Solomon Agutu (Head of Democratic Services and Scrutiny) took the chair, pending the appointment of the new chair to the statutory Board.

Solomon Agutu requested nominations and explained who was able to participate.

Cllr Adam Kellett proposed Cllr Margaret Mead and was seconded by Cllr George Ayres
As there being no other nominations, Cllr Margaret Mead was duly appointed as Chair.

Solomon Agutu then requested nominations for Vice Chair.

Cllr Adam Kellett proposed Cllr Tim Pollard and was seconded by Cllr Margaret Mead
As there being no other nominations, Cllr Tim Pollard was duly appointed.

There were no disclosures of pecuniary interest at this meeting. The chair explained that, although the legislation means that, once interests have been registered, there is no need to mention them, it is normal practice to raise them under the item at the meeting.

Members of the Board were reminded of the need to register their interests with the Council's monitoring Officer. Reminders would be sent.

After the Chair had explained the purpose of the report, the Board RESOLVED to:
  

1.1 Note the Council has established a Health & Wellbeing Board as a committee of the Council
1.2 Note the decision that the maximum number of members is 28 and only 19 will be voting members, with any additional members above 19 being non-voting
1.3 Appoint a Chair and Vice-Chair (as already covered in items 2 and 3)
1.4 Appoint persons set out in the appendix as members of the Board (see item 7)
1.5 Appoint an Executive Group, consisting of Hannah Miller, Paula Swann, Mike Robinson and a Healthwatch representative (Guy Pile-Grey) (see item 8)
1.6 Note the requirement for disclosures of interest.

As in item 6, resolution 1.4, additional members as listed in the appendix were proposed by Cllr Margaret Mead, seconded by Cllr Maggie Mansell and duly appointed by the Board.

As in item 6, resolution 1.5, the Executive Group was proposed by Cllr Margaret Mead, seconded by Cllr Maggie Mansell and duly appointed by the Board.  It was agreed that Paul Greenhalgh should have been on the appended list and he was duly appointed.

The Board RESOLVED that the minutes of the meeting of the Shadow Health & Wellbeing Board on 13 February 2013 be agreed as an accurate record.

There was no urgent business.

There were no Part B items.

Geraldine O'Shea (Croydon People First) and Mike Corrigan (Joint Commissioning Manager) gave a presentation around the four Learning Disabilities Partnership Priorities for 2103-2014 of lifestyle, college employment & volunteering, Lifespan Planning and speaking Out.

The presentation can be viewed from this link: att1993.pdf

A discussion followed the presentation.

Issues and concerns raised by participants in the discussion included:
Bullying of people with disabilities;
Transition from children's to adult services - is it working?
Elderly care - people with learning disabilities often have long relationship with parents - there is a lack of friendships when outside the 'ring of care'. Being able to use facilities is one way of making friendships, especially in elderly age groups.

There was a question on the different approach to supporting an adult and a child, particularly where disability includes behaviour issues, e.g. autism, and there was a question about employment opportunities and where the LDP was seeking to get support and what the obstacles are that need removing in order to get a more positive response.

In reply it was stated that Croydon does have a strategy. It is a challenging process - wide differences from the broad range of abilities of an autistic person to the lesser ones which those with extreme disabilities have. We are trying to work with families from an earlier age. It is about having a strategy for the needs of people with autism. In reply it was stated that a behaviour challenges team was being developed, to deal with behaviour issues. It will support families and promote confidence and capability. We cannot underestimate the impact on a family when teenagers become robust individuals. It can lead to family breakdown, if there is nowhere for a young person to go. What is adequate funding? We need to use funds better - to add value to people's lives and provide services so people can expand and grow. We need a benchmark for everyone being supported, so we can see progress. It was noted that there is different legislation governing the care of children and the care of adults.

In reply to the question on employment opportunities it was reported that the "Making a Difference Group" was trying to overcome the difficulties in getting apprenticeships. In the current climate, it is doubly difficult for those with disabilities. Payment, rewards, benefits - there is a whole mosaic of issues. The Disability Partnership is aware of the enormous difficulties. Outturn figures for last year for people supported into employment - Croydon ‘held our own', showing a slight increase. There are far more opportunities for people to try voluntary employment, with an expanding range of skills and skills training, with more attention to individuals. Longer term investment is beginning to pay off.

There was a question about whether people with learning disabilities are pushed towards doing courses with no real outcome.
In answer it was stated that it is difficult to get jobs but people still need things to do during the day. We are looking for each placement to be outcome-focused. Placements are not just about care but a wide variety of skills, such as training in getting up, catching a bus etc.

It was also asked how austerity affected the plans - is there adequate funding? What assessment has been done so far to assess outcomes?. After further discussion, the board moved to the next item on the agenda.

Dr Mike Robinson introduced Jenny Hacker (Consultant in Public Health) and David Osborne (Senior Analyst), who gave a brief presentation covering significant aspects of the report. The report was a high level summary of some of the information in the 2012/13 Croydon JSNA Key Dataset, highlighting and discussing both the key good news stories and the major challenges emerging from this comparative analysis. The paper also highlighted some of the emerging challenges facing Croydon

Issues and concerns raised by participants in the discussion included:
Childhood obesity and Immunisation - what is being done about the MMR vaccine for those who missed it 3-5yrs, now their cohort is 10-15?

It was reported that the recommendation is still that we should have 95% of all the population immunised with 2 doses of MMR. However, the chance of a measles outbreak in Croydon is very unlikely in the short term. We are in daily contact with NHS England and Public Health England. Over the next few months the NHS is looking at what can be done. It is high on the agenda. Further, the first two priorities of the recently published Children & Young People's plan include an action plan to address obesity and MMR issues.

We have a moral responsibility as a Board to promote vaccinations - Redesign how services work - Look at care pathways. This is a work in progress. Challenges are higher in Croydon than the rest of the UK but we are keeping an eye on how we progress.

There was a discussion about the care homes support team.  This team has been expanded, using NHS investment in social care monies, to increase input into tissue viability and medication reviews.  A key challenge for the CCG is inappropirate admissions to hospital from care homes.

There was a question about female genital mutilation and what is being done to identify children at risk. It was not an issue the local safeguarding board has considered but it would be taken back. It affects particular groups of communities and is a serious problem in London. We need to connect up - to identify the communities where it is happening. It is difficult getting prosecutions in the UK, although it has been a criminal offence for a long time.

There was a question about oesophageal cancer, which was answered and a question about the management of diabetes in Croydon. Roughly 50% of GPs are doing all 9 NICE tests every year. It should be nearer 90%. It is a particular issue for North Croydon. There would be some answers next week, following a meeting on this. 
 

After further discussion the Board RESOLVED to:

1.1 provide approval for the 2012/13 JSNA Key Dataset (attached), allowing this to be disseminated to stakeholders in a timely fashion.

1.2 note the findings of the summary report (below) accompanying the JSNA Key Dataset (attached) and consider the report, alongside the broader information contained in the Key Dataset, in the refresh of the Health and Wellbeing Strategy.

The British Heart Foundation's Heart Town initiative aims to mobilise communities across Britain, to fight Britain's biggest killer - heart disease. Heart Towns work by bringing communities together through local fundraising and volunteering to help beat heart disease and other circulatory diseases such as stroke. This report seeks support for the establishment of Croydon as a Heart Town. There are currently around 50 Heart Towns across the country and eight in London.

Dr Mike Robinson presented the report and explained that it is an opportunity to bring together and focus on a range of activities to encourage reduction in heart disease.

During discussion it was reported that the London Ambulance Service has raised the issue of spreading understanding of resuscitation techniques. We need to think about how to raise this issue through workplaces and communities and schools.
 

The Board RESOLVED to support the proposal for Croydon to become a Heart Town for an initial period of two years.

No written questions had been received and no members of public wished to ask any.

Steve Morton gave a brief update:

• Forward plan for the coming year
• Long list of topics - for Board members to indicate which ones they support so Executive Group can decide future agendas

The following issues were suggested by Board members for the consideration of the Executive:

• Immunisation
• Asset-based community development
• GPs - more inventiveness
• Fuel poverty - event in July.
• GP access for people on probation.
• Dignity in care following the Francis Enquiry
• Definition of ‘team' - community services - joining up.

The Board RESOLVED to agree the Work Plan.

All future meetings will be held in public, at 2pm in the council chamber, on Wednesdays:
12 June 2013
11 September 2013
23 October 2013
4 December 2013
12 February 2014
26 March 2014