Agenda and minutes

1.            Minutes of the last meeting

1.1       The minutes of the last meeting were agreed as an accurate record.

2.         Declarations of Interest

2.1       There were no declarations of interest.

3.         One Public Estate Update

3.1       Freddie Murray presented this report. One Public Estate (OPE) is an initiative delivered in partnership by the Cabinet Office Government Property Unit and the Local Government Association. It provides practical and technical support and funding to Councils to deliver ambitious property-focused programmes.

3.2       The Lewisham Partnership submitted an expression of interest in May 2016 and received £50k to fund the preparation of a full bid. Lewisham’s bid was successful and the Partnership were awarded £200k, from an initial ask of £500k, to facilitate the progress of three main projects:

·         Development of a Strategic Plan for Ladywell, centring around the former Ladywell Leisure Centre site.

·         Reconfiguration of the Lewisham Hospital site for the provision of a neighbourhood “hub”, mental health bed / SLaM re-provision and other new service facilities.

·         Reconfiguration of Downham Health and Leisure Centre to facilitate a neighbourhood “hub”.

3.3       Lewisham Strategic Plan – This has not progressed as quickly as hoped due to the complexity of land ownership and the need for more extensive public consultation. It is intended that work over the next six months will give more focus to the long term future of the former Leisure Centre site.

3.4       Lewisham Hospital Site Reconfiguration – Design and consultation work has started to identify the development opportunity on the hospital site. These proposals focus around land and buildings which don’t form part of the acute service provision. The outline proposals include potential for new service accommodation including: a neighbourhood “hub”, a new SLaM mental health facility; Stepdown facility, Care Home and Skills Academy. Lewisham and Greenwich Trust (LGT) have begun to engage the Council’s Planning Department with a view to entering into a formal pre-application process in the New Year.

3.5       Downham – First stage of the feasibility study was completed earlier in the year. This was around understanding the building and the PFI contract in more detail as well as which areas of the building could be released and the resulting financial effects on the income within the building. Alongside this has been work to identify which and what type of services could move into the building. Space planners have been appointed to look at the building and opportunities in more detail.

3.6       Funding for Phase 6 of OPE is now open and existing partnerships have been invited to make further applications. Specifically Lewisham’s application will seek funding for:

·         Further work to support development of the Lewisham Hospital site reconfiguration and neighbourhood “hub”;

·         Work to further develop the potential “hub” opportunity in Downham;

·         Potential for redevelopment of Sydenham Green health facility for new health facilities and housing;

·         Redevelopment potential of health centres in Lee and Honor Oak for new health facilities and housing.

3.7       The Board raised the following questions regarding the One Public Estate update:

            Q: How effectively can the NHS respond to pressures in London re estates?

            A: The One Public Estate initiative has better links into NHS estates personnel, with earlier engagement and more effective lines of  ...  view the full minutes text for item 3.

4.         Annual Public Health Report

4.1       Danny Ruta presented this report. It provided members of the Health and Wellbeing Board with the proposed content of the Annual Public Health Report (APHR) for 2017. The theme of the APHR this year is ‘Mental Health and Wellbeing’ and it aims to:

·         Provide user-friendly information about the levels of mental health and wellbeing in Lewisham, including information about risk and protective factors.

·         Provide real-life stories from Lewisham residents across the course of life about living with and through mental ill health.

·         Provide information on the strategies, initiatives and interventions being delivered in Lewisham that aim to promote mental wellbeing and prevent mental ill health.

·         Provide information about where residents can seek help if concerned about their mental ill health to ensure that mental ill health is identified and treated at the earliest possible opportunity.

4.2       The 2017 APHR will adopt a new online format to enhance accessibility of the report for members of the public. The following sections will be included in the online microsite:

·         Introduction

·         Why is this topic important to Lewisham?

·         What is it like to live with metal ill health?

·         What we do to keep mentally well?

·         What can we do to help others keep mentally well?

·         What is happening to help improve mental health and wellbeing in Lewisham?

·         Where can you go if you need help with your mental health?

4.3       The online microsite is currently being developed within the Public Health team in liaison with the Council’s Communications Team. The microsite is planned to go live at the end of November 2017.

4.4       This revised approach to the APHR is intended to keep it more user-friendly and interactive, through the use of videos and Infographics. The target audience is Lewisham residents rather than professionals, and in particular young males.

4.5       In response the Board made the following comments:

·         Lewisham is leading the way in its approach to the APHR, particularly relevant where the borough has a high incidence of mental health compared to the national average (1.3% versus 0.9%).

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

5.         Safeguarding: New Protocol and Lewisham Safeguarding Boards Annual Reports 2016-17

5.1       These reports were jointly presented by Nicky Pace and Michael Preston-Shoot.

5.2       Both the Lewisham Children Safeguarding Board (LCSB) and Lewisham Adult Safeguarding Board (LASB) are required to publish an annual report to outline the work of their Boards in the previous year and identify areas where further work will be required in the forthcoming year.

5.3       Both Boards are statutory bodies set up to coordinate work to safeguard children and adults and to challenge the effectiveness of local arrangements.

5.4       The proposed ‘Protocol for safeguarding partnerships’ outlines the cooperative relationship between the Lewisham Safeguarding Children Board, Lewisham Safeguarding Adults Board, Health and Wellbeing Board, Children and Young People’s Strategic Partnership Board, Safer Lewisham Partnership and the Youth Justice Management Board to safeguard, promote the welfare of children and adults in the Borough of Lewisham.

5.5       The Protocol describes how partners can work together more effectively on cross-cutting issues and where there is value to be added by adopting this approach. It looks to avoid work taking place in silos or parallel workstreams and ensure that there is a uniformity in approach. In this context, the Protocol confirms:

·         Role and responsibility of the partnerships

·         Accountability and governance arrangements

·         Conflict resolution and challenge

5.6       Collaboration between the partnerships is based on these agreed key principles:

·         Commitment to working together to shared aims;

·         Respect for each other’s partnership roles, responsibilities and work within the agreed protocol;

·         Culture of mutual challenge and professional accountability; and

·         Effective interface and regular communication.

5.7       The Board made the following comments regarding these reports:

·         The LCSB/LSAB do excellent work in networking through the faith communities in Lewisham. Training for faith groups on adults safeguarding is up and running.

·         More work could be done in hearing the voices of carers and family members through VAL, Healthwatch and other VCS organisations.

·         Training and awareness in Primary Care must remain a priority, especially on financial abuse. Referrals pathways need to be explicit.

·         Practitioners need to recognise racial and disability hate crimes as a form of neglect.

·         Data protection protocols remain a barrier to sharing data between organisations regarding potential safeguarding issues.

·         There is a need to manage the balance between duty of care and autonomy/self-determination.

5.8       Action: The Board noted the contents of the LCSB and LASB annual reports and agreed the ‘Protocol for safeguarding partnerships’.

6.         Whole System Model of Care – Accountable Care System Update

6.1       Martin Wilkinson presented this report. The attached presentation provided the Board with a short update on the activity and progress that has been made by Lewisham Health and Care Partners across the system over the summer period. This included updates on:

·         Integrated commissioning (including agreement to combine Adults and Children’s Joint Commissioning Groups)

·         Provider alliances (including exploration of alliances for Community Based Care and Mental Health)

·         Population health system

·         Prevention and early intervention

·         Neighbourhood care

·         Enhanced care and support

6.2       The Board made the following comments regarding the report:

·         12 week pilot currently underway on a neighbourhood basis. Creating database of frail/vulnerable patients that may be under the radar. Rapid response actions to prevent A&E admission. Regular weekly meetings with OTs, physio, SALT, GPs and social workers.

·         Need to harness IT to increase flexibility and free up the time for professionals to engage with one another, the patients/clients and understand each other’s limitations.

·         London Devolution agreement pilot expected very soon. Our pilot work on integration will examine whether to combine domiciliary and nursing care roles.

·         Pharmacies are essential in working with minor ailments, medicine usage, medicine optimisation and poly-pharmacy drug use, all of which help to reduce A&E admissions.

·         New online wellbeing forms available for users and their carers. Builds in self-help, self-management and self-assessment. Smart links from GPs, libraries and Day Centres. Also being piloted in hospitals.

6.3       Action: The Board noted the contents of the report

7.         South East London Sustainability and Transformation Plan (STP) Update

7.1       Martin Wilkinson presented this report which provided members of the Board with an update on the NHS South East London Sustainability and Transformation Plan.

7.2       NHS England and the Department of Health recently announced the first ratings for STPs. OHSEL was rated as ‘advanced’ – the second highest rating. The collective OHSEL leadership was rated as advanced – the highest grade. NHS Leadership have published this baseline assessment in the ‘STP progress dashboard’ which will be updated annually.

7.3       Experts in the development of integrated organisations, Credo, have been appointed for a two month role to look at the complex organisational and care structures in south east London, speak to stakeholders, and make some recommendations on the options available for moving forward. This is about how the SEL health and care services can work in a more integrated way.

7.4       OHSEL has received around £20 million through the Estates and Technology Transformation Fund to support ten new estates projects across south east London. All these projects are expected to be completed by 2019/20 – the majority are in Primary Care. In addition, there is around £3.5 million being invested in improving GP premises across south east London in 2017/18.

7.5       The proposal for orthopaedic elective centres on two sites is not proceeding. OHSEL are progressing with establishing an Orthopaedic Clinical Network to drive the improvements expected over existing sites instead with close monitoring to ensure expected outcomes are delivered. If not, further consideration of a different configuration may be revisited.

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

8.         Health and Wellbeing Board Work Programme

8.1       Salena Mulhere presented this report which advised the Board of the current work programme and provided them with an update on the latest work of the Health and Wellbeing Strategy Review Group.

8.2       The Board were reminded that a workshop on mental health has been scheduled for 29 November 2017.

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

9a - Air Quality Campaign Plan 2017-18

9b - South East London Clinical Commissioning Group Review