Public Health Officers delivered a presentation based on the Best Practice Evidence Review Report written for the BHR Children and Young People’s Transformation Board. The Joint Commissioning Board had asked the Transformation Board to prioritise the three areas of ‘Best Start in Life’, ‘Adverse Childhood Experiences’ (ACEs) and ‘Special Educational Needs and/or Disabilities’ (SEND) due to their potential to significantly improve health outcomes for children and young people living in BHR.
Officers asked the Board, having considered the report, to discuss the following questions:
· The next steps and quick wins across the three priorities of Best Start in Life, ACEs and SEND; and
· The opportunities for joint commissioning and the role the Health and Wellbeing Board would play.
The Board agreed that one of the next steps would be to get different parts of the system to agree to invest in one pot in order for joint commissioning to work, as this seemed to be a key barrier. The Board’s role was to challenge partners to go back to their governing bodies to get permission to go outside of normal spending restrictions and obtain the commitment for joint commissioning. Board members stated that it was important to identify clear shared benefits of joint commissioning, present evidence for return on investment and create a good understanding of what each element of the system was responsible for commissioning. A potential ‘quick win’ was to build on the ‘early years intervention’ initiative. Finally, rather than trying to deliver all three priorities at once, the Board felt that officers should consider initially prioritising one area, namely ‘Best Start in Life’, and delivering it well.
Public Health Officers delivered a presentation on BHR Older People and Frailty,based on the Best Practice Evidence Review Report written for the BHR Older People and Frailty Transformation Board. The report was structured around the four priority areas of ‘healthy well’ (aging well), integrated models of care, high intensity interventions and end of life.
Officers asked the Board, having considered the report, to discuss the following:
• The main opportunities and threats to successfully moving away from a hospital-centric system to one that’s more outward focused; and
• How the Health and Wellbeing Board could support the integration of care for older adults within Barking and Dagenham.
The Board commented that community support was essential to moving away from a hospital-centric system. In order to do this, commissioners must understand the assets of the community, and have good governance arrangements in place to ensure the best outcomes. Board members also discussed the social prescription model and the contribution of peer support networks.
The Board noted previous pieces of work which could provide frameworks for building on to create a culture and community where everyone looked out for one another, such as the ‘I Care’ initiative and the ‘Good Neighbour Guide’. The Board also noted that the upcoming joint meeting of the BHR health and wellbeing boards involving various local partners, would provide opportunities to take forward this agenda. Board members discussed the ongoing system transformation, the development of integrated care pathways and the building of partnerships to enable this vision. The Board acknowledged that the Borough had a good history of integrated working which provided a foundation to build upon and that its role was to ensure different parts of the health system get on board to take this agenda forward.