Agenda and draft minutes

RESOLVED that Cllr Bell be appointed Vice Chair of this Board for the remainder of the 2023/24 municipal year.

RESOLVED that the minutes of the meeting held on 18 July 2023 be confirmed and signed.

There were no declarations of interest.

          Th Executive Director for Community Services introduced the report.

          Resolved that Better Care Fund Plan 2022-23 end of year report be approved.

5.1    Jack Davies, Public Health Registrar in the Public Health Team, addressed the Board with the aid of slides. He had been involved in putting together the annual public health report on health and culture. He raised the following points:

·         The report aimed to highlight the role between culture and health and explore how they influenced each other set in a backdrop of Lewisham’s year as Borough of Culture last year.

·         UNESCO’s definition of culture had been chosen because it allowed a wide understanding of culture which included art and literature, ways of living and beliefs: ‘the set of distinctive spiritual, material, intellectual and emotional features of society or a social group, that encompasses, not only art and literature, but lifestyles, ways of living together, value systems, traditions and beliefs’.

·         The role of culture on health and wellbeing falls into three categories; prevention, management and treatment and policy and strategy.

·         Completed and ongoing cases were discussed. The first was prevention which included We are Lewisham – Climate Emergency Programme. The second was Management and Treatment which included social management and Up Up which was a healthy weight management service for African and Caribbean members of the community. The third case was the cultural strategy which had recently been published. It discussed how culture could be included in policies and strategies going forward.

·         Key considerations – Three key questions had come out of producing the report and hopefully could be translated into practice. The first was ‘How can culture amplify the conversation that we were looking to have?’. The second was ‘How can I co-design with those this will impact?’ and finally ‘How can I ensure that the impact of culture is considered within my organisation?’

5.2    The following comments were then made.

·         Mr Brown commended the report and said that it focused on wellbeing rather than clinical interventions. He commended the report and said that everyone should promote it through their networks to ensure that people could see the benefits.

·         The health report 2022/23 was not online at the time of the meeting due to design timelines. It would be published on Lewisham Observatory and Lewisham website within two weeks of this meeting and a copy would be sent to all members.

·         The next steps now that the report had been produced and the benefits to the community were discussed. It was intended to encourage thinking about the wider determinants of health and a more holistic view of that which keeps people healthy and how the next health and wellbeing strategy could be framed around these wider determinants of health, culture and the arts.

·         The aim of producing the report was to ensure that people had a better understanding of the importance of culture in terms of health and the link between them. The questions at the end of the report were intended to help residents to understand and prioritise the cultural competence of services and work streams.

·         Funding was not attached to the implementation of the health report,  ...  view the full minutes text for item 5.

6.1    Kerry Lonergan introduced the report which gave an update on the coverage of vaccinations amongst children aged 12-15 years in Lewisham. She said that the HPV vaccine had gone from two doses to one. There had been better coverage in dose one and it was hoped that more people would have dose one.

6.2    Mr Ghoshal said that apart from the HPV vaccine, Lewisham’s take up rate for the other two vaccines mentioned in the report, were fairly consistent. In response to his question about whether parents could be asked to opt out of having the vaccine rather than opting in if they did not want their child to receive the vaccine, Ms Lonergan said that this could be difficult considering the general feeling about vaccinations. She did not consider that this would be an acceptable way to manage the process. There could be resistance; schools could refuse to grant access to the school nursing service. In Lewisham, there were not many schools who refuse entry to the nursing service, but in other parts of London, entry was refused. School age immunisations were commissioned through NHS England. They had a contract with the school nursing service, and they contacted schools directly to arrange delivery of vaccinations. Parents will have had a two-hour introduction prior to the vaccination day, on how to access the consent portal and help to complete the forms if required. If parents had to opt out of the process, this could be particularly challenging for those for whom English was not their first language or if the consent form was not available in the language they required.

6.3    Mr Ghoshal said that he would be willing to facilitate a conversation with schools to discuss how the take up of vaccinations could be improved for young people.

6.4    Ms Jacob referred to the table in the report which showed that Lewisham demonstrated consistently higher rates of the HPV vaccination coverage when compared to London and England’s averages. This was surprising considering the general hesitancy of the take up of vaccines in the borough generally. There was then a slow decline. She asked whether the reason for this was known and what could be taken from this for all the other vaccines. Ms Lonergan was not sure but thought that the timings of entering schools could have been significant. Lewisham had a good relationship with the schools’ immunisation service and were involved with the discussions around vaccine hesitancy and the flu and covid vaccination weekly meetings. In 2019/20, she said that it was fortunate that the school nursing service was able to go into the schools, when they were not locked down, to give the vaccinations. Girls in year 8 were able to consent to receiving the vaccine. If the parent had not given consent, the nurse could ring the parent on the day to discuss the issue.

6.5    Mr Brown said that there was a disproportionate hesitancy in this borough amongst some communities towards vaccines. He  ...  view the full minutes text for item 6.

7.1       Ms Lonergan presented the report.

7.2       Ms Jacob said that tobacco, drugs and alcohol was a broad area. Although there was some overlap with drugs and alcohol, tobacco was more variable. The strategy could be huge, as would the implementation plan. Ms Lonergan said that the common theme was addiction but agreed that it was an ambitious area of work. Workshops would be considering understanding stigma, whether there should be stigma around those addicted to drugs compared to alcohol and tobacco. Addiction was a health problem not a societal problem it affected everyone, and this was why such a wide approach was being taken. The starting point was ‘why did people need drugs and how could they be helped particularly into housing and work?’

7.3       This was an all-age strategy. Ms Lonergan was asked for a breakdown of the figures in terms of the impact on children.

7.4       Ms Lonergan said that she would be trying to measure the impact of addiction on members of the public who felt unsafe in public areas. She said that work shops were working with colleagues in parks and open spaces to understand how to measure park usage and safety. They were also working with waste services with regard to nitrous bulbs and lithium batteries; how they could be identified and monitored. They also discussed trends with waste management and whether they had noticed an increase or decrease of substances in public spaces.

7.5       In response to questions from the Vice Chair, Ms Lonergan said that there was no data around ADHD. As part of the autism launch last week, work was being done with the lead from SE London to understand how some of the data could be interrogated, to understand those who were diagnosed with neurodivergent, what the health implications were and how that differed. It was hoped that more detailed information could be collected from clients within the service.

7.6       Ms Lonergan said that cumulative impact of addiction was collected as part of the DTMS data. As well as addiction there were mental health issues, and she was working with mental health support to work out how to support people with a dual diagnosis as they attempted to come off an addiction.

7.7       Ms Lonergan said that she was hoping to undertake work on understanding the level of vaping in Lewisham by young people in schools. Data showed that young people were drinking less alcohol, but more were smoking vapes. As part of this strategy, she was also looking at young people who were looked after by parents/carers with substance addiction and how well they were supported in the borough and what support was needed. The Vice Chair said that targeted messaging was required to explain why vaping was not a good idea because there were health disadvantages.

            RESOLVED that

          (i) the report be noted,

          (ii) a breakdown of all ages in the data be provided,

          (iii) information be provided on vaping and the impact on children and  ...  view the full minutes text for item 7.

8.1       Helen Buttivant presented the report.

8.2       Mr Brown had attended one of the workshops and was pleased that there was a universal focus on prevention and wider determinants of health which would make a difference to peoples’ lives. He commended the team because the sessions had been engaging and he expected positive outcomes as a result.

8.3       Councillor Best said that she was not a member of the board so was not invited to the workshops. She asked to be invited to the feedback session and asked for the Healthier Communities Select Committee to be invited to review the draft strategy at the appropriate time. This was noted. The Vice Chair asked for the draft strategy to be submitted to the Healthier Communities Select Committee for scrutiny before it was submitted to Mayor and Cabinet. Anyone could still feed into the strategy because it was still in draft form. He hoped that unpaid carers would provide feedback as well as people with neurodiversity.

8.4      The Vice Chair said that he wanted Lewisham’s Health and Wellbeing Board to be the best in London, if not England and the GLA would provide support. When complete, the strategy would live and breathe. He thanked public health for their exemplary work because it was important to have a baseline, be able to track outcomes and be data driven. He asked for the language used in strategies to be considered. He gave the example of the term ‘obese’ which, although was a medical term, in his opinion, it did not help people to feel good about themselves.

            RESOLVED that

(i) the report be noted, and

(ii) the draft strategy be sent for scrutiny to the Healthier Communities Select Committee at the appropriate time before submitted to Mayor and Cabinet.