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Agenda and minutes

Venue: Committee Room 1, Town Hall, Upper Street, N1 2UD. View directions

Contact: Jonathan Moore  020 7527 3308

No. Item


Welcome and Introductions


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


Apologies for Absence


Apologies for absence were given on behalf of Dr Katie Coleman, Tony Hoolaghan, Jennie Williams and Angela McNab.



Declarations of Interest

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 an interest as a GP provider in the borough.


Order of Business


The Chair advised that Item B5, Joint Targeted Area Inspections, would be considered following Item B2, Islington Safeguarding Children Board Annual Report 2016/17.


Minutes of the previous meetings pdf icon PDF 148 KB

·         26 April 2017

·         19 June 2017 (meeting in common with LB Haringey)

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That the minutes of the previous meetings held on 26 April and 19 June 2017 be agreed and the Chair be authorised to sign them.


Safeguarding Adults in Islington in 2016/17 pdf icon PDF 143 KB

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James Reilly, Independent Chair of the Safeguarding Adults Board, presented the report which summarised the work of the Safeguarding Adults Board in 2016/17.


The following main points were made in the discussion:


·         There had been a sharp increase in concerns and enquiries about vulnerable adults following the introduction of the Care Act 2014, however in 2016/17 these began to plateau.

·         In the first year following the introduction of the Care Act, 60% of concerns raised resulted in Section 42 enquiries being carried out. In 2016/17, 40% of concerns carried through to enquires. It was commented that Chairs of Adult Safeguarding Boards constantly reviewed and audited the work of statutory agencies to ensure that thresholds for commencing enquiries were being applied appropriately.

·         There had been an increase in concerns about vulnerable adults. The Independent Chair emphasised that this did not mean there had been a significant increase in abuse and neglect, rather that there had been an increase in reporting of such concerns. It was commented that an increase in the reporting of concerns was a positive development.

·         The Independent Chair highlighted three key local issues: the capacity of care homes and the difficulty of commissioning care accommodation in inner city areas; the ‘requires improvement’ grade given to Camden and Islington NHS Foundation Trust by the most recent Care Quality Commission inspection; and the safeguarding concerns at HMP Pentonville highlighted by the recent murder in the prison.

·         The Safeguarding Adults Board had completed a serious case review which had considered how best to handle instances of a neglect in a vulnerable adult’s own home when there are multiple complex factors.

·         It was commented that changes in personnel had an adverse impact on the work of the Safeguarding Adults Board and the Independent Chair was challenging partners to keep a focus on the Board’s activities.

·         Participation in the Safeguarding Adults Board’s four sub-groups had fluctuated over the previous year and this had an impact on the delivery of the Board’s action plan.

·         The Independent Chair commented on the need for Safeguarding Adults Board members to mutually problem solve in a constructive way. It was important to build a culture of openness which recognised the issues in organisations and worked to improve these.

·         Key themes for the Safeguarding Adults Board included modern slavery, social isolation, and those suffering from the often inter-linked issues of homelessness, mental health and addition. It was commented that people experiencing homelessness could exhibit very challenging behaviour and sometimes would not engage with support services, however they were some of the most vulnerable people, were at risk of exploitation and harm, and tended to die younger than expected.

·         A member asked a question about the financial abuse of adults with learning disabilities who have dependent children. It was advised that the Safeguarding Adults Board had not reviewed this in detail, however could look into particular cases if appropriate. It was known that adults with learning disabilities were increasingly being targeted and exploited financially and sexually.

·         It was suggested that  ...  view the full minutes text for item 167.


Islington Safeguarding Children Board Annual Report 2016/17 pdf icon PDF 192 KB

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Alan Caton, Independent Chair of the Safeguarding Children Board, presented the report which summarised the work of the Safeguarding Children Board in 2016/17.


The following main points were noted in the discussion:


·         The Independent Chair welcomed the positive Ofsted report into the work of the Board. Ofsted had made a number of recommendation which the Independent Chair agreed with.

·         It was emphasised that, although the local authority had a lead role in safeguarding children, safeguarding was everybody’s responsibility.

·         The Independent Chair commented on the difficulty of increased financial constraint at a time of increasing demand for services.

·         The Safeguarding Children Board was continuing to focus on its priorities, which included neglect and building resilience; domestic violence, parental mental health and substance abuse; and child sexual exploitation and holding perpetrators to account.

·         The Independent Chair commented that he had previously been concerned by the lack of a strategic multi-agency response to Prevent, however Councillor Watts had attended a Safeguarding Children Board meeting in May to discuss the matter and the Independent Chair was pleased with the progress made.

·         The Independent Chair commented on the risks associated with private fostering arrangements and highlighted that the local authority was only aware of 12 such instances in Islington. It was suggested that all professionals should be encouraged to report such arrangements.

·         The Independent Chair highlighted the importance of the child’s voice and understanding the lived experience of children. The Safeguarding Children Board had held a meeting in a local school and listened to young people’s concerns about serious youth violence.

·         It was recognised that knife crime was still an ongoing issue in the borough and this was being addressed by the Safer Islington Partnership and the Youth Justice Board.

·         The Safeguarding Children Board had raised concerns about service delays and the number of young people under emergency police protection, which were being reviewed further.

·         The Independent Chair highlighted two serious case reviews carried out during the year and summarised the learning from these cases. It was noted that learning was shared London-wide and nationwide.

·         The Board noted that the Children and Social Work Act 2017 would abolish the Safeguarding Children Board, and mandate local authorities, the Police, and CCGs to design their own local arrangements. It was expected that a transition process would take place in 2018/19. The Corporate Director of Children’s Services commented that there was no appetite to significantly alter local safeguarding arrangements in the borough. It was known that some areas were reconfiguring their local safeguarding arrangements to cover their Sustainability and Transformation Partnership footprint, however this was not thought to be appropriate in North Central London. The Board expressed concern that this change would result in inconsistent safeguarding arrangements across the country.

·         Following a question, it was advised that the Board had not considered the impact of problem gambling on children. It was commented that 3,500 adults in the borough were affected by problem gambling and there was bound to be an impact on young people.

·         The Board queried the  ...  view the full minutes text for item 168.


Joint Targeted Area Inspections pdf icon PDF 214 KB


Carmel Littleton, Corporate Director of Children’s Services, presented the report which summarised the arrangements surrounding Joint Targeted Area Inspections.


It was noted that nine days’ notice would be given before an inspection would be carried out. The Safeguarding Children Board was to establish a working group to lead on preparations for a potential inspection.


An inspection would take place over three weeks and focus on a particular theme. Although an inspection was anticipated in the near future, it was not known what the theme would be.




That the report on Joint Targeted Area Inspections be noted.


Islington Fair Futures Commission pdf icon PDF 279 KB


Tania Townsend, Children’s Partnership Development and Strategy Manager, introduced the report which provided an update on the progress of the Islington Fair Futures Commission.


The following main points were noted in the discussion:


·         The Commission had focused on the lived experience of young people and had been keen to hear the ‘hidden voices’ of marginalised young people, such as young carers. The Commission had focused on three themes: place, power and possibilities.

·         The Commission had considered how ‘places’ and the built environment impact on young people. It was recognised that Islington had a limited amount of green space for young people to enjoy. It was thought that community cohesion could be improved by young people having a greater sense of ownership over the local area.

·         Young people were significantly impacted by a lack of affordable housing. Overcrowding had a detrimental effect on young people’s health and exacerbated long term conditions.

·         The Commission had considered the issues faced by young carers. Some young carers had to take time out of school for hospital appointments, and felt that health providers did not consider the impact of rescheduling appointments on their education. Young carers felt that their issues did not receive a high profile and were not understood by schools or health professionals.

·         Young carers wanted the opportunity to share their experiences with each other. It had been highlighted that some young carers were not aware of the support services available.

·         Young people felt that services for adolescents interacted with them in a negative way, focusing on crime, antisocial behaviour and risky behaviours, as opposed to their strengths and personal development.

·         Young people were keen to use online services, including remote consultations and online peer support networks.

·         Young people felt that schools did not focus enough on life skills and readiness for work. Some young people felt that they lacked the social skills to succeed in the workplace.

·         Members of the Health and Wellbeing Board were invited to attend the forthcoming ‘Their Ambitions, Our Future’ Fair Futures Commission event on 8 November 2017.

·         The Board were challenged to consider how they could improve services for young people without allocating additional resources to services. It was suggested that such issues could be considered by the Haringey and Islington Wellbeing Partnership Sponsor Board.

·         It was noted that the Fair Futures Commission was in the processes of developing recommendations. The Board hoped that these would be practical recommendations which would help to steer the strategy of Islington Council and its partner organisations. It was suggested that local agencies could lobby central government on any issues which were outside of their area of responsibility.


The Board thanked Tania Townsend for her attendance.




(i)            That the progress and next steps of the Fair Futures Commission be noted;

(ii)           That all Health and Wellbeing Board members be encouraged to fully engage in the next phase of the Commission. 


Healthwatch Islington Work Plan 2016-18 pdf icon PDF 196 KB

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Emma Whitby, Chief Executive of Healthwatch Islington, introduced the report which outlined Healthwatch Islington’s Strategic Plans for 2016-18. It was noted that Healthwatch would be reviewing its work plan from January 2018.


The following main points were noted in the discussion:


·         Healthwatch was carrying out a review of mental health day service provision and had spoken to over 100 service users. It was hoped that the review would inform future commissioning decisions.

·         Healthwatch was carrying out a mystery shopping exercise of accessibility for people with autism and the findings would be reported to the Autism Partnership Board.

·         Healthwatch was to review digital inclusion, as it was thought that online health services were not reaching some BAME communities.

·         Healthwatch was continuing to work with local organisations who did not have a strong focus on safeguarding.

·         The Board noted their thanks to Olav Ernstzen, who had resigned as Chair of  Healthwatch Islington earlier in the year. The Board noted that Olav had a key role in the development of the organisation.




That Healthwatch Islington’s Strategic Plans be noted.


Child and Adolescent Mental Health Services Transformation Plan pdf icon PDF 435 KB

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Sheron Hosking, CAMHS Commissioning Manager, introduced the report which summarised the progress with the CAMHS Transformation Plan.


The following main points were noted in the discussion:


·         The full transformation plan was due to be finalised shortly. This would set out local priorities and how national targets would be met.

·         The transformation plan was progressing well. There was an emphasis on workforce development and the training of practitioners.

·         A national access target had been set, which required 70,000 more children to access CAMHS services by 2020/21. This would require Islington CCG to increase access by 35% within four years. It was clarified that ‘access’ was defined as accessing two NHS appointments in six weeks. This was particularly problematic as 25% of young people accessing CAMHS services in Islington only attended one appointment.

·         Following a question, it was confirmed that there was a non-attendance rate of 20% in Islington, which was consistent with national statistics.

·         It was commented that there was a wide range of CAMHS services and it was essential for young people to access the right services at the right time. For this reason, it was essential to correctly signpost young people. Signposting could be supported through appropriately resourcing the voluntary and community sector, sharing data between services, and developing effective digital services.

·         The Board commented on the importance of reducing waiting times. The average waiting time for an appointment was six to eight weeks; some young people become increasingly vulnerable in this time and this can result in a referral to children’s services. The need for early intervention was emphasised.

·         Following a question, it was advised that CAMHS services were keen to embrace new technologies such as online consultations, however practitioners needed to be confident in referring to digital therapies. It was intended to pilot an app which would support people with low level anxiety and depression.

·         The Board commented on the importance of CAMHS services and the need for local services to care for young people as they would their own children. It was commented that a greater emphasis on outcomes would be welcomed.

·         It was noted that the final plan would be circulated to members of the Health and Wellbeing Board in due course.


The Board thanked Sheron Hosking for her attendance.




(i)            That the progress made on the Transformation Plan be noted. 

(ii)           That the final plan be signed off outside of the meeting in order to meet the deadline set by NHS England.


Draft Pharmaceutical Needs Assessment 2018 pdf icon PDF 266 KB

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(i)            That the draft Pharmaceutical Needs Assessment be approved for consultation;

(ii)           That final approval of the Pharmaceutical Needs Assessment be delegated to the Chair, following any necessary changes made in response to the consultation.


Better Care Fund Update pdf icon PDF 291 KB

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It was noted that a letter had been received from the Secretaries of State for Health and Communities and Local Government which indicated that the government may intervene in areas where delayed transfer of care targets were not met. The Board did not believe that Islington would meet the criteria for intervention.


It was commented that in future years a more collaborative cross-borough approach may be taken through the Haringey and Islington Wellbeing Partnership.




That the submission of the Better Care Fund plan for 2017/18 be noted.