Agenda and minutes

Councillor Richard Watts welcomed everyone to the meeting.

Apologies for absence were submitted on behalf of Alison Blair, Islington Clinical Commissioning Group (substitute: Paul Sinden); Sorrel Brookes, Islington Clinical Commissioning Group; Olav Ernstzen, Islington Healthwatch (representative: Jeni Kent); Dr Henrietta Hughes, NHS England; Sean McLaughlin, Islington Council (representative: Simon Galczynski); and Lesley Seary, Islington Council.

If you have a Disclosable Pecuniary Interest* in an item of business:

·         if it is not yet on the council’s register, you must declare both the existence and details of it at the start of the meeting or when it becomes apparent;

·         you may choose to declare a Disclosable Pecuniary Interest that is already in the register in the interests of openness and transparency. 

In both the above cases, you must leave the room without participating in discussion of the item.

If you have a personal interest in an item of business and you intend to speak or vote on the item you must declare both the existence and details of it at the start of the meeting or when it becomes apparent but you may participate in the discussion and vote on the item.

*(a)Employment, etc - Any employment, office, trade, profession or vocation carried on for profit or gain.

 (b)Sponsorship - Any payment or other financial benefit in respect of your expenses in carrying out duties as a member, or of your election; including from a trade union.

 (c)Contracts - Any current contract for goods, services or works, between you or your partner (or a body in which one of you has a beneficial interest) and the council.

 (d)Land - Any beneficial interest in land which is within the council’s area.

 (e)Licences- Any licence to occupy land in the council’s area for a month or longer.

 (f)Corporate tenancies - Any tenancy between the council and a body in which you or your partner have a beneficial interest.

 (g)Securities - Any beneficial interest in securities of a body which has a place of business or land in the council’s area, if the total nominal value of the securities exceeds £25,000 or one hundredth of the total issued share capital of that body or of any one class of its issued share capital. 

This applies to all voting members present at the meeting.

None.

No changes were proposed to the order of the agenda items.

RESOLVED:

That the minutes of the meeting of the Board held on 15 April 2015 be confirmed as a correct record and the Chair be authorised to sign them.

Lela Kogbara and Graeme Cooke introduced the report, which proposed the establishment of a dedicated Health and Work programme in Islington, jointly run by the Council and the CCG, in partnership with Jobcentre Plus.

The following main points were noted during the discussion:

·         It was explained that employment was generally beneficial to people’s health and wellbeing. A coordinated multi-agency approach was required to improve residents’ health and employment outcomes.

·         The Board noted recent developments which had contributed towards addressing health and employment issues. This included that Islington Council’s Assistant Chief Executive (Strategy and Community Partnerships) had recently been appointed as the Director of the Learning Disabilities Employment Programme at NHS England.

·         NHS England had agreed to trial partnership work with Islington Council, Islington CCG, and Jobcentre Plus to improve employment outcomes among people with a health condition or a disability. It was noted that this trial presented a significant opportunity to implement system changes as part of a wider Health and Work programme, which would re-focus services around addressing health and employment issues.

·         The Board considered the challenges that the Health and Work programme would face. It was commented that such a programme would require senior officer engagement, consideration of how those with health conditions can be best supported into work, information sharing arrangements, and reviewing the role of the Council and NHS as major local employers.

·         The CCG confirmed its support for the proposed Health and Work programme, and noted that work would be required to develop a narrative to underpin changes to systems and structures.

·         Further thought was required as to the mechanisms of how the health service would support the Health and Work programme. For example, it was suggested that the current arrangements did not provide sufficient time for a GP to fully assess a patient’s employment status during a standard consultation.

·         It was commented that the programme presented an opportunity to look widely at how all local services support employment and health outcomes. It was suggested that the programme could seek to work with schools to ensure that related support was universally available to young people. Engagement with the voluntary sector was also proposed.

·         A discussion was had on the structural changes required to support the programme and the need to avoid duplication. It was suggested that primary care services, such as GPs and pharmacies, may be best placed to ensure universal access to the programme; however it was noted that this could alter the dynamic between healthcare professionals and patients.

·         The importance of the multi-disciplinary Expert Reference Group was emphasised, which was helping to shape the programme trial in Islington by providing ideas and challenge to authorities. This group included mental health professionals and representatives of the CCG, DWP, Public Health England, and the Business Disability Forum, amongst others.

·         It was considered important to establish clear governance arrangements to ensure confidence in the programme.

·         It was queried if the programme could maximise its available budget by drawing on various external employment and health funding streams.  ...  view the full minutes text for item 54.

Eleanor Schooling introduced the annual report on behalf of the Independent Chair of the Islington Safeguarding Children Board (ISCB).

The following main points were noted during the discussion:

·         The Islington Safeguarding Children Board, an independent multi-agency body, was required by law to submit its annual report to the Chair of the Health and Wellbeing Board. 

·         Given the limited resources available to all local agencies, it was suggested that there was a need to ensure resources were focused on the most vulnerable children. A discussion was had on the prioritisation of targeted and universal services.

·         The Board commented on the ISCB priorities and how these could align with the Joint Health and Wellbeing Strategy and the work of Health and Wellbeing Board members. It was noted that there was no specialist programme in the Borough to support children with the impact of domestic abuse.

·        A discussion was had on the sensitivities surrounding child sexual exploitation. For example, it was queried if agencies should question teenagers about their relationships when providing free contraception. It was noted that authorities had a duty to safeguard all children against sexual exploitation, including those over the age of consent.

·         Attention was drawn to high profile cases of child sexual exploitation identified in other areas. The Board noted the national cultural change in regard to child sexual exploitation and agreed that it was important to learn from mistakes made elsewhere.

·         It was suggested that the Health and Wellbeing Board should also consider the Safeguarding Board’s priorities in light of the Council and CCG’s Child Health Strategy; as safeguarding children was essential to ensuring the wellbeing of children and maximising their life chances.

·         There were also linkages to be made to the Youth Crime Strategy, as it was known that young offenders were often vulnerable people who may either be suffering from abuse, mental health conditions, or parental drug and alcohol dependency.

·         The importance of early intervention to both protect children and secure their health and wellbeing was emphasised. It was commented that the Safeguarding Board’s priority to ‘address the consequences and harm that children and young people suffered as a result of domestic violence, parental mental ill-health and substance abuse’ was being addressed through the Council’s early intervention and prevention approach set out in its Corporate Plan. 

·         It was advised that local healthcare professionals had recently received IRIS (Identification Referral to Improve Safety) training, which aimed to detect and support victims of domestic violence through General Practice. It was commented that although healthcare professionals may be able to identify abuse and neglect through physical symptoms, it was more difficult to identify cases of emotional abuse.

·         Although the CCG could facilitate safeguarding training for healthcare professionals, further thought was required as to how safeguarding matters could be taken into account when commissioning other health services.

·         The importance of schools in identifying abuse and neglect was highlighted. In response to a query, it was advised that it can be more difficult to identify instances of abuse and neglect of  ...  view the full minutes text for item 55.

Julie Billett introduced the report, which provided an update on progress against the Health and Wellbeing Board’s priorities.

The following main points were noted during the discussion:

·         Particular attention was drawn to the launch of the Young People’s Sexual Health Network, the recent performance of the Long Term Conditions Locally Commissioned Service, and the forthcoming review of mental health promotion programmes.

·         In response to a query, it was advised that it had historically been difficult to collect data on breastfeeding prevalence at 6-8 weeks. It was advised that this relied on collecting data from new parents who understandably had other concerns at the time. Anecdotal evidence suggested that the borough performed well in this area.

·         Councillor Janet Burgess advised of a recent meeting with Islington Youth Councillors in which she was advised of long waiting times for accessing the Child and Adult Mental Health Service (CAMHS). It was advised that there was always a high level of demand for this service, however officers would investigate and report back to the relevant executive members.

RESOLVED:

That progress against the Health and Wellbeing Board’s priorities be noted.

Simon Galczynski introduced the report, which provided an overview of two separate self-assessments completed relating to services for people with learning disabilities and autism.

The following main points were noted during the discussion:

·         Islington performed favourably in terms of partnership working, employment outcomes for those with learning disabilities, personal budgets, and providing accommodation to those with learning disabilities.

·         Further work was required to close the health inequalities faced by those with learning disabilities, as there was no evidence that their health outcomes were improving.

·         The Board noted the problems faced by adults diagnosed with autism who do not also have learning disabilities.

RESOLVED:

1.    That the findings of both self-assessments be noted.

2.    That the priorities for service improvements and commissioning in 2015/16 be endorsed.

3.    That the national drivers, including statutory duties relating to services for people with autism and the need for improved accountability and leadership, be noted.

4.    That the importance of data collection as a crucial area for improvement in order to evidence outcomes, particularly as they relate to health, be noted.

5.    That a full report on people placed in hospitals for treatment and assessment be presented to a future meeting of the Health and Wellbeing Board.