Solomon Agutu, Head of Democratic Services and Scrutiny, took the chair for this item and asked for proposers and seconders for Chair and Vice-Chair, who were duly elected as follows:

Chair: Councillor Maggie Mansell - proposed by Councillor Louisa Woodley and seconded by Hannah Miller

Vice-Chair: Councillor Margaret Mead - proposed by Councillor Yvette Hopley and seconded by Councillor Maggie Mansell.

The Board RESOLVED that the minutes of the meeting of the Health & Wellbeing Board (Croydon) on 26 March 2014 be agreed as an accurate record.

Apologies were received from Dr Agnelo Fernandes, Councillor Alisa Flemming, John Goulston, Paul Greenhalgh, Vanessa Hosford, Mark Justice, David Lindridge, Andrew McCoig, Councillor Margaret Mead, Steve Phaure and Karen Stott.

There were no disclosures of pecuniary interest at this meeting.

Reform of services for children who will be subject to education, care and health plans

It was agreed this would be considered after item 12. 

The reason for urgency: the Children and Families Act 2014 becomes enacted in September, before the next meeting of the Board, and this aims to provide assurance to the partnership of our collective readiness to being implementation of the significant reforms relating to SEN.

Jane Doyle, Director of Community & Support Services, introduced the briefing note.

Linda Wright, Head of Inclusion, Learning Access and SEN, gave a brief explanation.

The Board NOTED the briefing note.

There were no exempt items.

Dr Mike Robinson introduced the report and explained that the director of public health’s annual report normally focuses on a particular theme. This year's report focused on the New Addington & Fieldway community. Dr Robinson reported that this is a deprived area and suffers from significant health challenges. The report, however, takes an asset based approach and examines local assets and the ways in which the local community and its people are working to improve their health. A discussion followed. It was pointed out that by focusing only on the positive an opportunity may have been missed to identify needs. There was also a request for more comparative data on the health of the local population in order to inform service provision. Dr Robinson said that his team could make this information and also made the suggestion that an update report be produced in a year's time, alongside the next Annual Report.

The Board RESOLVED to endorse the Annual Public Health Report for 2014, having considered the public sector equality duty and the Joint Health and Wellbeing Strategy.

Michelle Rahman, Interim Director of Quality and Governance, Croydon CCG, gave a Powerpoint presentation (attached).

A discussion followed on the issue of how to raise awareness of pressure ulcers in the community, in order to prevent them occurring, as well as treating those which still occur.

The Board RESOLVED to extend the work initiated by Croydon Health Services, by leading public awareness campaigns with the public, patients and carers, including galvanising the support of voluntary sector organisations to assist in the focus of reducing the risk of pressure ulcers developing at home.

The Board recommended that a task and finish group be set up following the stakeholder event in August.

Anna Kitt, Health Improvement Principal, Public Health Croydon, and Sarah Nicholls, Consultant in Public Health, highlighted the main points of the report.

There was a discussion including a question on how the proliferation of fast food outlets could be addressed. Dr Mike Robinson stressed that the Croydon Heart Town project includes an 'Eat Well' project, which will encourage fast food businesses to offer healthier choices.

The Board RESOLVED to:

1. approve the document in principle and delegate final approval of any further amendments to the responsible directors;
2. endorse the recommendations of the rapid Healthy Weight JSNA.

Jenny Hacker, Consultant in Public Health, gave a brief summary of the report.

The Board RESOLVED to agree to needs assessments taking place, a part of the annual JSNA cycle, on the following in 2014-15:

• Service provision for the over 65s
• Respiratory illness, children and young people
• Maternal health

Paula Swann introduced the report.  Stephen Warren, Director of Commissioning Designate for Croydon Clinnical Commissioning Group, and Brenda Scanlan, Director of Adult Care Commissioning, Croydon Council, summarised the highlights of the report.

The Board DISCUSSED and COMMENTED on the report, making the following points:

• Need for mental health services to work differently with Primary Care
• Intervention strategy needed to ensure patients continue with their medication
• Vital to work more closely with primary care, including pharmacies
• GP infrastructure needs to include having a mental health specialist in each cluster
• GP training in mental health issues crucial to the development of the strategy

The Strategy document can be downloaded from the Council website here: http://www.croydon.gov.uk/contents/departments/healthsocial/pdf/815523/imh-strategy-adults

Dwynwen Stepien, Head of Early Intervention Support Service, Children, Families & Learning (Croydon Council) and Tina Hickson, Associate Director Nursing Family Services (Croydon Health Services NHS Trust), gave a presentation to illustrate the main points of the report.

Dr Mike Robinson recommended that the development of this initiative should be brought back to the Board, to look at it further in relation to the review and refresh of the joint health and wellbeing strategy later in the year.

It was noted by the CCG that the paper had inadvertently included maternity services which were outside of the scope of the delivery model review.

The Board RESOLVED to recommend that consultation and engagement on the development of a new integrated delivery model of services to children under five and their parents be designed around the needs of families, to ensure a more effective service delivery.

Anne Milstead asked a question regarding public consultation:

"The NHS Constitution quite clearly states that, " the NHS belongs to us all" and in the document, Transforming Participation in Health and Care, by NHS England, it says, under s. 14Z2 of the Health and Social Care Act 2012:

Public Involvement and Consultation by Clinical Commissioning Groups - Legal Duties for Clinical Commissioning Groups and NHS England - "the Clinical Commissioning Group must make arrangements to secure that individuals to whom the services are being or may be provided are involved in the planning of the commissioning arrangements by the group

a) in the development and consideration or proposals by the group for changes in the commissioning arrangements where the implementation of the proposals would have an impact on the manner in which the services are delivered to the individuals, or the range of services available to them and
b) in decisions of the group affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact
c) in decisions of the group affecting the operation of the commissioning arrangements where the implementation of the decisions would (if made) have such an impact

My question is:

Exactly with which patients and public did the CCG "make arrangements to secure that individuals to whom the services are being or may be provided are involved" when they made the first decision to downgrade the services and reduce the hours in New Addington and Purley Hospital before they made the announcement at the CCG Board meeting in May, 2013?"

As this was an operational question, Paula Swann agreed to have the information circulated, as agreed at the CCG Board meeting, when the same question was asked.  The information is below:

"A written question was received from Anne Milstead who asked why the CCG had not taken action on legible, large-lettered, easy to read from the footpath, signs about new opening hours outside New Addington and Purley. There was a sign outside Edridge Road and there was a large banner advertising for new patients outside Parchmore, so why was there no signage outside New Addington and Purley? In addition exactly which group of patients and public did the CCG consult and engage with before the CCG took the decision to reduce the hours bearing in mind that this was first announced, without notice, in May 2013?

Stephen Warren responded that as part of the CCG's wider communication plan about the minor injuries unit at Purley and Parkway it had pressed for improvement to signage at both sites. Although some progress had been made the CCG had asked for additional options to be explored including large signs and banners outside each site The CCG was currently working with the service providers, site owners and NHS Property Services to find a suitable solution.

With regard to engagement, the changes had been discussed at the CCG Governing Body meetings in public on a number of occasions with final agreement being given on 24 September 2013. The proposals and local clinical support from GPs, who had discussed them at the Croydon GP clinical networks, were supportive of the need to change the current service model and had been involved in the development of the new service specification. Discussions had been held with the Purley and Woodcote Residents Association (PWRA) in September 2013 and an offer was made to provide a briefing to the full Executive Committee of the PWRA if required, however, no concerns, feedback or representations were received. Briefings were also provided to all local councillors, Croydon MPs, the Overview and Scrutiny Committee, Health & Wellbeing Chair, Croydon Voluntary Action (CVA), Healthwatch, Croydon Neighbourhood Care Association, the Croydon BME Forum and Diabetes UK, with an offer of follow up meetings to discuss the proposals in detail if required but no concerns feedback or representations were received. The CCG confirmed that it would review the service regularly and would be involving the residents' associations as part of the review of these changes to share findings and obtain feedback."
 

Steve Morton drew attention to specific points in the report.

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.
 

CCG Response to a request to update the Croydon Health and Wellbeing Board on the Joint SWL Collaborative Commissioning 5 Year Strategy

Paula Swann requested any comments to be emailed to her and, if necessary, an update will be given at the next meeting.
The report was noted.

The next meeting of the Health and Wellbeing Board will be on Thursday 11 September in the Council Chamber, Croydon Town Hall. The start time in the afternoon will be announced later.