Agenda and draft minutes

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Councillor Watts referred to information on the agenda and members noted the guidance in respect of filming at meetings.

Councillors Watts and Kober welcomed everyone to the meeting and the members of the Sub-Committee introduced themselves.

Apologies for absence were received from Councillor Weston, Councillor Arthur, Dr Katie Coleman, Carmel Littleton, Angela McNab, Cathy Herman, Geraldine Gavin, Geoffrey Ocen and Siobhan Harrington (representative: Helen Taylor, Clinical Director and Deputy Director of Strategy, Whittington Hospital).

There were no items of urgent business to consider.

A member with a disclosable pecuniary interest or a prejudicial interest in a matter who attends a meeting of the authority at which the matter is considered:

(i) must disclose the interest at the start of the meeting or when the interest becomes apparent, and

(ii) may not participate in any discussion or vote on the matter and must withdraw from the meeting room.

A member who discloses at a meeting a disclosable pecuniary interest which is not registered in the Register of Members’ Interests or the subject of a pending notification must notify the Monitoring Officer of the interest within 28 days of the disclosure.

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

RESOLVED:

That the minutes of the previous meeting held on 19 June 2017 be agreed and the Chair be authorised to sign them.

Notice of questions must be given in writing to the Committee Clerk of either or both boroughs by 10 a.m. on such day as shall leave five clear days before the meeting (e.g. Friday for a meeting on the Monday 10 days later). The notice must give the name and address of the sender.

A deputation may only be received by the Sub-Committee if a requisition signed by not less than ten residents of either or both boroughs, stating the object of the deputation, is received by the  Committee Clerk of either borough not later than 10am five clear days prior to the meeting.

No questions or deputations were received.

Julie Billett and Jeanelle De Gruchy introduced the report and presented on a cross-borough approach to tackling obesity. It was proposed that the Joint Sub-Committee agree to six pledges to improve healthy food choices in Islington and Haringey, and that Islington and Haringey Councils sign up to the Local Government Declaration on Sugar Reduction and Healthier Food.

The following main points were noted in the discussion:

·         It was queried if the removal of sugar sweetened soft drinks could have unintended consequences, for example an increase in the sale of sugar-rich fruit juices and unhealthy ‘zero calorie’ beverages. In response, it was advised that consideration was needed to ensure that messages around the health benefits of fruit were consistent with messages around reducing sugar consumption.

·         Dentists were particularly concerned about dental decay in children and this was attributed to the consumption of sugar-rich food and drink, including fruit.

·         It was suggested that further work was needed on communicating the benefits of avoiding sugar.

·         A discussion was had on how sugary food and drink is advertised to children, particularly through the use of brand characters. Children felt an attachment to certain products and brands because they were advertised in a “fun” way.

·         Work was needed to address the idea of home cooked food always being a healthier option, as home cooked food could contain high amounts of sugar and fat. 

·         It was suggested that communications on sugar reduction should be customised for different ethnic and cultural groups, otherwise key messages may only reach a narrow section of the population and health inequalities may be enhanced, particularly among non-English speakers.

·         The Sub-Committee considered the difficulties of encouraging local business to reduce the supply of sugar-rich food and drink. It was noted that there was a high profit margin on these items and several small businesses were struggling in the difficult economic climate. In response, there was an appreciation of these challenges, and it was also noted that the greatest impact would potentially be realised through a focus on major retailers.

·         It was suggested that communications on reducing sugar consumption and healthier eating should be also related to communications on physical activity, including sustainable transport options such as walking and cycling.

RESOLVED:

(i)            That the Haringey and Islington Health and Wellbeing Boards Joint Sub-Committee agree to the pledges set out in the report submitted;

(ii)           That Islington and Haringey councils sign up to the Local Government Declaration on Sugar Reduction and Healthier Food.

Tony Hoolaghan introduced the report and presented on the progress of the North Central London Sustainability and Transformation Plan (NCL STP).

The following main points were noted in the discussion:

·         The NCL STP was transitioning to the implementation phase. It was intended for some joint acute commissioning to be carried out across North Central London in the near future.

·         A new CCG leadership team had been appointed across Haringey and Islington.

·         NCL STP arrangements had been subject to scrutiny at a local level and at the NCL Joint Health Overview and Scrutiny Committee.

·         The STP was a complex and ambitious plan and capacity was needed to deliver the work identified in the plan. It was intended for the STP to enhance prevention, primary care, and community resilience, however, capacity to deliver the ambitious plans set out in the STP will be drawn largely from within existing resources and capacity.

·         In response to a question on voluntary sector engagement, it was advised that engagement with the sector had increased as the STP process had developed.

·         A member queried how hospital discharge could be improved through the STP. In response, it was advised that national guidance would be followed and patients would be categorised into streams. Work was in progress for patients to be dealt with in a consistent way across Islington and Haringey. Once a patient had been admitted to hospital, it was intended for the patient to be safely discharged as soon as possible.

·         It was commented that those with complex care needs were best assessed in their normal place of residence, as those in need of care may have different capabilities in different environments.

·         A discussion was had on hospital discharge arrangements. It was emphasised that hospital discharge should only occur when the patient is able to care for themselves independently or with appropriate support. It was commented, for example, that the discharge of patients with mental health conditions should not take place while patients are still vulnerable.

·         The Sub-Committee noted the work of the National Housing Federation, which was working with housing providers to support hospital discharge. It was suggested that housing officers should be contacted at the point of admission so bespoke arrangements can be made, if required.

·         The Sub-Committee considered examples of patients who did not require acute care, however were returning home to a hazardous environment. It was considered that engagement with housing providers was essential to ensure that vulnerable patients were appropriately supported.

·         In Haringey, multi-disciplinary team conferences were held weekly, which considered the needs of vulnerable patients planned for discharge.

·         The Sub-Committee noted concerns about the STP process, and on the financial pressures of public bodies. Whilst it was welcomed that progress had been made, it was commented that honest conversations were needed between partner bodies about how services can improve and work closer together within existing resources. It was suggested that the STP needed a stronger focus on social care services and would benefit from a more system-wide approach.

·         The importance of  ...  view the full minutes text for item 23.

Rachel Lissauer, Director of the Haringey and Islington Wellbeing Partnership, introduced the report.

The following main points were noted in the discussion:

·         The Wellbeing Partnership was recognised within the NCL STP as a positive example of cross-borough partnership work.

·         Work was underway to develop working arrangements across organisations and foster a more collaborative approach.

·         Governance structures had been re-shaped to streamline decision-making. Following this preliminary work, there was a need for the Partnership to deliver real change.

·         The Partnership was focusing on improving hospital flows, simplifying discharge processes, and reducing the length of admission for patients. It was previously the case that hospitals serving both boroughs had to work with separate discharge and intermediate care arrangements, however there was now a single process in place.

·         Future work would focus on recruitment, workforce development, and estates strategies.

·         It was queried what differences patients were experiencing in health and care services. In response, it was advised that a number of improvements were in progress, for example the availability of physiotherapy in GP surgeries. In other cases, efficiency savings would improve sustainability and protect existing services.

·         It was commented that trust had developed between partner organisations and as a result positive conversations were taking place. It was thought that a more collaborative approach would improve clinical pathways and lead to a more positive patient experience.

·         Whilst the positive work of the Wellbeing Partnership was recognised, it was suggested that further work was needed to demonstrate and communicate that the Partnership was making a tangible difference.

RESOLVED:

That the report be noted.

Julie Billett and Jeanelle De Gruchy introduced the report and presented on progress with developing a cross-borough Joint Strategic Needs Assessment.

The following main points were noted in the discussion:

·         There would be practical benefits to having a joined up health analytics and intelligence function. It was suggested that this would help to determine how cross-borough services were commissioned and delivered.

·         It was noted that the full JSNA would include a detailed population analysis, and would reflect the number of residents suffering from multiple disadvantages.

·         The Sub-Committee emphasised the importance of a joint narrative to accompany the raw data.

·         The Sub-Committee noted the importance of equalities data, and noted the importance of ensuring the needs of different communities are understood and described, in order to help shape services to better meet those needs and reduce inequalities.

RESOLVED:

That the report be noted.

Julie Billett introduced the Mayor’s Health Inequalities Strategy. The Mayor of London was seeking partner organisations to endorse and contribute to the strategy’s five aims. It was proposed that a joint Islington and Haringey response be submitted to the strategy consultation.

The Sub-Committee endorsed the strategy and agreed to submit a joint response, however emphasised that the GLA also had responsibilities and powers which influenced the health of local people. For example, the GLA had influence over air quality through public transport emissions and the regulation of taxis and other vehicles.

It was suggested that the strategy’s objectives could be more specific, and strengthening the objectives was more likely to result in meaningful change.

RESOLVED:

That the development of a joint Islington-Haringey response to the consultation be endorsed.

To consider any new items of urgent business admitted above.

None.