       This is the third year of operation of the Prevention and Primary Care Strategy and the group are looking to consolidate the successes of the last two years. 

 

·       Development of the four GP networks is continuing.  Two networks are going through the accreditation process. 

 

·       Expressions of interest for co-commissioning services were invited by NHS England in May 2014.  Possible areas being considered include primary care, bariatic surgery, chemical and radio therapies and HIV treatment.  Co-commissioning could operate at various levels. 

 

·       The CCG has been informed that it will receive £0.5m less than hoped from transition arrangements.  Spending priorities are being adjusted. 

 

Questions/Comments 

 

1.               The impact of losing the money is still being worked out.  Savings will be made across the larger areas and will be reported to the Improving Primary Care Sub Group.  More feedback will be included in the next update report.

 

2.               Childhood obesity is reducing.  The specific intervention with 30 of the most obese children was successful but this was very expensive.  The wider public health team will be working to address the problems.

 

3.               Female Genital Mutilation was a relatively new area of work for the NHS. NHS England would be asked to report to the board on what was being done.  Referrals are made to children’s social care. 

 

AGREED to note the contents of the report.