Agenda and minutes

Venue: Bromley Civic Centre

Contact: Steve Wood  020 8313 4316

No. Item




Apologies were received from Cllrs Pauline Tunnicliffe, Terence Nathan and Ruth Bennett.  


Apologies were also received from Linda Gabriel, and Folake Segun attended as substitute.






There were no new declarations of interest.




The minutes were agreed subject to the following inclusion:


Minute 35:


“the VSSN is a forum composed of the larger health related charities, Age UK, Mind, Mencap, Carers, and CAB.”….  



RESOLVED that the minutes of the meeting held on the 11th February 2016 be signed and agreed as a correct record.



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 Friday 15th April 2016.


No questions were received.






The report was presented to the Board so that members could review the Work Programme and the progress that had been made on matters arising from previous meetings.


The Board were requested to consider what items (if any) should be removed from the list of outstanding items to be scheduled. The Board were encouraged to suggest new items for the Work Programme going forward. 


Concerning the update on dementia and cognitive development, it was felt that due to the development of the Integrated Care Network (ICN)  programme, and the development of the Dementia Hub, this action could now be regarded as completed.  The PRUH update had been completed, along with the feedback from the CCG to Healthwatch concerning their Annual Report; both these actions could therefore be regarded as completed. 


It was noted that enquiries had been made to LBB Communications around the possibility of providing a link on the LBB website to the Working for Wellbeing Partnership. Action was being undertaken concerning this, and so it was agreed that this action point could be closed.


The matter concerning the Mental Health Sub Group was discussed under the agenda item concerning the Mental Health Champion. 


The Board noted that a programme plan document concerning out of hospital care in Bromley had been supplied as requested, and that this had been incorporated onto the agenda. This action could therefore be regarded as completed.


The Board noted that minute 24 of the previous meeting (concerning the Work Programme) stated that it had been agreed that Dr Jenny Selway would attend the April 2016 meeting to provide a report concerning the mental health of young people and adolescents in Bromley. This was going ahead, and was item 16 on the agenda. The report was marked as a part 2 item as some of the information in the report was of a sensitive nature. This would be expanded upon in the part 2 minutes. This action was therefore regarded as completed. 


It was noted at the previous meeting that the development of the HWB strategic priorities would be discussed further at the April meeting; this was item 10 on the agenda. It was noted at the meeting that further consideration of the Strategic Priorities would be given at the next meeting, subsequent to data input received from the updated JSNA. 


It was confirmed that the date of the next meeting was June 2nd 2016, and that for the moment the date should still stand. If key reports were not ready in time, then the meeting would be cancelled, and the Board would meet again on July 28th 2016.


RESOLVED that the Work Programme and Matters Arising report be noted, and that the Work Programme be amended as outlined above.   





At the previous meeting of the HWB on 11th February 2016, the Board noted a briefing paper that had been drafted by Mary Currie, the Interim Director of Transformation at Bromley CCG. The purpose of the report was to provide an update on the proposed direction of travel for the plans concerning out of hospital care in Bromley. The Chairman had requested that a Gantt chart be provided so that members of the Board would get a clearer understanding of the project schedule.


The High Level Programme Plan was therefore added to the agenda as item 6. The Board noted that the implementation date for Integrated Care Networks (ICN) was 1st October 2016. The Board were informed that as part of a cohesive strategy, all three ICN hubs would be activated simultaneously. Dr Bhan informed the Board that Kings, Bromley Health Care, Oxleas, and St. Christopher’s were all happy to sign a memorandum of understanding; this should be completed by the end of April or the beginning of May 2016.


Dr Bhan informed the Board that it was anticipated that six or seven key voluntary organisations were likely to be involved. It was also the case that a presentation had been made to the LBB Cabinet on the same day as the meeting of the HWB, and this was to update them on progress with the ICN programme. Dr Bhan continued that plans were being developed to integrate geriatric services and case management, and also to increase the capacity of mental health crisis support centres. A frailty pathway was being developed, and data sharing agreements were in place. GP contracts were being developed and aligned, and plans were being developed to increase the roles of pharmaceutical services.


Ian Dallaway emphasised the role of the voluntary sector in the integration process. Councillor William Huntington Thresher hoped that there would be a development of the role of Community Pharmacy Services. Dr Bhan mentioned that it was important that the public understood how to correctly administer medication to themselves. A high percentage of admissions to Accident and Emergency were related to patients not taking medication correctly.


RESOLVED that the High Level Programme Plan be noted.




The Primary Care Co-Commissioning update was given by Dr Angela Bhan.


Dr Bhan reminded the Board that with respect to the CCG Co-Commissioning Process, there were three stages:


·  Level 1—the CCG has a limited input

·  Level 2—The CCG would co-commission with NHS England

·  Level 3—The CCG would commission independently


Dr Bhan stated that although Bromley CCG was technically still at level 2, it was the case that in reality they were operating at level 3 in shadow form.


The Board were reminded that progress concerning GP contracts had been looked at in depth during the previous meeting. Dr Bhan informed the Board that the London Wide LMC (Local Medical Committee) had requested a pause in negotiations, and that this had been the case until the end of March. Negotiations had resumed, and it was hoped that these would be completed by the end of May. It was anticipated that all of the negotiations around the contracts and the equalisation process, would be completed by the end of May.


Resolved that the Primary Care Co-Commissioning update be noted.           




The Health and Social Care Integration Update was provided by Dr Angela Bhan.


Dr Bhan explained to the Board that discussions around Integration were ongoing between the CCG and LBB, and that much good work had already been accomplished. There was a requirement for a more robust governance structure. It was a requirement of the Government and NHS England that an Integration Plan be finalised by 2017.   


BCF LOCAL PLAN 2016-2017 pdf icon PDF 180 KB

Additional documents:


The BCF Local Plan 2016/17 was presented as a joint paper on behalf of Chief Officers from LBB and BCCG. Dr Bhan thanked Richard Hills for his hard work in drafting the Plan. The Board heard that BCF funding would continue for the 2016/17 financial year, and that the minimum amount required for Bromley as set out by NHS England was £21, 611,000. This had been created mainly from CCG baselines, and so was not new money. The aim was that LBB and BCCG would provide a whole system integration plan for 2017. It was imperative that the joint integration work be properly funded. The BCF Local Plan report was required to be approved by the Health and Wellbeing Board.


The Board were informed that after the final plan was signed off by the HWB, the plan would be submitted to NHS England by 3rd May 2016. The Board were briefed on the national conditions that the Bromley Plan would be required to meet. Local areas would subsequently be required to demonstrate how the local plans would be pooled together to meet these requirements. The local plan would have to demonstrate how services would be integrated to benefit residents. 


The Board were briefed concerning a local example of pooled BCF commissioning which was Bromley‘s new Dementia Hub that was scheduled to launch in July. The Dementia Hub had been developed to address needs that had been identified by the JSNA. In this regard, the key metric for 2016/17 was to provide adequate support for post diagnosed dementia.


Section 6.3 of the report highlighted the expenditure assumptions for 2016/17. An update to these assumptions had been emailed to members of the Board during the week before the meeting. The Board were advised that the legislative basis for the Better Care Fund derived from an amended version of the NHS Act 2006—amended by the Care Act 2014. This allowed NHS England to include specific requirements for the establishment and use of an integration fund.


The Board were briefed concerning the conditions that would have to be met in Bromley to access the BCF Funding:


·  A requirement that the Better Care Fund be transferred into one or more pooled funds, established under section 75 of the NHS Act 2006

·  A requirement that the HWB agree how local monies should be spent, with the plans signed off by both LBB and Bromley CCG

·  A requirement that the plans be approved by NHS England in consultation with the Department for Heath, and the Department for Communities and Local Government.

·  A requirement that a proportion of the areas allocation will be subject to  new conditions which may include a wide range of services, including social care


The Board heard that a need for change had been identified in six key areas:


1.  A need to improve joined up working

2.  A need to improve access to care

3.  A need to improve care coordination

4.  A need to improve the use of resources

5.  A  ...  view the full minutes text for item 47.




Dr Nada Lemic opened the discussion around the development of the Health and Wellbeing Board Strategy. It was noted that areas of high and low burden, together with areas that were improving and worsening had been outlined at the previous meeting. The Chairman had expressed the view that alcohol mis-use and issues around Carers could be considered as possible future priorities. Others had expressed concern around the issues of homelessness and the mental health of young people. 


Dr Lemic stated that she was waiting for new data from the updated JSNA, so the HWB Strategy would for the time being continue to be based around existing priorities. It was possible that the HWB may decide to adopt homelessness and alcohol mis-use as new priorities. New data around homelessness would be available from the next JSNA. The matter would be revisited in the meeting in June 2016.


RESOLVED that the HWB strategic priorities update be noted, and that the issue be discussed at the next meeting subsequent to new data being available from the JSNA   





Dr Bhan informed the Board that the walk in services at Kings, the Beacon and the PRUH would be retained. In some cases there were problems with waiting times. The CCG were looking to commission a booked approach in addition to the retention of walk in services. It was noted that patients liked the phlebotomy services provided by GP surgeries. The plan of the CCG was to commission a mixed economy of services, and that all procurement issues would be finalised in June 2016. It was envisaged that new services would be in place by the commencement of 2017.


RESOLVED that the phlebotomy update be noted, and that regular updates be provided to the Board.




At the previous meeting, there had been a brief discussion concerning whether or not it was appropriate to appoint a Mental Health Champion (MHC). It had been resolved that the role of the Mental Health Champion be clarified, and the matter be revisited at the next meeting in April 2016.


The Chairman opened the discussion by suggesting that the role of the mental health champion might be a collective one, to reflect the points raised at the previous meeting and in follow up bilateral conversations. Cllr Evans explained that the original idea for a mental health champion had been raised by Cllr Kathy Bance at Full Council.  He noted that other boroughs had mental health champions. Previously, LBB had appointed champions for Design and Heritage, and that Cllr Tunnicliffe had been appointed as the Champion for Young People; a precedent therefore existed. He suggested that Cllr Kathy Bance be considered for the role of MHC, as this was an area in which she had a keen interest.


Mr Dallaway stated that Mencap and Mind would have an interest in the matter, and so it may be prudent to approach them to see if they were interested in appointing a representative. Cllr Ian Dunn stated that if a committee were formed to take on the role of MHC, this may be counterproductive as decision making could be hindered as no one may take overall responsibility.


Cllr Diane Smith suggested that it may be appropriate to set up a mental health sub group/task and finish group. Stephen John agreed with Cllr Evans and Cllr Dunn in that he was also of the view that the role would be diluted by a committee; he felt that this was a high profile role that should be allocated to a Councillor. Folake Segun similarly felt that this was a high profile role that should be allocated to a Councillor, and that it may be prudent to consult with other boroughs to see what they were doing in this regard.


Harvey Guntrip favoured a hands on and proactive approach and suggested enrolling staff onto a “mental health first aid” course that would have practical and tangible benefits. The Chairman suggested that both courses of action could be actioned in parallel as they were not mutually exclusive. He asked Mr Guntrip if he would like to chair a newly formed Task and Finish Group, and Mr Guntrip accepted. Cllr Evans proposed that Cllr Bance be co-opted as a member of the new working group. Cllr Diane Smith and Folake Segun both expressed an interest in being appointed to the group. Dr Bhan added that she may be able to facilitate the appointment of a mental health commissioner, and possibly a GP. Cllr Dunn also expressed an interest in joining the working group.


RESOLVED that a mental health task and finish group be set up, and that this be chaired by Mr Harvey Guntrip.  






Obesity Sub Group pdf icon PDF 20 KB


Cllr Angela Page stated that she had no more to add to the briefing incorporated onto the agenda. There was going to be a meeting of the sub group on the 12th May 2016, and members of the HWB were welcome to attend. 


RESOLVED that the Obesity Sub Group update be noted.


Dementia Sub Group


At the previous meeting it had been resolved that the Dementia Sub Group be retained for the present time.


Councillor William Huntington Thresher felt that the aims and objectives of the Dementia Sub Group had been achieved, and that all that was now required was for some “tidying up” to take place


RESOLVED that the Dementia Sub Group be paused for a year.




Members are invited to suggest items for the next meeting and for the Work Programme.


Annie Callanan referred to the working agreement between the Bromley Safeguarding Children's Board (BSCB) and the Bromley Health and Wellbeing Board. The document had been signed off by the Bromley Directors of Children’s Services and Ms Callanan as Independent Chair of the BSCB.


Ms Callanan asked if she could bring the signed MoU/working agreement to the next HWBB for agreement and ratification. The Chairman agreed that it could come to the next Health and Wellbeing Board as an agenda item for agreement and, if agreed, for ratification.


RESOLVED that the working agreement document pertaining to the BSCB and the HWB be brought to the next meeting of the HWB, so that agreement and ratification could be sought.



The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is 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.




This report was drafted by Dr Jenny Selway—Consultant in Public Health Medicine. The report described the approach in Bromley to address local adolescent mental health issues and the emerging picture across South East London. Work in Bromley had initially concentrated on the management of self-harm, but had now broadened to address general mental health issues in children and young people in Bromley.


The full minutes are detailed in the part 2 minutes.




(1) that Dr Jenny Selway be appointed as a member of the newly formed Mental Health Task and Finish Group


(2) that Dr Selway report back to the HWB in six month’s time









The date of the next meeting is June 2nd 2016


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