Agenda and minutes

The Chairman thanked Members for their understanding and forbearance with the rearrangement of the meeting which had been made to allow Members to attend the funeral of Councillor Andrew Lee. Several options had been explored to try to accommodate report deadlines and Members’ diaries.

Apologies for absence were received from Councillor Thomas Turrell, Richard Baldwin, Teresa Bell, Rachel Dunley, Jim Gamble and Harvey Guntrip.

Apologies for absence were received from Charlotte Bradford and Jane Walters attended as substitute.

Apologies were also received from Jacqui Scott (Bromley Healthcare).

In relation to item 6, Councillor Yvonne Bear declared that she was Governor at Oxleas NHS Foundation Trust.

In accordance with the Council’s Constitution, members of the public may submit one question each on matters relating to the work of the Committee. Questions must have been received in writing 10 working days before the date of the meeting – by 5pm on Thursday 2^nd November 2023. 

Questions seeking clarification of the details of a report on the agenda may be accepted within two working days of the normal publication date of the agenda – by 5pm on Friday 10^th November 2023.

One question had been received from a member of the public for written reply and is attached at Appendix A.

RESOLVED that the minutes of the meeting held on 21^st September 2023 be agreed.

The Director of Public Health noted that an amended version of the Health and Wellbeing Strategy had been provided – the changes were highlighted in red and incorporated the comments received from Board Members. Work would be undertaken to develop action plans for the individual priorities – this would be done in collaboration with partners, and they would ensure they aligned with the ICB Strategy.

The Bromley Place Executive Director agreed that the strategy linked well with the ICB five-year strategy, including its focus on prevention and the approach to population health. It was suggested that further discussion be held with regards to implementation to ensure that there was no duplication.

A Board Member highlighted the importance of the implementation plan being co-produced with partners. In response to questions, the Senior Clinical Lead noted that the measurements of success were currently being considered – partners were already collecting data and they would need to discuss how it would best be collated to provide a true picture. The Chairman noted that it may take in excess of ten years to see the full effects of some of the priorities. The Bromley Place Executive Director advised that with regards to the work around the South London Listen's pledges, some pledges related to the work of the ICB, but some were broader and applied more to theinner London boroughs that had been engaged with this approach. However the principles around listening to vulnerable populations and using their input to shape services was appropriate. With regards to young people, the Chairman noted that the strategy would be presented to the Youth Council.

The Director of Public Health advised that the ‘Vital 5’ key preventative areas would feed into the implementation plan and there would be input from other partner agencies and Boards. Once the action plan was agreed it was proposed that there be a standing item at each meeting during which a progress update would be provided.

The Chairman thanked the Director of Public Health and her team for all the work undertaken to produce the strategy.

RESOLVED that the Health and Wellbeing Strategy 2024-2029 be agreed.

Report CSD23142

The Board considered a report providing an update on Children and Young People’s Mental Health. The Chairman welcomed James Postgate, Associate Director – Integrated Commissioning, NHS South East London (Bromley) (“Associate Director”), Johanna Dench, Senior Commissioning Manager – CYP MH & Wellbeing, NHS South East London (Bromley) (“Senior Commissioning Manager”), Gill Allen, CEO – Bromley Y, Ingrid Bresnahan, Operations Manager – Bromley Y and Dominic Leigh, CAMHS Service Manager – Oxleas NHS Foundation Trust to the meeting.

The Associate Director noted that an update had been provided to the Board in June 2022. At that time services were receiving a high number of referrals, complex presentations and long waiting times. Since then a number of initiatives had been implemented and progress had been made, however a number of challenges were emerging. The Senior Commissioning Manager delivered the presentation provided in the agenda pack which summarised the current situation. The CEO – Bromley Y highlighted that since coming out of the COVID-19 pandemic services had experienced enormous pressure. They were now seeing a drop in the number of referrals into the single point of access (SPA) and a decrease in caseloads. It was considered that the integrated SPA was working effectively, with more young people being accepted onto the right pathway at the right time.

A Members noted that it was pleasing to see the improvement in waiting times to access CAMHS. During the last update received there had been some concerning data related to emergency presentations of children in crisis at A+E and it was questioned if this had reduced following improved access to services. The Associate Director advised that a deep dive was currently being undertaken in relation to this. The CAMHS Service Manager said that over the last year there had been a slight reduction in the number of presentations at A+E. For a number of years Bromley had been an outlier but was now at the same level as its neighbouring South East London boroughs. This was due to a number factors, which they were currently evaluating, including significant investment into crisis care. Specialist CAMHS clinicians were based in hospitals – 24/7 crisis and liaison services were available at the PRUH and Queen Elizabeth Hospital, and intense community treatment pathways had also been established. It was noted that a significant increase in the complexity of presentations was still being seen, and they often saw a number of young people regularly attending A+E. The CEO – Bromley Y said that they now covered all of the Bromley secondary schools and would be looking at the data to ensure that appropriate referrals were being dealt with.

In response to a question from the Chairman, the Associate Director said that more referrals were received during exam times. The data would be reviewed, and they would be working with the Director of Education to provide outreach and support to schools. The Associate Director said he would be happy to share any data as it came forward. The CAMHS Service  ...  view the full minutes text for item 32.

The Director of Public Health informed Board Members that the HIV infections audit had now concluded and would be brought to the Board meeting on 8^th February 2024. As previously mentioned, the surveillance programme had highlighted that although Bromley had relatively low incidents of HIV there tended to be late diagnosis and the demographic of patients had changed. It was noted that as the numbers were so small it was harder to draw general conclusions. A workshop would be held with clinicians from across London to gain better learning from those experiencing similar situations.

In response to a question, the Director of Public Health highlighted that the late diagnosis was mainly due to late presentations. Clinically, there were no issues in terms of managing and treating patients. With regards to the demographic of patients, they were seeing more older heterosexual males being diagnosed.

RESOLVED that the update be noted.

Report CEF23057

The Chairman noted that apologies had been received from the Independent Chair of the Bromley Safeguarding Children Partnership, however a video providing an overview of the Annual Report had been circulated to Board Members prior to the meeting.

A Member considered that a fantastic report had been produced – it was very detailed and provided an excellent picture of the work being undertaken in Bromley.

The Chairman advised that any questions could be sent directly to the Bromley Safeguarding Children Partnership Manager for response.

RESOLVED that the Bromley Safeguarding Children's Board Annual Report 2022/23 be noted.

The briefing comprises:

·  Better Care Fund and Improved Better Care Fund Performance Update – Q1 and Q2

·  Pharmaceutical Needs Assessment (PNA) reprocurement

Members of the Health and Wellbeing Board 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.

The Health and Wellbeing Board Information Briefing comprised 2 reports:

·  Better Care Fund and Improved Better Care Fund Performance Update – Q1 and Q2

·  Pharmaceutical Needs Assessment (PNA) reprocurement

The Director of Public Health advised that it was a statutory duty of the Board to publish a PNA which was an assessment of need for pharmaceutical services in the borough. The process for reprocuring a consultancy to produce and maintain the PNA had commenced and would be ready for publication in 2025.

RESOLVED that the Information Briefing be noted.

Report CSD23127

The Board considered its work programme for 2023/24 and matters arising from previous meetings.

The following items would be added to the forward rolling work programme for the Health and Wellbeing Board:

-  Health and Wellbeing Strategy – update on priority areas (standing item)

-  Update on Children and Young People's Mental Health (summer 2024)

The Chairman advised Board Members that representatives from Mytime Active would attend the meeting on 8^th February 2024 to deliver a presentation regarding their work on health prevention.

With regards to a question on the matters outstanding, the Director of Public Health advised that partners had been trying to source the data relating to falls. There was data available, however it was collected in different ways and efforts would need to be undertaken to extract and analyse it. It was noted that an extract from the Better Care Fund report regarding falls data had been circulated.

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

There was no other business.

1.30pm, Thursday 8^th February 2024

1.30pm, Thursday 18^th April 2024  

The next meetings of the Health and Wellbeing Board would be held on:

1.30pm, Thursday 8^th February 2024

1.30pm, Thursday 18^th April 2024