Apologies were received from Dr Karen Worthington, Khadiru Mahdi and Yvette Stanley.

Gordon Murray, Service Manger Permanency Placements & LAC Services, attended in place of Yvette

There were no declarations of interest.

The Chair commented that Merton had the best perfoming discharge rates in London in January 2018 and congratulated Hannah Doody and James Blythe on this result.

He continued by thanking all members of the HWBB for their work during the current administration

RESOLVED: That the minutes of the meeting held on 28 November 2018 were agreed as an accurate record.

The Director of Public Health presented the  report on the refreshed Merton Story 2018 which provides a snapshot of local needs identified through the Joint Strategic Needs Assessment (JSNA). Producing the JSNA is a statutory duty of  the Health and Wellbeing Board. At the request of HWBB members more demographic data and trends are included this year. The Merton Story describes Merton is a good, healthy and safe place to live, but acknowledges that there are areas for concern and these are covered by the main headings of; Inequalities and the Health divide, Healthy lifestyles and emotional wellbeing, Child and Family vulnerability and resilience, Increasing complex need in an ageing population and lastly a new category of Hidden Harm and emerging issues.

Gordon Murray asked the Board to note that the figure on page 19 for Merton Resident Children with an EHCP had increased was now 1543.

The Director of Public Health confirmed that the information regarding Alcohol Harm related specifically to residents of the Borough. She also explained that it will be helpful to have partners input into the Hidden Harm and Emerging issues section.  A member asked about the data that shows that disabled residents report lower levels of happiness than non-disabled. The Director of Public Health  replied that she would look further at this point.

The Board discussed the proposed infographics and asked for ‘Think Family’ to be included, The Director of Public Health said she would circulate some ideas for the infographics.

Members asked for consideration to be given to addressing risk factors in specific groups, for example people with disabilities, to ensure that these groups have access to all the necessary care. Members also asked if Dental Health details could be included in future.

The HWBB agreed that they were happy with the categories covered by the  Merton Story 2018.

RESOLVED

The Health and Wellbeing Board:

1. Considered and commented on the refreshed Merton Story (2018) – health and wellbeing in Merton, part of the Joint Strategic Needs Assessment.
2. Agreed to actively use the Merton Story as a tool to disseminate the key messages relating to the health and wellbeing of our local population, to inform strategic commissioning decisions.

The Director of Public Health presented the report on Health in all Policies (HiAP), Health and Wellbeing(HWB) Strategy update and HWB Strategy Refresh. 

Board Members welcomed the work that has been done as part of the Health in all Policies action plan and mentioned specifically the successful Prevention Matters workshop, the planned roll out to the social prescribing pilot, the development of the  Social Value commissioning toolkit and the work to promote Healthy Workplaces. The Board noted that Healthy Workplaces included Council Staff and that Smoking was discouraged. The Board also noted the Air Quality Action Plan included in Health in All Policies has been noted as good practice.

The Director of Public Health continued outlining the reporting on the HWB Strategy Indicators; some existing indicators are not for the best ways of measuring progress. Some are red and are longer term, for example the indicator on childhood immunisation. She was asked if there could be a new indicators based on points raised by residents survey that disabled people feel less safe in their communities. The Director of Public Heath said that new indicators will be developed and that that she was open to ideas.

Board Members noted that the CAMHS (Children and Adolescent  Mental Health Services)  waiting time indicator is another consideration, as the issue is not just about speed of access but also about how we support children with mental health issues and some of the data on this is not good quality. The single point of access is an improvement but needs ongoing consideration

The Director of Public Health concluded by talking about how the refresh of the HWB Strategy from 2019 and how this will  to link closely like to the Local Health and Care Plan, building on  the Joint Needs Strategic Assessment (JSNA).  The Local Health and Care plan will itself link   to the SW London Health and Care plan. It was agreed that the October meeting of the HWBB will include a development session to discuss and potentially include consideration of the HWB Strategy but accepted that the timescales for the Local Health and Care Plan will require some elements to be completed before October 2018.

 RESOLVED

The Health and Wellbeing Board Agreed:

1. To note and have oversight of the progress in delivering Health in All Policies across the Council and partners.
2. To consider the update on the outcome indicators measuring progress on the Health and Wellbeing Strategy (HWBS) 2015-18, which is coming to an end.
3. To agree to the proposed process for refresh of the HWBS, consider the relationship with the Local Health and Care Plan and proposed inclusion of the Health in All Policies action plan as a part of the new HWBS; achieving a single action plan for implementation

A verbal update will be presented at the meeting

James Blythe gave the board a verbal update on the ongoing Neurological Conditions work. He had considered the views of the representative with the Motor Neurone Disease who attended the November 2017 HWBB meeting, and received more detailed feedback especially regarding rehabilitation service gaps and counselling. This feedback has been balanced against the needs of a wide range of neurological conditions and a proposal to fill the service gaps will be available in April 2018. It will be important to keep the engagement ongoing. A full report will come to HWBB later in the year

A verbal update will be presented at the meeting

The Director of Environment and Regeneration gave the Board a verbal update on the Local Plan, with an emphasis on the health related issues.

The Plan would support house building, and this raised three important questions for Health Infrastructure in the Borough:

1. Health sites currently owned by NHS, is there a need for investment?
2. Are there places in Merton that lack decent primary care premises – do we need to identify sites?
3. How do we find sites for new homes? What health infrastructure is needed to support the proposed housing growth and how will this be funded? 

James Blythe asked if Chris has the necessary links into the CCG and suggested Lucy Lewis and Andy McMylor as the best contacts.

There was a discussion about levels of occupancy and affordability of new homes. The Director explained that the plan would make reasonable assumptions about the types of accommodation required. The Plan cannot control the market but it can require developers to provide affordable housing, but this is subject to viability. Also the definition of affordable has been stretched up to 80% of market rent. The Council is considering making public the Viability Assessments of Developers. The Council has set up the Local Authority Housing Company in order to build houses, initially 77 units on 4 sites, and will seek to deliver 40% affordable housing.

The next iteration of the Local Plan will be in October 2018 with the Examination in Public likely summer 2019.

The Director Of Community and Housing presented the Adult Safeguarding Board Annual Report, and asked HWBB to note the duties of the Adult Safeguarding Board in line with the care Act 2014. She highlighted the achievements of the Board over the last 6 month; the appointment of an Independent Chair, commitment from partners, gaining additional resources from CCG appointment of permanent Board Manager and  working more closely with the Safeguarding Children’s’ Board including the recent successful conference. 

The Director of Community and housing gave a ’health warning’ regarding some of the data received from partners for the annual report and reported that work is being done to address this through including creation of a data sub group. The Board is also reviewing its current membership.

HWBB members noted that Advocacy services are reported on through the Mental Health trusts. They also noted that Children’s Services are represented on the Board by Paul Bailey and that the Board has linked with Community Safety to look at modern slavery and trafficking.

The Director of Communities and Housing continued by saying that the Board’s next annual report would be looking at key themes across Merton.  She would be happy to join with the Children’s Safeguarding board in considering Trauma/PTSD. The HWBB noted that there would be an event to increase understanding of Adult Safeguarding in October 2018.

RESOLVED

The HWBB noted the Merton Adult Safeguarding Board Annual Report

ITEM TO FOLLOW IN SUPPLEMENTARY AGENDA

The Director of Public Health presented the Pharmaceutical Needs Assessment (PNA) report and explained that the Health and Wellbeing Board has a statutory duty to publish the PNA by 1 April 2018.  The Board noted that Merton Public Health has worked collaboratively with neighbouring boroughs on the refresh of the PNA. The PNA is a useful tool for NHS England to regulate market entry for new pharmacies. Following the PNA consultation, extended opening hours have been introduced by some pharmacies, increasing the service offer.  The conclusion on the current provision is that no gaps were identified, but this can be updated by a supplementary assessment  once new housing developments are built and  it is a requirement that the PNA is renewed every three years.

RESOLVED

That Health and Wellbeing Board members:

1. note the collaborative work that has produced a Merton Pharmaceutical Needs Assessment (PNA) that is compliant with the regulations and best practice.
2. note that the process of undertaking the PNA has led to extended opening times and therefore improvements in accessing community pharmacies in the east locality in evenings during the week and on Saturday afternoons.
3. agree to adopt the PNA, attached in final draft form as an appendix to this report, in advance of the statutory deadline of 1st April 2018.

Please note that Future Meetings will be held in Merton Civic Centre (unless otherwise advertised) at the new time of 18.15 – 20.15.

The Dates Are:

Tuesday 26 June 2018

Wednesday 3 October 2018

Tuesday 27 November 2018

Tuesday 29 January 2019

Tuesday 26 March 2019