Agenda and minutes

1.1       The minutes of the last meeting were agreed as an accurate record, with no matters arising.

2.1       There were no declarations of interest.

3.1       Sarah Wainer presented an update on the action being taken by Lewisham Health and Care Partners (LHCP) Executive Board to develop new partnership arrangements for the delivery of community based care. The LHCP are proposing to secure external consultancy to identify options for the governance of these proposed partnership arrangements. Once this work is concluded, partners will report back to the Health and Wellbeing Board on the options that have been considered and the preferred option for development.

3.2       LHCP is supported by a number of steering groups, including a Communications and Engagement Steering Group. The Group is currently developing and implementing a communications and engagement strategy and plan. As part of this work, a set of core messages have been produced and will be further enhanced over time. A set of pledges have also been drafted, outlining what Health and Wellbeing Board members will do to support the improvement of health and wellbeing across the borough. These will be expanded to provide concrete examples of what health and care partners are doing or will be doing to fulfil their pledges.

3.3       The Adult Integrated Care Programme continues to be one of the key delivery vehicles for integration activity and LHCP continue to oversee the activity and deliverables that have been agreed within the 2016/17 programme, including workstreams for Prevention and Early Intervention, Neighbourhood Community Teams and Enhanced Care and Support.

3.4       Members of the Board made the following comments regarding the report:

·         The ‘Pledges’ should also demonstrate how residents will be supported to improve their own health and wellbeing.

·         GPs could be used more effectively as a communications channel to signpost and promote healthy living programmes such as free swims for the over 60’s.

3.5       Action: The Board approved the recommendations contained within the report.

4.1       Martin Wilkinson provided the Board with a summary of the South East London Sustainability and Transformation Plan (STP), which has now been published.

4.2       The STP is a place-based, all-partner whole system plan driving the NHS Five Year Forward View locally. The plan must meet quality and performance standards whilst ensuring financial sustainability. The STP is the single application and approval process for transformation funding for 2017/18 and thereafter.

4.3       The STP focuses on five priority areas:

·         Developing consistent and high quality community based care (CBC), primary care development and prevention

·         Improving quality and reducing variation across both physical and mental health

·         Reducing cost through provider collaboration

·         Developing sustainable specialised services

·         Changing how we work together to deliver the transformation required

4.4       The STP also includes a plan to develop two elective orthopaedic centres. These will bring together routine and complex care onto sites with ring-fenced facilities. The rationale is that this will minimise cancellations and ensure critical mass for certain procedures. The centre will work as part of a clinical network and link with local hospitals and community-based settings. Formal public consultation on this specific proposal will run for 12-14 weeks, with feedback to the Committee in Common to decide whether to proceed in Spring 2017.

4.5       Further updates on the SEL STP will be provided at future meetings of the Board, with a focus on specific areas within the delivery plans e.g. Urgent Care, Community Based Care etc.

4.6       Members of the Board made the following comments regarding the report:

·         Public expectations and anxiety with regards to STPs are increasing as the publication date for Plans moves closer. It will be challenging to distinguish Lewisham apart from this wider context and some of the more negative messaging playing out nationally.

·         It should be made explicitly clear to the local population that the SEL STP requires all A&E and Maternity Units to remain open.

·         The Autumn Statement will set out future funding for social care and without a strong financial base it will be difficult to make progress on the delivery of the STP.

·         The representative for the Voluntary and Community Sector recognised the opportunities for engagement on the STP and draft proposals regarding the elective orthopaedic centre.

4.7       Action: The Board noted the progress of the STP and agreed that future meetings will focus on specific areas within the delivery plan.

5.1       Susanna Masters provided the Board with an overview of the draft Partnership Commissioning Intentions for Adults.

5.2       NHS Lewisham Clinical Commissioning Group (LCCG) and Lewisham Council are responsible for commissioning the majority of health and care services in Lewisham. The ‘Intentions’ set out the shared plans and priorities to commission health and care for adults for the next two years (2017-19. There are separate Partnership Commissioning Intentions for children and young people’s services.

5.3       The intentions are intended to give health and care partners and the public an initial understanding of the specific commissioning areas that will be focussed on – Prevention and Early Action, Planned Care and Urgent and Emergency Care – in order that they may provide feedback to inform future planning.

5.4       Members of the Board made the following comments regarding the report:

·         The health and wellbeing advice and brief interventions delivered by community pharmacies as part of the ‘Healthy Living Pharmacies’ initiative may be impacted by the national reduction in funding. This is due to take effect from December 2016, though may be staggered.

5.5       Action: The Board agreed the recommendations contained within the report.

6.1       Danny Ruta presented the 2016 Annual Public Health Report (APHR) to the Board, which is themed on tackling obesity. It focuses on the Whole System Approach to Obesity, of which Lewisham is working alongside Leeds Beckett University as one of four national pilot sites. The report also profiles the Jamie Oliver / Sustain Sugar Smart initiative which Lewisham was the first London borough to launch in October 2016. Wider information on the entire population is also provided through the Public Health Performance Dashboards.

6.2       The APHR is a useful tool to recruit organisations from across the sector to sign-up to these initiatives and help promote an environment that supports healthy weight and wellbeing as the norm. Both Lewisham Hospital and Millwall Football Club have signed-up to the Sugar Smart initiative, and eight schools in Lewisham are running the Daily Mile, where all children in the school are allowed to run outdoors for 12 minutes each day. The aim is to get 80-90% of primary schools involved in this initiative.

6.3       Members of the Board made the following comments regarding the report:

·         The workplace needs to be added to the whole system approach to tackling obesity, and reflected in the strategy.

·         The possibility of having local high-profile individuals (e.g. Olympic athletes) to champion these programmes should be explored.

·         There should be engagement with local sports clubs to help expand these initiatives.

6.4       Action: The Board noted the contents of the report.

7.1       Catherine Mbema provided members of the Board with an overview of the Lewisham Public Mental Health and Wellbeing Strategy 2016-19 which was launched on 10^th November 2016. This strategy contributes directly to the priority area within Lewisham’s Health and Wellbeing Strategy to improve mental health and wellbeing in Lewisham between 2015 and 2025.

7.2       The main overarching aims of the strategy are:

·         To improve mental health and wellbeing for all in Lewisham across the life course.

·         To attempt to bring together all initiatives in Lewisham that impact positively upon mental health and wellbeing under one strategic ambition.

·         To increase and optimise the use of community assets for mental health and wellbeing initiatives.

·         To reduce stigma and increase awareness amongst the public and professionals of factors which build resilience, protect and improve mental health and wellbeing.

7.3       An action plan is being developed with the support of a multi-agency working group, and robust evaluation measures will be put in place to monitor the intended impacts of the strategy.

7.4       Members of the Board made the following comments regarding the report:

·         All service areas need to show due consideration to mental health issues as part of their routine service delivery. This strategy is a step in the right direction.

·         Links between physical and mental health are strongly reflected in the SEL Sustainability and Transformation Plan and mental health is at the forefront of the STP agenda.

7.5       Action: The Board noted the contents of the report.

8.1       Folake Segun presented the Board with an executive summary of the Healthwatch Lewisham Annual Report 2015-2016.

8.2       During 2015-16 Healthwatch have:

·         Carried out focused engagement with over 100 people from Tamil, Polish, Vietnamese and Turkish communities.

·         Gathered the views of over 70 young people and young carers, aged between 10 and 17 in discussions about their mental health.

·         Worked with 74 local organisations in partnership-building.

·         Contributed 500 hours of additional capacity through the work of 17 volunteers.

·         Utilised 7 local hubs across four Lewisham localities to deliver information and listen to people’s experiences on health and wellbeing services.

8.3       Action: The Board noted the delivery and outcomes for 2015-16 that were contained within the Healthwatch Annual Report.

9.1       Stewart Snellgrove presented the Health and Wellbeing Board with a draft work programme for discussion and approval. The following items have been added to the work programme, or amended since the last Board meeting:

·         Neighbourhood Networks: Update on Community Development (March 2017).

·         Joint Strategic Needs Assessment (JSNA) update has been brought forward from July 2017 to March 2017, to better align with business planning processes.

·         Local Account has been re-scheduled to March 2017.

9.2       The Board made the following comments regarding the report:

·         Future meetings should provide focus for discussion on specific areas within the Sustainability and Transformation Plan.

9.3       Action: The Work Programme for the Board will be updated accordingly.

A – Lewisham Clinical Commissioning Group: Annual Review 2015/16

B – NHS Lewisham CCG Winter Resilience Plans 2016/17

C – Lewisham Safeguarding Adults Board Annual Report 2015/16