The Health and Wellbeing Board met on 7 January 2016 to discuss a range of important issues affecting the health and wellbeing of Harrow residents. Key topics included a serious case review into the death of a baby, an update on A&E performance, and the draft revenue budget for the upcoming year. The Board also received progress reports on the Better Care Fund and noted the annual health protection profile for Harrow.

Harrow Safeguarding Children Board (HSCB) Serious Case Review: Child F

The Board noted the findings of a Serious Case Review into the death of an 11-month-old baby, referred to as 'Child F', in 2014. The review highlighted systemic weaknesses in ante-natal midwifery services, a lack of effective follow-up for concerns due to the mother's transient lifestyle, and misunderstandings regarding the use of police powers of protection and emergency protection orders. The mother received a six-year prison sentence for manslaughter. The review identified areas for multi-agency learning, including the need to challenge avoidant parental behaviour, ensure children in mobile families do not become invisible, and improve the investigation of referrals from the public. The Harrow Safeguarding Children Board is monitoring the implementation of an action plan to address these issues.

Annual Health Protection Profile for Harrow 2014

The Director of Public Health presented the Annual Health Protection Profile for Harrow 2014, which detailed local health protection issues, including communicable diseases and actions being taken. The report noted an increase in scarlet fever cases and highlighted that Harrow has one of the highest rates of tuberculosis (TB) in the country. Actions to address TB include prompt identification of cases, community awareness campaigns, and support for patients to complete treatment. The report also indicated that sexually transmitted infection (STI) and HIV rates in Harrow are low compared to London averages. The Board noted that NHS England is responsible for immunisation programmes, and an action plan is in place with local partners.

A&E Performance

An update was provided on A&E performance at London North West Healthcare Trust for the 2015/16 period up to November 2015. Performance remained below the national 4-hour wait target of 95%, with reasons cited including bed capacity, patient flow, and staffing issues. However, improvements were noted, with a substantial reduction in weekly breaches. Plans to address these issues include commissioning two extra wards to provide 48 additional beds, increasing community and primary care capacity, and exploring expanded ambulatory care. The Board heard that while staff shortages are a national problem, Harrow has an established bank system, and efforts are being made to recruit staff.

Better Care Fund Progress Report

The Board received a progress report on the Better Care Fund (BCF) for the first two quarters of 2015/16. Steady progress was reported on agreed schemes and national conditions, indicating the fund was on track for delivery. Work had commenced on designing the 2016/17 BCF plan. A CCG representative noted a proposed increase in the 'protecting social care' element of the 2016/17 plan, which would result in an overall shortfall in the BCF budget. Ongoing discussions between Harrow Council and the CCG were planned regarding the Better Care Plan for 2016/17. The Board resolved to note the report and delegate officers to develop and progress the 2016/17 BCF for submission in March.

Draft Revenue Budget 2016/17 & Medium Term Financial Strategy 2016/17 to 2019/20

The Director of Adult Social Services introduced the draft Revenue Budget and Medium Term Financial Strategy (MTFS) for 2016/17 to 2019/20. The report detailed the Council's financial position, highlighting significant funding reductions and the need for savings. The draft budget aimed for a balanced position for 2016/17 to 2018/19. Attention was drawn to the Council's Commercialisation Strategy, which aims to deliver benefits through innovative partnership working.

Concerns were raised by a CCG clinical representative regarding the draft budget, specifically how Children's Services would align with the 'starting well' priority, the development of early intervention, and the proposal to take finance from public health. The CCG also expressed concern about the BCF assumptions in the draft budget. The Healthwatch representative shared these concerns, highlighting the economic benefit of preventive measures and the potential impact of grant reductions for public health. The Board was informed that projects on early intervention, children's centres, and early years were being launched, and health visiting provision was to be protected from public health budget reductions. The ring fencing for public health was expected to continue until March 2018, with future funding potentially coming from business rates. The Board noted the report.

Other Business

The Board noted that one public question had been received and responded to, with the recording placed on the Council's website. No petitions or deputations were received. The item regarding the CNWL Community Redesign Model for Mental Health Services and the Community Services Model were withdrawn from the agenda. Councillor Janet Mote declared a non-pecuniary interest in Agenda Items 8 and 10 due to her daughter's employment at Northwick Park Hospital.