Agenda and minutes

In accordance with the Council’s Constitution and the ICB Sub-Committee’s Terms of Reference, Members of the Committees in Common are asked to declare any interest they may have in any matter which is to be considered at this meeting.

The minutes of the Health and Wellbeing Board and ICB Sub-Committee meeting held on 26 June 2023 confirmed as correct.

The Chair will call for nominations for the position of Deputy Chair.  The Deputy Chair should be a member of both the Health and Wellbeing Board and the ICB Sub-Committee, in order to carry out the Chair’s full responsibilities.

The Health and Wellbeing Board and ICB Sub-Committee agreed to appoint Charlotte Pomery, Executive Director, NHS North East London, as Deputy Chair for the 2023/24 municipal year.

The Chair introduced a report from the Council’s Chief Executive relating to proposed changes to the membership of the Health and Wellbeing Board.

The proposals related to the reallocation of one of the two Barking and Havering and Redbridge University Hospitals NHS Trust (BHRUT) seats to Newham University Hospital (NUH), to reflect the greater role of NUH in providing patient services to local residents, and the inclusion of the local Independent NHS Complaints Advocate as a standing invited guest. 

The Health and Wellbeing Board:

(i)  Approved the reallocation of one of the two BHRUT seats on the Board to NUH and note that Simon Ashton, Chief Executive Officer at NUH, was expected to take up the seat (Note: NUH subsequently confirmed that the seat would be filled by Tom Ellis, NUH Director of Strategy);

(ii)  Agreed that the Independent NHS Complaints Advocate for Barking and Dagenham be given ‘Standing Invited Guest’ status on the HWB; and

(iii)  Noted that the appropriate amendments to Part 2, Chapter 7 of the Council Constitution shall be reported to the next meeting of the Assembly.

The ICB Sub-Committeenoted the report.

The Chair introduced a report from the Council’s Commissioning Manager for Adults’ Care and Support which provided the first annual update on the delivery and ongoing development of the Action Plan linked to the Carers Charter 2022-2025.

The Charter had been co-produced with unpaid carers from the Borough and was adopted by the HWB at its meeting on 12 January 2022 (Minute 40 refers).  The Charter set out the Council’s and its partners’ commitment to carers in Barking and Dagenham and how they would be supported in their caring role.  The Charter was accompanied by an Action Plan that acted as the framework for the delivery and development of services, working practices, and the identification and support of unpaid or informal carers in the Borough.

The Chair drew attention to the 2021 Census which showed that 1 in 14 of the Borough’s residents, which represented approximately 14,000 individuals, were recorded as performing a caring role.  However, the Council was only aware of approximately 4,000 of those individuals and whilst GP surgeries also recorded carer information, it was apparent that the majority of carers in the local community were unknown and unrecognised.

The Action Plan had been designed to represent an achievable, staggered programme of improvements and the Chair referred to several aspects, which included the greater involvement of carers in the hospital discharge pathway and signing-off of care plans, carers’ assessments, training for front-line staff to raise awareness of carers and the support available to them, and support for young carers, such as respite. 

Arising from the discussions, reference was also made to:

·  The critical role of carers during the Covid-19 pandemic and the need to reflect their role in winter planning arrangements;

·  The development of a Carers Strategy by the North East London Foundation Trust (NELFT) and the need to triangulate activities across the partnership to ensure consistent messaging and avoid duplication;

·  The importance of Education, Health and Care (EHC) plans being in place for young carers and the role of Schools in identifying young carers to ensure they received the right support;

·  The improvements being made in the sharing of relevant data across partner organisations; and

·  The need to develop a partner-wide communications strategy that would help to identify carers and make them aware of the support available, with a particularly focus on those ethnic groups who were less likely to identify themselves as carers.

The Health and Wellbeing Board and ICS Sub-Committee:

(i)  Noted the update on the delivery of the Carers Charter Action Plan, as detailed in Appendix 2 to the report; and

(ii)  Endorsed the sharing of relevant data by partners to support the delivery of the Action Plan.

The NHS North East London’s Director of Partnership Impact and Delivery for Barking and Dagenham (DPID) introduced a report and presentation on the winter planning preparations across the Barking and Dagenham place-based partnership, which was underpinned by the Barking and Dagenham, Havering and Redbridge (BHR) Places Urgent and Emergency Care (UEC) Improvement Plan.

The Winter Plan for 2023/24 focused on the three core areas of prevention, hospital avoidance and discharge support. Priorities and key actions had been developed through a partnership workshop and would be developed further through the Adults and Children’s Delivery Groups, ensuring it was responsive and dynamic. 

The DPID commented on the additional impact that the cost-of-living crisis was having on the local community and referred to a number of health and equality pilot projects that would help to address some of those issues, which had been incorporated into the Winter Plan.  Another key element of the Winter Plan related to national guidance issued by the Department of Health in July, which set out the responsibilities of ICBs and NHS Trusts in terms of High Intensity Interventions (HII) that covered 10 specific aspects.  It was noted that the ICB actions would be led via the Place Based Partnerships and be amalgamated into the NHS NEL Plan.

A workshop held on 9 August was well attended by partners and discussed opportunities to strengthen the partnership response to winter resilience. The workshop focused on the areas of Right Care First Time, prevention, proactive care and discharge support. Some key themes that came out of the discussion included:

·  Improving the communication channels between providers – strengthening and improving access to a directory of services that enabled practitioners to refer to the full range of out of hospital services;

·  Education and better communication with residents so they know how to access local community services and care for themselves and their families;

·  Early preparation and taking a more proactive approach to planning – engage with residents well ahead of winter so that they feel that they have a stake in what is being offered;

·  Development of a robust response for people presenting with mental health conditions in the community;

·  Optimising current services and pathways e.g. integrated case management, voluntary sector support post discharge; 

·  Improving the discharge process – better understand the reasons for delays for B&D residents and support early discharge planning. 

Stemming from the issues referred to above, the DPID referred to the draft Winter Plan and UEC Improvement Strategy and Plan which were appended to the report, the funding required to support the initiatives for 2023/24 and key risks.  The Committees in Common also heard from NHS NEL officers on a range of communication campaigns aimed at raising residents’ awareness of where and how to access services, changing behaviours

Members very much welcomed the Winter Plan and made a number of observations, which included:

Ø  Taking advantage of Community Hubs, several of which were based in health-related buildings, to deliver a combined health programme and the additional role that  ...  view the full minutes text for item 18.

The Council’s Chief Executive advised on action she had taken on behalf of the Health and Wellbeing Board in respect of approving a variation of the contract for the provision of the integrated 0-19 Healthy Child Programme with NELFT for a period of 16 months from 1 September 2023 to 31 December 2024, as a decision on the matter was required prior to this meeting.

The Health and Wellbeing Board and ICS Sub-Committee noted the action taken by the Council’s Chief Executive, in accordance with the Urgent Action procedure under Part 2, Chapter 16, paragraph 4 of the Council Constitution, in relation to:

(i)  Agreeing to waive tendering requirements and approve the variation of the contract for the provision of the integrated 0-19 Healthy Child Programme with NELFT for a period of 16 months from 1 September 2023 to 31 December 2024, in accordance with the strategy set out in the report; and

(ii)  Delegating authority to the Director of Public Health, in consultation with the Cabinet Member for Adult Social Care and Health Integration, to enter into the extended contract and all other necessary or ancillary agreements with NELFT to fully implement and effect the proposals.

There were no additional questions from the public.

The Chair stressed the need for a more dynamic flow of information sharing amongst the various organisations, local authorities, Boards etc. to enable a better understanding of best practice and new initiatives across health-related services.  Average national waiting times across health authorities and patient choice were given as examples to enable the Committees in Common to assess how the North East London area, and Barking and Dagenham in particular, compared with other areas. 

The Executive Director, NHS NEL, advised that performance framework discussions were taking place and suggested that the matter could be considered in detail at the Adults and Children’s Delivery Group, with a more succinct paper then presented to the Committees in Common.  The Executive Director of Partnerships, NELFT, further advised that she was already discussing with partner organisations the collection and sharing of relevant local data with Place Based Partnerships and a presentation would be given at the next meeting of the Committees in Common.