Agenda and minutes

The Chair to welcome everyone to the meeting.

1.1      Councillor Addenbrooke welcomed everyone to the meeting and confirmed that as the concurrent Board meeting was being held within RBKC 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 Councillor David Lindsay (RBKC - Lead Member for Family and Children’s Services), Iain Cassidy (Open Age), Natalia Clifford (WCC – Public Health), Olivia Clymer (Healthwatch Westminster), Jules Martin (Central London CCG), Hilary Nightingale (Westminster Community Network), Dr Neville Purssell (Chair of the Central London CCG) and Jennifer Travassos (WCC – Head of Prevention, Housing and Regeneration).

2.2      Toby Hyde apologised for delayed arrival.

To receive declarations by Members and Officers of the existence and nature of any pecuniary interests or any other significant interest in matters on this agenda.

3.1      No declarations were made.

i)                The City of Westminster Health and Wellbeing Board to approve the Minutes of its sovereign meeting held on 3 July 2019.

ii)               The Royal Borough of Kensington & Chelsea and City of Westminster Health and Wellbeing Boards to agree the Minutes of the concurrent meeting held on 3 July 2019.

Angela Silversides wished to add that she had also attended the sovereign Westminster Health & Wellbeing meeting, as deputy for Olivia Clymer. Subject to the above it was: -

RESOLVED:

4.1      The minutes of the sovereign Westminster Health & Wellbeing Board meeting held on 3 July 2019 be agreed as a correct record of proceedings.

4.2      The minutes of the concurrent Royal Borough of Kensington & Chelsea and Westminster Health & Wellbeing Board meeting held on 3 July 2019 be agreed as a correct record of proceedings.

Sarah Newman, Interim Executive Director of Bi-Borough Children’s Services, and Houda Al-Sharifi, Bi-Borough Interim Director of Public Health, to present a verbal update on Taking?a Public Health approach to?Serious?Youth Violence.

Anne Pollock, Principal Policy Officer, to present a verbal update on the Dementia Strategy.

5.1      Sarah Newman provided an update on Serious Youth Violence. Unfortunately, the situation was worrying with several violent incidents recently, particularly in the Northern part of Westminster. The various agencies were working closely and Guidance to Parents and Carers had recently been issued. The Clerk would circulate this Guidance document to all Members of the Board.

5.2      Ms Newman detailed other actions. There was close work with schools to tackle exclusions, both fixed term and permanent (which were closely linked to gang involvement). New rapid response procedures in the event of incidents were being developed and further consideration was being given to ways to best reassure the community.

5.3      Members of the Board echoed these concerns. Issues of poverty/drugs/gangs were very complex and deeply entrenched. From the Metropolitan Police D.I. Adjei-Addoh commented that a lot of under-18s were being exploited, there were complex ‘victim v perpetrator’ issues. A multi-agency approach, engaging the community was necessary to tackle these issues. Ms Newman reassured the Board that there was cross London work taking place in respect of sharing intelligence and best practice.

5.4      Anne Pollock provided an update on the Dementia Strategy. Work was taking place to complete this and ensure it was as robust as possible. This issue would be on the Board’s next agenda.

To consider a protocol for public speaking at Board meetings (Senel Arkut).

6.1      Tristan Fieldsend introduced the Speaker Protocol. One Member thought 72 hours was a short window, but Mr Fieldsend responded that some questions could be of a technical nature. The Board agreed to trial the protocol with a 72 hours deadline. A member of the public pointed out that not everyone had access to computers and email.

6.2      Following a comment from a member of the Board Mr Fieldsend agreed to amend the Protocol to make it clearer that questions need not necessarily relate to matters on the agenda.

6.3      Subject to the above it was: -

RESOLVED:

That the Concurrent Health and Wellbeing Board approve the Speaker Protocol.

Joe McGale (West London CCG) and a representative from Central London CCG to present an update on the PCN Alignment.

7.1      Simon Hope (Deputy Managing Director – West London CCG) introduced the report and drew attention to the network maps for the two boroughs. The networks were in place and from April they would be delivering to a high standard he asserted.

7.2      Councillor Charles Williams stated that he supported the direction of travel on PCNs but he had one major concern – the obvious location for a PCN was Chelsea and Westminster Hospital rather than the Violet Melchett hub. Dr Steeden responded that a PCN hub was not planned for Violet Melchett. Councillor Acton was disappointed that no PCN had linked Queens Park and Paddington with the rest of North Westminster and also that the PCN areas were of varying sizes and not defined on any geographic basis. Dr Steeden and Ms Proctor responded that PCNs were not statutory bodies. The proposed PCNs came from the practices themselves. Individual GP practices would retain responsibility for quality and safety standards on the understanding that each PCN would be developing some system to ensure patient experience was factored in. ChelWest and Imperial commented that they would be keen to help in order to increase agility in the system, make sure the right expertise was available and stressed the importance of involving the local authorities.

7.3      Other contributions welcomed the opportunities offered by PCNs. It was recognised that they were new organisations and needed to be supported in their formation, their choice of who to work with, and in their development their need to become agile (to move quickly and easily). It was noted that Healthwatch was happy to support the new networks.

Senel Arkut to present an overview of the recent BCF submission, which was sent to NHSE ahead of the deadline of 27 September.

8.1      Senel Arkut recalled the discussion at the previous Board meeting, this report was an update. The two plans (for Westminster and RBKC) had been submitted over the Summer and it was believed that they would be close to reassurance in December. In response to a member’s question it was confirmed that, although the BCF plan is reduced to ‘minimum required’ (in terms of investment), services had not been reduced but that things were now being jointly (where appropriate) delivered outside the BCF, via different governance arrangements.

8.2      From West London CCG Ms Proctor confirmed that the commitment to work together and make best use of resources was still very much in place. The Board’s attention was drawn to paragraph 3.5 of the report and the agreed areas of joint work.

8.3      Ms Arkut confirmed that further update reports would be provided in due course.

8.4      It was requested and: -

RESOLVED:

That retrospective approval be given to the Westminster and RBKC Better Care Fund plans for 2019/20.

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

9.1      Councillor Acton informed the Board that Westminster had received additional grant funding to tackle homelessness. Discussions would take place with partner agencies as to how best to use these resources.

9.2      She also asked members to note the response from NHS NW London CCG (Mark Easton) to our comments sent regarding the 8:1 CCG proposal for NW London. We had proposed that should 8:1 be delayed until April 2021, then a Bi-borough Integrated Care Partnership (ICP) be piloted, which would entail working across the two boroughs as one integrated body, including one CCG. This proposal was supported by NHS NW London and work would begin to take this forward. Members were in support of this proposed pilot.

9.3      Annabel Saunders and Neil Hales notified of two documents that would require the approval of the Board Chairs (prior to the next meeting of the full Board): -

(i)              The Care Quality Commission (CQC) was inviting Health and Wellbeing Boards in England to self-assess local support services for children and young people with mental health problems against the recommendations made in their ‘Are we listening?’ report;

(ii)             The Children and Adolescent Mental Health Services (CAHMS) Local Transformation Plan (LTP) 2019/20 refresh was being worked on currently.

9.4      Senel Arkut reported a recent meeting with the Local Government Association (LGA). There were people at the LGA who could usefully talk to this Board to assist with its development. (The name of Alyson Morley, Senior Adviser, Health Systems was specifically mentioned). The Board was happy for Ms Arkut to approach the LGA to pursue this.