Agenda and draft minutes

1.1     RESOLVED that the minutes of the meeting held on 24 July 2024 be confirmed and signed.

2.1     There were no declarations of interest.

3.1     The Director of Public Health introduced the report and advised the report was one of the JSNA update items.

3.2     The Public Health Intelligence Specialist provided a brief update and reminder of JSNA, which was a continuous process of needs assessment of people living in the borough and health inequalities and should inform decision making, strategies and commissioning. With the aid of slides, the Public Health Intelligence Specialist informed the meeting of the work carried out on Autism Needs Assessment and Children and Young People with special education needs and disabilities.

3.3     The aim of the Autism Needs Assessment was to better understand the physical and mental wellbeing needs of that population. Data analysis would be shared when the report was finalised. Resources for Autism was the current service provider and discussions would continue about services. Focus Groups were being planned with autistic people, parents and carers which an independent person who had an awareness of autism would facilitate. A suggestion had been put forward for one session to be led by someone who was autistic.

3.4     With reference to the assessment on Children and Young People with Special Educational Needs and Disabilities (SEND), a refresh of the data (schools census data) had been completed. There was a second part, known as SEND-2, which covers children with an educational healthcare plan; positive improvements had been made in meeting the crucial 20-week threshold for completion of assessments.

3.5     The Chair thanked the Public Health Intelligence Specialist for the work done on the JSNA and noted she was looking forward to seeing the work being done on autism.

3.6     The Public Health Specialist Registrar, with the aid of slides, provided an update on the inequalities in immunisation and cancer screening uptake in Lewisham.

Inequalities in Immunisations

3.7     Key findings from the immunisation report showed that Lewisham vaccination uptake mirrors London; there is a way to go to meet national targets. The key findings of the measles, mumps and rubella (MMR) deep dive showed that London has the lowest MMR vaccination coverage overall and the trend was mirrored in Lewisham. Analysis showed that deprivation played a role; according to GP records there are some groups who made up a high proportion who had not received the vaccine - children from black and mixed ethnicity, as well as a high proportion of children whose main language spoken was either Polish, Romanian or Russian.

3.8     GPs were contacted to get an insight, particularly around getting people to take up the MMR vaccine. They pointed to increased hesitancy to get vaccines post pandemic and conflicted scheduling information of dose 2 which is 18 months in Lewisham and 3 years 4 months nationally. It was expected that national timeframes would be brought in line with what Lewisham did locally which would help alleviate confusion. Some people also chose to have vaccines in their own country; therefore, records were not being updated causing inconsistencies in data.

3.9     The below observations/comments were made:

·         The vice-chair offered thanks for  ...  view the full minutes text for item 3.

4.1     The Director of Public Health presented the report and advised this was a two year on stakeholder document; produced to give stakeholders an update on what had happened since publication of the report in 2022.

4.2     The below observations/comments were made:

·     The Chair commended the momentum with BLACHIR and commented it would be good to engage young people to grow that information from an early age; making use of the Young Mayors team who had a radio station and used TikTok.

·     The Executive Director of Adult Social Care and Health stated she had not heard of BLACHIR work before coming to Lewisham and was very impressed with it. She added that the two-year update was a helpful check back on the work; it was good to be ambitious for more from the programme.

·     A Board member commented the work that had been done was good and asked if there was any data on how communities were accessing the service.

·     The Director of Public Health noted work had been done testing and trying some things to meet the recommendations; on the next phase work is being done on how to evidence narrowing the gap between black and ethnic minority communities. The next initiative should be on the local initiatives and how these could be scaled up. A report would be presented to the Board in March which will provide project updates.

·     The former Young Mayor of Lewisham was invited to speak with reference to the BLACHIR podcast he had been involved with. He noted it was good to talk in an informal way about issues such as prostate cancer; informal conversations are being had about the BLACHIR report.

·     The Senior Manager for BLACHIR advised that BLACHIR community forums had been established which looked at each theme with communities to provide them with progression. There was a mechanism within the system to provide feedback to system leaders responsible for the opportunity for action, so the community voice continued to be heard.

4.3     RESOLVED that

(i)              the report be noted.

5.1     The Director of Public Health presented the report and advised a new Health and Wellbeing Strategy was being developed, the previous version having expired in 2023. A number of workshops and a range of activities had been held and chose to focus on wider determinant areas of poverty, education and housing. It had been intended to hold some specific deep dive groups to deal with actions, but the timelines had not been met.

5.2     The Director of Public Health sought approval from the Board to approve a shift in the timeline to present an update on actions and a draft Health and Wellbeing Strategy to the meeting in March 2025.

5.3     RESOLVED that:

(i)              The report be noted.

(ii)             Approval of revised timeline for completion of new Health and Wellbeing Strategy in March 2025.

6.1     The Assistant Director of Adult Integrated Commissioning presented the report and with the aid of slides provided an outline of joint work across housing, health and care to develop a joint working protocol to support better interfacing across those areas.

6.2     The purpose of presenting the report to the Board was for information and to ask the Board how it would like to be updated on progress.

6.3     The below observations/comments were made:

·         The vice-chair offered thanks to the Assistant Director of Adult Integrated Commissioning and the Director for Housing Strategy for the protocol noting it is an internal document around how internal teams are working together with external partners for the benefits of residents. It was a human intervention and a huge step forward. The vice-chair commented the protocol shows positive contributions are being made under very difficult circumstances and praised the team because it was a really important intervention moving us forward.

·         The Chair echoed the comments made by the vice-chair.

·         The Director of Public Health also echoed the comments of the vice-chair and referred to the last slide in the presentation on next steps, noting that the protocol could be used in primary care.

·         A Board member also offered thanks for the presentation and noted the protocol focused on the main statutory organisations but the solution to many of the issues would involve a host of other agencies including the voluntary community sector. He asked how the other agencies were brought into the process as there would be intelligence, knowledge and opportunities they could bring which would need to be an integral part of the whole process.

6.4     RESOLVED that:

(i)              The report and presentation be noted.

7.1     The Assistant Director of Service Development and UEC presented her report and, with the aid of slides, provided an update.

7.2     The Lewisham Health and Care winter plan was a jointly prepared plan developed by all system partners across health and social care, LBL and the voluntary sector. The plan was part of an annual cycle which was done every year following a wash up at the end of every year where discussions are held with staff across all sectors.

7.3     The plan was approved at the Bexley, Greenwich and Lewisham Urgent Emergency Care Board on 4 November and was going through a series of different committees, including this Health and Wellbeing Board.

7.4     There had been a lot of work done with care homes this year. A Care Homes Liaison Nurse had been recruited who sits between the care homes and the hospital wards; he was forming a bridge between the two and was working to improve documentation from the hospital to the care homes.

7.5     The final element of the winter plan was how it was communicated to make sure that everyone was aware and there was better understanding of all the different services in place across the system to reduce pressures. One workshop had been held with another to be held week commencing 25 November; the workshops were well attended by GP practice staff and staff from other service delivery areas.

7.6     The below observations/comments were made:

·         The Chair thanked the Assistant Director of Service Development and UEC for the comprehensive report.

·         The Chair referred to the appointment of the liaison officer and noted that he seemed to be doing a lot of good work and asked if this wouldl be monitored to employ a second person to cover any absence periods.

·         The Assistant Director of Service Development and UEC advised that, if a good impact was seen from the work of the liaison officer and there were good results, the intention was the pilot would be turned into a substantive project which there was funding earmarked for.

7.7     RESOLVED that:

(i)              The report be noted.

8.1     The Public Health Intelligence Specialist presented the report and advised that if there were any changes to the Pharmaceutical Needs Assessment a supplementary statement needed to be produced; this had now been produced and published in November 2024 on the council website.

8.2     RESOLVED that:

(i)              The report be noted.

9.1     The Director of Public Health informed the Board that the NHS 10-year plan consultation opened on 21 October via an online portal where members of the public could share what they would like to see in a 10-year strategy for the NHS. There were also staff surveys on the portal and organisations could give responses. The consultation would close on 2 December 2024; Lewisham council would submit a response.

9.2     With reference to the consultation, a member from NHS South East London ICB advised that South East London had been doing some engagement. There would be two events online webinar engagements with senior leaders in December and January; they were also organising two major public engagement meetings through South London Listen. There had also been work with the six Healthwatch engaging and supporting local communities.

9.3     A Board member from Healthwatch Lewisham noted he was aware that Healthwatch England was keen to be involved; engagement was important. As the consultation proceeded, clear feedback both on the ideas being put forward would be required and, in time, why they were or were not implemented. It would be a good discipline for the process for the organisations and the public who gave their time to respond get a clear response to the points they made.

9.4     The Chair encouraged all members of the Board to also submit a response to the consultation.

There being no further business, the meeting closed at 16:39.