Agenda and minutes

Apologies for absence had been received from Mr Keith Spencer (Co-Chairman), Councillor Susan O'Brien (Vice Chairman), Mr Richard Ellis, Mrs Derval Russell and Ms Patricia Wright (Mr Jason Seez was present as her substitute).

There were no declarations of interest in matters coming before this meeting. 

RESOLVED:  That the minutes of the meeting held on 13 June 2023 be agreed as a correct record. 

It was confirmed that Agenda Items 5 to 7 would be considered in public and Agenda Items 8 to 11 would be considered in private. 

Mr Gary Collier, the Council's Health and Social Care Integration Manager, advised that the value of the Better Care Fund (BCF) submission in 2023/24 had been £96.5m, which had been a reduction from £109m in 2022/23 (this had largely been attributed to a reduction in the Integrated Care Board voluntary contribution).  The provisional value for 2024/25 was £98.5m. 

Feedback had been provided by the Assurance Team with changes to the Avoidable Admissions target (which would make the target less challenging to achieve in 2023/24) and a correction to the rationale supporting discharge to the Usual place of residence metric (which did not affect the target).  Additional text had been added to the narrative plan document that supported data in the demand and capacity worksheet in the submission template.  Changes had also been made to the demand figures to reflect those individuals that needed low level assistance.  Once confirmation of assured status had been received, a Section 75 legal agreement could be entered into which would satisfy the final BCF national condition by the end of November 2023. 

The Co-Chairman commended Mr Collier and his team for the excellent work that they had undertaken during a very difficult period.  She gave her personal thanks for this very comprehensive piece of work.  Professor Ian Goodman, North West London Integrated Care Board, suggested that further work be undertaken to reflect the changes in the percentage of patients presenting at A&E that had been admitted compared to attendances.  Mr Jason Seez, Deputy Chief Executive at The Hillingdon Hospitals NHS Foundation Trust, advised that Hillingdon Health and Care Partners would need to do a deep dive into this and then take it back to their Board. 

With regard to the metric for Discharge to normal place of residence, Professor Goodman noted that this had been 92.18% in Quarter 1 against a target of 92.8%.  However, Homefirst/Discharge to Assess Pathway 2 figures showed that 4% of hospital discharges went into rehabilitation or short-term care in a 24-hour bed-based setting and Pathway 3 figures showed that 1% required ongoing 24-hour nursing care in a bedded setting.  This would suggest that the metric for Discharge to normal place of residence should be 95%, not 92%.  Mr Collier advised that these figures had been provided by different sources.  He would investigate the discrepancy and share this information with the Board.

Mr Collier noted that this year had not been without its challenges with reviews of the BCF scheme.  The report set out the parameters for the North West London (NWL) review of schemes which would be undertaken by an external organisation.  It would be important that the need to address the key lines of enquiry within the BCF planning requirements was not lost within this process.  In addition to the work undertaken at a NWL level, a place-based review would be undertaken locally in relation to out of hospital spend.  It was anticipated that this would be completed by the end of October 2023.  Results  ...  view the full minutes text for item 17.

Ms Suzi Gladish, Safeguarding Partnership Quality and Improvement Manager, advised that the report set out the work that had been undertaken by the Partnership which had to undergo independent scrutiny.  This year, the focus had been on the impact of strategic work on practice and evidence had been found of strong partnerships and the facilitation of continuous improvement. 

The report set out the progress of subgroups (such as the Making Safeguarding Personal subgroup and the Domestic Abuse subgroup) that had worked with multi agency colleagues on the prevention, identification and response.  With regard to learning from practice, three useful learning reviews had been undertaken during the year which had resulted in improvements and a safeguarding adults review had been undertaken in relation to self-neglect. 

Ms Gladish advised that a multi agency quality assurance framework had been introduced.  A safeguarding adults audit tool had been developed on a pan-London basis but had not been progressed as further improvements were needed.

With regard to the quality of safeguarding practice, training sessions had proved very successful with a 43% increase in continuous professional development across the sector.  A webinar programme had also been developed. 

Highlights from partner agencies over the past year included an increase in the number of domestic abuse (DA) reports and a drive by the North West London Integrated Care Board in relation to annual health checks.  Central and North West London NHS Foundation Trust (CNWL) had also held its fifth Annual Domestic Abuse conference this year.  The Safeguarding Families Team at The Hillingdon Hospitals NHS Foundation Trust had been fully established and had focussed on ensuring that safeguarding remained at the forefront of clinical care through a range of interventions such as training and staff engagement.  An Independent Domestic Violence Advocate (IDVA) had been co-located at Hillingdon Hospital to help identify and support patients who had been victims of DA.  It was recognised that there were significant benefits in learning from practice and that it would be good to see more IDVA involvement in GP surgeries.  It was suggested that the Hillingdon Training Hub had been well attended by GPs and might be the best way of targeting GP engagement.  Ms Gladish had attended the GP Safeguarding Forum and training was readily available to all GPs.  It was suggested that this issue be investigated further outside of this meeting. 

CNWL had been focussed on the Year of the Child, including identifying the voice of the child in every contact.  This had been identified as a partnership priority for this year and consideration needed to be given to what else was needed from partner organisations in order for this to be successful.  Ms Gladish needed to know what partner organisations would be doing in response to the feedback and would take this up with them outside of this meeting.  A "You Said, We Did" exercise would also be undertaken by the end of October 2023. 

Self-neglect was when someone was not able to keep themselves clean, safe and well.  Sometimes  ...  view the full minutes text for item 18.

It was agreed that the following reports be considered at the Health and Wellbeing Board meeting on 28 November 2023:

1.    Health and Wellbeing Strategy – One Year On; and

2.    Drug and Alcohol Strategy.

RESOLVED:  That the Board Planner, as amended, be noted. 

RESOLVED:  That this item be deferred to the meeting on 28 November 2023. 

RESOLVED:  That this item be deferred to the meeting on 28 November 2023. 

RESOLVED:  That the Part II minutes of the meeting held on 13 June 2023 be agreed as a correct record. 

There were no current or emerging issues or any other business that the Co-Chairman considered to be urgent.