Councillors and committees
Agenda and minutes
You can view the individual reports for this meeting by selecting the headings from the numbered list of items at the bottom of this page. Alternatively you can view the entire agenda by selecting 'Agenda Reports Pack' below.Watch key Council meetings here
Venue: Guildhall, Kingston Upon Thames
Contact: Marian Morrison, Democratic Services Officer Tel: 0208 547 4623/email; email@example.com
Questions and Public Participation
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.
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
Apologies were received from Councillor Diane White, Dr Naz Jivani, Dr Peter Smith, Dr Anthony Hughes, Dr Mark Potter, Robert Henderson and Siobhan Clarke.
Councillor Hilary Gander attended on behalf of Councillor Diane White and Diane Chalmers on behalf of Siobhan Clarke. Joan Myers, Assistant Director, Health Services and Child Nurse, AfC attended on behalf of Robert Henderson. Dr Annette Pautz, GP also attended the meeting.
As this was the last meeting which Grahame Snelling would be attending as Health Watch representative, Councillor Liz Green took the opportunity to thank him for his contribution to the Board and the work he had done for local patients. Cllr Rowen Bass, Chair of the Health Overview Panel 2017/19 echoed this view. It was noted that Dr Liz Meerabeau would represent Healthwatch at future meetings and Grahame Snelling would continue as a Healthwatch Board Member.
To confirm the minutes of the meeting held on 15 March 2018
The minutes of the meeting held on 15 March 2018 were confirmed as a correct record and signed.
To note the updates
The report, requested by the Co-Chair (Leader of the Council), provided a number of updates on progress with health related areas and requested that the board gives its approval to Kingston’s Public Health Department setting up a Health Protection Committee with the terms of reference being brought to a future Board meeting for approval.
Updates were received on the following areas:
· Thrive Kingston, a mental health strategy one year on
· Joint Strategic Needs Assessment
· Refugee resettlement
· Self Care and Connect Well
· Health Protection
· Measles update
· Heatwave and summer preparedness
· Winter Planning and seasonal flu immunisation
· Antenatal and new born screening
· Sexual Health
· Sector led improvement event across London – Alcohol
· Public Health grant
· Uptake of cycling resulting from Mini-Holland schemes
· Local Plan
· Annual engagement assessment
· Patient and public engagement review 2017/18
· Reducing health inequalities for patients with learning disabilities
· SWL Health and Care partnership update
· Healthy London Partnership
· Quality in Primary care
· Red Bags (for care home residents) to be rolled out across England
· Kingston Co-ordinated Care
· Financial performance
· AGM on 11 September at 12.30 for 1.00pm, King’s Centre
· CAMHS and Dementia priorities
Adult Social Care
· Maximising independence
· Work in Hospitals
Voluntary Sector – KVA
· Contractual and senior staff changes
· Health and wellbeing network
· Kingston Data Hack
· Connect well Kingston
· Food Poverty (verbal)
A verbal update was given by Healthwatch. The latest annual report has been circulated and reflects a year of consolidation and progress it also identifies five areas for focus for the following year:
· a service user review on IAPTS and at Tolworth Hospital plus implementation of the Mental Health Strategy
· all age learning disability partnership venture
· experiences of hospital discharge
· Connect well Kingston and the on line prescribing tool
· Safeguarding in the community.
KVA gave a further update about the work being undertaken by the Voluntary Sector on work with Public Health on food poverty. Food poverty is often symptomatic of wider disadvantages which need interagency support. KVA has been asked to co-ordinate a local food poverty action plan and is examining the current system and root causes. A survey and workshops are being planned with food bank beneficiaries and others who may experience food poverty first hand. Patricia Turner asked the Board to consider how HWB partners can make recommendations which fall under respective remits.
The Co-Chair proposed that the action plan be brought to a future meeting and added to the HWB work plan.
Further details were given about the CCG’s CAMHS 5 year Transformation Plan and the greater emphasis on prevention and developing young people’s resilience. The Board heard that levels of self harm and suicide are reducing which may be outcomes of the preventative programme. (Note further discussion is captured in the HWB Strategy update.)
Details were also given of a wide range of initiatives covering mental health in schools, areas of relative deprivation in Norbiton, Malden Manor and Chessington South and utilising the diversity of the work force including Rangers, street sweepers and postmen ... view the full minutes text for item 5.
To make appointments
The Council appoints representatives to a number of bodies and Strategic Committees make appointments relevant to their remit. The following vacancies arising from expiry of terms of office or resignation needed to be made:
· Kingston Hospital NHS Foundation Trust Governor (3 year term) – one vacancy arising from the retirement of former Councillor Ken Smith. (Note the second representative’s term of appointment, Councillor Margaret Thompson, continues until June 2020).
· London Health and Wellbeing Board Chairs (the Leader)
· NHS South West London Sustainability and Transformation partnership Leadership Group (the Leader)
· Kingston Primary Care Commissioning Board (Leader or Portfolio Holder)
The following appointments are made:
Kingston Hospital NHS Foundation Trust Governor (term 3 years to June 2021) – Councillor Rowena Bass
London Health and Wellbeing Board Chairs (the Leader) (term one year) –
Councillor Liz Green
NHS South West London Sustainability and Transformation partnership Leadership Group (the Leader) (term one year) – Councillor Liz Green
Kingston Primary Care Commissioning Board (Leader or Portfolio Holder) (term one year) - Councillor Liz Green
Voting – unanimously in favour
To receive the report on progress with the strategy
The report provided a summary of progress over the past six months in respect of implementing the Strategy recommendations which relate to four themes:
· Children and young people
i.e. CAMHS, a single point of access to services, development of a Joint All Age Learning Disability Strategy, programmes for obesity, assessments of children and young people participating in risky behaviours progress with the young carers needs assessment.
· Mental health
i.e. Thrive Kingston, Suicide Prevention Strategy, CAMHS transformation plan, dementia strategy action plan.
· Older people and people with long term conditions
i.e. social prescribing and the Connect Well model
· Addressing the needs of socially excluded and disadvantaged communities.
i.e. action plan for initiatives in most disadvantaged areas, the Health Improvement Plan for marginalised communities, mental health improvement programme for disadvantaged communities
Particular focus was given to the two priority actions:
· Delivery of the transformation plan for Child and Adolescent Mental Health Services (CAMHS) (pages C2-C4)
CCGs are required to publish a 5 year strategic plan which is refreshed annually. Good progress has been made to increase access via on-line counselling and increase capacity for a number of services including eating disorders. There has been a spike in the number of children and young people admitted to inpatient care (14 in 16/17 compared to 9 in 15/16). A proportion of those admitted had a learning disability and action has been taken to implement Care and Education Treatment Reviews to proactively prevent admissions.
The demand for Autistic Spectrum Disorder and Attention Deficit Hyperactivity Disorder services has continued to increase. Additional investment has been made but the reduction in waiting times is taking longer than planned.
Families have identified a need for day to day advice to manage ASD/ADHD traits.
· Implementation of the Joint Dementia Strategy, including creating “Dementia friendly Kingston” (page C4)
In September 2017 RBK achieved a “working towards” rating for a dementia friendly community status and the annual review will take place in the autumn.
1,800 training and awareness sessions have been held across a range of public and private sector organisations and businesses.
Training for community transport operators has happened and talks to secondary school children have been planned.
In response to a question about the increase in inpatient care for CAMHS services Dr Moore explained that there has been a recent increase in the profile of CAMHS services and this could account for the increase in demand and he drew attention to the need for good services and support in the community. Stephen Taylor added that there had been a 50% increase in demand across London and that demand is likely to be high for the next three years. Tonia Michaelides stated that across South West London, preventing people becoming mentally unwell and increasing resilience is a priority for both children and adults and inpatient admissions should be avoided. A Member pointed out, however, that beds can be a place of safety as challenges can often be found in the home. Other pressures for young people ... view the full minutes text for item 7.
Annual Public Health Report 2018 - Clearing the Air
To consider the recommendations for collective action
The Annual Public Health Report 2018 “Clearing the Air” was introduced by Iona Lidington, Director of Public Health. Annual reports are a statutory duty and this year’s has embraced a digital approach was launched on 21 June 2018. The report picks up on progress with the previous year’s recommendation and information can be found on line.
The report explained that air pollution is the biggest environmental cause of ill-health in the UK and in Kingston it is estimated to contribute to the equivalent of one in 20 deaths of people living in the area, with children and the unborn being the worst affected. People with long term conditions, older people and deprived communities are also impacted. Road traffic is the single biggest contributor to air pollution locally, followed by domestic and commercial gas. Three schools have pollution above EU limits. However air pollution in Kingston has reduced and if action is taken this will reduce further and we all have a part to play.
Air pollution contributes to ill health – primarily cardiovascular disease, followed by chronic lung disease, infections and cancer and it can also widen inequalities. The National Institute for Health and Care Excellence has identified seven ways to reduce the impact of air pollution from roads:
· Development Management
· Clean air zones
· Reducing emissions from public sector transport and fleet vehicles
· Smooth driving and speed reduction
· Walking and cycling
· Awareness raising.
The council published its Air Quality Action plan in 2017 and has taken a number of actions including:
· New planning conditions to manage the air quality impact of new developments
· Calling for improvements to bus routes to reduce pollution
· Monitored and reported on air quality at 40+ locations in the borough
· A number of initiatives around cycling including cycle skill sessions and the new cycle route in Portsmouth Road.
Members welcomed the report and the focus on this area and asked how schools and the community were getting information about air quality and Iona Lidington confirmed that there had been a number of workshops, and actions around healthy schools and sustainability.
Dr Moore commented during the discussion that GP surgeries were having difficulty filling staff vacancies due to very limited parking local to the Surbiton Health Centre. He also commented that buses were very uncomfortable for older people.
RESOLVED that: the report is noted.
Voting: Unanimously in favour.
To note the report summarising the work of the Health Overview Panel at the meetings held on 28 March 2018 and 20 June 2018
The report updated the Board on the meetings of the Health Overview Panel held on 28 March and 20 June 2018.
At the March meeting the Panel considered the KCCG’s interim report on the provision of services in Kingston for people with Emotionally Unstable Personality Disorder. The Panel requested that Kingston CCG maintains a dialogue with Healthwatch Kingston and responds to further observations issues and questions that Healthwatch may have and a further report and action plan is reviewed again by the Panel in 6 month’s time to scrutinise progress.
The Panel also considered transport for children and young people with special educational needs and disabilities. This is a statutory service for SEND children aged 5-16. A revised SEN Transport Policy introduced in September 2016 has enabled the development of a wide range of activities to promote travel independence in line with the preparing for adulthood aspiration in the 2014 Children and Families Act. This included the independent travel training offered by Balance which has proved very successful. The Panel recognised the achievement since 2016 and recommend the consideration of the introduction of telephone follow up with parents of students who have undertaken the Balance programme to ensure progress is maintained.
The Panel also received a detailed report on Progress with the Locality and Wellbeing Teams from the Kingston Co-ordinated Care Programme Manager which looked at the new way of working being piloted and implemented locally across health, social care and the voluntary sector in order to achieve improved and more effective outcome for local residents.
There are two main objectives:
· To ensure people stay independent, healthy and well for longer with good community support so they can enjoy their lives to the full
· To ensure people have easy access to top quality. Person-centred, co-ordinated health and social care support when they need it.
Four Locality Teams and Wellbeing Teams are being introduced at Kingston, New Malden, Kingston, Surbiton and Chessington to enable a more targeted support for people in their own homes. This will be delivered by a skilled workforce supported by local health and adult social care providers and the voluntary sector.
The June meeting was largely introductory and the Panel received an update on the South West London Sustainability and Transformation Partnership. During question time questions were asked about disabled parking at Kingston Hospital and the Director of Nursing and Quality, Kingston Hospital gave a brief update on the progress of the Hospital’s review and answered questions.
RESOLVED that: the report is noted.
To note the forward plan
Items for the next meeting on 26 September 2018 were agreed as follows:
· Kingston Safeguarding Adults Annual Report 2017/18
· Local Children’s Safeguarding Board Neglect Strategy
· Local Children’s Safeguarding Board Child Death Overview Panel Annual Report
· Draft Health and Care Plan
· Child O learning lessons review Kingston LSCB (postponed from 12 July)
· Partners Update
Future agree items:
· Food poverty action plan for the future.
· Terms of reference for the Health Protection Committee
· Update on developing communications to encourage people to seek dementia diagnosis to enable appropriate support
It was noted that a workshop on the Health and Care Plan for Kingston is being arranged to take place before the next Board meeting in September.
Urgent Items Authorised by the Chair
There were no urgent items.
Exclusion of the Press and Public
To exclude the public from the meeting under Section 100(A)(4) of the Local Government Act 1972 on the grounds that it is likely that exempt information, as defined in paragraphs 1 and 2 of Part I of Schedule 12A to the Act, would be disclosed and the public interest in maintaining the exemption outweighs the public interest in disclosing the information for the following two items:
Child J learning lessons review Kingston LSCB
Child O learning lessons review Kingston LSCB
The committee resolved to exclude the public from the meeting under Section 100(A)(4) of the Local Government Act 1972 on the grounds that it is likely that exempt information as defined in paragraphs 1 and 2 of Part 1 of Schedule 12A to the Act, would be disclosed and the public interest in maintaining the exemption outweighs the pubic interest in disclosing the information for the two following items.
Voting: unanimously in favour.
To consider the learning lessons
The report alerted the board to the local and national learning for health agencies from the recent case review concerning Child J. It was noted that the learning has been accepted by agencies and will be progressed.
RESOLVED that: the actions proposed were fully supported by the Board.
Voting: unanimously in favour.
To consider the learning lessons
The report alerted the board to the local learning for agencies in Kingston, particularly around management of concerns for neglect in families, from the recent case review concerning Child O. The Board was asked to note the learning from the learning and improvement case review and to endorse the Neglect Strategy which is due to be launched in the autumn 2018.
RESOLVED that: this item be postponed to the meeting on 13 September 2018 due to the lateness of the hour.
Voting: unanimously in favour