Agenda and draft minutes

Venue: Bromley Civic Centre

Contact: Kerry Nicholls  020 8313 4602

Items
No. Item

19.

APOLOGIES FOR ABSENCE

Minutes:

Apologies for absence were received from Councillor Ruth Bennett, Janet Bailey, Harvey Guntrip and Dr Nada Lemic.

 

Apologies for absence were also received from Colin Maclean and Janet Tibbalds attended as his substitute.

20.

DECLARATIONS OF INTEREST

Minutes:

There were no declarations of interest.

21.

MINUTES OF THE MEETING ON 7th SEPTEMBER 2017 pdf icon PDF 199 KB

Minutes:

RESOLVED that the minutes of the meeting held on 7th September 2017 be agreed.

22.

QUESTIONS FROM COUNCILLORS AND MEMBERS OF THE PUBLIC

In accordance with the Council’s Constitution, questions to this Committee must be received in writing 4 working days before the date of the meeting.  Therefore please ensure questions are received by the Democratic Services Team by 5.00pm on 24th November 2017.

Minutes:

No questions had been received.

23.

Nash College Presentation (NASH)

Minutes:

The Board received a presentation from Simon Cartwright, Head of College and Steve McDermott,Regional Livability Manager outlining the work of Nash College, an independent specialist further education college for students aged 19-25 years with a range of special educational needs and disabilities based in Hayes, Bromley.  Nash College had approximately 70 students, 10 of whom accessed the College’s residential offer.

 

Nash College was one of the services run by Livability, a national Christian disability and community engagement charity which worked to tackle barriers and promote inclusion for all and provided a range of commissioned care and community projects throughout the UK, including residential care homes and supported living schemes, schools and wellbeing centres.  Livability’s values were to be open, enabling, inclusive and courageous, and an emphasis was placed on ‘Livable Learning Community’ with the objective of creating this in Bromley through a programme of personalised learning and by supporting students to participate in the community and access vocational opportunities.  Nash College had been awarded a ‘Good’ rating by both Ofsted and the Care Quality Commission in relation to its work with both day and residential students. 

 

Livability’s key priorities for the future development of special educational needs and disabilities provision within Bromley were to enable access to specialist placements within the local community, support increased joint commissioning and involve the third sector in improving the local care offer. 

 

In response to a question from a Member, the Regional Livability Manager reported that the residential offer at Nash College had reduced in recent years as more young people with special educational needs and disabilities chose to access day provision, and that the residential offer would be refreshed to support students to live more independently.  The Head of College noted that whilst the College currently provided an education offer for young people with more complex special educational needs and disabilities, future provision might be expanded to include young people with less complex needs or from an earlier age as the College was registered for pupils from the age of 16 years.

 

In noting the benefits of an education offer for the 16 to 25 year age group to support transition to adult services, a Board Member asked for more information about learning at Nash College.  The Head of College confirmed that the College offered both accredited and non-accredited learning and developed its curriculum collaboratively with other schools and colleges.  There was a need to ensure that non-accredited learning provide tangible learning outcomes and work was being undertaken with key partners including Bromley Mencap to develop the employability offer, part of which would include opening a charity shop and café.  A Next Steps provision was also available for former students on the site of Nash College.  This had initially been a day opportunities service offering a further 12 months provision to students leaving the College to encourage successful transition into adulthood; however the service had developed and grown and now offered learning and development day programmes to adults who had not  ...  view the full minutes text for item 23.

24.

Update on the Homelessness Strategy (LBB) pdf icon PDF 68 KB

Additional documents:

Minutes:

Report CS18107

 

The Board considered an update on the draft Homelessness Strategy 2018-23 that had been scrutinised at the meeting of Care Services PDS Committee on 14th November 2017.  This update would also be considered by Council’s Executive at its meeting on 6th December 2017 with a view to seeking authorisation for an eight week public consultation exercise, following which the Homelessness Strategy 2018-23 would be finalised and presented to the Council’s Executive for approval.

 

The Local Authority had a legal requirement to agree a published homelessness strategy.  The draft Homelessness Strategy 2018-2023 had been developed in consultation with service users and stakeholders and detailed the Local Authority’s approach and further planned developments to strengthen homeless prevention and increase access to affordable and sustainable accommodation, thus reducing demand for emergency accommodation.  The proposed strategic priorities within the draft strategy comprised early identification and prevention of homelessness, achieving positive outcomes for young people, increased access to and promotion of the supply of accommodation and achieving improved health and wellbeing by supporting people to break the cycle of homelessness.  The draft Homelessness Strategy 2018-2023 also reflected a significant change to the Local Authority’s statutory duties in relation to homelessness and temporary accommodation within the Homelessness Reduction Act 2017 that would come into force in April 2018.  Should the Council’s Executive authorise the eight week public consultation exercise, Members of the Health and Wellbeing Board were requested to provide their views as part of the consultation.

 

In considering the report, the Chairman was pleased to note the range of preventative work being undertaken to support people to remain in their homes.  The Chief Officer, Bromley Clinical Commissioning Group noted that whilst Integrated Care Networks were currently focused on older people with complex needs, it might be possible to widen this out to include other vulnerable groups who were at risk of homelessness or placed in temporary accommodation, such as people with mental health needs or young families, to ensure their health needs continued to be met in a coordinated way. 

 

A Board Member reported that Healthwatch Bromley had recently undertaken work on how people who were homeless or who had been placed in temporary accommodation were supported in maintaining their registration with a GP surgery.  The Housing Compliance and Development Manager confirmed that the Support and Resettlement Team worked to support families who were homeless or placed in temporary accommodation to access appropriate school and health services, particularly where they had been placed outside of the Borough.

 

RESOLVED that the update be noted.

25.

Vulnerable Adolescent Strategy (BSCB) pdf icon PDF 125 KB

Additional documents:

Minutes:

Report CS18108

 

The Board considered an update on the Bromley Safeguarding Children Board Vulnerable Adolescent’s Strategy 2017-19 that was ratified by the Bromley Safeguarding Children Board in July 2017 and had been shared with Ofsted at the monitoring visit in August 2017. 

 

The Vulnerable Adolescent’s Strategy 2017-19 was a multi-agency document providing a strategic foundation upon which the local safeguarding framework would be further developed.  The Strategy would also define the roadmap to strengthen the identification and assessment of vulnerable adolescents in Bromley and outline intervention procedures.  The strategy focused on five priorities comprising knowing the problem and response, strong leadership, prevention and early intervention, protection and support, and disruption and prosecution.  The strategy would be underpinned by the protocols for Child Sexual Exploitation and Missing Children, published in Summer 2017, as well as the forthcoming protocol in Gang Involvement and Association.  Members of the Health and Wellbeing Board were requested to note the strategy and ensure that all relevant staff were aware of the Vulnerable Adolescent’s Strategy and the underpinning protocols for Child Sexual Exploitation and Missing Children.  The Independent Chairman, Bromley Safeguarding Children Board explained that whilst the Vulnerable Adolescent’s Strategy provided the overarching strategy, the operational protocols for Child Sexual Exploitation, Missing Children and Gang Involvement specified how this would be delivered.

 

In considering the report, a Member praised the excellent layout of the strategy and queried how it would be communicated to all key partners, including schools.  The Independent Chairman, Bromley Safeguarding Children Board confirmed that a robust strategy was in place for the publication of the Vulnerable Adolescent’s Strategy which included an App to assist parents, carers and professional in identifying vulnerable young people.  The Vulnerable Adolescent’s Strategy would also be part of the training programme for designated Child Safeguarding Leads in schools.  Another Member underlined the need to engage with voluntary groups, and the Independent Chairman, Bromley Safeguarding Children Board noted that following the recent reconfiguration of the Bromley Safeguarding Children Board, a Community Engagement Sub-Group had been created to develop closer links with the community which would support the communication of the strategy.

 

A Member queried a statement within the Vulnerable Adolescent’s Strategy identifying a correlation between living in a more deprived part of the Borough and increased risk of self-harm and suicide which the Independent Chairman, Bromley Safeguarding Children Board clarified as a finding of a 2017 study by the Samaritans.  The Chairman requested that work be undertaken to identify if this was applicable to Bromley, as suicide and self-harm amongst vulnerable young people in the Borough had historically been identified as impacting high-achieving young people as well as those living in deprived and disadvantaged circumstances.

 

The Independent Chairman, Bromley Safeguarding Adults Board highlighted the importance of both Safeguarding Boards working together to ensure that young people were safeguarded in a seamless manner as they transitioned to adult services.  The Independent Chairman, Bromley Safeguarding Children Board agreed that there should be a focus on early intervention to address issues experienced by vulnerable  ...  view the full minutes text for item 25.

26.

Bromley Improved Better Care Fund (LBB) pdf icon PDF 154 KB

Minutes:

Report CS18101

 

The Board considered an update on the Bromley Improved Better Care Fund (IBCF) which was a time-limited grant to the Local Authority to fund adult social care services.

 

In the Spring Budget 2017, the Local Authority had been awarded an IBCF Grant of £4.2M for 2017/18, £3.4M for 2018/19 and £1.7M for 2019/20, which was provided for the purposes of meeting adult social care needs, reducing pressures on the NHS including timely discharge, and ensuring that the local social care provider market was supported.  The Local Authority had worked closely with the Bromley Clinical Commissioning Group regarding the use of the grant for 2017/18, and the Bromley Clinical Commissioning Group and Council’s Executive had agreed the proposed spending plans which included workforce development within social care, support for Integrated Care Networks and investment to increase the uptake of Direct Payments.  The Local Authority had also produced a set of recommendations for how the IBCF Grant could be used to best effect to create a financially sustainable adult social care system beyond 2020 to meet the needs of Bromley residents.  Members of the Health and Wellbeing Board were requested to note the proposals for the Improved Better Care Fund and to promote these proposals within their individual organisations.

 

In response to a question from the Chairman, the Director: Adult Social Care advised that there had historically been a low take-up of Direct Payments in Bromley due to the difficulties service users faced in managing their own care packages and a lack of choice within the local care market.  The proposed investment of IBCF Grant to fund a Direct Payments Lead Officer would drive forward the whole system response for Direct Payments and was expected to increase the uptake of Direct Payments by service users, enabling them greater choice and independent in managing their care as well as supporting the development of the local care market. Another Member noted the proposed investment in the Care Homes Investment Options Appraisal.  The Director: Adult Social Care reported that the Local Authority was facing increasing difficulty in securing local nursing home placements due to competition from self-funders and other local authorities.  To address this it was proposed to explore the potential for the Local Authority to purchase but not manage a care home with full nomination rights on the placements by instructing the Local Authority’s property surveyors to undertake a two-phased options appraisal on the purchase of suitable accommodation to identify if this was a viable proposal. 

 

A Member was concerned at a proposal to invest in a market development and support initiative.  The Director: Adult Social Care outlined the aim of the proposed investment which was to improve the sustainability and performance of Bromley care homes, assist in staff training and provide emergency care funding for those providers in danger of failing financially.  The Interim Director: Programmes noted that this was expected to drive a general improvement in the quality of care home provision across Bromley as well as enabling the Local  ...  view the full minutes text for item 26.

27.

Update on Social Isolation Presentation (LBB)

Minutes:

Development Officer (ECHS) giving an update on work being undertaken to address the issue of social isolation as part of the November Campaign 2017.

 

The Bromley MyLife Portal included a directory of activities and events with over 800 entries that were searchable in a number of ways such as by activity, age, postcode and need.  A range of befriending services and volunteering opportunities were also advertised via the Portal, as well as through other media and community venues.  During the November Campaign 2017, 1454 pages relating to social isolation within the Bromley Mylife Portal had been viewed by 794 unique visitors.  Following the month-long event, further work was underway to tackle the issue of social isolation amongst all groups including older people and parents with young children which included publicising the Social Isolation Portal to Bromley residents and residents’ associations and continuing to update the Bromley Mylife Portal with new events and activities.  Social isolation would also be included as a key issue in new health and social care strategies. 

 

In considering the presentation, a Board Member highlighted the importance of ensuring that this information was available to all Bromley residents, as some may not be able to access online information.  The Senior Planning and Development Officer confirmed that this initiative would be advertised in a number of ways including through voluntary groups and community venues, and that the promotional material encouraged people to think of their friends, family and neighbours who might benefit from the programme of events and activities.  The Board Member noted the value of informal activities, such as sewing circles, and suggested that it might be useful to produce guidance on how people could establish informal social groups.

 

The Independent Chairman, Bromley Safeguarding Children Board noted that the Bromley Safeguarding Children Board had electronic contact details for a number of residents across Bromley through which the initiative could be promoted, and would provide this information to the Senior Planning and Development Officer following the meeting.  The Chairman requested that an update be provided on the progress of work being undertaken to address the issue of social isolation at the meeting of the Health and Wellbeing Board on 29th March 2018.

 

The Chairman reminded Board members, and especially Councillors, that all had a role to play in encouraging and championing local initiatives to address social isolation.  The Chairman led Members in thanking Denise Mantell for her excellent presentation which is attached at Appendix B. 

 

RESOLVED that the presentation be noted.

28.

Community Health Contract - Verbal Update (CCG)

Minutes:

The Board considered a verbal update by Dr Angela Bhan, Chief Officer, Bromley Clinical Commissioning Group on the Community Health Contract.

 

The Community Health Contract had been separated into three Lots comprising children’s services, management of people with long term conditions in the community and discharge of care.  A range of service improvements had been developed as part of this contract including an extension to the working hours of the Children’s Community Nursing Team which would now provide an evening service seven days a week. A Care Coordination Centre for children would also be established at a central location in the Borough to provide ‘one stop shop’ referrals to a wide range of services.  Some services under the new contract were still being negotiated; however most of the services would commence on 1st December 2017.

 

RESOLVED that the update be noted.

29.

Local CAMHS Transformation Plan 2017/2018 Refresh (CCG) pdf icon PDF 129 KB

Additional documents:

Minutes:

Report CS18109

 

The Board considered an update on the Local Child and Adolescent Mental Health Services (CAMHs) 2017/18 refresh by Daniel Taegtmeyer, Head of Integrated Commissioning and Transformation, Bromley Clinical Commissioning Group.  The update outlined plans to transform emotional wellbeing and child and adolescent mental health services by creating a sustainable local and proactive system of support and treatment that responded to the needs of individuals and communities.

 

The Local Child and Adolescent Mental Health Services (CAMHs) 2017/18 refresh was a continuation of the key transformation aims and vision as set out in the initial Local Child and Adolescent Mental Health Services (CAMHs) Plan for 2015/16 which focused on:

 

1)  Increasing capacity across the system to cope with increasing demand;

2)  Improving accessibility to services;

3)  Improving the quality of the service offer across early intervention and specialist community CAMHs; and,

4)  A commitment to co-producing the future system and referral and care pathway design.

 

The Local Child and Adolescent Mental Health Services (CAMHs) 2017/18 refresh would incorporate evidence on the impact of Transformation Plan investments and would also provide oversight on what had worked well and what had been learnt.  There was a requirement for the Bromley Clinical Commissioning Group and its partners to complete a Local CAMHs Transformation Plan refresh for 2017/18.  With the agreement of the Chairman and Vice-Chairman, the draft plan had been completed and submitted to NHS England for assurance on 31st October 2017, and the Health and Wellbeing Board was requested to approve the Local CAMHs Transformation Plan refresh.

In response to a number of questions from Members, the Head of Integrated Commissioning and Transformation confirmed that the need to recruit and retain a skilled workforce would be a key issue in designing future service provision.  Part of the challenge would be to move away from a tiered service and towards a delivery model in which individualised support met the complex needs of service users.  The Clinical Chairman, Bromley Clinical Commissioning Group noted that there had been a number of recent improvements to the service including the delivery of early intervention services by the Bromley Wellbeing Service. 

 

RESOLVED that the Transformation Plan be approved.

30.

Update on Delayed Transfers of Care (LBB/CCG) pdf icon PDF 180 KB

Minutes:

Report CS18105

 

The Board considered a report providing an update on Delayed Transfers of Care.

 

At the meeting of Health and Wellbeing Board on 7th September 2017, it had been reported that the average Delayed Transfer of Care for the beginning of September 2017 was 9.73 beds per day.  This had been reduced to 3.13 beds per day for the beginning of October 2017, which represented a significant improvement on the previous month and on the same period in 2016.  A number of initiatives had been introduced from 1st October 2017 to manage the transfer of care during Winter 2017, and further work would be undertaken to strengthen oversight of whole system flow through health services as well as work with providers to secure additional resources across domiciliary care and placements.  A system-wide Demand and Impact Evaluation would be undertaken in Quarter 4 2017/18 and was expected to influence partnership transformation.

 

The Chief Officer, Bromley Clinical Commissioning Group advised the Board that local data was not being reflected in national reporting due to systemic issues and work was being undertaken to address this. 

 

RESOLVED that the update be noted.

31.

Bromley Communications and Engagement Network - Activity Report 2017 (Healthwatch) pdf icon PDF 53 KB

Additional documents:

Minutes:

The Board considered a report outlining the activity of the Bromley Communications and Engagement Network during 2017.

 

The Bromley Communications and Engagement Network had been established in 2014 as an operational group bringing together communication and engagement representatives from across the Bromley statutory and voluntary sector to share work ideas and best practice, as well as delivering joint campaigns, information and engagement activities.  The Network also worked to help local people to improve community health and wellbeing, and support agreed Borough priorities and other community initiatives.  During 2017, the Bromley Communications and Engagement Network had met on a regular basis to share information and advertise high profile campaigns, encourage wider participation of public surveys, and promote a range of public events and high profile meetings.  The Building a Better Bromley Communications Group had recently been established to support the delivery of the Borough Officers Strategic Partnership Forum priority areas including those relating to health.

 

In response to a question from a Board Member, Folake Segun, Chief Executive, Healthwatch Bromley confirmed work was underway to engage more closely with schools and colleges, and that London South East Colleges had been invited to join the Bromley Communications and Engagement Network.  The Chairman noted that NHS England and NICE used a range of innovative communication methods which could be useful, and queried whether there was any value in producing a quarterly newsletter, similar to Environment Matters, as a promotional tool.  Another Member suggested that whilst online information was important, people unable to use online services would find a list of telephone numbers of key partners and voluntary sector organisations helpful.

 

The Chairman requested that an update on work of the Building a Better Bromley Communications Group be reported to the meeting of the Health and Wellbeing Board as an interim update on 1st February 2018 and a full update on 29th March 2018.

 

RESOLVED that the update be noted.

32.

HEALTH AND WELLBEING BOARD INFORMATION BRIEFING pdf icon PDF 50 KB

The briefing comprises:

 

·  Immunisation and Screening Programme as at August 2017

·  Public Health Programmes Performance Update 2016/17

·  Pharmaceutical Needs Assessment Update

 

Members and Co-opted Members have been provided with advance copies of the briefing via email.  The briefing is also available on the Council's website at the following link:

 

http://cds.bromley.gov.uk/ieListMeetings.aspx?CId=559&Year=0

 

Printed copies of the briefing are available on request by contacting the Democratic Services Officer.

Additional documents:

Minutes:

The Health and Wellbeing Board Information Briefing comprised 3 reports:

 

·  Immunisation and Screening Programme as at August 2017

·  Public Health Programmes Performance Update 2016/17

·  Pharmaceutical Needs Assessment Update

 

The Chairman reported that the draft Pharmaceutical Needs Assessment would be open for public consultation until 20th December 2017, and requested that Members of the Health and Wellbeing Board provide their views at the below link:

 

http://www.bromley.gov.uk/news/article/297/pharmaceutical_needs_assessment_consultation

 

RESOLVED that the Information Briefing be noted.

33.

WORK PROGRAMME AND MATTERS ARISING pdf icon PDF 215 KB

Minutes:

Report CSD17156

 

The Board considered its work programme for 2017/18 and matters arising from previous meetings.

 

The Chairman advised the Board that he had attended an event on 29th November 2017 about how medical technology could support people to remain in or enter the workforce.  There had also been meetings of the London Health Board in recent months.

 

Following consideration by Members, a number of items were added to the forward rolling work programme for the Health and Wellbeing Board as outlined below:

 

·  Joint Strategic Needs Assessment (1st February 2018)

·  Pharmaceutical Needs Assessment Report (1st February 2018)

·  Building a Better Bromley Communications Group: Interim Update (1st February 2018)

·  Building a Better Bromley Communications Group: Update (29th March 2018)

·  Update on Social Isolation Work (29th March 2018)

·  Obesity and Promoting Exercise (29th March 2018)

·  Improved Better Care Fund Projects: Winter Resilience 2017/18 (June 2018)

 

In response to a query from the Vice-Chairman, the Chief Executive, Healthwatch Bromley confirmed that the unprogrammed outstanding item on ‘Healthwatch Project to Explore Sexual Health and Gender Identify’ was a piece of work undertaken with 400 pupils during a programme of school visits.  The project aimed to develop an understanding of young people’s views on sexual health and gender identity and would be reported to a future meeting of the Health and Wellbeing Board.

 

RESOLVED that the work programme and matters arising from previous meetings be noted.

34.

ANY OTHER BUSINESS

Minutes:

There was no other business.

35.

DATE OF THE NEXT MEETING

1st February 2018

Minutes:

The next meeting of Health and Wellbeing Board would be held at 1.30pm on Thursday 1st February 2017.

36.

LOCAL GOVERNMENT ACT 1972 AS AMENDED BY THE LOCAL GOVERNMENT (ACCESS TO INFORMATION) (VARIATION) ORDER 2006 AND THE FREEDOM OF INFORMATION ACT 2000

RESOLVED that the Press and public be excluded during consideration of the items of business listed below as it was likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.

37.

Bromley Safeguarding Children's Board Annual Report (BSCB)

Minutes:

The Board considered the report and supported the recommendations.

Appendix A: Nash College Presentation pdf icon PDF 3 MB

Appendix B: Update on Social Isolation Presentation pdf icon PDF 3 MB

 

Original Text: