Agenda and minutes

Health and Wellbeing Board
Monday, 20th June, 2016 6.00 pm

Venue: Civic Offices, St Nicholas Way, Sutton, SM1 1EA

Contact: Fiona Bywaters, Committee Services Team Leader, 020 8770 5122 | Email: 

No. Item


Apologies for absence and notification of substitutes


Apologies were received from David Williams (Vice Chair), Niall Bolger (Chief Executive), Gwen Kennedy (NHS England), Susanna Bennett and Rachael MacLeod, (Voluntary and Community Sector), as well as Tolis Vouyioukas (Strategic Director, People Services).



Declarations of Interest


There were no declarations of interest.



Minutes of the previous meeting pdf icon PDF 131 KB

Minutes of the meeting held on 21 March 2016.



The minutes of the meeting held on 21 March 2016 were agreed as a correct record and signed by the chair.



Better Care Fund Update pdf icon PDF 187 KB

While awaiting confirmation of full assurance for the 2016/17 Sutton Better Care Fund plan by NHS England in June 2016, the plan remains ‘Assured with Support’ along with all other plans in London.  As reported to the Health and Wellbeing Board in March 2016, a Section 75 Agreement will continue in place between the London Borough of Sutton and Sutton Clinical Commissioning Group and the budget remains as agreed at the March 2016 meeting.


This report provides an update on progress with implementation.



Megan Milmine, Director of System Resilience and Integration, Sutton CCG, presented a report on the Better Care Fund Update highlighting progress made with its implementation. Key focus areas were mentioned as aligning the social services START team with the crisis team, and intermediate care.


The Chair, Councillor Ruth Dombey, thanked the Director for her presentation, underlined the evidence of the integration of social care and asked for further information on the work of the ‘Swoop Team.’ The Director responded that the team encompasses the rapid response team, receives added staff support and looks at the different pathways of complex discharge needs.


Dr Brendan Hudson, Vice Chair, further commented on the success of many of these workstreams in light of growing demand. The Vice Chair suggested that the Board might wish to send congratulations to the teams involved in recognition of their hard work and success, and the Chair agreed, requesting that this be noted in the minutes.


Councillor Colin Stears, Vice Chair, posed a question on the organisational models involved and who staff work for, and are employed by, in integrated teams. Nick Ireland, Executive Head of Adult Social Care and Safeguarding, explained that not all aspects of this were yet concluded but work was underway looking at single point access and referral groups, with clarification by September 2016, to then decide on a management structure for integrated teams.


The Chair recognised that this was the last meeting which the current Director of System Resilience and Integration would be attending and thanked her for her excellent work on the Better Care Fund, to which the thanks of the Board were added.


Resolved: That the Health and Wellbeing Board:


1.    Notes the continuation of the implementation work to deliver the Better Care Fund Plan.

2.    Delegates final authority to the Strategic Director, People Services, in consultation with the Chair and Vice-Chair to sign off any final amendments to the 2016/17 Better Care Fund Plan made as a result of feedback from NHS England.



The Director of Public Health's Annual Report pdf icon PDF 162 KB

Directors of Public Health in England have a statutory duty to write an Annual Public Health Report to demonstrate the state of health within their communities and the local authority’s duty is to publish it (section 73B(5) & (6) of the National Health Service Act 2006, inserted by section 31 of the Health and Social Care Act 2012).


Additional documents:


Dr. Nicola Lang, the Director of Public Health, presented the Director of Public Health’s Annual Report with the theme of sexual health and family planning. Key points highlighted included:


·         Sutton as the first Borough to use ‘integrated tariff’;

·         Self-service;

·         Increasing the offers available in GP Surgeries; and

·         Testing for HIV in ‘unusual’ places.


It was further added that this work would involve close cooperation with the Sutton CCG.


The Chair asked that the Director of Public Health elaborate on the ‘integrated tariff’ and whether HIV testing in ‘unusual’ places had been successful. Dr. Lang responded that ‘integrated tariff’ provided a better overview of the services the population is using, aiding their procurement, and good results had been seen from HIV testing in libraries and leisure centres. The Chair agreed with the importance of early detection as well as awareness raising.


Councillor Stears, Vice Chair, thanked the Director for the report and enquired as to how best its contents could be disseminated in an easy-to-read format. Dr. Lang suggested that perhaps a young person could help with this process given the relevance to their demographic and agreed to action this.


Councillor Jane Pascoe asked if there was any intention to deliver services outside medical centres, for example, via a roadshow. The Director explained the new venue model of Chelsea & Westminster NHS Foundation Trust as a provider, and that an easy-to-access central location would be determined in the Borough. Sutton also funds pan-London activity so that its residents are protected across other Boroughs.


The Chair suggested that such a topic would benefit from the involvement of Healthwatch to which Pete Flavell, Sutton Healthwatch, answered that they would be happy to promote the services among their concerned groups particularly if information was provided in an easy-to-read format.


Dr Brendan Hudson commented on the novel nature of providing these services and looked forward to liaising on communication and engagement. Councillor Wendy Mathys also added that minority groups must be made aware of these services, to which the Director of Public Health responded with positive evidence of this.


Resolved: that the Health and Wellbeing Board:


1.    Notes the Director of Public Health’s Annual Report 2015-2016.



Sutton's Joint Health and Wellbeing Strategy pdf icon PDF 165 KB

The Health and Wellbeing Board is asked to sign off Sutton’s Health and Wellbeing Strategy.  The strategy is a statutory document and its purpose is to improve the health and wellbeing of Sutton residents and to reduce inequalities for all ages.


Additional documents:


Dr Nicola Lang, Director of Public Health presented Sutton’s Joint Health and Wellbeing Strategy, outlining the 9 priorities within.


Following the presentation, Councillor Wendy Mathys asked whether Sutton was a pioneer with this strategy and noted the connection to early years and children and if more detail could be provided at a later date with regards to Children’s Centres. The Director outlined in response the benefits of cross-silo working within the local space and that other strategies may not take such a wide focus.


The Chair commented that the return of public health to local government would allow exciting opportunities for cross-department collaboration and Councillor Colin Stears, Vice Chair, added his congratulations.


Following Member questions, the Chair invited the voluntary sector representatives present in the public gallery to make a statement. The main points of the statement delivered by Navroop Kullar of Imagine Mental Health and Marian Harper of AGE UK Sutton included the:


·         Inability of the sector to agree the strategy in its current format.

·         Failure to capture the contribution made by the voluntary sector.

·         Lack of further consultation and meaningful involvement in strategic discussions.

·         Disappointment that offers of help were not taken up.

·         Cursory mention of the voluntary sector as insufficient.


The Director of Public Health thanked the representatives for their response and detailed comment. The Chair expressed disappointment at the dissatisfaction of the sector and asked whether there was at least agreement of the nine priorities. However, the representatives responded that their remit at the Board was solely to read the statement on behalf of the sector and could not comment further.


The Chair suggested that discussions with the sector be continued outside the meeting in a hope that they could continue to work together and clarify cooperation with regards to strategic aspects versus awareness-raising.


Councillor Wendy Mathys also expressed disappointment at the concern of the representatives, commenting on the overarching nature of the strategy and that she hoped the sector would remain involved in any implementation.


Dr Brendan Hudson commented on his dismay at the pushback of the voluntary sector in such strong terms as the drafting of the strategy has taken place over a long period of time. He requested that an early set of meetings be held with the voluntary sector, with the involvement of the Sutton CCG, so that all are engaged in a deliverable action plan. Dr Chris Elliott also wanted to know the next steps following this challenge. The Chair responded that the key point is how a meaningful partnership ensures that the strategic direction properly represents our communities.


Councillor Jane Pascoe highlighted the difference between the voluntary sector and volunteers, adding that a directory of volunteer services is required. The Director of Public Health clarified in return that this strategy is a high level statement of intent and that the Care Act looks at such a directory instead. Councillor Colin Stears, Vice Chair, added his recommendation of the strategy as fantastic, explaining that it is not about individuals  ...  view the full minutes text for item 6.


Update on Primary Care Commissioning Governance Arrangements pdf icon PDF 150 KB

From 1 April 2016, NHS Sutton Clinical Commissioning Group (CCG) has been delegated, by NHS England, the additional responsibility for commissioning primary medical services (general practice). The attached Delegation Agreement (Appendix A) sets out the scope of this responsibility. Also attached (as Appendix B) are the Terms of Reference for the new Primary Care Commissioning Committee, which describes the governance arrangements for this new area of responsibility.

Additional documents:


Jonathan Bates, Sutton CCG, presented an update on the Primary Care Commissioning Governance Arrangements.


With regards to the recommendation that the Sutton Primary Care Commissioning Committee includes a representative of the Health and Wellbeing Board as a non-voting member, the Chair asked Jonathan Bates whether a Councillor had to be appointed rather than an officer. Dr Brendan Hudson clarified that this was at local discretion due to the commitment involved. It was also stated that a substitute could be named at a later date.


Resolved: as amended, that the Health and Wellbeing Board:


1.    Notes the new responsibilities for NHS Sutton CCG as described in the Delegation Agreement (Appendix A).

2.    Notes the membership of the Sutton Primary Care Commissioning Committee and that this includes a representative of the Health and Wellbeing Board as a non-voting member.

3.    Approves Councillor Ruth Dombey, Chair of the Health and Wellbeing Board, as the nonvoting member of the Sutton Primary Care Commissioning Committee, with a named substitute to be agreed in due course.



CCG Annual Operating and Commissioning Plan 2016/17 pdf icon PDF 387 KB

The item will be presented as a verbal update. ‘Sutton CCG – Our plan on a page 2016 – 2017’ is included in the pack for information.


Jonathan Bates briefly presented the CCG Annual Operating and Commissioning Plan 2016/17 for information.


Following the presentation, Councillor Jane Pascoe commented that she would welcome additional emphasis on CAMHS services and Jonathan Bates accepted this feedback. Dr Brendan Hudson added that some of these concerns would also be covered by the next item on the agenda. In addition, Councillor Wendy Mathys noted the review of the ASD Service.


Councillor Colin Stears, asked in light of the CQC Report for St Helier Hospital, how hospital care would be affected. Jonathan Bates responded that such areas remain a priority and that this document was put together before the CQC Report was in the public domain. Dr Chris Elliott added that the hospital trust remained active in mitigating issues raised with them.



Sustainability and Transformation Plan pdf icon PDF 1 MB

The item will be presented as a verbal update. Presentation slides are included in the pack for information.



A verbal update and presentation was given by Dr Chris Elliott on the South West London Sustainability and Transformation Plan.


Following the presentation, Dr Brendan Hudson commented that the Sustainability and Transformation Plan will be published shortly and will be an item before the Health and Wellbeing Board in September.


Pete Flavell, Sutton Healthwatch, asked a question on the subject of finance in relation to bed numbers. Dr Chris Elliott explained the premise of four acute sites across Southwest London and the consideration of the financial consequences in terms of sustainability.


The Chair asked if the Sustainability and Transformation Plan looked at the high presentation levels at Accident and Emergency, with a positive response mentioning the work to advertise how pharmacies can assist within the community.




Urgent business brought forward at the direction of the chair


No urgent business was brought before the Board.



date of next meeting

The next meeting of the Health and Wellbeing Board will take place on 26 September 2016.



The next meeting will take place on 26 September 2016.