Agenda and minutes

Venue: Committee Room 2 - Bromley Civic Centre. View directions

Contact: Steve Wood  020 8313 4316

Items
No. Item

1.

APOLOGIES FOR ABSENCE

Minutes:

Apologies for absence were received from Cllr Terence Nathan, Annie Callanan, Linda Gabriel and Ian Dallaway.  Colin McClean attended as substitute for Ian Dallway and Folake Segun attended as a substitute for Linda Gabriel.

 

2.

DECLARATIONS OF INTEREST

Minutes:

There were no declarations of interest.

3.

MINUTES OF THE MEETING HELD ON THE 8TH OCTOBER 2015 pdf icon PDF 675 KB

Minutes:

The minutes of the meeting held on 8th October 2015 were approved, and signed as a correct record.

4.

QUESTIONS BY COUNCILLORS AND MEMBERS OF THE PUBLIC ATTENDING THE MEETING

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 2nd December 2015. 

Minutes:

No questions were received.

5.

PRIMARY CARE CO-COMMISSIONING UPDATE

Minutes:

Dr Angela Bhan informed the Board that the CCG had been Co-commissioning with NHS England (NHSE) for eight or nine months.  There had been extensive discussions at the meeting between the South East London CCG Boards around governance arrangements but it appeared that there was now general agreement.  The Boards would be focusing on the quality of General Practice and working to get a clearer idea of the key issues.  The CCG had been doing some development work with GP Practices, trying to ensure consistency in the way standards were raised.

 

The CCG Board would also be reviewing contracts with general practices.  Currently, 60% of practices in Bromley had Personal Medical Services (PMS) contracts. PMS was a locally-agreed alternative to General Medical Service (GMS) contracts for providers of general practice.  This figure was significantly lower than the average for South East London where the figure was generally above 90%.  PMS contract funding would need to be reviewed before any program of services for delivery could be agreed.

 

Dr Bhan reported that the CCG would provide a written update on the PMS contracts to the Board in 2016.

 

The CCG Board would also be reviewing how the patients of the 40% of general practices operating under GMS contracts could be offered an improved service.  There would be cost implications associated with this and no decisions could be taken until there was clarity surrounding the financial settlement for the CCG.

6.

JOINT STRATEGIC NEEDS ASSESSMENT UPDATE pdf icon PDF 141 KB

The Health and Wellbeing Board is asked to consider the emerging issues and the priority actions as outlined in the JSNA draft document.

 

Additional documents:

Minutes:

The Board considered the Joint Strategic Needs Assessment (JSNA) which was a statutory requirement of local authorities and NHS primary care trusts since 2008 and was expected to be carried out jointly by the Director of Public Health, Director of Adult Social Services and Director of Children’s Services.  The aim of the JSNA was to deliver an understanding of the current and future health and wellbeing needs of the population over both the short-term (three to five years) and the longer term (five to ten years) in order to inform strategic planning commissioning services and interventions that would achieve better health and wellbeing outcomes and reduce inequalities.  The final draft of the 2015 JSNA had been circulated to members of the Health and Wellbeing Board for consideration early in November.

 

The Health and Wellbeing Board were asked to approve the 2015 JSNA, and to consider a proposal for the structure of the 2016 JSNA.

 

The proposal for the 2016 JSNA  noted that Bromley was moving to a system of delivering health and social care through integrated care networks and it had been suggested that that the JSNA structure reflected and supported the new arrangement.  This would require an even more collaborative approach in terms of information and data sharing to help inform commissioning arrangements.

 

The Director of Public Health highlighted that that the JSNA provided information on the population of the Borough as a whole.  Once this high level information had been gathered more in depth needs assessments could be undertaken.  The suggested areas for detailed investigation were reviewed and accepted.  It was recognised that introducing a more detailed analysis of all these areas for 2016 might be too burdensome for officers and therefore the new categories would be ranked in priority order and their introduction phased in over 2016 and 2017.  It was noted that issues arising from the JSNA would inform a number of future policy areas.

 

It was agreed that regular updates on the progress of the 2016 JSNA should be provided to the Board.

 

RESOLVED:

 

(1) that the Joint Strategic Needs Assessment for 2015 be approved  

 

2) that the Health and Wellbeing Board receive regular updates on the progress of the Joint Strategic Needs Assessment for 2016.

 

7.

HEALTH AND WELLBEING STRATEGY UPDATE

Minutes:

This item was deferred to the next meeting of the Board.

8.

PRESENTATION FROM MIND ON WORKING FOR WELLBEING SERVICE

Minutes:

Frances Westerman from Bromley Mind gave a presentation to the Board about the Bromley Working for Wellbeing Partnership (attached at Appendix A).  The presentation outlined:

 

-  The main contributors to the Partnership;

-  The history of the service;

-  What the service offered

-  The nature of support available; and

-  The structure of the service.

 

It was noted that all counsellors providing the service had participated in the therapy as part of their training.

 

In response to a question Ms Westerman reported that the Partnership had been working hard to engage with Job Centre Plus in order to target the service at people who were vulnerable to mental health issues as a result of work related issues and unemployment.  There was an acknowledgement that the Bromley Working for Wellbeing Partnership needed to advertise the service further although the restrictions on advertising made this challenging.  Further work needed to be undertaken to encourage more GPs to refer individuals who could benefit from the service.  In addition to this there would be a focus on branding the service and further work would be undertaken in distributing literature about the service more widely and ensuring that it was displayed prominently. 

 

Dr Parson reported that GPs were beginning to adjust to the changes that were being made to the way in which counselling services were being delivered across the Borough and many improvements had already been made concerning the way in which referrals were made.  Work still needed to be undertaken to address the problems with referral routes and it was important that GPs had a good knowledge of all the services that were provided by the Bromley Working for Wellbeing Partnership.

 

The Chairman suggested that it would be helpful to have a link to the Bromley Working for Wellbeing Partnership on the Council’s website and asked Officers to investigate this.

 

It was suggested that the monthly Borough Officers’ meeting could be a useful network for Bromley Working for Wellbeing Partnership and Ms Westerman was invited to attend a future meeting.

 

The Chairman thanked Ms Westerman for attending the meeting and outlining the work of the Bromley Working for Wellbeing Partnership.

 

9.

UPDATE ON THE TRANSFORMATION PROJECT FOR HEALTH AND SOCIAL CARE

Minutes:

Dr Angela Bhan reported that a meeting with GPs in the Borough was planned for early in 2016 and following on from this an implementation plan would be developed and presented to the Board.  A Memorandum of Understanding had been drafted in order to ensure buy-in from all key partners and an implementation strategy was being drafted, recognising that the proposals represented a big change for Bromley.

 

The Board noted that arrangements in Bromley were more advanced than in some other Boroughs.  The Chairman suggested that it could be helpful to publicise what was happening in Bromley more widely.  The Chairman also asked if it would be possible for members of the Board to be provided with a one page summary of the developments in Bromley.

 

In response to a question surrounding the “Care Navigator” role, Dr Bhan reported that there was an emerging workforce of Patient Liaison Officers with the right skill set currently based in GP practices.  Further discussions needed to take place around whether there was an on-going need for these Officers to be located in GP practices and as part of this further thought would need to be given to how the Care Co-ordinator/Care Navigator role would evolve.

 

10.

BROMLEY CCG TRANSFORMATION PLAN--CHILDREN AND YOUNG PEOPLE'S MENTAL HEALTH AND WELLBEING pdf icon PDF 190 KB

Additional documents:

Minutes:

The Board considered a report providing an update on the Transformation Plan for Children and Young People’s Mental Health and Wellbeing.  In March 2015, NHS England (NHSE) published “Future in Mind: Promoting, Protecting and Improving our Children and Young People’s Mental Health and Wellbeing”, which required all local areas to develop Local Transformational Plans to take forward the key principles of the plan and improve access and quality of local services.  NHSE required CCGs to submit their Transformation Plans by 16th October 2015, developed with local Health and Wellbeing Boards, and in partnership with Public Health, Local Authorities, Youth Justice Services, and Education and Specialist Commissioning.

 

The Transformational Plan was submitted to NHSE by the required deadline of 16th October 2015 and had been approved by the Chairman of the Health and Wellbeing Board before submission.  Following assurance and regional moderation, the plan was rated as ‘successful’.  NHSE confirmed that more detailed feedback on the plan would be provided in due course.

 

The Board noted that Bromley was one of the few CCGs across London to have submitted its plan by the deadline.  Further updates of how the plan was expected to evolve, would be provided to future meetings of the Board.

 

RESOLVED that the Bromley CCG Transformation Plan – Children and Young People Mental Health and Wellbeing be noted, and that details of the implementation of the plan will be brought back to the Board in due course.

11.

SHORTAGE OF GP PROVISION IN BROMLEY TOWN CENTRE

Minutes:

Further to the update provided by Dr Angela Bhan on 8th October 2015, the Board noted that no additional information was available and it was agreed to consider the item at the next meeting.

 

12.

UPDATES FROM SUB GROUPS

12a

Obesity Sub Group

Minutes:

The Obesity Sub-Group update was provided by Cllr Angela Page who reported that the attendance from external organisations was encouraging.

 

The last meeting of the sub-group had focused on two areas:

 

-  Feeding in to the  local plan and planning guidance

-  Healthy Weight Pathway

 

A further meeting had been arranged for January 2016 and a further update would be provided to the Health and Wellbeing Board in February 2016.

 

12b

Diabetes Sub Group

Minutes:

The Diabetes Sub-Group update was given by Cllr Ruth Bennett who reported that a further meeting would be held in January 2016. A great deal of progress had been made locally on diabetes prevention and Bromley would soon know whether it would be included in the national programme. The Director of Public Health suggested that it might be helpful to integrate the work of the Diabetes Network in Bromley with the work of the Sub-group.

 

This suggestion would be taken forward.

 

12c

Dementia Sub Group

Minutes:

The Dementia Sub Group update was provided by Cllr William Huntington-Thresher who reported that the recent Dementia Conference had been well attended.  It was noted that there were significant inequalities in the range of services provided across the Borough and it could be helpful to better publicise events and identify areas where more services were required.

 

12d

Adolescent Mental Health Sub Group

Minutes:

A further update on Adolescent Mental Health Services would be provided at the next meeting in February 2016.

13.

WORK PROGRAMME AND MATTERS ARISING pdf icon PDF 228 KB

Minutes:

The Board considered its rolling work programme and agreed that the following additional items would be considered at the meeting on 11th February 2016:

 

-  Update report  on Primary Care Co-Commissioning

-  Bromley Safeguarding Children’s’ Board Annual Report

-  Joint strategic Needs Assessment 2016 Update

-  Health and Wellbeing Strategy

 

RESOLVED: That the updated work programme be noted.

14.

ANY OTHER BUSINESS

Minutes:

Update from the Director of Finance on the Spending Review 2015 (Health and Social Care)

 

The Director of Finance tabled a briefing note (attached at Appendix B) outlining the key features of the Chancellor of the Exchequer’s Spending Review delivered on 25 November 2015.

 

There was a strong emphasis on health and social care in the Spending Review.  The 2% precept dedicated to funding adult social care was a significant change and it appeared that the Government intended to streamline health and social care funding streams and a small step included expanding the Better Care Fund.  A key message from the Government arising from the Spending Review was the need for change in health and social care as it was acknowledged that the current arrangements were not sustainable.

 

Core funding to Bromley had been cut by 56% confirming that the pressures facing the Local Authority arising from austerity would continue. The Spending Review had confirmed that the Better Care Fund would continue, and there were indications that additional funding would be allocated, although it was likely that this would be at the expense of other funding streams such as the New Homes Bonus.

 

The Spending Review had confirmed the intention of the Government to nationally integrate health and social care by 2020.  There were no specific details for local arrangements but it was clear that local areas were expected to have a plan for this in place by 2017 with full implementation by 2020.

 

It appeared that there was a significant reduction in funding for Public Health.

 

A Member of the Board noted that there appeared to be a drive towards further devolution of funding which could present further challenges for Bromley.

 

15.

DATE OF THE NEXT MEETING

Minutes:

The Board noted the next meeting was scheduled for 11th February 2016.

 

Appendix A pdf icon PDF 229 KB

Additional documents:

Appendix B pdf icon PDF 376 KB