Agenda item

1)    Update on Ambition 8 of the Health and Wellbeing Strategy - Baseline and Target Measure

2)    Clinical Commissioning Group Commissioning Intentions

3)    Health and Care Integration Programme Update

4)    Haringey Better Care Fund Plan Update

5)    Annual Safeguarding Reports – Children’s and Adults

UPDATE ON aMBITION 8 OF THE hEALTH AND wELLBEING sTRATEGY – BASELINE AND TARGET MEASURE

A report was included in the agenda pack at page 61. Dr Tamara Djuretic, Assistant Director of Public Health, gave a presentation to the Board on the baseline measure and target for Ambition 8 of the Health and Wellbeing Strategy. Following the presentation the Board discussed the findings.

Some of the key points raised in the presentation were:

• Haringey’s Health and Wellbeing Strategy’s Priority 3 focuses in improving mental health and wellbeing across the borough and Ambitions 7, 8 and 9 are set to monitor progress of the implementation of Priority 3.
• Ambition 8 was more adults will have good mental health and wellbeing.
• PHE were commissioned to undertake a survey. 10,000 households were contacted and over 1,000 people completed the survey. 500 across the borough and an additional 500 from the most deprived areas.
• The results on the Warwick Edinburgh scale were an average score of 26.10 across the borough and 26.21 in the most deprived areas. The Board noted that Haringey’s baseline WE score is moderate and that there was no significant difference in the score across the borough compared to most deprived areas.
• The maximum score was 35. A low score was classified as below 21, a moderate score was 22-29 and high score was 30 and over.
• The national average score was 25.3.
• The target for Ambition 8 was noted as increasing the average score on the short Warwick-Edinburgh mental wellbeing scale by 15% from 2015 baseline to a score of 30 by 2018.
• Scores for 16-24’s, over 65’s in most deprived areas and women were lowest.
• Factors positively impacting on mental wellbeing were; good health, time to do enjoyable activities, spending time outdoors, physical exercise, personal relationships, trust and feelings of neighbourhood belonging.
• Factors negatively impacting on mental wellbeing were;  childhood experience of unhappiness and violence, inability to work due to sickness and disability, poor educational attainment and financial difficulties.

Ms. Grant enquired whether care had been taken in the sampling in regards to race, ethnicity, age etc. The Assistant Director of Public Health responded that care had been taken around including specific demographics including a number of factors which were linked to deprivation, such as educational attainment.

RESOLVED:

I). That the findings of the borough-wide mental health and wellbeing survey be noted; and the proposed trajectory for Ambition 8 be agreed.

II). That a full report on the survey be brought back to a future meeting of the Board.

cLINICAL cOMMISSIONING gROUP cOMMISSIONING INTENTIONS

A cover report and presentation on the CCG Commissioning intentions for the forthcoming financial year were included in the agenda pack at page 67.  The Chief Officer Haringey CCG gave the presentation to the Board. The Board noted that it was a requirement for the CCG to liaise with the Health and Wellbeing Board about its commissioning intensions.

The Board noted that one of the main areas that had seen significant progress this year was the Better Care Fund. The BCF provided integrated care for people who were older and possibly frail, and who had complex needs and used hospitals frequently. A lot of work had been undertaken to ascertain how best to provide support to those patients in a more joined-up manner.

The Chief Officer, Haringey CCG advised that through joining a team of people around the individual had started to have a significant impact on people’s experience of health care and reducing the number of times people had to go into hospital. 

The Chief Officer, Haringey CCG also advised that going forward some real challenges remained around un-scheduled care. There was a high level of cases of children going to A&E at night and the Board noted that a priority for next year would be to look into providing alternative services for them. The Board noted that the CCG would also be looking at; 7 day services for end of life care, bereavement support, building capacity in services that were used to help avoid admissions to hospital and how community services might be used more effectively to stay out of hospitals. The other area that was being examined as part of this process was looking at long term conditions and how healthy life expectancy might be addressed in a more joined-up manner across different agencies.

The Board was advised that the CCG would be working with partners to develop those priorities and how they might be best achieved and that discussions would be ongoing between now and the beginning of the financial year.

Cllr Waters, the Cabinet Member for Children and Families asked whether it was know what proportion of residents were registered with GP’s. The Chief Officer, Haringey CCG responded that there were significantly more people registered with GP’s in Haringey than lived in the borough, due to people who lived near the borough boundary registering with a Haringey surgery. This made it quite difficult to ascertain how many people were not registered. The CCG’s responsibility was to people who were registered with a GP in Haringey.

In response to a follow up question about whether people not being registered with a GP was the main reason for pressure on A&E services, the Chief Officer Haringey CCG advised that this was not the predominant reason. Factors such as communities who are not used to using general practice and the fact that A&E is open 24 hours a day and those patients knew they would be seen, were much more significant.

RESOLVED:

I). That the report be noted.

HEALTH AND CARE INTEGRATION PROGRAMME UPDATE

A report on the progress of the Health and Care Integration Programme was included in the agenda pack at page 83. The Deputy Chief Executive presented the report to the Board. The Board noted that significant progress had been made in terms of thinking about how the commissioning could be integrated services, particularly through the Better Care Fund, for example. Signals from the government suggested that integration would continue to be pushed as the preferred model. The Deputy Chief Executive advised that a Haringey Stat meeting was being planned for the new year which would be based on a discussion of the factors that drive admissions avoidance across the whole system, both in residential and acute care.

RESOLVED:

I). That the report be noted.

HARINGEY BETTER CARE FUND PLAN UPDATE

A report on the progress of the implementation of the Better Care Fund was included in the agenda pack at page 87.  Beverley Tarka, Director of Adult Social Services, presented the report to the Board. The Board was asked to note the following updates on the Haringey Better Care Fund:

• The Haringey BCF, and its associated services, was making steady progress with implementation according to its assigned budget.
• The governance of the Haringey BCF was established and included a range of stakeholders in health and social care
• Quarter 1 (April – June 2015) data was available on a number of outcomes, however it was still too early to draw conclusions on the effectiveness of Haringey BCF.

RESOLVED:

I). That the report be noted.