Given the need to consider the Better Care Fund report at this meeting, the Chair decided to adjourn the meeting to obtain a quorum.

In the meantime, those present received an informal presentation from Roger Clifton (Chief Operating Officer of the East London Vision) on the Tower Hamlets Plan for Eye Care.

The meeting reconvened when the meeting was quorate and the formal meeting began.

Change in the order of business.

The Board agreed to change the order of business as follows: Item 2.4, 1.1-1.3, 3.1, 3.2 and 2.5. However for ease of reference, the minutes are set out in agenda order.

To receive apologies for absence and subsequently the Chair to welcome those present to the meeting and request introductions.

Councillor Asad welcomed everyone to the meeting and invited everyone to introduce themselves.

To note any declarations of interest made by members of the Board. (See attached note of Monitoring Officer).

No interests were declared.

To confirm as a correct record the minutes of the meeting of the Tower Hamlets Health and Wellbeing Board held on 8^th July 2014 and to consider matters arising.

The minutes of the meeting held on 8^th July 2014 be approved as a correct record.

Regarding the Presentation on the Expression of Interest for the co-commissioning of Primary Care Services in Tower Hamlets (item 2.4), John Wardell (Deputy Chief Officer, Tower Hamlets Clinical Commissioning Group) reported that it was expected to receive feedback on the application soon.

He also reported that no feedback had been received on the letter to the Secretary of State about GP services and the Minimum Practice Income Guarantee. However, it was understood that short term support would be made available for GPs surgeries readjusting to the changes subject to compliance to a criteria. Mr Wardell stated that the CCG could carry out work to identify how many GP surgeries in TH could meet this criteria and were offering surgeries support to meet the criteria.

To consider and comment on the Forward Programme.

Lead for item: Deborah Cohen, Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH.

Item deferred for consideration at the next meeting of the Board in November 2014.

Verbal Update.

Lead for item: Dianne Barham, Director of Healthwatch Tower Hamlets.

Item deferred for consideration at the next meeting of the Board in November 2014.

Recommendations:

Note the update on performance set out in part 3 of the report and detailed in Appendices 1- 5;

Comment on the usefulness of the information and format, as this is the first report of this type, which we can revise for future reports;

Indicate any areas of poor performance or delays where more information is requested.

Note that the next six monthly monitoring report will be considered by the Health and Wellbeing Board in January 2015.

Lead for Item: Louise Russell, Service Head, Corporate Strategy & Equality, LBTH.

Report deferred for consideration at the next meeting of the Board in November 2014.

Recommendation:

Note the contents of the report and support the implementation of plan

Lead for item: Deborah Cohen, Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH.

Discussed informally before meeting.

Recommendation:

To note the progress outlined in this report.

Lead for Item: Jane Milligan, Chief Officer, Tower Hamlets Clinical Commissioning Group.

Report deferred for consideration at the next meeting of the Board in November 2014.

Lead for item: Deborah Cohen, Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH.

Special reasons for urgency.

• The report was unavailable within the standard timescales set out in the Authority’s Constitution because of continuing work to review the new NHS criteria for Better Care Fund applications and to finalise the Tower Hamlets Council and CCG submission.

• One of the terms of the Better Care Fund for 2015/16, is the requirement that HWBBs approve for submission to the Department of Health the updated template document which sets out the CCG and Council’s joint plans for the application of those monies. The HWBB approved the Local Authority and CCGs BCF Planning Template on the 24th March 2014. However, following on from this the Department of Health and Local Government Association has asked all Local Authorities and CCGs to resubmit their Better Care Fund Planning Templates for 2015/16 with more narrative and detail on the proposed expenditure of the fund. Local Authorities and Clinical Commissioning Groups (CCGs) are now required to resubmit their jointly agreed Better Care Fund Planning Template for 2015-16 to the Local Government Association (LGA) and NHS England by 19th September 2014.

Deborah Cohen (Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH) invited the Board to consider the revised Better Care Fund (BCF) Planning template following consideration of the original BCF by the Board on 24^th March 2014.

She explained the need for the resubmission of the template to reflect the reinstatement of the ‘payment for performance’ aspect for emergency admissions. As a result, greater narrative on the budget plans were required. The general thrust was the same as the original BCF plans signed off by the Board in March 2014.

Members were reminded of the aims of the BCF to deliver better integrated services, shared by the NHS and Local Authorities, in community settings for older and disabled people. Members were also advised of the key features of the BCF including the implementation plans.

It was anticipated that in future, a BCF model could be developed for Children’s Services. A Member sought clarity about this.

It was noted that steps were being taken to ensure the BCF plans fitted into other health strategies – such as the CCG plans and the transforming lives agenda.  John Wardell (Deputy Chief Officer, Tower Hamlets Clinical Commissioning Group) assured Members that the plans fully complied with the government requirements and highlighted the significant amount of consultation with service users on the plan. He welcomed the true partnership approach to the BCF.

The Chair thanked the Council and the CCG staff for all their work in the BCF initiative and making it a success.

Subject to Mayoral approval

1.            That the resubmitted version of the Better Care Fund Planning Template (Appendix 1) be agreed before final submission to NHS England on 19 September 2014

2.            That it be noted that the resubmitted Better Care Fund Planning Template does not deviate from the original submission in April, but provides more detail on the agreed budget lines; risk mitigation and outcomes. 

Recommendation:

The Health and Wellbeing Board is asked to comment on the approach, priorities and how members would like to involved in raising the profile of liver disease in their organisations and the community. It is proposed to bring an update on progress to the Board in 9 months.

Lead for Item: Dr Somen Banerjee, Interim Director of Public Health, LBTH

Dr Somen Banerjee, (Interim Director of Public Health, LBTH) presented the report on Liver Disease in Tower Hamlets. He drew attention to the relatively high levels of liver disease in the Borough, based on a needs assessment, and the actions underway to address this. The aims for the future included: to increase awareness of liver disease, reduce incidence and improve early identification of hepatitis eg through immunisation and case finding, better linking of services, such as the drugs and alcohol services with liver disease treatment pathways. The priorities were fully set out in the paper.

In response to questions, the Board heard about the risk factors for liver disease such as diabetes and lifestyle factors. The Board felt that it was important to increase awareness of liver disease and the causes amongst younger people and teenagers given experience. It was suggested that the use of social marketing could help raise awareness amongst young people. The Board also noted the need to raise awareness in schools.

Members also noted the proposed timescale for these plans that reflected the service procurement timescale.

1.               That the report and Board comments on the report be noted.

2.               That an update be on progress be brought to the Board in 9 months.

Recommendations:

Provide comment and feedback to the programme team based on their review of the Interim Case for Change. This will be used in the development of the final case for change, which is due to be published in October.

Consider and confirm requirements and timings for future updates and presentations about the final Case for Change and any future work programmes.

Lead for Item: Jane Milligan, Chief Officer, Tower Hamlets Clinical Commissioning Group.

Neil Kennett-Brown (Programme Director, Transformational Change

NEL Commissioning Support Unit) and Dr Anna Riddell (Children's Services Clinical Director Children's Clinical Academic Group Barts Health NHS Trust), presented the progress report on the Transforming Services, Changing Lives initiative.

The Board were reminded of the background to the programme, established by local health care providers to provide the best possible health services for local people. They also explained the drivers for change including: population growth and changes, the need to improve services to meet the challenges and to make better use of technology and resources.

They reminded Members of the continuing work to gain feedback on the plans including engagement with the patient group Health watch. Further consultation was planned. They also explained the key milestones. The interim Case for Change was published in July 2014. It was planned that the final plans would be published in the Autumn. The initiative covered a number of key areas including adolescent services, community services and urgent care. It did not at this stage outline any recommendations for change

With the permission of the Chair, the Board heard from Councillor Andrew Wood. Whilst noting the involvement of patients groups in the process, it was felt that the initiative had moved too quickly and that more effort should be made so that patients were on board.

A Board Member also stressed that the programme was about the benefits of collaboration across the North East London health economy and  London as whole. It was not clear that this came across strongly in the public report. 

The Chair of the Children’s Safeguarding Board stressed the need for the Board to be fully involved in and consulted on the initiative.

It was also reported that LB Newham were considering setting up a joint HWB with other Authorities.

1.         That the feedback from the Board be reported to the programme team based on their review of the Interim Case for Change. This will be used in the development of the final case for change, which is due to be published in October.

2.         That the requirements and timings for future updates and presentations be agreed about the final Case for Change and any future work programmes.

Recommendations:

To note:

Progress made on the MOU, contained within the table within this report.

The need for ongoing working between the Council and Barts Health on employment which exists in a number of different parts of the One Tower Hamlets Partnership but specifically lead by the One Tower Hamlets Prosperous Community theme which drives the work on employment and skills. 

That the majority of the MOU’s actions are being carried forward by existing work programmes connected to the HWBB such as the Better Care Fund, Public Health’s Healthy Lives work programme and HWBB’s subgroups.

The recommendations laid out in the table outlining the original MOU actions.

That the work on employment, enterprise and young people’s careers be better carried out through the work of the Economic Task Force and that the decision to put in place a new MOU between the Council and Barts Health on skills development and local employment is facilitated by the Councils Economic Development Team. 

Lead for item: Deborah Cohen, Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH.

Deborah Cohen (Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH) presented the report on progress with the Memorandum of Understanding (MOU). The MOU was a non legally binding agreement between LBTH, the CCG and Barts Health to reduce equalities in respect of health and social care.

Most of the actions in the MOU had now been completed or superseded by the Better Care Fund. However, there was still a need to focus on the employment aspects in the MOU. These actions (points 5 and 6 in Appendix 1) would be taken forward by the Council’s Development and Renewal Directorate.

It was noted that Bart’s Health worked closely with the Council in creating local employment opportunities and skills as part of the initiative. (Appendix 3 of the report provided a breakdown of Bart’s Health staff at 31^st March 2014).  Alistair Camp (Non-Executive Director, Barts Health and Chair of the Integrated Care Board) commented on the success of the placement scheme in terms of securing job offers for participants. It remained one of Bart’s Health key ways of tackling unemployment.

That the Board note:

1.            Progress made on the MOU, contained within the table within this report

2.            The need for ongoing working between the Council and Barts Health on employment which exists in a number of different parts of the One Tower Hamlets Partnership but specifically lead by the One Tower Hamlets Prosperous Community theme which drives the work on employment and skills. 

3.            That the majority of the MOU’s actions are being carried forward by existing work programmes connected to the HWBB such as the Better Care Fund, Public Health’s Healthy Lives work programme and HWBB’s subgroups.

4.         The recommendations laid out in the table outlining the original MOU actions.

5.         That the work on employment, enterprise and young people’s careers be better carried out through the work of the Economic Task Force and that the decision to put in place a new MOU between the Council and Barts Health on skills development and local employment is facilitated by the Councils Economic Development Team. 

Recommendations:

Comment on the proposed approach and issues for the refreshing the Community Plan

Explore the key questions related to health and social care and the wider determinants of health and wellbeing. 

Lead for Item: Louise Russell, Service Head, Corporate Strategy & Equality, LBTH.

Report deferred for consideration at the next meeting of the Board in November 2014.

To consider any other business the Chair considers to be urgent.

The Chair reported that this would be the last meeting of the Board that Deborah Cohen (Service Head, Commissioning and Strategy, Education, Social Care and Wellbeing, LBTH) would be attending as she would be leaving the Authority for a position with the NHS. The Board thanked Ms Cohen for all her work for the Board and Tower Hamlets and wished her well for the future.

Noted.