Agenda and minutes

1.1  An apology for absence was received from Cllr Rahilly.

1.2  Apologies for absence were also received from Cllr Clark, David Maher and Simon Galczynski.

2.1  There were no urgent items and the order of business was as on the agenda.

3.1  Cllr Maxwell stated that she was a Member of the Council of Governors of HUHFT.

3.2  Cllr Snell stated that he was Chair of the Trustees of the disability charity DABD UK.

4.1  The Chair stated that the Mayor’s letter to the Secretary of State re rare and uncommon cancers had been omitted in error from the agenda pack but was subsequently added to the electronic version and a hard copy was circulated at the meeting.#

4.2  On Action 5.3(g) the Chair stated that the lobbying letter to NHSEL on possible future co-commissioning of childhood immunisation services would now be issued after the General Election and the Christmas break.

4.3  Members gave consideration to the minutes of the meeting held on 4 November and agreed them as a correct record.

5.1  The Chair stated that he had invited officers to provide an update to the Commission on the plans for a new Neighbourhoods and Care Service to which will, in part, replace the current Community Health Services contract with the Homerton which ends at the end in March 2020 and Members gave consideration to a briefing paper.  He welcomed to the meeting:

Siobhan Harper (SH), Workstream Director Planned Care, CCG-LBH-CoL

Jonathan McShane (JMc), Integrated Care Convenor, CCG-LHB-CoL

5.2  SH took Members through the briefing describing how they were mainstreaming the approach.  There was a need to integrate services to avoid patients’ having to attend at a number of locations.  The aim was to bring the partners together and there had been 18 months of work on these plans.  They were also taking place concurrently with the with the changed national policy context with the creation of Primary Care Networks and the NHS Long Term Plan. The aim was to connect all services into the PCNs and their respective neighbourhoods.  The aim was to avoid a series of hand-offs between providers and instead have a more integrated and collaborative model.  Once the plan had been worked up they had tested the model in the market and a Prior Information Notice (PIN) had been issued to begin the contractual process.  A key element in its success would be signing up Social Care to the model and letters of intent had been shared between the NHS and both LBH and CoL. The three providers of the new Alliance model would be HUHFT’s Community Service team, ELFT’s Community Mental Health Team and the GP Confederation.  The final contract would be signed off by an Independent Oversight Group of the CCG’s Governing Body.  HUHFT’s current contract will expire in April and there will be an overlap and it is expected the new alliance contract will commence in July.  JMc added that that they were building on strong foundations here.  City and Hackney benefits from high performing and solvent providers and the leaders of the constituent organisations have been in place over a long period. 

5.3  Members asked detailed questions and the following points were noted:

(a)  Members asked why no other providers had bid.  SH replied that the questionnaire had been out for a month but perhaps some might have viewed it as too much of a challenge.  Members asked if they would see the initial document.

(b)  Members asked what would be new here vis-à-vis the existing provision.  SH replied that one aspect was that it sought to integrated mental health in a way which hadn’t been done before.  It was also important to note that the changes here could not happen overnight and there would be a need to prioritise the order of the service changes.  One of the issues is how Adult Community Nursing  ...  view the full minutes text for item 5.

6.1  Members gave consideration to a report on the development of Hackney’s Ageing Well Strategy noting that this arose from one of the Mayor’s manifesto commitments.  The Chair welcomed to the meeting:

Sonia Khan (SK), Head of Policy and Strategic Delivery, LBH

Soraya Zahid (SZ), Strategic Delivery Officer, LBH

Gareth Wall (GW), Head of Commissioning for Adult Services

6.2  Officers took Members through the report noting that the aim of this work was to ensure that Council policies were age-friendly, that community partnerships recognise the distinct interests of older people, that barriers relating to access and attitudes are removed and that some creative and innovative proposals for older people are developed with stakeholders and with the older people themselves.  The challenge here was to better integrate service delivery given the complex nature of the systems which serve and support older people.  SZ described how they worked with a very diverse groups of Facilitators in running focus groups to co-produce the strategy.  They helped design the questions and plan the sessions or interviews.  They also worked, for example, with Interlink on a focus group on issues for the Charedi community. 

6.3  Members asked detailed questions and the following points were noted:

(a)  Members praised the inclusion of the Dementia Friendly aspects and asked how to better develop the intergenerational aspects building on, for example, the events with school children held during the Dementia Festival and they asked what more could be done to engage shops, businesses and transport providers.  SK replied that the need for intergenerational work came through very strongly from all the workshops and this would be picked up. She described how they also talked to the Young Futures group about shared priorities e.g. on access to toilets for example.  On the issue of outreach to shops and businesses she said the work on the Strategy was deliberately broadly based and they were looking at whole borough and whole community solutions.  There needs to be work on attitudinal change on ageing she added and work was ongoing with business groups and with Hackney Circle.  GW added that the Ageing Well Strategy would complement and not replace the Dementia Strategy and they will join up the work on both strategies to avoid duplication and to build on the success so far of the Dementia Friendly Communities work, especially with local businesses.

(b)  Members asked what could be done on the issue of “initiating movement” for older people and on “initiating engagement in conversation” and asked if there could be practical training sessions for officers on these aspects.  He asked how well resourced were the facilitators and whether they had the tools they needed.  SZ replied they were paid positions and there was also a part time co-ordinator to support them.  There was a focus on “reflective practice” and the work was well resourced.  GW replied that the Alzheimer’s Society do deliver support on ‘initiating movement’ and he could provide details. 

(c)  A Member commented that he was aware of  ...  view the full minutes text for item 6.

7.1  The Chair stated that he had asked officers to provide a briefing to the Commission on the legacy plan for Connect Hackney after the National Lottery funding for that programme ends in March 2021.  Members gave consideration to a report on the ‘Legacy Plan for Connect Hackney’ and the Chair welcomed to the meeting:

Tony Wong (TW), Programme Director for Connect Hackney, HCVS

Sonia Khan (SK), Head of Policy and Strategic Delivery, LBH

7.2  TW took Members through the report which outlined the background to the programme, the scale of loneliness in the borough, the programme’s achievements, the learning from the programme, the legacy objectives and about how Members might help Connect Hackney achieve its legacy ambitions.  It was noted that activities that were considered fun and which were key to reducing social isolation were often difficult to commission.

7.3  Members asked detailed questions and the following was noted.

(a)  Members asked for further clarification on the detail behind the outcomes measures “73% either improving or maintaining their De Jong score”.  TW replied that the report was merely an overview and the statistical analysis was being completed and that at the end of January he would be able to provide data at a much more granular level.  A lot of the targets were “test and learn” so it was more difficult to provide tracked data. 

(b)  Members asked if they could see a full list of the activities which had been commissioned and more detail on how these are maximised.  TW undertook to provide this.

(c)  A Member asked why a new Older People’s Committee had been set up when the Older People’s Reference Group was already in existence.  TW replied that in the initial modelling for the governance of the programme there was a view that the OPRG could be more diverse and so efforts were made to ensure that the OPC was more diverse in terms of age/ethnicity/religion.  One problem the National Lottery had was that collection of data was challenging and the amount of quantitative data to be collected was limited.  For this reason, he questioned whether they might continue to fund further activity on reducing social isolation among older people.

(d)  Members expressed concern at the observation in the report that the VCS struggled to find innovative ways to support people who need help to leave their homes as funders were reluctant to fund projects which included support for getting out and about.  TW replied that the challenge here was that transport was expensive and people who were isolated and/or frail have a limited ability to leave their homes. Transport outreach was a key challenge and already there was an example in Hackney  ...  view the full minutes text for item 7.

8.1  The Chair stated that he had asked Adult Services to provide an update on the work they are doing to increase the use of assistive technology in adult social care.  Members gave consideration to a report “Assistive technology update” and the Chair welcomed to the meeting:

Gareth Wall (GW), Head of Commissioning, Adult Services

8.2  GW took Members through the report.  They key point of the activity he stated was to ensure that the Council is not held to a standard which is led by the industry and instead that they are held to a standard of their own which focuses on the needs of residents of Hackney.  He drew attention to the contract with Riverside who are the new providers for the Floating Support contract and who have allocated £100k towards piloting assistive technology in their service and in employing a dedicated AT co-ordinator.

8.3  Members asked detailed questions and the following points were noted:

(a)  Members asked if any of the technology being considered was predictive i.e. could it predict that an frail elderly person might fall.  GW replied that that technology is in a formative stage and for example there are applications which include inflatables, like airbags in cars, which can sense if someone falls.  The focus of this work is to ask if there is a need and a demand for a particular application. There is a lot of encouragement from tech providers to get councils to invest at scale but a lot of the work so far has made councils sceptical and a bit more cautious. 

(b)  Members asked how ambitious we were being here and if we were focusing on making life easier and helping people to take part in activities.  GW replied that they had just started focusing on for example the telecare watch which is a development from the pendant which acts as an alarm to alert a monitoring centre when there is a fall/incident.  This will be piloted and then rolled out if it can be proved to be more effective.  He added that there is a link between Assistive Technologies and Assisted Health Care which is huge and expanding area.  In the long term there will need to be joint investments with health partners in these but they must be based on what people’s needs are. 

(c)  The Chair asked if the pilots were shared out between boroughs so as to avoid duplication.  GW replied that they were and that that Rob Miller the Council’s Head of IT sits on the London Office of Technology and Innovation (LOTI), which is a pan-London councils’ body.  This body has collectively agreed on an evaluation framework to use in future pilots and they have agreed that there would be mutual benefit from sharing the results of pilots.  The idea is to make it easier for boroughs to learn from each other and to collaborate and compare products and to set standards.

(d)  The Chair asked how in the tendering process it will  ...  view the full minutes text for item 8.

9.1  Members noted the updated work programme for the Commission.

10.1  A resident asked if the issue of the rebuilding of Whipps Cross hospital could be considered at a future meeting.  The Chair stated that this was an NEL issue and would be best dealt with at INEL JHOSC where he would ensure it was raised.  He also raised an issues about closure of side roads which the Chair stated was outside the remit of the Commission.