Agenda, decisions and minutes

1.1.RESOLVED: that the minutes of the last meeting be agreed as a true record.

1.1. RESOLVED: that the minutes of the last meeting be agreed as a true record.

1.2. A member of the Committee mentioned that under section 4.11 of the minutes it was suggested that all Lewisham Councillors would be provided with data so that they could establish an effective relationship with the care homes in their wards. The Committee hadn’t received this data yet and requested a follow-up on this.

2.1.Councillor Jacq Paschoud declared a personal interest as she had a close family member in receipt of a care package from Lewisham Social Care.

2.1.Councillor Jacq Paschoud declared a personal interest as she had a close family member in receipt of a care package from Lewisham Social Care.

RESOLVED: That the Committee

·         welcomed the report and fully supported the development of a new model of care and modernisation of our mental health estates.

·         would be happy to assist with the resident engagement exercises required for the development of this business case.

·         be kept informed of the progress on this business case.

Bobby Pratap (Director of Implementation, SLaM) and James Lowell (Chief Operating Officer, SLaM) introduced the report. The following key points were noted:

3.1. The Ladywell Unit in its current state presented an unfit physical environment for the patients and staff. £3 million had been spent on the building to allow basic renovations, but the building still remained unfit for purpose.

3.2. Even though the modern-day minimum requirement for mental health units was to have ensuite toilets for all rooms, the Ladywell Unit only had 2-3 toilets per 18 people.

3.3. Instead of just replacing the Ladywell Unit with a modern fit for purpose building, it was agreed that this situation presented an opportunity to pause, review and modernise the model of care being delivered.

3.4. It was discussed that there was mistrust in the community when it came to statutory mental health facilities in the borough, especially amongst residents from Black ethnic groups. Levels of coercion, medication and police interaction were cited as being the key reasons for this mistrust.

3.5. Black residents in Lewisham were over-represented in the mental health wards, constituting 50% of inpatient bed days in Lewisham acute and psychiatric intensive care units (PICU).

3.6. There were national concerns around the fundamental model of acute mental health care and recent high-profile incidents had raised concerns around breach of human rights in these mental health facilities.

3.7. The business case for the mental health care model modernisation would require significant investment in the long-term future infrastructure of Lewisham’s mental health services. With a robust and compelling case, there may be opportunities for some charitable fundraising.

3.8. Most of the Trust’s investment and activity was focused on inpatient and acute care which left relatively little for community and social based care. Currently, ~58% of the adult NHS mental health budget was being spent on supporting ~4% of the people which meant the remaining 96% people had to be serviced with 42% of the budget.

3.9. However, there were some positive reflections in relation to Lewisham’s mental health service such as Lewisham implementing SafeWards and the local authority’s commitment to supported housing pathway.

The Committee members were invited to ask questions. The following key points were noted:

3.10. At the Ladywell Unit, there were around 600 admissions last year out of which 70% were detained under the Mental Health Act. 50% of those admitted belonged to the Black ethnic group. Officers from SLaM stated that they would confirm these figures and data for the Committee and would circulate the data on what proportion of admissions were because of treatment orders.

3.11. SLaM had a medium secure, forensic acute admissions ward that was based in River House at Bethlem Royal Hospital.

3.12. A significant number of clinicians within SLaM were researchers who had contracts with the Institute of Psychiatry, Psychology and Neuroscience (IOPPN) which helped SLaM form strong links with the clinical academic groups.

3.13. Developing a new model of care was not driven by NHS budget reductions. On the contrary,  ...  view the full minutes text for item 3.

RESOLVED: That

·         the report be noted.

·         the Committee have the opportunity to receive the Physical Activity Strategy for pre-decision scrutiny.

Neville Graham (Sport and Leisure Service Manager) introduced the report. The following key points were noted:

4.1. There were 2 contractors that operated leisure centres in the borough. One was Greenwich Leisure Limited (GLL) that operated 6 sites. The second one was 1 Life that had managed Downham Health and Leisure Centre (DHLC) since March 2007 and had a 32-year contract through a Private Finance Initiative (PFI).

4.1. As part of the budget cuts, changes were proposed to the concession arrangements within the leisure centres that allowed free gym, swim & athletics track access to all those over the age of 60 or those who were disabled.

From October 2022, the concession offer was continued for those who were disabled but those over 60 had to pay a subsidised concessionary rate rather that retaining free access.

4.1. Leisure centre participation had been steadily increasing since January 2022.

4.1. In November 2021, the Mayor & Cabinet approved a detailed feasibility study that would consider options for the future re-provision of the Bridge Leisure Centre which had remained closed following the Covid-19 pandemic when other leisure centres re-opened. This study was due to conclude soon, and public engagement would begin once the study had concluded.

4.1. A vacant unit in the Lewisham Shopping Centre had been converted into a health & wellbeing space called the CommUNITY space. This space was being used as a ‘warm welcome zone’ along with being a wellbeing space that provided free activity sessions, warm meals and support & advice to the local community.

4.1. The Council had been working with the Lawn Tennis Association (LTA) to agree and deliver a programme of work that would upgrade the Tennis Courts across the following sites- Ladywell fields, Telegraph Hill, Hilly Fields and Chinbrook Meadows.

4.1. The Physical Activity Strategy that focused on increasing borough wide physical activity rates by working in partnership with local stakeholders was currently in the final stages of development.

The Committee members were invited to ask questions. The following key points were noted:

4.1. The Pool Water Treatment Advisory Group (PWTAG) recommended that the pool water temperature and the composition of chemicals used in pool water were monitored regularly so all leisure centres in Lewisham followed this practice.

4.1. There was a wide range of activities available in the leisure centres for the general public and the exercise on referral scheme meant the leisure centres also had specialist programmes for people with specific health conditions. GLL was exploring the opportunity to have an exercise on referral scheme for cancer patients in the pre-operative stage to help their bodies prepare for surgery.

4.1. After the concessionary arrangements at leisure centres were changed, older residents (60+) lost free access to swim & gym but were told they would be eligible for discounted rates. GLL was offering the Be Active membership to older residents (60+) at £29.95 per month. The Committee enquired how this was a concessionary rate since membership had previously been available at this price to everyone. Officers agreed that further  ...  view the full minutes text for item 4.

RESOLVED: That

·         the report be noted.

·         the Committee have further opportunity to contribute into and review the Lewisham Health & Wellbeing Charter before it was agreed.

·         the Committee receive the Joint Local Health & Wellbeing Strategy (JLHWBS) for pre-decision scrutiny.

Councillor Paul Bell (Cabinet Member for Health & Adult Social Care) conveyed the Mayor’s apologies and provided the Committee with an update from the Health & Wellbeing Board. The following key points were noted:

5.1. Councillor Chris Barnham (Cabinet Member for Children's Services and School Performance) and Councillor Juliet Campbell (Cabinet Member for Communities, Refugees and Wellbeing) would be made formal members of the Health & Wellbeing Board (HWB).

5.2. Lewisham’s Health & Wellbeing Strategy was due to expire this year and a new Joint Local Health & Wellbeing Strategy (JLHWBS) was being developed with support from the Local Government Association (LGA). Councillor Bell stated that he would welcome this Committee’s comments on the strategy. The HWB wanted to be data-led, outcome-focused with a human face and the strategy would reflect this ethos.

5.3. The data from the JSNA (Joint Strategic Needs Assessment) and Census 2021 would inform the development of the JHLWBS.

5.4. LGBTQ+ health, particularly Trans healthcare was one of the areas of focus for the HWB. Data from 2021 Census highlighted that Lewisham had a significant number of trans people. There were 2471 people in Lewisham aged 16 years and over whose gender identity was different from their sex registered at birth.

5.5. Data from 2021 Census also demonstrated how indicators of bad health were significantly worse in some wards such as Bellingham and Downham.

5.6. The HWB had also noticed the challenges around the provision of information regarding a woman’s right to choose an abortion and wanted to work towards enabling safe access to healthcare for all.

5.7. BLACHIR and the ICS strategy which was being published would play an important role in shaping the JHLWBS.

5.8. Following a 60-day consultation period that ended on the 15th of November 2022, the Lewisham Pharmaceutical Needs Assessment had been finalised and would be presented to the HWB in March 2023.

Catherine Mbema (Director of Public Health) provided the Committee with an update on the Lewisham Health Care & Wellbeing Charter. The following key points were noted:

5.9. The Lewisham Health Care & Wellbeing Charter was a way for the Council to work with our residents and would seek to address the feedback that had been obtained by Healthwatch and other existing surveys on access and provision of services.

5.10. A People’s Partnership Committee (PPC) was being established by the Local Care Partnership that would function as the main forum for engaging with residents and the VCS (Voluntary & Community Sector).

5.11. The PPC would be launched in April 2023 and would work alongside the development of the JLHWBS. Both the draft Charter and the draft JLHWBS would be presented to the HWB in July 2023.

5.12. Four Health Equity Fellows had been recruited to four Primary Care Networks (PCNs) in Lewisham. Work was ongoing to align them with community groups within each PCN to form Health Equity Teams that would lead on community engagement and action to address health inequalities.

The Committee members were invited to ask questions. The following key points were noted:

5.13. The  ...  view the full minutes text for item 5.

RESOLVED:

·         That the completed work programme for 2022/23 be noted.

It was discussed that the Committee would have an informal meeting to discuss suggestions for the Committee’s 2023-24 Work Programme.

RESOLVED:

·         That the completed work programme for 2022/23 be noted.