Agenda and minutes

To confirm the appointment of Chair following the Annual Council meeting on 4 May 2021.

It was confirmed to the Board that Councillor Janet Campbell was appointed as the Chair of the Health and Wellbeing Board for municipal year 2021/2022 at the Annual Council meeting held on 4 May 2021.

In accordance with the Council’s Code of Conduct and the statutory provisions of the Localism Act, Members and co-opted Members of the Council are reminded that it is a requirement to register disclosable pecuniary interests (DPIs) and gifts and hospitality to the value of which exceeds £50 or multiple gifts and/or instances of hospitality with a cumulative value of £50 or more when received from a single donor within a rolling twelve month period. In addition, Members and co-opted Members are reminded that unless their disclosable pecuniary interest is registered on the register of interests or is the subject of a pending notification to the Monitoring Officer, they are required to disclose those disclosable pecuniary interests at the meeting. This should be done by completing the Disclosure of Interest form and handing it to the Democratic Services representative at the start of the meeting. The Chair will then invite Members to make their disclosure orally at the commencement of Agenda item 3. Completed disclosure forms will be provided to the Monitoring Officer for inclusion on the Register of Members’ Interests.

There were no disclosures at this meeting.

To receive notice of any business not on the agenda which in the opinion of the Chair, by reason of special circumstances, be considered as a matter of urgency.

There was none.

Public Questions should be submitted before 12 noon on 14 June 2021 to democratic.services@croydon.gov.uk. Any questions should relate to items listed on the agenda. 15 minutes will be allocated at the meeting for all Public Questions that are being considered.

There were none.

To receive a presentation and discuss an update on the Integrated Care System (ICS).

The Director of Strategy Croydon Health Services, Neil Goulbourne, presented the update. He explained that the transition to the new arrangements in April 2022 would be managed through the One Croydon Alliance structures.

There had been a round of significant organisational changes to the NHS circa 10 years ago and Clinical Commissioning Groups (CCGs) were introduced. Their creation brought greater competition for services and a collaborative approach was encouraged, which differed to previous reforms. He noted that a progress had already been made in Croydon towards integrated working, more so than other regions, which was reflected in the white paper.

The purpose of the white paper, and the legislation to follow, was to encourage development in those collaborative approaches, to remove further of the barriers to integration and to formalise agreements where consensus was identified.

The guidance sets out that services should be delivered locally where possible, closer to patients and their communities.  He informed the Board that the white paper was relatively silent on social care and was primarily NHS and acute care focused. The government had set out an assurance that there would be further reform of social care, but it was not addressed as part of these papers. He added that the white paper was also notably light on Public Health, however  it was clear they would have a role to play.

A Partnership Board would be introduced at Integrated Care System (ICS) level, which would have an advisory role and would create a long term strategy bringing together the NHS and partner. Additionally, there was a newly introduced requirement of a duty to collaborate placed on the NHS and local authorities; however that would not bring a material effect to Croydon as those systems were already in place.

The role of Health and Wellbeing Boards was still seen as important entities, and although it was left to local discretion as to the Boards involvement, it was repeatedly acknowledge that they should be integrated into the developments.

There were three elements to the ICS:

·       ICS Level Body – This would comprise of a board, a partnership board, an executive team and a significant number of staff. Strategic planning would be carried out and the focus would be on inequalities.  There was a disproportionate level of need within Croydon and for which funding was note reflected and should be adjusted accordingly.

·       Place – In SW London there were 6 ‘Places’, Croydon being the largest by population. 

One Croydon Alliance closely matches how Place should operate, as outlined within the white paper. There would need some changes to be made to enable Place to form a contract with the ICS, through which it would have delegated powers.

·      Provider Collaborative – There was a SW London Acute Provider Collaborative which brought together the four Acute Provider Trusts.  Using those systems, there were collaborated share back services and clinical pathways providing mutual aid to manage waiting times. 

The white paper and guidance presented an enhanced role for all collaboratives with a  ...  view the full minutes text for item 5/21

To receive a presentation and discuss an update on the Health and Care Plan refresh.

The Interim Director of Commissioning and Procurement, Rachel Soni, and the Associate Director for System Strategy for SW London CCG and Croydon Health Services, Sam Boyd, introduced the Health and Care Plan Refresh update and outlined the following:

·      The Council was refreshing the Plan, to be completed by 1 October 2021.

·      The Plan was forward and backward looking and due to the pandemic some milestones had not progressed to the point as originally planned.

·      An engagement event was due to be held on 24 July 2021 and local resident’s and patient’s input would be built into the refreshed Plan.

·      The three aims of the refreshed Plan that were co-designed with local people in 2019 would remain as; a proactive and preventative approach; to making most of community assets; and to ensure services were in the heart of communities.

·      The Health and Care Plan covered every health and care service delivered across Croydon.

The Chair thanked officers for their update and invited questions and comments from the Board.

The Vice Chair stated that the aim now was to refresh the Plan, taking into consideration the impact of the pandemic. As the Health and Care Plan was owned by the Health and Wellbeing Board, Dr Fernandes asked how the Board was involved in shaping and leading the refresh.

In response, the Interim Director of Commissioning and Procurement stated they had mapped existing stakeholders and documents had been brought together collating learning during the pandemic. The Shadow Health and Care Board tracked the Plan and the delivery so that the Health and Wellbeing Board was assured that the Plan could deliver the Health and Wellbeing strategy.

Additionally, the Associate Director for System Strategy for SW London CCG and Croydon Health Services said that a desktop exercise of work had been carried out by various organisations which included engagement with communities.  Most of the learning, from progress or gaps, were because of the pandemic and often services had changed for the better during this time.

Councillor Hopley highlighted that many different types of services which had evolved during the pandemic and asked how these groups had liaised with aforementioned work as this should form a good basis for the Plan going forward.

The Croydon Voluntary Action (CVA) CEO, Steve Phaure, informed the Board that there were different types of services taking place throughout the whole borough. He was reassured by learning described by colleagues. He added that at local voluntary partnership level there was a lot of discussion in regard to learning and changes to services, which was rich information to shape the Health and Care Plan going forward.

The Interim Director of Commissioning and Procurement agreed with colleagues that presented was a tight timetable and ambition to complete tasks by 1 October, which may require tempering.  There was a total programme structure, and within that a lot of work would take place within groups and fed into the overarching Plan as set out across the organisation. She noted that any plans must be  ...  view the full minutes text for item 6/21

To receive a presentation and discuss an update on Integrated Community Networks.

The Interim Deputy Director One Croydon Alliance, Laura Jenner, introduced the update and explained that the programme was being carried out with voluntary and community partners. She stated that the Integrated Community Network Programme and Locality work aims rooted from the Croydon Health and Care Plan moving services locally to connect and support with the community. The aim was to focus on prevention, unlocking community and putting services back into the heart of the community within the six Integrated Care Networks (ICNs).

This work had commenced within Thornton Heath and was now rolling out within the other five localities. Within Thornton Heath, staff had been co-located with community nursing, occupational therapy, pharmacists, network facilitators, Age UK PICs and also mental health PICs as well as under 65 social workers who had recently joined. Talking therapists were available to speak on subjects such as anxiety and loneliness. A huge amount of work had been carried out to connect with the local community to support the clients in a multi-disciplinary way which had resulted in excellent outcomes.

It was recorded that some colleagues were apprehensive, but the feedback had been positive and this approach to working was found to be beneficial.

The model was an asset based model using a person centred point of view. A Talking Point had been set up which had been virtual during the pandemic.  This brought together voluntary groups with referrals from GPs to support people with housing, benefits and connecting them with the community which had been very successful in Thornton Heath.

The CVA CEO gave an overview of the work being carried out with the Kings Fund Programme, which had resources to support the wider work across Croydon.  This had taken place across the borough and food relief had been provided from early on in the pandemic with the emphasis on people in the community supporting each other. He said that this was Croydon’s unique contribution to devolution in the borough.

The Healthwatch Croydon CEO added that this brought together representatives from the statutory bodies involved in the One Croydon Alliance with the voluntary sector partners to deliver this model.  There were challenges in the large and diverse range of organisations within Croydon, supporting people in the community to develop a model of leadership, which was being worked through.

In addition, there was a need for the ICNs to work together with a range of voluntary organisations to ensure people were connected with their communities which puts less demand on statutory services. Money is tight for all organisations concerned and there was a need to develop a range of preventative services which could only be done by diverting resources from statutory services.

·      This was being worked on through the Funding and Commissioning Group to effect change and deliver improved outcomes for individuals.

·      Cllr Hopley asked how data was being tracked regarding the different needs of residents within the 6 localities. 

·      In response, JL said a broad needs assessment analysis had been carried out which could  ...  view the full minutes text for item 7/21

To receive a presentation and discuss an update on the Croydon Mental Health Transformation programme.

The Deputy Head of Mental Health Commissioning SW London CCG Croydon Place, Wayland Lousley, introduced the Croydon Mental Health Transformation update. The Woodley Review, which was review of mental health services was launched in late 2016 to assess progress against Croydon’s mental health strategy (2014-19) and identify trends in inequalities, took place where there was clear evidence that there was a disproportionate model of care delivered in acute settings for mental health rather than across the voluntary sector. 

A need was identified to develop a vision to look at an alternative which was more preventative and early intervention focused. A blue print was built to deliver this vision over a number of years ensuring the funding was correct. It was noted that some start dates were delayed because of the pandemic. Despite this, the Recovery Space was actioned in October 2020, which was an alternative café style setting for people presenting with mental health crisis, but who had been assessed as not needing clinical intervention and would enable them access to ongoing support across the voluntary sector.  This was actioned in October 2020 and had been extremely successful. 

The key focus was to develop the first pilot mental health and wellbeing Hub, which would be delivered in the Central area in September/October 2021 and the second hub going live in 2022/23.  Leading on from the successes of the Local Voluntary Partnership across Croydon over the past two years, a bespoke focus was placed on mental health. The focus on key communities such as The Turkish Youth, Asian Resource and Croydon BME Forum, the Body and Soul Initiative (for people experiencing HIV) and to extend the counselling provision which was in response to the impact of Covid and preparing for the surge to meet the expected demand going forward.

Underpinning all the work was a focus on ethnic minority interventions where there was a need. Another initiative was the Ethnicity in Mental Health Improvement Programme, which was a development of an expert panel of local leaders to start addressing what was happening within communities to engage with them in a more productive way and at a deeper level. Hubs would be able to support those communities more effectively and look at the pathways through the crisis and the community pathway to improve the experience and inpatient services with better outcomes as a result.

Croydon Integrated Community Network Plus outlined all of the activity across the out of hospital work, the engagement with the GP communities and the connection between the council and out of hospital work, which brought together social and physical health care.Mental health had been a key partner within this process and this was about dealing with people with physical health as a primary issue, but also mental health as a presenting need.

The model of care for mental health wellbeing hubs was being developed in partnership with the BME Forum, in collaboration with SLaM.  These hubs would be hosted by the voluntary sector with clinical input from  ...  view the full minutes text for item 8/21

The following motion is to be moved and seconded where it is proposed to exclude the press and public from the remainder of a meeting:

“That, under Section 100A(4) of the Local Government Act, 1972, the press and public be excluded from the meeting for the following items of business on the grounds that it involves the likely disclosure of exempt information falling within those paragraphs indicated in Part 1 of Schedule 12A of the Local Government Act 1972, as amended.”

This was not required.