Agenda and minutes

Please note that 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. 

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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 Members present to agenda Item 1 as shown on the agenda in respect of filming at this meeting, and Members noted the information contained therein’.

Apologies for absence were received from Cllr Felicia Opoku and Helena Kania.

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 as noted below).

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 Members’ Register of 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 interest are

defined at Paragraphs 5-7 and Appendix A of the Members’ Code of Conduct.

Cllr Pippa Connor declared an interest by virtue of her membership of the Royal College of Nursing.

Cllr Pippa Connor declared an interest by virtue of her sister working as a GP in Tottenham.

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

None.

To approve the minutes of the previous meeting.

Cllr Connor reported that, following the previous meeting, a useful briefing on mental health had been distributed to all Councillors which had been provided by Tim Miller, Lead Commissioner for Adult Mental Health.

Cllr Connor referred to an action point from the previous meeting where a query had been raised about an assessment fee of £25 charged for counselling by the Haringey Wellbeing Network. An explanation had now been received on what costs these fees cover but Cllr Connor requested that further explanation be requested on what more could be done to help anyone in severe financial difficulties who requires this support. (ACTION)

AGREED: That the minutes of the meeting held on 4^th March 2019 be approved as an accurate record.

Report to follow.

Paul Durrant, Head of Finance and Business Partnering, presented an overview of the financial performance of services within Priority 2 (Enable adults to live healthy, long and fulfilling lives) as at the end of quarter 4, 2018/19. Overall the final outturn resulted in an overspend of £4.2m.

The headline placement costs showed an overspend of £7.2m which was broken down into:

• Learning difficulties - £3.6m overspend
• Mental health - £2.4m overspend
• Physical support - £1.42m overspend

A further overspend of £0.7m on Osborne Grove Nursing Home brought the total overspend to £7.9m. This was mitigated by a resilience reserve contribution of £2m from Corporate Services, an underspend on staffing and overheads by £0.8m and the capitalisation of occupational health costs from the revenue budget which altogether resulted in the final figure of a £4.2m overspend.

The report provided to the Panel also provided a breakdown of the budget allocation for Priority 2 services for 2019/20 which shows a gross budget of around £114m and a net budget of around £82m. The column marked “other ASC” on the second table represents staffing and overheads costs.

Cllr Connor thanked Paul Durrant for the report, noting that it had been requested at short notice. She said that the Panel would find it useful to have a more in-depth study of the budget at a future meeting, looking at the budget in its entirety and including both revenue and capital costs. This will help the Panel to have a really robust understanding of the overall budget when looking at budget savings in future. The request from the Chair was therefore for an in-depth look at the budget at the September meeting of the Panel. (ACTION)

Asked about the term “Net budget (not including overheads)” on the second table in the report, Paul Durrant said that the overheads not included related to non-service costs such as accountancy and HR.

To update the Panel on recent progress on suicide prevention, including on improving support for construction workers following a previous recommendation of the Panel.

Chantelle Fatania, Consultant in Public Health, introduced the update report on suicide prevention noting that a previous report had been provided to the Panel in November 2018 and that this new report provided a further update on progress over the last six months. In particular, the Panel had been interested in following up on action to support construction workers which has been identified as a high-risk group for suicide and also has a significant presence in Haringey borough in the moment because of the high level of construction projects. In April 2019, the Chair of the Haringey Suicide Prevention Group (HSPG), Professor David Mosse, had attended a meeting of the Construction Partnership to present to them about the work of the HSPG and the about the range of interventions available locally. His feedback was that while there are several initiatives that the group is engaged with, this engagement is patchy across the partnership as a whole. Further work is ongoing and representatives of the group have been invited to attend future meetings of the HSPG.

Other successes over the last 6 months are covered in the report. These include the provision of funding for a ‘postvention’ suicide liaison service [‘postvention’ refers to the support to a local community following a suicide] across North Central London (NCL) which is expected to provide practical and emotional support to around 100 families and social networks affected by suicide each year in the NCL area. Fencing to prevent suicide is currently being installed on Archway Bridge. Several community organisations have recently joined the HSPG and there is now representation from LGBTQ, Turkish, Kurdish and Jewish communities. The HSPG will be preparing the next suicide prevention plan for Haringey which is due to start from April 2020. This is likely to be supported by a new suicide audit in 2020 but the data is currently being awaited. It is no longer possible to access data directly from coroners and the data is being gathered on a London-wide level. There hasn’t yet been guidance on what type of data will be provided or whether it will provide enough detail to allow analysis on risk factors.

Asked for further detail on the specific concern about construction workers, Chantelle Fatania said that there is no specific data for Haringey but Professor David Mosse had recommended further action in this area as they are known from other areas to be a high-risk demographic group and require support to maintain good mental health and wellbeing. Cllr Connor commented that it would be useful to hear further feedback from the construction industry after their next meeting. (ACTION)

Responding to further questions from the Panel, Chantelle Fatania confirmed that the CCG commissioner for mental health services is on the HSPG and that the next suicide prevention plan in 2020 will be more specific about how mental health services are linked in.  She also confirmed that suicide rates in BAME communities tend to be higher than the general population for multi-factorial reasons.

To inform the Panel about a plan for a ‘place-based approach’ in North Tottenham which aims to develop more integrated public services.  

Rachel Lissauer, Director of Commissioning and Integration at Haringey CCG, introduced the first part of this item speaking about the practical partnership work around integration and prevention. The context had been signalled in advance by the NHS Long Term Plan published in January 2019 which set the direction through the mandate that all areas are to be become integrated care systems by April 2021. Within each integrated care system there is an expectation that there will be a single CCG which would be at a much higher level than currently so this is likely to require a merger of existing CCGs. The Long Term Plan also signalled that GPs should work as part of primary care networks with more contractually based partnerships and these networks, each covering around 30,000 to 50,000 populations, have now been signed off in Haringey. There has also been a focus on developing integration at Borough level as well as the NCL level and, in addition, a series of workshops have been held which proposed a greater degree of localised working.

Charlotte Pomery, Assistant Director for Commissioning, said that the response from the Health and Wellbeing Board about the Borough partnership had been based on the wider governance arrangements and key outcomes such as reducing health inequalities, ensuring that health and wellbeing outcomes are improved for all residents. The existing joint working across the NCL area, including through the Sustainability and Transformation Plan means that Haringey is starting from a strong position. They were also keen to emphasise that the integrated care system should not just include health and care services but should also include factors that impact on health and wellbeing such as housing and the environment. There is currently an intention to build a broad, inclusive and collaborative approach. There was also some specific feedback about ensuring that there is sufficient capacity at Borough level, that there is enough time to work through the key issues and that the views of local residents are built into the work.

In response to questions from the Panel, Rachel Lissauer said that the signal of the CCGs of their intention to form a single CCG is likely to happen in September. Staff for the existing CCGs will remain in their Boroughs as the governance structures integrate into the single CCG. Charlotte Pomery said that in terms of IT there is already a large digital programme in place across the NCL area including a strand on sharing health and care records. Rachel Lissauer said that the leadership would be shared and emphasised that a lot of joint working had already been established in NCL before the Long Term Plan was published. Beverley Tarka, Director of Adults and Health, added that the NCL has put together a co-design group and has called for nominations from all stakeholders so this is very much a shared endeavour.

Jonathan Gardner, Director of Strategy at Whittington Health NHS Trust, introduced the next part of the presentation. The area of biggest need where the  ...  view the full minutes text for item 9.

An opportunity to question the Cabinet Member for Adults & Health, Cllr Sarah James, on developments within her portfolio.

Cllr Sarah James, Cabinet Member for Adults & Health, took questions from the Panel on issues within her portfolio.

Cllr White raised improving cycling infrastructure as a way of making a positive impact on health and suggested that Cabinet-wide support is needed to drive these changes. While transport is not specifically within Cllr James’ portfolio she said that she is fully signed up to the active travel agenda and recognises the long-term health benefits. Cllr Hakata suggested that healthier travel options should be part of Cllr James’ portfolio as a public health issue. Cllr James said that a lot of public health work was already ongoing in this area including mapping areas of pollution, diabetes, asthma and obesity which often correlate. Cllr Connor suggested that a briefing on the public health implications on this issue could be obtained. (ACTION)

Cllr Da Costa said that at a recent briefing, Members had been told that the take up of direct payments in Haringey is only 22% which is lower than other Boroughs and asked what was being done to address this. Cllr James said that the remedy is to focus on particular groups of social care recipients and new clients to encourage them to switch to direct payments.

Asked about Osborne Grove Nursing Home, Cllr James said that a paper on this would be going to a meeting of the Cabinet in July after the feasibility study was completed in May. Four options were examined by the feasibility study, two of which involved refurbishment of the existing premises and an extension and two of which involved a demolition and rebuild. The study has demonstrated that it is feasible to build a 70-bed nursing home on site and that will be the intended objective but final costing figures are being worked up. Her preference is for demolition and rebuild across the site including the health centre already there. This would enable a state of the art nursing home with outward facing community facilities and possibly also supported housing units. There are difficulties with the existing building which has been found to be at risk of progressive collapse in the event of a fire. There is no lift capable of taking a bed as the doors are not wide enough and some of the rooms are not big enough but enlarging the size of them would be structurally difficult if the refurbishment option was chosen. The whole feasibility study has been conducted with the involvement of the co-design group which has contributed ideas that have been incorporated such as the maximisation of garden space.

Cllr Lucia das Neves, Chair of the Overview & Scrutiny Committee, said that the Cabinet Member’s comments on the risk of progressive collapse should be fed into the Overview & Scrutiny Committee ongoing work on fire safety as Osborne Grove had previously been looked at as part of the fire safety scrutiny review and this particular concern had not emerged. (ACTION) Cllr James said that this risk had only became apparent when the  ...  view the full minutes text for item 10.

To consider potential issues for inclusion within the work plan for 2019-20.

The updated work programme was noted and Cllr Connor reiterated the request for a public health briefing paper on transport issues to be followed up and considered before deciding whether this could be added as a future item on the work programme. Cllrs da Costa, Hakata and White suggested that commissioning of services could be a topic for a future scrutiny review.

·         5^th Sep 2019 (6:30pm)

·         14^th Nov 2019 (6:30pm)

·         12^th Dec 2019 (6:30pm)

·         25^th Feb 2020 (6:30pm)

·         5^th Sep 2019 (6:30pm)

·         14^th Nov 2019 (6:30pm)

·         12^th Dec 2019 (6:30pm)

·         25^th Feb 2020 (6:30pm)