Agenda item

Mr Kevin Byrne, the Council’s Head of Health and Strategic Partnerships, advised that the report provided the Board with a summary of a range of issues rather than including individual reports for each of these.  The report highlighted the appointment of Rob Hurd as Chief Executive of the NWL ICS from January 2022, Professor Ian Goodman’s appointment as Borough Medical Director for Hillingdon, Dr Mohini Parmar’s retirement from March 2022 and Pippa Nightingale’s appointment as Chief Executive for London North West University Healthcare NHS Trust.  It was also noted that, as the Health and Care legislation was likely to be delayed until beyond April 2022, the ICS shadow status would remain in place for a while longer. 

The publication and maintenance of a Pharmaceutical Needs Assessment (PNA) was a statutory function of the Health and Wellbeing Board with a prescribed process.  Engagement was being undertaken with the Local Pharmaceutical Committee (LPC), Healthwatch and the CCG.  An update on the progress of the project plan would be scheduled for the Health and Wellbeing Board’s next meeting on 8 March 2022. 

It was also suggested that the models of working and Neighbourhoods needed to include pharmacies and community pharmacies.  Consideration would need to be given to how this would work in practice at a local level and support the PNA process.  Mr Byrne would liaise with Ms Caroline Morison, Co-Chairman and Managing Director at Hillingdon Health and Care Partners (HHCP). 

Ms Vanessa Odlin, Director of Hillingdon and Mental Health at Central and North West London NHS Foundation Trust (CNWL), provided the Board with an update on the 16-25 Young Adults Service which had been developed to better bridge the gap between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS).  A lot of work had been undertaken on this over the last twelve months which had included stakeholder engagement.  This engagement had resulted in the development of ten underlying principles which had formed the base for the development of a partnership model. 

A Hillingdon implementation group had been established to lead on the work with the aim of going live in April 2022.  The new model would include multi agency young adult triage meetings with a flexible interface between services to support young adults to move from CAMHS to AMHS.  It was anticipated that discussions would be undertaken to see about embedding this into H4All. 

As Hillingdon had the highest number of CAMHS and AMHS new referrals, it was queried what action was being taken to capture data on the related intervention outcomes.  Ms Odlin advised that it was very stark from a Hillingdon perspective and that more work would be needed to record this information. 

Mr Byrne advised that tooth decay in children had been an issue of concern in the Borough for some time.  The report of the External Services Select Committee (ESSC) into children’s dental services had made nine recommendations which had been ratified by Cabinet.  The Children and Young People’s Dental Health task and finish group would be reviewing these recommendations and building actions into their delivery plan.  ESSC would be reviewing the progress made with regard to the implementation of the recommendations. 

Ms Lynn Hill, Chair of Healthwatch Hillingdon, noted that Healthwatch had seen a recent resurgence of residents having problems with access to dental services, particularly older people and those with a disability.  Mr Byrne advised that, as this was outside of the scope of the report, he would liaise with Ms Hill outside of the meeting. 

Hillingdon’s Joint Health and Wellbeing Strategy set out an ambition to “Tackle unfair and avoidable inequalities in health and in access to and experience of services.”  The Joint Strategic Needs Assessment (JSNA) identified emerging issues and was being updated in collaboration with Brunel University.  With the epidemiology work already nearing completion, it was hoped that a stakeholder engagement event could be planned before Christmas to review the findings.  Further work to better understand the drivers behind health inequalities would be undertaken and would be reported to the Health and Wellbeing Board at its meeting on 8 March 2022. 

NWL ICS had embarked on a Population Health Management Programme (PHMP) to support the work on tackling health inequalities in relation to diabetes using the Hayes and Harlington Neighbourhood as Hillingdon’s pilot between December 2021 and January 2022.  It would be important to ensure that this programme dovetailed with the other health inequality work being undertaken in the Borough.  With regard to Covid vaccinations, it was noted that work had been undertaken on take up which had identified health inequalities. 

In Hillingdon, 60% of eligible residents with diabetes had received health checks but only 24.1% of those eligible with a severe mental illness had received physical health checks and 33% of those with learning disabilities (in the year to date against a target of 75%).  It was queried, with regard to PHMP, whether all NWL boroughs were focussing on diabetes and how this condition had been chosen.  Ms Morison advised that NHS England (NHSE) had commissioned this work to support the Primary Care Networks (PCNs).  Diabetes had been chosen by NWL as it was indicative of inequalities and it would help to test the model which could then be rolled out elsewhere.  It was noted that a lot of work was also being undertaken separately in the Borough in relation to severe mental illness and learning disabilities. 

North West London and the ICS were currently in a process of transition and ICPs had been renamed as Place Based Partnerships (PBPs).  It was noted that a review was being undertaken of HHCP but that this would be an iterative process that would also look at restating ambitions and visions about what the organisation wanted to achieve.  An update would be brought to the Health and Wellbeing Board’s next meeting on 8 March 2022. 

It was agreed that that the NWL Needs Assessment would need to be considered at a future Board meeting.  Hillingdon partners were currently undertaking granular bottom-up work to meet targets but further information was needed on how this was meeting / contributing towards the wider NWL curve.

RESOLVED:  That:

1.    updates on the following issues be considered at the Board’s next meeting on 8 March 2022:

a.    the progress of the PNA project plan;

b.    an update on the drivers behind health inequalities;

c.    the review of HHCP; and

d.    the NWL Needs Assessment; and

2.    the issues in the report and their implications for the health and care system in Hillingdon be noted.