Greenwich Council

Agenda and minutes.

Venue: Council Chamber - Town Hall, Wellington Street, Woolwich SE18 6PW. View directions

Contact: Anthony Soyinka  Email: anthony.soyinka@royalgreenwich.gov.uk or tel: 020 8921 2230

Items
No. Item

1.

Apologies for Absence

To receive apologies for absence from Members of the Board.

Minutes:

Apologies for absence were received from Councillors Mark James and Averil Lekau, Dr Krishna Subbarayan, Andy Trotter (Oxleas Trust) Dr Greg Ussher, Dr Jaisun Vivekanandaraja, Borough Commander Simon Dobinson.

2.

Urgent Business

The Chair to announce any items of urgent business circulated separately from the main agenda.

Minutes:

There was no urgent business.

3.

Declarations of Interest pdf icon PDF 40 KB

Members to declare any personal and financial interests in items on the agenda.  Attention is drawn to the Council’s Constitution; the Council’s Code of Conduct and associated advice.

Minutes:

Resolved –

 

That the list of Councillors’ memberships as Council appointed representatives on outside bodies, joint committees and school governing bodies be noted.

4.

Minutes pdf icon PDF 66 KB

Members are requested to confirm as an accurate record the Minutes of the meeting held on 17 October 2018.

 

No motion or discussion may take place upon the Minutes except as to their accuracy, and any question on this point will be determined by a majority of the Members of the body attending who were present when the matter in question was decided.  Once confirmed, with or without amendment, the person presiding will sign the Minutes.

Minutes:

Resolved -

 

That the minutes of the meeting of the Health and Wellbeing Board held on 17 October 2018 with minor amendment to the attendance list be agreed and signed as a true and accurate record.

5.

Proposed update to the Board's organisational arrangements pdf icon PDF 57 KB

To approve the proposal for amendments to the organisational arrangements for the Health and Wellbeing Board designed to strengthen its oversight of children’s health and wellbeing priorities.

Additional documents:

Minutes:

The report was presented by the Director of Public Health. He drew Members’ attention to Appendix 1, highlighting the organisational chart, which depicted the proposed new arrangements for the Board. The arrangements would include a new group, Start Well Greenwich Partnership Board and incorporate the existing Children’s Services Strategic Partnership (CSSP).

 

In response to questions from the Board, the Director of Children’s Services explained that the CSSP as a senior officer group would support the Board on children’s matters, operating alongside the Health and Wellbeing Executive Group. She added that the Children and Young People Plan was owned by the partnership whilst the Council owned the Directorate Plan. 

 

Circulate the terms of reference for the CSSP to the board.

Action: Director of Children Services

 

Resolved –

 

That the proposal for amendments to the organisational arrangements for the Health and Wellbeing Board designed to strengthen its oversight of children’s health and wellbeing priorities be approved.  

6.

Developing Integrated Care pdf icon PDF 165 KB

To receive and comment on this report regarding the development of integrated health and social care in the Royal Borough of Greenwich and

agree that further development of this approach should be undertaken by officers from the Council and Greenwich Clinical Commissioning Group.

Additional documents:

Minutes:

The Managing Director of NHS Greenwich CCG presented the report. He advised that the Health and Wellbeing Board Executive Group had met four times and were committed to continue to develop joint commissioning of services between RBG and Greenwich CCG in areas where there are identifiable health improvements in services that will benefit the population such as children’s services, mental health, learning disabilities and adult social care.

 

The Board received a video presentation on ‘Joined Up Care’ to illustrate integrated care and what it meant for the individuals receiving it.

 

The Chief Executive of Lewisham and Greenwich NHS Trust commented that one of the real challenges was getting the evidence base showing the financial benefit of moving care into the community and pursuing the integrated approach. He added there was need to be bolder and make a longer-term commitment to ensure that enough time is given for an adequate evaluation and measure of impact.

 

The Chief Executive of Oxleas NHS Foundation Trust gave an example of implemented integrated care system advising that global costs increased in the initial years and long-term benefits were observed from year 3 onwards, that such investments did not deliver immediate returns however, evidence suggested it could deliver better outcomes in the longer term for taxpayers.

 

The Director of Health and Adult Services explained that the implementation plan due early on in 2019 was about identifying which issues to tackle and addressing the challenges in the system such as how to support people through non-clinical services.

 

Resolved –

 

1.     Receive and comment on this report regarding the development of integrated health and social care in the Royal Borough of Greenwich.

 

2.    Agree that further development of this approach should be undertaken by officers from the Council and Greenwich Clinical Commissioning Group.

7.

Establishing the Provider Alliance (Verbal Update) pdf icon PDF 30 KB

To receive a verbal update by the Chief Executives, Lewisham and Greenwich Trust and Oxleas NHS Foundation Trust on “Establishing the Provider Alliance”.

Minutes:

The Chief Executive of Lewisham and Greenwich NHS Trust gave a verbal update. He advised that the purpose of establishing a provider alliance in Greenwich was to have a formal framework in place on how all providers within the Borough worked and collaborated. He stated that over the last decade, the environment had been about competition and the retendering of services, which had hindered effective collaborative working. He added that there had been significant changes to the policy framework and a number of operational initiatives in the works with a commitment to breaking down artificial barriers.

 

The Chief Executive of Oxleas NHS Foundation Trust stated they were looking at how best to bring resources and teams together to better meet the needs of populations and individuals. 

 

In response to questions from the Board, the Chief Executive of Lewisham and Greenwich NHS explained that the main challenges faced were around regulations.

 

The Board felt that the Provider Alliance made sense and as an example that there was a strong fit between Lewisham and Greenwich Trust and Oxleas, in terms of the patient journey and the overlap in geographical as well as functional portfolios, which would allow areas for efficiency savings.

 

The Managing Director of NHS Greenwich CCG stated that from a commissioner perspective that their role was increasingly about setting strategic outcomes and not stating how services should look. Further adding that the CCG now had delegated commissioning for primary care. 

 

Resolved –

 

That the verbal update by the Chief Executives, Lewisham and Greenwich Trust and Oxleas NHS Foundation Trust on “Establishing the Provider Alliance” be noted.

8.

Proposal to develop an Alliance working model pdf icon PDF 164 KB

To receive and comment on this report regarding consideration of an alliance joint commissioning model for adult mental health services for the Royal Borough of Greenwich and to agree that further development of this approach should be undertaken by officers from the Council and the Clinical Commissioning Group, together with members of the strategic mental health partnership.

Minutes:

 

The report was presented by the Director of Commissioning GCCG. He advised that officers were working with colleagues in Lambeth and had identified three key threads to their approach on Integrated Personalised Support for those with severe and enduring mental health needs. Firstly, that it was important to have a strong focus on the user experience and include the voluntary sector to challenge what was being done from a user perspective. Secondly making decisions together on outcomes which they aimed to shift and thirdly to include input from Housing. He stated that there were two options available as detailed in paragraph 6.2 and 6.3 in the report. He explained that the preferred option was option 1, which would be to begin discussion and negotiation with statutory and voluntary partners with expertise and investment in mental health services. The joint contract negotiations with GCCG and RBG would be completed within the context of collaborative working and would support a future alliance model. The next steps would be further market engagement to share a vision, find willing partners and agree how to work together to identify outcomes and produce results.

    

The Director of Health and Adult Services commented that there was strong commitment from colleagues in Housing to help find better ways to support those with mental health in the community with the work being embedded in the forthcoming Housing Strategy about vulnerable groups and that though this was a challenge in London felt Greenwich was well set to make progress in this area.

 

In response to questions from the Board, the Director of Commissioning GCCG said that they were looking to bring on board different users to shape the alliance to address the over-representation of BAME young people in adult non-elective admission numbers.

 

In response to questions from the Board about the high attendance of people with mental health and drug and alcohol problems, he stated that there were a range of services all presently commissioned as silos which were undergoing a process looking at how changes could be made. 

 

The Director of Commissioning GCCG explained that one of the primary objectives of the alliance was to make the shift to prevention, allocating more resources with focus on crisis lines and cafés to reduce levels of admissions. He said they were also looking at how to reach those in need of support from BAME backgrounds earlier to increase positive impact on outcomes.

 

Resolved –

 

1.    That the report regarding consideration of an alliance joint commissioning model for adult mental health services for the Royal Borough of Greenwich be noted.

 

2.      That it be agreed that further development of this approach should be undertaken by officers from the Council and the Clinical Commissioning Group, together with members of the strategic mental health partnership group.

9.

Live Well Greenwich Prevention System pdf icon PDF 485 KB

To consider the progress made in relation to the development of the Live Well Greenwich Prevention System and continue to champion the prevention at scale approach for Greenwich and to note the links between Live Well Greenwich and Start Well.

Additional documents:

Minutes:

The report was presented by the Assistant Director of Public Health.

 

The Director of Public Health advised that the Board had agreed to the development of a more systematic approach to prevention and that the report provides an update on the progress made in relation to the development of the Live Well Greenwich Prevention System.

 

In response to questions from the Board, the Assistant Director of Public Health said in relation to the A Hubs they wanted to see how the capacity builds and take lessons learnt from the implementation of the first, to inform the development of others. She stated that measuring the impact of the utilisation of health and care resources was a challenge but they had begun to measure outcomes of patients and that over the next year the digital infrastructure would enable better monitoring of outcomes.

 

Resolved  

 

1.    That the progress made in relation to the development of the Live Well Greenwich Prevention System and continuing to champion the prevention at scale approach for Greenwich be noted.

 

2.    That the links between Live Well Greenwich and Start Well, illustrating Start Well’s role in supporting the delivery of the wider Live Well prevention system be noted.

 

3.      That areas for future development be noted.

10.

New Clinical Facility Presentation pdf icon PDF 28 KB

To receive an oral presentation by the Chief Executive Lewisham and Greenwich Trust on the “New Clinical Facility at Queen Elizabeth Hospital.”

Minutes:

The Chief Executive, Lewisham and Greenwich NHS Trust gave a presentation to the Board. He explained that there had been a number of challenges around the infrastructure at Queen Elizabeth Hospital and the Department of Health and Treasury had awarded £48 million pound to undertake a programme of infrastructure works. Additional capacity was created which contained 58 beds and opened on schedule on the 30th November 2019 with patients moving in on the 6th December 2019.

 

He stated that it was a welcomed and significant investment to the Hospital and he would continue to work on the clinical model to ensure best use of the facility and available resources.

 

In response to questions from the Board, the Chief Executive, Lewisham and Greenwich NHS Trust said that it was a system under huge pressures stating that on a busy day 587 adults attended the Hospital with 40 – 50% going to the urgent care centre and that it regularly received about 100 – 130 ambulances a day. He commented that the ambulance handover times was around 15 minutes and were one of the best within London. He highlighted the importance of earlier agenda items of this meeting such as the Provider Alliance, Live Well Greenwich in alleviating the pressures. 

 

Resolved –

 

That the presentation by the Chief Executive Lewisham and Greenwich Trust on the “New Clinical Facility at Queen Elizabeth Hospital” be noted.

11.

NHS Long Term Plan (Verbal Update) pdf icon PDF 27 KB

To receive a verbal update by the Managing Director NHS Greenwich CCG on “NHS Long Term Plan”.

Minutes:

Resolved -

 

That the item be deferred to the next meeting.

*

*

 

The Chair agreed to a member of the public addressing the Board.

 

A member of the public raised questions about the plans for the redevelopment of Plumstead Health Centre.

 

The Managing Director NHS Greenwich CCG stated it had been an Oxleas site since 2011, who were currently in the process of looking at how the health centre and site could be redeveloped. He said a conversation was being had with the Local Estates Forum which had representation from partners on the Health and Wellbeing Board. They would involve and continue to engage with the Patient Participation Group throughout the process, that the proposals still needed to be presented for planning consent. The opportunities available were being assessed, as there were a number of GP practices nearby that were in unfit for purpose buildings.