Hounslow Council

Agenda and minutes

Venue: Committee Rooms 1 & 2, Civic Centre, Lampton Road, Hounslow. View directions

Contact: Kay Duffy on 020 8583 2067 or at: Email: kay.duffy@hounslow.gov.uk 

No. Item


Welcome and Introductions


The Chair welcomed all present and invited a round of introductions.


Apologies were received on behalf of Misak Ohnanian, Councillors Bath and Mann, Fire Commander Stuart Low, Steve Shrubb (Sarah Rushton in attendance), Ann Bond (Carol Hopkins in attendance), Sarah Bishop, Thomas Neumark (Vanessa Coutinho in attendance), Frank Sims (Jo Manley in attendance) and Detective Chief Superintendent Bussey.



Minutes of the meeting held on 24 June 2014 and Matters Arising pdf icon PDF 92 KB


That the minutes of the meeting held on 24 June 2014 be agreed and signed by the Chair as a correct record, subject to the following amendments:


Minute 1: Welcome and introductions:

It was noted that Susan Sinclair had attended the meeting for Dame Jacqueline Docherty.


Minute 6: Whole Systems Integrated Care (Paragraph 2):

Remove the second ‘was’ from the following sentence “A population of between 40-60,000 was considered was small enough to be managed by one team”


Minute 6: Whole Systems Integrated Care (Paragraph 3):

formerly known as Reablement” to be amended to read, “formerly known as Reablement and Rehabilitation”.


Minute 7: Shifting Settings of Care (Paragraph 4):

Amend “Sarah Ruane” to read “Sarah Rushton” in this paragraph. 


Joint Strategic Needs Assessment - Stakeholder Engagement Report - Ian Carter (LBH) pdf icon PDF 76 KB

Additional documents:


See report from the Assistant Director for Strategy, Intelligence and Engagement, Agenda Item 3.


Ian Carter, Assistant Director for Strategy, Intelligence and Engagement, presented the final instalment of the JSNA refresh and asked the Board to approve the document.


When asked whether the issues obtaining data from NHS England had been resolved (see Engagement with Professionals, 2nd Paragraph), Mr Carter acknowledged that no progress had been made to date.  Sarah Rushton asked him to write directly to her on the matter.


Dr Burbidge noted that commissioning support unit (CSU) functions would transfer from NHSE to CCGs from 1 October 2014.  When asked whether Hounslow was intending to use the Hounslow CCG’s CSU or the South London CSU, Mr Carter confirmed that the intention was to approach colleagues at Hounslow CCG, adding that he would liaise with Sue Jeffers about getting access to data.


Ian Robinson reported that a Demanding Capacity Commissioning Tool had been commissioned, which should sort out the information sharing issues.



That the Joint Strategic Needs Assessment (JSNA) 2014 – stakeholder engagement report be noted and approved.


Health and Wellbeing Strategy (Next Steps) - Imran Choudhury (LBH) pdf icon PDF 117 KB


See report from the Director of Public Health, Agenda Item 4.


Imran Choudhury, Director of Public Health, led members through the submitted report, noting that a draft action plan should be available at the Board’s November meeting.


Donald McPhail requested that both the Local Safeguarding Children Board and the Local Safeguarding Adults Board be permitted to comment on the draft plan and influence action plans moving forward.


Jo Murfitt welcomed the proposals on immunisations and screening, which she viewed as a good opportunity to work together.



1.    That the creation of a joint action plan to underpin the delivery of the Board’s Health and Wellbeing Strategy be approved;

2.    That responsibility for creating and subsequently updating the action plan be delegated to the existing Health and Wellbeing sub-groups;

3.    That regular updates on the action plan be brought back to the Board.


Joint Commissioning Intentions - Sue Jeffers (CCG) pdf icon PDF 127 KB

Additional documents:


See report from the Deputy Managing Director at Hounslow CCG, Agenda Item 5.


Sue Jeffers welcomed members’ comments on this early draft of the commissioning intentions proposals.  She drew attention to the timetable and noted that a more detailed report would be taken back to this Board in November.


6.50pm – Councillor Bruce joined the meeting at this point.


Sue Jeffers the intentions for 2015-16 built on work over the past three to four years.  The CCG worked closely with colleagues in neighbouring CCGs and with Public Health and Joint Commissioning colleagues at the Council.  The Patient Reference Carer Group event in August had included discussions on key areas of the document with over fifty service users.


Drawing attention to the colour diagram, Sue reported that this was being used across the entire North West London NHS area and that the Shaping a Healthier Future (SaHF) proposals were a key feature in service configuration. 


Note: PMCF on Page 1 of the submitted diagram refers to Prime Minister’s Challenge Fund.


In response to questions the following was noted: 

·         There were a number of risks to consider around finances, the delivery of the proposals (taking into account workforce/ organisational development and capacity issues).  Members were assured that, when more work was done to flesh out each of the bullet points, colleagues would begin to address the risks, which would be included in the report to the Board’s November meeting.

·         It was acknowledged that the promotion of the self-management agenda to hard to reach groups would be a challenge.  The strategy was to access easier to reach groups through which efforts could be made to engage with those harder to reach groups. 

·         It was proposed to work jointly with the Council on publicity campaigns as part of in-depth work on communicating with residents.

·         There had been a step change in 2014-15 on patient empowerment and engagement.  It was hoped that as a result of residents’ increased confidence about their voice being heard and their ability to shape services that the whole systems model would work.

·         When asked whether the profile of mental health would be raised under the whole systems model, Sue indicated that mental health services was a focus and that a further detail would be included in the November report by Dr Annabel Crowe, Lead GP for mental health.



1.    That the draft Commissioning Intentions for 2015-16 be noted at the Board.

2.    That the plans for further development and finalisation be noted. 


Better Care Fund update - Sue Jeffers (CCG) and Ian Robinson (LBH) pdf icon PDF 217 KB


See presentation slides, circulated at the meeting and attached with the electronic agenda pack following the meeting, Agenda Item 6.


Alan Adams, Director of Children’s and Adults’ Services, drew attention to the Government’s amendments to the rules following the Better Care Fund submissions in April.  There was now more emphasis on involving providers in the submission.  Hounslow differed to a number of health and wellbeing boards as provider organisations were members of the Board and sub-groups.  Whilst the submission planned for September was fundamentally the same as that previously submitted, members were guided through the presentation.


A key piece of work had been on funding.  The increasing pressure on resources was acknowledged as a national concern.  It was not anticipated that the proposals would reduce the number of non-elective hospital admissions.  However £1billion was being held back, subject to the reduction in non-elective hospital admissions.


The approach taken by Hounslow was to ensure that the Better Care Fund was central to the delivery of the Whole Systems Integrated Care.  In June the Board constituted the sub-group whose key role was to enable providers to develop the systems redesign. That sub-group had met on 1 September and included representation from all providers including Ashford and St Peters Hospital and Imperial College Hospital.


Sue Jeffers asked the Board to give its chair, Councillor Curran, delegated authority to approve the Better Care Fund submission so that it could be submitted by the 19 September deadline.  When members raised concerns about what they would be giving the chair authority to sign off on, Sue assured members that she would keep providers updated on the financial proposals over the coming weeks so that all providers fully understood the costs and benefits, ensuring that each provider would be part of the submission.


Dame Docherty raised concern about the need to work closely together to ensure that everyone understood the shared risks and that the submission did not include anything that was diametrically opposed to each other, particularly in light of the ambition to take as one the Commissioning Intentions, the Better Care Fund and the Whole Systems Integrated Care proposals.


Ian Robinson, Assistant Director Joint Commissioning at Hounslow Council, echoed Sue Jeffers’ assurances that the key providers would continue to be engaged with closely.  He proposed that the final draft submission could be sent for comments to members and that this commentary could be incorporated into the final submission. Sue Jeffers proposed that, due to the time constraints imposed on the submission, either a second sub-group meeting was convened or Ian’s suggestion of a ‘virtual Board meeting’ to ensure that members were all up to speed with the detail of the submission.  Whilst she acknowledged the concerns raised by Dame Docherty, Sue Jeffers sought to assure members that each of the three documents were aligned and travelling in the same direction. 


The Chair asked whether a formal risk sharing agreement had been incorporated, Sue Jeffers indicated that this was a conversation for the Council, CCG and  ...  view the full minutes text for item 17.


Systems Resilience - Ian Robinson (LBH) and Sue Jeffers (CCG)


Ian Robinson confirmed that Hounslow Council had funds of £1.6million for Systems Resilience. This funding was formerly known as Winder Pressures Money and was used to alleviate pressure on the acute system during the period from November to March.  The CCG asked providers to put forward proposals and invited proposals from voluntary sector groups.  A more detailed update would be provided at the November Board meeting.



1.    That the brief update provided at the meeting be noted.

2.    That a further update be brought to the November Board meeting.


Winterbourne View Report - Ian Robinson (LBH) pdf icon PDF 157 KB


Ian Robinson referred to the update contained within the submitted report.  It was noted that, although the ambition was to bring all clients residing in a hospital setting within the Winterbourne definition back to the borough, some of those clients had highly complex cases.  As clients often had very high support needs, they continued to be monitored once repatriated.


It was reported that some of the clients’ families had launched legal challenges against the proposals to move clients to less secure settings. Ian Robinson assured the Board that there may be cases where the borough had to move a client against the wishes of that individual’s family, but this was only done in extraordinary circumstances and only where it was in the best interests of the client in question.  Sarah Rushton offered her organisation’s help in looking at how systems could be improved in respect of mental health.



1.    That the progress the Borough has made in achieving the actions set out in the Winterbourne View Concordat since its last briefing be noted.

2.    That the latest submission and Hounslow’s compliance with the six priority areas set out by NHS England be noted.


Any Other Business


Members were reminded of the forthcoming Annual General Meeting of the Hounslow Clinical Commissioning Group to be held on Wednesday 17th September from 12.30pm to 2.30pm.


Date of next meeting - 19 November 2014 from 6.30pm


The date of the next scheduled Board meeting was noted.