Apologies for Absence were received from:

Chris Lee – Director of Environment and Regeneration

James Blythe – Chief Executive of Merton And Wandsworth CCG

Dave Curtis – Merton HealthWatch

There were no declarations of interest

RESOLVED: That the minutes of the meeting held on 27 March 2018 are agreed as an accurate record.

The Chair opened the meeting by thanking the former Councillors Katy Neep and Gilli Lewis-Lavender for all their work and contributions to the Health and Wellbeing Board over the previous few years.

The Chair said it was an exciting time for the Health and Wellbeing Board to be systems leaders for health and wellbeing and asked all members of the Board to introduce themselves and talk briefly about an aspect of their passion for health and wellbeing.

The Director of Public Health presented her report on Tackling Diabetes that gave a full write up of the findings of the recent Diabetes Truth conversations. She outlined the learning and insight that Health and Wellbeing members have gained through the work. She explained that the work will now feed into the Diabetes Plan and that this will involve continuing to listen to the community through ‘mini conversations’, with clinicians taking forward the clinical approach through the planned Diabetes Summits.

The Director of Public Health was asked what would practical support for tackling diabetes look like, for example how long would a person have to wait to see a nutritionist? The Director replied that often people are overwhelmed by their initial diagnosis and the most important factor is that they know what help is available to them so that they can then engage with it.

The Vice Chair commented that it was superb report, and suggested that it might be best to pick on a few things that could be done to make a difference. The Director of Public Health agreed with this and explained that a Whole Systems Approach is needed.

The Board acknowledged that it was important for this work to widely involve residents and communities within Merton. The proposed ‘mini conversations Diabetes Champions, peer networks and conversations with those who manage diabetes in different communities would assist with this process. Councillor Howard commented on the role of pharmacists in reaching communities.

The Chair thanked Dagmar Zeuner and Mahri Davis and the team who delivered the Diabetes Truth Programme, and especially the expert witnesses who gave up their time to attend.

RESOLVED 

The Health and Wellbeing Board agreed to:

A.   Discuss and endorse the findings of the Diabetes Truth programme.

B.   Consider the proposed approach to tackling diabetes, including the continued engagement of communities and the development of a Diabetes Strategic Framework.

C.   Consider and agree (in principle) to support the launch of the Merton Mile, as part of the promotion of healthy living and as a celebration of community assets in Merton.

The Director of Public Health presented the Annual Public Health Report (APHR). The aim of this report was to measure progress in closing the gap of inequalities in Merton but analysis of the available data showed this was not straight forward. This report clarified meaning, definition and measures of health inequalities, analysing trends over time, proposing measures to monitor future progress and summarising evidence of what works to reduce health inequalities.

 The Vice Chair asked about life expectancy and the impact of accumulated life experiences. It was agreed that a definition of how life expectancy is calculated be added to the Glossary.

The Board discussed the indicators used and it was asked if indicators related to financial resilience could be considered. Indicators relating to people living with a disability were raised as was a desire for more Merton specific data. The Director of Public Health answered that other indicators could be considered in future years, but it was important to achieve a balance in the amount of data presented. She explained that there was also a balance between local and regional indicators, confidence levels in the statistics needed to be high enough to enable conclusion to be drawn.

The Director of Children, School and Families asked the Board to consider how the information in the APHR could be used to inform future reports and strategy. She suggested that it should be referred to more regularly, made live in discussions, and used to reposition baseline information and shaped according to need.

RESOLVED

The Health and Wellbeing Board agree to:

A. To receive and endorse for publication the attached Annual Public Health Report (APHR) 2018 on Health Inequalities.

B. To consider the recommendations of the APHR, how partners can work to tackle and monitor health inequalities and use existing infrastructure to take this forward.   

Julia Groom, Consultant in Public Health presented the report on the Merton Autism Strategy 2018-2023 and Action Plan, highlighted the collaborative work involved in developing this and asked Health and Wellbeing Board members to champion Merton as an autism friendly borough

There was agreement that the involvement of people experiencing autism and their carers in the engagement was really good practice. The timescale for training was raised and Julia Groom agreed to look at this.

The Board noted that of the Strategy had helped recognise that mental health pathways are complex so working with St George’s SWL MH Trust and others and avoiding labels to improve access if vital.

RESOLVED

The Health and Wellbeing Board Agree:

A.   To approve the Autism Strategy 2018-2023.

B.   To endorse the Strategy Action Plan.

C.   To  champion the ambition to make Merton an autism-friendly borough, and in particular to support the objective to improve autism awareness in the wider population which was highlighted as a priority in engagement on the Autism Strategy.

D.   The proposed governance arrangements for the Strategy.

The Director of Public Health presented her report on the plans for developing the Health and Wellbeing Strategy 2019-2024. She emphasised that she wants to translate learning and current knowledge into the new HWB Strategy, and is keen to involve the Board in the process. It will be important to consider the outcomes and indicators of this strategy carefully (using the APHR and JSNA), that will focus on the four themes of ‘Start Well’, ‘Live Well’, ‘Age Well’ and ‘….in a healthy place’

It was agreed this work should link to that of the Strategic Collaborative Working Group  with the voluntary sector.  She commented that the Merton Story has now incorporated comments from the HWBB and that work was ongoing on a more in depth chapter on disability for the JSNA.

The Director of Children, Schools and Families said that she wanted to ensure that Children and Young People were involved in the engagement process and she would lead on this piece of work.

The Director of Public Health said that she would like a Board Member to chair each of the session and would let them know about workshop dates

RESOLVED

The Health and Wellbeing Board Agree:

A.   To review and clear the proposed plans for developing the Health and Wellbeing Strategy (HWS) 2019-2024

B.   To provide feedback on the proposed task and finish workshops; the proposed themes: proposed agenda: and to discuss whom from the HWBB would like to attend the workshops

C.   To note the synergies between the Health and Wellbeing Strategy and the Merton Local Health and Care Plan

Josh Potter, Director of Commissioning at Merton CCG, delivered his presentation on Merton Health and Care Together programme and the Merton Health and Care Plan. The Plan marks a new relationship between providers and commissioners setting out the priority areas of  ‘Start Well, Live Well, Age Well’  for joint work where we can best add value.

The Board noted that it was currently planned to finalise the Merton Health and Care Plan in Autumn 2018, depending on the timing of the release of the NHS 10 year plan and Government Green Paper on Health and Social Care.

The Chair asked whether the Merton Health and Care Together reports through the Health and Wellbeing Board and Josh Potter confirmed it did.

The Director of Communities and Housing explained that this work on integration has been taken back locally from South West London and now needed to be delivered. It was agreed that clinicians should be involved early on. The Board noted that the programme needed to ensure a person centred approach, and a continuous improvement system that made listening to service users central.

The Board noted that the plan would come back to them in the Autumn and agreed the recommendations in the report.

RESOLVED

The Health and Wellbeing Board

A.   Noted the background to, and development of, the Merton Health and Care Together programme, and the Merton Local Health and Care Plan

B.   Approved the priorities contained within the Health and Care Plan