Agenda and minutes

RESOLVED:

That, in the absence of the Chair, Councillor Janet Burgess be elected as Chair for the meeting.

Apologies for absence were received from Councillor Richard Watts (substitute: Councillor Kaya Comer-Schwartz), Sorrel Brookes (substitute: Lucy de Groot) and Simon Pleydell.  

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.

Dr Jo Sauvage declared a personal interest as a GP provider in the borough.

No changes were proposed to the order of agenda items.

RESOLVED:

That the minutes of the meeting held on 20 April 2016 be agreed as a correct record and the Chair be authorised to sign them.

Sean McLaughlin introduced the report which set out progress in the joint work between Islington and Haringey through the ‘Wellbeing Partnership’.

The following main points were noted in the discussion:

·         Islington and Haringey had chosen to work together as they faced similar challenges. The boroughs had a similar demographic profile, similar health and care needs and shared ambitions in regards to transforming services to best meet people’s needs and provide world class care.

·         The Wellbeing Programme was a partnership of local authorities and NHS organisations and would also seek to work with residents, patients and the voluntary and community sector. It was thought that a partnership approach would develop more joined up and better quality services and assist with meeting financial challenges. It was commented that the strength of the programme was that all partners were highly committed to working together.

·         The Board noted that the programme should not be considered in isolation, and should instead be viewed in the context of the North Central London Sustainability and Transformation Plan. There was a need to ensure that the programme was an integral part of the STP.

·         The parameters and ground rules of the programme had been agreed with partner organisations and five priority workstreams had been identified which would also address cross-cutting themes.

·         A small project management office had been established to support the programme and assist the partner organisations in developing a more collaborative working culture. A joint workshop for members of the Islington and Haringey Health and Wellbeing Boards had been arranged for 26 July.

·         Alison Blair reported that a similar paper had been strongly endorsed by the Islington CCG governing body. It was recognised that the challenges faced in the health and care sector required radical proposals and collective action to best meet the needs of the local population.

RESOLVED:

(1)  That progress in the development and delivery of the Wellbeing Partnership be noted; and

(2)  That proposals for the next phase of work be supported, as set out at Section 8 of the report submitted.

Julie Billett introduced the report and presentation which provided an update on the North Central London Sustainability and Transformation Plan.

The following main points were noted in the discussion:

·         The Plan would seek to improve health outcomes, reduce inequalities in the quality of care and support the sustainability of services across North Central London. There were robust governance arrangements surrounding the development of the Plan in which Islington was strongly represented.

·         An initial plan had been submitted to NHS England. Although this did not include specific details, it did indicate the broad areas of transformation, which would be developed further over the coming months.

·         A Clinical Cabinet had been appointed to develop the Case for Change. Work was underway to establish a shared understanding of the clinical challenges faced across North Central London and a unified vision of how these should be addressed. Initial messages agreed by the Clinical Cabinet included an emphasis on prevention and early intervention. There was a need to reduce the demand on acute services by supporting people in staying well and delivering services in community and primary care settings.

·         It was commented that there were variable outcomes and a variable quality of care across North Central London. It was hoped that the STP would identify best practice to raise standards and improve consistency across the area. This work had already commenced through bringing clinicians and medical directors together in the Clinical Cabinet.

·         It was intended for the STP to provide a fully integrated system in which patients accessed the right services, at the right place and time, supported by the right systems. A review of the most effective use of estates, workforce and ICT systems would be crucial to this.

·         It was commented that analysis of the financial pressures facing the health and care sector typically focused on NHS services and it was queried why local authorities were not included. In response, it was advised that local authorities were required by law to set a balanced budget and therefore accounted differently to NHS bodies which could operate a managed deficit. Furthermore, the pressures on local government finances were more generalised and it was difficult to attribute specific shortfalls to particular services.

·         It was reported that the Directors of Adult Social Services in the North Central London area met regularly, including in London-wide settings. The budgets of local authority social services departments varied considerably depending on demographic factors and local priorities. Although it was thought that some social care services could be implemented at a cross-borough level, it was suggested that more specialist services generally needed a more localised focus, as this eased integration into other local services.

·         Public engagement activity was to commence in the autumn. It was suggested that the national Healthwatch network could be approached about the most effective way to engage residents in the production of STPs. Detailed proposals and clear messages would be needed in advance of any engagement activity on both the STP and the Haringey and Islington Wellbeing Partnership.  ...  view the full minutes text for item 93.

Hannah Bowman, Head of Housing Partnerships and Communities at Islington Council, made a presentation to the Board on changes to national social housing policy and the associated health and wellbeing impacts.

The following main points were noted in the discussion:

·         The Housing and Planning Act enabled a significant amount of national housing policy to be enacted through secondary legislation. As regulations had not yet been published only limited details were available. It was expected for the legislation to have a negative impact on the supply of affordable housing and council tenants.

·         Due to the very high land values in the borough and the large number of council-owned homes, Islington was expected to be one of the areas most affected by the annual levy to be paid to the government which was intended to be funded through the sale of higher value empty properties. It was thought that the council could be required to pay a levy of around £200m each year, equivalent to the sale of around 300 homes. The levy was to fund discounts being offered to housing association tenants as part of the new Right to Buy. 

·         As the council did not routinely collect data on the incomes of its tenants the impact of the Tenant Tax was not yet known, however it was advised that this would not include adult children if they were not on the tenancy of the property. At one stage it was expected for any household with an income of over £50,000 to pay market rent on their council home, however it was now thought that a taper mechanism would be introduced. Income raised through the tax was to go towards national deficit reduction. 

·         The national emphasis on the delivery of ‘Starter Homes’ was expected to reduce the amount of new housing being developed for social rent.  Due to the sale of council housing the council was expected to have a third fewer properties available, and the supply of housing association properties would also decrease due to the new Right to Buy. 

·         It was commented that the requirement for all new tenants to be subject to fixed term tenancies would reduce tenant security. It was suggested that residents with lifetime tenancies would stay put, potentially in overcrowded or inappropriate housing, as a means of ensuring security.

·         It was thought that the sale of council properties on the open market would speed up the polarisation of communities; due to the high property prices in Islington only the wealthy would be able to purchase the council’s homes. This would alter the demographic profile of the borough and change the demand for services. 

·         Requiring income information to administer the Tenant Tax and implementing tenancy reviews could make the council’s relationship with tenants more adversarial which may impact on service delivery.

·         The council’s housing service was experiencing increased financial pressure due to the annual 1% reduction in social rents introduced through the Welfare Reform and Work Act. The council was previously expecting to implement 5% rent increases.  ...  view the full minutes text for item 94.

RESOLVED:
That the updated work programme for 2016/17 be approved, subject to the followingamendments:

(i)            A response to the Healthwatch review of mental health services for young adults be scheduled for a future meeting;

(ii)           An update on progress with the STP be reported to every meeting;

(iii)          An update on the health effects of housing policy be reported annually.