Agenda and draft 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.  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’, 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 to the filming at meetings notice and attendees noted this information. The meeting was held virtually and there was a member of public in attendance in person at George Meehan House.

The Chair welcomed Board members and attendees to introduce themselves. An adjustment was made to the running order of items to accommodate for a scheduling conflict, with Item 9 being addressed as Item 12 and other items brought forward accordingly. It was noted that as the meeting was conducted virtually, it was considered inquorate, and therefore no decisions could be made at the meeting.

To receive any apologies for absence.

There were apologies for absence from Mike Hakata, Ann Graham and Richard Gourlay. There were apologies for lateness from Lynette Charles.

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 at agenda item 13).

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.

There were no declarations of interest.

To consider any requests received in accordance with Part 4, Section B, Paragraph 29 of the Council’s Constitution.

There were no questions, deputations and petitions.

To confirm and sign the minutes of the Health and Wellbeing Board meeting

held on 20 September 2023 as a correct record

RESOLVED:

To approve the minutes of the meeting held on 20th September 2023 as a correct record of the meeting.

To receive a presentation on the Workforce update - November 2023.

Cassie Williams, CEO of the GP Federation, presented the Haringey Borough Partnership Workforce update. The focus was on recruiting, nurturing talent, and integrating insights from health and care colleagues. The goal was to address any unexplored concerns from Haringey and reinforce the importance of workforce development. A workforce integration lead was hired through the training hub to address and work on this initiative.

The North Central London Integrated Care System (NCL) had pinpointed three main areas of focus which were workforce supply, development, and transformation, incorporating new care models and work approaches. On Governance, the People’s Board advanced initiatives in NCL, while in Haringey, the borough partnership had oversight over the workstreams such as the Neighbourhood and Health Inequalities Board, which handled workforce efforts. Early priorities for Haringey's Workforce Integration included entry-level recruitment, neighbourhood training, and workforce information dissemination.

The GP Federation's collaboration with Haringey Works had led to the local recruitment of numerous staff, which showcased efforts to maximise employment opportunities. Early initiatives in disseminating Workforce Information aimed to enhance the communication and address challenges within Haringey Borough Partnership.

The following points were noted in the discussion:

• Community Hubs such as the Northumberland Resource Centre, demonstrated effective collaboration. Integrated neighbourhood services worked to address frailty, and also involved multi-agency teams including the mental health trust, the Whittington, GP's, social workers, and the voluntary sector.

• Neighbourhood training involved multi-agency efforts which covered topics such as rough sleeping, CAMS care for suicide prevention, and had built awareness around gambling. The chair recommended that other examples of hub working should be shared with the Board.

• There were concerns about staff competition within the partnership and salary differences were acknowledged, and the Board was informed that development routes for all staff would be explored as part of this.

• It was noted in the meeting that further work was needed to enhance collaboration on the workforce and its integration with family hubs.

• Haringey tenant John Poulter raised concerns about delays and waiting times due to staff and resource shortages. Nadine Jeal, Clinical and Care Director for Haringey, assured ongoing recruitment efforts, including new roles, and expanded apprenticeships to address the issues, while acknowledging challenges in wait times and lists for services such as physiotherapy heavily impacted by Covid-19 pauses.

• Some community services, like heart failure and diabetes programs, were able to meet targets around time and reached deprived areas successfully. The Chair suggested an examination into national strategies, and Councillors were encouraged to promote these efforts, especially those related to schools in their wards.

• It was recommended that neighbourhood working should be a key focus in the workforce plan.

• There were challenges in connecting primary care and mental health services due to stretched recruitment. The current workforce efforts focused on entry-level recruitment to address the challenge.

ACTIONS:

• It was agreed that some example projects of workforce, how it has worked and lessons learned would be brought to a future Health and Wellbeing Board in  ...  view the full minutes text for item 21.

To receive a verbal update on North Central London Start Well Consultation.

The following points were noted in the discussion:

• Rachel Lissauer, NHS North Central London ICB, provided a brief update on the North Central London Start Well Consultation which had now been launched.

• It was advised that there should be a specific Haringey Council response going forward to the Start Well consultation.

• It was noted that the partnership, including Primary Care, had been active in providing feedback and Rachel thanked members for doing so.

• Councillors and local MPs had provided responses to the consultation.

• The Chair highlighted concerns particularly on Whittington maternity closures, on equity of outcomes for patients from black and minority ethnic backgrounds, access to services and outcomes for mothers and children within the borough.

• Jonathan Gardener, Whittington Health NHS Trust, emphasised the importance of maintaining Whittington services was the preferred option however urged the importance of respond to the consultation.

RESOLVED:

The update was received and noted.

To receive a verbal update on the Haringey Health and Wellbeing strategy development

Will Maimaris, Director of Public Health, provided a brief verbal update on the new Haringey Health and Wellbeing strategy development.

The following points were noted in the discussion:

• It was noted that this was a key strategy for Haringey Health and Wellbeing that would be owned by the Health and Wellbeing Board for the next 4 to 5 years, previously the board was updated on the process of development of the strategy which incorporated working with the community and co-design.

• In Autumn 2023, several community engagement efforts were held including a large event, smaller focused events, library sessions, and online consultations. Principles guiding the work include co-production, equity, challenging discrimination, partnership working, and ensuring quality and accessibility of services. Key themes that emerged from the engagement activities included mental health, housing and health equity, placemaking, and preventative health. These themes were intended to inform the draft strategy document for future consideration by the Health and Wellbeing Board.

• The Chair concurred that the evolving themes demand collaboration across various council departments, partnerships, and the community. The next stage would focus on defining deliverables, establishing governance and structure, and wider efforts to enhance the ownership of the strategy.

• Councillor Brabazon agreed that housing should be prioritised for its crucial role in health and wellbeing of residents with an emphasis on allocating housing based on need, not just time on the housing list.

• It was noted that there were ongoing efforts by the People's Board calling for the review on housing allocations as there was a need to focus on addressing wealth disparities in the borough with an equity lens.

• Beverly Tarka, Director of Adults Health and Communities in Haringey Council provided feedback to the board from the previous ICP meeting, which covered topics such as outcome measurement and defining equity.

• John Poulter, member of the public, expressed concerns about delays in repairs, which led to him and his family onboarding at a hotel due to lack of heating. John highlighted the impact on NHS due to such issues and emphasised the disappointment in the repairs service. John expressed his readiness to collaborate with the Health and Wellbeing Board and sought clarity on outcomes and decisions from public consultation activities. The Chair offered to follow up with John on this issue outside of the meeting.

RESOLVED:

The update was received and noted.

To receive an update on the Better Care Fund Plan.

The Better Care Fund (BCF) Plan is a national programme to fund integration of health and cares services at a local level. In Haringey, it is underpinned through a £38m annual Section 75 agreement to pool funds between North Central London (NCL) ICB and London Borough of Haringey (LBH). The Department of Health & Social Care (DHSC) who run the BCF Programme requested each local area to submit a full Plan in June 2023 for the period 2023/24 and 2024/25.

Paul Allen and John Tomlinson from NHS Haringey CCG presented the Better Care Fund Plan 2023/24.

The following Points were noted in the discussion:

• It was noted that this report was delayed for the Council meeting last year.

• The report included a narrative, an investment schedule, and metrics for delivery.

• The report also encompassed Demand and Capacity analysis for Haringey’s intermediate care services.

• It was noted that the Health and Wellbeing Board's needed to approve the submitted Better Care Fund (BCF) Plan.

• BCF is a national program supporting health and social care integration for resident independence and improved outcomes.

• Haringey's BCF 23/24 aligns with the Borough Plan and supports the Ageing Well Strategy.

• The Plan was aimed to assure the Board of Haringey's commitment to health and social care integration.

• The national BCF requirements are for each Board to submit its Plan to the national BCF Team. The national BCF Policy Framework includes a joinlty agreed local plan signed off by the Health and Wellbeing Board, NHS Contribution to social care maintained in line with uplift to NHS (at 5.7%) and investment into NHS commissioned out-of-hospital services.

• Boards were required to submit Narrative and Excel spreadsheet outline of its plan. Implementing the BCF policy objectives such as enabling people to stay well, safe and independent and home for longer and provide the right care in the right place at the right time.

• Haringey’s investment schedule showed that the BCF plan was £38m investment in 2023/24 (£42M in 24/25) – nationally set level of minimum investment of which at least £7.7m needs to be on Adult Social Care related spend and £6.7m needs to be NHS commissioned out of hospital spend.

• There was also additional Funding for social care directly via Improved Better Care Fund (iBCF) and Disabled Facilities Grand (DFG’s). £2.4m Discharge Fund included in 2023/24 with £4.3m available in 2024/25.

• On the structure of the narrative, it was noted that there was a tiered approach to investment or the ‘Care Cone’, which is followed through of the BCF Plan, this starts with Healthy Safe and Well, Early Help, Severe/Complex and Specialist/Emergency at the top.

• The Plan addressed three key challenges, both locally and nationally:

• Firstly, the plan responded to the pandemic's legacy, managing increased cases of deteriorating underlying health. Secondly, to prepare out-of-hospital systems for heightened NHS Trust activity to ensure safe winter hospital discharge. Lastly, to tackle issues related to equity of access, outcomes, and experiences, especially in deprived areas within the Borough.

• The progress since 2022 was highlighted and this included:

• The successful distribution of 2,000 ‘Ageing Well Guide’ copies and provided training for 'age-friendly Haringey'.

• It was noted that there was an approximate 30% increase in GP consultations for older people, especially in deprived areas.

• MACCT received positive evaluation, reducing emergency admissions by 40%.

• There was a continued investment in out-of-hospital services, with 93% of  ...  view the full minutes text for item 24.

To receive a presentation on Haringey Borough Partnership update and an

update on the Integrated Care Partnership.

Rachel Lissauer, NHS North Central London ICB, provided an update on various programs within the Haringey Borough Partnership and Integrated Care Partnership which included Start Well, Live Well, and Age Well and highlighted the positive progress in areas like speech and language support for primary schools and initiatives for long-term conditions and dementia.

The following points were noted in the discussion:

• Emphasis was placed on the multidisciplinary collaboration in neighbourhoods, with discussions involving GP and clinical leads.

• The Board received updates from Borough Partner Executive Meeting were discussed which focused  on mental health challenges, workforce recruitment, and system priorities.

• The Chair highlighted the significance of medication accessibility for residents and suggested further discussion on the matter.

• John Poulter, member of the public, praised Rachel's efforts and shared his involvement with suicide management.

• Nnenna Osuji addressed concerns about the North Middlesex maternity unit's performance, clarifying that CQC ratings do not directly impact the review process.

RESOLVED:

The presentation was received and noted.

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

There were no items of urgent business.

Members of the Board are invited to suggest future agenda items.

To note the dates of future meetings:

20 March 2024

• Will Maimaris, Director of Public Health, provided a brief update to the board on the recent Integrated Care Partnership (ICP) meeting held on the 16^th of January 2024.
• In the North Central London (NCL) integrated care system, efforts were focused on improving population health and wellbeing.
• The themes discussed in the recent ICP meeting included establishing working relationships with the council and NCL, adding value, and addressing health inequalities.
• The themes which emerged from the meeting encompassed physical and mental health, heart health, and admissions.