The Chair, Cllr Amy Whitelock-Gibbs welcomed everyone to the Health and Wellbeing Board. In particular she welcomed Charlie Ladyman, co-chair of Healthwatch Tower Hamlets and a coptee member of the Board, as well as the Young Mayor and his deputy.

The Chair stated she would respond to the ‘Tower Hamlets Keep our NHS Public’ group, who had requested their letter regarding the North East London Sustainability and Transformation Plan (NEL STP) be circulated to Board Members. For the record, Cllr Whitelock-Gibbs stated that the Board had at previous meetings received reports regarding the STP and would do so at future meetings following the NHS engagement process.

Apologies for absence were received from Cllr Rachael Saunders - Cabinet Member for Education and Children’s Services; Cllr Ayas Miah – Cabinet Member for Environment; Cllr Asma Begum – Cabinet Member for Culture; Debbie Jones – Corporate Director for Children’s Services; Simon Hall – Acting Chief Officer, NHS Tower Hamlets Clinical Commissioning Group; Dr Navina Evans – Chief Executive, East London NHS Foundation Trust; Shazia Hussain – Divisional Director for Customer Access; Esther Trenchard-Mabere – Associate Director for Public Health; Christabel Shawcross – Independent Chair of Safeguarding Adults Board and Tracy Stanley – Senior Strategy, Policy and Performance Officer.

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 minutes from the Board meeting of 13^th December 2016 were agreed and approved as an accurate record of the meeting subject to the following clarifications:

Page 2 - Cllr Whitelock – Gibbs did give her apologies for the meeting.

Page 5 – final paragraph should state NEL STP ‘engagement’ rather than ‘consultation’

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

No Member of the Board declared an interest.

Dr Somen Banerjee, Director of Public Health provided the Board with an update regarding the Health and Wellbeing Strategy 2017-20.

He stated the final analysis from the consultation had been undertaken and there was broad agreement on the approach, priorities and proposed outcomes of the Strategy. The qualitative feedback provided a rich insight from residents and local organisation which would help shape the action plans.

Somen informed Members there would be an organisational development session for the Board, which would further examine the strategy priorities and the impact nationally, regionally and locally. The provisional date for the workshop is the 21^st March 2017.

The draft strategy is going to Cabinet for formal sign off and at the next meeting of the Board, the following strands will be reporting on the progress made so far:

·         Communities leading change

·         Healthy environments and

·         Employment and Health

Dr Banerjee referred Members to page 17 of the agenda which summarised the key findings.

The qualitative findings were of great interest and there was strong feedback from residents and local stakeholders to be inclusive of groups such as older people, those with long-term conditions and disabilities ensuring they are represented and heard.

Around the healthy place priority there was significant concern around air pollution - What can be done to improve the quality of air we breathe?

The feedback also highlighted the need to engage with stakeholders such as Tower Hamlets Housing forum as part of the Integrated Care priority.

Board Members made the following comments:

·         Voluntary Sector groups who have expressed an interest should be represented on the Board Champion Groups.

·         Equalities should be incorporated in all the priority areas of the strategy.

Board Members AGREED voluntary sector groups should be included in each Board champion groups as well as equalities.

The Health and Wellbeing Board

1.    NOTED the findings of the consultation and the approach to delivering the strategy and

2.    FORMALLY approved the Strategy

Layla Richards, Service Manager Policy Programmes and Community Insight presented her report.

The “How we are doing?” magazine represents the sixth annual Local Account on adult social care.

The primary purpose of the Local Account is to inform residents, adult social care users and carers of the quality, performance and future priorities of adult social care, so that the local authority is transparent and accountable. It is an expectation that all councils with social care responsibilities produce a Local Account, although it not a statutory requirement.

Staff and Stakeholder feedback has informed the publication and two new forewords have been inserted. A report will be going to April Cabinet with a communications plan also attached.

Members of the Board made the following comments:

·         Good to see the magazine style document is clear and accessible.

·         The magazine needs to include residents and users patient experience.

·         Referring to Page 56 – Is the Council benchmarking against other local authorities? Denise Radley responded stating the magazine by its nature was not intending to provide too much detail. She acknowledged that in Tower Hamlets spend on care homes is higher than other local Authorities and is a challenge. She supported the opportunity to consider how Adult Social Care can communicate spends to the community.

·         Can the Local Account state what happens when need is unmet and how this compares with other authorities?

·         Page 69 – require a softer approach such as “If you are worried about someone you can contact…” Information on how to access safeguarding processes.

The Health and Wellbeing Board

1.    Commented of the “How are we doing?” Local Account magazine for publication in spring 2017; and

2.    NOTED the Local Account Communications Plan, setting out how the Local Account magazine will be communicated to residents, adult social care users and carers.

Karen Sugars, Acting Service Head for Commissioning and Health referred Members to the strategy and stated this was the first strategy of its kind in Tower Hamlets. The strategy set out how local services would support adults with autism over the next five years and how the local authority and its stakeholders will collectively meet national policy requirements in relation to adults with autism.

The strategy has eight priorities which will be further developed and delivered over the next five years.

Karen referred Members of the Board to Pages 95 – 104 of the agenda pack, which set out in greater detail the aims and objectives of each priority.

Members of the Board made the following comments:

·         The wider consultation should seek to test the definition of Autism? There is a disparity between diagnoses and access to treatment.

·         It would be beneficial to see data in terms of how many people are identified through GP databases and how many cases local services would expect to be dealing with, in order to inform the level of under diagnosis. The strategy would need to monitor this.

·         The communications plan needs to be inclusive of the Autistic community and should be widely circulated; co-production of the document is encouraged.

The Health and Wellbeing Board

1.    NOTED and commented on the 2017-22 Autism Strategy for Adult; and

2.    Endorsed a full public consultation of the Strategy, which would be a joint consultation with the Clinical Commissioning Group.

Thorsten Dreyer, Service Manager for Strategy, Performance and Resources explained to Members there were two reports before them.  The Open Space Strategy 2017-27 and the Indoor Sports Facilities Strategy 2017 -27. Both strategies were being presented together as they were intrinsically linked, focusing on the borough’s facilities and assets. It is restricted to conditions set by Sports England and the Mayor of London respectively.  

The two strategies sat in a suite of Council led strategies including the Health and Wellbeing Strategy, discussed earlier, with the aim of delivering the vision and priorities of the Borough.

The Open Space Strategy and the Indoor Sports Facilities Strategy were being developed in alignment with the Council’s vision to make the borough a great place to live with healthy and supportive communities. Some of the challenges faced were the continuing financial restraints and austerity measures; population growth, pressure of local infrastructure and how to meet increasing need for publicly accessible facilities that support physical activities, sport and healthier lifestyles.

Both strategies were in draft format and Thorsten invited views of Board members about the key findings informing the emerging themes within the strategies. He also stated Sport England were looking for 10 pilot areas to drive up participation, with a funding pot of £13m, for each area. He invited stakeholders to express their interest by contacting him directly.

Board Members made the following comments:

·         The Open Spaces strategy needs to link in with the Health and Wellbeing Strategy priority of ‘Healthy Environments’, in particular with air quality.

·         The Local Plan should encourage developers to provide open space for children’s play, as should registered social landlords. Response: It was acknowledged the ‘Play strategy’ was due to be refreshed and that assessment of play space would be conducted separately to the open space strategy. Thorsten said he would discuss with Children’s Services about the cross-relationship between the two strategies.

·         Both strategies need to highlight the health benefits of exercise and healthy lifestyles. Future leisure facilities need to be designed so they are inclusive and inviting to all groups – for example, people with disabilities and impairments, mental health and BME communities. Under-utilization of open space and ‘no go’ zones because of animals also needs to be addressed.

·         Wider consideration needs to be given to getting people more active and the barriers to accessing leisure facilities and open space in the borough. Healthwatch is willing to support with engagement activities.

·         More should be done to ensure School facilities are opened for community use. Some schools are better than others but the strategies could harness the benefit of wider community through the emerging strategies.

·         Outdoor gyms should be promoted as a method of physical exercise and other activities such as walking, cycling, gardening should also be highlighted. The strategies should link with the Green Grid and active transport initiatives and mental wellbeing should be considered in the development of the strategies plus addressing accessibility for those who are out of work.

·         The strategies should link in with the  ...  view the full minutes text for item 5.2

Denise Radley, Corporate Director for Adult’s, informed Members of the Board the publication of the national Better Care Fund (BCF) planning guidance and policy framework for the period 2017-19 had been delayed, together with details of available resources. The anticipated guidance would be different in a number of aspects for that covering 2016-17. 

She made a presentation to the Board on what was currently known and what was anticipated in the guidance. There is a need to maintain the programme locally and she expected the anticipated guidance to be a two year programme as opposed to one and said there needs to be better alignment with the local STP.

She said integration of health and social care was a key priority in the Health and Wellbeing Strategy and the BCF was committed to delivering joint up service planning and delivery. There was an opportunity to ‘graduate’ from BCF regime using a similar methodology applied to the ‘Stepping up to the Place’ assessment. The Health and Wellbeing Board are required to approve the BCF programme and plan however the Board has previously agreed to delegate responsibility of BCF to Denise Radley and Simon Hall.

The Health and Wellbeing Board were asked to NOTE:

1.    The delay in the issuance of national guidance governing BCF for 2017-19, which had delayed the production of the borough’s proposed BCF programme and plan;

2.    Delegate to the Joint Commissioning Executive (JCE) responsibility for signing off and submitting to NHS England the borough’s BCF Plan and Programme for 2017-19;

3.    Agree that the proposed BCF Plan and Programme should be circulated to members of the HWBB for comment prior to submission; and

4.    Agree that a further report be presented to the Health and Wellbeing Board’s April meeting.

ACTION: Denise Radley to outline BCF programme and plan at the next meeting scheduled in April 2017, given national guidance is available.

Martin Bould, Senior Joint Commissioner for Mental Health and Joint Commissioning Team, Tower Hamlets Clinical Commissioning Group presented his report stating that the Local Transformation Plan was an opportunity for the partners to set the strategic direction for the next five years and provide transparency about spending and services.

The Transformation Roadmap set out the journey made so far and what needed to be achieved by 2021.

The refreshed priorities for 2016 – 2021 are to increase the number of Children and young people receiving treatment to 35% of the diagnosable population and greater integration of services.

The Plan is consistent with Tower Hamlets Joint Mental Health Strategy and approval of the plan will improve mental health services for children and young people in 2017/18 and set the framework for future development.

Board Members asked the following comments:

·         There needs to be parity of esteem between mental health objectives and the services delivered.

·         Public engagement and communication of the strategy with service users and members of the public needs to be make clear the offer available – i.e. 0-5 years, Child and Adolescents, identification of metal health and prevention treatments available.

·         Board Members agreed the reference the proposed 10% reduction in suicide rates in the plan, should be a target of 0%. This should be the aim of the service.

·         Schools need to offer more Mental Health support to young people and the school offer needs to be improved. Communication and awareness among young people is required.

The Health and Wellbeing Board:

1.    Approved the Local Transformation Plan for Children and Young People’s Mental Health.

No other business was discussed.

Members of the Health and Wellbeing Board were asked to note the next meeting of the Board was for the 18^th April 2017.