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

The Vice-Chair welcomed everybody to the Health and Wellbeing Board. She reported that the meeting would largely focus on the Council’s agenda to transform local health services, receive an update on the Better Care Fund and a report on air quality.

Apologies for absence were received from Mayor John Biggs, Will Tuckley, Jackie Sullivan, Stephen Halsey, Phil Langworthy and Sarah Baker.

The Board noted that no questions had been received from members of the Public.

Councillor Whitelock-Gibbs welcomed everyone to the meeting of the Health and Wellbeing Board and invited everyone to introduce themselves.

Councillor Whitelock-Gibbs advised that the meeting would be focusing on the refresh of the Health and Wellbeing Strategy 2016-2020 based on the workshop at the last meeting, Transforming Services and Air Quality.

She statated that the Board had a large amount of business to complete and ask members to be succinct in their comments.

Apologies for absence was received from Mayor John Biggs (Chair), Dr Sam Everington (NHS Tower Hamlets Clinical Commissioning Group), Dr Navina Evans (Deputy Chief Executive of East London and Foundation Trust)  and Steve Stride (Chief Executive, Poplar HARCA).

The Board noted that no questions had been received from members of the public.

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

There were no declarations of disclosable pencuniary interests.

To confirm as a correct record the minutes of the meeting of the Tower Hamlets Health and Wellbeing Board held on 12 January 2016.  Also to consider matters arising.

RESOLVED –

That minutes of the meeting of the Tower Hamlets Health and Wellbeing Board held on 12 January 2016 be agreed as a correct record.

Matters arising – Somen Banerjee reported that formal feedback on the Local Plan has been submitted on behalf of the Health and Wellbeing Board.

To note any actions by the Director of Public Health Under Delegated

Authority since the last meeting of the Board on 12 January 2016.

There were no actions outstanding under the delegated authority function.

To consider and comment on the Forward Programme.

Lead for item: Somen Banerjee, Director of Public Health, LBTH.

The Board noted the forward plan and agreed that the board development session on the 12^th April will be facilitated by the Local Government Association (LGA). The focus of the session will be on how the board works together to deliver the Health and Wellbeing Strategy.

Somen requested board members to prioritise the date.

The report outlines progress with the Better Care Fund (BCF) programme in 2015-16 and seeks the endorsement of the Health and Well-Being Board for the proposed Better Care Fund programme for 2016-17. It covers a more detailed report presented to, and endorsed by, the Integrated Care Board on 18 January 2016.

Lead Officers:  Josh Potter, Deputy Director of Commissioning and Transformation, NHS Tower Hamlets CCG and Steve Tennison, Senior Strategy, Policy and Performance Officer – Integration Lead, LBTH

Kate Bingham, Service Head for resources Children’s and Adults Services presented this report on behalf of the Clinical Commissioning Group.

She provided an update on the Better Care Fund and referred members to the draft Section 75 agreement, which the Mayor on behalf of the Council and the CCG would be formally invited to adopt.

She referred to the recommendation outlined on page 11 and asked members to take note and endorse the fund for 2015/16.

Subject to legal arrangements the plan is to deliver seven day care and there would be a joint assessment of care plans.

The key points to note moving forward are highlighted in section 3 of the report which went to the Integrated Care Board on the 18^th February 2016.

The plan will continue to deliver the initiatives identified in 2015/16, whilst new initiatives identified for 2016/17 come on stream, such as the proposal for seven day working in the community.

Following the Boards discussion Cllr Gibbs was able to confirm that the section 75 agreement is required to be signed by the Mayor and CCG only.

RESOVLED

That the recommendations as outlined on page 11 for the agenda pack are endorsed and;

It was agreed that more effective engagement of users will be considered at the Integrated Care Board. Dianne Barham offered to support. 

The report sets out the key issues emerging out of the two Health and Wellbeing Strategy development workshops and discuss the implications for the Strategy.

Dr Somen Banerjee, Director of Public Health introduced this report explaining why a Health and Wellbeing strategy was required. He stated that there needed to be a clear definition between Health and Wellbeing. Whilst health referred to the absence of disease, wellbeing related to the subjective evaluation of how we feel and experience life. Factors such as the environment, employment, aspirations etc all count towards good health.

The strategy sets the aims and objectives for Tower Hamlets and page 116 refers to the thinking about a ‘Healthy community’ and what factors influence and support this.

Section 4 of the report sets out our approach and objectives of our current strategy - what we are doing and what we want to achieve. It is important to identify a small number of core areas to make a difference.

Sections 5 to 5.6 relates to our shared understanding of health and wellbeing and improving the outcomes for patients. Addressing consequences of deprivation and reducing childhood obesity, improving health through housing are some of the challenges that this strategy aims to deliver on.

5.8 identifies the ‘transformational areas’ and the significant positive impact this can have. Collectively the Local Authority and the NHS can strive to make a change.

Section 6 – page 120 gives more information on the ‘transformational areas’ and what we want the strategy to focus on.

The proposal is that each identified transformational area is given to volunteers from the Board to draw out priorities for the board.  The task is to identify what aspects of these ‘transformational areas’ the Health and Wellbeing Board needs to focus on and where the Board can use its levers to make the difference.

The following are the groups proposed including Board members and officer support:

·         Addressing the health impacts of deprivation

o   Cllr Amy Whitelock Gibbs

o   Will Tuckley

o   Ian Basnett

o   Somen Banerjee

o   Officer support: Kevin Kewin

·         Helping communities lead change around health

o   John Gillespie

o   Dianne Barham

o   Officer support: Emily Fieran Reed/Ellie Hobart/Public Health Locality Manager (tbc)/Sade Johnson

·         Healthy Place

o   Cllr David Edgar

o   Shazia Hussain

o   Officer support: Esther Trenchard-Mabere/Tim Madelin/D&R (tbc)

·         Tackling Childhood Obesity

o   Cllr Rachael Saunders

o   Sam Everington

o   Debbie Jones

o   Officer support: Esther Trenchard-Mabere

·         Developing a truly integrated system to support health

o   Cllr Amy Whitelock Gibbs

o   Denise Radley

o   Jane Milligan

o   Officer support: Chris Lovitt/Karen Sugars/Simon Hall

RESOLVED

To endorse the development of the Health and Wellbeing strategy and the proposed ‘transformational areas’ identified in the report as set on pages 120-121 of the agenda pack.

     Lead Officer : Neil Kennett Brown, Transformation Manager, NEL CSU

Transforming Services Together (TST) is a partnership programme between Newham, Tower Hamlets and Waltham Forest CCGs and the Barts Health Trust who have published its Strategy and Investment case.

The TST Strategy and Investment Care Part 1 Summary has been published on the website and is open for comments until the 22^nd May 2016. It sets out the proposals on how we intend to address the challenges facing the NHS and social care system.

The TST partnership have been working together over the past two years, looking at how we are prepared to tackle the financial pressures facing the NHS and how population growth has and will impact on the services which we provide. This means that we need to identify different ways of working and need to support the preventative agenda – in other words look at how we can prevent our population from ill health yet at the same time improve the pathways into care and improve patient experience.

We propose to make changes to the approach to End of Life Care – how we can support the patient and families at a difficult time. We are engaging locally and Healthwatch regularly attend meetings and discuss in an open forum.

Cllr Whitelock-Gibbs asked when the consultation was to commence.  The consultation period is from 29 February – 22 May 2016. It was also noted that the TST Partnership is planning engagement sessions in each of the Boroughs.

The report sets out the significant negative impact air pollution has on health with effects ranging from worsening respiratory symptoms and poorer quality of life, to premature deaths, from cardiovascular and respiratory diseases. The report also reports on a recent report and  suggests links between air quality and diabetes, obesity, and changes linked to dementia. 

Recommendations

The Health & Wellbeing Board is recommended to:

1. Note the outcome of the research presented and the general impact on health and wellbeing from poor air quality.
2. Review and prioritise the following actions that could be undertaken at a local level to reduce the impact of poor air quality on health.

Lead Officers : Esther Trenchard-Mabere, Associate Director of Public Health, LBTH;                      Professor Chris Griffiths, QMUL

Dr Somen Banerjee introduced the report stating that the subject of air quality is an important issue for the Board to discuss as air quality contributes to premature deaths in the country.

Prof Chris Griffiths, Prof Jonathan Grigg and Dr Isobel Dundas made a presentation to the Board Members of their research findings regarding the impact of poor air quality to young children in Newham and Tower Hamlets. This followed by a short video presentation featuring how Tower Hamlets schoolchildren feel about the impacts of air pollution in the borough.

Discussion took place about levels of air pollution around schools, how green spaces could be better utilised and whether there is a possibility to introduce a developer levy to support infrastructure improvements around air quality across the boroughs green spaces.

Tower Hamlets is recognised to be a Yellow polluted on the EU benchmark and with high density residential areas the impact of air pollution is significant and a threat to public health. 

Developing policies to tackle car use and parking were also discussed.

RESOLVED

That the Council needs to adopt a collaborative approach to tackle poor air quality issues and to raise awareness of the impact of poor air quality, particularly amongst young children.

That the Lead Member discuss further with the Mayor and relevant Members around how to take this forward.

The report provides the Health and Wellbeing Board with a summary of achievements and priorities as set out in the Local Account of Adult Social Care.

Recommendation

1.     The Health and Wellbeing Board are asked to note content of the attached Local Account 

2.     The Health and Wellbeing Board are asked to consider if the scope of the next Local Account should be extended to take into account the integration agenda and widen the remit to public health and align it more closely to the work of the Health and Wellbeing Board.

Lead Officer:  Luke Addams, Interim Director of Adult Services, LBTH

Kate Bingham presented the Local Account. The aim of the Local Account is to provide transparency for local people to better understand how social care is being delivered in Tower Hamlets, leading to greater involvement and challenge. This Local Account covers the period of 2014-2015 and also sets out priorities for 2015/16.

Board members discussed how the Local Account can add value to the integration agenda in future publications by strengthening user engagement in the development of the Local Account. This will help understand how useful the Local Account is to the public and how accessible it is to residents of Tower Hamlets. There was a suggestion that the Local Account should be consulted with user groups because people we often need to hear from do not responds to questionnaires and surveys.

Cllr Whitelock-Gibbs requested that a performance matrix be included in future publications to make it more user friendly to residents of Tower Hamlets.

RESOLVED

To note the content of the Local Account 

The next Local Account should be extended to take into account the integration agenda and widen the remit to public health and align it more closely to the work of the Health and Wellbeing Board.

The briefing paper gives an update on dental care access for children in Tower Hamlets.

The paper summarises the dental services available to children, and provides information on current access figures, trends and comparisons. The paper identifies national and local action to improve access to dental services and suggests further action that will be taken in 2016/17 to increase dental service uptake.

          Recommendations

          That the Tower Hamlets Health and Wellbeing Board:

Note the actions that are being taken to improve access to dental services to increase access by 5% in 16/17 (from 50.4%).

Lead Officers:  Jane Milligan Chief Officer, Tower Hamlets Clinical

  Commissioning Group)

                          Somen Banerjee, Director, Public Health

Dr Somen Banerjee updated the Board on the progress made and noted that dental access for children had flatlined over the past 5 years or so and was below the London average. He referred Board Members to page 244 of the agenda pack and said that the CCG along with its partners are working hard to improve dental access including increasing capacity through the new practice in Harford Street and improving training to dental teams to work with very young children.

He referred Members to page 246 which state the key priorities for 2016/17.

RESOLVED

To receive an outcomes report in 12 months time.

The report provides an update on the council’s current review of Healthwatch Tower Hamlets (HWTH) and some of the emerging findings. The aim of the review is to develop a model for HWTH which builds on existing strengths, identifies areas of improvement and incorporates good practice from other local Healthwatch organisations. The review findings will help to set out a refreshed vision for Healthwatch Tower Hamlets and inform the retender of the Healthwatch contract.

The existing contract for HWTH expires on 31^st March 2017 and the Council is required to have a new contract in place by 1^st April 2017. The paper outlines the methodology for the review and timetable for reporting on the findings and commissioning of the new Healthwatch contract.

Recommendations:

The Health & Wellbeing Board is recommended to:

Note the report and provide any comments on the future model for Healthwatch Tower Hamlets.

Afazul Haque introduced this report. He informed the Board that a review has taken place of Healthwatch Tower Hamlets (HWTH) and outlined some of the emerging findings.

The Council is using the evidence collated from the review, HWTH’s progress to date, learning from other local Healthwatch and the insight from the various consultations and workshops to develop a revised vision and service model for Healthwatch and will base the specification for the new contract on this.

The existing contract for HWTH expires on 31st March 2017 and the Council is required to have a new contract in place by 1st April 2017.

It was noted that stakeholder engagement will take place from April through to June 2016.

RESOVLED

The report and timetable was noted.

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

No other business.

New meetings dates will be decided by the next Council AGM