Agenda and minutes

Sarah welcomed everyone to the first meeting of Lewisham’s statutory Health and Wellbeing Board.

Attendees introduced themselves. The Board welcomed Elaine Sammarco and congratulated her on her appointment as the representative of Healthwatch to the HWB.

As the first order of business, the Board was requested to ratify the appointment of the Chair and to nominate and approve a Vice Chair.

It was explained that, in line with the Council’s Constitution, the Board would be chaired by the Mayor, Sir Steve Bullock.

Councillor Best moved to approve the formal appointment of the Mayor as Chair of the HWB and nominated Dr Helen Tattersfield as Vice Chair.

Cllr Best’s recommendations were agreed.

RESOLVED  that, for the municipal year 2013-14,

(i)   the Mayor, Sir Steve Bullock, be confirmed as Chair of the Health and Wellbeing Board and

(ii)  Dr Helen Tattersfield be confirmed as Vice Chair of the Health and Wellbeing Board.

For the benefit of the Board, the Chair explained the considerations governing any declarations of interest.

There were no declarations of interest.

A packet containing forms for new members to complete, relating to various declarations and undertakings, was also distributed to all the members.

Sarah Wainer informed the Board of the comments and views of

the Healthier Communities Select Committee on the development of the Health and Wellbeing Strategy, which it considered at its meeting on the 16 April 2013.

The Committee recommended that the Health and Wellbeing Board specifically address the issue of engagement with service users, through either

(i)   appointments to the Health and Wellbeing Board or

(ii)  a second tier of user groups feeding directly into the Health and Wellbeing Board.

The Mayor noted the report and remarked that the current membership of the Board would likely grow in the course of the meeting.

It was noted that the issues raised within this referral would be covered as part of agenda items on the Terms of Reference and supporting structures.

RESOLVED  That the report be received and the Board respond.

Ed Knowles introduced the report and summarised the key features of the Board’s Terms of Reference (ToR), including the criteria for membership, as well as procedures for it to follow as a committee of the Council.

The report proposed additional members to join the Health and Wellbeing Board and included the Council’s proposals for membership and voting

rights for consideration by the Health and Wellbeing Board.

Ed explained that the scope of the HWB’s ToR expressed the difference between the current Board and its predecessor, the Shadow HWB, in that the HWB needs to operate as a committee of the Council, whereas the shadow board had not operated as one.

Members of the Health and Wellbeing Board were invited to:

·         note the Health and Wellbeing Board’s Terms of Reference, the

Council’s procedure rules, and the particular provisions which

apply to the Health and Wellbeing Board;

·         note the means by which membership of the Board may be

amended or changed;

·         consider the Council’s proposals on membership and which

members will have voting rights; and

·         decide whether there are any other organisations or individuals

who ought to be included in the membership of the Health and

Wellbeing Board.

The Health and Wellbeing Board agreed with the Council’s proposals regarding membership and voting rights and with the particular provisions that apply to the Health and Wellbeing Board as set out in the Council’s Constitution.

The Constitution establishes an expectation that the Council will appoint two members to the Board, representing Voluntary and Community organisations. Accordingly the Board invited Tony Nickson, Director of Voluntary Action Lewisham to join the Board. The Board also asked Tony to develop a process to identify another representative of the sector.  Tony and this additional representative will then be appointed to the Board by the Council.

The Chair noted that NHS England had expressed interest in applying for membership of the Board, with the understanding that it would be for the Board to decide the applicant’s status and role, should membership be granted.

The Chair notes that a number of organisations have expressed interest in the work of the Board and how best to be involved.  In discussion, it was noted that the sub-groups of the Health and Wellbeing Board would provide a number of opportunities whereby different organisations might be able to contribute their skills and expertise         

In view of the above discussion, the Board

RESOLVED 

(i)  letters will be sent to the Lewisham Local Medical Committee and the Lewisham Healthcare NHS Trust inviting them to nominate a representative to be a member of the Health and Wellbeing Board.

(ii) that the proposal to accept an NHS England representative to the HWB be accepted, and that the delegated position be accorded a non-voting role.

(iii)  that Tony Nickson will develop a process to help the Board select an  additional representative from the voluntary and community sector.

(iv) that the agreement of the Board with proposals regarding membership and voting rights be reported to  ...  view the full minutes text for item 4.

Ed Knowles introduced the report detailing information on the supporting groups that will complement the Board and support the delivery of its strategic intentions.

The Board was invited to note each proposed supporting group and its relationship with the HWB, as well as its relationship with the HWB’s agenda going forward. In particular, Ed highlighted the multi-agency range and depth of the collective resources involved, drawing special attention in this regard to the map of the architecture included in the papers.

It was stressed that the map’s indicated groups by no means exhaust the groups or issues relevant or available to the HWB: the map is merely a useful working model for the Board to start its work with.

The discussion highlighted the following points:

·         The Engagement Group will need to address the HCSC’s requirement for engagement (please see Item 3, above) by adapting the CCG’s existing Public Engagement Group for broader application.

·          In order to avoid duplication of resources, clear relationships should be established with other relevant boards already monitoring HWB outcomes, e.g. the Joint Commissioning Group which monitors issues such as obesity, smoking and sexual health for children and young people.

The report was noted.

Sarah Wainer, with Danny Ruta,  presented the Board with a draft of Lewisham’s Health and Wellbeing Strategy, highlighting the key actions that need to be populated and published.

The draft strategy is based upon the information and the areas of need identified through Lewisham’s Joint Strategic Needs Assessment.

The report outlined the statutory requirements associated with Health and

Wellbeing strategies, the process through which Lewisham’s strategy and

its key areas of focus have been developed, and the extensive

engagement activity that has been undertaken with residents and

stakeholders to ensure that the strategy reflects the experiences and

needs of local people. The report also set out the next steps that will be taken to ensure the strategy fully aligns with the Government’s vision for person-centred coordinated care and support and that partners’ planned activity underpins the health and wellbeing priorities.

Members of the Health and Wellbeing Board were invited to:

·         note the key principles of the Health and Wellbeing Strategy, its key aims and the nine areas of focus as proposed by the Shadow Health and Wellbeing Board;

·         note the engagement activity that has taken place, the messages arising from this activity and how this information has been incorporated into the Health and Wellbeing Strategy;

·         agree the arrangements by which progress towards achieving Lewisham’s Health and Wellbeing Strategy will be monitored and reported upon; and

·         agree the remaining activity that will take place to finalise the strategy.

The discussion highlighted the following points:

·         The Key Actions should be high-level actions leading to a more detailed, 1-year Action Plan, to be presented to a near-future Board and subsequently monitored, including for costs.

·         Given the crucial importance of joined-up working, all the priorities should be approached in the context of the Integrated Care Model.

In light of the report, recommendations, and discussion, the Board

RESOLVED that a 1-year Action Plan showing high-level    HWB-APG

actions for implementing Lewisham’s Health and Wellbeing

Strategy be presented to the Board before year’s end.

Joy Ellery presented the update following the Secretary of State’s decision to proceed with the closure of Lewisham Hospital’s Accident and Emergency department and to merge that hospital with Queen Elizabeth Hospital in Greenwich.

It was pointed out that Lewisham Healthcare Trust (LHT) had already expressed an interest in becoming a Foundation Trustbefore the Trust Special Administrator T(SA)’s report on Lewisham Hospital/LHT was published.

The following points were highlighted:

·         The TSA’s report targets the A&E department in the main.

·         The likely outcome is integration between the Lewisham and Queen Elizabeth hospitals.

·         The Trust has instigated—and is keen to promote—a “Business as Usual” campaign, and has kept “extremely busy” throughout this period of transition.

·         Staff feel very much at risk; at the same time, preparations need to progress towards creating a safe new organisation.

The discussion highlighted the following points:

·         The impending integration is not expected to affect the commissioning role of the CCG in any fundamental way, although it would be important to maximise people’s access to local services. In general, however, CCG-related business can be expected to continue as  before.

·         Also, the same smooth transition is expected in the case of Community Services.

The report was noted.

Susanna Masters presented the report summarising the recent national guidance on Integrated Care (May 2013) and asked the Board to agree that further work be undertaken on an integrated service delivery model for adult social care and health across the borough.

Members were invited to

(i)  agree that further joint work be undertaken to explore the feasibility

and benefits of an integrated service delivery model for adult health

and social care services across Lewisham; and

(ii)  agree that an Expression of Interest be submitted on behalf of the

Health and Wellbeing Board to become an Integrated Pioneer site

by 28 June 2013.

The discussion highlighted the following points:

·         It is important for the Board to keep in mind that there is no funding attached to its becoming an Integrated Pioneer Site.

·         Demand will soon outstrip resources.

·         Attempts to address issues and problems in isolation from the broader issues and available resources are unlikely to succeed. In this respect, the Feasibility studies are crucial guides.

·         While the Council has made considerable savings already, efficiencies can still be gained from Integration. However, all other possible means of gaining efficiencies through savings will now need to be considered, and “Pioneer” status will offer  greater flexibility for these purposes.

·         Some money from Public Health could also be contributed towards Integration.

In light of the above discussion, the Board

RESOLVED  that

(i)  further joint work be undertaken to explore the feasibility

and benefits of an integrated service delivery model for adult health

and social care services across Lewisham; and

(ii)  an Expression of Interest be submitted on behalf of the

Health and Wellbeing Board to become an Integrated Pioneer site

by 28 June 2013.

(iii) the 11 July board will submit a proposal regarding ways in which Public Health money could contribute to the Primary Prevention agenda in Lewisham.

Sarah Wainer presented the Board with a draft work programme for discussion and approval.

Members of the HWB were invited to

(i)   note the current draft of the work programme and consider whether changes or additions were necessary;

(ii)  approve the work programme; and

(iii) agree that the work programme would be considered as a standing item at each meeting of the Health and Wellbeing Board.

Following input from various members, the work programme, as updated, was agreed.

RESOLVED that

the work programme would be considered as a standing       HWB

item at each meeting of the Health and Wellbeing Board.