Agenda and minutes

To note the attendance at this meeting of any Substitute Members, in accordance with paragraph 4.12 of the Harrow Partnership Governance Handbook.

AGREED:  To

(1)               note the attendance at this meeting of the following substitute members:-

(2)               note the apologies received.

(if any).

AGREED:  To note that the following interests were declared:

Agenda Item 5 – Joint Dementia Strategy

Mr Howard Bluston declared a personal interest in that his father had suffered from dementia.  He would remain in the room whilst the matter was considered and voted upon.

That the minutes of the Board Meetings held on 15 June 2010 and 22 July 2010, be deferred until the next ordinary meeting of the Board.

A Member of the Board commented that it would have been helpful to have sight of the minutes of the previous meetings as they would have informed some the debate for this meeting.  The Chairman explained that the minutes of previous meetings were not usually presented at special meetings of the Board.  The minutes of the previous meetings would be circulated to all Members of the Board.

AGREED: That the minutes of the Board Meetings held on 15 July 2010 and 22 July 2010 be deferred until the next ordinary meeting of the Board.

Report of the Assistant Chief Executive, Harrow Council.

The Divisional Director, Partnership Development and Performance, explained that there were two aspects to the report presented to the Board.  The first aspect consisted of the Leader of the Council’s report which included the draft vision and priorities.  The second aspect related to the Year Ahead Statement which set out information and data on performance, demographic change and resident perceptions.

The purpose of the report was to highlight that the consultation on the draft vision and priorities had commenced.  In light of this, a Harrow Strategic Partnership Summit meeting had been scheduled for 22 November 2010.  This would allow for a partners and stakeholders to provide their input into the proposed vision and priorities and inform the future approach to community involvement.

The Chairman commented that the draft vision and priorities were important given the financial difficulties the Council and its partners faced.  The vision proposed was Working together: our Harrow, our community.  This was applicable to all partners and stakeholders and would ensure that there was a sense of pride in the borough.

The Chairman reported that the draft priorities included

·                     Keeping neighbourhoods clean, green and safe.

·                     United and involved communities:  A Council that listens and leads.

·                     Supporting and protecting people who are most in need.

·                     A Town Centre to be proud of: changing Harrow for the better.

The Chairman explained that the priority relating to the Town Centre would also involve district centres.  There was an appetite to invest in Harrow despite the national financial difficulties and this was to be welcomed.

The Chairman encouraged Board Members to inform those whom they represented that the consultation had commenced and to encourage them to provide views and comments accordingly.

During the discussion Members of the Board raised several queries which were responded to by the Chairman, officers and other Board Members as follows:

·                     if invited, the Chairman, in his capacity as Leader of the Council, and the Portfolio Holder for Performance, Customer Services and Corporate Services would be happy to attend a meeting of the Overview and Scrutiny Committee to answer questions relating to the draft vision and priorities;

·                     the general power of competence which was proposed for local authorities was welcomed.  Further analysis was required to understand its impact on the Council;

·                     there was an opportunity for further detailed questions to be asked of Cabinet at their meetings;

·                     950 volunteers had already been recruited to act as Neighbourhood Champions.  Volunteers consisted of persons representing a wide age range and diverse ethnic backgrounds;

·                     a possible slogan about protecting local businesses and businesses could be considered.

AGREED: That

(1)               the Year Ahead Statement and Leaders Report be noted;

(2)               the pilot programme for community consultation be noted;

(3)               Members of the Board engage in the consultation on the Council’s new vision and priorities.

Report of the Commissioning Manager, NHS Harrow.

The Commissioning Manager, NHS Harrow, conducted a presentation for Members of the Board. He explained that the National Dementia Strategy had been published in February 2009.  This strategy consisted of 17 key objectives.  One of the underlying principles of the strategy was to work within partnerships and communities to deliver higher quality and cohesive care for those people living with dementia.

The Commissioning Manager explained that following publication of the Strategy a Steering Group had been established.  This involved representatives from the Council, the Primary Care Trust, the Voluntary Sector, Local Involvement Networks and the Central and North West London (CNWL) NHS Foundation Trust.

A Stakeholder Workshop was then held in March 2010 with a sub-group established in July 2010 to develop an action plan.  The strategy and action plan were then consulted upon in July 2010 before being ratified by the Harrow NHS Delivery Committee in August 2010.

It was reported to the Board that the Action Plan would consist of:

·                     events being organised during the Dementia Awareness Week;

·                     referral rates per GP cluster being monitored;

·                     information available on Dementia Services would be reviewed;

·                     a Dementia Adviser would be employed.

The next steps as part of the strategy would include reviewing and auditing the service at the end of each year to monitor progress and setting up a Dementia Implementation Board.

During the discussion on this item, Members of the Board raised a number of queries which were responded to as follows:

·                     Dementia was a sensitive topic to some people within a family which could lead to a lack of recognition and diagnosis.  Early diagnosis was key and it was anticipated that the proposed advocacy service and transfer of Primary Care Trust’s responsibilities to GP consortia would assist in addressing this issue;

·                     there was still further work to be done regarding the financial implications of the strategy.  This would form part of the implementation process;

·                     the endorsement of employing a Dementia Advisor was noted and investigations would take place to see if a Dementia Café could be opened in Harrow.

Members of the Board made a number of comments on the item which included:

·                     it was important to note that memory clinics had been established and it was important to improve health services.  There was changing national guidance regarding the cost effectiveness of memory enhancing drugs which was important to note;

·                     as the borough had a large number of people over the age of 65 years, it was likely that the number of cases of Dementia would rise.  The strategy was a good start to assisting those with Dementia and dealing with Dementia.  It was important to look at other facilities in the future.

The Chairman thanked the NHS Commissioning Manager for the report and his presentation.

AGREED: That the report be noted.

Report of the Corporate Director, Place Shaping.

The Board received a report on the 2011 Census which was scheduled for 27 March 2011.  The Assistant Census Liaison Manager provided an overview of the census process and reported that:

·                     the census process in Harrow would be managed by the Office for National Statistics (ONS).  The Council would be working in partnership with the ONS on the census;

·                     the ONS had employed an area manager for Harrow and a community adviser specifically for the Indian population.  This was deemed to be necessary given the diversity of the borough and its large Indian population;

·                     the report provided to the Board outlined the issues anticipated.  It was envisaged that there could be difficulties in engaging with minor ethnic groups;

·                     in the 2001 Census the response rate was only 92%.  The ONS had stated that responses to their routine surveys were falling by about 1% per year.  The census would be a challenge for every borough as it was imperative to achieve a good response rate to the census as possible;

·                     for every 1000 people who were missed out from the census, this resulted in an approximate loss of about £500,000 to the Council;

·                     the population in Harrow had grown by about 18,000 in the last ten years.  In addition to population growth there is a considerable amount of population churn.  In 2008/09 nearly 14,000 people moved to Harrow from other parts of the UK and nearly 15,000 people moved to other parts of the country;

·                     Members of the Board were requested to assist by disseminating census literature particularly to those groups who were hard to reach.  Census literature was available in different languages to assist this process.  Additionally information and feedback was requested in order to identify hard to reach groups.  Another purpose of publicising the census was to alleviate fear;

·                     A temporary field force was required.  This would involve the recruitment of approximately 150 people who would assist in collecting data and assisting those who required extension forms.  It was hoped that there would be assistance from the Police in protecting these workers to ensure that their duties were carried out safely.

During the discussion on this item, Members raised a number of queries which were responded to as follows:

·                     there would be a number of checks to ensure that the data received in the census was accurate.  This would involve cross checking with the Council Tax register and data held by the Primary Care Trust;

·                     asuggestion of putting notices in supermarkets was noted.  Other examples of work being done included assisting the Chinese community by putting up notices at take-aways, restaurants and clinics.  It was also hoped that there would be an opportunity for residents to fill in the relevant forms at various sites within the borough;

·                     in response to concerns raised about members of hard to reach group not being literate in their own language, the Area Manager from the ONS was meeting with many of these groups to discuss such issues.  A partnership plan was  ...  view the full minutes text for item 28.

Presentation by the Representative of the Further Education Sector.

The Board received a presentation from its representative of the Further Education Sector relating to the role of Stanmore College, Harrow College and St Dominic’s 6^th Form College within the Partnership and the borough generally.  The following points were highlighted:

·                     there were over 4,500 6^th Form students at the Colleges.  Normally this figure would only be 1,200 students;

·                     42% of these students were from High Schools within Harrow;

·                     90% of its students went on to higher education;

·                     last year 7,000 students received training on a college based course.  The courses ranged from entry level 1 course to level 6 courses comprising of Degree top ups;

·                     in addition to the numbers of students, 1,800 adults were also employed at the work place;

·                     around 60% of adults at the Colleges were residents in Harrow;

·                     there was a range of different ethnicities amongst the student population;

·                     2 of the further education colleges provided family training.  Parents had successfully been placed into employment as well as being provided with active help;

·                     350 adults had achieved a level 2 qualification and 375 adults had achieved a level 3 qualification.  Additionally approximately 1,500 students had achieved skills for life up to level 2;

·                     the Colleges were continually developing its curriculums to meet future needs;

·                     the Colleges contributed towards the income of the borough by obtaining around £2 million in fees;

·                     around 285 companies had been assisted by the Colleges last year;

·                     the Colleges had played a significant role in training those already in work.  Almost 1100 employees were on the Train to Gain programme.  Around 200 employees were on fully funded programmes by their employers.  Additionally almost 500 staff from the Council and 250 staff from the NHS had been trained by the colleges;

·                     the Colleges had played an important role in boosting employment prospects especially in the current climate.  Around 535 people had been assisted by undertaking an intensive skills training programme where they had been unemployed for 6 months.  Around 180 people who were at risk of redundancy also undertook a new skills course at the Colleges.  Approximately 75 who were not in work were also trained in new skills;

·                     the 2012 Olympics had also presented opportunities for those studying at the colleges.  Over 20 people had obtained a stewarding certificate.  Additionally staff had been provided with time off to train as volunteers and those who were unemployed were given extensive experience in supervision;

·                     the Colleges were taking an active role in trying to persuade employers to take apprentices.  In order to promote this, the Colleges had commenced employing apprentices.

During the discussion on this item Members of the Board raised a number of queries which were responded to by the representative as follows:

·                     more information would be provided to Members of the Board on how many people obtained work from the 535 people who undertook the intensive skills programme and who were unemployed for more than 6 months;

·                     the students within the Colleges came from a wide range of places  ...  view the full minutes text for item 29.

Report of the Assistant Chief Executive, Harrow Council.

The Board received a report which presented a revised Governance Handbook for the Harrow Strategic Partnership to strengthen its decision making process.  The Board were informed that the revised handbook had been previously presented to the Board at its meeting on 15 June with comments requested by 15 September 2010.

A Member of the Board sought clarification on a provision relating to the financial protocol of the Harrow Strategic Partnership.  This related to the contribution proportion to the annual budget from the three statutory partners (Council, Police and NHS Harrow).  An officer responded that in the current year there was no requirement for a contribution because no relevant expenditure was necessary.  If expenditure was required in the future and was agreed, the proportion of contributions would be divided as highlighted.

AGREED: That

(1)               the revised Harrow Strategic Partnership Governance Handbook be adopted;

(2)               the circulated substitution list be completed;

(3)               nominations be requested for the membership of the decision making sub-group for agreement at the next meeting.

Report of the Chief Executive, NHS Harrow.

The Chief Executive, NHS Harrow, provided the Board with an update on its financial position and its turnaround plan.  He reported that the Board had been provided with information relating to the current financial position and end of year forecast at month 5 of the current financial year.

The Board were informed that the current financial position for NHS Harrow was deteriorating.  This was occurring because expenditure by it had not realised the savings which had been previously anticipated.  The biggest overspend had been in relation to additional acute activity.

NHS Harrow was heading for a £15.9 million deficit.  This was clearly an unacceptable position and would make the financial plan for next year increasingly difficult.  There may be a need to cut next year’s budget by 10?15%.

In order to try and remedy the situation, a mid year budget review was proposed and this would accompany and contribute towards the budget setting process for next year.

During the discussion on this item, Members of the Board raised a number of queries which were responded to as follows:

·                     NHS Harrow had identified that only £11.3 million of savings needed to be achieved in year to achieve its financial plan.  This had been within the range specified by auditors;

·                     In response to concerns raised about the financial, governance and management controls of NHS Harrow, it was not perceived that there were any issues in relation to these areas.  The financial department was sound and problems mostly resulted from investment in primary community care not significantly impacting upon the amount of acute care required.  Additionally the savings programme had been risk managed against 3 categories; high, medium and low.  Around 1/3 of the measures in the savings programme had been categorised as high so these had been assessed correctly;

·                     An urgent care centre had been opened to provide quick access to primary care services.  Additionally 3 walk-in centres had been opened in Harrow to reduce the numbers attending Accident and Emergency.  Unfortunately these had not experienced the number of patients envisaged;

·                     NHS Harrow was trying to bring their expenditure down to the amount provided by Central Government for the borough.

During the discussion on this item, Members of the Board made a number of comments which included:

·                     it was unlikely that NHS Harrow would have a balanced financial position at the end of the current financial year;

·                     there were concerns that NHS Harrow were now back to the financial position at the beginning of the financial year when a overspend of £32 million was predicted;

·                     there were concerns that having to make cuts of around 10-15% of NHS Harrow’s budget would have a big impact on public health in Harrow.

The Chairman requested that an update report on the finances on NHS Harrow and the consequences for its partners be provided to the next meeting of the board on 14 December 2010.

AGREED: That

(1)               it be noted that NHS Harrow has a significant financial shortfall in 10/11 and that  ...  view the full minutes text for item 31.

Verbal update by the Chief Executive, NHS Harrow.

The Chief Executive, NHS Harrow, provided a verbal update on the transition arrangements for local Primary Care Trusts (PCT).  He advised that there was a need for a significant reduction in management costs.  There were currently 8 management teams which was considered not to be a sustainable model.  It was therefore intended that there would be a single management team for both Harrow PCT and Brent PCT.  Both PCTs would be distinct from one another and have two different set of accounts but there would be just a single management group.  There would be a one month consultation period on the proposals.  It had been confirmed that he would be the Chief Executive if this single management group.

In response to a query raised by a Member of the Board, the Chief Executive, NHS Harrow stated that there would be 2 specific directors appointed to represent Harrow’s interests.  Turnover of staff was expected as PCTs needed to be abolished by 2013.

AGREED: That the verbal update be noted.

Report of the Assistant Chief Executive, Harrow Council.

The Chief Executive, Harrow Council, commenced by congratulating the Chief Executive, NHS Harrow on his appointment as Chief Executive of the single management group for Brent and Harrow Primary Care Trusts.

The Chief Executive explained that the report presented to the Board now consisted of a quarterly performance report which provided information on how the management groups were performing.

The overall analysis was that things were heading in the right direction and opportunities were being built upon.  The Comprehensive Spending Review was due to be announced soon and it was suggested that the proposed Summit meeting on 22 November 2010 would also be a good opportunity to have a discussion with partners about the challenges envisaged.  The Chairman commended this suggestion and further commented that working in partnerships was vital to ensure that the challenges were met.

The Divisional Director Partnership, Development and Performance, Harrow Council, highlighted the key issues of the performance report which included that:

·                     the Health Inequalities Strategy delivery plan had been circulated for comment.  All partners would be reviewing the delivery plan and consider potential resource implications;

·                     partners were requested to consider how sporting activities targeted to reduce crime could be maintained.  This was in light of future MPA funding for sporting activities to reduce crime being ceased.  Research was being conducted by the Police and the Council to understand the potential impacts;

·                     the indicator relating to emergency bed days was significantly over performing and creating a major drain on resources;

·                     it was agreed that the management group structures of the Harrow Strategic Partnership would be reviewed alongside a review of the partnership, in light of the Comprehensive Spending Review.

Members of the Board made a number of comments during the discussion on this item including:

·                     the performance monitoring report was helpful.  It would also be useful to have further information providing analysis where tough decisions would have to be made, some of the language used may need to be changed and real savings would need to be identified;

·                     the performance monitoring report demonstrated that there was a lot of good work being conducted within the Harrow Strategic Partnership.

In response to a query raised by a Member of the Board, the Chief Executive, Harrow Council, commented that it was always good practice to review the structure of the Harrow Chief Executives Group especially in a changing environment.  This would occur if necessary.  There were currently representatives from the voluntary sector on this group.

AGREED: That the report be noted.

The next Board Meeting is scheduled for 14 December 2010.

AGREED:  To note that the next meeting of the Board would be held on 14 December 2010.