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Health & Wellbeing Board
Wednesday, 25th March, 2015

Health & Well-Being Board (Croydon) Minutes

Date:
Wednesday 25th March 2015
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, Yvette HOPLEY, Maggie MANSELL (Chair), Margaret MEAD (Vice-Chair), Louisa WOODLEY

 

Officers of the council:

Paul GREENHALGH (Executive Director of People)

Dr Mike ROBINSON (Director of public health)



NHS commissioners:

Stephen WARREN (Croydon Clinical Commissioning Group)

 

Healthwatch Croydon:

Not represented



NHS service providers:

John GOULSTON (Croydon Health Services NHS Trust)



Representing voluntary sector service providers:

Kim BENNETT (Croydon Voluntary Sector Alliance)

Sara MILOCCO (Croydon Voluntary Action)

 

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

Not represented



Non-voting members:

Ashtaq ARAIN (Faiths together in Croydon)

Andrew McCOIG (Croydon Local Pharmaceutical Committee)

Lissa MOORE (London Probation Trust (Croydon))

 

Also present: Councillor Andrew Rendle, Fiona Assaly, Fouzia Harrington, Alan Hiscutt, Sara Milocco, Steve Morton and Brenda Scanlan 

Committee Manager: Solomon Agutu

Also present:
Councillor Andrew Rendle, Fiona Assaly, Fouzia Harrington, Alan Hiscutt, Sara Milocco, Steve Morton and Brenda Scanlan Committee Manager: Solomon Agutu
Absent:
Nero Ughwujabo (Croydon BME), Marie T Brown (Croydon College), David Lindridge (London Fire Brigade), Dr Agnelo Fernandes (NHS Croydon Clinical Commissioning Group), Vanessa Hosford (Healthwatch Croydon), Mark Justice (Croydon Charity Services Delivery Group), Stuart Routledge (Croydon Charity Services Delivery Group), Steve Phaure (Croydon Voluntary Action), Karen Stott (Croydon Voluntary Sector Alliance), Dr Jane Fryer (NHS England), Paula Swann (NHS Croydon Clinical Commissioning Group), Adam Kerr (National Probation Service (London))
Apologies for absence:
Dr Agnelo Fernandes (NHS Croydon Clinical Commissioning Group), Vanessa Hosford (Healthwatch Croydon), Mark Justice (Croydon Charity Services Delivery Group), Stuart Routledge (Croydon Charity Services Delivery Group), Steve Phaure (Croydon Voluntary Action), Karen Stott (Croydon Voluntary Sector Alliance), Dr Jane Fryer (NHS England), Paula Swann (NHS Croydon Clinical Commissioning Group), Adam Kerr (National Probation Service (London)), Marie T Brown (Croydon College), Nero Ughwujabo (Croydon BME)



Item Item/Resolution
MINUTES - PART A
A14/15 MINUTES OF THE MEETING HELD ON WEDNESDAY 11TH FEBRUARY 2015

The Board RESOLVED that the minutes of the meeting of the Health & Wellbeing Board (Croydon) on 11 February 2015 be agreed as an accurate record.

A15/15 APOLOGIES FOR ABSENCE

Apologies were received from Dr Agnelo Fernandes (NHS Croydon Clinical Commissioning Group), Steve Davidson (South London & Maudsley NHS Foundation Trust), Dr Jane Fryer (NHS England), Paula Swann (NHS Croydon Clinical Commissioning Group), Vanessa Hosford (Healthwatch Croydon), Mark Justice (Croydon Charity Services Delivery Group), Stuart Routledge (Croydon Charity Services Delivery Group), Steve Phaure (Croydon Voluntary Action), Karen Stott (Croydon Voluntary Sector Alliance)), Adam Kerr (National Probation Service (London)), Marie Brown (Croydon College), Nero Ughwujabo (BME Forum)

 

Dr Mike Robinson gave apologies for lateness.

A16/15 DISCLOSURE OF INTEREST

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

A17/15 URGENT BUSINESS (IF ANY)

There was no urgent business.

A18/15 EXEMPT ITEMS

There were no exempt items.

A19/15 HEALTH AND WELLBEING OF OFFENDERS & THEIR FAMILIES

This item had been circulated late. The Chair proposed and the meeting agreed to adjourn for five minutes while Board Members read the paper. The meeting adjourned at 2.10pm and resumed at 2.15pm

 

The report was presented by Lissa Moore, London Probation Trust. The report was asking the Board to agree to a deep dive JSNA on offenders' health and care needs in order to facilitate the development of a joint strategy. She explained how offenders' health needs are above average from the health of the population. They suffer from multiple issues and all the key determinants of ill health are present in their usually chaotic lifestyles, lack of jobs, lack of accommodation, not registered with GP, alcohol and drug misuse. Those with mental health issues are also more likely to disengage from probation services.

 

Lissa then explained the recommendations and said that they could not be achieved in isolation- they need an integrated pathway and work with others. The example of Sutton GPs accepting the probation service building as the registered address allowed those without a local address to access local services was given of how joint working could produce good outcomes.

 

After further discussion The Board RESOLVED to refer the report to the Executive Group with a view to timetabling the deep dive request with other deep dive requests.

A20/15 JOINT HEALTH AND WELLBEING STRATEGY 2015-18

The report set out the proposed amendments to the Joint health and wellbeing strategy following a process of review by the Board. The purpose of the review was to learn from other JSNAs and to make the JSNSA accessible and useable by reducing the amount of supporting information included in the body of the Strategy. Such background information would be included as appendices. It was emphasised that the exercise was presentational and not intended to change the substance.

 

The presentation led to a detailed discussion where typographical and presentational matters were raised. Key issues raised included the challenge that the document had no quantities although it referred to “reducing” and “increasing”. It thus did not set out the level of our ambition. It needed to have more statistical information so that we knew how well we were doing. The challenge was accepted and report authors would revisit and incorporate key indicators which were realistic but ambitious. It was accepted that in the process of making it accessible too much information may have been extracted and will need to be reinstated, although most of the baseline information would be presented separately.

 

The authors were asked to make it clear that that there was a link with the Best Start programme. The question was asked how different this document was from ones published two years ago /10 years ago /20 years ago. This led to a discussion whether the strategy could include information about what happened a generation ago as comparative data.

 

There was a request to add to page 13 para 31: “people will have timely access to health and social care when needed”.

On this basis the Board RESOLVED to agree the recommendations.

A21/15 CLINICAL COMMISSIONING GROUP - FINAL COMMISSIONING PLANS 2015/16

This report sets out the CCG draft operating plan for 2015/16 and would be submitted to the NHS England on 10 April 2015. CCG's are required to produce operating plans which are in accordance with the relevant Local Joint Health and Well Being Strategy. The role of the Health and Wellbeing Board is to annually provide an opinion on whether the CCG's final commissioning plan has taken proper account of the Local Joint Health and Wellbeing Strategy.


The Board consequently considered the presentation and made comments. It was pointed out that the appendix to the report was 15 pages long, not the two pages as printed.


It was pointed out that the plans aligned with the JHWS and that the strategic aims principles and priorities were as set out in paragraph 2.1. The achievements were set out in page 46 and the biggest challenge for 2015/16 was prevention and self-care and shred decision making.

 

There was a discussion on the content of the report in relation to causes of the cancellations of planned care. There were also discussions about the need for an explicit statement that the CCG Plan is aligned with other Strategies. This then led to a discussion about the London quality standards, the urgent referral targets, the 1:28 ratio of midwives to patients, the £12m worth of QUIP efficiencies and the number of beds available at Barrington lodge. It was emphasised that there was an appendix with 15 programmes to be added when reading the Plan.

 

After further discussion, the Board RESOLVED to agree the recommendations.

A22/15 MENTAL HEALTH CRISIS CARE CONCORDAT

The Board was asked to note the Concordat. During the presentation of the report the Board was asked to note the broad themes of the concordat and to note that a number of the aspirations in the concordat were already happening and schemes were already implemented in Croydon. Examples of these were given. On this basis the Board was being urged to agree the concordat.

 

Attention was drawn to the role of pharmacists. The question was asked why Pharmacy was not included in the list of partners. Referral pathways should be available to all healthcare professionals including pharmacists. The example was given of a young person who had wondered into a pharmacy where she was known and by their behaviour, it was clear that they were in need of urgent attention - they were known to have come off their medication. The pharmacists had not known whom to contact as pharmacies are not privy to that information. A plea was made for pharmacies to be included in circulation lists of such information material.

 

There was also a challenge to report authors that young people under 25 do not seem to be included in discussions.

 

The Board RESOLVED to change the word "Note" for Support" in the recommendations as published, and thus to support the concordat. And also RESOLVED that Pharmacists representatives are to be included in discussions, treated as partners and included in circulation lists.

A23/15 WINTERBOURNE VIEW ACTION PLAN

In 2012 the BBC Panorama television programme exposed abuse of people with disabilities in Winterbourne View. A national response set out an action plan. In Croydon there is a small number of service users affected who were placed on a "Winterbourne View Register". Their cases have been reviewed and progress is being made to move them to alternative settings. It was asked why one of them was still in hospital. Pressed on this, it was reported that the problem with low numbers was being addressed in the market position statement. The low numbers meant that we have to work with other boroughs in sourcing appropriate placements. It is being addressed in a new framework agreement approved by cabinet.


This report to the Board was for information only and the Board RESOLVED to note the report.

A24/15 DRUG AND ALCOHOL PHASE 2 RECOMMISSIONING

This report was for information only. The Board was advised about the new provider appointed under phase 1 and the Board asked for details of the services to be brought to a later meeting. Paragraph 3.1 detailed that there was an under representation of BME and women in the substance misuse service and the question was asked what was being done to resolve this. It was responded that as the service was now intended to be wider than the previous service which concentrated on heroin use, the wider service will be able to deal with those who use substances other than heroin.


As this was for noting only, the Board RESOLVED to note the report.

A25/15 PHARMACEUTICAL NEEDS ASSESSMENT

The health and wellbeing Board has a statutory duty to prepare and agree a Pharmaceutical Needs Assessment (PNA) for the Borough. The purpose of the PNA is to guide NHS England when dealing with applications for new pharmacies or variations. The Director of Public Health leads on the production of the PNA report. The Board was being asked among other things to agree the publication of the PNA within the statutory timetable. The draft PNA was available online.
 

The report and draft PNA was well received with one Board member saying it was a superb document and highly commended it.


There was a discussion about the content. Questions were asked about home delivery services and was stated that home delivery is not a contractual requirement but many pharmacists do it on a voluntary basis. In relation to location within wards, it was questioned why Waddon and Selsdon Ballards were the only Wards in the Borough not to have a pharmacy - this would be referred to NHS London.


After further discussion it was RESOLVED to accept the recommendations namely:

  1. Agree the publication of the pharmaceutical needs assessment (PNA) to take place by 1 April 2015 in accordance with the statutory requirements;
  2. Delegate responsibility to the Health and Wellbeing Board executive group for ongoing maintenance of the PNA as per the regulations outlined above until such time as the PNA will be reviewed in 2018;
  3. Be provided with an annual update from Health and Wellbeing Executive Group on maintenance of the PBNA and progress on the maintenance.
A26/15 PUBLIC QUESTIONS

There were a number of public questions from Peter Doye (NHS complaints and Advocacy Services), South London YMCA (how Social services will change with the implementation of the Care Act) and Bob Sleeman (Council tax leaflet). The questions and answers will published separately.

 

 

(Please see Appendix for response to questions raised by Ann Creighton at 11 February meeting)

A27/15 REPORT OF THE CHAIR OF THE EXECUTIVE GROUP

The Board considered the report and asked a number of questions including one on the Francis Report (paragraph 3.4) and one on the determinants of ill health and whether a needs assessment of this was needed.

 

The Board RESOLVED to:

  • Note risks identified at appendix 1
  • Agree proposed changes to the board work plan set out at paragraphs 3.4 and 3.5

 

The next meeting will be on Wednesday 10 June at 2pm in the Council Chamber, Croydon Town Hall.

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