To receive an overview of the development of the Haringey Borough Partnership for Health and Care and how it fits in with the wider Integrated Care System for North Central London.
Minutes:
Will Maimaris, Director for Public Health at Haringey Council, and Rachel Lissauer, Director of Integration for Haringey at North Central London ICB, introduced slides providing an overview of the integration of health and care services in Haringey and how this would fit within the wider Integrated Care System (ICS) for North Central London:
Rachel Lissauer and Will Maimaris then responded to questions from Panel Members:
Further slides were presented with the following key points:
Cllr Gourtsoyannis asked for further details about the expected co-production process. Rachel Lissauer said that a scheme had been developed with HealthWatch which could potentially be adopted by the Borough Partnership. There had also been some good examples of co-production and co-design locally which would be taken in account as well. Cllr das Neves added that she defined co-production as begin where a service is designed for and with residents and where there was a focus on lived experience about what works. While co-production may not necessarily work for every aspect of a service, she felt that there was scope to have lived experience input for many services. This could help to deliver better outcomes for residents and to address objectives such as reducing health inequalities.
Cllr Connor suggested that, while this process was being put together, further information could be shared with the Panel on the principles of co-design and co-production that would be applied through integrated working. Beverley Tarka emphasised that co-design principles needed to be developed with residents. However, details could be shared about what had worked well so far and how the learning on the ways of working in this area had progressed. Cllr Connor added that an understanding of how the process would be developed with residents would also be useful. (ACTION)
Cllr Brennan observed that, as a new Councillor, she felt that communication from the Council on services and projects could often be lacking or would focus too heavily on jargon or buzzwords that were often unclear to residents. Cllr das Neves agreed that the Council needed to do more to improve on this, particularly through using more straightforward language, communicating through formats such as digital newsletters and establishing models of co-production that involve clear and easily understood outcomes. Cllr Connor suggested that information about the communications and engagement process for a specific project could be brought to the Panel at the next time that a suitable new project was in development. (ACTION)
Cllr Peacock asked about co-optees and resident representation on the partnership boards. Rachel Lissauer said that there was a representative of Haringey Over-50s on the Aging Well partnership board. Cllr Peacock referred to other pensioner groups in the borough that would also be in a position to contribute. Will Maimaris agreed that there could be conversations with other groups about how they might most appropriately contribute through the new governance structures. This wouldn’t necessarily have to involve direct partnership board representation. Rachel Lissauer added that there was a resident and voluntary/community sector group (the Community Health Advisory Board) that meets in parallel to the Health and Wellbeing to discuss the same items on the agenda. Cllr das Neves agreed that it would be worth communicating with voluntary/community groups that are not currently involved in order to understand whether they would be interested in contributing. It was agreed that this should be explored further. (ACTION)
Will Maimaris then spoke about efforts to improve population health outcomes at Borough level. There had been challenges regarding this since 2010 and overall life expectancies had been reducing, particularly in the most deprived areas and amongst men. The Covid pandemic had then reduced life expectancies further. The Covid vaccination programme had proved to be successful in systematically working on a population outcome. This approach could now be taken forward through the Borough Partnership in other areas to reduce health inequalities and improve health outcomes. A range of population health measures were used to track these outcomes.
Cllr Gourtsoyannis suggested that further detail on the policies to support these outcomes would be useful. Will Maimaris noted that the framework illustrated in the slide was relatively new but that details on specific policies could be provided to future meetings in any areas that the Panel wished to explore further. Cllr Connor added that it would be important to understand what had changed under the new system compared to the public health approach used in the past and how this was expected to improve outcomes. Will Maimaris said that the NCL outcomes framework itself was new and allowed a more systematic approach to specific health outcomes. Cllr Connor suggested that it would be useful to see the progress with regular updates on the new data, perhaps through the finance and performance briefings, so that specific areas could be scrutinised. (ACTION)
Asked by Cllr Brennan about the national requirements for integrated working, Rachel Lissauer said that there were fairly fixed expectations of what had to be done included a balanced budget, an outcomes framework and performance on health quality. What was less fixed was the role of Place and Borough in relation to the integrated care system.
Asked by Cllr Connor about the implications of integrated working for budget scrutiny and how Councillors could fully understand how budgets were being used, Beverley Tarka said that she recognised the challenge and that some of the practical issues were still being worked through so this was all still at an early stage. Rachel Lissauer added that, as the Borough Partnership evolved, it would be possible to consider under which areas joint budgets and oversight would help in better using finite resources. Cllr Connor suggested that this issue should be monitored as arrangements were put into place with further details provided to the Panel when available. (ACTION)
The Panel agreed to continue to monitor progress on the implementation of integrated working and noted that the Chair and Scrutiny Officer would liaise with officers over expected timescales for this. (ACTION)
Supporting documents: