Agenda item

The Director of Adults and Health introduced this report which described progress made since December 2018 with developing Haringey’s approach to locality based care in North Tottenham. The report also set out the feedback received through the Collaborate ‘deep dive’ in North Tottenham, where the Council asked frontline staff for their views on how they could be supported to offer co-ordinated and preventative care.

The following was highlighted to the Board:

• Significant progress had been made in the previous 6 months with a number of sign-ups from senior leaders in the Council, the Trust, and the CCG and more.
• The Council had commissioned a piece of work from the Bridge Renewal Trust to conduct interviews and surveys with residents to ensure their voices were heard. Resident feedback noted areas in need of improvement, such as long waits for appointments, long waits for therapy services, lack of proper care for the elderly and vulnerable. The residents also felt the services were not working in an integrated way and were suffering as a result.
• Officers were concerned that residents were not aware of the services that could be provided by the adults social service. Efforts were being made to redress this by exploring how the public could be better informed of this service, which included simplifying the technical terminology associated with it and ensured services were more accessible.
• The Council had conducted ‘deep dive’ one on one interviews and focus groups with multi-agency staff within North Tottenham.
• For the programme to succeed, it was accepted that there would need to be a structural change in how the multi-agencies operated together.
• There was to be a more efficient joined-up governance of strategy and spend with the Council and NHS, so that they were jointly deploying available resources to achieve the most impact.
• The Assistant Director of Commissioning informed that there had been a productive workshop with all partners represented at the Board regarding how the locality-based care in North Tottenham could be developed. There was a great deal of enthusiasm at the community level for this approach to locality-based care but it was important to get the balance right with making sure the governance structure worked and provided the right results.
• Housing had been a proactive partner in workshops held by the Council, and it was noted Homes for Haringey managed approximately 5,000 tenancies and had developed wellbeing hubs. It was important that such initiatives and projects undertaken (which might previously have not been known to fellow organisations) were publicised to ensure their impact was widespread. This highlighted the need to join up resources to ensure there was no overlap between services and that available resources were being utilised to their fullest potential.  

The Chair next invited questions and comments from the Board members. The following was noted:

• The Cabinet Member for Children, Education and Schools suggested changing at page 37 “Co-ordinate children’s services” to “Services for Children” as the former could be misconstrued to mean just the Council children’s services whereas this was a number of different services brought together. The Cabinet Member was pleased to see children and young people mentioned within the report but felt their role could have a greater focus throughout. The Cabinet Member also wished to see a greater level of feedback sought from children, not just 16/17 year olds. The Assistant Director of Commissioning replied it was not the intention for children and young people to be marginalised in any way and that family was an integral part of the locality-based care.
• The Lay Member for the Clinical Commissioning Group (CCG) felt the work of the local area coordinators from community first should not be hampered by the locality-based care and that the good work they had already begun in building relationships and trust amongst the community should be allowed to continue.
• The Chief Officer of the CCG highlighted his support for the project and its emphasis on function over form in the delivery of frontline services. He also informed the Board of the change to the GP contract, which enabled them to formally work in primary care networks.
• The Chief Executive of Whittington Health suggested rewording the sentence on page 29 - “Ambition is to turn the community into a self-sufficient village” - as it was unclear. Additionally, there was a risk the change to the GP contract did not support the integrated system and this had to be carefully managed. The Chief Executive also noted there was an opportunity missed in not addressing recruitment and looking at how a joint recruitment process could be developed.
• The Chief Executive of the London Borough of Haringey commended the piece of work but noted there was the potential risk it could develop into a list of action plans. The Board, as system leaders, should be conscious of what it could do to enable the locality-based care to succeed, identifying the risks such as the change to the GP contract, what barriers could be removed and what enablers could be put in place to assist its development.
• The Chief Executive of the Bridge Renewal Trust welcomed the report and suggested ‘community first’ on page 37 should include an additional commitment to put customers first and ensuring people were treated as individuals rather than a number. Show that you care for what we are doing. The Assistant Director of Commissioning responded by saying the primary focus would be on a community led approach and acting on what was being said.
• The Head of Community Safety and Enforcement highlighted the significant work done by the Local Area Co-ordinators in helping to improve confidence within the borough at a community level.

The Director of Adults and Health confirmed a report detailing updates on locality-based care in North Tottenham would be provided to the Board at a future meeting.

RESOLVED

That Health and Wellbeing Board note and support the developmentof Haringey’s locality based care.