The Health and Wellbeing Board met on Wednesday 17 January 2024 to discuss workforce updates, the Better Care Fund, and the Haringey Health and Wellbeing Strategy. The Board approved the submission of the Haringey Better Care Fund (BCF) Plan for 2023-25 to NHS England.

Workforce Update - November 2023

Cassie Williams, CEO of the GP Federation, presented an update on the Haringey Borough Partnership's workforce initiatives. The focus was on recruitment, talent development, and integrating insights from health and care colleagues. The North Central London Integrated Care System (NCL) has identified three key areas: workforce supply, development, and transformation. Haringey's Workforce Integration priorities include entry-level recruitment, neighbourhood training, and workforce information dissemination.

The Board noted concerns about staff competition within the partnership and acknowledged salary differences. Efforts to enhance collaboration on workforce integration with family hubs were also discussed. John Poulter, a member of the public, raised concerns about delays and waiting times due to staff and resource shortages. Nadine Jeal, Clinical and Care Director for Haringey (NCL ICB), assured the Board that ongoing recruitment efforts, including new roles and expanded apprenticeships, are in place to address these issues, while acknowledging the challenges in wait times for services like physiotherapy, which were heavily impacted by COVID-19 pauses.

It was agreed that examples of workforce projects, their outcomes, and lessons learned would be shared with the Board in six months. Other examples of good practice in hub working would also be circulated. A more in-depth discussion on tackling staff and resourcing issues in the NHS is scheduled for the next meeting.

North Central London Start Well Consultation

Rachel Lissauer from NHS North Central London ICB provided an update on the North Central London Start Well Consultation. It was advised that Haringey Council would provide a specific response to the consultation. The Board noted that partnership feedback, including from Primary Care, Councillors, and local MPs, had been provided. Jonathan Gardener from Whittington Health NHS Trust emphasised the importance of maintaining Whittington services, while urging a response to the consultation.

Haringey Health and Wellbeing Strategy Development

Dr Will Maimaris, Director of Public Health, gave a verbal update on the development of the new Haringey Health and Wellbeing Strategy. This strategy will guide the Board's work for the next four to five years and has been developed through community engagement and co-design. Key themes emerging from engagement activities include mental health, housing and health equity, placemaking, and preventative health. Councillor Zena Brabazon highlighted the importance of prioritising housing for residents' health and wellbeing, with an emphasis on allocation based on need. Beverly Tarka, Director of Adults, Health & Communities, shared feedback from a previous Integrated Care Partnership (ICP) meeting regarding outcome measurement and the definition of equity. John Poulter, a member of the public, raised concerns about delays in repairs and their impact on NHS services, and expressed his willingness to collaborate with the Board.

Approval of Haringey Better Care Fund (BCF) 2023-25 - Submission to NHS England

Paul Allen and John Tomlinson presented the Haringey Better Care Fund (BCF) Plan for 2023/24. The BCF is a national programme aimed at integrating health and social care services to promote resident independence and improve outcomes. Haringey's BCF 23/24 plan aligns with the Borough Plan and supports the Ageing Well Strategy. The plan assures the Board of Haringey's commitment to health and social care integration.

The report detailed national BCF requirements, including a jointly agreed local plan signed off by the Health and Wellbeing Board, maintenance of the NHS contribution to social care, and investment in NHS-commissioned out-of-hospital services. Haringey's investment schedule outlines a £38 million investment for 2023/24 (projected to be £42 million in 2024/25), with specific minimum allocations for Adult Social Care and NHS-commissioned out-of-hospital services. Additional funding is provided through the Improved Better Care Fund (iBCF) and Disabled Facilities Grants (DFGs). A £2.4 million Discharge Fund is included for 2023/24, increasing to £4.3 million in 2024/25.

The plan addresses three key challenges: managing increased cases of deteriorating underlying health post-pandemic, preparing out-of-hospital systems for heightened NHS Trust activity to ensure safe winter hospital discharge, and tackling issues related to equity of access, outcomes, and experiences, particularly in deprived areas. Progress since 2022 was highlighted, including increased GP consultations for older people, positive evaluations of the Multi-Agency Care & Coordination Team (MACCT), and a reduction in emergency admissions for older residents.

New and expanded investments for 2023/24 include continued investment in Early Help and Prevention, bereavement services, and community health services. The ICB Wheelchair Services have been incorporated into the BCF plan. The Discharge Fund will support intermediate care services and those in challenging housing environments. An additional £400,000 investment in carer services was announced.

The Board noted the ongoing work within the NCL ICB to assess local needs, compare them with other boroughs, and allocate resources accordingly, extending beyond community health. This work will involve Councillors to gather views on service delivery and innovation. Concerns were raised about the effectiveness of the BCF for reablement and the need for genuine co-production with community involvement.

The Health and Wellbeing Board resolved to note the year-end summary for the Haringey Better Care Fund (BCF) Plan Narrative for 2021/22, confirm the plan meets national BCF Plan Conditions for 2023/24 and 2024/25, and endorse the BCF Plan submission for 2023-25.

Haringey Borough Partnership Update and Integrated Care Partnership Updates

Rachel Lissauer from NHS North Central London ICB provided an update on various programs within the Haringey Borough Partnership and Integrated Care Partnership, including Start Well, Live Well, and Age Well. Positive progress was noted in areas such as speech and language support for primary schools, initiatives for long-term conditions, and dementia care. The Board discussed the Borough Partner Executive Meeting highlights, focusing on mental health challenges, workforce recruitment, and system priorities. The Chair raised concerns about medication accessibility for residents, and Jonathan Gardener from Whittington Health NHS Trust addressed questions regarding the North Middlesex maternity unit's performance.

Haringey Health and Wellbeing Strategy Development

Dr Will Maimaris, Director of Public Health, provided a verbal update on the development of the new Haringey Health and Wellbeing Strategy. The strategy, which will guide the Board's work for the next four to five years, has been developed through community engagement and co-design. Key themes identified include mental health, housing and health equity, placemaking, and preventative health. Councillor Zena Brabazon emphasised the need to prioritise housing for residents' health and wellbeing, focusing on allocation based on need. Beverly Tarka, Director of Adults, Health & Communities, shared feedback from a previous ICP meeting on outcome measurement and the definition of equity. John Poulter, a member of the public, raised concerns about repair delays and their impact on NHS services.

North Central London Start Well Consultation

Rachel Lissauer provided a brief update on the North Central London Start Well Consultation, noting that Haringey Council would provide a specific response. The Board acknowledged the feedback provided by various partners, including Primary Care, Councillors, and local MPs. Jonathan Gardener from Whittington Health NHS Trust stressed the importance of maintaining Whittington services while encouraging a response to the consultation.

Any Other Business

Dr Will Maimaris provided a brief update on the recent Integrated Care Partnership (ICP) meeting, highlighting discussions on improving population health and wellbeing across North Central London. Key themes included establishing working relationships, adding value, addressing health inequalities, physical and mental health, heart health, and admissions.

The meeting was noted as being inquorate due to being conducted virtually, meaning no formal decisions could be made. However, the minutes of the previous meeting held on 20 September 2023 were approved as a correct record.