Agenda item

The Board received a report which outlined proposed changes to the Board’s membership and terms of reference following a review undertaken, as agreed at the Board meeting of 26^th February 2016. The report was introduced by Stephen Lawrence-Orumwense, Assistant Head of Legal and was included in the agenda pack at page 77. The aim of the review was to ensure the right level of representation to provide system leadership for Haringey and its residents, and to take account of wider developments across the local health and care system. The developments mentioned in the review included the introduction of five year Sustainability and Transformation Plans, the increasing collaboration between Haringey and Islington health and care economies, and the statutory footing of the Safeguarding Adults Board under the Care Act 2014. The review also considered the Board’s terms of reference to ensure that they reflected current operations and supported its future ambitions. The Board was advised that following consideration of the paper, any revisions to membership would go forward to Full Council for approval.

The Board was advised that one of the key findings of the review was that the Board should consider maintaining its existing terms of reference as they provided clear mechanisms for engagement, but that the board should seek to utilise these frameworks in order to engage with other stakeholders. Furthermore, the review also identified some minor changes in order to better reflect its current way of working; including formalising the inclusion of the Deputy Chief Executive to the Board and the inclusion of the Independent Chair of the SAB. The review further proposed that the terms of reference should be amended to reflect the Board’s ambition to collaborate across borough boundaries and to enter into joint working arrangements with other HWB’s.

The Chair of Healthwatch Haringey suggested that the review raised questions about the role of the Health and Wellbeing Board and advocated that there was a serious problem of local accountability in terms of Health and Social Care. The Chair of Healthwatch Haringey commented that the recent review of the workings of the partnership boards was fairly critical of the way those boards represented the users of health and social care services and suggested that the Health and Wellbeing Board had minimal representation of patients and service users in its current format.

The Chair of Healthwatch Haringey suggested that one solution might be to undertake supplementary activities under the auspices of the Health and Wellbeing Board to enable further patient and user engagement. The Board was advised that there had been significant changes to health and social care in the last year, particularly around the closure of residential homes and services for people suffering from conditions such as autism and dementia. The Board considered that the relatives and families of those affected had to go through a very stressful process, addressing a number of different forums to voice their disapproval.

The Cabinet Member for Health and Finance commented that in relation to the recommendations contained in the above mentioned report there was a cafe meeting planned in order to discuss the best way to ensure the voice of residents was heard through the partnership board process. The Cabinet Member for Health and Finance acknowledged the need to engage with users and residents more broadly but suggested that inclusion of a further representative on the Board could be tokenistic and suggested that engagement might be best done outside of the confines of Board meetings. The Leader commented that she was concerned about where the strategic partnership space would be if it wasn’t through this Board. In addition, the Leader responded that those who had objections to the closure of services were now involved in the process, as well as having given a number of deputations to Council bodies such as Cabinet, Full Council and Overview & Scrutiny, as well as numerous other informal groups.

The Lay Member, Haringey CCG advocated that the role of the Board was to challenge all of the organisations to consult and engage with residents and to ensure that they did it well. It was also suggested that it was undesirable to get one or two people to fully represent a diverse range of service users and that instead the Board as a whole should be responsible for facilitating engagement across different levels and holding each other to account for this.

The Director of Adults Social Services advised that the review of the workings of the partnership boards was commissioned by the Council in recognition of the need to make partnership boards operate more effectively. A co-production steering group had been established where users had been encouraged to engage and have a meaningful voice in terms of design and delivery of service. In response to a question around how residents accessed the Board, the Chair advised that there was the ability for residents to come and give deputations, bring petitions or ask questions of the Board. The Board noted the presentation on primary care capacity in Tottenham Hale, in response to the Healthwatch report, by way of an example which demonstrated a clear outcome.

 RESOLVED:

1. That the existing framework in the Board’s terms of reference should be used to engage other partners or stakeholders to contribute to the workings of the Board as systems leaders; 

2. That the HWB reviews reporting links between the Board and other relevant partnerships or forums and considers ways in which these links could be strengthened to contribute to the workings of the Board;

3. That the current Local Authority membership of the HWB should be amended to include the Deputy Chief Executive who has the strategic oversight of children and adult social care  and public health;

4. That the current membership of the HWB should be amended to include the Independent Chair of the Safeguarding Adult Board (with attendance at meetings when appropriate) and the membership of the Independent Chair of the Local Safeguarding Children Board should be on the same footing; and 

5. That the HWB terms of reference should be amended to reflect the Board’s ambition to collaborate across borough boundaries and pan London and to enter into joint working arrangements in its area of responsibility with other HWBs and for the benefit of residents of the borough.