Apologies were received from Melanie Monaghan and Howard Freeman.

No declarations of interest were made.

RESOLVED:  That the minutes are agreed as an accurate record of the meeting.

Julia Groom introduced the report and outlined the key findings including positive aspects and challenges.  She also highlighted the recommendations and actions detailed in paragraph 2.7 of the report.

Councillor Maxi Martin noted the challenge for the local authority in taking over not only this function but also all other functions included within the public health remit.  She welcomed the report but suggested that the visibility of the service section could be amplified.  She also asked for an update on negotiations with LB Sutton on the workforce allocation.  Julia Groom confirmed that a paper outlining Merton’s view of a fair allocation has been submitted to LB Sutton and their response is awaited. 

Julia Groom amended the third recommendation to read:

“To welcome the £36k increase in funds to provide additional capacity to address higher needs schools in the east of the borough”.

Councillor Maxi Martin outlined the work she has undertaken with the Baitul Futuh Mosque in Morden to encourage parents in the local community to take up free school meals where appropriate. This will not only benefit the children, but also increase levels of funding to schools.  Ian Beever suggested similar work should be carried out with the Korean, Polish, and Tamil communities.

Yvette Stanley advised that the report has been delivered to the Children’s Trust and the Local Safeguarding Board, and welcomed the £36k funding.  There are 3.5k more primary school children in the borough than in 2008 so any additional resources must be carefully allocated.

Kay Eilbert advised that a post has been created in the CSF department to support and develop pathways with health visitors, midwives, GPs, and children centres.  Eleanor Brown recommended that the report be shared at locality level. 

RESOLVED:

1.            That the HWB note the findings from the review of School                 Nursing Services in Merton and progress following the review.

2.            That the HWB welcomes the £36k increase in funds to provide        additional capacity to address higher need schools in the east of        the borough.

Julia Groom introduced the report and highlighted the areas of good progress and areas for improvement.  She directed the Board’s attention to the four outcomes and invited comment and questions.

In response to a query from Councillor Gilli Lewis-Lavender, Julia Groom advised that a low birth rate is below 2500g (5 lbs 8 oz). 

Eleanor Brown welcomed the report and commended the inclusion of measurements and data. She highlighted the recent outstanding Ofsted report for Acacia Children’s Centre and asked how children’s centres can be more closely aligned with primary care. Julia Groom advised that when recruited, the co-ordinator’s role will be to develop pathways and establish improved referral and communication routes.  Kay Eilbert added that representatives from Public Health attend monthly GP locality meetings and provide data regarding the outcomes, for example rates of immunisation broken down by GP practices.  Yvette Stanley explained that eight of the eleven children’s centres are based in schools and 70% of the children who need the services on offer are based in the east of the borough.  She advised that all children’s centres have been Ofsted rated at good or above.

Councillor Maxi Martin noted that work must be done to ensure children from all communities are school ready (immunised, toilet trained, etc.).  She asked that routes of funding be explored in order to produce leaflets in a range of community languages to be shared among parents in the borough.  Julia Groom undertook to investigate any sources of funding. 

Report received. 

Yvette Stanley introduced this report and advised of the intention to establish a VAWG governance board to ensure Merton is fully compliant with best practice.  She invited comments and questions. 

Yvette Stanley confirmed that the Violence against Women and Girls Strategy does include men and same sex abuse, and undertook to ensure that this is made very clear.

Councillor Maxi Martin noted her concern about the possible stereotyping of victims of domestic violence and reminded all present that victims can be in any socio-economic group, or from any cultural background.  Yvette Stanley confirmed that those involved in this area do not make such generalisations.

RESOLVED:

1.            That the HWB agrees the recommendations in the needs assessment.

2.            That the HWB agreed the way forward, with further work to be done in the light of potential changes to Safer Merton.

Adam Doyle presented this report and invited comments and questions. 

Adam Doyle undertook to include CAMHS in the plan on a page, and also to ensure prevention of obesity is given a high priority. 

Kay Eilbert commended the CCG on their use of the JSNA.

Report received.

Eleanor Brown delivered a short verbal report on the plans for CCG co-commissioning, and on transforming primary care.  She undertook to bring a formal report to the November meeting of the Board. 

With regard to co-commissioning, Eleanor Brown explained that Merton, Kingston, Sutton, Croydon and Wandsworth have submitted an expression of interest to be co-commissioners.  The process will start with a needs assessment, and CCGs will work closely with NHS England.   She noted that the governance arrangements will require a lot of thought, and local authorities are considering how they may assist. 

The transformation of primary care programme will launch in November and will focus on prevention, reactive care and the adoption of new initiatives and technology.   Focus will be given to workforce, estates and affordability.  CCGs are considering how GPs could join together to change the way they deliver services, for example offering seven day cover.  A task and finish group will be established, to be chaired by Howard Freeman. 

Simon Williams asked if the project will look at GP morale, recruitment and retention, which, anecdotally, is low.  Matthew Trainer (NHS England) acknowledged that this is a concern, not just for GPs but also in Nursing, and advised that the project must consider the workforce challenges being faced. 

Councillor Gilli Lewis-Lavender supported the move towards introducing new and innovative ways of contacting GPs in order to maximise use of their time. 

Ian Beever advised that Healthwatch have carried out research into GPs which is due to be published on Friday 3 October, and shows that older people prefer to see a GP and have little confidence in nurse practitioners. However, younger people are happy to do so, and also happier to communicate by phone or email with their doctor. 

Eleanor Brown thanked the Board for their comments. 

Simon Williams introduced this report and thanked James Corrigan, Programme Manager for leading on this piece of work.  Eleanor Brown and Matthew Trainer echoed those thanks. 

Adam Doyle advised NHS England’s local area team have confirmed the Plan is cohesive, robust and achievable.  They asked to see full risk register which has been provided and some more information on one scheme has already been supplied. 

The Board approved the resubmitted plan, noting that the Chair, due to time constraints, had approved it as chair’s action.

Report received.

AnjanGhosh delivered a short presentation on the key findings of the Merton Mental Health Needs Assessment, and then invited comment and questions.  The presentation covered:

• Headline findings;
• Where Merton is doing well;
• Gaps in Merton;
• Gaps expressed by service users and carers;
• Ethnicity of in-patients, in-patients by deprivation, and of East/West of the borough;
• Health and social care recommendations;
• Promoting mental health and wellbeing;
• Parental and child mental health;
• Tackling dementia.

Ian Beever noted his concern at the lack of continual contact with people suffering from mental ill-health, as this can lead to crisis.  He suggested that, given the gap in drop-in and day centre care, an alternative model of intervention should be developed. 

Ian Beever warned that the voluntary sector for mental health in Merton is at very low capacity and funding is needed to build up the capacity to continue to play a vital role in supporting people with mental health issues. 

Ian Beever reported that MVSC will launch a mental health forum in January, which will bring providers together.  The project has been funded for two years

Councillor Maxi Martin noted the need to ensure that people from all ethnic backgrounds are adequately supported and access services. 

Adam Doyle thanked Anjan Ghosh for his presentation and noted the challenge faced in closing the gaps identified.  He advised that the CCG will devise a programme to take forward the work required, but a full partnership approach is needed.

Councillor Gilli Lewis-Lavender noted that when she chaired the Healthier Communities and Older People Scrutiny Panel, special meetings were regularly held to focus solely on mental health.  She noted that she will be suggesting that this practice be reinstated.  She also noted that day centres should be renamed activity clubs, in order to remove the stereotype of day centres and encourage people to attend. 

Councillor Cooper-Marbiah invited all present to visit the Dementia Hub and to consider becoming a dementia friend. 

Report received.

The report was introduced by Ranjit Kaile (Head of Communications) and Sharon Spain (Head of Nursing) from the South West London and St George’s Mental Health NHS Trust.  Ranjit Kaile outlined the proposed consultation, explained where it could be found and how it was being carried out, and invited comment and questions.

Dave Curtis noted his concern that the consultation launched on Monday 29 September but he was not aware of it. Ranjit Kaile detailed the range of people and groups consulted and undertook to discuss the consultation further with Dave Curtis after the meeting.

Yvette Stanley asked if young people would be affected by the changes, given the requirement in the Children and Families Act for services to be provided up to 25 years of age.  Ranjit Kaile undertook to find out more information and report back on this issue. 

Councillor Gilli Lewis-Lavender noted her concern that residents do not all receive local newspapers so may not be aware of the engagement events in October.  The Merton event will take place on 10 November at 7 pm in Drake House, Wimbledon. 

Simon Williams asked how Merton residents will be affected, given that most patients are directed to Springfield Hospital.  Adam Doyle responded that the impact on Merton’s residents should be minimal.

Simon Williams asked if the HWB will be asked to give their view on the proposals.  Ranjit Kaile advised that a Joint Health Overview and Scrutiny Committee (JHOSC) has been formed, and will meet three times in October and November, and carry out site visits.  The final meeting before making a recommendation will be on 21 December 2014.  It is expected that the views of this Board should be fed into the JHOSC, and it is possible that the HWB will be given a report on the final decision.  Yvette Stanley noted the problems of the HWB feeding into the JHOSC, given that the HWB makes recommendations to the Executive, not to Scrutiny and Ranjit Kaile undertook to check the process. 

Report received.

Adam Doyle introduced this report, detailing progress to date with the Nelson and Mitcham local care centres.

With regard to the Mitcham care centre, Adam Doyle outlined the current dilemma; the available sites in the town centre may not be large enough to accommodate all of the services wanted, but a full suite of services can be provided in one of the sites outside the centre of Mitcham.  On 2 October, a public event will be held to outline the process and discuss options. 

SW congratulated the CCG on their efforts into this project and acknowledged the difficulties faced.   He noted there is no perfect solution and advised that the Board would need to show collective support for the option which is on balance preferred and adopted. 

Councillor Maxi Martin, whilst thanking the CCG, expressed frustration at the time the project has taken and will take.  Eleanor Brown reminded the Board that the Nelson project took a huge amount of time.  She appealed to the Board members to push the project forwards, for example in areas such as planning.  Whilst noting that councillors cannot influence the planning process, Chris Lee undertook to discuss this matter further with Adam Doyle and to ensure that the CCG receive planning advice when required. 

Councillor Gilli Lewis-Lavender suggested that the Board look to the future rather than the past. 

Report received.

Kay Eilbert presented this report. 

RESOLVED:

1.            That Public Health respond on behalf of the HWB to consultation documents from neighbouring boroughs.

Kay Eilbert introduced this report.

RESOLVED:

That the HWB agrees the terms of reference for the One Merton Group.

Dave Curtis introduced this report. He noted that Healthwatch are already involved in many of the areas on the agenda for the meeting.  He advised that Healthwatch have built up a good level of trust with local groups and aims to remain transparent in order to retain that trust.

Councillor Maxi Martin congratulated Dave Curtis on the achievements made. 

Ian Beever advised that approval has been given for MSVC to change the governance model for Healthwatch Merton.  A sub-group will be constituted, with an independent chair, to lead on this piece of work. 

Eleanor Brown thanked Dave Curtis for the help of Healthwatch with patient and public involvement.

Dave Curtis offered to share Healthwatch’s reports and data with any party that may find it useful.  

Report received.