Agenda and draft minutes

1.1   RESOLVED that the minutes of the meeting held on 20 November 2024 be confirmed and signed.

1.1   There were no declarations of interest.

1.1   The Director of Public Health introduced the report and draft Health and Wellbeing Strategy 2025-2030. The Board were recommended to review and comment on the draft Strategy. The Director of Public Health advised comments and additions on the Strategy were being received on an ongoing basis and comments from Board members would be welcome.

1.2   The Director of Public Health highlighted the below points:

·       Aim of the draft strategy is to improve health and wellbeing for Lewisham residents and also to reduce health inequalities.

·       The strategy will amplify partnership action on the social determinants of health.

·       Three areas to be prioritised are poverty, education and housing.

·       Areas for action each have a focus action.

·       The Strategy Working Group had talked about consultation activity and is ongoing.

·       The final Strategy would be brought back to the Board for approval.

·       When the Strategy is published, a detailed action plan for implementation of the Strategy would be set up with key metrics.

1.3   The Chair thanked the Director of Public Health and her team for the work put into the Strategy. The Chair noted the Strategy is evidence based, data driven, grounded in stakeholder and resident lived experience. The Strategy looks at the wider social determinants of health in terms of poverty, housing and education and some of the key enablers of the strategy being data sharing between partners.

1.4   The below observations/comments were made:

• The Executive Lead at Lewisham, South-East London Integrated Care Service commented she liked the focus of the Health and Wellbeing Strategy, particularly poverty proofing and opportunities with health providers.
• The representative from Healthwatch Lewisham noted he had been involved in the Working Group and the Strategy had evolved into a useful document. He referred to the key enablers and felt engagement with the community was missing; people will only buy into these things because they believe and trust the measures. One point at the heart of the action plan should be ‘how do we engage by using existing mechanisms through the voluntary sector’?

·       The Chair agreed and commented it would be good to draw this point out in the action plan in more detail.

·       Cllr Sheikh noted the next Strategy is being formulated and asked what factors were considered from the previous Strategy – what was achieved and not achieved; what is the continuing work?

o   The Director of Public Health commented in the draft Strategy there is an overview of prevention and discrete focus on specific prevention areas. The draft Strategy includes details on good progress on some of the metrics but there are areas where more needs to be done on prevention and wider determinants; for example, premature mortality - early death due to cancer and heart disease.

·       The Deputy CEO Lewisham and Greenwich NHS Trust commented the Strategy document reads really well and the engagement that had taken place had been good. He asked for more detail on how things would be organised to implement the Strategy.

o   The Director of Public Health commented  ...  view the full minutes text for item 3.

1.1   The Assistant Director Service Development and UEC, NHS South East London ICB Lewisham presented the Better Care Fund (BCF) Plan for 2025-26 and highlighted the below points:

·       The Health and Wellbeing Board oversees the BCF Plan.

·       It is a £53m joint fund managed between the Council and Health with governance through the Health and Wellbeing Board. The Board has typically delegated authority to a Section 75 Agreement Management Board that oversees the submission of regular reports to NHS England and approval of the plans.

·       This year the BCF Plan has a number of changes which requires sign off by both CEOs of the Council and the ICB.

·       The BCF Plan has also changed some of the targets and metrics to be reported against.

·       The requirement of the BCF Plan is that it tracks metrics and trajectories for adults, with a focus on the over 65 population.

·       The objective of the BCF plan is to support the shift from sickness to prevention and to support people living independently and the shift from hospital to home.

·       One of the metrics is tracking the discharge ready date of patients being discharged from hospital.

·       Financial contributions have been agreed and signed off by the finance leads for each of the organisations.

1.2   The Assistant Director Service Development and UEC, NHS South East London ICB Lewisham noted the report requested the Board to continue to delegate approval of the BCF Plan quarterly returns to the Section 75 Agreement Management Group; approve the current proposal for the plan; delegate approval of the final BCF 25/26 Plan to the Section 75 Agreement Management Group for submission to NHS England by noon on 31 March 2025.

1.3   The below observations/comments were made:

·       The Deputy CEO Lewisham and Greenwich NHS Trust commented it was good to hear of the impact the BCF is having and asked if there is representation from LGT in the working group.

o   The Assistant Director Service Development and UEC, NHS South East London ICB confirmed that representation from LGT was involved in the working group.

·       Cllr Sheikh referred to hospital discharges, reducing hospital admissions, step down beds and transfer of care hub and asked for more information.

o   The Assistant Director Service Development and UEC, NHS South East London ICB advised the transfer of care hub is the discharge team which is an integrated team between LBL and LGT. The team arranges discharges from hospital and supports patients through the initial period and comprises of nurses, physiotherapists, occupational therapists, social workers and case managers. Welfare checks are carried out within 24 hours of hospital discharge with follow up checks with the patient for a period of six weeks. Six step down beds are currently purchased from Alexandra Care Home which are block booked for hospital discharge. There are three further care units which are principally for people who might have housing issues or who are awaiting social care support at home. There are 14 beds at Brymore Care Home for people who need  ...  view the full minutes text for item 4.

1.1   The Lewisham Place Executive Lead NHS SEL ICB introduced the report and advised the Joint Forward Plan is a five year plan; there is a requirement to review it every year, make updates and check progress against the plan. The five priorities in the plan were agreed across the Council in October 2022.

1.2   The Associate Director of System Development, South East London ICS (Lewisham) noted there are connections with the Health and Wellbeing Strategy, particularly around prevention and inequalities. There is also work being done at a neighbourhood level on the integration of primary and community based care, with the stronger and healthier families priorities which is being developed.

1.3   The Joint Forward Plan 2025-26 is out for engagement across South East London and the Plan will be finalised in early April.

1.4   The below observations/comments were made:

·       The representative from Healthwatch Lewisham commented the Plan appears to progress everything except the resources to do it. In terms of workforce with the latest announcements about NHSE and the ICBs, the question was asked whether this would have an impact on the ability to implement any of the measures in the Plan.

o   The Lewisham Place Executive Lead NHS SEL ICB commented there is still a lot of unknown from the recent announcements but noted it is not just about ICB staff. There may need to be a tightening of priorities which would be done in line with the Health and Wellbeing Strategy

1.5   The Chair commented the Joint Forward Plan was a good document, the way it is laid out and designed and what it communicates is good. The Chair wished to put on record, from Lewisham Council’s perspective, how grateful they are to the ICB staff for the work they do for Lewisham and South East London. The Chair gave thanks to the ICB staff for the work they do.

1.6   RESOLVED to note the report and agree the recommendations.

1.1   The Public Health Intelligence Specialist presented the Lewisham Joint Strategic Needs Assessment (JSNA) update report and provided a background of the JSNA.

1.2   The central government department responsible for the indices of multiple deprivation, which is a data set that is looked at when doing funding bids, will be updated at the end of 2025.

1.3   In terms of the updated in-depth topic assessments, there are no finalised in-depth topic assessments to present currently. At the last meeting, in-depth topic assessments were done on both cancer screening and immunisations; these are now published. The current topic assessment is the all age autism needs assessment which is nearing completion. Work is being done with South Bank University to run focus groups for those who self-identify as autistic, have an autism diagnosis or are awaiting an autism diagnosis.

1.4   The other in-depth topic assessment outstanding is on children and young people with special educational needs. Feedback has been received from stakeholders with final feedback awaited. This will be presented to the Board later in the year.

1.5   Consideration is being given to how needs assessments will line up with the priorities of the Health and Wellbeing Strategy when it is published later in the year.

1.6   The below observations/comments were made:

·       The Lewisham Place Executive Lead NHS SEL ICB noted there is the safeguarding leaders group where the leads across children’s, safeguarding adults and safe communities with the next meeting having a focus on autism and suggested joining the conversation with colleagues who may be able to feed into the topic assessment.

·       The Chair welcomed the updates in the JSNA around autism and SEND. The Chair referred to Drumbeat Outreach and noted there are proposals within Drumbeat itself to cut its outreach service and suggested more work needs to be done and requested the Public Health team to liaise with Drumbeat.

1.7   RESOLVED to note the report.

1.1   The LBL Community Development Officer presented the report and provided a brief background.

1.2   The Director of System Development across the Council and the ICB advised following the request from the Assembly, the team researched the request looking at the GPs available in the area and found they do have availability within their lists. The study looked at where the GPs within the area are based and distance travelled for residents in the area; taking into account walking, transport and cycling it was determined that there was no distance more than 15 minutes.

1.3   A meeting was held with the Councillors in Forest Hill to go through the report and answer questions. This has also been extended to other people who are interested in the report.

1.4   The report also covered pharmacy; a pharmacist in the area closed so there is an opportunity for another one to be opened.

1.5    The below observations/comments were made:

·       Cllr Shiekh referred to GP practices and how they are allocated in terms of distance and asked if the criteria could be made available.

o   The Director of System Development commented when looking at population, it is necessary to look at the infrastructure and what is available and GPs is one of them. There isn’t a capacity issue; the GPs within that area are open so there is availability. One of the issues that arose was that people have to travel to GP practices. There is a nursing residential home that has a separate contract and visited by GPs. The report also provides information on the work taking place to improve access so there is availability to have consultations online.

·       When measuring access, both online and physical access is looked at so the study should be mindful of the fact that not everybody has online access which could narrow the choices and impact services provided.

o   The Director of System Development advised there is work being carried out to ensure that people who are not able to have online access are able to phone the GP surgery to make an appointment.

·       Reference to phone access was mentioned however phone access is diminishing with GP practices.

o   The representative from the Lewisham Local Medical Committee commented there needs to be an understanding about GP access noting it is not just about accessibility, it is also about access and capacity and providing a safe service. The move towards digital platforms on non-accessibility is the direction of travel GPs had been asked to take. Digital platforms do not exclude other forms of access; they are there as a tool for those people that can access online, but are not there to exclude those that cannot. If patients that are digitally enabled to use digital platforms as their first point of access are encouraged to do this, the phone line capacity could be increased for those patients who cannot use online access.

o   The Lewisham Place Executive Lead NHS SEL ICB advised GP practices have cloud telephony which  ...  view the full minutes text for item 7.