Agenda and minutes

Please note this meeting may be filmed or recorded by the Council for live or subsequent broadcast via the Council’s internet site or by anyone attending the meeting using any communication method.  Although we ask members of the public recording, filming or reporting on the meeting not to include the public seating areas, members of the public attending the meeting should be aware that we cannot guarantee that they will not be filmed or recorded by others attending the meeting.  Members of the public participating in the meeting (e.g. making deputations, asking questions, making oral protests) should be aware that they are likely to be filmed, recorded or reported on.  By entering the meeting room and using the public seating area, you are consenting to being filmed and to the possible use of those images and sound recordings.

The Chair of the meeting has the discretion to terminate or suspend filming or recording, if in his or her opinion continuation of the filming, recording or reporting would disrupt or prejudice the proceedings, infringe the rights of any individual, or may lead to the breach of a legal obligation by the Council.

The Chair referred those present to Agenda Item 1 as shown on the agenda in respect of filming at this meeting and asked that those present reviewed and noted the information contained therein.

The Chair welcomed those present to the meeting and the Board introduced themselves.

To receive any apologies for absence.

The following apologies were noted:

·         Cathy Herman, Lay Member, Haringey CCG

·         Sir Paul Ennals, Chair of Haringey’s LSCB

·         Julie Billett, Joint Director of Public Health - Camden and Islington(substitute: Jason Stellar)  

·         Sean McLaughlin, Corporate Director of Housing and Adult Social Services (substitute: Brenda Scanlan)

·         Dr Helen Brown

The Chair will consider the admission of any late items of urgent business. (Late items will be considered under the agenda item where they appear. New items will be dealt with under agenda Items 12 or 14).

There were no items of urgent business.

A Member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:

(i) must disclose the interest at the start of the meeting or when the interest becomes apparent, and

(ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.

A Member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Register of Members’ Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.

Disclosable pecuniary interests, personal interests and prejudicial interests are defined at Paragraphs 5-7 and Appendix A of the Members’ Code of Conduct.

No Declarations of Interest.

To consider any requests received.

No Questions, Deputations or Petitions were tabled.

The Board received a report which updated the Health and Wellbeing Board on the development of the North Central London Sustainability and Transformation Plan (STP). The report was introduced by Zina Etheridge, Deputy Chief Executive Haringey and was included in the agenda pack at pages 5-17.

The Chair advised that the draft Sustainability and Transformation Plan and the joint statement were published in October on all 5 NCL council websites following submission to NHS England. The Chair raised concerns with the overall lack of public engagement that had been undertaken around the STP and welcomed the opportunity to hold a discussion in public with both Health and Wellbeing Boards. The Board were advised that they were not being asked to endorse the STP, instead this was an opportunity to raise any concerns or seek clarification, and that a note of the discussion would be sent to those leading and managing the STP process for NCL.

The Board were advised that the STP estimated a financial gap in NCL NHS Services of £876m by 2020/21. For social care, the combined social care budget gap across NCL’s boroughs would be in excess of £300m by 2020/21. A number of opportunities for public engagement had been carried out since publication of the NCL STP, including via each respective council and CCG website, a public event convened by Keep Our NHS Public on 15^th December, meetings with the voluntary sector and respective CCG meetings held in public. In addition the NCL Joint Health Overview & Scrutiny Committee undertook a review of the draft NCL STP, they received written and verbal evidence from a range of stakeholders and published a report which set out a number of recommendations to challenge and inform development and delivery of the plan going forward.

The aim of the STP was to set out how to transform the whole system in order to improve both system sustainability and to make financial savings, whilst also improving outcomes. The Deputy Chief Executive advised that a key concern with the STP was a failure to consider the implications for wider care services within the overall health care system.

The Chief Executive, Bridge Renewal Trust reiterated concerns raised around a lack of public consultation and a lack of clarity about what exactly the STP would look like.

The Haringey Cabinet Member for Finance and Health welcomed the fact that the STP gave equal consideration to mental health and wellbeing and physical health but commented that further consideration needed to be given on how to support the voluntary sector in providing more community level care, given the significant financial constraints on the voluntary sector. The Cabinet Member for Finance and Health further commented that the STP needed to set out how to capacity build within the voluntary sector to support the development of community level mental health and wellbeing services. The Cabinet Member for Finance and Health sought clarification on what the next steps were in terms of the formal sign off process and the  ...  view the full minutes text for item 7.

A presentation will also be given by Dr Helen Taylor on progress with respect to the Wellbeing Partnership’s work-stream on frailty.

The Board received a presentation from Dr Helen Taylor on the frailty workstream of the Wellbeing Partnership. Following the presentation the Board discussed its findings.

The Board considered that in addition to age, there were a number of factors that determined health needs such as; social housing, possessing long term conditions, reduced mobility and mental health issues. In determining how to care for these people it was evident that there was a cohort of patients who received a high level of care and were know to the system. Dr Taylor advised that in developing the frailty workstream it was hoped that the partnership could intervene in cases where people may be developing long term conditions or have reduced mobility but only became known to the system once they had suffered a crisis and were admitted to an A&E department. The Board was advised that the proposal was to mirror schemes undertaken by south west academic health science networks and in places like Humberside in which frailty was considered as a long term condition. Frailty was described as a loss of reserve, due to factors such as a loss of mobility and the presence of other long term conditions etcetera, which would result in a period of hospitalisation following a crisis.

Using this definition, a cohort of service users had been identified through workshops and pathways were sought to reduce their level of potential vulnerability and to intervene before they reached a crisis point. In determining what was already in place, the Board was advised that there were already a significant amount of interventions available but the challenge was to connect these together and think strategically at a population level. Dr Taylor also advised that the task was to deliver the correct outcomes, that the patient wanted, and to do so before they suffered a health crisis. An e-frailty index had been developed to that effect which provided a way of indentifying frailty across a range of factors and categorising them in terms of mild, moderate and severe frailty which would then be linked to GP records. The Board was advised that the proposal was due to be taken to the sponsor board and Dr Taylor invited the Board to provide comments and consider what the next steps were. In response to a request for clarification, Dr Taylor advised that a key consideration was how to take the work been done by the Wellbeing Partnership and get it to the point where this could work at a population level. The Chair commented that there were some interesting pilot schemes involved, and the question was at what point was there enough of an evidence base to incorporate into them into mainstream service provision.

The Board also received a report from Tim Deeprose, Programme Director for the Wellbeing Partnership which sought views on the extent of the collaboration involved in the establishment of the Wellbeing Partnership Agreement, which was to be presented to Council Cabinets, Trust Boards and CCG Governing Bodies  ...  view the full minutes text for item 8.

The Board received a report and presentation which set out a joint approach to tackling obesity across Islington and Haringey. The report and presentation were included at pages 37 and 53 respectively and were introduced by Dr Jeanelle De Gruchy, Director of Public Health LB Haringey.

The Director of Public Health advised that both Haringey and Islington Public Health teams had come together to workshop what was being done locally to tackle obesity. Haringey and Islington faced similar challenges with over 1 in 3 children aged 10-11 classed as overweight or obese. Tackling obesity through the partnership emerged as a priority area following the scoping of the CVD/diabetes, children’s and prevention work streams. The Board was advised that the potential impact between a healthy and non-healthy life style was hugely significant in terms of overall health outcomes and their knock on effect. The Director of Public Health, LB Haringey outlined the areas for collaboration set out in the report and the types of approach being taken. It was emphasised that the aim was to create healthy environments to facilitate a wider culture shift within the population. The Director of Public Health, LB Haringey highlighted the removal of ‘no ball-game signs’ and the play weekend in April as activities designed to encourage children to be physically active.

The Director of Public Health, LB Haringey also drew the Boards’ attention to the Sugar Smart campaign in conjunction with the Jamie Oliver Foundation and Sustain. The aim was to increase awareness of and reduce sugar consumption across all age groups and communities, and in doing so becoming the first Sugar Smart joint borough. As part of the campaign it was proposed to undertake an audit of all Council and commissioned properties to assess what their food offer was and to then develop a food standards policy and toolkit to help providers look at alternatives. The Healthy Workplace Charter was also highlighted to the Board, which was a structured framework to recognise and support business investment in employee health and wellbeing.  Initiatives included: Promotion of 5 a day and the ‘one you’ website, reduced price gym membership, running clubs, walks at lunchtime, cycle to work schemes and the provision of showers and lockers for people to promote cycling and running to work.

Cllr Watts advised that he welcomed proposals to remove ‘no ball-game’ signs and that he and Cllr Kober were keen to include the Play Streets scheme into the proposals. Cllr Watts also proposed that a high profile campaign should be launched to generate public interest and garner momentum, and suggested that the Board might want to focus on campaigning against a particular product. The Chair requested that the Director of Public Health, LB Haringey and the Assistant Director Public Health LB Islington develop proposals around launching a profile campaign.

Action: Jeanelle De Gruchy & Jason Strelitz 

RESOLVED

That Haringey and Islington work together to:

I.        Create healthier food environments and reduce sugar consumption

·         To sign up to London’s Sugar Smart Campaign and to  ...  view the full minutes text for item 9.

The Board received a report which set out the terms of reference for more formal joint arrangements between the Haringey and Islington Wellbeing Boards, to strengthen governance arrangements and provide a platform for further joint working.

The report was included at pages 59 and was introduced by Stephen Lawrence-Orumwense, Assistant Head of Legal Services, and LB Haringey.

The Board agreed two minor amendments to the proposals as set out in the report: The committee would be a joint sub-Committee of each borough’s respective Health and Wellbeing Board and that voluntary sector representation would be added to the membership of the Board. The Board agreed that discussions would be held with the Bridge Renewal Trust to ascertain how to work with Islington voluntary sector organisations to ensure that there was representation across both Haringey and Islington voluntary sectors. 

Action: Geoffrey Ocen & Emma Whitby

The Committee Clerk will provide an update on dates for future meetings of the new Haringey and Islington Joint Health and Wellbeing Board for the new municipal year 2017/18. 

The dates of future meetings were to be agreed.

To consider any new items of urgent business admitted at Item 4 above.

None

To consider whether, in view of the nature of the remaining items on the agenda, any of them are likely to involve the disclosure of exempt or confidential information within the terms of  Schedule 12A of the Local Government Act 1972 and, if so, whether to exclude the press and public during discussion thereof.

N/A

Any exempt items which the Chair agrees should be considered urgently by reason of special circumstances. The reasons for urgency will be agreed by the Chair and recorded in the minutes.

N/A