Agenda and minutes

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

Apologies for absence were received from Jo Sauvage (substitute: Katie Coleman), Emma Whitby (substitute: Olav Ernsten), Carmel Littleton (representative: Lisa Arthey), Angela McNab and Councillor Janet Burgess.

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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.

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This applies to all voting members present at the meeting.

None.

No changes were proposed to the order of business.

·         25 January 2017

·         31 January 2017

RESOLVED:

That the minutes of the meetings held on 25 January 2017 and 31 January 2017 be agreed as a correct record and the Chair be authorised to sign them.

Julie Billett, Director of Public Health, introduced the draft report which provided an overview of health and wellbeing in Islington and focused on the economics of prevention.

The following main points were noted in the discussion:

·         The report focused on the importance of prevention; it was explained that Islington faced significant health and wellbeing challenges and it was not possible to increase the scale of services within existing resources. As a result local agencies were considering innovative ways of transforming services through initiatives such as the Haringey and Islington Wellbeing Partnership.

·         The Board considered the financial challenges on health and care services and commented on the importance of reviewing both what services are provided and how they operate. For example, it was suggested that services could become more efficient by minimising the number of assessments carried out by services and taking a more holistic approach to supporting service users. This would require integrated services and a strong degree of trust between agencies.

·         Islington health and care services had a combined annual budget of £800m. The Board considered the importance of reducing bureaucracy to ensure that best use was made of these funds. It was commented that creating jobs in the local community helped to keep local people in good health.

·         It was highlighted that a significant amount of money was spent on a relatively small cohort of highly vulnerable people; it was suggested that ‘quick wins’ were needed, such as reducing duplication between services, to minimise the spend on these individuals and to redirect resources towards prevention.

·         The Board commented on the ‘make every contact count’ initiative. It was suggested that this could reach a wider audience by extending the initiative to voluntary sector organisations, in particular those working with individuals with long term conditions. The Board recognised the assets of the voluntary and community sector and it was suggested that champions from the sector would be welcomed.

Councillor Caluori entered the meeting.

·         It was advised that Islington CCG was fully supportive of enhancing preventative work, commenting that greater collaboration between agencies and across local authority boundaries would increase resources and improve the effectiveness of services. The Board noted the challenge of focusing primary care services on early intervention whilst the existing work load is so large.

·         Graeme Cooke, Head of Strategy and Change, advised that there were between 1,500 and 3,000 residents in Islington who faced multiple disadvantages and had a significant demand for local services. These people may have housing vulnerabilities, be domestic violence victims, have mental or physical health issues, or substance misuse problems. It was suggested that a radically different model was needed to improve outcomes for these people and reduce the costs to public services.

·         A discussion was had on how other agencies can contribute to the ‘make every contact count’ initiative. It was reported that 130 housing repairs operatives had received relevant training. Whist expanding the initiative would be welcomed, it was commented that culture change would be needed to re-focus some services on  ...  view the full minutes text for item 148.

Lisa Arthey, Director of Youth and Communities, and Manju Lukhman, Strategy and Commissioning Manager, introduced the report which set out the borough-wide Violence Against Women and Girls Strategy.

The following main points were noted in the discussion:

·         The Violence Against Women and Girls Strategy had been agreed by several partner organisations, including the council, the Police, and members of the Safer Islington Partnership. It was emphasised that organisations needed to work together to minimise the risk of domestic abuse and support victims effectively.

·         It was explained that the strategy was focused on women and girls but did not exclude men and boys, who could also be victims of domestic violence.

·         The Strategy was supported by an action plan which focused on providing support to victims and perpetrators, as well as developing infrastructure to support the reporting of domestic violence.

·         It was considered that primary care services were well placed to both identify and support victims of domestic violence. The IRIS project assisted GPs, pharmacists, dentists and others in identifying and supporting domestic violence victims.

·         It was reported that female victims of domestic violence could leave home and then return up to ten times before permanently leaving their partner; it was suggested that services need to offer continual and consistent support to these women.

Katie Coleman entered the meeting.

·         A discussion was had on Clare’s Law, which allowed people to find out if their partner had a history of perpetrating abuse. Although this was welcomed, it was queried if there was a method of requiring perpetrators to declare their history to their partners, as it was thought that the law put the onus on the wrong partner. It was advised that this would be investigated further.

·         It was advised that the council could support domestic violence victims by serving anti-social behaviour orders on perpetrators and by seeking to evict perpetrators living in council accommodation. It was also suggested that homes could be adapted to provide safety features for victims.

·         It was suggested that greater partnership working with adult social care could be an effective method of identifying victims of abuse.

RESOLVED:

That the Violence Against Women and Girls Strategy be noted.

Julie Billett, Director of Public Health, and Graeme Cooke, Head of Strategy and Change, introduced the update on the Wellbeing and Work Partnership, which worked to improve the employment and health outcomes of those with a long term condition or disability.

The following main points were noted in the discussion:

·         The partnership had resulted in system-wide benefits including creating professional networks, improving the knowledge of staff, and developing services through co-production with those with lived experience.

·         30 out of 33 GP surgeries had signed up to the trial. The trial commenced in January 2017; it was reported that there had already been 135 referrals made through the Partnership, with a target of 1,000 referrals over 18 months.

·         The Board considered that it was not only important to support people into work, but to help people retain employment if they were at risk of losing their employment due to a health issue.

·         A partner organisation was being sought to develop a peer led mentoring programme. Single Homeless Project (SHP) had expressed an interest in developing this programme.

·         It was emphasised that that long-term unemployment had a considerable detrimental impact on health and wellbeing. The Board thanked officers for their work in developing the partnership.

RESOLVED:
That the progress of the Wellbeing and Work Partnership be noted.

Sean McLaughlin, Corporate Director of Housing and Adult Social Services, introduced the report which set out the progress and requirements of the Better Care Fund.

The following main points were noted in the discussion:

·         Technical guidance had not yet been received for the 2017-19 Better Care Fund period. It was reported that the council and CCG would work together to develop detailed plans once the guidance was received.  It would be necessary to align these plans with wider health and wellbeing activity, including the Haringey and Islington Wellbeing Partnership and the North Central London Sustainability and Transformation Plan. It was advised that detailed plans would be reported to the Board in October 2017. 

·         The additional adult social care funding announced in the government’s Spring 2017 budget would provide an additional £11m over the next three years.

·         The Board considered the achievements of the Better Care Fund over the past year.

RESOLVED:

(i)            That the achievements of integrated working in 2016/17, including areas of improvement of services, be noted;

(ii)           That the planning principles for 2017-19 be noted and that a further update report be received by the Board in October 2017, to include the final arrangements for Islington for 2017-19. 

A member of the public queried how early intervention and prevention initiatives were put into practice, and queried if businesses had been approached directly to support the Wellbeing and Work Partnership.

In response, it was advised that it was intended to support residents to develop healthy behaviours through ‘nudge’ techniques; this included providing intensive support before problems became entrenched, shaping places to become healthier environments, focusing health services around supporting people to stay well, and effectively signposting to services and activities.

It was confirmed that businesses had been approached as part of the Wellbeing and Work Partnership. It was important to develop positive relationships with employers, and to support them in creating opportunities tailored for those with long term conditions.