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Agenda item

Health & Wellbeing Board

This Sub-Committee is asked to review the work of the Health & Wellbeing Board. (Report to follow)

Minutes:

The Sub-Committee considered a report from the Chair of the Health and Wellbeing Board, Councillor Louisa Woodley which, along with a presentation delivered at the meeting, provided an overview on the work of the Board.

A copy of the presentation can be found at the following link:-

https://democracy.croydon.gov.uk/documents/b7133/Health%20Wellbeing%20Board%20-%20Presentation%2028th-Jan-2020%2018.30%20Scrutiny%20Health%20Social%20Care%20Sub-Comm.pdf?T=9

Following the presentation the Sub-Committee was given the opportunity to question the Chair of the Health and Wellbeing Board on the work of the Board. The first question concerned the Board’s work with schools on mental health provision for children and young people and whether there were any particular barriers. It was highlighted that the Board had contacted schools on this issue, with it found that the main barrier was often a lack of funding being available to support work in this area. Through the work of the Board funding had been acquired through the Trailblazer Project and also the Mayor of London’s Young Londoners Fund. It was confirmed that an evaluation on the difference made by these projects would be undertaken.

As the presentation had listed the Board being a committee of the Council as a potential weakness and it was questioned why this would be the case. It was confirmed that being a council committee meant that the approach to Board membership could be overly formal and restricted the ability to effectively respond to specific issues. In order to mitigate against this the Board took a flexible approach to representatives being invited to attend as guests. This ensured that the Board was able to have the relevant people around the table to participate in the discussion of specific issues.

As the South London and Maudsley NHS Foundation Trust (SLaM) was not coterminous to Croydon and operated over a wider area, unlike the other partners on the Board, it was questioned whether SLaM was able to be as effective a partner as others. It was advised that partners already worked together through the One Croydon Alliance creating a good working relationship, which had been carried through to the Board with full participation and attendance from SLaM. By working across a wider area, the biggest issue for SlaM was often the number of different local Health and Wellbeing Boards they had to attend, but there were no issues from a Croydon perspective.

It was questioned whether the Board coordinated its work with other forums such as the Violence Reduction Network. The Chair confirmed that she had attended the conference to set up the Violence Reduction Network and had visited Glasgow with others to review their public health approach to violence reduction. The Director of Public Health report on the First 1,000 Days contained many outcomes that linked with the public health approach to violence reduction and there were a number of statutory officers on the Health and Wellbeing Board who had roles on other boards as well.

In response to a question about whether the Board had any work streams focused on the prevention of either domestic or sexual abuse, it was highlighted that these were not normally dealt with by the Board, as they were community safety issues. However the Board could review whether it could add value to the existing work being carried out elsewhere, as it was important not to duplicate the work of others.

It was noted that when they were established, one of the main functions of Health and Wellbeing Boards was to oversee the closer integration of Social Care and Health services. Given that in Croydon integration was fairly well established through the work of the One Croydon Alliance, it was questioned whether this lessened the role of the Board. In response it was highlighted that integration was a continuous journey, with the Board having the power to ensure that partners reported back with evidence to demonstrate how they were working together.  The Health & Wellbeing Board provided the architecture for the strategic leaders of the health and social care systems to come together, with it envisioned that this could be extended in future to include other partners covering areas such as housing and employment.

As a follow up it was questioned whether, given the pioneering integration led by the One Croydon Alliance, whether Croydon was best placed to start a national conversation on the role of Health and Wellbeing Boards. In response it was advised that the role of the Board had been adapted to the needs of Croydon and it was difficult to know whether a similar approach would work elsewhere.

As it was noted that the Board was aspirational, it was questioned whether there was a long term vision for health in the borough. It was highlighted that the Board operated at a strategic level, holding services to account, with other delivery mechanisms responsible for service change. The Board did have priorities for the near future, which included continuing to oversee the integration of health and social care and expanding its remit to include other areas such as housing. There was also a commitment to ensuring that people had a good start in life and a good end of life.

As it was noted that life expectancy across the borough could vary significantly, it was questioned how this was being addressed. It was advised that improving life expectancy in specific areas was challenging particularly in poorer areas as people who were helped tended to move out of the area and be replaced by other poorer people. It was important to recognise that different areas of the borough had different issues which needed to be addressed.

At the conclusion of the item the Chair thanked the Chair of the Health & Wellbeing Board for her attendance at the meeting and her engagement with the questions of the Sub-Committee.

Conclusions

Following discussion of the report, the Sub-Committee reached the following conclusions:-

  1. Although the Sub-Committee recognised that the partners had made significant progress in the development of the Health & Wellbeing Board, it was difficult to reach any concrete conclusions on its performance without measurable targets.
  2. The Sub-Committee felt that there was a certain amount of uncertainty over the long term role for the Board given all the changes made to the health and care systems in the borough.
  3. The Sub-Committee agreed that it would be interesting to review the Board’s effectiveness in influencing the identified wider determinants of health such as housing and employment, once this work had commenced.

Supporting documents: