Agenda, decisions and minutes

1.1  The Chair welcomed all those present to the meeting.

To appoint the following new members to the Health and Wellbeing Board:

·  Paul Senior (Interim Director of Education)

·  Mary Clarke (Director of Nursing and Corporate Development at the GP Confederation

2.1   The Chair noted that Annie Gammon and Laura Sharpe would no longer be members of the Board due to their retirements and thanked them for their work on the Board, with particular thanks to Laura Sharpe for her work during the COVID-19 Pandemic.

RESOLVED:

That Mary Clarke of City and Hackney’s GP Confederation and Paul Senior (Interim Director of Education - Hackney Council be appointed as members of the Health and Wellbeing Board.

3.1  Apologies for absence were submitted on behalf of Stephen Haynes,Raj

Radia and Paul Senior. 

4.1  There were no apologies for absence.

RESOLVED:

To agree the minutes of the previous meeting as a correct record.

RESOLVED:

To agree the minutes of the previous meeting as a correct record.

RESOLVED:

To note the updates on the Actions Tracker.

RESOLVED:

To note the updates on the Actions Tracker.

RESOLVED:

To note the report.

7.1  Sally Beaven introduced the report capturing how local people were

experiencing the Cost of Living Crisis. It was known that the health and mental the wellbeing of people across the country was suffering as the cost of living rose. Sally Beaven highlighted the following:

·  56 local residents had been consulted;

·  Most respondents were over the age of 60;

·  Large numbers reported being less able to make additional purchases or buy essentials, having to decide between food, gas and electricity;

·  Household bills were rising without consequent increases in income and benefits;

·  Significant consequent impact on wellbeing and mental health;

·  Requests were made for advice on debt, energy efficiency, home budgeting, meals on wheels, help to insulate, 

·  A large number of individuals were not aware of what was available to them in the community.

7.2  Councillor Fagana-Thomas stressed the need to focus on those on low

incomes and helping people who are facing challenges to build resilience in terms of their mental health.

7.3  Susan Masters thanked those involved in the preparation of the report She told the Board that the Community and Voluntary Sector was carrying out similar work looking at the impact of increases in costs on the Community and Voluntary Sector. She suggested the submission of a paper to the Board on this in January 2022 to include on building resilience, considering solutions and training for other voluntary sector organisations. Susan Masters asked if any of the feedback received had been surprising.

  Action: Susan Masters

7.4  Councillor Kennedy asked for clarification on whether this type of work was being carried out in other areas and whether these could be coordinated to assist in identifying any particular issues in Hackney.

7.5  Rosemary Jawara highlighted that the current crisis was impacting on

relationships within households, particularly people with mental health issues. She continued that the crisis was impacting the most vulnerable, with consequent changes to diets and routines and growing anxiety. There would be a need to support this  in an environment of stretched resources. 

7.6  Mayor Glanville asked whether the demographic of the cohort consulted

was known and whether they were well known to Healthwatch. He stressed the importance of using trusted partners to put out messages and assist Healthwatch in this regard. He asked if the Board could assist the process in shaping questions to ensure that when the matter is returned to the Council any gaps are filled in. Mayor Glanville considered that those individuals with long term conditions on the edge of care would require exploration in particular in relation to those on fixed incomes. He referred to the need to track those vulnerable individuals moving between different health care settings.

7.7  Sally Beaven highlighted that:

·  That those consulted varied from those already known by Healthwatch to others who were reached through outreach work with opportunities to establish networks to be used for messaging and signposting;

·  That consideration would be given to a focus on resilience;

·  Healthwatch had been surprised by the large numbers  ...  view the full minutes text for item 7.

RESOLVED:

To note the report, in particular the development of a system wide plan and governance, which the Council isworking closely with the Director of delivery – City and Hackney Place BasedPartnership to establish.

8.1  The Head of Policy and Strategic Delivery introduced the report setting out the response that the Council had developed to respond to the Cost of Living crisis, which was seeing already high levels of poverty becoming even more entrenched. The report was submitted to the Board to ensure that the opportunities to work across the system to support residents were maximised. The Board was asked to consider, in particular the development of a system wide plan and governance, which the Council was working closely with the Director of Delivery – City and Hackney Place Based Partnership to establish.

8.2  The Head of Policy and Strategic Delivery highlighted the following:

·  There was a need to bear in mind the drivers of poverty such as wage entrenchment, good quality employment and housing cost;

·  The necessity to make the case for a benefits system that works;

·  That any response should take into account material needs, ensuring a preventative approach;

·  There was need to consider our ways of working, involving the Voluntary and Community Sector in delivery, building relationships and identifying vulnerable people; 

·  There was a need for collaborative work across the system in regard to progressing the work of the Poverty Reduction Framework;

·  Residents often had multiple needs;

·  Strong political leadership existed in regard to the Cost of Living Crisis and poverty reduction;

·  The focus of the report was to consider what can be put in place to meet people’s needs;

·  There was a need to consider the community impact of the crisis;

·  Staff needs and service viability required consideration;

·  The need to consider ways of working with the health and care partnership;

·  A system-wide group was in place to consider the Cost of Living Crisis and Poverty Reduction;

·  There was a need to consider interactions with the Health and Wellbeing Board, with the possibility of situating the framework within its area of responsibility;

·  The provision of advice on energy efficiency was an important element;

·  How long term health conditions interact with poverty;

·  Thanks for the work carried out by Healthwatch Hackney in regard to the Cost of Living crisis;

8.3  Mayor Glanville highlighted the following:

·  the need to distinguish between Council governance and the System’s governance. The Board had an inequalities focus with consideration also being given to long term poverty reduction; 

·  Would direct accountability for this work fall within the System group?

·  Discussion was ongoing with the Voluntary and Community Sector about volunteering and learning from the lessons of COVID-19 Champions, building these into the cost of living crisis response;

·  That the current arrangements for the provision of energy advice was not adequate and that there was a need to explore this area; 

·  Thanks to the health partnership for its investment in the response.

8.4  Deputy Mayor Bramble thanked all those involved in the preparation of the report. She stressed the need to ensure that the principles of this work sit within the poverty framework. She highlighted that some residents may find it difficult to seek help and that this  ...  view the full minutes text for item 8.

RESOLVED:

·  To note that the Council has developed a Strategic Plan that will be taken to Cabinet for adoption this month;

·  To note the key issues that the plan is seeking to address which are set out in the report.

9.1  The Head  of Policy and Strategic Delivery introduced the report. Hackney Council adopted a corporate plan in 2018 which set out borough and corporate challenges. This was refreshed in the light of the pandemic with a direction of travel for the plan agreed in July 2020. The plan identified the direction of travel for new ways of working, learning from work that had been accelerated during the pandemic. With new corporate leadership and a new political administration elected in May 2022, a new Strategic Plan has been developed. The move to describe this as a “Strategic Plan” rather than a “Corporate Plan” is reflective of the outward facing nature of the plan, which considers the role of the Council within a wider partnership.

9.2  The Head of Policy and Strategic Delivery highlighted:

·  The emphasis on the wider framework of partnership working;

·  The Plan contained the key policy commitment for the coming 4 years, reporting on a yearly basis to ensure stakeholder accountability;

·  The emphasis was to work with existing statutory Boards on cross cutting issues;

·  There was a need for increased working in localities with neighbourhood work and a place based approach;

·  The entire plan needed to be seen as supporting health and wellbeing and priorities for tackling the wider determinants of health;

·  The Health and Wellbeing Board involvement could include around the drivers of poor mental health, social connecting opportunities, financial security, impact of impact on in work poverty, drivers of serious violence, climate change, etc.

9.3  Mayor Glanville referred to the possibility of an enhanced role for the Board in particular around shared areas of responsibility. He emphasised that the Health and the Wellbeing Strategy was reflected in the Strategic Plan with an increased emphasis on working with existing Boards across the system. He re-emphasied the need to focus on mental health, financial security and social connection and the challenges involved given the budgetary work that was currently underway. It was necessary to recognise the dangers of retrenchment under financial pressure with partnership work sometimes suffering such as around reducing social isolation. 

9.4  The Director of Public Health stated that she welcomed the opportunity to take health and wellbeing into the community strategy and make a firm connection between the health and wellbeing strategy and the community strategy with an offer of support from the public health team in developing this during the strategy refresh. 

9.5  The Director of Delivery, City and Hackney’s Place Based Partnership thanked all those involved in the engagement with wider partners on the Strategic Plan. She stressed the need for strong links between the Strategic Plan and the Health and Wellbeing Strategy, together with the City and Hackney Integrated Care Board, given the overlap in ambitions. 

9.6  The Chief Executive of the North East London Foundation Trust welcomed the potential for joining up of corporate responsibilities in terms of community cohesion.

9.7  The Head of Policy and Strategic Delivery highlighted:

·  That the Strategic Delivery Team was involved in the next steps  ...  view the full minutes text for item 9.

RESOLVED:

To note the report

11.1  Dr Adi Cooper, Chair of the Safeguarding Adults Board introduced the report. She referred to the fact that it had been a challenging year and thanked partners for sustaining their responsibility to safeguard adults in hackney. Dr Adi Cooper highlighted the following:

·  There had been a significant increase in reporting around self neglect

·  related to the impact of COVID-19 and the Cost of Living Crisis;

·  Advocacy had been commissioned to ascertain resident experience;

·  3 adult safety reviews had been carried out; learning from these was

·  important in terms of development and improvement;

·  Work was being carried out around fire safety;

·  There were challenges around fuel poverty going forward;

·  There continued to be challenges in the delivery of adult and social care;

·  The future of adult safeguarding would be challenging given issues

·  around the cost of living crisis, austerity and workforce issues, etc;

11.2   Councillor Kennedy thanked Dr Adi Cooper and Raynor Griffiths for their work in this area. Raynor would be leaving the service after years of good service. He told the Health and Wellbeing Board of the good work of the Safeguarding Board on anti-social behaviour and housing and how this intersects with adult safeguarding.

11.3  Mayor Glanville thanked Dr Adi Cooper and the Safeguarding Board for its work.

RESOLVED:

To note the report

RESOLVED:

To note the report

12.1   The Lead Commissioner (Hackney Council) introduced the report. Members are asked to: consider, discuss and comment on the proposed approach to develop the North East London Integrated Care Strategy, comment on, and shape the development and content of the strategy. The Lead Commissioner Hackney had recently refreshed its strategy, based on extensive engagement with local residents.

12.2  The Lead Commissioner highlighted priorities:

·  The delivery of the Integrated City and Hackney Integrated Delivery Plan;

·  To help reduce health inequalities;

·  To support the big ticket items for the partnership transformation programme;

·  To continue to support the neighbourhood work and the hospital discharge.

12.3  Mayor Glanville expressed concern at the dependence on this funding

mechanism. Councillor Kennedy expressed concern at being dependent on one off funding to enable delivery across the system. He considered that there would be a better use of resources and the ability for improved planning if funding arrangements were known well in advance. 

RESOLVED:

·  To note the report

RESOLVED:

·  That the Health & Wellbeing Board note and endorse the national planning requirements and the Plan for Hackney for 2022/23.

·  That the Health & Wellbeing Board note that the BCF Plan will benefit

  residents by continuing to fund:

·  Effective Hospital Discharge including temporary accommodation;

·  Homeless Pathway to support hospital discharge;

·  Support to Carers;

·  Disables Facilities Grant to support.

12.1   The Lead Commissioner (Hackney Council) introduced the report. Members were asked to: consider, discuss and comment on the proposed approach to develop the North East London Integrated Care Strategy, comment on, and shape the development and content of the strategy. The Lead Commissioner Hackney had recently refreshed its strategy, based on extensive engagement with local residents.

12.2  The Lead Commissioner highlighted priorities:

·  The delivery of the Integrated City and Hackney Integrated Delivery Plan;

·  To help reduce health inequalities;

·  To support the big ticket items for the partnership transformation programme;

·  To continue to support the neighbourhood work and the hospital discharge.

12.3  Mayor Glanville expressed concern at the dependence on this funding

mechanism. Councillor Kennedy expressed concern at being dependent on one off funding to enable delivery across the system. He considered that there would be a better use of resources and the ability for improved planning if funding arrangements were known well in advance. 

RESOLVED:

·  To note and endorse the national planning requirements and the Plan for Hackney for 2022/23.

·  That the Health & Wellbeing Board note that the BCF Plan will benefit residents by continuing to fund:

-  Effective Hospital Discharge including temporary accommodation

-  Homeless Pathway to support hospital discharge

-  Support to Carers

-  Disables Facilities Grant to support adaptations for residents

-  Increase costs to care packages

RESOLVED:

·  To note and endorse the national planning requirements and the Plan for Hackney for 2022/23.

·  To note that the BCF Plan will benefit residents by continuing to fund:

·  Effective Hospital Discharge including temporary accommodation;

·  Homeless Pathway to support hospital discharge;

·  Support to Carers;

·  Disables Facilities Grant to support.

RESOLVED:

To note the report

13.1  The Director of Strategic Development, East London, highlighted the following:

There was a focus across North East London on health and inequalities, greater financial wellbeing for the population and employment;

The 4 systems priorities were:

Babies, children and young people;

Long term conditions;

Workforce and employment;

Mental Health.

The importance of social connectedness with a growth in social isolation. Workshops were being run;

There was a current focus on tackling the Cost of Living Crisis, financial sustainability and workforce using the collective voice to influence;

Increased focus on prevention with an integrated focus.

13.2  Mayor Glanville highlighted the following:

That both the Joint Strategic Needs Assessment and the Health and Wellbeing Strategy were always evolving with the need for the interactive work to continue;

The need to reduce inequalities in outcomes under the 4 systems priorities;

The need to improve the overall performance of the system including around access;

Hackney Council had made some clear positions around conditions such as  Sickle Cell and HIV. A long COVID-19 motion had recently been passed to ensure that this was fully recognised as a long term condition;

The need to reducing inequality in work around Mental Health;

The importance of the community and co-production together with resourcing the Community and Voluntary Sector in a sustainable way to ensure effective delivery;

The challenges facing the NHS were recognised but in focusing entirely on financial difficulties there was the chance of losing opportunities around prevention.

13.5  The Group Director for Adults, Health Integration and Public Health welcomed

the report, stressing the importance of a place based strategy feeding into the work of the Integrated Care System/ Integrated Care Board. Hackney Council had a coherent strategy linking to the other Council Strategies, preventing overlap. There was engagement with the place based strategy to ensure that there was a bottom up approach.

13.6   The Director of Public Health stressed that some conditions affected particular

communities. She considered that the Strategy should relate to people with long term conditions, providing examples of these. She emphasised the need to recognise the entire workforce, incorporating the needs and views of the Community and Voluntary Sector into the  Workforce Strategy for the health and care system in addition to employment and strategy. 

13.6  The Director of Nursing and Corporate Development at the GP Confederation

stressed the importance of having a Workforce Strategy across health and

social care, including community and voluntary organisations in this. She

considered that equalities and diversity should be considered in relation to Workforce and Employment. In addition to the system’s priorities there was a need to be aware of the priorities from NHS ENgland, the Department of Health and Social Care and Health Education England, dovetailing these into work programmes to meet all priorities.

13.7  Susan Masters considered that were currently a gap in the North East London

Workforce in relation to the Community and Voluntary Sector. Further, those

working in the voluntary sector were paid less than those in other sectors. This issue had  ...  view the full minutes text for item 13.