Agenda and minutes

To approve the minutes of the meeting held on 20 January 2021 and 17 June 2021 as an accurate record.

RESOLVED that the minutes of the meetings held on 20 January 2021 and 17 June 2021 were agreed as a correct record.

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

Councillor Yvette Hopley declared that she was the Vice Chair of the South East Cancer Help Centre.

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

There was none.

Public Questions should be submitted before 12 noon on 15 October 2021 to democratic.services@croydon.gov.uk. Any questions should relate to items listed on the agenda. 15 minutes will be allocated at the meeting for all Public Questions that are being considered.

There were none.

To receive two presentations themed on the health of Croydon’s black community and Black History Month.

The Chair introduced the item and stated that there were two speakers. She firstly invited Dr Kevin Vento to address the Board.

Dr Kevin Vento stated that he was the psychosis lead for Croydon South London and Maudsley (SLaM) services for adult mental health and that he would be speaking on both the Croydon Health and Wellbeing Space, which was in the process of being launched, and black mental health. He detailed the following:

·         A common misconception was the black people, particularly black men, did not benefit from mental health services. However there were challenges in engaging the black community with mental health services.

·         It was known that black communities struggled engaging with primary care services, and the difficulty was in the first step in getting help where they were underrepresented, which needed to be improved. Black communities were overrepresented in secondary care services.

·         A black person is almost three times more likely to be detained under the Mental Health Act, which as a statistic had not changed in the past 20 years.

·         The NHS Long Term Plan included embedding services within the community and for community to work closer together. The Croydon Health and Wellbeing Space was a collaboration between Mind in Croydon, the Croydon BME Forum and SLaM.

·         Dr Vento stated that he would be the clinical lead for the Space, which would be based at the Whitgift Centre, and he expressed his optimism for a true partnership going forward.

·         The site would be open seven days a week and have an open door policy to maximise engagement and be an inviting venue. This initial engagement would then increase the access to secondary health services. As well as sign-posting, the Space would run in-house services and groups to support residents coping with traumas.

·         The Space will be a service to fit the community and an accessible place, staffed by local people and link to local churches and other community groups.

The Chair thanked Dr Vento for his introduction and invited questions from the Board.

Councillor Yvette Hopley praised the idea and the model to provide services to people within the community, staffed by members of those communities the service users would feel comfortable to share their experiences with. She expected the Space to be a success story for Croydon and said the message needed to be shared with residents and associations that this site was operating and what services it provided.

Sarah Burns, CVA Head of Communities, welcomed the approach and stated that the ambition was positive. She said there were a few questions that needed to be considered in the early stages of development; firstly, in how the wider voluntary sector would be able to work with the BAME community, and secondly, how they would connect people struggling with mental health issues  to the Health and Wellbeing Space. She said there were possible solutions to those, adding that one that should be considered was that the Mental Health Alliance. This Alliance would soon be launching which would  ...  view the full minutes text for item 14/21

To receive a verbal update and discuss the Integrated Care System (ICS).

Neil Gouldbourne and Mike Bell, Croydon Health Services NHS Trust, introduced the ICS update, outlining the following:

·         There was a national timetable to move away from Clinical Commissioning Groups (CCGs) to the new statutory bodies in the Integrated Care System (ICS), with duties transferred.

·         There were several elements important to note of the South West (SW) London ICS in the context of Croydon:

Ø  There would be two Boards for the district: the Integrated Care Board, which would hold the NHS budgets, and an Integrated Care Partnership Board to focus on the wider detriments on health (which would include more collaboration from the council and the voluntary sector).

Ø  Discussions were taking place about how the Boards should relate to one another, their membership and remit.

Ø  There was understanding that Croydon was already working in an integrated and collaborative way that the upcoming changes were aimed to enable across the country, and Croydon would continue on its own journey in that context.

Ø  A hallmark trait of CCGs was the prominent positions of GPs in the running and management of the health service, and in Croydon it was clear that had brought value. They intended to continue that strong voice for GPs in Croydon following the structure changes.

Ø  With the dissolve of CCGs, it was important to investigate what GP leadership should look like going forward. A number of workshops took place to review what had worked well in Croydon and now there was a draft plan for the future arrangements of a GP leadership group within the Croydon structure and a position in the One Croydon Alliance.

·         There were successful acute provider collaboratives in SW London, which run the SW London elective orthopaedic centre, SW London Pathology and a range or other initiatives. ICS was intended to further develop provider collaboratives and potentially provide a larger vehicle for the planning for the standardisation of clinical pathways procedures.

·         The leadership of the ICS: the Chair had been confirmed as Millie Bannerjee and the process of appointing the induvial as the Chief Executive was underway.

·         The staffing of the ICS: the ICS would inherit the CCG staff. There would be decisions to follow on how they would be deployed, given the move to a strategic commissioning model.

Dr Agnelo Fernandez, Vice Chair, stated the following:

·         It was important to retain aspects of the clinical leadership in the new model. There would likely be only one representative at the ICS level for SW London.

·         There was concern over the budgets going forward for clinical leadership, which were vital for its provision. Croydon was already currently underfunded. Croydon started the year with a deficit and ending in surplus due to efficiencies made and supported by good working relationship of the CCG and the integration agenda.

There would be risks and opportunities with the new model, however there was a history of Croydon of working together to achieve the best outcomes and working with communities that would put Crouton in  ...  view the full minutes text for item 15/21

To note the Annual Healthwatch report which sets out a summary of what has been achieved between 1 April 2020 and 31 March 2021.

Hilary Williams, Healthwatch CEO, introduced the report and slides to the Board which summarised the work achieved by Healthwatch Croydon between 1 April 2020 and 31 March 2021.

Additionally invited to speak were services users James Kotai, Carole Hembest, Michael Hembest on their experiences and Healthwatch colleague Robyn Bone. Firstly, the service users described how they were involved in a project to improve signage for patients in hospitals and to ensure that signage was aligned to messaging to hospital letters. The project also involved designing a digital signposting system. Secondly, the Healthwatch colleague described the Croydon College placements in Healthwatch and how young people were engaging and influencing the services and the key skills and they gained. It was clear from the placements that the area of mental health particularly resonated with young people.

Councillor Yvette Hopley thanked Healthwatch for their valuable work for residents and stated that awareness of health systems were important, adding that even small changes helped patients. She asked if Healthwatch would be engaging in more Covid-19 specific work. The Healthwatch CEO responded that there was a live survey on long-Covid on the Healthwatch Croydon webpage which could be accessed on the following link: https://www.healthwatchcroydon.co.uk/take-part/projects/

Additionally, Healthwatch Croydon were involved in work on urgency and emergency care and looking at redesigning the pathways in Croydon and across SW London.

Councillor Margaret Bird congratulated the work of Healthwatch. She asked if there was any work, ongoing or planned, which focussed on diabetes services. She added that the Croydon contract for type two diabetes in the past moved to Bromley and had returned to Corydon. In response, the Healthwatch CEO stated that they would note diabetes as a new stream of work to discuss.

Mike Bell, Croydon Health Services NHS Trust representative, echoed his thanks to Healthwatch for their work and excellent examples of co-production with residents, and on this occasion particularly in relation to the improvements to signage. He welcomed the upcoming work on emergency care pathways for Croydon.

Yusuf Osman, Adult Social Service User Panel, thanked Healthwatch for their work during the difficult time of the pandemic and successfully collating resident feedback. He asked if there were any plans in the upcoming year for Healthwatch Croydon to review the accessibility of information for the NHS in Croydon, particularly in relation to alternative formats for people who have disabilities. In response, Gordon Kay, Healthwatch Manager, stated that they had just been awarded a grant from Healthwatch England to carry out work on promoting accessibly beyond the current level, and for Croydon this will particularly focus on accessibly for residents and those of refugee status who speak little or no English. This work would then feed into the national  accessibly of information standard.

RESOLVED: The Board agreed to note the recommendations as detailed in the report.

To provide an update on the changes to the JSNA operational processes detailed in the report.

Jack Bedeman, Public Health Consultant, introduced the report.

Yusuf Osman, Adult Social Service User Panel, asked if there was any data collected in relation to the number of residents living in Croydon with disabilities and whether this was sub-divided into separate impairments. He stated that type of data was important for planning local authority and NHS services. In response, Jack Bedeman stated that there was a limitation in what data was collected and that it was often stored disconnectedly across services, which resulted in Public Health’s limitations to data access. Going forward, co-production was important in considering what data was required to build pictures of areas of interest and to retrieve the important data in a timely manner to understand what gaps needed to be filled and be outcome focussed.

Mike Bell stated that the statutory duty for Health and Wellbeing Boards to produce the JSNA continued under the new legislation. In the previous legislation, it was for CCGs to note the findings of the JSNA, however going forward he asked if there was a comparable duty for the ICS. Additionally, he asked if any discussion had taken place amongst the six SW London local authorities to aggregate some JSNAs for maximum impact of decisions taken at ICS level. In response, Jack Bedeman stated that there was not entirely clear steer yet on those positons.

Councillor Yvette Hopley asked what the role of the Board would be going forward and what sort of information would come to the board in the new strategic hierarchy. Secondly, she asked how data was picked up in the JSNA when local authorities provided for service users in other boroughs. In response, firstly, Jack Bedeman stated the JSNA was to provide baseline data which supported the development of the Health and Care Plan and the Health and Care Strategy, which both measured delivery and outcomes. The Board would benefit, in those terms, to have a clear forward plan and align that to the conclusions of those outcomes using a data driven approach - in relation to commissioning and and building bigger picture planning. Dr Agnelo Fernandez, Vice Chair, stated that the Croydon Public Health team in Croydon were national leaders of population health data, however going forward would be mined to a SW London level.

Mike Bell stated that in the move to the ICS system, it was critical for Croydon to retain the former CCG colleagues as a resource and analytical skill base. Councillor Yvette Hopley indicated the cross-party support of those intentions.

Edwina Morris and Jack Bedeman agreed there were opportunities for Healthwatch Croydon and Public Health to align and work together benefiting from strengths in combining the different types of data they handled.

RESOLVED: The Board agreed to note the recommendations as detailed in the report.

To note the annual report of the Health and Wellbeing Board which outlines the work of the Board between June 2020-2021, before reporting to Council.

Public Health Consultant, Jack Bedeman, introduced the report.

RESOLVED: The Board agreed to note the recommendations as detailed in the report.

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

This item was not required.