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

The Chair welcomed everybody to the meeting and asked attendees to introduce themselves.

Apologies were received from London Borough of Tower Hamlets Councillors David Edgar and Sirajul Islam; Debbie Jones – Corporate Director for Children’s Services and Will Tuckley – Chief Executive, London Borough of Tower Hamlets; Amjad Rahi – Chair of Healthwatch Tower Hamlets, Jackie Sullivan – Managing Director (Royal London and Mile End Hospitals), Barts NHS Trust and Jane Ball – Vice Chair of Tower Hamlets Housing Forum/ Chair of Health.

The Chair asked the Board to note that a representative of the Independent Group of Tower Hamlets Council had yet to be nominated to the Board.

The Chair introduced the new social media hashtag for the Tower Hamlets Health and Welbeing Board, #THhealthwellbeing. She explained its creation is to help raise the profile of the Board and its work, and encouraged all members and associates of the Board to use it.

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

The Chair referred members of the Board to the minutes from the meeting held on the 21^st June 2016. The Board approved these to be an accurate record of the meeting, subject to clarifying that Dr Navina Evans is now Chief Executive of East London NHS Foundation Trust.

Matters arising: The Director of Public Health, Dr Somen Banerjee, advised that the Transforming Care Partnership Plan (as referred to at Minute 3, page 5 of the 21^st June minutes) would be submitted to a future meeting of the Board.

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

There were no declarations of interest.

The Chair updated the Board on recent activity to update its Terms of Reference. She reminded members that changes to the Board’s membership had been proposed following a Local Government Association (LGA) peer review, that the proposed changes had been considered and approved by Full Council on 20^th July 2016, and that a representative of the Independent Group (as the largest majority group on the Council) had been added, though a nomination was awaited.

The Board RESOLVED to note the revised Terms of Reference, taking into account the changes as agreed by the Board at its meeting of 21st June 2016, which were approved by Full Council at its meeting of 20th July 2016. Attached to the report submitted as Appendix 1.

The Chair informed the Board that, pursuant to the revised Terms of Reference agreed under the previous item, the Tower Hamlets Clinical Comissioning Group (CCG) had nominated Dr Sam Everington for Vice-Chair of the Board for 2016/17.

The Board RESOLVED that Dr Sam Everington is appointed as the Vice-Chair of the Tower Hamlets Health and Wellbeing Board for 2016/17.

Keith Burns, Programme Director of Special Projects, LBTH, introduced the report.  Keith explained that originally, this strategy was focused around residential and care home services in the borough, but that it has since broadened in scope and now encompassed a much wider range services and aims. The strategy has a number of parallels with other strategies being considered by the Board, for example the Health and Well-Being Strategy, the Housing Strategy and others.

The tabled strategy should be seen as an introductory proposal. Stakeholder engagement is planned, including with residents and community/voluntary sector bodies, and it is hoped this engagement will help define the scope of the strategy. Keith asked the board to specifically note the proposed governance arrangements, production timeline and the ambition that the strategy be co-produced with local stakeholders

The Chair welcomed the strategy, in particular the following elements:

a)    The broadening of its scope to focus on ‘ageing well’, as she believed that the definition of an older person is changing and that ensuring wellbeing for older people today involves more than the traditional view of social care. She felt ageing well involved a range of partner services and the full range of Council services.

b)    The commitment to involve the Board and other stakeholders in its production. The Chair felt this reflected a genuine commitment to work with local people and community groups to define the strategy in terms of what local people really want.

The board recognised that the strategy had broadened in scope and asked that future iterations of the strategy and reports to the Board reflect this, by including the full range of services to be explored. Specifically, it asked that the strategy include a focus on skills and knowledge and work in later life. The Board welcomed the strategy’s recognition that ageing is changing and that traditional ways of viewing older people’s needs was no longer sufficient to ensure wellbeing in older age.  It stressed that we should no longer simply view older people as just ‘users’ of services, but should also ask how they can contribute and recognise that such contributions can have a real impact on their wellbeing.

The Board asked that the strategy also explore elements of intergenerational work. Members felt there are really good examples of such work in the Borough which officers could explore.

The Board RESOLVED to:

1.    Approve the proposed governance arrangements for development and delivery of the strategy, including the creation of an Ageing Well Strategy Group to act as a sub-group of the Board;

2.    Approve the proposal that the governance arrangements for the Ageing Well in Tower Hamlets strategy incorporate oversight of the actions and deliverables associated with the key aims of the Older Persons’ Housing Statement (2013-2015), which are currently being incorporated into the borough’s new Housing Strategy 2016 – 2019;

3.    Agree the proposed exploration of the feasibility of committing to making Tower Hamlets a dementia friendly borough by 2020, in line with the Alzheimer’s Society’s challenge, during the  ...  view the full minutes text for item 2.3

Martin Ling, Strategic Housing Officer, LBTH, introduced the First Stage Consultation of the Housing Strategy 2016. Martin explained that the strategy was prepared in a time of extraordinarily challenging circumstances for housing in the borough. The strategy recognises that housing and health of the community are inextricably linked. Martin highlighted some of the recent developments affecting the strategy’s preparation, including the Housing and Planning Act, the new Mayor of London, the development of the Council's Local Plan and the creation of the Mayor of Tower Hamlets’ Housing Policy and Affordability Commission. Martin explained that initial consultation on the strategy had completed in July 2016 and over 400 responses have been received. The strategy will be taken to Cabinet in September 2016, after which the second stage consultation will begin. Consultation will allow for both formal and informal input.

In response to questions from the Board, Martin provided and an update on  development of a licensing scheme for private landlords. Martin explained that since this ambition was first agreed, the rules have changed and it is no longer possible to implement borough-wide licensing schemes, as has been implemented in Newham. The Council has proposed a licensing scheme that will be applied in Weavers, Whitechapel and Spitalfields wards and is currently awaiting further guidance on Houses in Multiple Occupation (HMOs) licensing extension options.

The Board asked if the strategy could specifically address the following problems:

a)    How to minimise the health impacts on those living close to poor air quality areas.

b)    Providing places to live for key workers, for example health and council workers.

c)    Provision of open and community space, including possible application of section 106 resources and whether these could be used to maximise quality open spaces.

Martin explained that these concerns were matters for the planning process. The Chair agreed to pursue relevant matters in discussion with the Cabinet Member for Strategic Development to ensure they are included in the Council's Local Plan.

d)    The strategy to link to the Making Every Contact Count scheme. So that health workers could identify and sign-post uses encountering housing problems, e.g. damp, in the same way that is currently done with smoking and other lifestyle issues.

e)    Explore opportunities to connect new residents to local health provision such as an application pack with details of GP registration and other local health services.

f)     Explore possible changes to the Council's housing allocations policy to include (1) air quality information for social housing bidders and (2) recognition/additional priority for adults with learning difficulty or children with autism.

The Board received an update report on the NEL STP. Jane Milligan, Chief Officer, Tower Hamlets CCG, introduced the report. Jane explained that the Sustainability and Transformation Plan (STP) aims to set out how the CCG will respond to the financial as well as the health and well-being challenges it faces in coming years. Through the Plan, the CCG hopes to meet the challenge of carrying out its functions as effectively and productively as possible.  A key element of the Plan is the identification of where focus should be regional (north east London) and where local (Tower Hamlets).

Development of the Plan will be developed to include input from partners and stakeholders: preliminary consultation has taken place, though no feedback has yet been received. The CCG hopes to get feedback on the draft STP by end of October, following which, more detailed iterations will be developed. Jane is happy to make the full draft STP available to Board members on request.

The Chair welcomed the report, but felt there may be a risk or tension. She noted that elements of the draft STP include a broad, regional focus, yet other work in shaping the borough’s health landscape, including the work of the Health and Wellbeing Board, is much more local in scope. Jane agreed this did pose a risk, though the CCG would aim to mitigate it as far as possible.

The Board welcomed the opportunity to input and help shape the emerging STP. Members suggested this went some way to reducing what could be described as a democratic deficit in CCG planning and would welcome wider councillor engagement in the process. It also noted the synergies with other strategies and plans being considered and developed by the Board.

Dr Dianne Bell, Director of Insight, Cobic and Chris Banks, CEO, GP Care Group, gave a presentation on the discovery phase findings in the development of the Health and Social Care Outcomes Framework. They explained that, in their experience, securing successful development of health economies centred on understanding what outcomes matter to local people, how these outcomes are translated into frameworks and how those frameworks are applied. Dianne and Chris further outlined the governance model and the range of stakeholder engagement events that would support development of the Framework.

The Board welcomed the opportunity to contribute to the development of the Framework. The Chair stressed that joining up services is key to securing success and would welcome a plan which identified joint outcomes. The Board therefore has a critical role to play in identifying those inter-relationships and providing a focus point for joined-up working.

In addition, the Board made the following suggestions:

·         To revise the Population Segments section to also recognise a separate category of ‘young adult’, as this population group presents unique health risks.

·         To include ‘Environment’ as a separate heading under the ‘Place’ section of the potential objectives. 

·         To ensure non-statutory bodies have opportunity to participate in stakeholder engagement.

·         Encouraging  Barts Health clinicians to participate in the Framework’s development.

The Board received a report on the planned next steps of the Health and Wellbeing Strategy 2016-20. The Chair provided a reminder of previous decisions on the strategy’s development. Several workshops had been held and the Board had chosen to progress a short, focussed and accessible strategy that would explain the Board’s ambitions as distinct from those of individual partner agencies’.  It was agreed to focus on five core areas. A sub group has since been established for each of the core areas.

Dr Somen Banerjee, Director of Public Health, London Borough of Tower Hamlets, gave a presentation updating the Board on the strategy, including an overview of the five agreed priorities. The Board expressed agreement with the five priorities and made several suggestions for each, including:

·         More clarity of what is meant by ‘Leadership roles’ and recognition that some quality control may be necessary to ensure the right motives and skill set are identified in potential community volunteers.

·         Ensure we learn from current examples of excellent community leadership already taking place in Tower Hamlets.

·         Ensuring the Board is more outward-facing to connect with the community, including possibly rotating meeting venues beyond Mulberry Place, to increase its visibility and raise its profile in the local community.

·         Recognition that safety and perceptions of safety are critically linked to public confidence in open spaces.

·         Explore linkages with decision-makers on investment in open spaces, in particular Community Infrastructure Levy (CIL) allocation.

·         Include a specific focus on helping people with learning difficulties into employment, including a commitment to learn from good practice elsewhere.

·         The Board welcomed the focus on communicating with parents, as evidence suggests children are aware of the risks of eating unhealthily, yet parents’ poor food choices contribute to unhealthy weight.

Somen explained that the Shared Outcomes Framework (discussed in more detail at agenda item 2.6 of the agenda for this meeting) had been included in the strategy. The Chair also asked that Somen liaise with Dianne Barham to include relevant feedback from the recent public engagement event led by Healthwatch Tower Hamlets in the strategy.

The Board received a report which made suggestions for how it could become an exemplar Health and Wellbeing Board. The Chair introduced the report and explained that one of its suggestions was to hold an awayday session, where the Board could discuss its development and agree practical actions. The Chair stated that, in contrast to the detail of the report, the session need not be a full day and October 2016 had been identified as potentially most suitable.

Jane Milligan advised of related opportunities involving LGA workshops for development of STPs and agreed to explore any opportunities for sharing learning from the two events.

The Board RESOLVED to hold a one day or part day Board development session around October 2016, the exact date to be advised.

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

None.

The next meeting is scheduled for 5.30pm on Tuesday 18^th October 2016. The Chair advised that it had been necessary to schedule future 2016/17 meetings of the Board at the later time of 5.30pm, but that she would aim to keep meetings as short as possible.