The Health & Wellbeing Board and ICB Sub-Committee (Committees in Common) met on Tuesday 12 September 2023 to discuss preparations for winter pressures, updates on the Carers Charter and Action Plan, and the extension of the 0-19 Integrated Healthy Child Programme service contract. Key decisions included the endorsement of the Winter Plan 2023/24 and approval of the associated Demand and Capacity Investment Plan, as well as noting the urgent action taken to extend the contract for the 0-19 Integrated Healthy Child Programme.

Winter Planning for 2023/24

The committee received an update on the Barking and Dagenham Place Based Partnership's preparations for winter pressures. The plan focuses on prevention, hospital avoidance, and discharge support, with priorities identified through a partnership workshop. Key themes include improving communication channels between providers, enhancing education and communication with residents about accessing services, and early preparation to engage residents proactively. The plan also addresses the need for a robust response to mental health conditions in the community and optimising existing services and pathways.

Funding has been allocated to support winter resilience, including national funding for urgent and emergency services, capital investment for additional capacity, and funding for ambulance services. Barking and Dagenham has received specific allocations for demand and capacity funding, with schemes planned to enhance capacity in community, voluntary, and social care services. Additional investment is also being made in primary care, with plans to extend GP access hubs and a proposed minor ailments service.

Members welcomed the Winter Plan, highlighting the importance of leveraging community hubs, ensuring timely intelligence, reflecting the role of carers, and promoting community pharmacies. Concerns were raised about the term inappropriate attendance and the need for clearer communication, as well as the role of NHS 111 in signposting. The closure of Chase View Care Home and its impact on winter pressures was also noted. The committee endorsed the Winter Plan 2023/24 and approved the Demand and Capacity Investment Plan.

Carers Charter and Action Plan Update

An update was provided on the delivery of the Carers Charter Action Plan 2022-2025. The Charter, co-produced with unpaid carers, outlines commitments to supporting carers in Barking and Dagenham. The report highlighted that approximately 1 in 14 residents, equating to 14,000 individuals, provide unpaid care, with only around 4,000 known to services.

Key areas of progress include the development of training for frontline staff to identify hidden carers, improvements to the hospital discharge pathway to involve carers earlier, and the inclusion of carer information in hospital discharge leaflets. Efforts are also being made to involve carers in the development of care plans and to promote uptake of vaccinations for carers. The number of carers identified and recorded by GP practices has increased, and a GP TV information advert has been developed to raise awareness.

Discussions also touched upon the importance of Education, Health and Care (EHC) plans for young carers, the development of a Carers Strategy by North East London Foundation Trust (NELFT), and the need for a partner-wide communications strategy to identify carers and make them aware of available support, particularly for ethnic groups less likely to identify as carers. The committee noted the update and endorsed the sharing of relevant data by partners to support the Action Plan.

Extension of 0-19 Integrated Healthy Child Programme Service Contract

The committee noted the urgent action taken by the Council's Chief Executive to approve a variation of the contract for the provision of the integrated 0-19 Healthy Child Programme with NELFT. This extension, for a period of 16 months from 1 September 2023 to 31 December 2024, was necessary due to the release of new guidance from the Department of Health and an ongoing review of the Public Health Grant, which required more time for procurement and service redesign. The estimated value of the contract extension is £8.3 million. The decision to waive tendering requirements and approve the variation was made under the Urgent Action provisions of the Council's Constitution.

Membership of the Health and Wellbeing Board

The committee approved the reallocation of one of the two Barking and Havering and Redbridge University Hospitals NHS Trust (BHRUT) seats on the Board to Newham University Hospital (NUH), reflecting NUH's increased role in providing patient services to local residents. Simon Ashton, Chief Executive Officer at NUH, was nominated to take up the seat, though it was later confirmed that Tom Ellis, NUH Director of Strategy, would fill the position. Additionally, the Independent NHS Complaints Advocate for Barking and Dagenham was granted 'Standing Invited Guest' status on the Board. Amendments to the Council Constitution will be reported to the next meeting of the Assembly.

Other Business

Under Any other public items, the Chair highlighted the need for a more dynamic flow of information sharing between organisations to better understand best practices and new initiatives. The discussion also touched upon the importance of sharing performance metrics, such as outpatient waiting times, and understanding how provider collaboratives are working across the sector. The committee was informed that performance framework discussions are ongoing, and a more succinct paper on this topic will be presented in the future. The issue of patient choice and the challenges of travel for residents of Barking and Dagenham to access services in other areas was also raised.

The committee also discussed the importance of monitoring the impact of implemented plans, with suggestions for focusing on convenience, confidence, and complacency as key metrics. The need to address health inequalities and ensure that services are accessible and trusted by all communities was emphasized.

Finally, the committee was informed about the upcoming diagnostic work on mental health, learning disabilities, and autism, which will be presented to place-based partnerships. The role of housing in supporting step-down and step-up provision was also highlighted as integral to winter planning. The discussion concluded with a commitment to ensure that data and metrics are relevant locally and focus on outcomes for individuals.