Agenda and minutes

Apologies were received from:

1.    Councillors Jonathan Bianco, Keith Burrows and Scott Seaman-Digby.

2.    Co-opted Member Ms Robyn Doran from Central and North West London NHS Foundation and also her substitute member, Ms Maria O'Brien, as their Board meeting clashed with the Health & Wellbeing Board meeting.

3.    Co-opted Member Mr Rob Larkman from the Hillingdon Clinical Commissioning Group who was substituted at the meeting by Ms Ceri Jacob.

4.    Co-opted Member Mr Robert Bell from the Royal Brompton and Harefield NHS Foundation Trust who was substituted at the meeting by Mr Nick Hunt.

No interests were declared in matters before the meeting.

The minutes of the meeting held on 22 July 2014 were agreed as a correct record.

Matters to be discussed in both public and private parts of the meeting were agreed as per the agenda.

The Vice-Chairman of the Board introduced the report and the further work proposed to be undertaken to bring together reporting information for Hillingdon's Joint Health and Wellbeing Strategy, the Public Health Action Plan and the Better Care Fund (BCF) Plan which was welcomed by all.

Members noted that supplementary guidance on the Better Care Fund had been issued during July and August, which had required a full rewrite of the Plan. The guidance had not been clear as to how the new burdens imposed on local authorities under the Care Act should be funded. At this stage therefore, Board Members considered they were not in a position to approve the BCF Plan.

It was decided by the Board that the Chairman would write to the Secretary of State for Health outlining the outstanding issue and seeking a meeting with him at the earliest opportunity in an attempt to seek a resolution. The Board approved that, should the case arise where the issue regarding new burdens had been resolved, then the BCF Plan could be agreed by all parties and that the necessary delegated authority be given to enable this.

RESOLVED:  That the Board:

1)    Agrees the approach to refresh Hillingdon’s Health and Wellbeing Strategy action plan objectives for the years 2014-16, and instruct officers and partners to work together to complete a refreshed action plan which integrates the work of the Better Care Fund Plan, Public Health activity and new requirements of the Care Act 2014;

2)    Agrees that a refreshed action plan is presented to the next Board meeting in December 2014;

3)    Notes that the Better Care Fund Plan not be agreed at this point;

4)    Requests the Chairman to write to the Secretary of State for Health outlining the Board's issues regarding the Better Care Fund, seeking a meeting with him; and

5)    Delegates any final sign-off of the Better Care Fund Plan to both the Chairman of the Board and the Chairman of the Hillingdon Clinical Commissioning Group, in light of the above.

The Chairman of the Hillingdon Clinical Commissioning Group (CCG) introduced the report and provided Members with a useful update on the Primary Care Co-Commissioning proposals to National Health Service England (NHSE) and work to further integrate services.

Changes to Accident and Emergency out of the Borough that could have a potential impact were also raised in light of the reclassification of A&E in some hospitals as Urgent Care Centres. An update was also given on CCG commissioning and re-designing of service delivery.

The Chairman of the Board indicated his support for the Hillingdon CCG's co-commissioning preferred route with NHSE and sought clarification over how targeted efficiency savings would be met. The Chairman of the Hillingdon CCG indicated that this was laid out in a 3 year plan for savings.

RESOLVED:  That the Board notes the update for information.

The Chairman of the Hillingdon CCG introduced the report. Clarification was sought by the Board from the CCG's Chief Finance Officer attending the meeting about the organisation's deficit position.

Further information was given over the reconciliation between the actual position and one-off budget items during the year. The Chairman of the Board indicated that it would be useful for future updates to the Board to show actual income and expenditure on one hand, with any extraordinary items show separately. The Board welcomed that fact that the CCG's finances were going in the right direction.

RESOLVED:  That the Board notes the update for information.

The Chairman of Healthwatch Hillingdon outlined the activity during the first quarter and how the relatively new independent consumer champion was working well with commissioners and providers in the health sphere. It was noted that the organisation was seeking to establish a robust performance management framework.

The Board welcomed the good progress made by the organisation.

RESOLVED:  That the Board notes the report received.

The Board was provided with an update on the progress being made in allocating and spending planning contributions towards the provision of healthcare facilities in the Borough.

Members noted the progress with the new Yiewsley Health Centre, to serve residents in the south of the Borough.

The Board considered that the proposed St. Andrew's Park Health Centre on the former RAF Uxbridge site, was progressing less satisfactorily due to a number of factors. The Chairman of the Board indicated that the Council would be willing to assist the CCG in this venture and also potentially raise the issue of the slow interaction of NHS Property Services on this with the Secretary of State for Health.

Members welcomed the report, but requested that, in future, such reports show the risks associated with planning contributions more clearly.

RESOLVED:  That the Board notes the progress being made towards the allocation and spend of s106 healthcare facilities contributions within the Borough.

The Vice-Chairman of the Board welcomed the report and highlighted how pharmacies could play an even more important role in helping the Board help deliver its strategic health and wellbeing objectives. The Board Chairman agreed that Hillingdon People could be used to assist in this.

It was noted that the Pharmaceutical Needs Assessment would go out for the wider statutory consultation exercise before coming back to the Board.

RESOLVED:  That the Board:

1.    Agrees the draft recommendations set out in Hillingdon's Pharmaceutical Needs Assessment (PNA);

2.    Agrees the plan to review and publish Hillingdon’s PNA by the required deadline, including the statutory requirement to undertake a minimum 60 day consultation; and

3.    Agrees to delegate the final approval of Hillingdon's PNA consultation document prior to consultation to the Chairman of the Health and Wellbeing Board.

The Board considered its upcoming work programme.

RESOLVED:  That the Board requested that the Pharmaceutical Needs Assessment, following consultation, be added to the December meeting for approval.

The Chairman of the CCG and Co-opted Member, Ms Ceri Jacobs outlined the proposed Commissioning Intentions that would set out the health priorities that the CCG needed to focus on in the coming year and noted that consultation with the public would feed into the proposals.

In response to a query from the Cabinet Member for Education and Children's Services about how concrete the targets would be for paediatric service objectives, a reassurance was given that there would be more detail on this in the final schedule to be developed.

The Vice-Chairman of the Board put forward the importance of mental health services and the Chairman of the Board pointed out that the Commissioning Intentions should be linked up with the budget. Confirmation from the CCG was given that this would be the case.

The representative from the Royal Brompton & Harefield NHS Foundation Trust, Mr Nick Hunt, queried whether Breathlessness Services would form part of the proposals. Ms Ceri Jacobs assured him that this would be the case.

RESOLVED:  That the Board approves the direction of travel for the draft 2015/16 Commissioning Intentions and delegate authority for final sign off to the Chairmen of both the Board and Hillingdon Clinical Commission Group.

Exempt Information

This report was included in Part II as it contained information relating to the financial or business affairs of any particular person (including the Authority holding that information) and the public interest in withholding the information outweighed the public interest in disclosing it (exempt information under paragraph 3 of Part 1 of Schedule 12A to the Local Government (Access to Information) Act 1985 as amended.

No further items were considered by the Board.