Agenda and minutes

Health & Wellbeing Board - Wednesday 3rd July, 2019 4.00 pm

Venue: Lord Mayor's Parlour, 19th Floor, Westminster City Hall, 64 Victoria Street, London, SW1E 6QP

Contact: Tristan Fieldsend Committee and Governance Officer  Tel: 7641 2341; Email:

No. Item



The Chair to welcome everyone to the meeting.


1.1           Councillor Heather Acton welcomed everyone to the meeting and confirmed that as the concurrent Board meeting was being held within Westminster she would Chair the meeting in line with the agreed memorandum of understanding.



To report any changes to the Membership of the meeting.


2.1       Apologies for absence were received from, Lesley Watts (Chelsea & Westminster Hospital NHS Foundation Trust), Dr Naomi Katz ( West London CCG), Angela Spence (Kensington & Chelsea Social Council), Sue Harris (Executive Director Environment & Communities), Iain Cassidy (OpenAge), Sebastian Adjei-Addoh (Metropolitan Police), Bernie Flaherty (Bi-Borough Executive Director of Adult Social Care), Melissa Caslake (Bi-Borough Executive Director of Children’s Services) and Dr Andrew Steeden (Chair of West London CCG).



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


3.1      Angeleca Silversides declared that she was a Director and Trustee for an organisation that provided Special Educational Needs and Disabilities (SEND) services.




i)                          The Royal Borough of Kensington & Chelsea Health and Wellbeing Board to approve the Minutes of their sovereign meeting held on 9 May 2019.


ii)                        The joint Royal Borough of Kensington & Chelsea and City of Westminster Health and Wellbeing Board to agree the Minutesof the meeting held on 9 May 2019.

Additional documents:




2.1           That the minutes of the Royal Borough of Kensington & Chelsea and Westminster City Council joint Health & Wellbeing Board meeting held on 9 May 2019 be agreed as a correct record of proceedings.


4.2      The minutes of the Royal Borough of Kensington & Chelsea meeting held on 9 May 2019 be agreed as a correct record of proceedings.



To receive an overview of activity occurring across Westminster City Council and the Royal Borough of Kensington and Chelsea to tackle serious youth violence.


5.1           Sarah Newman (Director of Family Services) and Sarah Crouch

(Interim Bi-Borough Director Deputy Director of Public Health) provided the Board with an overview of activity occurring across Westminster and Kensington and Chelsea to tackle serious youth violence (SYV). It was explained that SYV was a term used to capture significant violent crime committed by youths up to the age of 25. It was recognised that the factors leading to youth violence were multi-faceted and had the potential to lead to a range of mental health problems and disorders.


5.2      The Board was concerned to note that knife crime had increased by 52% in Westminster and 24% in Kensington and Chelsea in the last year. Despite this the actual number of incidences involving violence and knife crime committed by under 18 youth offenders had decreased over the last three years. The risk factors relating to the likelihood of a person becoming a victim or perpetrator of violence were detailed. In response it was highlighted how a public health approach to SYV was being undertaken which looked at the root causes and the wider and contextual influences of health and crime. It was recognised that prevention and early intervention were key as well as working with a wide range of partners as part of a long-term, integrated multi-agency approach rather than taking a procedural justice response which dealt with the consequences. The three main issues which the Board was asked to consider related to:


i)       Leadership – ensuring there was a clear, defined and whole system action plan and accountability;

ii)     Data – to define and monitor the magnitude, characteristics and drivers of youth violence in Westminster and RBKC and a commitment to data sharing where relevant; and

iii)    Support Services and Prevention – to look strategically at mental health provision across the system and ensure it met needs in this context.


5.3           The Board held a detailed discussion over the issues of youth violence which included potential gaps in the data regarding information on whether offenders and victims were local residents or not. In response it was noted that the Westminster SYV Task Group was looking at an outcomes framework to identify such data as it was acknowledged that some of the data around victims and offenders was not yet in a form which allowed it to be fully investigated.


5.4           Asif Rahman and John Poyton from Redthread, a youth work charity, were invited to address the Board. They discussed the work undertaken with partners to address serious youth violence at an early stage and highlighted the issues encountered. It was recognised that young people often did not interact with GPs and as a result different models of practices were being investigated to improve levels of interaction. The Board then held discussions over how the work commenced could potentially feed into that undertaken by the Primary Care Networks and Family Hubs. It was suggested that the potential to use youth provision funds to establish drop-in centres at Family Hubs or  ...  view the full minutes text for item 5.



Additional documents:


6.1      Dr Neville Purssell (Central London CCG) and Dr Louise Proctor (North West London CCG) presented the Board with a paper providing information on the case for establishing a single CCG across North West London. The NHS England 10 Year Long Term Plan had been published in early 2019 which outlined a number of goals including the development of Integrated Care Systems (ICS) and more local Integrated Care Partnerships (ICP) which would be underpinned by Primary Care Networks (PCN). It was envisaged that each ICS would consist of just a single CCG replacing the eight North West London currently had in place. It was suggested that the changes would address the financial and care provision challenges faced by making the decision-making and administration processes as effective and efficient as possible. It was advised that the change would support consistency and equity in methods of engagement and simplify system wide financial planning.


 6.2     The importance of local authorities as key partners was stressed, especially in helping to determine local priorities and strengthening local accountability. It was envisaged that the role of the Health and Wellbeing Board of providing a strategic steer for effective local delivery of health and care outcomes would continue and the importance of the local authorities in scrutinising health services would continue under any reform of commissioning structures. It was explained that Westminster’s and Kensington and Chelsea’s Boards would also continue to play a key role in shaping and developing local services.


6.3           Concern was expressed that at this stage there appeared to be a lack of clarity with regards to the proposed governance structure under any potential new arrangements. The Board was informed that currently an engagement process was being undertaken with stakeholders up until 24 July 2019 and the Board was asked to feedback any specific comments to help inform the proposals.


6.4      The Board discussed in detail how the proposals would impact on the role of the voluntary sector, potential changes to patient facing services and how it was envisaged that the ICPs would operate. The Chair advised the Board of the importance of feeding into the engagement process to help inform the proposals to establish a single CCG.



To receive an update on work to implement the SEND reforms introduced in the Children and Families Act 2014 and a summary of inspection arrangements.

Additional documents:


7.1      Ian Heggs (Director of Schools Commissioning and Education) and Steve Comber (Head of Local Offer and SEN Outreach) provided an update to the Board on the work carried out to implement the SEND reforms introduced in the Children and Families Act (CFA) 2014 in addition to a summary of inspection arrangements. The report also introduced the Special Educational Needs and Disabilities (SEND) Self-Evaluation Frameworks (SEF) for both local areas.


7.2      The positive changes and the challenges that the Council had faced since the introduction of the reforms were detailed. The Board was pleased to note the level of joint working undertaken with partners including the CCGs, school representatives and parents to deliver those reforms.


7.3      An overview of the joint Ofsted and Care Quality Commission (CQC) inspection process was provided which focused on the areas of education, health and social care provisions available for children and young people with SEND. The inspectors would review the journey of progress since the introduction of the CFA and how this had been achieved as a local area partnership. As part of the process the inspectors had to understand the robustness of local self-monitoring processes and policies. The Board was advised that Westminster and RBKC had not yet been inspected since the process was introduced in 2016. It was confirmed that once an inspection had been arranged the Board would be updated accordingly. The Board’s attention was then drawn to the SEND local area governance arrangements and how the various partners, including the Board, worked together.


7.4      The Board discussed potential issues regarding the process of children receiving an Education, Health and Care Plan (EHCP) and the level of support provided. It was recognised that there was increasing demand for EHCPs and an increase in the complexity of needs encountered. However, services were being tailored accordingly to meet these challenges and nearly 100% of EHCP assessments were now being undertaken within the 20-week timeframe. Schools and colleges had also developed more accessible websites which clearly communicated the Local Offer of support for children and young people with SEND.


7.5      The Board noted the update and expressed its thanks for all the work undertaken to implement the SEND reforms.



Additional documents:


8.1      Senel Arkut (Bi-Borough Director of Health Partnerships) introduced a paper which summarised the outcome (Q4 Return) of the Better Care Fund (BCF) Plan for 2018/19 for both Westminster and Kensington and Chelsea. Details on the jointly developed BCF plans for 2019/20 were also provided. It was explained that the services and resources that form part of the 2019/20 BCF were organised into the following five themes:


i)                High quality care in the community, preventing unnecessary hospital admissions and ensuing timely discharge;

ii)               Joint work on mental health supported accommodation and homelessness;

iii)             Advocacy, carers cervices, advice and guidance and prevention;

iv)             Aligning the boroughs and CCG BCF with wider strategic plans; and

v)              Use of the iBCF, winter pressures, disabled facilities grant funding as enablers for BCF plans in Westminster and Kensington and Chelsea.


8.2      The Board discussed the plans in detail and noted that delays in issuing the national guidance meant that many Health and Wellbeing Boards would not have formally approved their 2019/20 Plans before they needed to be submitted for assurance. It was expected that for Westminster and Kensington and Chelsea the submission deadline was likely to be before the next Board meeting in October. The Board considered options for approving the 2019/20 BCF and agreed that following endorsement of the Plan from partners, responsibility for sign-off of the 2019/20 BCF would be delegated to the Chairs of the Boards for approval. Following which, the final submission, once approved by NHS England, would be retrospectively tabled at a meeting of the concurrent Board.




1)    That the headline details of the BCF Q4 return that was submitted to NHS England in April 2019 be noted;


2)    That the 2019/20 BCF plans be circulated to partners for endorsement before responsibility for sign-off be delegated to the Chairs of the Health and Wellbeing Boards in order to obtain the necessary assurance from NHS England that plans were in place for the delivery of the 2019/20 BCF Plan;


3)    That the final submission, once approved by NHS England, would be aimed to be retrospectively tabled at the concurrent Health and Wellbeing Board scheduled for 10 October 2019; and


4)    That the approach in Westminster and Kensington & Chelsea outlined in the report be noted.



The Board to consider any other business which the Chair considers urgent.


9.1      Councillor Acton provided an update on a recent visit to the Dementia House in Watford and suggested that a briefing note be circulated to the Board.