Agenda and draft minutes

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

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

It was noted that, in the absence of Councillor Joseph Ejiofor, Councillor Peray Ahmet would co-chair the meeting with Councillor Richard Watts.

Apologies for absence were received from Councillor Joseph Ejiofor, Councillor Joe Caluori, Tony Hoolaghan, Jennie Williams, Carmel Littleton, Angela McNab, Dr Dina Dhorajiwala and Cathy Herman.

No items of urgent business were declared.  

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None.

RESOLVED:

That the minutes of the previous meeting held on 29 January 2018 be agreed as a correct record of the meeting.

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.

None.

Rachel Lissauer, Director of the Haringey and Islington Wellbeing Partnership, made a presentation which summarised the achievements of the Partnership to date.

The following main points were noted in the discussion:

·         Haringey and Islington had a shared conviction and determination to tackle health inequalities and improve the health of the local population. Joint work was underway in a number of areas to improve health and care services. This included developing shared infrastructure and connecting pathways of care.  

·         It was important to make best use of public estates. The Wellbeing Partnership was submitting a bid to One Public Estate to maximise the use of estates for housing.

·         There were new opportunities arising from developing shared professional networks and training opportunities across Islington and Haringey. It was suggested that improvements to workforce practices may assist with retention and recruitment.

·         It was commented that quality improvement work was underway across community health services.

·         Multi-agency access to shared digital records would improve services for residents, particularly those with multiple conditions who work with several different professionals.   

·         Front line staff did not want to work within traditional service boundaries and were keen to break down barriers between services.

·         Events would be held with public sector staff across North Central London to consider service integration. 

·         The Sub-Committee commented on the progress that had been made so far and the positive benefits this had for residents. A member of the Sub-Committee commented that the improvements to hospital discharge arrangements had been particularly positive.

·         It was commented that services for children and young people should be included in the transformation work being carried out by the Wellbeing Partnership; it was thought that further integration between health and care and early help and preventative services would provide more holistic support to children and young people.

·         A member commented on the importance of resident engagement and co-production, noting that it was vital for the local community and service users to be involved in the development of services. In response, it was commented that co-production had been limited to date as the majority of work had related to internal staffing and technical arrangements, however resident engagement would be critical to the development of place-based services. Members would be keen to review an action plan for community service user engagement.

RESOLVED:

1.    To note the progress made on integrating pathways of care with a focus on people with diabetes, frailty, musculo-skeletal conditions and people needing immediate care.

2.    To recognise ongoing work on enablers to integrated care, particularly integrated digital care records, estates and community services.

3.    To note the learning to date and plans for the next phase of work.

(a)  Developing Place Based Services in Islington

(b)  Developing Locality Based Care in Haringey

Maggie Kufeldt introduced the report setting out the progress made in developing place-based services in North Islington.

·         Islington had a strong preventative model that was based on supporting the resilience of service users.

·         A place-based services prototype was being developed in the north of the borough and was intended to be replicated elsewhere once arrangements had bedded in.

·         Place-based care would bring together health, housing, children’s, community and social services. It was intended to significantly increase the collaboration between services.

·         Islington Council could not develop place-based services in isolation and was keen to work with NHS and voluntary sector partners, as well as other housing providers and the emergency services.

·         Place-based working would reduce duplication between services and enable more joined up service delivery. An integrated multi-disciplinary team working across the public sector would help to address the root causes of the issues affecting residents and develop a connected and efficient workforce.

·         It was expected that services would be delivered from fewer, better buildings which would increase the land available for social housing.

·         Service redesign events and workshops would be held with council staff and colleagues from partner organisations. Resident engagement would begin in 2019.

Beverley Tarka and Will Maimaris introduced the report on the locality-based care pilot in North Tottenham.

·         Haringey was developing locality-based care for similar reasons to Islington. The Haringey pilot had a focus on early intervention and whole-system outcomes.

·         The importance of resident engagement was reiterated. Residents are important partners in developing successful locality-based arrangements.

·         Haringey’s pilot had focused on North Tottenham. It was commented that significant public resources were already being spent to provide services in the area; the pilot would facilitate greater coordination between services, which would make them more effective and responsive.

·         Residents in North Tottenham faced significant health inequalities. There was a 17 year gap for women and a 15 year gap for men in heathy life expectancy in Haringey between the most affluent and most deprived populations.

·         The North Tottenham pilot involved key partner organisations including Homes for Haringey.

·         The pilot was seeking to achieve immediate improvements in the short term. A longer term plan for more transformative work had been developed.

The following main points were noted in the discussion:

·         It was queried if voluntary and community sector partners would also benefit from workforce development initiatives, including access to training and information sharing. In response, it was advised that further work around this would be needed, however it was noted that partnership working with the voluntary and community sector on a locality basis would be beneficial.

·         It was advised that the NHS had previously debated including voluntary and community sector organisations in Community Provider Networks. To date this had not been fully implemented, however it would be valuable for the voluntary and community sector to be involved in locality working projects.

·         It was commented that the views of service users needed to be taken into account in defining measurable outcomes and on the use of public estates. It was suggested  ...  view the full minutes text for item 9.

Rachel Lissauer introduced the report which set out the need for further development of local health and care governance arrangements.

It was noted that both Islington and Haringey Health and Wellbeing Boards were reviewing their membership and as a result the membership of the Joint Sub-Committee may be revised.

RESOLVED:

1.    To note the evolving governance designed to support the delivery of more integrated care at a locality and borough level.

2.    To note that national and local plans to develop more integrated health and care services are likely to prompt further consideration of governance arrangements. These will be brought back to borough Health and Wellbeing Boards and the joint Sub-Committee as appropriate.