Decision details

The Board will be provided with the annual report of the Director of Public Health, for information and discussion.

The Director of Public Health presented his Annual Report for 2018/19, which provided an opportunity for an independent assessment of the health of the population and to focus on some priority areas the Council and its partners needed to think through in order to improve health outcomes. He referred to the transformation taking place in integrated care across Barking and Dagenham, Havering and Redbridge (BHR) and stated that it was an opportunity for Public Health to give direction to health system leaders. His key message was that applying the same strategy would lead to the same outcomes and it was necessary to take a fundamentally different approach to health and care and shape the system’s accountability and governance arrangements to ensure they served desired outcomes. He strongly believed that gaining consensus on what local services should look like and building relationships in the community would lead to improvements in performance and outcomes.

The Chair praised the report for its quality and felt that it demonstrated that the Council knew its community well. She asked that the Barking and Dagenham Clinical Commissioning Group (CCG) place the report on the agenda for their governing body meeting so that it could be discussed in more detail in their role as commissioners.

The Board discussed the meaning and importance of co-design and co-production of services and documents, particularly with residents. To achieve this, Board members felt that when reviewing governance arrangements, system leaders would need to go beyond the ‘usual suspects’ and find people who had a strong stake and passion in the community. They emphasised the importance of this Board challenging other local boards on these ambitions and whether they are looking at ways to join-up their work.

The Chair stated that there seemed to be a perception that various local boards had fallen into ‘silo’ working again and that the Away Day in July this year, which would be a joint meeting of health and well-being boards across BHR, was an excellent opportunity to review and address this.

The Director of People and Resilience stated that she was confident that the new Multi-Agency Safeguarding Board arrangements would give a stronger voice to children and their families and facilitate the Council to self-assess, which would drive continual improvement. She added that officers in adult social care would be undertaking a ‘story-telling’ exercise in July whereby residents would lead their own assessments for eligibility for social care to ensure social workers understood their circumstances fully. These types of initiatives gave her confidence that the Council would be able to respond to the challenge of resident involvement in how services are shaped and delivered.

The BHRCCG’s Director for Transformation and Delivery stated that she welcomed the report and felt that it was in line with the direction the BHRCCGs were taking regarding system working. She felt also that there had been some loss of direction in the CCGs reporting back to this Board and other local boards; although she felt it important to highlight the good collaborative work that had taken place in primary care and older people’s care transformation.

Dr Jagan echoed the above comments. He believed the recent lapse in communications between different boards could be easily resolved. Whilst reports like this helped understand the extent of ill health in local communities better, it was imperative for local systems to think carefully about how services could be designed to enable earlier interventions to stop progression of ill health and disease.

The Board was informed of a recent event held by the Early Intervention Foundation which involved professionals such as mid-wives and health visitors. There had been an excellent turnout with many discussions around the importance of early years intervention, which supported the Board’s discussions today.