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Health & Wellbeing Board
Wednesday, 10th December, 2014

Health & Well-Being Board (Croydon) Minutes

Date:
Wednesday 10th December 2014
Time:
2:00pm
Place:
The Council Chamber, The Town Hall, Katharine Street, Croydon CR0 1NX
 

Attendance Details

Present:

Elected members of the council:

Councillors Alisa FLEMMING, Maggie MANSELL (Chair), Margaret MEAD (Vice-Chair), Louisa WOODLEY

 

Officers of the council:

Paul GREENHALGH (Executive Director of Children, Families & Learning)

Hannah MILLER (Executive Director of Adult Services, Health & Housing)

Dr Mike Robinson (Director of public health)
 

NHS commissioners:

Paula SWANN (NHS Croydon Clinical Commissioning Group)

 

Healthwatch Croydon

Vanessa HOSFORD (Healthwatch Croydon)
 

NHS service providers:

Steve DAVIDSON (South London & Maudsley NHS Foundation Trust)

John GOULSTON (Croydon Health Services NHS Trust)
 

Representing voluntary sector service providers:

Kim BENNETT (Croydon Voluntary Sector Alliance)

Nero UGHWUJABO (Croydon BME)

 

Representing patients, the public and users of health and care services:

Stuart ROUTLEDGE (Croydon Charity Services Delivery Group)

Karen STOTT (Croydon Voluntary Sector Alliance)

 

Non-voting members:

Not represented

Also present:
Councillor Andrew Rendle
Absent:
Councillor Yvette Hopley, Dr Agnelo Fernandes (CCG), Dr Jane Fryer (NHS England), Mark Justice (Croydon Charity Services Delivery Group), David Lindridge (London Fire Brigade), Lissa Moore (London Probation Trust), Steve Phaure (Croydon Voluntary Action), Ashtaq Arain (Faiths together in Croydon), Marie T Brown (Croydon College), Adam Kerr (National Probation Service (London)) and Andrew McCoig (Croydon Local Pharmaceutical Committee)
Apologies for absence:
Councillor Yvette Hopley, Dr Agnelo Fernandes, Dr Jane Fryer, Mark Justice, David Lindridge and Lissa Moore and (for lateness) Hannah Miller.

Item Item/Resolution
MINUTES - PART A
A68/14 MINUTES OF THE MEETING HELD ON WEDNESDAY 22ND OCTOBER 2014

The Board RESOLVED that the minutes of the meeting of the Health & Wellbeing Board (Croydon) on 22 October 2014 be agreed as an accurate record.

A69/14 APOLOGIES FOR ABSENCE

Apologies were received from Councillor Yvette Hopley, Dr Agnelo Fernandes (CCG), Dr Jane Fryer (NHS England), Mark Justice, David Lindridge (London Fire Brigade) and Lissa Moore (London Probation Trust) and (for lateness) Hannah Miller.

A70/14 DISCLOSURE OF INTEREST

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

A71/14 URGENT BUSINESS (IF ANY)

There was no urgent business.

A72/14 EXEMPT ITEMS

There were no exempt items.

A73/14 COMMISSIONING INTENTIONS 2015/16

Stephen Warren and Brenda Scanlan highlighted the main points of the report: 

  • The report set out the high level commissioning intentions for Croydon Council, Croydon Clinical commissioning Group and NHS England for the health and wellbeing board to comment on their alignment with the priorities identified in the joint health and wellbeing strategy 2013-18, as informed by the joint strategic needs assessment (JSNA). Detailed intentions are in the appendices.
  • The aim of commissioning is to ensure that people's identified needs are addressed within the resources available; that commissioners commission the appropriate services to meet local needs; and that the right services are in place in order to improve health and to reduce health inequalities. Commissioning can be undertaken across a range of geographical areas depending on the nature and scale of the needs and services required. This can be at a national level for some highly specialised services, regionally and locally (for example, at borough or sub-borough level).

 

Issues raised were:

  • Priorities have arisen from strategies developed over the last few years
  • 23 December - further planning guidance on national priorities
  • Local Authority and CCG priorities - working together
  • Effective commissioning services are about providing more services in Primary Care and enhancing the work of GPs
  • More clinics in the community for rapid access and a focus on Primary Care - including echo-cardiogram testing at GPs
  • Redesigning mental health services in Croydon - clear about role of voluntary sector
  • Multi-pronged approach to tackle issues affecting mental health, including helping people to manage debt and housing situations
  • Asset based community services programme with funds for grants
  • Explanation of tiers:
    • Tier 1 - interventions any professional expected to make to support SEND child;
    • Tier 2 - CAMHS services;
    • Tier 3-4 - more specialist provision
  • Need to ensure child poverty is prioritised
  • Importance of reduction in temporary accommodation for families
  • With reduction in capacity and the introduction of new services, is there any loss of access?
  • Urgent Care Centres - concern about people being unaware of these services - better signage and explanation needed
  • Need to ensure enough support for nursing homes. Work around rapid response service
  • Has deprivation of liberty led to more people falling through the gaps?
  • Additional workload for GPs needs training to ensure quality of service
  • Importance of listening to carers - additional support needed
  • Diabetes and end of life care - how will self-management and prevention be managed? 
  • Early intervention - are there any plans to put support services into communities to make access easier?
  • Concerns about over-medication
  • Mental health in BME communities - concerns about how services relate to certain groups of people - Lambeth have a commission on the issue
  • Resolution of housing issues to prevent people becoming unwell
  • Access to GPs
  • Difficulties in encouraging more consultants to specialise in Paediatrics
  • London quality standards on Maternity over next 5 years - would need strategic change to provide maternity standards required to get 24/7 cover on maternity wards
  • Transition from CAMHS to adult services difficult - important to have pathway
  • Need to provide enhanced digital offer and more information for residents, particularly regarding cancer diagnosis
  • Would be useful to have list of services and who is responsible for commissioning which (see attached) (PAULA SWANN TO PROVIDE)

 

The Board RESOLVED to note the report.

A74/14 HEALTH PROTECTION UPDATE

Dr Mike Robinson introduced Miranda Mindlin (Public Health England) who gave a summary of the report:

  • Following a previous update by the Director of the SW London Health Protection, the Health & Wellbeing Board requested annual updates on local Health Protection issues.

Miranda Mindlin explained how SW London team is structured and the work they cover:

  • 24 hour service
  • Gastroenteritis and food safety are major parts of work
  • Work on tuberculosis with partners in local hospitals
  • Work with pollution team
  • Flooding - provided support to Gold Command
  • Immunisation - provide technical advice to colleagues in Primary Care
  • Migration and infectious diseases
  • Contribute to national work - such as Ebola issue

 

Issues raised were:

  • Childhood infections - are we achieving better coverage with immunisations?
  • Scrutiny has been looking at immunisation. Local Authorities are responsible for accounting for immunisation targets. We want to know if Croydon up to standard. (NHS England will be called back to Scrutiny - they apologised for being unable to attend yesterday)
  • It would be useful to provide a list of the responsibilities of the Health Protection system. (see attached) (MIKE ROBINSON TO PROVIDE)
     

The Department of Health has suggested that Local Authorities may wish to form a Health Protection Forum to assist the Director of Public Health in providing assurance. The Committee agreed this should come back to a future meeting with a firm proposal. Currently the Director of Public Health relies on information from health colleagues. The Health Protection Forum would be accountable to the Health & Wellbeing Board.

 

The Board RESOLVED to note the report and to support the recommendation to set up a Health Protection Forum.

A75/14 CROYDON FOOD FLAGSHIP

Dr Mike Robinson introduced the report and John Currie attended to respond to questions:

  • Obesity is an increasing problem in Croydon. The causes are multi-factorial and include greater consumption of processed food, more sedentary lifestyles in both adults and children, and changes in employment and family norms. Obesity rates in Croydon children and adults are higher than the London average.
  • The national School Food Plan was published in 2013, with a recommendation that two London Boroughs be established as Food Flagship Pilots, with schools being the catalyst for change in a whole system transformation of the food landscape.
  • The high level outcomes for the food flagship which have been specified by the London Food Board are:
    1. Reduction in levels of childhood obesity
    2. Increase in school attainment
    3. Decrease in the numbers of new cases of type-2 diabetes
  • The pilot is intended to last five years, to allow time for the whole system transformation needed and for this to make an impact on the chosen outcomes.  Initial funding is for two years. Local intermediate outcomes have been identified for impact over the initial funding period.
  • The Food Flagship pilot links to Croydon Council's themes of "Ambitious for Croydon":
    • Longer, healthier lives
    • Healthy and resilient families
    • Quality schools and learning
    • Places that communities are proud of
    • Financial resilience and affordable living
  • The connection between these outcomes and programme deliverables is set out in appendix 1 Food Flagship Plan on a Page.
  • The pilot links to Croydon Clinical Commissioning Group's objectives of reducing the difference in life expectancy between communities and enabling children to achieve their full potential. It will contribute to the local priority of reducing diabetes.
  • The principles underpinning the design of the pilot are as follows:
    • When children experience the benefits of eating good food at school, this will encourage longer term behaviour change not only in themselves but also in their parents, wider family and local community
    • Learning to cook real food at school (for parents as well as children) will influence food shopping habits and cooking at home
    • Learning how to grow food, and experiencing the satisfaction of cooking and eating the produce will similarly change longer term shopping habits and diets.
  • Resources for the Food Flagship include a £530,000 GLA grant over 2 years. The council will provide a new cash match of £150,000 from the Public Health Grant, as well as other contributions in kind such as Healthy Schools.

 

Issues raised were:

  • Strong engagement needed with BME sector. There are more pronounced issues in north of borough - particularly with the number of fast food outlets
  • Need to continue to encourage fast food outlets to offer healthy options
  • 'Good Food Matters' in New Addington is leading in this area, encouraging and enabling families to eat more healthily
  • 'Eat Well Croydon Initiative' - a specialist made contact with fast food outlets, starting in north of the borough. We want businesses to offer a healthy choice but they were reluctant to sign up to the initiatve for fear of the loss of business
  • Need to lobby central government - once fast food business established, we cannot stop it
  • There is an allocated resource to develop new businesses to promote healthy eating, such as Community shops to reduce dependence on food banks
  • Lot of allotments in north of borough - encourage schools to get involved
  • More education needed about diabetes and reducing salt intake etc
  • Need to raise issues with influencers - GPs, community leaders, religious leaders etc
  • GPs have very important role as opinion formers
     

The Board RESOLVED to:

  • note progress on development of the Food Flagship and health outcomes it will support
  • endorse the proposed approach to its delivery
A76/14 PUBLIC QUESTIONS

There were no new public questions. The question raised by Anne Milstead and put to the October meeting had initially received an incomplete response but the revised version provides the reply regarding consultation: (see attachment).

A77/14 REPORT OF THE CHAIR OF THE EXECUTIVE GROUP

Steve Morton summarised the report:

  • Impact of highest risk - differs for different partners of Board - remains the most significant risk
  • Work plan - two additional items for February meeting and JSNA chapter moved to June

 

The Board RESOLVED to:

  • Note risks identified at appendix 1
  • Agree changes to the board work plan set out at paragraph 3.4
A78/14 DATES OF FUTURE MEETINGS

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

 

As this was the last meeting for the retiring Executive Director of Adult Services, Health & Housing, Hannah Miller, the Chair made a presentation of flowers and a card, in recognition of all her work for the Health & Wellbeing Board.

MINUTES - PART B
  None
The meeting finished at 4:15pm.