Agenda and minutes

Apologies for absence had been received from Ms Lynn Hill (Ms Lisa Taylor was present as her substitute), Ms Vanessa Odlin and Mr Nick Hunt.

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

It was noted that Caroline Morison was not a Councillor. 

RESOLVED:  That, subject to the above amendment, the minutes of the meeting held on 14 June 2022 be agreed as a correct record. 

On behalf of the Health and Wellbeing Board, the Co-Chairman thanked Ms Caroline Morison for the excellent work that she had undertaken in Hillingdon and wished her every success going forward. 

It was confirmed that Agenda Items 1 to 11 would be considered in public and that Agenda Item 12 would be considered in private.

The Director of Public Health advised that the focus had been on Public Health Management (PHM) being used as an enabling framework to tackle health inequalities.  The work commissioned in North West London (NWL) had focussed on place based projects in relation to frailty and falls in Hillingdon.  There had also been some initial focussed work on obesity and health checks. 

The Board noted that Ms Caroline Morison, former Managing Director of Hillingdon Health and Care Partners (HHCP), had presented the PHM information to the Borough HPB.  Consideration needed to be given to the approach that would be taken and prioritising the use of the PHM framework going forward in the Borough. 

Ms O’Neill stated that the PHM work being undertaken by Optum had progressed well.  However, the process had been paused to enable Healthwatch Hillingdon to support the process by engaging with residents as this intelligence had been missing.  Action Learning Sets had been held and key interventions had started to be developed and implemented.  It was agreed than an update on the progress of the Optum project be provided to the Board at its next meeting on 29 November 2022. 

At a NWL level, £7.2m of health inequalities funding had been made available from NHS England.  A three week consultation had been undertaken across NWL to identify how this funding could be used to build capacity but the outcome of the consultation had yet to be confirmed. 

Health Checks

Ms Becky Manvell, the Council’s Public Health Manager, advised that the NHS Health Check programme in Hillingdon aimed to prevent heart disease, stroke, type 2 diabetes, kidney disease and some types of dementia.  Eligible residents should receive an NHS Health Check every five years.  These appointments were undertaken in all 45 general practices in Hillingdon, lasted approximately 15-20 minutes and measured height, weight, waist circumference, pulse rhythm and blood pressure.  Information was also gathered in relation to alcohol consumption, physical activity and smoking status and their CVD risk was calculated and communicated and healthy life advice given or a GP referral made where necessary. 

Covid had negatively impacted on the Borough’s ability to meet its target for the number of Health Checks undertaken (65% / 2,700 per quarter) and there appeared to be a significant variation in achieving this at a Primary Care Network (PCN) and local practice level. 

Currently, Hillingdon had worse levels of cardiovascular disease (CVD) than the London average as well as the national average.  It was anticipated that an increase in the Health Checks undertaken across eligible groups would enable the identification and treatment of more people with undiagnosed CVD.  Those with a higher risk of developing CVD could be supported and those with a lower-level risk could be signposted and advised.  The more Health Checks that were carried out in Hillingdon, the greater their impact would be. 

The Board was advised that there was some overlap between the areas with the fewest Health Checks undertaken and the areas of greatest deprivation.  Consideration would need  ...  view the full minutes text for item 17.

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that the mental health Crisis House was now operational and people had moved in.  The Crisis House was able to help different categories of guests and, therefore, evidence needed to be provided on a quarterly basis to determine whether or not the criteria needed to be altered. 

As there had been some developments in relation to the Cove Café, Mr Collier would ask Ms Vanessa Odlin to circulate the information to members of the Board. 

Although there was reference made to the Better Care Fund (BCF) in this report, it was noted that it had not been possible to include the BCF report on this agenda.  It was likely that guidance in relation to the post April 2023 BCF arrangements would not be forthcoming until after November 2022. 

RESOLVED:  That:

1.    Ms Vanessa Odlin be asked to provide the Board with information in relation to developments at the Cove Café; and

2.    the report be noted. 

Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that it had not been possible to provide a report on the 2022/23 Better Care Fund (BCF) Plan.  As such, it was agreed that authority to approve the plans and amendments from the assurance process with NHS England be delegated to the Council’s Executive Director, Adult Services and Health in consultation with the Health and Wellbeing Board Co-Chairman, the Joint Borough Director, NHS North West London and the Chairman of Healthwatch Hillingdon.  This would be reported back to the Board’s subsequent meeting. 

RESOLVED: That:

1.    formal approval of the submission documentation be delegated to the Executive Director, Adult Services and Health in consultation with the Health and Wellbeing Board Co-Chairman, the Joint Borough Director, NHS North West London and the Chairman of Healthwatch Hillingdon, on behalf of the Board; and

2.    on behalf of the Board, authority to approve amendments to the 2022/23 plan in response to feedback from NHS England be delegated to the Executive Director, Adult Services and Health in consultation with the Health and Wellbeing Board Co-Chairman, the Joint Borough Director, NHS North West London and the Chairman of Healthwatch Hillingdon.

Mr Naveed Mohammed, the Council’s Head of Business Performance and Insight, advised that consultation on Hillingdon’s Pharmaceutical Needs Assessment (PNA) had been undertaken between 21 June 2022 and 19 August 2022.  A separate consultation had been undertaken with partners.  As it was thought to be a niche topic, there had not been a huge number of comments received during the consultation period.  However, an amendment to the opening hours had been made following feedback from one respondent.  In addition, on 12 September 2022, NHS London had raised ten issues and questioned the localities that had been chosen. A response was being put together. 

Professor Ian Goodman noted that Primary Care Networks had been funded to employ community pharmacists that were now in great demand and short supply.  He queried whether the PNA covered future workforce planning.  Mr Mohammed would get back to Professor Goodman outside of the meeting.

It was agreed that the inclusion of further amendments to Hillingdon’s PNA 2022 and publication be delegated to the Council’s Director of Public Health and Head of Performance and Insight. 

RESOLVED:  That the Health and Wellbeing Board:

1.    agree the final version of Hillingdon's Pharmaceutical Needs Assessment (PNA) including the recommendations and inclusion of summarised comments from the statutory 60-day consultation.

2.    agree that the PNA be published by 1 October 2022.

3.    agree to delegate further amendments to Hillingdon's PNA 2022 prior to publication to the Head of Performance and Insight and Director of Public Health, should further changes be required.

Ms Sandra Taylor, the Council’s Executive Director Adult Services and Health, advised that the Council had been working with care home providers about the fair cost of care.  Consideration needed to be given to how this was being addressed and assessed and the eligibility for financial assessment before the care cap became effective in October 2023.  Eligibility thresholds had increased from £23k to £100k.

It was noted that the Council would be able to start undertaking fair cost of care assessments from February 2023.  In the meantime, the authority would need to produce a market position statement by 23 October 2022 on the fair cost for care home placements and domiciliary care.  An update would be provided to the Board at its meeting on 29 November 2022.

RESOLVED:  That:

1.    Ms Sandra Taylor provide the Board with an update on the fair cost of care at its meeting on 29 November 2022; and

2.    the update be noted.

Mr Richard Ellis, North West London Integrated Care System (NWL ICS) Joint Borough Lead Director, advised that, although he had been unable to attend the revised meeting date, the Director of Strategy and Population Health at NWL ICS had been keen to talk to the Health and Wellbeing Board about the ICS strategy. 

Mr Ellis noted that the NWL ICS had been committed to working in partnership with local authorities.  To this end, a number of workshops had been set up (including one in October 2022) for partners to attend.  Invitees had included Councillor Palmer as well as the Council’s Chief Executive, Executive Director Adult Services and Health, Executive Director of Children and Young People’s Services and Director of Public Health.  Those that had been invited to the workshops were encouraged to engage.

The NWL Integrated Care Board (ICB) had developed four objectives to tackle issues such as health inequalities similar to those discussed earlier on the agenda.  Furthermore, NWL aimed to replicate the joint working achieved through the Hillingdon Health and Care Partners (HHCP) which had worked across health, social care, voluntary sector and local authority. 

NWL ICB had developed nine deliver programmes to look at: mental health; acute care; workforce development; research; maternity; children and young people; cancer; support for people with long term conditions; and older people.  Mr Ellis noted that Hillingdon had overachieved in some of these areas. 

RESOLVED:  That the update be noted. 

Consideration was given to the Board Planner.  It was noted that the following items be included on the agenda for future meetings:

·         an update on the progress of population health management interventions to gain residents’ insight be provided to the Board at its next meeting on 29 November 2022. 

·         an update of the fair cost of care be provided to the Board at its meeting on 29 November 2022.

·         an update on the uptake and outcomes of health checks be brought back to the Board at its meeting on 7 March 2023.

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

Consideration was given to the make up of the North West London Integrated Care Board (NWL ICB) and NWL Integrated Care System (ICS).

RESOLVED:  That the discussion be noted.