Agenda and minutes

To note the attendance at this meeting of any duly appointed Reserve Members.

Reserve Members may attend meetings:-

(i)                 to take the place of an ordinary Member for whom they are a reserve;

(ii)               where the ordinary Member will be absent for the whole of the meeting; and

(iii)             the meeting notes at the start of the meeting at the item ‘Reserves’ that the Reserve Member is or will be attending as a reserve;

(iv)              if a Reserve Member whose intention to attend has been noted arrives after the commencement of the meeting, then that Reserve Member can only act as a Member from the start of the next item of business on the agenda after his/her arrival.

RESOLVED:  To note that there were no Reserve Members in attendance.

To receive declarations of disclosable pecuniary or non pecuniary interests, arising from business to be transacted at this meeting, from:

(a)               all Members of the Committee;

(b)               all other Members present.

RESOLVED:  To note that there were no declarations of interests made by Members.

That the minutes of the meeting held on 9 January 2014 be taken as read and signed as a correct record.

RESOLVED:  That the minutes of the meeting held on 9 January 2014, be taken as read and signed as a correct record.

To receive any public questions received in accordance with Board Procedure Rule 14.

Questions will be asked in the order notice of them was received and there be a time limit of 15 minutes.

[The deadline for receipt of public questions is 3.00 pm, 14 March 2014.  Questions should be sent to publicquestions@harrow.gov.uk  

No person may submit more than one question].

To note that 2 public questions had been received and responded to and, in line with the statement made by the Chairman, the recording has been placed on the website.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Board Procedure Rule 13 (Part 4B of the Constitution).

RESOLVED:  To note that no petitions or deputations had been received.

Report of the Interim Head of Paid Service and Corporate Director, Community Health and Wellbeing, Harrow Council and Chief  Officer, Harrow Clinical Commissioning Group.

In accordance with the Local Government (Access to Information) Act 1985, the Board agreed to the late receipt of the report in order to comply with the timetable for the submission of a Better Care Fund to the NHSE by 4 April 2014.

An officer introduced the report, which had been jointly agreed by Harrow Council and Clinical Commissioning Group, stating that reaching an agreement had been a significant challenge for both organisations.  The organisations were now in a good position for the submission of the funding arrangements to the NHSE by the deadline of 4 April 2014.  The final paper had only just been agreed and was presented at the meeting.  It was acknowledged that both the CCG and the Council had worked hard to meet the deadline of the Health and Wellbeing Board and changes to the final paper had taken place right up to the point of its presentation.  The proposed options to reduce the CCG BCF expenditure in a full year from 1 April 2015, in partnership with Harrow Council, did not involve new funding but reflected changes in ambition for integrated working and how current funding was used across the health and Local Authority functions.

The options indicated in the report, for access to the West London Alliance framework for the CCG, ICE project, and the Integrated Care Pilot, had been agreed in principle but required further work to ensure that the delivery would be robust.  The potential expenditure reductions for access to the West London Alliance framework could not be quantified as the services for the CCG would differ from those for the Local Authority but the estimate was legitimate.  There were opportunities to extend the In Case of Emergency (ICE) project originally funded as a social care initiative by including this as an integrated element of the ICP.  It is expected to pilot this and other jointly agreed options in 2014/15 and to report back to the Board.

The Local Authority was experiencing financial pressures and was required to identify substantial savings in addition to the Better Care Fund efficiencies.  It was noted that both parties were concerned at the financial risk of entering into an agreement to deliver £3m of funding which had not yet been identified.  As a result the CCG and Council had agreed a 50:50 benefits and risk share which commit both the CCG and Council to joint working to deliver a programme of health and social care integration.  It was considered appropriate that this should be subject to the conditions outlined in the report. As a result, the BCF was agreed on the conditions set out in the report and Appendix 3.

In response to a question it was confirmed that both organisations recognised the need to invest to make savings and this was referenced in the financial implications contained in the report.  The Board was informed that should either organisation identify efficiency savings for the other then they would share this information.

The Vice-Chairman stated that, whilst  ...  view the full minutes text for item 67.

Report of the Director of Public Health.

The Board received a report which set out the current status of the Pharmaceutical Needs Assessment, together with the process for engagement and future reporting.

An officer introduced the report informing the Board that, in accordance with the statutory duty to review the current PNA no later than 31 March 2015, an outside organisation had been commissioned and work had commenced.  A Steering Group had been set up and volunteers were sought from Harrow Council, CCG and Healthwatch.  Subsequent to consultation a final report would be submitted to the Board by the end of the year. 

RESOLVED:  That

(1)               the report be noted;

(2)               any expressions of interest in volunteering for the Steering Group be conveyed to the Director of Public Health.

Report of the Director of Public Health.

A report was received which set out the strategic priorities for the prevention and treatment of overweight and obesity in Harrow.  It was noted that, using intelligence from the Harrow Obesity Needs Assessment 2014 and evidence of effective approaches, it outlined the refinements needed to the obesity pathway across the life course.

The Board was informed that the draft Obesity Strategy had been developed in partnership with agencies, CCG and Harrow Council and much had been learned from users of services and partners.  The Strategy would be further developed and finalised and an action plan produced.  The intention to ensure that pregnant women, early years children and vulnerable adults such as those with mental health issues or disabled were properly linked into the obesity pathways was noted.

In response to questions, the Board was informed that:

·                    it was the intention that tailored physical health programmes for those with mental health issues would be available from specially trained staff;

·                    as part of the development of health checks, outreach and marketing initiatives were being examined in order to identify ‘hidden’ people, such as the housebound;

·                    the strategy was currently a draft and comments were welcomed;

·                    national figures indicated that obesity was more prevalent in women than men and in certain ethnic groups such as south Asian and black Caribbean/African who also had a lower threshold for adverse impacts of weight such as diabetics.

The Board was informed of details of the Active Harrow Weekend during March 22/23 2014, at which the Director of Public Health would be promoting what was available with regard to tackling obesity.  Board Members were also asked to disseminate information on the Healthy Harrow Day on 2 April 2014.

The importance of the Council and CCG working with partners, including carers, regarding obesity was recognised.  The propensity for those with mental health issues to be heavier in general due to inactivity and isolation at home was recognised.

RESOLVED:  That the Harrow Obesity Strategy 2014-2018 be noted. 

Report by the Independent Chair of the Harrow LSCB.

A report by the Harrow LSCB Independent Chair was received which outlined the expectations of Ofsted in their forthcoming inspections for LSCBs.

An officer introduced the report and informed the Board that Ofsted’s expectations signified a shift for Boards in terms of scrutiny of local safeguarding, including a transparent assessment of local strengths and weaknesses and a broadening to consider early help and preventive universal services.

RESOLVED:  That the report be noted.

Report by the Independent Chair of the Harrow LSCB.

The Board considered a draft protocol which set out joint working arrangements between the Health and Wellbeing Board and Harrow Local Safeguarding Children Board.

It was noted that the governance arrangements would enable the HWB and LSCB to assess whether local agencies were fulfilling their statutory responsibilities to help, including early help, protect and care for children and young people.  This protocol extended to the LSAB (Local Safeguarding Adults Board) and its at present non-statutory role in respect of vulnerable adults.  It was agreed that every presented matter would be considered for its implications for both children and adults.

RESOLVED:  That the protocol be approved.