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 will welcome those present to the meetings and introductions will then be made.

The Chair welcomed those present to the meeting. 

To receive any apologies for absence.

The following apologies were noted:

• Sir Paul Ennals  - Chair of Haringey LSCB
• Beverley Tarka - Interim Director Adult Social Care
• Jon Abbey - Interim Director of Children’s Services (Gill Gibson attended as substitute).

Dr Sherry Tang and Cllr Waters noted that they needed to leave the meeting early.

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 ).

None.

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.

Cathy Herman, Lay member; Haringey CCG, advised the Board that she was chairing the Primary Care Co-commissioning Committee across North Central London. Haringey was identified as part of that group.

Dr. Dina Dhorajiwala, Vice Chair Haringey CCG, notified the Board that she was a GP provider at the Vale practice in Crouch End.

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

No Questions, Deputations or Petitions were tabled.

To consider and agree the minutes of the meeting of the Board held on 24^th March 2015.

RESOLVED:

That the minutes of the meeting held on 24th March 2015 be confirmed as a correct record.

The Board received a presentation, from Jonathan Weaver, NHS England, and Cassie Williams, Assistant Director of Primary Care Quality & Development which gave an overview of key developments relating to the development of additional Primary Care capacity, particularly in Tottenham. Following the presentation the Board discussed the findings.

A copy of the draft Strategic Premises Development Plan was included in the agenda pack; the Board noted some of the key issues raised by that report. The current progress to date was summarised as:

• The baseline for Haringey primary care locations and their conditions were identified.
• Growth areas were identified.
• Capacity plan had been undertaken in key areas of focus across predominately the east of Haringey.
• The Board was requested to give comments on the draft report prior to its submission to July FIPA (NHSE financial planning committee) for NHS England endorsement.

The main conclusions of the report were noted as:

• Haringey was identified as having a poor primary care estate – 79% of the premises were identified as being red or amber rated for non-statutory compliance.
• Haringey population predicted to increase by 37k by 2026
• All of Haringey wards fall in top half of deprived wards nationally, and 8 were in the top 500.
• GP practice capacity pressures identified in east of borough. (particularly around Tottenham Hale)
• Many residents c.28,500 (10.5%) in Haringey were registered with a practice outside of the borough.
• No evidence of a significant number of unregistered residents
• The need to plan for retiring GPs was identified as a key consideration, particularly in terms of the potential for existing capacity issues to be exacerbated. 

The key recommendations of the draft Strategic Premises Development Plan were outlined as:

• Pursuing with Primary Care Infrastructure Fund (PCIF) applications.
• Appetite to absorb current capacity issues to be determined through dialogue with GPs.
• New Primary Healthcare facilities needed to be established. The Board noted that this would be a medium to long term solution to capacity issues. Mr. Weaver commented that new primary healthcare facilities would need to be built with a view to co-location with other services and linked into planning cycles with housing developments.

Mr. Weaver advised the Board that the draft Strategic Premises Development Plan identified that, with expected population growth levels over the next 10-15 years including the current deficit, an additional primary care capacity for 70k people could be required as a worst case scenario. This translated into 39 additional doctors (Whole Time Equivalents) and 7,842 square metres of additional consulting capacity.

The following short term responses from NHS England to the recommendations from the Draft Strategic Premises Development Plan,  were noted:

• A temporary new surgery in Tottenham Hale established by autumn.
• Existing surgery premises improved, based on PCIF Bids incl. increasing consulting room capacity.
• Practices encouraged to bid for next round of PCIF & for 2015/16 Improvement Grants for existing surgery premises based on PCIF Bids.

In addition, by 31^st March 2016:

• GP succession plans developed.
• Focus on existing GP contract performance.
• Schemes explored to facilitate more  ...  view the full minutes text for item 8.

A report was circulated as part of the agenda pack. Dr Jeanelle de Gruchy, Director of Public Health, gave a presentation to the Board on the draft Health and Wellbeing Strategy, which incorporated revisions made following the public consultation that concluded in March. Following the presentation, the Board discussed the presentation and agreed a number of performance measures for the strategy.

The Board noted that the purpose of the strategy was to enable:

• All partners to be clear about our agreed priorities for the next three years.
• Priorities to be embedded by all members of HWB within their own organisations and ensure that these were reflected in their commissioning and delivery plans.
• Joined-up commissioning and delivery plans to be developed by key agencies to address these priorities.
• Member organisations held to account by the HWB for their actions towards achieving the priorities within the strategy.
• Members of the HWB to work with and influence partner organisations outside the HWB to contribute to the priorities and the approaches for working agreed within this strategy; this included residents engaged in co-producing solutions.

The Board noted that strategy focused on three key priority areas:

• Reducing obesity.
• Increasing healthy life expectancy.
• Improving mental health and wellbeing.

Dr. de Gruchy proposed that the Strategy had nine ambitions to be delivered within the three key areas. The nine ambitions were:

• Fewer children and young people will be overweight or obese
• More adults will be physically active
• Every resident enjoys long lasting good health
• Haringey is a healthy place to live
• People can access the right care at the right time
• More people will do more to look after themselves
• More adults will have good mental health and wellbeing
• More children and young people will have good mental health and wellbeing
• People with severe mental health needs live well in the community

The Board was asked to agree the performance measures and the level of the ambitions for the Health and Wellbeing Strategy.

The Board agreed to work towards a 35% target for childhood obesity at Year 6 by 2018, in line with the England average. A 35% target equated to a 2% year on year decrease. Gill Hawken, HAVCO Interim Joint CEO / Management Consultant commented that targeting parents, possibly through a programme of evidence based parenting activities, was required. Dr. de Gruchy responded that a number of intervention programmes were in place, starting with breastfeeding, but the challenge was how to affect change at scale.

Ms. Etheridge commented that the Board may wish to set an ambition that reflected the aim of reducing childhood obesity without specifically saying by how much to prevent setting a level of specifity and targeting that may not be achieved.  Ms. Herman advocated a less specific measure such as, agreeing to match the England average, as this was more likely to be relevant to local residents. Sarah Price, Chief Operating Officer of Haringey CCG, commented that obesity figures would be very different across different parts of the borough and suggested  ...  view the full minutes text for item 9.

Verbal update.

The Board received a verbal update from Ms. Etheridge on Health and Care Integration programme. The Board noted that the programme was divided into three overall themes; adults, children and mental health & wellbeing. Under the adults theme there were 19 projects running which were divided into four sub-themes. Ms. Etheridge commented that a very successful launch event for the Better Care Fund took place recently.

The Board noted that there was also a significant amount of work underway on the children’s theme, including support for children’s special educational needs and disabilities and a series of pieces of work looking at children’s paediatrics. In relation to the mental health and wellbeing framework, a number of projects were being progressed. In particular, a mental health and wellbeing framework strategy was being developed along with a number of action plans that sat below it. A number of pieces of work around enablement were also being progressed.

Urgent action taken by the Chair of Health and Wellbeing for noting.

·         Better Care Fund

The Board noted the record of Urgent Action taken following the previous meeting regarding the Better Care Fund. 

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

No new items of Urgent Business were tabled.

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

The dates of future meetings are:

• 24^th September, 19:00.
• 24^th November, 18:00
• 23^rd February, 18:00

It was noted that the date of the next meeting was 24^th September at 19:00

The following items were agreed for the next meeting:

·         Primary Care Update – Including a discussion on the monitoring arrangements going forward.

Remaining performance measures for Health & Wellbeing Strategy to be discussed at November meeting of HWB.