The Board RESOLVED that the minutes of the meeting of the Health & Wellbeing Board (Croydon) on 11 September 2014 be agreed as an accurate record.

Regarding Minute A49/14, Given the issues raised about GPs and pharmacists making child protection referrals at the previous meeting, a letter has been sent out to all GPs and pharmacists clarifying these issues.

Apologies were received from Mark Justice (Stuart Routledge deputising) and Steve Davidson and, for lateness, Cllr Alisa Flemming and Dr Mike Robinson.

There were no disclosures of a pecuniary interest not already registered.

There was no urgent business.

There were no exempt items.

Dr Jane Fryer elaborated on the attached presentations.

• 90% of consultations happen in GP surgeries and pharmacies but only 7-8% of budget is spent in those areas.
• Need to strengthen and transform primary care.
• Many recommendations regarding primary care are in Mayor of London's report on health this week.
• South London areas piloting approach of making access to primary care 24 hours a day.
• Need to work together with CCGs so commissioning for primary care will be much more local.
• Way to deliver care will be vary from borough to borough.

Paula Swann explained the role of the CCG in relation to General Practice:

• Commissioner of specific local services outside of the standard contract
• Quality improvement in General Practice
• Quality improvement - Primary Care variation
• Additionally, the CCG now had an opportunity to explore co-commissioning of Primary Care. To avoid conflict of interests this was being explored across NHS England.

Issues raised:

• How do we make primary care a more attractive career?
• How do we keep GPs in London - how many short are we?
• Seen quality improvements in supporting change for patients. 
• Challenges - created more work for primary care but logical solution. 
• Funding gap getting wider. 
• Here and now is burning platform for Croydon. 
• How do we deliver services with reduced funding?
• Co-location of services would make being a GP more attractive/interesting.
• How can we encourage GP practices to work together in the community? 
• Co-commissioning - interface between primary care and care - does the model recognise the whole system?
• Challenges in designing commissioning system - matching services to areas in an integrated way.  A committee is being formed around how to commission primary care.

The Board NOTED the content of the presentations.

David Osborne (Senior Public Health Information Analyst) gave a presentation to explain the report.

Issues raised:

• Concern that there are still people who are unsure about MMR and other immunisations.
• Public Health is aware of the low uptake of IAPT (Improving Access to Psychological Therapies).
• Need to pick a smaller number of main issues which do not have strategies in place, to address them for the next HWB Strategy.
• Diabetes identification.

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

• Provide approval for the 2014/15 JSNA Key Dataset, allowing this to be disseminated to stakeholders in a timely fashion.
• Note the findings highlighted by this report, and consider the report alongside the broader information included in the Key Dataset, in the refresh of the Joint Health and Wellbeing Strategy.
• Use the findings from the Key Dataset in their ongoing work to oversee health and wellbeing in Croydon.

Paula Swann (Chief Officer of Croydon's Clinical Commissioning Group) introduced the report.

Stephen Warren (Director of Commissioning Designate) gave a presentation, including an illustrative video entitled 'Sam's Story' - available online: http://www.kingsfund.org.uk/audio-video/joined-care-sams-story

• Looking at integrated solutions for care for the over 65s
• Gone through initial stages - identified funding - in the design stage
• Will need sign off from Council and CCG
• Next stage - commissioner funding and vehicle and provider contracting
• Aim to have contract in place by April 2016

Issues raised:

• Duplication is an irritation
• Residents welcome being able to stay in their own homes
• Communication between the carers and services crucial
• Will secondary care choice be reduced?

The Board NOTED the report.

Alan Hiscutt (Head of Integrated Commissioning - Working Age Adults & Contracts Support Services) gave a summary of the Partnership Groups report on Adults with learning disabilities:

• Croydon had the best results in London
• Winterbourne Review - implications for Croydon: there were only 2 people who were reported on in Panorama programme and clear plans are in place for the future of these 2 individuals

Steve Morton (Head of Wellbeing) summarised the Partnership Groups Summary report:

• All but one of the partnership groups is now reporting every 6 months
• Need to ensure connection with Health & Wellbeing Strategy
• Structure need clarifying for how partnership groups report into the Board
• Partnership groups are delivering the work of the Board

The Board NOTED the reports.

A member of the public raised the issue of deprivation of liberty which is a huge issue nationally. Councils all over the country have been addressing the issue without any increase in funding. Hannah Miller suggested raising a paper on the topic to be brought to a future Health & Wellbeing Board meeting. (See Appendix)

Steve Morton asked for comments on the reports:

• Highest rated risk is around financial constraints

Issue raised:

• Croydon has permission to have a deficit in the CCG

The Board NOTED the report.

The report was circulated with the agenda.

All Wednesdays in the Council Chamber in the Town Hall:
10 December 2014
11 February 2015
25 March 2015