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 meeting and introductions will be given.

The Chair welcomed those present to the meeting. 

To receive any apologies for absence.

The following apologies were noted:

• Cllr Claire Kober  - Leader of the Council
• Cllr Ann Waters - Cabinet Member for Children
• Sharon Grant – Chair, Healthwatch Haringey (Mike Wilson attended as substitute).
• Cathy Herman (Lay Member, Haringey CCG)

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 10).

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.

None

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 23 June 2015.

RESOLVED:

That the minutes of the meeting held on 23^rd June 2015 be confirmed as a correct record.

The Board received a presentation from Mike de Coverley, NHS England, and Jill Webb, Head of Primary Care - NHS England which gave an overview of key developments related to the provision of additional Primary Care capacity in Tottenham Hale. Following the presentation the Board discussed the findings.

A copy of the presentation slides was included in the agenda pack and the Board noted some of the key points raised. The current progress to date was summarised as:

• NHS England Finance, Investment, Procurement & Audit Group (FIPA) ratified the findings and recommendations of the Strategic Premises Development Plan.

·         NHS England, Haringey CCG and Haringey Council planners were developing a Delivery Plan which set out, in detail, proposed solutions to meet the challenges outlined in the Strategy Plan.

• NHS England Decision Making Group (DMG) approved a process for the selection of a provider to enter into competitive dialogue to establish the proposed pilot practice in Tottenham Hale.
• NHS England, in conjunction with colleagues from the London Borough of Haringey and Haringey CCG, undertook and completed the competitive process of pilot provider selection.

·         A local practice partner was selected as the provider.  The decision was then ratified by PCC DMG and the provider was notified.

• Lea Valley Estates confirmed that they would have builders on site until June 2016, who would be able to rapidly establish services to the facility.
• NHS England and Haringey CCG were working on an IT solution that would rapidly allow connectivity to the new temporary facility.

The next steps and upcoming milestones for the project were noted as:

• Completion of dialogue had been commenced with pilot provider to establish final costs and service specification
• Final Agreement of pilot costs and service specification required by DMG Primary Care Commissioning.
• NHSE had begun the process of drawing up the contract for services
• Preparation of business case for pilot premises
• Dialogue and agreement of co-commissioners on premise funding responsibilities (in progress). Ms. Webb advised that NHSE were undertaking a process to bring primary care medical services commissioning arrangements back within the CCG umbrella.
• Sourcing of temporary facility (commenced)
• Approval of business case for pilot premises by FIPA  
• Site mobilisation with new Partner Practice
• Planned service commencement by early January 2016

Cllr Morton, the Cabinet Member for Health & Wellbeing, welcomed the commitment from NHSE and acknowledged that this was a significant step forward on something that partners had been working on for a long time to get it to the position that it was currently in.  Cllr Morton advised that the process had taken 12 months and a resolution was at least another 6 months away. Cllr Morton emphasised that a resolution could not happen fast enough both for existing residents but also to meet the additional demand as a result of the area being a major regeneration zone for London. Cllr Morton observed that primary care was part of the wider investment in the area and offered an unprecedented opportunity to improve the borough and the lives  ...  view the full minutes text for item 21.

A Presentation was circulated as part of the agenda pack. Dr Tamara Djuretic, Assistant Director of Public Health and Shelley Shenker, Assistant Director MH Commissioning – Haringey CCG, gave the first part of the presentation on Mental Health and Wellbeing. The second part of the presentation was delivered by colleagues from Barnet, Enfield and Haringey Mental Health Trust: Dr Jonathan Bindman - Medical Director; Maria Kane - Chief Executive and Katherine Edelman - Clinical Director of services for Haringey. Following the presentation the Board discussed the findings.

Some of the key points raised in the presentation were:

• The performance indicators for Ambition 9 were: Percentage of people aged 18-69 on Care Programme Approach in employment and percentage of people aged 18-69 on Care Programme Approach in settled employment.
• Current performance was noted as 76.8% of adults in contact with secondary mental health services were in stable accommodation which was similar to our statistical neighbours but was lower than the London average and higher than the England average. 5.1% of adults in secondary mental health services were in paid employment. 5.1% was lower than Haringey’s statistical neighbours and both the London and national average.
• 5.7% of women in secondary mental health services were in paid employment, compared to only 3.3% of men.
• The aim for Ambition 9 was to increase the percentage of adults receiving coordinated care who were in employment to 9.85%, which would be top quartile nationally and to increase the percentage of adults receiving coordinated care who were in settled accommodation to 80%, which would be in line with Haringey’s statistical neighbours. 
• The joint CCG and LBH Mental Health and Wellbeing Framework was published in March 2015 following extensive engagement and consultation. A whole system approach was adopted in the definition of enablement adopted in the framework: “...supporting people to meet their potential to live independently, to have meaningful social relationships, maintain good quality housing, find and/or maintain employment and live a satisfying life.”
• The proposed enablement outcomes were divided between outcomes for the individual and outcomes for the system:

For the individual:

•      Strong social networks and reduced isolation

•      Sustained employment, meaningful activity

•      Stable accommodation

•      Improved resilience and self-confidence

•      Resources are effective in achieving personal goals

•      Improved physical health

•      Positive service user experience

For the system:

•      Reduced activity in intensive, high cost resources/increased activity in low intensity, lower cost resources

•      Pathways to and availability of resources understood by all stakeholders

•      Improved mental health awareness and reduced stigma

•      There was a choice of readily accessible resources available that met a range of needs and preferences

• In order to deliver these outcomes, an integrated, personalised and goal orientated care approach would need to be adopted in order to facilitate a life beyond diagnosis.
• The delivery of more interventions at the earliest possible stage in order to keep people well and supporting people with community based services when they do become un-well was also a key aspect of  ...  view the full minutes text for item 22.

A Presentation was circulated as part of the agenda pack. Catherine Swaile, Vulnerable Children’s Joint Commissioning Manager, gave the presentation to the Board on the review of Haringey Children’s and Adolescent Mental Health Services (CAMHS). Following the presentation the Board discussed the findings.

Some of the key points raised in the presentation were:

• The review was linked to Ambition 7 of the Health and Wellbeing Strategy, more children and young people will have good mental health and wellbeing. The performance measure for this ambition was based on a survey that was being developed for school children, based on the Warwick-Edinburgh wellbeing score for children and young people. As the process was not finalised, a target had not yet been set for this ambition
• The Department of Health published a report earlier this year called Future in Mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing.The report identified participation and collaboration as a core principle, promoting services designed in collaboration with children, young people and families to meet their needs. The report also contained 49 proposalsto transform the design and delivery of a local offer of services for children and young people with mental health needs
• Haringey’s allocation of the £280m Transformation fund for CAMHS announced in the Autumn Budget was £515,302, recurrent for 5 years.
• CAMHS Review Project Board were leading the review of Haringey CAMHS, comprising representatives from the CCG, the Council, NHSE, CSU and Healthwatch.  The process involved an engagement event for over 50 people in March and a follow up event was booked for 18^th September to feedback on the review outcomes and to develop a transformation plan. Themed workshops were held on Looked after Children, Children with Learning Disabilities/ASD and Crisis.
• In addition, online surveys were conducted with feedback from 152 stakeholders including both children and young people and parents.
• Participation in the review was received from all providers to ascertain what the issues were in mental health and to see what improvements could be made.
• The latest estimated prevalence data showed that low level universal support was required by around 9000 children or young people in Haringey. No data was available for the numbers or Haringey’s commissioned activity.
• Ms Swaile identified a significant gap at the next tier of support up, where a mental health professional was working with a family (but not as part of a multi disciplinary team) where Haringey commissioned around 300 services across health and social care but would expect about 4000 people requiring a response.
• Haringey’s commissioned activity was around 1200 cases for multi- disciplinary specialist care services, against an estimated 1150 cases.  Ms Swaile commented that this suggested an escalation of cases because need was not being met at the tier below.
• The number of cases at tier 4, which was classified as highly specialist inpatient services, was below what the estimated prevalence data would suggest with 17 cases against an estimate of around 50.
• Feedback was positive in  ...  view the full minutes text for item 23.

A report on the governance arrangements for Priority 2 of the Corporate Plan was included in the agenda pack. Charlotte Pomery, Assistant Director of Commissioning, presented the report to the Board.

The Council established governance arrangements to oversee delivery of each of the five priorities in the Council’s Corporate Plan. The current arrangements consisted of internal boards focusing on delivery of both the outcomes in the Corporate Plan and the budget reductions required in the Medium Term Financial Strategy. The Healthy Lives Board was set up to focus on delivery of the second priority of the Corporate Plan: Empower all adults to live healthy, long and fulfilling lives with control over what was important to them.

In order to foster and enable the whole systems and collaborative working needed to deliver the Corporate Plan, the establishment of a partnership Outcome Board for each priority had been proposed. The paper set out the background to this requirement and requested that the Health and Wellbeing Board be ratified to take on this function for Priority 2, working across Haringey’s health and social care system.

Dr Jeanelle de Gruchy, Director of Public Health requested more information around the Board’s role in Priority 1 of the Corporate Plan:Enable every child and young person to have the best start in life, with high quality education. In response, Ms Pomery agreed that there was a significant synergy across health and wellbeing for both adults and children as shown by the CAMHS review.  Ms Pomery advised that there was a proposal to establish a separate partnership Outcomes Board for Priority 1. The Board noted that there would need to be discussions on how the two partnership Outcomes Boards linked together in order to ensure that there were no gaps between the two priorities.

RESOLVED:

I). That the Health and Wellbeing Board, within the context of its functions, be ratified as the external Outcomes Board to oversee the delivery of Priority 2 of the Corporate Plan.

1.    Priority 2 Governance Arrangements

2.    NHS 111 and GP Out-of-Hours Procurement Update

 A report on the NHS 111 service and the GP Out-of-Hours Procurement update was included in the agenda pack. Jill Shattock, Director of Commissioning – Haringey CCG, presented the report to the Board.

The Board noted that Haringey CCG was working with the other four CCGs in north central London (Barnet, Camden, Enfield, and Islington) to bring together the NHS 111 service and the GP out-of-hours service to enable them to work better together. 

The CCG held a number of events over the preceding 8 months and received feedback from a wide range of members of the local community on the 111/OOH procurement proposals. The evidence gathered, including clinical evidence, showed that bringing the two services together across the five boroughs would meet local need for the service and provide a sustainable service. The procurement process was due to begin from 2^nd October

RESOLVED:

I). That the report be noted.

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 as follows:

·         24^th November, 18:00 – 20:00

·         23^rd February, 18:00 – 20:00

It was noted that the date of the next meeting was 24^th November at 18:00.

The following agenda items were agreed for the next meeting:

• LSCB Annual Report.
• Remaining performance measures for Health & Wellbeing Strategy (From June HWB)

The Board agreed that future reports should more clearly define what was being asked of the Board in the recommendations and to ensure that a covering report was included in the agenda pack.

Cllr Morton observed that keeping future agendas tight and to as few agenda items as possible in order to review those items in detail seemed to work well and also agreed that focusing items on the ambitions in the Health and Wellbeing Strategy was useful. Cllr Morton suggested that the issue was maintaining the correct balance between accountability and policy making.

The Deputy Chief Executive commented that there were a number of areas were the Board had to make a decision due to the powers vested in it, such as approving the Pharmaceutical Needs Assessment. The Deputy Chief Executive suggested that the discussion items on future agendas should focus on what the barriers were to the system delivering the changes required. Sir Paul Ennals endorsed this approach.

The Board agreed to keep the main format of future meetings to one or two strategic discussions, based on the ambitions of the HWB Strategy. The Board also agreed with tightening agendas and keeping the amount of time dedicated to presentations shorter in order to facilitate more discussion time.

Stephen Lawrence-Orumwense to be invited to future Health and Wellbeing agenda setting meetings.

The Board agreed to a start time of 18:00 for future meetings of the Board.