Apologies for absence were received from Councillor Gilli Lewis-Lavender, Dr Andrew Murray, Dr Karen Worthington, Simon Williams, Yvette Stanley and Melanie Monaghan

Leanne Wallder attended on behalf of Yvette Stanley

There were no declarations of interest.

RESOLVED: That the minutes of the meeting held on  28 March 2017are agreed as an accurate record.

The Director of Public Health presented her update monitoring report on the Health and Wellbeing Strategy 2015-18. The Board noted the information on the three outcome indicators that previously had a ‘red’ status in the Annual Progress Report; immunisation, childhood obesity and fuel poverty. The Board also noted that the report presented information on the Health and wellbeing Board 2016/17 priorities; Childhood Obesity and Social Prescribing and also information on the overarching aim of the strategy – the reduction in health inequalities across the borough as measured by life expectancy.

The Director of Environment and regeneration explained that the reduction of Fuel Poverty indicator could be reviewed in future. It is currently being tackled by promoting national and regional collective energy switching programmes. Unfortunately those residents with the most to gain from such schemes are often the least able to participate.

The Director of Public Health spoke about the work to tackle childhood obesity and pilot scheme for social prescribing, where people are linked up to non-clinical support by their GP. Dr Doug Hing said that this was very popular, and many people were now accessing services that they previously did not know about.

Anthony Farnsworth commented that the report says that no recurrent funding would be available to reduce CAMHS waiting times, but now this funding will be available for the year of 2017/18.  He also welcomed the commitment to review the ASD (Autistic Spectrum Disorder) pathway.

The Director of Public Health highlighted the good news on increased life expectancy for women in the east of the Borough. She explained that progress on immunisation was slow and the role of the Health and Wellbeing Board in this was indirect as we do not commission or provide this service.

The Chair asked how the Boards’ 2016/17 priority areas of Childhood Obesity and Social Prescribing will  still progress. The Director of Public Health said that the annual report of the Health and Wellbeing Strategy will – continue to report on progress on these issues.

RESOLVED

The Health and Wellbeing Board agreed:

A.   To consider the update on outcome indicators measuring progress on the Health & Wellbeing Strategy 2015-18.

B.   To consider the progress on Childhood Obesity and Social prescribing priorities (2016/17), and to continue to champion actions in these areas. 

Brian Dillon gave a verbal report on the work of Healthwatch Merton (HWM) and made points including:

• HWM are currently working on their medium term plan and HWBB members’ views on this are welcomed
• There is feedback event at Vestry Hall – all HWBB members are invited
• Request that the council should direct process for HWM future as soon as possible.
• A review of past HWBB agendas shows HWM’s involvement in a range of issues
• Going forward there are a number of workstreams that HWM are interested in including giving a voice to young people, LBGT issues, local mental health services.
• Opportunities for further development of local Patient Practice Groups

The Chair and the Director of Public Health thanked HWM for all their work and said how much they appreciated the contribution of HWM

Brian Dillon asked the Board to consider the impact of a two or three year contract on the ability of HWM to forward plan.

The Director of E&R presented the report on the Joint Strategic Framework for Prevention of Substance Misuse and related harm 2017- 2021. He asked the board to note that this report had already been presented at the Merton Safer and Stronger Executive Board which had welcomed the framework, and agreed to lead on delivery of the framework which the police were very pleased to see. This report set out clear evidence for prevention and delivers an holistic approach especially with the proposed redesign of the Adult Substance Treatment Service. He highlighted the strategic objectives contained in the report and asked all board members to consider what they could bring to the delivery of this framework.

The Director of Public Health welcomed the report and the opening up of this pathway, away from a more clinical approach. She also welcomed the governance arrangements in place to give Safer and Stronger the lead in delivery whilst linking to the HWBB.

Board members commented on the complexity of this issues involved, and spoke about the importance of the family agenda with the ‘Think Family’ elements being especially welcomed. Leanne Wallder explained the concerns of keeping children safe from adult substance abuse, in particular in the case of child carers looking after adults with substance abuse issues.

The Board spoke about whether it could influence cinema chains to stop the advertising of alcohol and it was suggested that  pan-London influence could be explored.

RESOLVED

That the HWBB:

1. Considers the Merton Joint Strategic Framework (LBM & MCCG) for Prevention of Substance Misuse and related harm 2017-21.
2. Endorses the whole systems perspective as the means of achieving shared outcomes and maximising the impact of limited resources, and specifically recognising that the current re-procurement of the Adult Substance Misuse Treatment Service is an important ‘invest to save’ measure –helping to reduce costs to health, social care, welfare and criminal justice.
3. Notes that the Safer Stronger Executive Board has oversight of the implementation of Substance Misuse Strategic Framework Action Plan- to ensure cross council, CCG and partners’ ownership and commitment.
4. Considers opportunities for Health & Wellbeing Board members to champion the SM strategic objectives and actions as systems leaders.

Dr Doug Hing presented his progress report on The Wilson Health and Wellbeing Campus and the Project Initiation Document, annexed to the report. Board members welcomed the report.

The Director of public health said that the PID showed the  infrastructure and governance are now in place to deliver the Wilson. Dr Hing said that there was a need to continuously engage with the community especially as there have been concerns regarding the closure of the walk-in centre.

The Chair endorsed the view that the next step was to go back to the community with something tangible, and noted that a workshop to look at community involvement was a key event.

The board noted the work that is being done to determine the services that will be provided on the campus and that there is increasing clarity on some of the services that will be on site whilst other ideas are being developed.

The need for effective community involvement was discussed and the Board thanked Dr Karen Worthington for arranging the locality meeting with ward councillors and local clinicians. The Board thanked Dagmar Zeuner, Doug Hing and Dave Curtis for their work.

RESOLVED:

A.   To note the progress of the Wilson development and the reporting and accountability systems that have commenced.

B.   To note the Wilson Health and Wellbeing Campus Development PID (Project Initiation Document) and consider ways to support and facilitate the progress.

C.   To consider and make recommendations on the most appropriate method of engagement with the public and communities, identifying the key messages for this stage of the programme.

The Board received the report on Health in all Policies Draft action Plan, which has been developed following the HWBB seminar in January. This action plan was welcomed by board members.

Anthony Farnsworth, Interim Director of Commissioning CCG,  welcomed the approach and philosophy of ‘first and most’ and asked about the link of this work to Health Scrutiny.

The Voluntary sector asked that they be added to the Healthy Workplace action plan

RESOLVED:

The Health and Wellbeing Board agreed to:

A.   Endorse the final Health in All Policies principles and priority actions (point 12.1 – 12.7 and appendix 2).

B.   Agree to the proposed governance and the HWBB as the lead thematic partner to champion the approach, provide oversight for delivery of the action plan and propose further actions where required (point 14).

Annette Bunka, Senior Commissioning Manager Merton CCG, presented her report on the Better Care Fund (BCF). She guided the Board through an update on the  performance data for 2016/17 in the report, highlighting that the targets were met for re-ablement and admissions to care homes, but that the target for non-elective hospital admissions had not been met. The report outlined plans for the next two years 2017-2019.

The Board noted that the national  planning guidance for BCF  is still in draft stage, with no publication date set. Therefore the Board is asked to delegate the final review  of the BCF submission, if necessary to the Chair and Vice-Chair of HWBB, and final sign-off to the Chair of HWBB.

Anthony Farnsworth said that a good balance had been achieved, working with the council  supporting social care, despite the difficult financial situation.

RESOLVED:

That the Health and Wellbeing Board

A.   Notes this report

B.   Agrees to delegate the review of the BCF Plan submission to the Chair and Vice-Chair, and to delegate the final sign-off of the BCF submission  to the Chair of the Health and Wellbeing Board.

THIS REPORT WILL FOLLOW IN A SUPPLEMENTARY AGENDA

The Board noted the report on the Adult Social Care Local Account 2013-17

The Board noted the report on the Adult Social Care Funding 2017/18

The Board gave a vote of thanks to Simon Williams for all his work and wished him the best on his retirement