Meeting documents

Health & Wellbeing Board
Wednesday, 8th June, 2016

Health & Well-Being Board (Croydon) Minutes

Wednesday 8th June 2016
The Council Chamber, The Town Hall, Katharine Street, Croydon CR0 1NX

Attendance Details


Elected members of the council:

Councillors Margaret BIRD, Patricia HAY-JUSTICE, Yvette HOPLEY (Vice-Chair), Maggie MANSELL (Chair), Callton YOUNG


Officers of the council:

Paul GREENHALGH (Executive Director of People)

Ellen SCHWARTZ (Consultant in Public Health)


NHS commissioners:

Dr Agnelo FERNANDES (NHS Croydon Clinical Commissioning Group) (Vice-Chair)

Paula SWANN (NHS Croydon Clinical Commissioning Group)


Healthwatch Croydon

Charlotte LADYMAN (Healthwatch Croydon)

NHS service providers:

Zoe REED (South London & Maudsley NHS Foundation Trust)

John GOULSTON (Croydon Health Services NHS Trust)

Representing voluntary sector service providers:

Helen THOMPSON (Croydon Voluntary Sector Alliance)

Sara BURNS (Croydon Voluntary Action)

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:

Ashtaq ARAIN (Faiths together in Croydon)

Andrew McCOIG (Croydon Local Pharmaceutical Committee)

Also present:
Councillors Maddie HENSON and Bernadette KHAN, Solomon AGUTU (Head of Democratic Services & Scrutiny), Steve MORTON (Head of Health & Wellbeing), Jo NEGRINI (Executive Director of Place), Pratima SOLANKI (director of Adult Social Care & All Age Disability Services), Ashley BROWN (Public Health Programme Manager), Jimmy BURKE (Public Health Principal), Dr Emily SYMINGTON (Public Health) and Dave MORRIS (SSC Strategy Manager)
Rachel FLOWERS (Director of Public Health), Dr Jane FRYER (NHS England), Adam KERR (National Probation Service (London)). Dr Agnelo FERNANDES, Sharon KIRK (London Probation Trust (Croydon)), Sara MILOCCO (Croydon Voluntary Action), Sally CARTWRIGHT (London Fire Brigade), Claire ROBBINS (Metropolitan Police)
Apologies for absence:
Rachel FLOWERS (Director of Public Health), Dr Jane FRYER (NHS England), Adam KERR (National Probation Service (London)), Dr Agnelo FERNANDES, Sharon KIRK (London Probation Trust (Croydon)), Sara MILOCCO (Croydon Voluntary Action), Claire ROBBINS (Metropolitan Police), Councillor Andrew RENDLE, Brenda SCANLAN (Director of Adult Care Commissioning)

Item Item/Resolution

Councillor Maggie Mansell welcomed some new Members to the Board: Councillors Callton Young and Margaret Bird, Dr Ellen Schwartz (on behalf of Rachel Flowers, Director of Public Health).

The Members of the Board then introduced themselves.


Solomon Agutu (Head of Democratic Services and Scrutiny) took the beginning of the meeting, to explain that this being the beginning of a new municipal year, the Board had to be reconstituted.  He requested nominations for the Chair, to be elected by the Councillors and ex-officio statutory representatives on the Board.  Solomon Agutu explained that the statutory members do not have to be elected:

  • Councillor Maggie Mansell was proposed by: Cllr Callton Young and seconded by: Cllr Yvette Hopley

There were no other nominations, so she was duly elected and took the chair for the remaining appointments.


She explained that agreement to nominate a second Vice-Chair, representing the CCG, had been agreed at Council on 25 January 2016.

  • Vice-Chair (CCG) - Dr Agnelo Fernandes was proposed by: Paul Swann and seconded by Cllr Maggie Mansell:

There were no other nominations, so he was duly elected.

  • Vice-Chair - Councillor Yvette Hopley was proposed by: Paula Swann and seconded by: Cllr Callton Young

There were no other nominations, so she was duly elected.


Appointment of Other Voting Board Members, appointed by their organisations, proposed by Councillor Maggie Mansell:

  • Croydon Healthcare NHS Trust - John Goulston, Chief Executive
  • South London and Maudsley Hospital Trust - Zoe Reed, Service Director
  • CVA - Sara Milocco, Head of Communities
  • Croydon Charity Services Delivery Group - Stuart Routledge (Chief Executive, Age UK)
  • Croydon Voluntary Sector Alliance (CSVA) (2 members) - Karen Stott (Director of Off the Record) and Helen Thompson (Carers Information Services)
  • BME Forum - Nero Ughwujabo

Councillor Callton Young seconded the motion and the members were elected en bloc.


(FOR INFORMATION: Non-Voting Members, appointed by their organisations:

  • Faiths Together in Croydon - Ashtaq Arain
  • London Fire Brigade - Sally Cartwright, Borough Commander
  • Metropolitan Police - Inspector Claire Robbins
  • National Probation Service (London) - Adam Kerr, Assistant Chief Officer
  • London Community Rehabilitation Company (LCRC) - Sharon Kirk, CRC Stakeholder and Partnership representative (replacing Lissa Anderson)
  • Croydon Local Pharmaceutical Committee - Andrew McCoig, Chief Executive Officer
  • Croydon College - no nomination confirmed)


Andrew McCoig suggested 2 of non-voting members be put forward as voting members.


Strategic item P3 - Cllr Hay-Justice asked who is leading on the point about maternity services booklets only being printed in English.  The BME Forum is leading?  John Goulston ???


The minutes of the meeting held on 13 April were then agreed as an accurate record.


There were none.


There was no urgent business.


There were no exempt items.


Jimmy Burke (Public Health Principal) and Dr Emily Symington gave a  presentation (see attached):

  • This shows the developments since a previous presentation brought to the Board in 2013
  • NHS facing challenging times with major financial problems
  • Ageing population and increasing burden of long term disease
  • Need to ensure we are meeting the needs as they occur
  • Encouraging communities to be more independent, to manage their own health with professionals
  • Supporting communities to become involved in healthcare
  • Large number of local projects under way
  • 'Right care first place, first time'
  • Working with other partner services to address societal issues affecting health


Cllr Mansell: Important to recognise where started with position of financial deficit.  Three quarters of Trusts in financial deficit - not bad management but under funding.  In public health, working to prevention agenda since Black report in 1980.  Lot of actions taken, trying to educate people to live more healthily.  Middle classes become healthier but others stayed where they are.  Gap has widened.  Very complicated issue - take away people ready to go home and fill with those who are ill, then needs increased.  Cannot take average cost.


Charlie Ladyman gave a summary of the Healthwatch Croydon report:

  • Findings of patient experience with regard to self-care and self-management
  • Secondary patient experience data (evidence-base) is from internet sources, such as NHS Choices
  • Generally residents still think GP when they could visit a pharmacy
  • Approx. 20% of people who use A&E do not have a medical issue
  • It is a big change going from paternalistic to self-managed


The Board then split into 4 groups, including members of the public, to debate the following:


"As part of promoting self-care in 'Together for Health', we encourage people to ask three questions when thinking about their health or care needs:

  • What are my options?
  • What are the pros and cons of these options?
  • Where can I find information to decide which is the best option for me?"

Each table was asked to feed back the main issues arising from their discussions on the following:

  1. Considering your knowledge of the health and care system in Croydon and personal experience, discuss the response to these questions for a Croydon resident.
  2. How could services throughout Croydon work together better to empower residents to self-care?

Table 1:

  • Education and information are important
  • Patients should be used as a resource
  • Services are under separate contracts which causes problems for joint working
  • Learn lessons from the trailblazing 'Outcomes based Community Programme for the over 65s' and extend the approach 


Table 2:

  • Need to build a shared vision for Croydon
  • Responsibility for keeping healthy must shift into the community
  • Major cultural change from service dependency to self and community reliance
  • Need to increase social connectedness with health workers working together to keep people well


Table 3:

  • Communication is key - GP practices and pharmacies should have a care navigator who can signpost patients to the right place (NHS services, voluntary sector, health and fitness classes etc)
  • Learn from others in carers groups who have gone through the same experience
  • Major challenge as it is most effective to invest in prevention but initially it costs more


Table 4:

  • Lack of consistency across the services
  • Clearer framework needed to facilitate quality of access, with residents in contact with professionals
  • Services need to be signposted better
  • Services must work together with the community


The Board NOTED the presentation and report.


Paul Greenhalgh introduced the report, which is an overarching strategy across all areas in the borough.  It is the Council's most important strategic planning document and provides a framework for the work of all partner organisations within Croydon's Local Strategic Partnership (LSP) and the context for future strategies and plans in the borough.


Cllr Yvette Hopley: How well are we working within internal departments in the Council?  We need a more joined up approach.

Cllr Maggie Mansell:  That is what we are trying to do.  Gateway service - helping people to deal with financial, housing, school, social care problems, rather than penalising them for not paying rent.

Paul Greenhalgh: 18 months ago the Council restructured into 3 departments, to ensure there is a much stronger join up between areas. 


Nero Ughwujabo:  Will someone look to see if the priorities of the Board are reflected?

Paul Greenhalgh:  We are asking for approval to ensure alignment across the entire agenda and business and interests of HWB, as reflected in the HWB strategy.

Steve Morton:  Ot is for the Board to think about the HWB strategy joining up with the Community Strategy - e.g. social isolation issues.


The Board RESOLVED to:

  1. Approve the draft Community Strategy 2016-21, Appendix 1 to this report and recommend its adoption by Cabinet and Full Council
  2. Agree that the Health and Wellbeing Board adopt the Community Strategy as approved by Full Council, for delivery over the period 2016-21
  3. Agree that the Executive Director People and the Chief Officer of Croydon CCG are authorised to make minor factual or presentational amendments to the Community Strategy response to feedback from engagement detailed below prior to approval by Full Council.

Paula Swann gave a presentation:

  • The STP footprint is SW London. 
  • Priorities - 4 key areas of change
  • Submission deadline is 30 June


Board members were asked to feedback their comments to Paula Swann before the end of June.


The following comments were raised at the meeting:

  • Need clear focus to tackle challenges of deprivation in north of borough and New Addington and Fieldway.  Solutions being put forward with significant challenges of financial constraints.  Broader response rather than just a health response, which is struggling with resources.
  • Significant amount of health issues local people face is about behaviour. There is significant opportunity if services work better together. Benchmark health services against others to see how efficient we are. On journey for last 3 years.
  • £500,000 funding available to go to the best plan.
  • Council has made vigorous representations to the Treasury about underfunding of local government and also Croydon health services


The Board NOTED the contents of the presentation.


Ashley Brown (Public Health Programme Manager) summarised the report.


Obesity is an increasing problem in Croydon, caused by a number of issues, including 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 Programmes, with schools being the catalyst for change in a whole system transformation of the food landscape.  After a competitive bidding process, Croydon and Lambeth were awarded food flagship status by the GLA (Greater London Council) in 2014.


The programme has achieved significant successes in the past 14 months with key funded projects achieving, and in some cases exceeding targets.  There are 60 projects underway across the borough.  One main aim is to ensure better provision in schools.


The following comments were made:

  • Why has there not been a better take up in lower primary - are the portions not enough? 
  • Key Stage 2 - all eligible will get free lunches
  • GLA funding £20,000 for 2 years
  • Working with schools - trying to make changes where possible but not enough funding for all schools. 
  • Looking at things that work best
  • How is success measured?
  • Outcomes are ambitious - the national child development programme measures child obesity.  An external evaluator is helping to assess the impact of having more access to good food. 


The Board RESOLVED to:

  • note the recent developments of the Food Flagship programme
  • ratify the direction of travel for the future which is to embed system transformation across the council and its partners

At its meeting on 23 October 2013 the Health and Wellbeing Board endorsed a strategic partnership approach to improving heart health in the borough and the extension of Croydon's Heart Town programme from two to five years. The report provides an update on Heart Town activity since the last report to the board on 10 June 2015.


Steve Morton highlighted the main points in the report:

  • Since becoming a Heart Town, £30,000 has been raised to help fight heart disease
  • There is a focus on smoking and people with mental illness
  • Healthcheck programme from low uptake now seeing 500 people a month


The Board NOTED the report.


Paul Greenhalgh gave a brief summary of the report.


The board risk register was developed by the board at a seminar on 1 August 2013. The board agreed that the executive group would keep these risks under review and update them as required. (see Appendix 1)


The work plan for 2016/17 was agreed at its meeting on 13 April 2016. The work plan is regularly reviewed by the executive group and the chair. This paper includes the most recent update of the board work plan at appendix 2.


The Board RESOLVED to:

  • Note risks identified at appendix 1.
  • Agree revisions to the board work plan for 2016/17 at appendix 2.

There were no public questions.


The date of the next meeting is 14 September.

The meeting ended at 4:50pm