Councillors and committees
Agenda and minutes
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Questions and Public Particpation
A 30 minute question and answer session at the start of the meeting –advance notice of questions is encouraged.
There were no questions from members of the public on matters not on the agenda.
Declarations of Interest
Members of the Board are invited to declare any disclosable pecuniary interests and any other non- pecuniary interests (personal interests) relevant to items on this agenda.
There were no declarations of interest.
Apologies for Absence and Attendance of Substitute Members
Jane Bearman and Grant Henderson attended the meeting as substitutes for Stephen Taylor and Siobhan Clarke respectively. James Waugh also attended in an informal capacity on behalf of Grahame Snelling of Healthwatch.
To confirm the minutes of the meeting held on
The minutes of the meeting held on 14 September 2017 were confirmed and signed.
To alert the Board to emerging local and national policy and legislation, development opportunities and useful resources, to provide updates on matters of interest and support the Board with forward work planning.
The Board received updates from the Directors of Adult Social Care, the Director of Public Health and the Managing Director of the Kingston & Richmond Local Delivery Unit on a variety of issues including:
· Priorities emerging from the Child Dental Health Joint Strategic Needs Assessment
· Innovations and changes in respect of services for children and young people new audiology pathways, integration of Your Healthcare’s confidential and holistic drop in service for young people with the public health service specification, a weight management pilot, proposals to enhance asthma awareness in schools, a strategic review of the Risky Behaviours Service and new approaches to an increase in the illicit use of Xanax.
· The award of £338,000 of Government funding to support vulnerable refugees and migrants to learn English and integrate locally
· An update on progress with the resettlement of Syrian refugees into the Borough under the Syrian Vulnerable Persons Relocation Scheme
· The award of £277,000 over two years from Royal Marsden Partners to develop a model for increasing the participation rate in cancer screening programmes, focussing particularly on marginalised and disadvantaged groups or those who have never previously taken up the offer
· The local response to measles and seasonal flu outbreaks
· The implementation of a new BCG vaccination pathway
· An update on Cold Weather plans
· The award of a contract for the design and build of a new dementia nursing home on the former Newent House site in Surbiton
· A pilot arrangement for the use of postal workers to visit older people living alone
· Proposals for the development of additional capacity to support people with learning disabilities who lived in residential homes to step down to community based supported living
· Continued progress with the Kingston Co-ordinated Care programme.
· Revisions to the constitution of the CCG
· NHS England operating guidance to CCGs and providers
· An update on the Cedars Bed Move to Teddington Memorial Hospital
· The delivery of a ‘Stay Well Pharmacy’ campaign urging patients to initially consult a pharmacist on minor illnesses
· A Public Health England campaign to raise awareness in women over 70 of the symptoms of breast cancer
Verbal Updates from Kingston Voluntary Action and Healhwatch Kingston
The Board received updates on activity from Patricia Turner of Kingston Voluntary Action (KVA) and James Waugh, who was attending the meeting on behalf of Grahame Snelling of Healthwatch.
· The new commissioning contract was about to be signed, together with three other contracts
· The Health & Wellbeing Network had met in March and received a presentation on the ‘Expert Patient’ programme. Tonia Michaelides was due to attend the next meeting to engage on the development of the Health and Care Plan.
· A bid to the Department of Health and Social Care for funding to support the social prescribing model had been unsuccessful
Digital tools for the promotion of
‘Connect Well’ were being examined
James Waugh reported that:
· Healthwatch continued to work with volunteers, board members and staff to develop its strategies and policies
· The delivery of various contracts with the Council was being ramped up
· Work was being undertaken with Richmond Healthwatch and Kingston Hospital on the Blue Badge car parking charges issue.
· Healthwatch had recently referred the lack of delivery of a programme for Kingston residents with Emotionally Unstable Personality Disorder to the Health Overview Panel
To formally receive the Kingston Safeguarding Adults Board Annual Report for 2016/17
Members received the 2016-17 annual report of the Kingston Safeguarding Adults Board. The report outlined progress made during the year in safeguarding vulnerable adults at risk and was produced in consultation with key stakeholder partners.
The Board noted that a total of 893 safeguarding concerns had been raised during the course of the year, leading to 361 enquiries. This represented an increase in concerns which was viewed as a positive outcome because it demonstrated that partners and the wider community were aware of adult safeguarding and how to report it. There had been 781 Deprivation of Liberty requests received, compared with 729 in the previous year. 90% of referrals were received care/nursing homes with 10% coming from hospitals.
RESOLVED that –
the annual report of the Kingston Safeguarding Adults Board for 2016/17 be received.
Voting – Unanimous
To approve the refreshed Pharmaceutical Needs Assessment
The Board gave consideration to the refreshed Pharmaceutical Needs Assessment (PNA).
The PNA set out an assessment of the current need for community based pharmaceutical services commissioned by NHS England and was used by NHS England to make decisions on new pharmacy applications, changes to pharmaceutical services or the relocation of pharmacy providers. It was also used by local commissioners reviewing the health needs and services for the local population. The Kingston PNA examined the local population and health needs, assessed whether those needs were being met by pharmaceutical services, described the current level of services and sought to identify gaps in provision.
Members noted that the PNA had found there to be a good pharmaceutical provision overall in terms of geographical spread, access and service provision. There were 2 localities that had less pharmacies per head of population (South of the Borough and the Coombe Lane area) but access was still considered good for residents in these areas. It had concluded that there were no gaps in the provision of pharmaceutical services across the borough.
However, local actions and recommendations identified opportunities for improved working. These included maximising access to a range of advanced and locally prescribed services such as the New Medicines Service and Medicine Use review, Promoting Self Care agenda and Healthy Living Pharmacy interventions. Opportunities were identified for more collaborative working, for examples Pharmacy playing a role in the Kingston Coordinated care agenda.
The Board expressed its appreciation for the thoroughness of the review and welcomed the positive relations with pharmacies indicated by the fact that every single one had engaged with the Assessment. It was felt this augured well for self care initiatives. The difficulties of obtaining data on unfilled prescriptions (those not dispensed) was noted.
RESOLVED that –
The Pharmaceutical Needs assessment attached at Annex 1 to the agenda be approved.
Voting – Unanimous
To consider the Motion which the Council at its meeting on 12 December 2017 referred to this Board and to the Adults and Children’s Committee and to receive the Adults and Children’s Committee’s comments on the Motion
At its meeting on 12 December 2017 the Council had referred to both the Adults and Children’s Committee and this Board a motion in support of the mental health initiative ‘Thrive London’.
In considering the motion the Board was updated on progress with implementation of the mental health strategy ‘Thrive Kingston’, approved in 2017. Co-produced with more than 200 people from within the local community, the Strategy set out the start of a five year journey to enhance the mental wellbeing of the whole Kingston community, to shift efforts to prevention and to transform the experience and care of people with mental health problems, their families, friends and carers. The Strategy was focused on mental health services for adults and was aligned with children’s mental health service plans.
Members noted that the themes of the Strategy were wellbeing and prevention, early intervention, community connection, access to services and joined up care.
The priorities for 2017/18 were:
· Early years, children and family, schools – prevention
· Workplace mental health
· Directory of services
· The development of primary care
· Peer support networks
· Triaging and single point of access (and care coordination when required)
· Roadmap of services and the establishment of mental health and wellbeing hub
A number of the priorities of Thrive Kingston aligned very closely with Thrive London and achievements arising from the strategy included:
· work to empower individuals and communities to lead change, address inequalities that led to poor mental health and create their own ways to improve mental health. This included a commitment to explore the role of metal health and wellbeing champions from within the community in order to help develop mental health friendly communities.
· The implementation of activities to help people maintain good mental health and wellbeing including a training course called ‘Practical Ideas for Happier Living’ and the mental health first aid programme designed to end mental health stigma and discrimination. Some 133 frontline staff had attended the training in 2016 and 2017.
· Plans to work with Kingston and Richmond Youth Councils and Kingston Healthwatch to further engage young people in promoting positive mental health.
· Commitments to support Kingston employers to make mental health and wellbeing central to the workplace and to enhance employment support
· The exploration of new ways to access services and support including consideration of the use of digital technologies
· Continuing implementation of Kingston’s Suicide Prevention Strategy.
Members noted the comments of the Adults and Children’s Committee and endorsed the motion referred by Council in full.
RESOLVED that –
The motion set out below be supported:
‘This Council acknowledges that:
1. two million Londoners experience poor mental health, which equates to 62,500 people in each borough,
2. London’s suicide rate increased by 33% from 552 to 735 incidents between 2014 and 2015 – the highest figure recorded by the Office for National Statistics since records began.
‘This Council understands that:
1. employment for Londoners with a mental health problem is 31 percent lower than the UK average and that the financial cost of mental ill-health ... view the full minutes text for item 33.
To advise the Board of the findings of a report by Dr Ruth Chapman into access to healthcare for unaccompanied asylum seeking children and young people.
The Board received the findings of a report into access to healthcare for unaccompanied asylum seeking children and young people. There were approximately 25 young asylum seekers in the borough and the review, produced by Dr Ruth Chapman, drew both on their experiences and those of the multi-agency staff who supported them.
The main recommendations arising from the review were that;
· GPs should carry out an annual health review of unaccompanied young asylum seekers and develop a good understanding of refugee needs so as to influence access to healthcare both through childhood and beyond into adulthood;
· The ‘Health Passport’, which was the last Looked After Children medical just before the young person turned 18, and accompanying health action plans, should be translated into the young person’s language of origin; and
· Multi-Disciplinary team meetings should be re-instated in relation to work with young asylum seekers due to the importance of professionals understanding each other’s roles and the value of face to face meetings.
Members sought clarification on a number of issues arising from the review including the capacity in the primary care system to undertake the annual reviews, the responsibility for commissioning and the reasons for not providing translations of ‘Health Passports’ earlier than 18. A response would be sought on these matters from the report author.
RESOLVED that –
Subject to clarification from the report author on the outstanding question raised at the meeting the following recommendations from the review be endorsed:
1. GPs in Kingston have specific training and support to work with Unaccompanied Asylum Seeking Children and carry out a yearly health review of them;
2. the health passport be translated into the young person’s first language at the age of 18 years; and
3. consideration be given to Multi-Disciplinary meetings being reinstated for some work with children looked after, including Unaccompanied Asylum Seeking Children.
Voting – Unanimous
Members received a summary of the outcomes of an informal workshop designed to review the future purpose and form of the Board.
The workshop, held on 5th March 2018 and attended by both members of the Board and a wide variety of other partners, examined the core purpose of the Board, current opportunities and challenges for partnership working and ideas for the Board’s future operating model. Consistent themes identified in the discussions were that;
1) The Board should set the strategic direction of local preventative work and priorities in health and social care
2) The most important outcomes for the Board’s work were prevention of ill-health, improvement of wellbeing and reduction of health inequalities; and
3) Recognition that the Board had a small number of core statutory functions that it must fulfil, including development of the Joint Strategic Needs assessment and Joint Health & Wellbeing Strategy and assurance of national screening and immunisation programmes, but the Board should not be limited to these functions.
There were also suggestions that the Board’s purpose could include:
1) Direct oversight of the commissioning of local public health, NHS and/or care services;
2) Responsibility for local implementation of national and regional health and social care policies and initiatives; and
3) Oversight and formal decision making responsibility for a small number of specific joint priority projects, eg Kingston Coordinated Care.
Participants identified a number of existing opportunities in the way local
partnerships already operated, including the depth of existing relationships, the relatively compact size of the borough, geographical alignment between NHS and local authority boundaries, a strong evidence base from the Joint Strategic Needs Assessment and examples of good practice partnership programmes already in place, including Kingston Coordinated Care and the local dementia and mental health strategies.
The most commonly cited barriers to a stronger partnership were budget,
resources and mutual understanding. Challenges associated with being held
accountable for implementation of differing, and sometimes conflicting,
organisational priorities were also a key theme of discussions. Even where broad priorities were consistent, it was a complex challenge for some organisations to align their activities with plans set nationally, regionally, sub-regionally and in neighbouring boroughs as well as in Kingston.
With regard to the future operation of the Board there were suggestions that it should appoint an independent expert lay chair, hold more informal workshops and seminars and fewer formal meetings, include a wider range of organisations within its membership and set its activities and priorities based on identification of a shared agenda building on existing plans.
It was proposed that the Director of Public Health develop a full set of proposals for the future of the Board in informal consultations with existing members and other partners. This would include the identification of options and associated costs for new models of governance and reviewing evidence from the Joint Strategic Needs Assessment to support a priority setting process for the reconfigured Board later in 2018.
RESOLVED that –
the Director of Public Health be delegated to develop a formal ... view the full minutes text for item 35.
Urgent Items Authorised by the Chair
There were no urgent items.