Agenda and minutes

Please note this meeting may be filmed or recorded for live or subsequent broadcast 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 Haringey Cabinet Member for Finance and Health referred to agenda item 1, as shown on the agenda  in respect of filming at this meeting and members noted this information.

In the absence of Councillor Watts and Councillor Kober, Councillor Arthur, Haringey Cabinet Member for Finance and Health, was nominated and agreed as Chair of the meeting and Councillor Janet Burgess  was nominated and agreed as co-chair.

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

Apologies for absence were received from Islington Health and Wellbeing Members: Councillor Richard Watts Leader of Islington Council and Jennie Williams.

Apologies for absence were received from Haringey Health and Wellbeing Board Members: Councillor Claire Kober, Leader of Haringey Council, Dr Dina Dhorajiwala, Dr Jeanelle de Gruchy and Zina Etheridge.

There were no items of urgent business to consider.

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.

There were no declarations of interest put forward.

Notice of questions must be given in writing to the Committee Clerk of either or both boroughs by 10 a.m. on such day as shall leave five clear days before the meeting (e.g. Friday for a meeting on the Monday 10 days later). The notice must give the name and address of the sender.

A deputation may only be received by the Sub-Committee if a requisition signed by not less than ten residents of either or both boroughs, stating the object of the deputation, is received by the  Committee Clerk of either borough not later than 10am five clear days prior to the meeting.

No questions or deputations were put forward.

The Haringey and Islington Health and Wellbeing Boards Joint Subcommittee was asked to consider the latest version of the STP [Sustainability and Transformation Plan] which aimed to promote discussion and consideration of the implications of the STP for the Wellbeing Programme and for Haringey and Islington as boroughs.

The Acting Director of Commissioning, Haringey CCG, introduced the report, emphasising that this was not a plan for achieving financial balance as there was more work being completed on finances and partner contributions at a time of significant budget pressures. However, the report contained a lot more detail on the individual workstreams, than previously provided, Sanjay Mackintosh was completing further work on the terms of references and reporting mechanisms within the workstreams and nominated directors had been invited to reflect on the Adults element.

The Board noted that, to address the previously perceived democratic deficit around the STP, a Health and Social Cabinet had been established which was envisaged to be reflective of the Haringey and Islington partnership approach to health and work in an advisory capacity, acting as a sounding board for the implementation of STP plans.

A position was being reached where local authorities and CCG’s can establish how their work fits in with the responsibilities of the STP and how the Haringey and Islington partnership work as a sub system.

Further information was provided as follows:

·         Population based approach being taken forward by Haringey and Islington following approval of the partnership agreement.

·         Partnership to initiate what happens at STP level, showing best practice.

·         In relation to urgent care services, making sure that there was standardisation and overview ownership at the STP decision making level.

·         Considering integrated model delivery and STP position with the development of the out of hospital care.

·         STP required close working by agencies, in particular to support the intermediate services.

·         Tier services to reduce the reliance on institutional care. The Partnership had already identified areas of working together in this respect.

·         STP was an agent for quality care to ensure that this was provided to the required standard.

·         Preventative approach to be routed in the communities.

In response to consideration of the report and presentation, the following comments/ issues were made:

·         In relation to the STP role in urgent care, admissions to Accident and Emergency service for young people had risen and this was attributed to the rapid access initiatives in hospitals. To mitigate this rise, there would need to be same day access to GP’s. Also there was work to do on improving access hubs in GP practices and discussing with paediatricians on how to provide more advice/learning to parents to prevent admissions. Noted that there was also a peak in attendance at A&E, related to respiratory conditions and low level re-current problems such as constipation and reflux in children. These were everyday examples of needing to provide the right care at the right times and this required a financially viable care system. This also involved the STP understanding the issues and developing  ...  view the full minutes text for item 7.

Noted that the Partnership Agreement had been signed by both Islington and Haringey Councils, the CCG Governing Bodies for Islington and Haringey, University College London Hospital and Whittington Health. Haringey and Islington GP Federations have also agreed to sign the Agreement and to work with the Wellbeing Partnership, noting that the Federations are signing as organisations rather than on behalf of individual member practices.

The Joint Committee considered a presentation on the work underway across Islington and Haringey to develop Care Closer to Home Integrated Networks (CHINs) and Quality Improvement Support Teams (QISTs), key propositions of the North Central London sustainability and transformation plan.

The presentation further set out the case for change and provided an update of the development locally.

Comments were as follows:

• There was recognition of the importance of this work and how it supports understanding how fund flow through the partnerships; this will also help with understanding how the STP will work.

• This was a good grass roots initiative which Haringey and primary care providers were also positive about. The next theme being explored was a digital roadmap and it was hoped to have access to digital files on a shared scale to inform and utilise local working.

• With regard to a question about the decision making around commissioning of services from providers and in particular where a provider may provide one source of provision but may not be successful in gaining a contract in another related area, it was noted that this issue would be considered on a case by case basis. It may be the case that some service provision will not have a partnership solution attached but ultimately there will be consideration of cost and outcomes when commissioning the appropriate service.

The Joint Committee noted that Haringey and Islington face similar challenges with over 1 in 3 children aged 10-11 classed as overweight or obese. Tackling obesity through the Wellbeing Partnership emerged as a priority area following the scoping of the CVD/diabetes, children’s and prevention work streams of the Haringey and Islington partnership. In response, a joint approach to creating healthier environments and reducing sugar consumption was approved by the joint Health and Wellbeing Board in January 2017.

There were some bold actions for tackling Obesity highlighted in the presentation by the Islington Director for Public Health for the Joint Committee to comment on.

1. Improve the food controlled or influenced by the Council - Prevent any business operating on Council owned premises from selling sugar sweetened soft drinks and Introduction of a local sugar tax/levy.

2. Support businesses and organisations to improve their food offer- Rent relief / business rates relief for healthier retailers. Prevent ice cream vans from parking outside schools and / or playgrounds.

3. Public events - Provide incentives to food providers at events organised by the Council to replace unhealthy with healthier options or similar.

Comments were as follows:

• The above actions demonstrated that both Councils had an equally positive disposition to tackle obesity and there was a need to take forward bolder actions with fewer resources. In terms of the actions highlighted, there was a need to consider the resources available for enforcement and monitoring and whether both Council’s had the capacity to take these actions forward. Suggested there could be separate exercise to explore the common areas of working and where actions can have an impact.

• Agreed that the report and presentation is considered by the respective partnerships and consideration given to the common actions that can have an impact, whilst also giving consideration on how they fit in with existing contracts/ services.

• The Co- Chair suggested that after consideration by the individual organisations  this item is added to a future Joint HWB agenda to agree actions.

To consider any new items of urgent business admitted 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.

Not required.

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.

None

Next Joint Meeting  Monday 9^th of October 2.00pm Islington.