Appendix 3: Joint Health and Wellbeing Strategy progress report, November 2016 November 2017

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Appendix 3: Jint Health and Wellbeing Strategy prgress reprt, Nvember 2016 Nvember 2017 This prgress reprt prvides an verview f areas where we achieved and did nt achieve ur targets as set ut in the Jint Health and Wellbeing Strategy (2015 2020) as well as prviding a narrative fr the Barnet Health Prfile fr 2017. Based n ur prgress, recmmendatins are made fr areas f fcus fr the next year (t Nvember 2018). Theme Preparing fr a healthy life Objectives Imprving utcmes fr babies, yung children and their families Areas f fcus 1. Imprving the health & wellbeing f Lked After Children Target a) All initial health assessments cmpleted within time frame (20 days) b) Review Health assessments fr children lked after fr a year r mre Increase the prprtin f lcally placed lked after children t at least 46% (2017/18) t 53% (2019/20) Cntinue t clsely mnitr the prvider including staff vacancies. 2. Increasing the uptake f childhd immunisatins Target Increase uptake f childhd immunisatins t be abve the England average HWBB t receive regular reprts frm NHSE, scrutinising perfrmance against targets and NHSE and lcal remedial actin plans. 3. Early years review Target - The cuncil (including Public Health) will wrk with Barnet CCG t further integrate the service ffer f health-related services in early years settings, imprving service delivery fr families. What did we achieve? 1. Imprving the health & wellbeing f Lked After Children It is a statutry requirement that all children have an Initial Health Assessment (IHA) within 20 wrking days (28 calendar days) f cming int care; the target is fr ver 95% t be cmpleted within the timescales. Data frm 2015/16 and the beginning f 2016/17 shwed that this was nly the case fr 30% f children cming int care. a) Significant imprvements have been seen n IHA perfrmance in 2017(being within statutry timeframes):

50% in January 19% in February 92% in March 100% in April 93% in May 79% in June 86% in July 100% in August b) All review health assessments (RHAs) have been cmpleted within the timescales. All health assessments are yung persn-led and fcus n the child. Imprvements can be attributed t: Clearly dcumented prcess, with timescales, cmmunicated t all prfessinals invlved t avid perfrmance slipping Cmmissiners increased mnitring and implemented an imprvement plan which included regularly meeting with GP practices The nursing team increasing the number f reminders that yung peple and fster carers receive prir t the appintment which includes calls and emails the day befre the appintment Imprved cmmunicatin and wrking between CLCH and children s scial care Previusly key wrkers were reprting that n-ne was able t attend appintments with the yung peple, this issue has nw been reslved Independent Reviewing Officers are nw invlved in any key issues, this has been particularly helpful fr ut f brugh placements c) The CCG Executive, in August 2017, agreed an increase in resurce fr the LAC Health team fr an additinal Band 7 nurse, likely t start Nvember/December. This will enable the Designated Nurse t fcus n mre strategic wrk fr example verseeing the paediatric mdel fr IHAs, fllwing up n the mst vulnerable CYP (including children and yung peple with SEND) and imprving the ffer fr care leavers. Paediatric mdel fr IHAs fr LAC aged 0 9 - In March 2017, the CCG Executive apprved the mve t a paediatric mdel fr IHAs fr children aged 0 9. Currently IHAs are cmpleted by GPs. It is best practice fr these t be

cmpleted by paediatricians, particularly fr yung children due t the identificatin f develpmental delay, wrking with cases f neglect and prviding a cntinued pint f cntact Frm September 2017, 0-2s cming int care have been seen by a paediatrician; initial feedback is psitive frm all stakehlders and the service will cntinue t be mnitred. 2. Increasing the uptake f childhd immunisatins Supprting the natinal immunisatin campaign and prmtin f childhd immunisatins thrughut the year t GP s, children centres, frnt line staff and vlunteers. Includes sharing infrmatin and campaign resurces with children centres thrugh quarterly news letters Imprving and increasing awareness amngst GP s and practice managers (using the GP bulletin and Practice Manager bulletin) f the MMR 2 cverage t imprve uptake and achieve 95% cverage target Delivery f childhd immunisatins training t all children centres Utilised MECC (making every cntact cunt) training t engage and train frnt line staff and vlunteers fr brief interventins n childhd immunisatins Awareness raising with Barnet residents by updating the Barnet PH children s webpage t include infrmatin n immunisatins and immunisatins schedule 3. Early years review Develpment f Integrated Hubs fr Children, Families and Yung Peple Als kept cntinued gd registratin and access f targeted families at children s centres Successful delivery f the peri-natal health caches prgramme Launched in September the 30 hur ffer fr 3 and 4 year lds as per DfE requirements Where are the gaps? 1. Imprving the health & wellbeing f Lked After Children Imprve the quality f Initial Health Assessments T imprve the quality f IHAs the Designated Dctr and Designated Nurse fr LAC will be: Wrking with scial wrkers t imprve the infrmatin prvided t GPs and

paediatricians cmpleting IHAs regarding the child s histry Cmpleting an audit f IHAs and feeding back t GPs (by December 2017) Prviding training t GPs (Nvember December 2017) What remains a pririty? (suggested areas f fcus up t Nvember 2018) 2. Increasing the uptake f childhd immunisatins Uptake and data quality require further imprvement 3. Early years review The take up f free tw year ld places achieved is 60% fr the 2016/17 academic year. There is a clear strategy t imprve the upward trajectry and it is anticipated that take up will increase. 1. Imprving the health & wellbeing f Lked After Children t cntinue as a pririty fr 2018 Wrking with scial wrkers t imprve the infrmatin prvided t GPs and Paediatrician cmpleting the Initial health assessments regarding the child s histry Cmpleting an audit if Initial health assessments and feeding back t GPs (by December 2017) Prviding training t GPs (Nvember December 2017) Special educatinal needs and disability SEND embedding the SEND refrms 2. Increasing the uptake f childhd immunisatins Wrking t increase the uptake f all pre-schl bsters amngst the under 5s T increase the uptake f flu immunisatin amngst 2 and 3 year lds and pregnant wmen during autumn and winter seasns T maintain messaging t health prfessinals including GPs, children s centre staff, midwives, in rder t increase uptake and keep them up t date n latest plicy and guidance Supprt natinal immunisatin campaign at lcal level T take part and supprt NCL immunisatin assurance prgramme 3. Early years review Cntinue rll ut f Early Years hubs in Barnet.

Theme Objectives Areas f fcus Wellbeing in the cmmunity Creating circumstances that enable peple t have greater life pprtunities 4a. Child and Adlescent Mental Health Services (CAMHS) In rder t imprve CAMHS prvisin, Barnet CCG and Barnet Cuncil agreed t jintly recmmissin CAMHS at the HWBB in September 2016 Public health supprted the redesign f CAMHS; develping a prgramme f wrk based n the Thrive Mdel. The apprach aimed t imprve access t services by imprving sign psting, self-management and enabling ne ff cntact in rder t imprve cping mechanisms in children and yung peple. 4b. Adult mental health services The pririty area was t develp new service mdels that prvided earlier interventin, recvery and different ways f wrking. What did we achieve? 5. Emplyment Increase the prprtin f adults in cntact with secndary mental health services in paid emplyment. Increase the prprtin f adults with learning disabilities in paid emplyment Planned actins: Develping the market and engaging with prviders nt yet perating in the brugh and prcuring an apprved list in 2017 Embed emplyment in care plans develp the rle fr brkerage in securing emplyment pathways, embedding strengths based practice and cntinue t develp the Mental Health Enablement mdel Raising quality f prvisin within existing day-care including the Yur Chice Barnet transfrmatin and hld Jb Caching and Brkerage Skills training(delivered by British Assciatin fr Supprted Emplyment) The Cuncil as a public sectr leader - leverage t create jb pprtunities thrugh cntracting and becming a disability cnfident emplyer 4a. Child and Adlescent Mental Health Services - (CAMHS) Prcurement has been delayed due t negtiatins in regard t BEH NHST Trust. Transfrmatin f services supprted by the Barnet allcatin fr CAMHS Transfrmatin Fund (NHS England) has cntinued utside f the prcurement prgramme. Thrugh targeted resurcing and a waiting times reductin prgramme,

Barnet has reduced the number f yung peple waiting fr treatment fr ver 12 weeks frm 119 t 65 and average waiting times reduced frm 131 days t 90 days (30 th September 2016 t 30 th September 2017). In additin Barnet has develped new Early Help services and prgrammes including: Resilient Schls Prgramme-jintly led between BCCG and Barnet Public Health Kth Online Cunselling and Supprt which has been used by 120 yung peple in the first mnth (June 2017) Emtinal Wellbeing Team (part f Resilient Families Service-Barnet Cuncil) CVS Partnership Space2Grw fund with Yung Barnet Fundatin Raphael Huse (a lcal CVS) Cunselling Prject Specialist Educatin Psychlgy prvisin fr Yuth Offending Service The abve prgrammes cmbined will prvide emtinal wellbeing and mental health supprt t an additinal 500+ yung peple by June 2018, primarily fr thse children and yung peple wh wuld nt have met the CAMHS clinical threshld Planned activity: The CAMHS Transfrmatin Plan 2015-2020 is being refreshed and will be presented t JHWB in January 2018 Tw new psts have been created with the Yuth Offending Service 1. Clinical Psychlgist (starts 6 th Nvember 2017) and Mental Health Liaisn and Diversin Wrker (interview Nvember 2017) Space2Grw funded prjects t begin Nvember 2017 4b. Adult mental health services - Different ways f wrking with secndary and primary care fr adults mental health services: The Barnet Wellbeing Hub was established and its impact mnitred Wrk was carried ut t imprve talking therapies, with the aim that IAPT services will becme part f the Wellbeing Hub The Cuncil remdelled its mental health wrkfrce t fcus n recvery and expanded the Netwrk mental health enablement service t ffer mental health enablement and recvery supprt t mre peple. The Reimagining Mental Health Prgramme is cntinuing, rganisatins are cntinuing t

wrk cllabratively, with minimal investment in transfrmatin, t deliver imprvements fr individuals via primary care with dedicated BEH Mental Health Trust Primary Care MH Linkwrkers and frm cmmunity prviders fllwing a scial prescribing mdel. The Linkwrker team cmprises Psychiatrists, Psychlgist, Scial Wrker, Occupatinal Therapists, Mental Health Nurses, Graduate Mental Health Wrkers There have been fewer referrals t secndary care, especially t crisis care and mental health liaisn Linkwrkers are embedded in the new Wellbeing Cllabrative delivering wellbeing services t peple acrss Barnet. Organisatins are wrking clsely with cmmissiners t ensure that scial prescribing sits alngside clinical and scial care supprt Cverage has been rlled ut acrss all Barnet lcalities and referrals have been received frm all 62 practices Lead GPs in each lcality prmte the direct benefits f the Linkwrker and integrated service t their clleagues Linkwrkers attend lcality and cmmunity meetings t prmte the service Patient feedback cntinues t be psitive It was really gd that yu came t the dctr s surgery and It was very gd. I nw knw what is available and hw I can prgress Mst significant and measurable results: Achieved 40% reductin in referrals t secndary care frm Suth Barnet since cmmencement f linkwrker service (first quarter) Average f 94% f a ttal 225 referrals t linkwrkers were acknwledged within 24 hurs and were cntacted within 5 wrking days in the first quarter f peratin There has been a reductin t average length f stay with the Crisis Reslutin Hme Treatment Team since the intrductin f Linkwrkers, suggesting that peple are able t be discharged sner back t the care f their GP and can be stepped up as required Presentatins t Psychiatric liaisn in A&E remained high in January and February frm the Nrth Lcality. Despite this increase at the beginning f the year, the verall picture has since been lwer acrss all areas since prir t the Link Wrking service starting. This has reduced the incidence f breaches in the 1 hur target at Barnet Hspital and reduced presentatins at the Ryal Free, Hampstead

The Netwrk has develped strnger links with the Wellbeing Hub and has established a weekly jint referral meeting and a drp-in sessin fr the Wellbeing centre at the Netwrk building. The service is recruiting a Peer Supprt wrker t wrk with the wider wellbeing services. Emtinal health checks are being delivered by Wellbeing Practitiners acrss Barnet fllwing staff training and referrals have increased at a pace since February. Mre than 40 rganisatins are lead and delivery members f the Wellbeing Hub, which is currently based at the Meritage Centre in Hendn. Staff in all vluntary sectr rganisatins has been trained in Emtinal Health Checks which nly need t be delivered nce befre individuals are supprted with their individual scial prescribing plan t access the supprt they need. Peple are supprted t access a range f ptins based n the issues they themselves want t address. Individuals are still reprting high satisfactin with the service and further develpment f 3 rd Sectr High vlume web-based IAPT services have been in test phase thrughut September and Octber frm digital prvider Mind Time Therapies wrking with CmmUNITY Barnet and results are prving psitive. The new IAPT prvisin, Let s Talk IAPT began perating frm 1 st Octber 2017 and is wrking clsely with GPs, Linkwrkers and the Wellbeing Hub t receive referrals. They als have partners the Multi-lingual Wellbeing Service (wn-language IAPT service) and Twining Enterprise IPS (Emplyment Supprt) wrking with them t deliver integrated supprt t peple with cmmn mental illness Barnet is part f the Lndn Digital Mental Wellbeing is a tw year prgramme t develp, test and evaluate a 24/7 digital mental wellbeing service. The service is began its pilt phase in May 2017 and is expected t be available mre widely befre the end f the year. Cmmunity Centred practice aims t imprve cmmunity wellbeing thrugh cmmunity champins in General Practice The prgramme is nw taking place in five surgeries - due t a surgery clsure - and ne in a care hme. We nw have ver 60 champins prviding a wide range f activities acrss five surgeries including walking

grups, stry time fr children, diabetes self-help and gardening. Where are the gaps? What remains a pririty? (suggested areas f fcus up t Nvember 2018) 5. Emplyment - Increase the prprtin f adults in paid emplyment Prprtin f adults in cntact with secndary mental health services in paid emplyment was 7.6 % at quarter 4 (2016/17) against a target f 7.2% fr 2015/16 The cuncil have cmmissined new emplyment supprt and emplyment retentin services, fr wrking age adults with scial care needs. The services will be available frm Nvember 2017 The cuncil have cmmissined new day pprtunity prvisin fr peple with learning disabilities and autism, which will supprt peple t develp their life skills, increase their cnfidence and prgress them n their pathway t emplyment BOOST- The cuncil cntinues t wrk with partners t prmte emplyment and skills. In the first quarter f 2017/18 BOOST Childs Hill launched- this takes the multiagency apprach t the suth f the brugh. BOOST Burnt Oak cntinues t develp and is nw wrking side by side with arund 14 ther rganisatins n a sessinal basis at the library. Tgether the teams have engaged ver 400 residents and supprted ver 100 int wrk. In this perid the Cuncil has brught tw additinal emplyment t the brugh: the Skills Escalatr which aims t help peple wh are in wrk t find a better jb and the Mental Health and Emplyment Trailblazer which supprts peple with cmmn mental Illness t find wrk. The brugh s largest learning disability prvider, Yur Chice Barnet, transfrmed its services t fcus n access t emplyment and increasing independence in the cmmunity. New emplyment supprt and retentin teams were established, wrking with 22 service users initially f which 10 users gained emplyment and 8 started vlunteering t date. 4a. Further wrk is needed n the develpment and quality imprvement f Child and Adlescent Mental Health Services (CAMHS) 4b. Perfrmance imprvement f IAPT services 5. Emplyment ensuring as many peple as pssible are supprt t access new services and emplyment pprtunities. 4a. Child and Adlescent Mental Health Services (CAMHS) 4b. Fcus n mental health and wellbeing by Undertaking frmal pst-implementatin evaluatin f the Reimagining Mental

Health prgramme Clsely mnitring transferred Imprving access t psychlgical therapies services and wrk twards imprving access targets Wrking n wider wellbeing as part f the ThriveLDN initiative 5. supprt disabled peple t gain and retain emplyment by Implementing new emplyment supprt and retentin services fr adults with mental health needs and learning disabilities Ensuring the mental Health Netwrk prvides mental health recvery and enablement t all eligible residents wh wuld benefit The BOOST team t cntinue wrking with partners t prmte emplyment and skills The Emplyment Trailblazer t cntinue supprt peple with cmmn mental health illness t find wrk and t supprt Imprving access t psychlgical therapies Yur Chice Barnet rlling ut new emplyment supprt and retentin supprt fr peple with learning disabilities (PWLD) Recmmissining universal access emplyment supprt fr peple with autistic spectrum cnditins and PWLD Theme Hw we live Objectives Encuraging healthier lifestyles Areas f fcus 6. Reduce excess weight in children (10-11 years ld) & in Adults (verweight and bese) Target: reduce excess weight in adults and children Develp and agree an Obesity Strategy and Actin plan Establish the Fit and Active Barnet Partnership Thrugh a multi-agency apprach (Saracens Sprt Fundatin, England Athletics, LBB, Barnet Partnership fr Schl Sprt and MDX University) primary schls were encuraged t increase physical activity levels by participating in the Mayr s Glden KM Challenge, encuraging 15 minutes f physical activity every day. Seven schls engaged with the pilt phase and the initiative is currently recruiting mre primary schls, fcusing n recruiting PH 'pririty schls' (schls with the highest prevalence f verweight and bese children accrding t the Natinal Child Measurements Prgramme)

What did we achieve? Fcus n the built envirnment and hw we can maximise the built envirnments rle in encuraging healthy lifestyles fr all residents A new leisure management cntract t be develped with an increased fcus n public health utcmes. A frmal prcurement prcess cmmenced in Octber 2016, a successful bidder will be appinted in Octber 2017 and the new cntract will cmmence n 1 January 2018 7. Increase screening uptake T increase screening uptake PH t wrk with PC clleagues in CCG and NHSE t explre lcal actins t imprve uptake 6. Reduce excess weight in children (10-11 years ld) Barnet has develped a successful & cst-effective weight management prgramme The Healthy Weight Nurse (HWN) service: 31% lst weight and 69% wh were knwn t reduce r maintain their BMI in 16/17 Alive n Kicking (ANK): 80% either reduced r maintained BMI z-scre. This includes ANK afterschl Prgrammes, 1:1 and SEN Prgrammes Successful behaviur change in parents: 81% f parents accessing the ANK service increased their cnfidence in reading and understanding labels and changed their behaviur 100% made psitive imprvements t their eating behaviurs 100% reduced their cnsumptin f junk fd 80% increased fruit cnsumptin 60% increase physical activity the mst ppular being walking and swimming 60% reduced screen time (including TV and cmputer time) Supprted vulnerable children: The HWN service had 13 (21%) f children n the caselad wh presented with Autistic spectrum cnditins. 5 (8%) f children presented with Learning disabilities and 43 (71%) were vulnerable with a safeguarding plan. Reduce excess weight in adults (verweight and bese) Year Target Reprted 2016/17 56.8% Current (2016/17 quarter 2) 56.75%

The develpment f the Healthier catering Cmmitment cntinues t develp successfully with a fcus n takeaways and fd suppliers. There has als been successful liaisn with Kcher prviders t tackle healthier supply issues. Tier 1 and tier 2 weight management services have been integrated int the new leisure cntract t start in January 2018 7. Increase screening uptake PH cntinues t wrk with PC clleagues in CCG t explre lcal actins t imprve uptake In partnership with J s Trust, Public Health put tgether a series f events and activities t prmte awareness uptake f cervical cancer screening A diabetes awareness campaign was cnducted the week f 12 th June 2017. This included a partnership event at Brent Crss c-rdinated by Cllr Stck where apprximately 100 peple cmpleted a risk assessment questinnaire and 8 peple were identified with diabetes A Diabetes UK infrmatin stall was set up utside Edgware Bradwalk shpping Centre and Millway Medical practice ffered diabetes testing and advice t Barnet residents. Apprximately 20 peple had bld tests. Instructrs were placed at 11 utdr gyms acrss the brugh and cuncillrs jined residents in an Oakhill Park Run t raise Diabetic Awareness Preventin and Wellbeing Training based n the Making Every Cntact Cunt (MECC) principles has been delivered Where are the gaps? 6. Cntinue t wrk t reduce excess weight in children (10-11 years ld) & in Adults (verweight and bese, a refreshed actin plan will be presented t the HWB in early 2018. 7. Cntinue t wrk t increase screening uptake. This requires cntinued fcus and imprvement. What remains a pririty? (suggested areas f fcus up t Nvember 2018) 6. Reduce excess weight in children (10-11 years ld) & in Adults (verweight and bese) Imprving current services based n children s Tier 2 service evaluatin recmmendatins Imprving the current 0-19 Healthy Weight Care pathway t ensure that it reflects all services available within Barnet Re-cmmissining Tier 2 weight management services (as cntacts are due t expire

n 31st March 2018) Develping and implementing healthy weight actin plans fr children & yung peple (CYP) and adults Implementing a new range f pprtunities fr Barnet residents t be physically active thrugh the new leisure service (frm January 2018) Implementing a new range f health prmtin and preventin activities thrugh the new leisure service (frm January 2018) 7. Increase screening uptake Sending GP endrsed text reminders t encurage uptake f screening Learning frm NHS England funded Imperial University survey t identify the barriers t attendance f cervical screening in Lndn and funded pprtunistic cervical screening in sexual health clinics fr wmen wh were verdue screening Replacing in 2018/19, faecal ccult bld testing with faecal immunchemical testing within the bwel screening prgramme acrss England. Pilt studies have shwn that uptake will increase by up t 7% Carrying ut prmtin f bwel cancer screening Theme Care when needed Objectives Prviding care and supprt t facilitate gd utcmes and imprve user experience Areas f fcus 8. Care clser t hme The CCG and Cuncil have establishing executive supprt t a prgramme f wrk designed t radically enhance the delivery f apprpriate Care Clser t Hme. In rder t develp a new Care Clser t Hme apprach a key requirement is t create a majr shift f balance frm avidable hspital admissins t integrated health, scial care and third sectr mdels delivered in cmmunity and primary care settings. The implementatin f the care clser t hme visin will be verseen by the JCEG, reprting int the HWB, CCG gverning bdy and the STP prgramme bard. 9. Carers - delivering the Carer and Yung Carer Strategy

Fcus n identifying unknwn carers Imprving the health f carers (especially yung carers) What did we achieve? 8. Care clser t hme Barnet CCG and LB Barnet are wrking clsely with the Barnet GP Federatin and prvider rganisatins t deliver the Care Clser t Hme prgramme in Barnet. The prgramme has fur key elements: Develped and imprved access t cre general practice frm 8am t 8pm. This service is nw peratinal. Care delivered acrss clinically-led partnerships knwn as Care Clser t Hme Integrated Netwrks (CHINs). The first pilt area (Burnt Oak) has been selected and has identified its pririty areas as Diabetes and paediatric urgent access. This CHIN shuld cmmence wrk in early 2018. T he Care Clser t Hme Prgramme Bard has agreed a visin, develpment apprach, develpment prcess and prgramme delivery plan fr the rllut f CHINs acrss Barnet, including wider health and scial care services. Quality Imprvement Supprt Teams (QISTs) will wrk with general practice t imprve quality, reduce variatin and build resilience thrugh tailred infrmatin and analytics. The Barnet GP Federatin and CLCH have been engaged t prvide this service t the Burnt Oak CHIN. In clse cllabratin with the lcal cmmunity and vluntary sectr, deliver preventin and supprted self-management services that help peple stay healthy, strng, safe and cnnected as cntributing citizens. The Prgramme Bard has agreed that it is a pririty fr CHINs t draw effectively upn the many preventative services fr children and adults that are available in Barnet. Building n the cmmunity centred practice initiative and the extensin f Ageing Well int a full Lcal Area Crdinatin mdel, a scial prescribing ffer is planned fr incrpratin int the develping CHINs 9. Carers Gd prgress has been made n the Carers and Yung Carers Strategy Actin Plan The cntract fr integrated supprt services fr carers and yung carers cntinues t be delivered and is perfrming well.

LBB cntinues t be a member f the Emplyers fr Carers Scheme (membership n ~EFC 1588) which allws all LBB emplyees and all SMEs in the brugh (businesses which emplyee less than 250 staff) t access resurces such as: Supprting wrking carers- a carers guide Supprting carers in yur wrkfrce- an emplyer s guide Supprting carers in yur wrkfrce- a manager s guide The cuncil established a Specialist Dementia Supprt Service fr adults with dementia and their carers, fcused n helping t imprve their health and wellbeing, maximise their independence and help sustain carers in their caring rle. The cuncil supprted Carers Week 2017 with ur Lead Prvider fr Carers and Yung Carers Supprt Services t help supprt raising awareness f and champining carers, highlighting the challenges that they face and the cntributin they make t families and cmmunities and prmting lcal supprt available t carers The Cuncil intrduced dementia friendly swimming in the brugh The cuncil prvides mnthly training t staff t identificatin f carers and yung carers, carers assessments, supprt planning and understanding the carers supprt ffer Family Services cmmissined specialist training fr their staff n supprting yung carers The cuncil s carers web pages have been refreshed t imprve hw carers can access infrmatin, advice and supprt Where are the gaps? 8. Care clser t hme cntinued implementatin f the prgramme, at pace. 9. Carers Further wrk needs t ccur in health settings t prmte identificatin f unknwn carers (and yung carers) Further wrk needs t ccur in health settings t prmte health supprt available t carers in the brugh (e.g. Free health checks and flu vaccinatins) What remains a pririty? (suggested 8. Care clser t hme areas f fcus up t Nvember 2018) Mbilisatin f CHIN and QIST teams acrss Barnet Establishing an verarching partnership between cmmissiners and prviders t supprt the rll-ut f CHINs

Bradening the range f services that are available thrugh CHINs beynd the initial scpe f Primary Care and Cmmunity Services. Implementing preventin, scial prescribing and infrmatin and signpsting services linked t each CHIN Develping an emergency care attendance preventin pathway fr CYP within CHINs 9. Carers Cntinuing t fcus n identifying unknwn carers and yung carers Cntinuing t imprve the health f carers (especially yung carers) Cntinuing t prmte Emplyers fr carers s that mre Barnet carers can access and retain emplyment Prviding advice and infrmatin t carers thrugh the dedicated carers service Prviding specialist supprt fr carers f peple with dementia