Apologies for absence were received from Councillor Kely Braund and James Blythe

The Chair welcomed new members to the Board:

Cllr Oonagh Moulton

Barbara Price – MVSC

Rob Clarke – Health and Social Care Forum

And thanked the departing Members: Cllr Janice Howard, Khadiru Mahdi and Lyla Adwan-Kamara

There were no declarations of Pecuniary Interest

The minutes of the meeting on 26 March 2019 were agreed as an accurate record

Teresa Bell, the Independent Chair of the Merton Safeguarding Adults Board, presented the Merton Safeguarding Adults Board Annual Report 2017-2018.

The Independent Chair highlighted that this report is for 2017/18, and progress has been made since then including a new web site for the SAB. She continued by explaining that although the data for 2018/19 is not yet  validated, she is confident that this will show a change in the level of referrals. There is now a very useful dashboard available and she hopes to see a change in practice based on a sounder understanding.

The Independent Chair explained that it has not been possible to benchmark because the data is imperfect, and some time is needed to become more confident. This year she expects the data to be more in line with comparator boroughs. The Director of Community and Housing explained that for benchmarking purposes, the more concerns raised the better as it shows that people know what to do, it is important that these are then converted to Section 42 enquiries.

The voluntary sector representatives were pleased to note the engagement with the voluntary sector, and offered to help with continued engagement. The Independent Chair said that that her Board Manager would set up a session with the voluntary sector to establish the best way of engaging with them

The Board thanked Teresa Bell for her report

RESOLVED

The Board considers and approved the Merton Safeguarding Adults Board Report for the period 2017-2018

Julia Groom, Public Health Consultant, presented the report on the Merton Joint Sexual Health Strategy.

The Board discussed the report. In answer to a question Julia Groom replied that there was a need to better understand why STI are rising in the over 50 age group, and the wide age band needs to be built into the strategy.

When asked about HIV infection Julia replied that there were differences in the approach to two groups MSM (men who have sex with men)  and BAME communities. The Gay community is very aware of HIV issues and there is less stigma attached to HIV in this group. However there are challenges amongst some BAME communities. It is recognised that this is an area for continued focus and there needs to be support and prevention programmes with African and Faith groups.

Dr Doug Hing  raised the issue that there are opportunities to link sexual health with social prescribing and mental health services, particularly with relationship issues. He asked how much work had been done to understand the needs and services provided in neighbouring boroughs. Julia Groom explained that the current service model is for joint commissioning with Wandsworth and Richmond.

Councillor Moulton welcomed the report and noted that there had been success in reducing the number of teenage conceptions. She asked what we are doing for teenagers to further reduce these figures, especially targeting those in the east of the borough. Julia Groom replied that Merton continues to see a decline in these figures but there is still work to do around awareness, education, ambition and access to good services. Relationships and Sex Education will become statutory and support for teachers will continue. We are keen to look for other opportunities, and understand that young people want to focus on relationships and wellbeing

The Director of Children Schools and Families thanked Public Health officers for their high  level of consultation with children and young people regarding these issues. She then asked if the vision should include a reduction in sexual violence, Julia Groom said she will take on board

Dr Andrew Otley said the reduction of teenage pregnancy in the East of the Borough had been dramatic.

Julia Groom said they will be developing the Sexual Health Strategy over the summer and will bring back to the Board before going to Cabinet.

RESOLVED

That the Health and Wellbeing Board:

A.   reviewed and endorsed the proposed vision and priorities for the borough wide sexual health strategy;

B.   considered their roles and opportunities for promoting sexual health in the borough;

C.   supported the Fast Track Cities London programme.

The Director of Public Health presented the report on the Merton Health and Wellbeing Strategy 2019-2024 Final Draft – A Healthy Place for Healthy Lives

She explained that whilst the Health and Wellbeing board was not abdicating its oversight of health and care that the Health and Wellbeing Strategy is focussing on creating a healthy place – the physical, social and economic conditions all around us which make us healthy.

The Vice Chair said that he thought that this Strategy is brilliant, commended the engagement in developing the plan and particularly welcomed the way it complements the Local Health and Care Plan. He asked how we can ensure that the Health and Wellbeing Board really focusses on the Strategy and that just an annual report might not be enough.  The challenge is how we can make this a live working document.

The Director of Public Health explained the rolling programme priorities that will be reported to the Board in October. This will include a suggested priority of healthy workplace focussing on mental health and active travel. It will also include a continued focus on the whole system approach to diabetes.

The Chair thanked Dagmar and her team for all their work on this, and put a caveat on recommendation B that it in addition to the annual reporting of the Health and Wellbeing Strategy that it is a live document.

RESOLVED

That the Health and Wellbeing Board:

A.   Considered and agreed the final draft Health and Wellbeing Strategy 2019 – 2024.

B.   Noted and agreed the proposed annual reporting of the Health and Wellbeing Strategy to the Board

REPORT PUBLISHED IN SUPPLEMENTARY AGENDA

Sarah Keen, the  CAMHS Merton Commissioning Manager, presented her report on the CAMHS LTP refresh. She explained that this was the report for 2018 - 19  and that the report for 2019 – 20 will be reported later this year.

The Chair thanked the CAMHS Merton Commissioning Manager for her report and observed that some of the work is already familiar to the Board which has previously received reports on the Trailblazer and iThrive. 

Suzanne Marsello, said that she welcomed this report and particularly the Crisis Care Planning for 2019 which is an important area.

Hannah Doody commented that she would be interested in the data that sits behind the CAMH report and how it compares to other boroughs especially across south west London.

Board members agreed that it was a very good report and thanked Sarah for it.

RESOLVED

The Health and Wellbeing Board signed-off the Child and Adolescent Mental Health Service (CAMHS), Local Transformation Plan

Presentation Attached

The Board received a presentation from DR Andrew Murray on the NHS Long Term Plan, CCG merger discussions and thinking about Place-based Committees.

The Co-Chair of MVSC asked how will the dialogue work across PCNs (Primary Care Networks) for example, on social prescribing would there be a need to have a conversation with each PCN. Dr Murray answered that PCNs have a right to funding for social prescribing and it would make sense to work with MVSC, a lot of work has already been done.

Councillor Moulton asked how much consultation there will be with Local People? Dr Murray answered that PCNs are part of the national agreement, and so there will not be consultation with local people. Moving forward there will be more allied healthcare professionals in the network, and CCGs will merge. This will not change the GP service. Consultation is currently taking place on the PCN through engagement with GPs

The Director for Children, Schools and Families thanked Dr Murray for his presentation and asked where  safeguarding would sit in this future structure as there is a need for  very local information and discussion. Dr Murray replied that this was a very valid point, and that the CCG is also concerned. He suggested  that there may be some safeguarding activity across the borough with a local contact borough by borough.

The Chair of Merton HealthWatch voiced concern about integrated care and its resourcing, and the absence of the Green Paper. Dr Murray replied that the

Green Paper would be welcomed, but the annual NHS funding settlement may not meet demand. The integration outlined in the presentation, will free up resources and increase efficiency by reducing management and duplication. The Director of Community and Housing added that essentially it needs to be about how we do things better together.

The Chair concluded the discussion by explaining that the Governance arrangements are to be finalised, work is going on with CCG and through the LGA with HWBB chairs. The Leadership Centre is also helping us to look at what have achieved and how to use this learning. He thanked Dr Murray Andrew for the thorough presentation.