The Chair introduced new members - Vanessa Hosford (Healthwatch Croydon) - replacing Barbara Scott - and Karen Stott (Croydon Voluntary Sector Alliance) - replacing Charles Okech.

The Board RESOLVED that the minutes of the meeting of the Health & Wellbeing Board (Croydon) on 12 February 2014 be agreed as an accurate record.
 

Apologies were received from Cllrs Tim Pollard and Maggie Mansell, John Goulston (Croydon Healthcare Services NHS Trust) - deputised by Karen Breen, Andrew McCoig (Croydon Local Pharmaceutical Committee) - deputised by Beran Patel, Paul Greenhalgh (Executive Director of Children, Families & Learning, LBC) - deputised by Jane Doyle (Director of Community and Support Services), Annette Robson (Croydon College) and Nero Ughwujabo (BME Forum).

There were no disclosures of pecuniary interest at this meeting.

South West London (SWL) Collaborative Commissioning - Five Year Strategic Plan

Paula Swann explained the reason for the urgency in that the SWL has to submit the Strategic Plan in June 2014 and the Health and Wellbeing Board is not meeting again until July 2014. The Board agreed to accept the report as an urgent item.

The presentation sets out a summary of the Strategic Plan, emphasing the need for change. The Board discussed the report and a number of questions were posed, including the location of the proposed Centre of Excellence and the challenge of getting the right mix of skills and numbers for staffing 24/7, in order to meet the London Quality standards.

The Health and Wellbeing Board RESOLVED to note the contents of the report.

There were no exempt items.

Karen Breen (Deputy CEO & Chief Operating Officer, Croydon Health Services NHS Trust), supported by Chris Forster (Director of Estates & Facilities), presented this report. In so doing, they explained that Urgent care is provided through Virgin, not Assura Wandle, as stated in page 12 of the report. The key aspects of the Business Case were presented.

• The existing Emergency Department (ED) was designed in the 1980s and built for capacity of 70,000 patients per year but is now seeing 120,000 patients annually. As a result the department is poorly laid out, fragmented with poor sight lines, and the environment has inadequate ventilation and cramped facilities.
• During visits in July and September 2013, The Care Quality Commission (CQC) raised a number of concerns which this project will address.
• The patient Journey when attending the Emergency Department was described and how the design will enable far better patient experience.

In summary, the Strategic Outline Case (SOC) for the ED Redevelopment was approved in April 2013 by the Trust Development Authority (TDA), The outline case (OBC) will be issued to the TDA in April 2014. The Full Business Case (FBC) will be issued in August 2014. The planned main build start date is October 2014, with anticipated completion December 2015.

The Health and Wellbeing Board RESOLVED, having considered the public sector equality duty and the Joint Health and Wellbeing Strategy, to:

1. note the key objectives addressing the Trust's and CQC's issues as set out in the Outline Business Case (OBC) for the redevelopment of the ED, supports the case for change; and
2. endorse the proposals for redevelopment of the new ED.

Stephen Warren (Director of Commissioning Designate, CCG) presented the report. The Operating Plan sets out the direction of travel for the next two years.  The Plan addresses the significant challenges facing Croydon, particularly delivering care out of hospitals, the emergency service and Mental Health.

The discussion which followed established that this time next year the Board will be asked by NHS England to comment on CCG performance and the comments from the CCG will be based on this Plan. CCG officers stated that they will be reporting to their governing body on progress against the Operating Plan as a matter of course and would be happy to be assessed against it this time next year.
 

The Health & Wellbeing Board RESOLVED to receive and note the CCG operating plan.

This was an information only report presented by Amanda Tuke (Head of Partnerships & Business Development, LBC) and Stephen Warren (Director of Commissioning Designate, CCG). They drew attention to the change that 10 priorities this year compared to 40 last year will make and that the 5 year CCG plan will need to reflect these. 

The Board RESOLVED to receive the information.

Ellen Schwartz (Consultant in Public Health) presented the chapter. The aims of the chapter are:

• to provide overview around Domestic Violence and
• to enable target of services and resources better

The presentation was followed by a discussion, mostly on Female Genital Mutilation (FGM).

Having considered the domestic violence JSNA chapter, the Health and Wellbeing Board RESOLVED to:

1. approve the document in principle and delegate final approval of any further amendments to the responsible directors;
2. note the conclusions from the report.

Bernadette Alves (Consultant in Public Health) gave a summary of the report. The presentation highlighted the high level of ambulance call outs and the fact that most drinking takes place in the home (especially women drinkers).

The presentation was followed by a discussion which covered licensing issues, express stores, binge drinking (mostly young people) versus ordinary drinking and the impact of adult behaviour on children.

The Health and Wellbeing Board RESOLVED to:

1. consider the rapid JSNA alcohol chapter, approve the document in principle and delegate final approval of any further amendments to the responsible directors;
2. note the conclusions and recommendations;
3. endorse the recommendations of the rapid Alcohol JSNA.

Stephen Warren (Director of Commissioning Designate, CCG) and Jane Doyle (Director of Community and Support Services) gave a summary of the report. They reported a real urgency to drive this work forward and the need for a separate strategy on the health of LAC, which would include their emotional needs. 

The Health and Wellbeing Board RESOLVED to note the contents of the report and attached strategy Appendix 1  and to agree the action plan for 2014.

 Anne Milstead asked for clarification on her previously asked and unanswered questions:

1. What safeguards are there for the users of those services like care in the home under zero hours contracts?
2. What safeguards are there for whistleblowers when things start to go wrong when services are run by third parties?
3. Is there a place for public scrutiny and input of the procurement process BEFORE implementation?

For 1 & 2, what are the 'very stringent procedures' mentioned in the answer? Who does the monitoring? How do they do it?

A detailed verbal response was given at the meeting.

Appendix P&V was an attachment with the previous minutes and is attached again.
 

Steve Morton drew attention to specific points in the report.  (The Performance Report will be reviewed quarterly.)

The following issue was raised:

• CCG performance assessment should be added in

The Health and Wellbeing Board RESOLVED to agree proposed changes to the board work plan set out at paragraph 3.3 and to note risks identified at appendix 3.

Steve Morton explained that comments can be made on the PNA Needs Assessment when it comes back to the Board at a later date.

The next meeting of the Health and Wellbeing Board will be at 2pm on Wednesday 16 July in the Conference Suite in Bernard Weatherill House.