Agenda and minutes

1.1  Apologies for absence were submitted on behalf Dr Mark Rickets and Alistair Wallace for lateness

2.1  The minutes of the previous meeting were agreed as a correct record.

3.1  There were no declarations of interest.

To note that Dr Sandra Husbands (Director of Public Health) is now a member of the Board.

4.1  The Mayor welcomed Dr Sandra Husbands (Director of Public Health) as a member of the Health and Wellbeing Board.

5.1  Anne Canning presented the City and Hackney Safeguarding Adults Board Annual report. Adi Copper was unable able to attend the meeting. She referred to Board as effective and working well.  Anne Canning told the Board that on third of enquiries had led to a section 42 inquiry. She stressed the importance of those accessing the service to confident in doing so.  Three quarters of those spoke to had confirmed that their needs had been met by the service. Seeking feedback on the service was a high priority and the general statistics had improved. One of the key roles of the Board was to be involved when things go wrong. 

5.2  Anne Canning referred the Board to the SAR referrals in 1918/19 of Ms Q and Ms F. In the case of MS Q the SAR referral identified that a number of agencies had been involved in providing care to Ms Q and that there may have been a lack of effective agency work in managing identified risk to Ms Q including self-neglect. Ms F’s mattress had deflated and it had taken 7 days to fix, causing her significant harm. The risks to Ms F had not been recognised. Anne Canning referred the Board to the death of Mr S in a Bus Shelter in the Borough.     

5.3  One of the main areas of concern was abuse.  A system of champions in the community was being developed with a number of workshops on this and champions attending the safeguarding board.  Anne Canning stressed the need to get the message on safeguarding out into the Community.

5.4  Anne Canning told the Board that the City of London Corporation had developed a modern-day slavery statement in November 2018. The focus of the modern day slavery group was to raise awareness about this issue and provide training.  

5.5  Jon Williams told the Board that discussing safeguarding with the public remained a challenge and that the public felt an anxiety about reporting.

5.6  Carol Akroyd (keep the NHS public) spoke to the Board, stating that vulnerable people such as migrants were negatively impacted by a changes in NHS policy. Senior doctors were looking at ways to ensure there is access to the services. Catherine Pelley told the Board that bills were accompanied by debt management. There were not many people attending and a much of the service was free. Work would be undertaken with the migrants centre on this matter.

5.7  Councillor Bramble reported work with the Adults Safeguarding Board to help learn lessons. Anne Canning confirmed that children’s social workers consult with adult social worker on a way forward. There was a shared understanding of what was common to all through the points of transition from childhood to adulthood. She stated that when vulnerable young people move through the system, such as young people with SEND did not receive the same level of support.

5.8 The Mayor Philip Granville stressed the need for the provision of a consistent standard of safeguarding regardless of  ...  view the full minutes text for item 5.

6.1   Mark Scott (Deputy Director of Transformation PMO, ELCP) presented to the board on how the NHS was to plan the delivery on its commitments. It outlines how the NHS would give everyone the best start in life, deliver world-class care for major health problems, such as cancer and heart disease, and help people to age well. Work had been ongoing locally to plan how the long term plan’s commitments would be delivered over the next five years. On 15 November the document had been submitted to NHS England as draft because of the pre-election purdah period. The draft was now on the website to allow people to the opportunity to have their say on its content.  Mark Scott referred to population growth in East London was key with a projected increase of 13%.  In answer to a question he confirmed that there were no metrics for workforce at present. There would be work on tracking vacancy rates and the risks around EU staff. He confirmed to the Board in relation to governance arrangements that there would be an announcement on the appointment of independent chairs next week.

6.2   David Maher stressed the need to focus on the wider determinants of needs with a three system footprint. There would need to be an awareness of the potential of risk and monitor lost opportunities.

6.3  Carol Akroyd spoke to the Board on this matter, stating that the changes that were being major and that the public should be consulted and engaged on this. She referred to the messages that should be conveyed to the public such as changes of location of services.

6.4   Mayor Glanville agreed with concerns but stated that confirmed that no firm decision had been made and that there would be further consultation. Further, there was much internal debate. He referred to excellent KPIs. There would however be a need to look at the impact on inequality in terms of health outcomes and that there was need to develop engagement on this matter. There was a need to now ensure that there is emphasis on engagement and co-production. Mayor Glanville referred to the good performance of the Homerton Hospital in the winter crisis as evidence of a good performing system.

6.5  David Maher told the Board that 1000 residents had been consulted on the proposals and it was expected that the Council’s Scrutiny functions would be putting forward a view on the changes. He confirmed that the treatment of mental health was now on equal footing with physical ailments and that there was a good track record of service delivery. Deputy Mayor Anntoinette Bramble that much work had been carried out at neighbourhood level. Mark Scott stressed the importance of early service user involvements and that co-production had been signed up to.  

6.6  Laura Sharpe referred to local work that she was currently leading on in relation to workforce on health and social care. There was much data available but this was located in a variety of locations.  ...  view the full minutes text for item 6.

7.1  Raj Radia told the Board of the proposed decommissioning by NHS England in the London Area of two services which were currently being provided by community pharmacies to Hackney residents: pharmacy first – minor ailments service and medicines optimization service.

7.2   Sandra Husbands confirmed that under the Pharmaceutical Needs Assessment there was responsibility for the delivery of these services.  She confirmed that the purpose of the question was to ascertain the views of the Board in relation to decommissioning of these two services. She said that these services, provided by pharmacies helped to ease the pressure on the NHS and that decommissioning would impact most on the vulnerable in the Borough.

7.3   Some members of the Board expressed concern that without a report on this matter it was not possible to have a meaningful discussion and asked for clarity on the Board’s role in this matter. The Board agreed that a more detailed report with proposals be completed on this matter.  

8.1  The Board noted the report of the facilitator in the development session.

8.2  Mayor Glanville outlined his vision for the Health and Wellbeing Board including the following:

·  To have a significant role in the wider determinants of health

·  To have responsibility for strategic direction and prioritising specific areas of work

·  To have an overview of the JSNA.

·  To have oversight and ownership of the Borough’s Community Strategy

·  Discussion of mental health strategy

·  To consider cross cutting strategies

·  To review the London health inequality strategy  

·  To review KPI dashboard

·  To consider widening the current membership of the Board

·  For the Mayor to rotate the chair with the chair of the CCG

8.3  Dr Navina Evans that there was potential for the Board to have an increased role and redefine its powers. She referred to the experience of other local authorities with the devolving of accounts together with responsibility for managing budgets. Navina Evans considered that the Board should focus on people’s experiences and specific areas such as loneliness which had a big impact on people’s lives. She considered that the Board should be involved in holding the health system to account.

8.4  David Maher stressed that the Board should hold the health system to account with involvement in workforce and strategies for retraining. He referred to the positive aspects of the Health for Wales Act.

8.5   Sandra Husbands referred to the importance of the Board taking a strategic approach with long term thinking, having responsibility for individual work areas such as giving every child the best start and life chances for all people in Hackney. She considered that there was potential for the Board to ‘power up’. Sandra Husbands would submit a plan for the year to the next meeting of the Board.

  Action: Sandra Husbands

8.6  Raj Radia referred to the importance of having an overview of developments in the health area.

8.7  Dr Alan Rickets considered that the development sessions could see the value of having a strong Health and Wellbeing Board.  The Board would need to prioritise the elements of its responsibilities, focusing on specific areas of work.

9.1  There was no urgent business.

- 25 March 2020

- 08 July 2020 (Provisional) 

- 10 September 2020 (Provisional) 

- 11 November 2020 (Provisional) 

10.1   The Board noted the dates of future meetings:

·  25 March 2020

·  08 July 2020 (Provisional)

·  10 September 2020 (Provisional)

·  11 November 2020 (Provisional