Greenwich Council

Agenda and minutes.

Venue: Committee Room 6 - Town Hall, Wellington Street, Woolwich SE18 6PW. View directions

Contact: Daniel Wilkinson  Email: daniel.wilkinson@royalgreenwich.gov.uk or tel: 020 8921 5102

Items
No. Item

1.

Appointment of Chair

Members to appoint a Chair for the municipal year.

 

Minutes:

Councillor Lekau proposed and was seconded by Naomi Goldberg that Councillor Danny Thorpe be Chair of the Board for the duration of the municipal year.

 

Resolved –

 

That Councillor Danny Thorpe be Chair of the Board for the municipal year 2018/19

2.

Appointment of Vice-Chairs

Members to elect vice-chairs for the municipal year.

 

Minutes:

Neil Kennett-Brown proposed and was seconded by Councillor Gardner that Dr Ellen Wright be joint Vice Chair for the duration of the municipal year.

 

Councillor Gardner proposed and was seconded by Dr Wright that Councillor Averil Lekau be joint Vice Chair for the duration of the municipal year.

 

Resolved –

 

That Dr Ellen Wright and Councillor Averil Lekau be appointed joint Vice Chairs of the Board for the municipal year 2018/19.

 

3.

Apologies for Absence

To receive apologies for absence from Members of the Board.

Minutes:

Apologies for absence were received from Florence Kroll, Director of Children’s Services.

 

Apologies for lateness were given by Councillor Danny Thorpe, Leader of the Council.

4.

Urgent Business

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

Minutes:

There was no urgent business.

5.

Declarations of Interest pdf icon PDF 45 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.

6.

Minutes pdf icon PDF 69 KB

Members are requested to confirm as an accurate record the Minutes of the meeting held on 7 March 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 7 March 2018 be agreed and signed as a true and accurate record.

7.

Organisational arrangements for the health and care system in Greenwich pdf icon PDF 52 KB

To receive a report outlining the organisational arrangements for the health and care system in Greenwich, and to approve the proposal for the establishment of a Health and Wellbeing Executive group.

Additional documents:

Minutes:

The Director of Health and Adult Services presented the report. He drew Members’ attention to the Appendices, highlighting where the proposed Health and Wellbeing Executive would fit in with current organisations.

 

It was considered that with regard to ‘Appendix 2 Overview of Health and Care Services in Greenwich’ the levels of care were displayed in reverse.

 

Appendix 2 to be updated and circulated.

Action: Health and Adult Services

 

Members welcomed the proposal, and felt the diagrams were helpful for understanding where bodies were positioned.

 

The Director of Public Health and Wellbeing explained that the membership of the Executive would be open but that it needed to be effective. He clarified that the Executive’s Terms of Reference would be available by the time of the next meeting of the Health and Wellbeing Board.

 

Resolved –

 

1.       That the organisational arrangements for the health and care system in Greenwich be noted.

 

2        That the establishment of a Health and Wellbeing Executive group to support the Board in operationalising its decisions and priorities and to develop implementation plans for Board approval, be agreed.

 

 

8.

Health and Wellbeing Strategy update pdf icon PDF 81 KB

To receive and comment on the report regarding progress and plans for the implementation of the Health and Wellbeing Strategy.

Additional documents:

Minutes:

The Director of Public Health and Wellbeing presented the report.

 

In response to questions from the Board, the Director of Public Health and Wellbeing replied that performance indicators would be presented to the Board in a separate report. Existing priorities would not be overlooked.

 

An extended version of Appendix 1 to be circulated showing existing priority arrangements.

Action: Public Health and Wellbeing

 

The Board queried how children’s services fitted into the Strategy. The Director of Public Health and Wellbeing noted that Children’s Services were part of the Health and Wellbeing Board but that a dialogue was needed on how they fully connected to the Strategy.

 

The Board queried public involvement in the Strategy. The Director of Public Health and Wellbeing recognised that a balance had to be struck between creating a clinical strategy and the public’s perception. The Board felt it was essential that the public understand how the Strategy was reached even if there was disagreement from some individuals.

 

The Cabinet Member for Children’s Services felt the process of refreshing the Strategy had been inclusive, and that it was not the intention to exclude previous priorities.

 

Resolved –

 

That the progress and plans for the implementation of the Health and Wellbeing Strategy for the Royal Borough of Greenwich 2019-2023 be noted.

9.

Developing a Clinically Led Commissioning Strategy for Greenwich 2018 - 2021 pdf icon PDF 33 KB

To receive a presentation from Lewisham and Greenwich NHS Trust.

Additional documents:

Minutes:

The Board received a presentation from the Managing Director NHS Greenwich CCG on “Developing a Clinically Led Commissioning Strategy for Greenwich 2018-2021”. 

 

Dr Ellen Wright, Chair NHS Greenwich Clinical Commissioning Group, commented on the need to involve partners and public in the Strategy.  She said they needed to consider how they delivered primary care, they needed to look at all initiatives and think creatively.

 

The Managing Director NHS Greenwich CCG informed the Board that there had been an announcement from the Government that there was to be an average funding increase of 3.4% for the NHS. While welcomed, he suggested that a 4 to 5% increase was needed if radical transformation was required. The question now was how those new resources were used.

 

The Chief Executive of Lewisham and Greenwich NHS Trust commented that in relation to the increased funding they were not starting from a position of financial balance and they had existing significant financial challenges. He suggested that the funding was more like to go to existing services.

 

The Leader of the Council proposed that a formal letter be sent to the Government thanking them for the funding but emphasising that it was still a deficit.

 

The Board raised the issue of changing demographic trends.

 

The Managing Director NHS Greenwich CCG confirmed that would be considered. One aim was to tackle matters before individuals ended up the system and to facilitate a better discharge process.

 

The Director of Public Health and Wellbeing noted that Greenwich had a good performance in terms of delayed transfers of care.  

 

The Chief Executive of Lewisham and Greenwich NHS Trust said that sustainability and transformation partnerships had looked at population growth and an ageing population in South East London. The question was could they manage increasing demand without building a new hospital. He stressed that they needed to capitalise on the relationship between health and social care.

 

The Leader of the Council commented that public perception was that a growing borough population required another hospital.

 

The Board raised the issue of GP retention and recruitment.

 

The Chair NHS Greenwich Clinical Commissioning Group informed the Board that the GP Review Board was looking at the matter. They were looking at for example a mentoring scheme for new GPs, a retainer scheme for those who did not want to work full time, and they were looking at recruiting abroad. They had to look at the matter more broadly, including better use of pharmacists and better use of IT. She commented that GP numbers were not going to go up rapidly.

 

The Leader of the Council commented that GP hours were an issues for many people, and that many people preferred to talk to a GP rather than use an online service.

 

During discussion of the matter the Director of Strategy Metro GAVS noted that NHS bureaucracy was an issue.  The Cabinet Member for Adult’s Social Care, Health and Anti-Poverty noted the challenge of getting GPs and the pressure of more older people.

 

The Managing Director  ...  view the full minutes text for item 9.

*

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

 

The member of the public sought clarification on the difference between an integrated care system and accountable care system.

 

The Managing Director NHS Greenwich CCG stated he would supply the questioner with a copy of The King's Fund Report.  He clarified that the integrated care system sought joined up care and commissioning for outcomes, to try and get providers to work together to get the best outcome for the population.

 

The member of the public said the plan for primary care provision was difficult to understand, and he questioned if they would translate it into something the general public could understand.

 

The Managing Director NHS Greenwich CCG said the plan was a draft and it was recognised it would need to be explained to the public in an understandable way. He said it was not about creating all-in-one centres, it was about creating a hub for services.