Agenda and minutes

1.1  Apologies were received from Cllr Patrick, Cllr Adebayo, Cllr Kennedy, Dr Sandra Husbands, Dr Stephanie Coughlin, Louise Ashley. It was noted that Cllrs Turbet-Delof and Cllr Adebayo joined remotely.

1.2  The Chair welcomed Jillian Bradley Deputy Chief Nurse at the Homerton in place of the Chief Executive.

2.1  There were none.

3.1  There was none.

4.1  The Chair stated that this item was to receive a briefing on the progress of the Neighbourhoods programme.

4.2  He welcomed for the item:

Sadie King (SK), Programme Lead, Neighbourhoods Programme

Amy Wilkinson (AW), Director of Partnerships, Impact and Delivery, C&H PBP

4.3  Members gave consideration to:

Neighbourhoods update - presentation

Research paper on Neighbourhoods Models Options appraisal: Phase One Research into current approaches to Integrated Neighbourhood Teams

4.4  SK took Members through the slides in detail. The presentation covered: Overview of the programme; What is Neighbourhoods; Why Neighbourhoods; Case Study - what would this mean for Peter?; Examples of working with Neighbourhood forums; Neighbourhood Programme priorities for 24-27; Who we are working with?; Structure; Transforming Neighbourhoods; CYPMF services mobilising to Neighbourhood models; CYPMF services preparing for transition; CYPMF services in early planning stages of transition; CYPMF Neighbourhood Level Pilots; Culture; Supporting the workforce; Impact; Neighbourhoods Evaluation Approach: Contribution analysis and evaluation deep dives; Neighbourhoods future.

4.5  Members asked questions and the following was noted:

a) The Chair asked what the budget was in 2018 vs now and is the programme likely to evolve to a ‘business as usual’ project.

SK replied that the funding was from the Better Care Fund change programme. The placement of the funding was moving away from having just change managers to structural changes. There has been a significant investment in resident involvement through the Neighbourhood Forums. There were structures to engage with community pharmacists to engage in Neighbourhood working.  There were Care Coordinators funded for the next 3 years and the admin roles that support the Multi Disciplinary Meetings are being expanded to support leadership groups and staff meetings. The proposal was to decline the investment over the next 2 years in strategic project management staff as this service becomes business as usual.

b) The Chair asked what the change in the annual budget has been?

SK it was £1m currently and in 2 years will reduce to c. £800k for the following year and declines further the year after.

c) The Chair asked if it was correct that the programme funded the leadership management to facilitate greater integration and not core delivery. 

SK replied that yes it funded a programme of change and not new services.

d) A Member complimented the Well St Common Neighbourhood Group and asked how residents were informed about programmes and the support they can access. She also asked how they reach out to young people and to new people.

SK replied that the Neighbourhood Forums were key mechanisms for resident involvement and the model for that was that there were 4 Neighbourhood Forum facilitators seconded from grass root organisations. A huge amount of work happens between the forums that engage residents. If services want to work with a particular group of residents that work will happen and Well St had good examples of that.  Re young people, these issues were discussed at the Forums. They are looking forward to the integration of children's service with family  ...  view the full minutes text for item 4.

5.1  The Chair stated that this item was to receive a briefing on the Anticipatory Care programme which is a key component of the national Ageing Well Programme. He stated that anticipatory care has been relabelled proactive care and those who attend INEL JHOSC will be aware of NELs focus on this. 

5.2  He welcomed for the item:

Joel Reynolds (JR), Head of Adult Community Rehabilitation Team, Homerton Healthcare

5.3  Members gave consideration to a tabled presentation Proactive Care Team and JR the Operation Lead took Members through the presentation in detail. It covered: Proactive care in City and Hackney; Rationale; Background; the Team; Who do we support?; What does it involve; “What matters to you”?; Common concerns; Typical interventions and support; Resident involvement; 3x case studies; Health inequalities mitigation projects; Operational challenges; Wider supporting pathway;

5.4  JR stated that the Anticipatory Care pathway is part of an NHSE initiative and included in the Long Term Plan it also comes out of the national Ageing Well programme. Anticipatory Care also includes end of life care so NHSE renamed it Proactive Care.  In this instance City and Hackney made a decision to use a targeted population health approach to delivering this, using personalisations to focus on what matters to people and to intervene early before people get into an acute crisis.

5.5  Members asked questions and the following was noted:

a) The Chair commended the programme and asked that of the 4200 on the initial list how many had they managed to have a conversation with and of that how many had some sort of output e.g. getting benefit going to a class/activity.

JR replied that it was roughly half of those who had the initial invitation and about 25% had come and engaged and had a consultation. Once contacted on the phone people were generally very keen to engage. In the next 9 months they would do outreach with community groups using the community connectors. As regards outputs they are using the EMIS primary care record system and just that week they were able to get the first output report and some data analytics so they had got over the first hurdle.

b) Chair asked if this novel programme was NEL wide and nationwide?

JR replied that the programme was both widespread and novel and there was a national community of practice now for anticipatory care which they can draw from. He explained that it was slightly different in different parts of the borough.  You can focus just on High Intensity Users and there is a separate team for that but the novel part here has been to do more work further upstream in the system to ask ourselves what can we do a bit earlier to divert these individuals so they won’t end up requiring acute attention later on.

c) Members asked how the funding can be assured for this work and for the Neighbourhoods scheme and when did the national Ageing Well funding run out.

JR replied that  ...  view the full minutes text for item 5.

6.1  The Chair stated that this was prompted by media coverage and local concerns about the borough’s relatively very low vaccination coverage.  He added that there had been a serious outbreak in the West Midlands. Members would be keen to know if there was a resource that could be tapped into at this stage to set up additional vaccination drives or was the service under the same resource constraints as previously

6.2  He welcomed for the item:

Chris Lovitt (CL), Deputy Director of Public Health

Amy Wilkinson (AW), Director of Partnerships, Impact and Delivery, C&H PBP

Carolyn Sharpe (CS), Consultant in Public Health

Bryn White (BW), Childhood Immunisations Programme Manager, Public Health Unit

6.3  Members gave consideration to the following papers:

a) Hackney Public Health Measles briefing to Hackney Cllrs 29 Jan

b) NHS NEL briefing to MPs on Measles 22 Jan

c) UK Health Security Agency briefing on Measles in London 22 Jan

6.4  AW and CS gave a verbal update and took Members through the reports. CS described the nature of measles adding that it spreads very quickly among the unvaccinated particularly in settings such as nurseries and schools, homeless accommodations and asylum seeker accommodation. Typically most cases are in children under 10. It’s also a serious issue for babies under 1 who are too young to be vaccinated, pregnant women, those with weakened immune systems. The hospitalisation rate is 20 to 40% for those unvaccinated and that is a major concern. The burden is felt in children and young people who don’t have immunity through ‘wild immunity’ or infection. Compared to national rates local rates are heading in the wrong direction. In addition measles is endemic in some countries and so residents travelling from those places also present a problem.  There has been a steady increase in cases since last April. Since the start of Oct 2023 there had been  465 cases nationally and 20% of those in London. The cases in London are concentrated in the North West but sporadic across London.  There were no confirmed cases in Hackney, yet, despite Hackney having the lowest vaccination rate in the country.

6.5  Members asked questions and the following was noted:

a) Chair asked that as City and Hackney is an area with very low vaccination coverage, were they able to tap into extra funding at NEL level to do preventative immunisation that is needed now.

AW recalled the 2018 local outbreak and how they managed to get ahead of that where they picked up 1000 cases for vaccination. One of the challenges currently is the younger age children not being vaccinated, however they’d noticed that rates for 5 years olds are good so they were catching up.  NHSE commissions the vaccination programmes and a lot of work was done during Covid with NHS NEL (our ICB) using non recurrent funding to create a post for a immunisation coordinator, they did grants to third sector, they did special communications etc.  The good news was that NHS NEL  ...  view the full minutes text for item 6.

7.1  It was noted that the minutes of the 10 Jan ‘24 meeting would be included in the agenda for the next meeting and Members noted the updated Action Tracker.

8.1  Members noted the updated work programme.  It was noted that the next meeting has moved from 14 to 20th March and will deal with the primary care/out of hospital estates programme. 

RESOLVED:

That the updated work programme be noted.

9.1  There was none.