Agenda and minutes

Please note this meeting may be filmed or recorded for live or subsequent broadcast by anyone attending the meeting using any communication method.  Although we ask members of the public recording, filming or reporting on the meeting not to include the public seating areas, members of the public attending the meeting should be aware that we cannot guarantee that they will not be filmed or recorded by others attending the meeting.

Members of the public participating in the meeting (e.g. making deputations, asking questions, making oral protests) should be aware that they are likely to be filmed, recorded or reported on.  By entering the meeting room and using the public seating area, you are consenting to being filmed and to the possible use of those images and sound recordings.

The Chair of the meeting has the discretion to terminate or suspend filming or recording, if in his or her opinion continuation of the filming, recording or reporting would disrupt or prejudice the proceedings, infringe the rights of any individual, or may lead to the breach of a legal obligation by the Council.

The Chair referred those present to Item 1 as shown on the agenda and asked that they review the information on filming at meetings.

The Chair welcomed everyone to the meeting and introductions were given.

Apologies for absence were received from Sorrel Brookes (substitute: Lucy de Groot), Emma Whitby, Angela McNab (representative: Andy Stopher) and Carmel Littleton.

Apologies for lateness were received from Cllr Joe Caluori.

It was noted that the following members of LB Haringey’s Health and Wellbeing Board were not present: Jon Abbey, Director of Children’s Services, LB Haringey; Sir Paul Ennals, Chair of Haringey’s LSCB; Dr Jeanelle de Gruchy, Director of Public Health, LB Haringey; Dr Dina Dhorajiwala, Vice Chair of Haringey CCG.

None.

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None.

None.

Julie Billett, Director of Public Health, made a presentation to the Board setting out the key health challenges shared by Haringey and Islington.

The following main points were noted in the discussion:

·         Life expectancy was a good overall indicator of health outcomes across the two boroughs. Although life expectancy at birth had increased in both boroughs over the past decade, male life expectancy in Islington remained significantly lower than London and England averages. It was thought that life expectancy across both boroughs could be extended by addressing health inequalities in the most deprived communities.

·         The population across the two boroughs was close to 500,000 with a projected growth of 8% by 2026. Population growth would be concentrated amongst older age groups, which would have particular consequences for health and social care services in the future.

·         Both boroughs had similar levels of deprivation, which was a key influence on health and wellbeing.

·         Both boroughs had ethnically diverse populations, although there were differences in the ethnic make-up of the boroughs.

• Both boroughs had similar prevalence of health behavioural risk factors, although Islington had significantly more alcohol-related hospital admissions compared to Haringey. Prevalence of smoking in Islington and Haringey was significantly higher than the London average.

·         Both boroughs had a similar prevalence of long term conditions and prevalence of serious mental health conditions above the London and England average.

·         Both boroughs had among the highest rates in London of residents claiming out of work benefits or sickness/disability benefits.

·         It was considered that Islington and Haringey had similar health and care needs and faced similar challenges. The boroughs operated in a complex health and care system without neat system boundaries. Patients flowed between the boroughs and across London. 

·         The boroughs had a shared ambition to improve population health outcomes, care quality and system sustainability in the face of significant financial constraints. Islington and Haringey had shared values and were committed to working in partnership.

a.    Update on the Wellbeing Partnership (verbal)

b.    Developing an Accountable Care Partnership Across Haringey and Islington

c.    Discussion – Work stream on Cardiovascular Disease and Diabetes in Haringey and Islington

Item 8a. Update on the Wellbeing Partnership

Sarah Price, Chief Officer of Haringey CCG, provided a verbal update on the Haringey and Islington Wellbeing Partnership.

It was advised that Haringey and Islington had consolidated their position in relation to the other North Central London boroughs and the work of the Wellbeing Partnership was being recognised as a key component of the North Central London Sustainability and Transformation Plan.

Work around cardiovascular disease and diabetes was underway and would be key in helping to deliver sustainability. Work undertaken around mental health would also be very important. Work around musculoskeletal conditions was due to start following the appointment of a lead officer. A children’s and young people project was also being developed under the Wellbeing Partnership, in response to feedback from staff that they wanted to see its inclusion as one of the initial workstreams. It was noted that Tim Deeprose had recently been appointed as the Interim Programme Director for the Wellbeing Partnership, and that establishing a team to support the work was a key task to help drive the project forward.

Following a request for clarification, it was advised that the musculoskeletal work had not progressed at the same pace as other workstreams due to capacity and the need to identify resources and officers to lead on delivery of the project.

The Board noted that representatives from both Islington and Haringey CCGs, local authorities and the Whittington and North Middlesex hospitals had met the previous week to consider the children and young people workstream. It was thought that the workstream would review the demands of children and young people on A&E, as well as the pathways for children with long term conditions, and childhood obesity. Whittington Health had volunteered to draft a plan for the proposed work.

In response to a question on the pressures on A&E services at the Whittington, Simon Pleydell advised that the issue was around what was the most suitable setting to receive care and whether that was in a community setting or whether this was at an emergency department. This was a key challenge faced across the health sector. 

Item 8b. Developing and Accountable Care Partnership

Zina Etheridge, Deputy Chief Executive of LB Haringey, and Charlotte Pomery, Assistant Director of Commissioning at LB Haringey, presented the report which proposed the establishment of an Accountable Care Partnership. 

The following main points were noted in the discussion:

·         The Wellbeing Partnership was working well and it was thought that consideration should be given to developing formal governance arrangements. It was commented that a formal governance structure would assist partner organisations in making the transition to a more integrated model. The need for system-wide partnership working was recognised, however it was suggested that at present there was not the system-wide responses available to tackle them effectively.

·         Whilst work was underway to rationalise services through the partnership, it was commented that duplication and inefficiencies existed in the system. For example, each organisation had its own  ...  view the full minutes text for item 103.

Julie Billett introduced the report which provided an update on the development of the North Central London Sustainability and Transformation Plan (STP).

The following main points were noted in the discussion:

·         Members of the Board expressed frustration with the level of transparency around the STP process to date and indicated that it was in the public interest for Health and Wellbeing Boards to review the STP.

·         A high level STP had been submitted to NHS England in June and a final plan would be submitted on 21 October. Although a series of public engagement events had taken place in September, it was noted that there would not be an opportunity for the statutory constituent bodies to approve the STP prior to submission.

·         The Board considered the importance of managing an effective relationship between the STP and the Wellbeing Partnership. The Wellbeing Partnership was well-placed to commission and deliver services at a local level as appropriate, while contributing to the overall aims of the STP.

·         The timescales were unclear after the submission of the STP on 21^st October. The STP would be reviewed and signed-off by NHS England. As the STP timescales did not allow for democratic engagement prior to submission, there would be some subsequent engagement with each of the governing bodies, provider boards and Health and Wellbeing Boards involved. Delivery plans would be developed from November onwards and there would be an opportunity for these to be reviewed by constituent bodies both individually and collectively.

·         It was suggested that the submission of the STP would facilitate discussions between organisations about how services were funded, and how the best quality services could be provided. It was emphasised that as accountable statutory organisations, all partners would need to scrutinise the STP in detail and make representations on its content as appropriate.

·         It was commented that the ‘case for change’ document was a high level plan developed at speed, and as a result there was a lack of detail on the implications of the Plan at an operational level. It was commented that North Central London was not a recognisable geographic area and it was important for the Wellbeing Partnership to be more transparent and accessible to residents.

·         The Board considered that the need for transformative change across the health and care system was clear, however further work was needed to develop accountable and effective working arrangements at the local level.

RESOLVED:

 (1)          That the progress to date on the development of a Sustainability and Transformation Plan for North Central London be noted;

 (2)          That the overall objectives, vision and emerging plans for transformation of the heath and care system across North Central London, and its implications for and synergies with the Islington and Haringey Wellbeing Partnership, be noted.

Stephen Lawrence-Orumwense, Assistant Head of Legal and Deputy Monitoring Officer, LB Haringey, introduced the report which asked the Board to consider the frequency of joint meetings with the London Borough of Haringey’s Health and Wellbeing Board and the possibility of formalising joint arrangements.

The Board considered that three or four joint meetings a year would be appropriate. It was also suggested that consideration should be given to reducing the number of Islington-only Health and Wellbeing Board meetings as a result.

It was agreed that further work would be undertaken around formalising arrangements and that a follow up report would be brought to a future meeting.

RESOLVED:

 (1)        That further work be undertaken with a view to potentially establishing a Joint Committee.

 (2)        That the frequency of joint meetings be agreed at three or four meetings per year.

The Board agreed that the dates for future joint meetings with the London Borough of Haringey’s Health and Wellbeing Board would be circulated by email.