Agenda item

Report ECHS19035

The Board considered an update on the Joint Health and Wellbeing Strategy 2019-2023.

The Joint Health and Wellbeing Strategy 2019-2023 had been agreed and published, and work was now progressing towards its action plans. Following the last meeting of the Health and Wellbeing Board, arrangements had been made for the delivery of priority areas of the Health and Wellbeing Strategy. Over several months, the Director: Public Health had met with the relevant groups focussing on the priority areas, to discuss who would be best to lead on each area. An action plan had been provided to Board Members, setting out the finalised leadership arrangements for the Strategy, and included the proposed arrangements for delivery.

An example of the proposed template that each group would use to provide an action plan update was also presented. All groups leading on an area of delivery would draft an action plan for each of the priority areas. The Cancer Working Group had met twice and had discussed their priorities. Members had agreed that it was a good, simple model that helped focus their minds, and would not burden the groups. The action plan allowed them to list objectives for two or three key priorities, and how the objectives would be achieved and measured.

It was suggested that for reporting purposes, a refocussed Joint Strategic Needs Assessment (JSNA) Steering Group would coordinate the updates to the action plans. Once a year, they could provide a high level annual report, or individual groups could report to the Health and Wellbeing Board directly. It was highlighted that the JSNA Steering Group would meet every two months, and a comprehensive Terms of Reference document had been included as an Appendix to the report. The Independent Chair: Bromley Safeguarding Adults Board suggested that the membership of the JSNA Steering Group could include the Voluntary Sector Strategic Network (VSSN), which went much wider than the Bromley Third Sector Enterprise.

The Chairman considered that the action plans answered the questions of whom, what and why, but clear timelines were needed. The Chairman felt that the JSNA Steering Group coordinating the updates was a good idea, and suggested that a report be provided to the Health and Wellbeing Board every six months, starting from November 2019. In addition, a report from an individual group could be brought earlier by exception if required. A Board Member further suggested that a timescale column be added to the action plans, and that a RAG rating system be used when the reports were brought back to the Board.

A Board Member noted that there were a couple of priority areas where details on the process for delivery had not been provided, including the Learning Disability priority area. The Director: Adult Social Care advised that a first draft of the new Learning Disability Strategy was currently in development. It was suggested that this information could be included in the document. The Interim Director of Programmes advised Board Members that they were currently looking at how to assess the pathway and to support carers to find the most effective service. This had been scheduled to be discussed at the meeting of the Council’s Executive in October 2019.

The Managing Director: Bromley CCG noted that the processes for delivery matched the outputs and how they were to be measured, which would allow the lead groups to unpick the areas of focus. The Chairman commented that it was an overarching strategy which allowed the lead groups, who were those closest to the priority areas, to look at and develop them, before feeding back. A phased approach with a rolling programme of timelines for reporting back to the Board would ensure that issues did not get lost.

In relation to the cancer priority area, a Board Member asked how ‘areas with high levels of deprivation and where smoking and alcohol use were known to be higher’ would be targeted. The Director: Public Health responded that work would be undertaken with GPs in areas with those particular risk factors. Practices in the most deprived areas and with the lowest screening rates would be targeted first, to improve the screening uptake by patients. The Chairman noted that heat maps produced a very sensitive model, and allowed this type of information to be collated.

In response to a question, the Director: Public Health advised Board Members that the Ottawa model implemented at King’s was a programme that involved clinicians picking up on patients that smoked whilst they were in hospital, allowing intervention at an early stage. It was a model that had been developed and evaluated in Canada, and looked at the patients and their first and secondary relatives. It was considered to have had a huge impact, but the Clinical Chairman: Bromley CCG noted that follow up work connected to the model needed to take place in the community following a patients discharge from hospital.

In response to a question in relation to bowel screening, the Managing Director: Bromley CCG said that these screenings differed from the colonoscopies that took place at the Princess Royal University Hospital (PRUH). Bowel screenings mostly took place at Lewisham and Denmark Hill and were carried out in a timely manner. Work was being undertaken with the PRUH to reduce the long wait for surveillance colonoscopies – looking at waiting lists and using private hospitals to carry out some procedures, and a larger number were being completed as part of the two week cancer screening. The Clinical Chairman: Bromley CCG noted that the new FIT tests that identified blood in stools could potentially push down the number of two week tests, which could help aid the pressure on this service.

Following a discussion, in which Board Members considered how they would like updates on the action plans reported to the Health and Wellbeing Board it was agreed that a report be provided every six months, starting from November 2019, with reports provided by an individual group by exception, if required.

RESOLVED that the update be noted.