Mile End Hospital, Bancroft Road, E1 4DG

Board Meeting 5:00 – 7:00 Tuesday 13 December 2016 Room 1 Beaumont House Mile End Hospital, Bancroft Road, E1 4DG

1. Agenda 2. Time 3. Lea d

1 Welcome, introductions and apologies 5:00-5:05 Chair

4. Business Items

2 Minutes of the meeting of 4 October 5:05-5:15 Chair

3 Outcome of the Healthwatch tender and planning. 5:15-5:45 Di

Representation, roles and responsibilities 4 5:45-6:00 All Decision on Co Chairs. Other representational roles (breakdown of key roles attached page 7). Board Committees. Health and Wellbeing Strategy 5 6:00-6:30 Di/Randal Event and impact – draft report attached for discussion on recommendations. Formal response from Healthwatch. NEL Sustainability and Transformation Plan 6 6:30-6:45 Di/David HWTH engagement and outcomes Barts Health 7 6:45-6:55 Di/David/ CQC Report and Quality Summit Report due 15 Dec Iain site specific quality summits around 15 January. Collaborative Pairs with Kings Fund

8 AOB 6:55-7:00 All

5. Included for information

NEL Sustainability and Transformation Plan

Tower Hamlets Draft Health and Wellbeing Strategy

1 Date of next meeting: Tuesday 7th February 2017 5 pm to 7 pm Room 1 Beaumont House, Mile End Hospital

2 Healthwatch Tower Hamlets Board Meeting Tuesday 4th October 2016 Beaumont House, Room 1

Members: David Burbidge(DB), Karen Bollan(KB), Randal Smith(RS), Abdullah Al Junaid(AJ), Charlie Ladyman(CL), Peter Alexandrou (PA), Iain Macleod(IM), Mahbub Anan, (MA),Tim Oliver (TO) Staff: Dianne Barham(DI) & Rebeka Miah (RM) Apologies: Myra Garrett, Shahanur Khan

Agenda Item & discussion Actions 6. Welcomes, introduction to Tower Hamlets Healthwatch Board Meeting with new Board members attending. Apologies from Myra Garrett & Shahanur Khan 7. Getting to know you As this was the first Board meeting since the appointment of the new board members everyone was asked to introduce themselves and say a little bit about themselves, their background, strengths/skills, what they hope to bring to Healthwatch Tower Hamlets Board and how HWTH can support them. HWTH is here to collect and reflect the views of the residents. We are here to tell the providers what the service is like and how it can be improved. David Burbidge- Director and Co-Chair HWTH with a community development and social work background. Retired for ten years. Expertise in fundraising and community development. Skills are networking, bringing people together and project development. Karen Bollan- Resident of Tower Hamlets and current board member. Her background is Public Health and her interest is health and equality. Currently working at the Royal College of General Practitioners. Part of HWTH as is important as a voice of the community. Peter Alexandrou- Resident of Tower Hamlets- Currently a Health Regulatory Lawyer, with a dental aspect, Hearings officer. His role is to handle complaints at the end of the process. He is a member of his own PPG. He would like to help out with the various complaints queries and signposting requests related to complaints that arise. Abdullah Al Junaid (Junaid)- Resident of Tower Hamlets. Works at the Barkentine Practice as a Walk-in and Patients support administrator. His role is primarily dealing with patient engagement, training staff, dealing with complaints and supporting patients who come into the practice. He would like to get feedback on issues that arise from engagement at the Barkentine and make patients aware of HWTH Charlie Ladyman- Tower Hamlets resident. Currently Chief Exec at Healthwatch Croydon, wanted to pursue a career in management in the voluntary sector. She has a passion for Healthwatch. Soon to work at NHS

3 England as Patient Engagement Manager in specialised care. She would like to share her experience with HWTH, facilitate, report writing and attend panel meetings. Mahbub Anam- Current board member, LBTH Strategic Project Manager working on the development of a life science campus at Whitechapel. Looking at latest technology, with the scope to improve health services, which will be of national strategic importance. Rebeka Miah- HWTH Finance and Admin officer Randall Smith- Resident of Tower Hamlets. Background in international development, local government and now running his own business. He is trained in researching and is a historian (holds a PHd in History), field research, previously head of strategy and policy at LB Hackney. Interest in data analysis. LBTH and the JSNA. Web based and social media skills. Iain Mcleod- Resident of Tower Hamlets, got involved as a patient leader commissioned partly by Healthwatch and CCG. Led on the nutrition project with Barts that has culminated in a raft of changes in the new soft facilities management contract at Barts. Heavily involved in community engagement and mental health. Tim Oliver – Current board member. Works pro bono for the NHS. Mainly involved in dementia and mental health services. Involved in centralisation of healthcare facilities, from the aspect of transport. Dianne Barham- CE of Healthwatch Tower Hamlets. Resident for 20 years. Background in regeneration projects, community development, neighbourhood renewal funds etc. Passionate about making the voice of the community heard through HWTH. Members Feedback DB raises ‘Time off for public duties act’ PC will look up IM- If you are already on a committee there shouldn’t be a duplication of representation. There are already some people on some of these committees Di- The different hats that people can wear dependent on their role. DB- SERCO have the new contract for soft facilities. The new contracts procurement with Bart’s will pay for patient engagement. SERCO will have to pay for 40days worth of engagement. Will pay for at least 10 volunteers.

8. Minutes from the meeting of 3 August- No formal minutes as it was a general informal discussion. There were no formal minutes to the meeting as it was a general discussion on the approach and structure of the Healthwatch tender response.

9. Representation, Roles & Responsibilities Di to email a DB presents: summary of the key It is important for HWTH to support the interests of the board bodies where board members. members should be on if possible and a HWTH are always invited to sit on various panels and meetings. list of the other The advisory group sits alongside the board and is made up lay board/committees members and people from the voluntary sector such as Age UK. available. User panel and the MHTG which are sponsored by HWTH. JSNA, H&W Board, Health and Scrutiny, THT (Tower Hamlets Together), Patient

4 panels at RLH, Barts & MEH. Lots of opportunities for board members to sit on various committees Di  HWTH understands restraints of capacity, time and commitment by board members as some have jobs.

10.Your Voice Counts Event Di goes through ‘Your Voice Counts’ Community Event report. HWTH ‘Community Event’ was held at the Harford Multi-Centre on 4th August 2016 for the local community. First time the CCG, THT, Public health, LBTH social care, voluntary sector and HWTH have all come together to undertake community engagement. Health and Wellbeing Board have agreed to support this joint approach in different localities 4 times a year and that they will have the next H&W meeting in the same locality following the ‘Community Engagement Event’. People who attend the event will be invited back to the H&W board meeting. The organisations involved are responsible for feeding back the recommendations based on the intelligence gathered. HWTH combine the feedback and report back to the community on the impact. HWTH gained a better understanding and recommendations on how to get children and adults to play outside, parents/healthy eating and community’s leading change. Recommendations are at the back of the report which need to be followed up. The Advisory group recommended that HWTH take a locality approach leading up to the event. This would mean Advisory group meeting, enter and views take place in that locality. The localities are based on the GP networks. 8 networks, 4 localities’. This is a way of getting grassroots information in one go for commissioners and stakeholders. HWTH still need to push themselves as the independent voice for residents. HWTH have a lot more volunteers and lay people involved. Constraints for HWTH are staff resources and co-ordinating volunteers. Members Feedback KB- It was a fantastic event. Really engaging and well attended. RS- How many volunteers did HWTH recruit? RM- We were able to publicise HWTH and as a result have had an influx of volunteer recruitment. PC- If attendees are mostly patients can you use them as a consortium of people to consult when you need a patient voice? Di- A suggestion was every time people attend they leave their email address and we create a consultation group. These people get to attend various consultations and become a resource, educated enough to convey the information they receive to the rest of community.

5 KB suggests we have a memorandum of understanding. Giving feedback to the people who attend and getting the commissioners to show what they have changed in services as a result of the consultation. IM- Agrees that people are enticed with vouchers and food and there is never an outcome which is patient friendly to read. People want to know the outcome. CL- Agrees we need to have feedback and impact. PC- Raised the issue of data protection. HWTH do not have a public profile from the LBTH. DI- We need to have acknowledgement of facilitating consultations.

11.AGM Di discusses the AGM and the actions on the day. All agenda items were agreed. Reappointment of members, accounts were agreed, appointment of new members, reappointment of accountant agreed. Winding up the company if tendering is unsuccessful and staff notified of possible redundancy and termination of jobs. Other such formalities discussed. Di to send out doodle 12.Board induction & regular meetings poll for Board Need to plan a 2 hour induction for new board members. An induction. introduction to HWTH and the local health and social care system. Information on time Looking at committees and other board member related issues. off for public duties to be given Opportunity to get to know other board members and a refresher for to board. the current board members. Di to send out all Doodle poll to be sent out to find out board members availability for information needed to be put induction. on the company Board Meetings will be looked at once the new board members have details. settled in. DBS application for board members Members Feedback that need one. Discussion on away days- Twice a year for LBTH, staff, board and some volunteers. IM- suggests every board member partakes in an E&V.

13.AOB HWTH is going through a retendering process. Tender document circulated with papers: When HWTH was commissioned for the first time the successful tender was won by Urban Inclusion Community. Part of that tender specification was that Urban Inclusion would establish Healthwatch as an independent organisation. Healthwatch became a company limited by guarantee and a charity with its own legal entity. The current tender has gone in under Healthwatch Tower Hamlets, not Urban Inclusion Community. This is an open tendering process and we are not sure if we have any

6 competing organisations. The tendering process is now closed, HWTH has been shortlisted and the interview is taking place on Thursday 6 th October 2016, David and Di will be attending the presentation/interview. The top three organisations will be interviewed. If unsuccessful in the tendering the Board will still exist and be taken over by whoever wins the contract. The staff will still exist and would be TUPEd to the new provider. However there are no guarantees the structure would be same if taken over by another organisation. DB asks for feedback on the interview question for Thursday. ‘Commissioners of health and social care services consult residents on saving proposals which include closing or reducing some services. Healthwatch has gathers scrutiny intelligence that many residents are against the proposals, how would your organisation address these conflicting views to achieve the best outcome?’ Members Feedback Question on the interview process and the 18 questions of clarification. PC-There should be governing guidelines on the tendering rules. RS-Discusses issues on monitoring information. Answers to question… CL – Commissioners should be engaged and ask service users how they feel about a service. It shouldn’t be about saving money. Commissioners just roll over existing services to make some pockets of the community happy when the services aren’t really needed. If you empower and inform people then they feel valid and will complain less. IM- I think this is looking at the role of HWTH in such a situation. They are already cutting services. They are cutting back on adult social care and children’s social care. Duplication of effort. Point out examples of HWTH facilitator’s role previously. DB- Are they asking us to mediate? HWTH’s job is not to do this. Commissioners close services before consultation. It’s a controversial question. It’s our job to get organisations to talk to one another Di- Don’t say it’s a cost saving. Present the resources to the people and discuss from this angle. Take the angle of co-production and co design. We have to try and work within the constraints and get the best outcome for patients. Bringing the patient on board and getting them to help make decisions. We are an independent organisation. RS- The commissioner’s job is to design services; how can HWTH identify the priorities for the borough. I like the co-production approach and this is what they have suggested to you. KB- There’s no consultation if they have already made a decision. PC- Go back to the purpose of HWTH and remind these stakeholders what your role is. HWTH is here for the patient voice is. Values, objectives of HW.

7 Date of next meeting: Tuesday 13 December 2016 5 pm to 7 pm Room 1 Beaumont House, Mile End Hospital.

8 14. Key meetings with Healthwatch representation Meets every two months 5:30 – 7:30 Health and Wellbeing Board approximately Current Rep: space open for Co-Chair Moves around the Borough The aim of the Tower Hamlets Health and Wellbeing Board (HWBB) is to improve the health and wellbeing of Borough residents. To achieve this, the Board will carry out the following  To encourage joint working between health or social services providers in Tower Hamlets for the advancement of the health and wellbeing of Borough residents.

 To identify needs and priorities across Tower Hamlets and publish and refresh the Tower Hamlets Joint Strategic Needs Assessment (JSNA) so that future commissioning/policy decisions are based on evidence.

 To prepare the Joint Health and Wellbeing Strategy.

 To be involved in the development of any Clinical Commissioning Group Commissioning (CCG) Plan that applies to Tower Hamlets and to give its opinion to the CCG on any such proposed plan.

 To communicate and engage with local people on how they could achieve the best possible quality of life and be supported to exercise choice and control over their personal health and wellbeing. This will involve working with Healthwatch to make sure there’s a continuous dialogue with the public to ensure services are meeting need.

 To carry out new functions as requested by the Secretary of State and as advised in guidance issued from time to time.

Health Scrutiny Sub Meets every two months 6:30 – 8:30 Committee approximately Current Rep: David Burbidge and Tim Oliver Mulberry Place The role of the Health Scrutiny Sub Committee is to scrutinise local health services in accordance with the Health and Social Care Act 2001. In summary, the Panel will:  Review and scrutinise local health services within the Council’s area and make reports and recommendations as necessary.

 Respond to consultation exercises undertaken by an NHS body.

 Question appropriate officers of local NHS bodies in relation to the policies adopted and the provision of the services.

The Health Scrutiny Panel is made up of Members of the Council and nonvoting co-opted Members as appointed by the Overview and Scrutiny Committee. Healthwatch has two co-opted positons.

9 Meets monthly 3:30 to 5:30 alternate between a CCG Primary Care Committee formal meeting in public and a seminar in Current Rep: Karen Bollan private for developmental. It is a committee comprising representatives of: Tower Hamlets CCG, NHS England, Tower Hamlets Local Authority, LMC, Healthwatch, and Tower Hamlets General Practice. To make decisions on:  GMS, PMS and APMS contracts (including the design of PMS and APMS contracts, monitoring of contracts, taking contractual action such as issuing breach/remedial notices, and removing a contract);  Newly designed enhanced services (“Local Enhanced Services” and “Directed Enhanced Services”);  Design of local incentive schemes as an alternative to the Quality Outcomes Framework (QOF);  Decision making on whether to establish new GP practices in an area;  Approving practice mergers; and  Making decisions on ‘discretionary’ payment (e.g., returner/retainer schemes). The Royal London Hospital/MEH Meets monthly Wednesdays 3:30 to 6:00 pm Current Rep: Dianne Barham Clinical Quality Review usually at Mile End Meeting/Oversight and Assurance Meeting Meeting between Tower Hamlets CCG and site management of Royal London Hospital to review all the quality measures including safe guarding, never events, Serious Incidents, complaints and patient experience. Tower Hamlets Together Stakeholder Council Still in development Current Rep: David Burbidge and Dianne The SC will be expected to:  Provide partnership and community oversight of the THT Programme helping to identify priorities and address gaps and barriers  Articulate the learning from the experience of past and existing partnerships and engagement  Build a model based on trust and respect, listening to different views with the aim to create a consensus of opinion  Create a ‘critical friend’ culture that advises THT creatively  Minimise bureaucracy and hierarchical structures  Determine learning and training support Tower Hamlets Together User and Stakeholder Focus work Monthly 1pm on a Wednesday Current Rep: Bill Colverson and Dianne stream The aims of the User and Stakeholder Focus workstream are to:  Co-ordinate the outcomes of existing involvement and engagement to ensure they are shared, understood and integrated  Advocate the results into the broader THT work and the wider system and put engagement into action  Develop a more powerful patient and carer voice at the heart of policy and service design and delivery

10 The objectives are to strengthen the understanding of and partnership across THT through:  Ensuring the development, delivery and understanding of a new health and social model of care makes a positive difference for patients and carers  Ensuring the model of care is informed and led by patients and carers supported by staff and other partners  Involving patients, carers and stakeholders in the design, delivery and review of care services  Listening to patients, carers and stakeholders to understand quality care  Building awareness of the support available from and benefits of the integrated provider services among staff, patients and carers, the wider community and stakeholders  Using the user and stakeholder experience to develop integrated professional roles HWB Joint Strategic Needs Hasn’t met in a long time – was an afternoon Current Rep: Dianne Assessment Committee meeting at the Council every two months Member organisations of the HWB met with Public Health and the research team at the council to feed into the JSNA, needs assessments and fact sheets. This was a chance to feed our community intelligence in order to inform the commissioning strategies of HWB commissioners. These meetings are likely to recommence following the completion of the HWS. Hasn’t met in a long time – was an afternoon HWB Engagement Committee Current Rep: Dianne meeting at the Council every two months There is some discussion about this committee being run with or alongside the THT User and Stakeholder Focus workstream as it involves the same participants. We could push for Healthwatch to Chair this group as that was the original intention. It could potentially refocus on delivering the HWS priority of Communities leading change as this would give it a clearer focus. It also links to our work in delivering the quarterly joint engagement events. Healthwatch meeting with Barts Quarterly Current Rep: Dianne and David Chief Executive

Meeting to update Healthwatch from across the Barts patch on improvements in relation to the CQC inspection recommendations and financial special measures. An opportunity for local Healthwatch to raise concerns and develop cross Borough working. Barts Patient Experience and Every two months (has not met for the last 4 Current Rep: Dianne and David Engagement Committee months. To oversight of the patient experience and engagement strategy and delivery for Barts Trust from across the sites. Includes site leads for patient engagement and the local Healthwatch and members of the senior management team

Board Committees  Finance, Personnel and Review  Communications and Engagement  Patient and User Experience  Enter and View Review

11 Other regular meetings North Central East London Quality Surveillance Group (bi monthly) Healthwatch England London Network Meeting (bi monthly) PPE leads at CCG (monthly) Voluntary Sector Health and Wellbeing Forum Steering Group (bi monthly) Voluntary Sector Health and Wellbeing Forum (bi monthly) Primary Care Patient Reference Group Single Point of Access development group (monthly) NEL STP Healthwatch Steering Group (monthly) Regular catch ups with Acting Chief Operating Officer CCG, Chief Nurse Barts, Director Adult Social Service LBTH