Anna Stewart, North Central London CCG, and Chloe Moralesoyarce, North Central London CCG.
(Paper to follow)
Minutes:
RECEIVED a verbal update from Anna Stewart (Start Well Programme Director) with Chloe Morales Oyarce (Head of Communications and Engagement, North London Partners in Health and Care) and Emma Whicher (Joint Senior Responsible Officer for the Start Well Programme).
NOTED
1. The Start Well programme will link into the work already done in the Mental Health and Community Services Reviews. It is a long term review of services for pregnant women and people, babies, children, young people and their families.
2. Further to the update to the previous meeting, insights had been sought, engagement planned, and the case for change built.
3. The key themes were described, around the delivery of safe care and opportunities to improve care.
4. The 10 week period of engagement had begun this week, and would include engagement with staff, stakeholders, patients, and local residents to ask about what was considered most important in respect of care and check that other findings reflected people’s experiences. A summary version of the Case for Change and a patient leaflet had been produced. The engagement link was shared: https://nclhealthandcare.org.uk/get-involved/start-well/
There would also be an online residents’ panel, gathering of children and young people’s opinions, reverse mentoring and a youth summit.
5. Feedback from Board members would be welcomed, along with promotion of the engagement, and an opportunity to return and update the Board on the next steps for the programme.
IN RESPONSE
6. In response to the Director of Public Health’s queries, it was confirmed that population health data across North London was being examined, and that variations were apparent. Offers of assistance from the Council and from the voluntary sector were appreciated, and the team would be happy to come and talk to community groups, mother and baby groups, etc.
7. Vivien Giladi, representing the voluntary sector, welcomed the programme and wished to assist. She raised that the country had lost its Measles-free status, and that Enfield had seriously sub-optimal levels of vaccination of children across the borough: she appealed that inequalities funding for uplift should be directed to reversing this situation. The Director of Public Health commented that immunisation uptake was a priority and that there was an ICB delivery group working on the whole schedule, and more information could be brought to a future Board meeting. The Council could also offer sharper communications to raise vaccination awareness.
8. The Director of Adult Social Care raised the importance of health visitor services, and recent concerns in respect of midwife-led units not attached to acute hospitals. The Chair also raised the concerns of residents around lack of access to health clinics and their wish for more face-to-face opportunities. There were also long-standing inequalities in that national data highlighted that women of colour had higher rates of complications and deaths in pregnancy and childbirth.
9. The points were noted, and that it had become apparent that a lot of the care that happened in hospital could be done in the community, and that large numbers of children were presenting at hospital emergency departments. It was confirmed that the Ockenden maternity review principles underpinned the improvements being made. The requirements from the first part of the Ockenden review were already being met, and the Trust would continue to meet the next steps and take them forward as best practice. In NCL, there was only one stand-alone midwifery led birth unit at Edgware Birth Centre, which had a low number of births. In respect of data relating to experiences of Black women in pregnancy and childbirth, there were clear inequalities at the national level. Where possible this had also been reviewed at an NCL level, however for some areas with low numbers of cases it is not possible to make a robust statement for individual boroughs and the case for change has drawn on the national evidence base.
10. The next steps were to hear from a representative range of voices and to publish the reflections towards the end of September. The ICB would be asked to decide on actions regarding the next steps, working with system partners.