Agenda and minutes

To report any changes to the Membership of the meeting.

1.1       Apologies for absence were received from Dr Neville Purssell (Clinical Representative from the Central London Clinical Commissioning Group), Basirat Sadiq (Central London Community Healthcare NHS Trust), Dr Naomi Katz (Clinical Representative from West London Clinical Commissioning Group), Clare Robinson (Imperial College NHS Trust), Louise Proctor(Managing Director – NHS West London Clinical Commissioning Group), Melissa Caslake (Bi-borough Director of Children’s Services), Dr David Finch (NHS England) and Detective Inspector Iain Keating (Metropolitan Police).

To receive declarations of interest by Board Members and Officers of any personal or prejudicial interests.

2.1       No declarations were made.

I)             To agree the Minutes of the meeting held on 12 July 2018.

II)           To note progress in actions arising.

3.1       RESOLVED:

            That the minutes of the meeting held on 12 July 2018 be signed by the Chairman as a correct record of proceedings.

3.2       The Chairman was pleased to announce that Jennifer Travassos had been shortlisted for the Women in Housing Award 2018 and expressed the Board’s congratulations.

3.3       The Chairman expressed the Board’s concern that the Central London CCG was withdrawing funding from the Children’s Joint Commissioning Plan. In response, a letter setting out the Board’s concerns would be issued.

3.4       The Chairman invited Peter Armfield, Quality and Sustainability Manager for CityWest Homes, to join the meeting and provide an update on the housing initiatives he was leading on. The Board was informed that a budget had been allocated to help CityWest Homes tenants whose properties suffered from mould and condensation issues. Information on how the programme operated was provided along with an overview of the extensive number of site visits undertaken. These visits were intended to offer advice and help improve the ventilation and insulation of properties. A large public information campaign was also being undertaken and this proactive approach combined with the site visits was having a positive effect. The Board suggested that due to its positive impact it could potentially be useful to quantify the benefits of the project and consider whether it could be a purchased product for non-CityWest Home tenants. The Board thanked Peter Armfield for the update and the positive effects the project was having in combating mould and condensation issues in the local area.

To consider a report providing an update on local issues related to sugar consumption, oral health and childhood obesity.

4.1       Christine Mead, (Community Resilience Manager) introduced the item which set out the actions being taken at local and national levels to address rising levels of sugar consumption and its associated health outcomes amongst children and young people. The Board noted that levels of tooth decay for 5 year olds living within Westminster were higher than the London and England averages. It was also noted that the number of children aged 4 to 5 in Westminster had increased levels of obesity linked to sugar consumption than the London and England averages.

4.2       As a consequence the Board was informed of the various campaigns and initiatives that had been developed to reduce sugar consumption and promote healthier eating. An update was provided on the local oral health campaigns ‘Big Bites and Pearly Whites’ and ‘The Tale of Triumph Over Terrible Teeth’ which had been established to improve children’s, parents and carers knowledge regarding oral health. The Board was pleased to note that an initiative involving a number of local dentists visiting local schools to provide talks on oral healthcare to pupils was also being established.

4.3       Efforts to reduce sugar consumption and promote healthy eating formed a central part of the Tackling Childhood Obesity Together (TCOT) programme. The various components of the programme were detailed along with work being undertaken to identify opportunities to better integrate and co-ordinate activities between the Council and partners. This included developing a system wide approach to engage with communities and co-produce and run coordinated events and campaigns that aligned with local needs.

4.4       The Board noted the report and welcomed the proposed plans to integrate sugar reduction messages within a system wide obesity prevention approach. It was suggested that NHS England be invited to participate in this approach as they could potentially support the proposed plans.

To consider an update on the local health system’s delivery of the Primary Care Strategy discussed at the Health and Wellbeing Board in July and the Integrated Care Strategies discussed at the Board in November 2017.

5.1      Dr Niamh McLaughlin (Vice Chair, Central London CCG) and Holly Manktelow (Associate Director of Commissioning, Central London CCG) presented a report which provided an update on the local health system’s delivery of the Primary Care Strategy and Integrated Care Strategy. In particular, the report detailed progress with the procurement of a Multi- Speciality Community (MCP) provider for Westminster.

5.2      The Chairman confirmed that whilst the Board agreed with various aspects of the report, concern was expressed regarding some of the details contained within it and also the speed with which it was proposed to initiate the changes. The Board was of the opinion that before implementing any changes further consultation was required with the Council and other partners.  

5.3      Dr Niamh McLaughlin and Holly Manketlow explained that no decisions had yet been taken on the MCP programme and discussions with partners had taken place to explore the various options available. It was recognised that some partners had voiced concerns and, as such, the Central London CCG hoped to have further discussions regarding how to deliver an integrated system for joined-up care. Following a concern raised regarding the MCP approach being taken the Board was advised that whilst at this early stage it seemed the most attractive model, work would be undertaken on the options available to assess their potential impact on the local market and current providers before any decisions were made.

5.4      Maria O’Brien from the Central and North West London NHS Foundation Trust advised the Board of the health providers’ deep concerns regarding the approach. They were committed to providing integrated services, but there was no agreement with the Central London CCG on how this could be achieved. Concerns were expressed over the details in the report, the approach being taken and how this would impact on patients and the delivery of services. Further concern was raised over the proposed timelines and whether they were achievable. Maria O’Brien advised that the health providers had requested that the report be withdrawn in order for further discussions to take place.

5.5      The Board then held a detailed discussion on the report that covered the following areas:

·                     The financial aspects of the MCP;

·                     The levels of engagement undertaken, with a particular focus on commissioning intentions ; and

·                     The need to introduce an agreed integrated system.

5.6      Following this discussion, the Board noted the report. The Board also noted that its comments would be fed back to the Central London CCG which was requested to review its commissioning approach. The Board also requested that a report detailing the Central London CCG’s commissioning intentions be presented at their next meeting scheduled for 29th November 2018.

To consider the Learning Disabilities Joint Commissioning Strategy – No Paper for Publication

6.1       The Board was reminded that the deadline to receive comments on the strategy was the end of September 2018.

To consider the diagram – No paper for publication

7.1       The Board noted the flow diagram explaining the local Health and Social Care governance system and members were requested to forward on any comments.

8.1       The Chairman provided the Board with the following updates:

i)      Westminster City Council had prepared a programme of activity ahead of the 3 October 2018 launch of Stoptober, Public Health England’s annual 28-day stop smoking campaign.

ii)     The Director of Public Health’s Annual report would be shared with the Board in autumn for comment ahead of the next Board meeting in November 2018. The paper would then be included on the agenda for the November Board meeting, highlighting elements of the report linked to the Health and Wellbeing Board priority of loneliness.

iii)   Officers were exploring the possibility for an alternative venue for the next Board meeting, which would be themed around the Health and Wellbeing Board priority of loneliness.