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 a report updating them on the work of the Health Improvement Partnership Board:

 

1.1     Presentation of the Report

 

Allison Duggal, Consultant in Public Health, presented the report to the Board, highlighting the following: 

 

·       Two versions of the Annual Public Health Report had just been published: an abridged summary as well as a more detailed report.  The reports detail the work being carried out to tackle health inequalities across the borough.

 

·       Enfield’s report has synergies with the Better Health for London Report.

 

·       Public Health has recently produced some GP and locality based profiles to help inform commissioning decisions.  Ward profiles are also being put together.

 

·       On the 17 November 2014 a Child Poverty Conference will be held, showcasing the work being done to tackle child poverty.  From this an action plan will be put together to mitigate the effects of poverty as well as to minimise the intergenerational effects.

 

·       A poster campaign is being run to raise awareness of the need for adults to cut down on salt intake to reduce hypertension and heart disease.  

 

·       Public Health have had a successful engagement with four local mosques to raise awareness of health issues such as diabetes. 

 

·       They have worked closely with CCG colleagues providing advice and intelligence to feed into health care strategies.  

 

·       Pathway redesign has been prioritised for long term conditions including musculoskeletal, diabetes, cardiology and respiratory. 

 

·       12 independent funding requests had been received since April 2014.

 

·       The Pharmaceutical Needs Assessment Steering Group is making process on producing the pharmaceutical needs assessment.  A report will be bought to the Board later in the year.

 

·       A report on tobacco use in the Turkish Community has highlighted the fact that 50% of 11-25 year olds use tobacco and 37% of respondents use shisha.  Many are unaware of the risks.  Public Health will be running focus groups to enable targeted interventions. 

·       Quarter 1 figures for health checks will be available at the end of the month and will be included in the next report.

 

·       A universal BCG vaccination programme is being introduced across London.  Flu planning and immunisations are in place and the Ebola outbreak is being kept under review.

 

1.2           Questions/Comments

 

1.2.1         Members praised the quality and user friendliness of the Annual Public Health Report. 

 

1.2.2         The GP profiles were welcomed and it was hoped that they would provide a qualitative step forward in planning for the future needs. 

 

1.2.3         Concern was expressed about the situation where NHS England has the control over GP budgets.  It was felt that it would be more appropriate for the local CCG to control this area. 

 

1.2.4         The CCG was pleased to work in partnership with public health.  At one time a Turkish speaking officer had been employed to work with the Turkish community to help people give up smoking.  This has had excellent results.

 

1.2.5         It was suggested that it would be helpful to have the papers in advance for the Child Poverty Conference.

 

1.2.6         The suggestion was made that there should be more collaborative work included in the full report.  More emphasis needed to be placed on what can make the difference in tackling health inequalities and also the wider socio economic determinants of health.  Getting people into work was most important, but this was something that would take time and could not happen in the short term.  Focussing on how commissioners and health workers can make a difference in these areas would be helpful. 

 

1.2.7         More information was also required on how the work being done linked into the Health and Wellbeing Strategy and whether this was working. 

 

AGREED to note the contents of the report. 

 

2.               Joint Commissioning Sub Board Update

 

The Board received an update report on the work of the Joint Commissioning Board.

 

2.1     Presentation of the Report

 

Bindi Nagra (Assistant Director - Health, Housing and Adult Social Care - Strategy and Resources) presented the report to the Board, highlighting the following: 

 

·       The submission on the Better Care Fund took place on 19 September 2014. 

 

·       A response to the Care Act 2014 was submitted and we are now waiting for the regulations to be published.  We have already fed in to the commissioning approaches including market engagement and market management.

 

2.2           Questions/Comments

 

2.2.1     The Older People’s Assessment Units at Chase Farm and North Middlesex Hospital were both set up at the same time on the same basis but have developed differently.  Both have strengths:  at Chase Farm more social support has been given and at North Middlesex there has been more emphasis on geriatrician issues.  Following discussion at the Integrated Care Board, it is being proposed that both units are kept but that they should be managed jointly as one service.  There are plans to re-provide the centre as part of the redevelopment of Chase Farm.  Liz Wise advised that they would be re-commissioned.   

 

2.2.2     It was felt to be important to keep both units running as both different approaches were needed.  More work was required to work out how the services could be integrated, based on the needs of the older people who access them. 

 

2.2.3     Concern was expressed about the shortage of funding for the Enfield Warm Households Programme.  Discussions on this were continuing and it was possible that a one off grant could be found to keep the project going for another year, but there was no dedicated funding stream.   The Over 50’s Forum had recently held a very successful keeping warm event.

 

2.2.4     Members were encouraged to support the Best Breakfast Campaign for Carers, taking place on the following day, which aimed to stress the value of eating breakfast. 

 

AGREED

 

1.               To note the contents of the report and its appendix.

 

2.               To note that the Chair of the Health and Wellbeing Board, the Leader of the Council and the Chair of the Clinical Commissioning Group signed off the Better Care Fund paper on 19 September 2014. 

 

3.               Primary Care Improvement Sub Group Update

 

The Board received the report updating them on the work to date to implement the Primary Care Strategy.

 

3.1           Presentation of the Report

 

Dr Mo Abedi, Chair of the Enfield CCG, presented the report to the Board highlighting the following:

 

·       The underlying aims of the Primary Care Strategy are integration, enhancing and improving health outcomes, access, patient experience and quality.

 

·       Work is continuing on developing the GP networks.  Two pan Enfield provider organisations have been established. 

 

·       As part of the locality commissioning agenda the 4 GP networks are meeting together targeting special measures:  in accident and emergency, prescribing, administration of over 65’s and referrals.  The plan is to make good use of data and to target innovative measures. 

 

·       The 5 North Central London Boroughs have made a joint expression of interest to carry out joint commissioning arrangements from November 2014.  This has been judged as being “ready soon”.  NCL will have a shared risk pool of £2m.  The five boroughs will continue working with NHS England to progress the co-commissioning of services.   It was hoped to achieve full delegated responsibility for primary care from April 2016. 

 

·       Work is continuing on developing primary care premises.  The new Ordnance Road practice will be discussed further in the development session. 

 

3.2           Questions/Comments

 

3.2.1     Ray James welcomed the co-commissioning initiative which he saw as crucial to the wellbeing of the community.   It was suggested that the Board write to NHS England in support of the proposals.

 

3.2.2     Shahed Ahmad reported on the Ebola Outbreak.  He said that so far the majority of cases were in West Africa and it was most important to support health care in that region.  Brittain, France and the USA had sent support and there had been a good response to the call for volunteers.  

 

3.2.3     At the national level emergency preparations were in place.  Public Health in local government has an assurance role and to make sure that staff are adequately prepared.

 

3.2.4     There was some concern that the dissemination of information to GPs was patchy in some areas.  This would be passed on to NHS England.  A local planning exercise would be taking place next week and any gaps discovered would be followed up.  The equipment needed, apart from face visors, was that which would be normally held by a GP practice. 

 

AGREED

 

1.     To note the contents of the report.

 

2.     To write a letter on behalf of the board, to NHS England in support of the co-commissioning proposals.