Agenda item

To receive the following updates from the sub boards:

 

a.     Health Improvement Partnership Board

b.     Joint Commissioning Board

c.     Improving Primary Care Board

1.               Health Improvement Partnership Update

 

The Board received a report from Dr Shahed Ahmad, Director of Public Health, updating them on the work of the Health Improvement Partnership Board. 

 

1.1     Dr Tha Han introduced the report and invited questions. 

 

1.2     Questions/Comments

 

1.2.1     Work supporting other boroughs is carried out as part of a group of health sub groups looking at various issues across London. 

 

1.2.2     A DVD had been developed as part of a joint venture with Haringey about early access to maternity, talking to communities, that book in late, about their fears and what would change as a result of earlier booking. 

 

1.2.3     A scheme to work on extending the benefits of the HiLo project is being considered by the CCG. 

 

1.2.4     Recently there had been a successful conference on Female Genital Mutilation (FGM) with a good turnout of over 100 men and women.  An imam from a local mosque had attended and given a clear message that the practice was not a religious requirement. 

 

1.2.5     A report about the adequacy and quality of FGM services should be ready in February 2015. 

 

1.2.6     Individual Funding Requests involve very rare conditions that fall outside provider contracts. There is no policy or guidance governing them and they can be hard to justify. 

 

1.2.7     A fuller report on the initiatives coming out of the Child Death Overview Panel will be provided for the next meeting. 

 

1.2.8     Further information on the effectiveness of the media campaigns would be helpful, including how long the campaigns were running for, how many people have come forward and other outcomes. 

 

1.2.9     The smoking cessation targets were being met.

 

1.2.10  Enfield is currently working at just above the targets for carrying out health checks.

 

1.2.11  Everyone involved, including local GPs, were thanked for their work with the partnership. 

 

AGREED to note the report. 

 

2.               Joint Commissioning Sub Board Update Report

 

The Board received a report from Bindi Nagra, Assistant Director Strategy and Resources, Health, Housing and Adult Social Care, updating them on the work of the Joint Commissioning Sub Board.

 

2.1     Presentation of Report

 

Bindi Nagra presented the report to the Board highlighting the following: 

 

·       The Better Care Fund had been approved with support, which was a good outcome considering the challenging health and social care financial situation.  Thirty amendments were required, including the approval of the governance arrangements and issues around consultation responses.  This would not affect the programme or the finances. 

 

·       Once the changes had been agreed, the plan will need to re-signed by the Chair of the Health and Wellbeing Board, Chair of the Enfield CCG and the Leader of the Council before being sent back to NHS England. 

 

·       The procurement for the Sexual Health and School Nursing Services has currently been postponed, but it may be necessary to go out to tender early next year. 

 

·       Clinical Commissioning Groups are being given the option to choose a different co-commissioning model.  There are three possible models: greater involvement in commissioning decisions, joint commissioning arrangements and delegated commissioning arrangements. 

 

·       Once agreed, the approvals process will be straightforward with the aim of implementing the co-commissioning arrangements by April 2015.  This may cause governance issues, particularly around conflicts of interests which will need to be addressed.  Co- commissioning will take place at the Strategic Planning Group level, not the individual borough level. 

 

·       In line with the Winterbourne View concordat, most of the people with learning difficulties have now been repatriated to the borough. Only one or two people are now being catered for outside of the borough. 

 

·       The Community Intervention Service has been very successful in providing alternative options to avoid using bed nights in assessment and treatment units.  The Learning Disabilities Team were thanked for their excellent work which had been developed over several years:  they have been hailed as a model of good practice on a national level.

 

·       The Multi-Agency Safeguarding Hub is being set up for vulnerable adults, bringing together all the agencies involved.  It will be in operation from April 2014.  Reports on progress will be made to the board. 

 

·       A half yearly update on the Section 75 arrangements was also provided.  The partnership arrangements were generally working well.  Although there were problems with a new system which had caused delays in invoices being raised to Enfield CCG.  The wheelchair service would now be transferring in April 2015. 

 

2.2     Questions/Comments

 

2.2.1     Concern that a strong local group will be needed to preserve local interests when dealing with co-commissioning was expressed.  Co-commissioning will be discussed in more detail at the development session in January 2014. 

 

2.2.2     The figures from the Family Nurse Partnership were encouraging.  It had always been expected that the local authority would take on the funding:  possibilities for funding and expansion would be fed into the wider integration discussions. 

 

2.2.3     On the Warm Household Programme, a range of voluntary organisations have made submissions for providing the service, which are being considered by the Cabinet Member. The government grant which used to support this service had been cut. 

 

2.2.4     Formal announcements on the government funding settlement for local government 2015/16 were due in mid December 2014. 

 

2.2.5     The Care Homes Assessment Team has worked very well, reducing emergency admissions for older people by intervening at an earlier stage.  There had been an 8% reduction in emergency admissions between 2012/13 and 2013/14. 

 

AGREED to note the report.  

 

3.               Primary Care Update Report

 

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

 

Dr Mo Abedi presented the report to the board and invited questions. 

 

There were none.  

 

AGREED to note the report.