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 early intervention and prevention. It was suggested that further work with schools and youth hubs could be effective, particularly on issues such as alcohol abuse.
That the Annual Public Health Report be noted.