Agenda item

To receive updates on the following:

 

·       Health Improvement Partnership Board

·       Joint Commissioning Board (To Follow)

·       Primary Care

·       Better Care Fund

1.               Health Improvement Partnership Update

 

The Board received a report from the Health Improvement Partnership.

 

NOTED

 

1.1           The prevalence of diabetes is likely to increase to 30,000 by 2030.  This would place a huge burden on health and social care.

 

1.2           GPs are not able to share blood test results with the North Middlesex which means that repeat tests have to be made.  It was agreed that the board would write to Julie Lowe at the North Middlesex to ask if it would be possible for them to share their blood test results. 

Action:  Shahed Ahmad

 

1.3           CCG have been running structured patient education sessions in primary care.   

 

AGREED to note the contents of the report. 

 

2.               Joint Commissioning Update Report

 

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

 

NOTED

 

2.1           The responsibility for commissioning Health Visiting and the Family Nurse Partnership was transferred to the Council on 1 October 2015.  The council will be working with the main provider to work out how to provide the services most effectively.

 

2.2           A patient carer service is being commissioned at present.  It was planned that it would be open in January.  Further information would be provided to Deborah Fowler on the current situation. 

Action:  Bindi Nagra

 

2.3           Work was taking place to provide appropriate placements for older people needing long term mental health care. The Seacole Unit at Chase Farm was meant to be an assessment unit, not a place for long term care.  Support was being provided to the Community Intervention Team to enable them to support people in crisis rather than admitting them for treatment.  Bed usage had fallen to almost none.  It is anticipated that only one or two a year would be needed in future. 

 

2.4           Councillor Taylor welcomed the reduction in smoking prevalence. 

 

AGREED to note the report. 

 

3.               Primary Care Update

 

NOTED

 

3.1           A new Transforming Primary Care framework is being developed.  This sets out the key underpinning role for primary care and describes where it would like to be and what each organisation should do.  This includes developing the patient offer.  However currently there are no spare resources to develop the proposals.  It is hoped that once priorities have been agreed, over time it will be possible to implement them. 

 

3.2           A lengthy discussion on the framework had been held at the recent Health Improvement Partnership meeting.  The patient offer is a key part it, describing what is expected from patients and what they can expect from services. 

 

3.3           There was some concern expressed about how it would be possible to deliver the proposals and whether they would make a substantial difference.

 

3.4           It was felt that involving and engaging patients would be the key to success. 

 

3.5           The notion of self-care was one that it was felt should be treated warily.  On a continuum, it could be framed as a way to assist people in preventing their own ill health.  The patient offer should be seen as a way of enabling self-care. 

 

3.6           GPs needed to buy in to the framework.  It was not possible for every GP practice to do everything.

 

3.7           This was a good opportunity to focus on what was wanted and to start to move in the right direction. 

 

3.8           There was a need for an easier registration process for new patients at GP surgeries.

 

3.9           There was still no agreement on how local authorities would be represented on the new co-commissioning structure.  This group had so far only met once formally.  Previously it had been a steering group.  Deborah McBeal agreed to feed back on the representation issue.                                                                    Action:  Deborah McBeal

 

3.10       Mo Abedi advised that GPs were supportive of the new proposals.  He suggested that a wider discussion on this take place in a development session to which some of the GPs on the Clinical Commissioning Group board could also be invited.

 

3.11       There was concern expressed about the shortage of GPs in the borough at a time of rising population and when a large proportion of people in the borough were in poor health. 

 

3.12       Concern was expressed that two of the GP networks were not working well together.

 

3.13       Members were pleased that an on line booking system had been introduced but were disappointed that only 6% of bookings were being done on line.  It was felt that more advertising to let people know that they could book online was needed. 

 

3.14       More information was requested on what the clinical outcomes were and how and when they could be achieved.

 

AGREED to note the contents of the report and the local authority deliverables in the patient offer.

 

4.               Better Care Fund

 

The Board received an update report on the Better Care Fund from Bindi Nagra (Assistant Director Strategy and Resources – Health, Housing and Adult Social Care) and Graham MacDougal (Director of Strategy Enfield CCG) setting out the latest performance data and financial position. 

 

4.1     Bindi Nagra presented the report highlighting the following: 

 

·       Non elective admissions are forecasted to increase by over £1.8k compared to 14/15.  There has been little growth in accident and emergency.  The trends match the national picture.  Long term admissions are generally declining, but rising at North Middlesex.  The CCG were aware of the issue and it was being discussed. 

 

4.2           Board Questions and Comments

 

4.2.1     It would be helpful if the data could be presented without the need for colour. 

 

4.2.2     The Better Care Fund would be discussed again in January 2016.

 

AGREED

 

1.               To note the contents of the report, including the current performance metrics and actions being taken to improve the performance and respond to findings from recent reviews.

 

2.               To note the Q2 return was submitted to NHS England on 27 November 2015 as required.

 

3.               To note that further development sessions will be held in January 2016 with the Integration Board and wider stakeholders, to inform planning for the Better Care Fund in 15/16.