Agenda item

Report to follow.

Jonathan Gardner, Director of Strategy and Corporate Affairs at Whittington Health, introduced the report for this item noting that the emphasis on integration in this project was reflected by the colleagues present from a range of organisations involved. These were:

·         Beverley Tarka - Director for Adults, Health and Communities, Haringey Council

·         Rachel Lissauer - North Central London Integrated Care Board (NCL ICB)

·         Dr Mahmoud Asgheddi – Hornsey Wood Green GP Practice

·         Faye Oliver, Communications and Engagement Project Lead, Whittington Health

·         Chandraroop Banerjee – Whittington Health

Jonathan Gardner explained that the integrated health and wellbeing hub would bring community health services, primary care services, Council services and voluntary services all into one place in the Wood Green Shopping City to tackle issues holistically. The various teams had been working together to join services with co-design from the workforce. Co-design had also been a crucial part of the consultation process as set out in the report. 

Jonathan Gardner explained that there was a hub in the east of the Borough at Lordship Lane, a hub in the west at Hornsey and so this project would bring services in the central area of the borough into a hub that was more easily accessible than the existing multiple service locations.

Rachel Lissauer, Director for Integration at NCL ICB, added that this fitted with the overall direction of travel as the aim was to make the navigation process easier for residents. Quite often when residents saw their GP, they needed more attention for matters that were not pure health issues such as housing or employment. There was therefore an opportunity to locate various different community services together with a joined-up offer in an accessible neighbourhood place. There was a challenging picture for the primary care workforce in Haringey, particularly with low numbers of GPs, and so it was important to be able to offer state of the art premises where people wanted to work.

Dr Mahmoud Asgheddi from Hornsey Wood Green GP Practice said that he and his colleagues were excited about the move and that there were limitations with their existing premises, such as with a lack of space given their recent increase in patient numbers since the pandemic. The project was therefore a good opportunity to work with Whittington Health and the Council and to better support patients with needs that went beyond medical issues and could be addressed in collaboration with other services.

Beverley Tarka, Director for Adults, Health and Communities, said that an important consideration was the wider determinants of health and the ability to for services to intervene at as early a stage as possible. Having services all in place would help to do this and to do so more holistically. This would include supporting roles such as social prescribing and local area co-ordinators.

Jonathan Gardner and colleagues then responded to questions from the Committee:

·         Asked by Cllr Bevan about the location of the site within the Shopping City, Jonathan Gardner confirmed that it would be on the ground floor on the Mayes Road side. However, negotiations with the landlord were still ongoing so the exact space had not yet been agreed. Cllr Bevan observed that footfall on the Mayes Road side of the Shopping City had declined since the closure of the Post Office so this was an appealing offer to the landlord to have a new hub in that space.

·         Cllr Connor explained that she had been concerned for some time about people with complex mental health needs who required coordination between various different services as these was often difficult areas of casework for Councillors to resolve. Asked whether this kind of integrated working could help, Jonathan Gardner noted that Barnet, Enfield & Haringey Mental Health Trust and Camden & Islington NHS Foundation Trust would have a presence in the hub. While this would only be a few rooms to begin with, he could envisage a situation in future with mental health specialists working alongside other services such as housing. Rachel Lissauer agreed that this was an opportunity to develop these kinds of joined-up conversations. However, she added that this shouldn’t be dependent on having a physical co-located space to enable this to happen.

·         Cllr Connor asked for a response to an issue referred to in the report which stated that people had raised concerns about privatisation of the NHS and wanted to understand the ownership of the hub and the service providers. Jonathan Gardner confirmed that it would be NHS services provided by NHS staff at the hub with no private work. Cllr White raised concerns about the move from an NHS owned location to a privately owned location with rent paid and asked whether the old premises would be sold to the Council or GLA. Jonathan Gardner acknowledged that there would be a private lease arrangement at the new location and said that while the hope was to sell the old premises to the Council or GLA this stage of negotiations had not yet been reached.

·         Cllr White expressed concerns about further centralisation of services and that in some cases bringing services together might move them further away from some residents. Jonathan Gardner said that most of the individual services being moved to the hub were already centralised where they currently were so the change was only to move all of these into one place.

·         Asked by Cllr Connor and Cllr Gunes about the type of co-design used for the project, Faye Oliver, Communications and Engagement Project Lead at Whittington Health, explained that the consultation mainly involved speaking with service users/members of the public. However, the next steps involved more co-design with workshops underway already with conversations started using information obtained through the consultation stage. A co-design group would then be established and there would be face-to-face and digital options for engagement. Rachel Lissauer added that a balance would need to be achieved between people’s input through the co-design process on what they wanted an integrated service to look like, and the mechanics of Trust Board finances and the processes required to gain approval for the business case.

·         Asked by Cllr Simmons-Safo for further details about the sample group used for the consultation, Faye Oliver said that these were people who had used any of the Whittington Health community services that were being considered for relocation in the previous three years and that around 30,000 people had been contacted.

·         Cllr Simmons-Safo asked about issues of accessibility that were referred to in the Equality Impact Assessment and noted the underrepresentation of some BAME groups in access to services, including mental health services. Jonathan Gardner said that these were issues currently being worked through and acknowledged that while the hub may make services more accessible in terms of location and transport it needed to be balanced with other issues that can influence access such as privacy for example which would need to be considered as part of the design.

·         Yvonne Denny raised concerns about disabled access and noted that not all parts of the Shopping City were easy for users of wheelchairs or mobility scooters to use. She also expressed concerns about the difficulty for disabled people of using bus links to the Shopping City. Jonathan Gardner said that accessibility was everything for health services and when the exact location had been determined they would make sure that it was fully accessible. Specialist advice would also be obtained as part of the process to ensure that this was achieved. He added that the transport links at the hub relocation should make the services easier to access for the majority of the local population compared to Bounds Green or St Anns.

·         Lourdes Keever asked how people could be persuaded that they did not always need to see a doctor when there were various other health professionals that could treat them effectively. Dr Asgheddi agreed that there was a good case to be made to the public that they may often get a better service from a specialist health professional than from a GP who typically operated more holistically. Part of this needed to be about improving digital information to improve patient understanding of the services that they could access. The central location of the hub also meant that it was well placed to get public messaging out in multiple ways.

Cllr Bevan suggested that a visit by Committee Members could be made to the new community diagnostic centre which was due to open in the Shopping City in September as this could help with the discussion on accessibility concerns. (ACTION)

Cllr Connor requested that further information be provided to the Committee about the forthcoming co-design work including on how the co-design group would be formed and how various communities would be engaged with. (ACTION)

Cllr Connor requested that further information be provided to the Committee about the Council services that would be provided at the hub and how these would interact with the services provided by the NHS and others. (ACTION)

RESOLVED – That the Committee confirm its approval for the Haringey Health Hub project to continue to the next stage which would include the development of the business case and the design.