Agenda and minutes

In accordance with the Council’s Constitution, Members are asked to declare any interest they may have in any matter which is to be considered at this meeting.

There were no declarations of interest.

The minutes of the meeting held on 14 November 2022 were confirmed as correct.

The Director of Integrated Care (DIC) at the North East London Integrated Care Board (NEL ICB) presented an update on the NHS North East London Severe Weather System Response, which provided context as to:

• The main risks to the NHS and to patients during severe weather;
• NHS Emergency Preparedness, Resilience and Response (EPRR) planning;
• The NEL ICB Severe Weather Plan and multi-agency planning;
• How the NHS responded to the 2022 summer heatwave and lessons learnt from this; and
• 2023 heatwave planning.

In response to questions from Members, the DIC stated that:

• From a NEL ICB perspective, she was not aware of any issues that had been reported as a result of the Summer 2022 heatwave. The main risk that had presented had been around fire and the need for the ICB to respond to this.
• There had not been a cold weather alert this winter; however, the risks seen had largely presented around Covid-19 and infection.
• Elderly residents were a vulnerable group who were more likely to be impacted by extremes of weather than younger patients. Whilst one of the objectives of the Severe Weather Plan was to identify vulnerable groups who might require more support during extreme weather, it was not felt that this had occurred in a systematic way during the Summer 2022 heatwave and this was to be better incorporated into NEL ICB planning for the 2023 summer. NEL ICB also had the opportunity to take more of a localised approach to this through its Borough Partnership work.
• Whilst she did not have data that reflected the service impact of severe weather, it was fair to say that services had been impacted by this, such as through additional patient admissions.

The Cabinet Member (CM) for Adult Social Care and Health Integration (ASCHI) stated that there had not been enough analysis undertaken of who presented most during the severe weather periods, which she intended to look into at the Partnership Board and bring back to the Health Scrutiny Committee. Whilst data was available at a North East London level, she wanted to know what was happening at a local level. She also stated that a data sharing agreement between local partners was essential in helping to support all vulnerable patients during crises; all organisations needed to work with one definitive list, to ensure that no patient would miss out on support because they were on one organisation’s contact list, but not on another’s. A protocol needed to be developed, to ensure more effective planning.

The Integrated Care Director (ICD) at NELFT stated that it was important to define the term ‘vulnerability’ and what this meant in terms of actions that needed to be carried out. She also stated that extreme weather also led to the cancellation of clinical appointments, either because patients could not travel or the environments were too hot, for example due to the older buildings and lack of air conditioning. This would then delay patients’ treatment pathways, due to the inability to deliver the appointments  ...  view the full minutes text for item 65.

The Director of Public Health (DPH) presented his 2022 Annual Report, which was a statutory requirement of the DPH, mapping out the key issues facing Barking and Dagenham and considering potential solutions based on evidence and epidemiology. The DPH detailed:

• The context behind the report and how it was produced;
• The links between the report, the Health and Wellbeing Strategy and the Integrated Care Strategy;
• Key messages from the report, such as the fact that health inequalities had widened within the Borough, which had mostly been driven through individuals not coming forward for early identification of disease screening programmes and health checks;
• The implications of the Covid-19 pandemic and the cost-of-living crisis in widening health inequalities within the Borough;
• Potential solutions to widening health inequalities, such as through the development of the Place-based arrangements and the Integrated Care System;
• The breakdown of chapters within the report and where more information could be sought.

Members noted the report and the usefulness of its contents in supporting their lines of questioning around the development of both the Health and Wellbeing Strategy and the Integrated Care Strategy.

The Director of Public Health (DPH) presented a report which enabled the Committee to provide comment on the direction of travel for refreshing the Joint Local Health and Wellbeing Strategy (JLHWBS), in the context of the newly established Place-based Partnership and Integrated Care System. It was noted that:

• The current Barking and Dagenham Health and Wellbeing Strategy (HWBS) would end in March 2023 and would now be known as the Joint Local Health and Wellbeing Strategy (JLHWBS), to take into account the new Integrated Care System (ICS) and the Council’s relationships through the new place-based arrangements.
• Whilst the final version of the document would be approved at the Health and Wellbeing Board, it was important for the Committee to review the document, with a view to ensuring that it felt that the health and wellbeing vision for Barking and Dagenham was represented in the Strategy;
• The refreshed Strategy would set out a renewed vision for improving the health and wellbeing of residents and reducing inequalities at every stage of residents’ lives by 2028;
• The NHS NEL’s Integrated Care Strategy (ICS) would need to be considered when preparing the JLHWBS;
• A Joint Forward Plan would be developed to deliver the ICS, which would need to align to a Local Delivery Plan at Place for the delivery of the JLHWBS; and
• It was also important for the Committee to consider what needed to be brought to it at a local level and what would be better scrutinised at a wider level, such as through the Joint Health Overview and Scrutiny Committee (JHOSC).

The Cabinet Member (CM) for Adult Social Care and Health Integration (ASCHI) highlighted the importance of ensuring that all documents tied in together and reflected Barking and Dagenham priorities, as well as those of the other boroughs within outer North East London. She requested that the Committee inform both herself and the DPH of any potential gaps in the Strategy, as well as provide challenge around any programmes of action designed, as what might work in one part of the country, may not work locally.

In response to questions from Members, the DPH stated that:

• The priority of mental health related to the issues that were most prevalent within Barking and Dagenham, which were mainly anxiety and depression, and which were also increasingly prevalent within schools. As part of the Adults’ and Children’s Place Delivery Group, various questions would also need to be addressed, such as improving CAMHS’ waiting lists.
• Whilst there were some issues that would be best addressed by the JHOSC, where issues crossed borough boundaries and affected residents in a similar way in each borough, there were also some issues that would be best addressed by the Barking and Dagenham Health Scrutiny Committee (HSC), particularly where the needs of the borough were particularly unique and needed to be reflected. The DPH advised the Committee that if any Member was concerned about a particular issue that was fundamental to improving the health of Barking and Dagenham residents, that  ...  view the full minutes text for item 67.

The Chair of the Committee delivered a short update on the North East London Integrated Care Strategy Development, which was originally presented to the ONEL JHOSC at its meeting on 10 January 2023. This provided the Committee with some updates as to the key points that arose from the meeting, such as the next steps around the development of smarter metrics to measure success against the Strategy’s objectives, and engagement work that had been undertaken with the Voluntary Sector as part of the Strategy development. The Committee was also provided with the opportunity to give any further feedback around the Strategy, which could then be shared with NEL ICB.

The Cabinet Member for Adult Social Care and Health Integration stated that in terms of community consultation in the development of the Strategy, a programme called ‘the Big Conversation’ had been launched across North East London. These conversations would be influenced on a place-level and conducted within each borough, with best practice also being reflected into the engagement process. The Strategy was an interim document and would continue to change as community feedback was received. By pooling resources and knowledge, it was hoped that the Strategy and community conversations would be as effective as possible.

The Chair requested that for the public record, the Committee note the project plan and draft timeline that had been developed for its Scrutiny Review on the potential of the Voluntary and Community Sector. This project plan and draft timeline had previously been shared with the Committee as part of a presentation that had been delivered to it by the Director of Community Participation and Prevention on 19 December 2022. The Chair stated that he would be in touch with Members around the next steps for the review.

The agenda reports pack and minutes of the last meeting of the Joint Health Overview and Scrutiny Committee can be accessed via: Browse meetings - Joint Health Overview & Scrutiny Committee | The London Borough Of Havering

It was noted that the minutes of the last meeting of the Joint Health Overview and Scrutiny Committee could be accessed via the link provided on the front sheet of the agenda pack for this meeting.

The Chair informed the Committee of the following changes that had been made to the Work Programme since the last meeting, which were agreed by the Committee:

• The Finalised Governance Arrangements for the Place-Based Partnership item, which was due to be presented to the Committee on 29 March 2023, would now also include an update on the Joint Forward Plan, to provide additional context and as a draft of the Joint Forward Plan was due by 1 April 2023; and
• An item on the Draft Joint Local Health and Wellbeing Strategy would be added to the 29 March 2023 agenda, to enable the Committee to provide any initial comments.