Agenda and minutes

Apologies for absence were received from Dr Angela Bhan, Harvey Guntrip, Dr Nada Lemic and Councillor Angela Page.

Apologies for absence were also received from Janet Bailey and Stephen John, and Naheed Chaudhry attended as their substitute.

There were no declarations of interest.

In respect of Minute 47: Healthy Weight Bromley: Children and Young People Update – December 2017, the Chairman advised the Board that he had been approached by Mr Ashish Desai, Consultant Paediatric Surgeon and had agreed to hold discussions with him regarding work being undertaken at King's College Hospital NHS Foundation Trust in relation to childhood obesity which would be fed back to the Health and Wellbeing Board.

With regard to Minute 49: Approval of the Joint Strategic Needs Assessment 2017, Board Members were kindly requested to contribute to the evaluation of the Bromley Joint Strategic Needs Assessment 2017 by Friday 6^th April 2018.

RESOLVED that the minutes of the meeting held on 8^th February 2018 be agreed.

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 23^rd March 2018.

No questions had been received.

Report CS18134

The Board considered an update on the work of the Falls Task and Finish Group.

The Falls Task and Finish Group had been convened by the Health and Wellbeing Board to investigate the number and types of falls affecting Bromley’s older population and consider falls prevention work being undertaken in Bromley, including assessing the level of collaboration across primary, secondary, community and social care providers.  The review was being chaired by Professor Cameron Swift and a range of work had now been completed, including data analysis which aimed to establish what was known about falls epidemiology in the Borough.  Consideration had also been given to the evaluation approach to be used within the review which would be based on the National Institute for Health and Care Excellence (NICE) quality standards for falls prevention.  The conclusions of the Falls Task and Finish Group would be reported to the meeting of Health and Wellbeing Board on 19^th July 2018.

Laura Austin Croft, Public Health Speciality Registrar confirmed that a number of meetings had been held with primary, secondary, community and social care partners to consider falls prevention.  As a result of these meetings, two key themes had been identified which comprised the importance of active case finding and the development of the workforce to support increased falls awareness.  A meeting of the wider Falls Task and Finish Group would be convened to consider the findings of the data analysis work in May 2018.

In considering the report, a Board Member suggested that falls prevention measures should also focus on people under 65 years as strength, conditioning and nutrition played a key role in managing future risk of falls, and that people should be made aware of their increased vulnerability to falls as they grew older.  Medication was also a cause of falls and the role of pharmacists to provide falls prevention advice when dispensing medicines should be explored as part of the review.  Another Board Member underlined that a whole systems approach was required to support the prevention of falls that included the third sector, and that local voluntary organisations such as Age UK Bromley and Greenwich should be approached to contribute to the work of the Falls Task and Finish Group.  A Member suggested that a person’s home environment was a critical factor in their vulnerability to falls, and that work should be undertaken with housing associations to ensure that the risk of falls in social housing properties was minimised. 

RESOLVED that the interim report be noted and that thanks be passed to the Task and Finish Group for the excellent work undertaken so far.

Report CS18130

The Board considered a report outlining the infant mortality rate within the Borough.

The Joint Strategic Needs Assessment 2017 had identified an upturn in infant mortality rates within Bromley in recent years.  A range of work had been undertaken in response to this which indicated that the identified variations had been due to the very small number of infant deaths in Bromley and that current data on infant deaths in Bromley indicated that numbers were falling again.  It had also been identified that Bromley had very low numbers of deaths in infancy in comparison with statistical neighbours and that the infant mortality rate was lower in Bromley than the England average.  Infant mortality would continue to be kept under close scrutiny by the Public Health service as part of health surveillance, and also by the multi-agency Child Death Overview Panel which scrutinised every child death in Bromley with the aim of identifying any factors of concern.  The vast majority of child deaths in Bromley related to premature infants who had been born before the point of viability.

Dr Jenny Selway, Consultant in Public Health Medicine confirmed that there would be a review of the way infant deaths were assessed in Bromley during 2018, and that this would provide an excellent opportunity to ensure that the right measures were in place to monitor the infant mortality rate within the Borough.  This would be supported by work at a regional level as King’s College Hospital NHS Foundation Trust had recently developed an analysis tool to review causative factors for still births, and data on infant mortality would be analysed at a pan-London level from 2020 which was expected to deliver a more robust analysis. 

The Chairman requested a further update on the infant mortality rate in the Borough be considered at the meeting of the Health and Wellbeing Board on 21^st March 2019.

RESOLVED that the update be noted.

Report CS18131

The Board received a presentation from Colin Maclean, Chair, Bromley Third Sector Enterprise and Chief Executive, Community Links Bromley and Toni Walsh, Partnership Manager, Bromley Third Sector Enterprise on Bromley Third Sector Enterprise and Bromley Well.

First established in 2016, Bromley Third Sector Enterprise was a partnership of local voluntary sector providers which included Age UK Bromley and Greenwich, Bromley Mencap, Bromley and Lewisham Mind, Citizens Advice Bromley, Community Links Bromley and other associate members with the aim of improving the health and wellbeing of local residents.  Bromley Third Sector Enterprise had worked to support the Bromley Clinical Commissioning Group to develop a range of initiatives including the Out-of-Hospital Strategy, the Integrated Care Networks Programme and the pilot project for the Proactive Care Pathway for the Elderly Frail, and was currently commissioned to host the Dementia Support Hub and the Primary and Secondary Intervention Service.  Bromley Third Sector Enterprise also delivered the Bromley Well Service that had been launched in October 2017 to provide a single point of access service supporting Bromley residents to stay emotionally and physically well, avoid or delay the use of health and social care services and remain independent.  Approximately 1200 contacts had been made to the single point of access service each month since October 2017, and over 1800 Bromley residents were being actively supported by Bromley Well as at the end of December 2017.  Pathways within the Bromley Well Service linked to the key vulnerable groups identified within the Bromley Joint Strategic Needs Assessment including older people, those with mental wellbeing needs, and carers, and also offered support towards employment, education and volunteering as well as advice and guidance on social determinants for health such as housing and debt management.

The Chair, Bromley Third Sector Enterprise confirmed that the Bromley Well Service was working to build closer links with health services and that processes were in place to support confidential referrals from General Practitioners, Bromley Healthcare and other key health partners.  The Bromley Well Service was also part of the multi-disciplinary team supporting Integrated Care Networks and would continue to work with Oxleas NHS Foundation Trust with the aim of ensuring that key mental health and wellbeing services were available through the single point of access service.

In response to a question from a Board Member, the Partnership Manager, Bromley Third Sector Enterprise advised that a number of the services accessible through the Bromley Well Service undertook home visits and that this could assist in identifying cases of self-neglect.  The Bromley Well Service worked closely with the Police and Fire Service to ensure that people received the support they needed to remain safe in their homes and to identify safety concerns such as hoarding.  A Member noted that older people who had suffered the loss of a partner were particularly vulnerable to social isolation and could benefit from the befriending services accessible through Bromley Well. 

The Chairman led Members in thanking Colin Maclean and Toni Walsh for their excellent presentation which is  ...  view the full minutes text for item 63.

Report CS18132

The Senior Planning and Development Officer (ECHS) gave an update on local and national initiatives to address the issue of social isolation.

Social isolation impacted the physical and mental wellbeing of individuals and left them at greater risk of abuse.  Groups at risk of social isolation included older people, people with physical or learning disabilities or mental health needs, young parents and care leavers without a local support structure.  To help reduce social isolation in the Borough, the Connecting Bromley campaign had been developed which included befriending services, volunteering opportunities and a searchable directory of activities available on the Bromley Mylife Portal.  A meeting had been held with the Bromley Youth Council to discuss how young people could work more closely with older people, as a result of which members of the Bromley Youth Council would be volunteering with local charities during Summer 2018.  Future work to tackle social isolation included plans to include social isolation as a priority within the forthcoming strategy for older people and those approaching old age.  At a national level, the issues of loneliness and social isolation continued to be highlighted in the media and the Prime Minster had appointed a Minister with responsibility for loneliness with the aim of developing a cross-cutting national strategy later in 2018.

Denise Mantell, Senior Planning and Development Officer (ECHS) advised the Board that 532 responses had been received to the Adult Social Care Survey 2017/18.  Although this data had not yet been validated, initial indications suggested that levels of social isolation were similar to those identified in the 2016/17 survey, with 5% of respondents saying they felt socially isolated.  The Bromley Mylife Portal continued to be promoted, including via e-mail notifications sent out immediately prior to the Christmas and Easter periods following which there had been a significant increase in the number of visits to the Connecting Bromley area.

In response to a question from a Member, the Senior Planning and Development Officer (ECHS) confirmed that the definition of being lonely was self-defining, but that social isolation was defined by the level of contact an individual had with other people, although it was a personal choice to pursue any kind of social contact.  A Member suggested that work to promote social inclusion be taken forward in relation to work to extend the take-up of Direct Payments, and a Board Member underlined the need to engage all key partners in the development of the forthcoming strategy for older people and those approaching old age, including the third sector.  A Board Member observed that social isolation could lead to individuals making poor decisions about their wellbeing, and another Member highlighted the importance of ensuring people had access to quality social contact.

The Chairman noted the success of the Adult Services Stakeholder Conference on social isolation in November 2016 and queried whether it would be useful to host a further event on a similar theme.  It was agreed that outcomes from the engagement with older people towards developing the  ...  view the full minutes text for item 64.

An update on Delayed Transfers of Care performance would be provided to Members following the meeting.

A Member noted that a number of Bromley residents had recently been admitted to hospitals in the London Boroughs of Lewisham and Croydon hospitals as a result of service pressures at the Princess Royal University Hospital, and that efficient discharge processes would need to be in place for these patients.

RESOLVED that the update be noted.

An update on the Building a Better Bromley Communications Group was provided to the Board by Susie Clark, Communications Executive.

The Bromley Communications and Engagement Network continued to bring communication and engagement representatives together from across the Bromley statutory and voluntary sector to share work ideas and best practice.  Joint campaigns, information and engagement activities were delivered on areas such as community health and wellbeing, including a recent campaign to promote the Bromley Well service.  The Building a Better Bromley Communications Group also worked to support the delivery of the Borough Officers’ Strategic Partnership Forum priority areas, including those relating to health.  Work currently underway included the development of a local ‘Stop Smoking’ campaign with Public Health, and the publication of the Bromley Joint Strategic Needs Assessment 2017.

In response to a question from a Member, the Communications Executive confirmed that a range of media was used to ensure that key messages were targeted in the right way to individual groups.  The Connecting Bromley campaign had been promoted in a variety of ways with the aim of raising awareness of the campaign across all Bromley communities.

RESOLVED that the update be noted.

The Board considered the Chairman’s annual report of the Health and Wellbeing Board which would be reported to a future meeting of the Full Council.  The Chairman thanked all Board Members for the significant contribution they had made to the Health and Wellbeing Board during the 2017/18 municipal year.

RESOLVED that the report be noted.

The information items comprise:

The Health and Wellbeing Board Information Briefing comprised one report:

• Healthwatch Bromley Report: "Let's Talk About Sex" - Children and Young People's Sexual Health and Healthy Relationships in the London Borough of Bromley

RESOLVED that the Information Briefing be noted.

Report CSD18002

The Board considered its work programme for 2018/19 and matters arising from previous meetings.

A number of items were added to the forward rolling work programme for the Health and Wellbeing Board as outlined below:

·  Engagement Outcomes towards the Forthcoming Strategy for Older People and those approaching Old Age (September 2018)

·  Bromley Safeguarding Adults Board Annual Report (November 2018)

·  Update on Infant Mortality Rate in Bromley (March 2019)

·  Update on Childhood Obesity Work by King's College Hospital NHS Foundation Trust (to be programmed)

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

1.30pm, Thursday 7^th June 2018

1.30pm, Thursday 19^th July 2018

1.30pm, Thursday 27^th September 2018

1.30pm, Thursday 15^th November 2018

1.30pm, Thursday 31^st January 2019

1.30pm, Thursday 21^st March 2019

The next meeting of the Health and Wellbeing Board would be held at 1.30pm on Thursday 7^th June 2018.

There was no other business.

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.

Board Members are advised that these minutes are draft and have not yet been agreed by the Integrated Commissioning Board.

RESOLVED that the exempt minutes of the Integrated Commissioning Board meeting held on 12^th February 2018be noted.