Agenda and minutes

1.          Election of Vice Chair

1.1       Cllr Barnham nominated, and Cllr Sheikh seconded, Cllr Paul Bell to be appointed Vice Chair of the Health and Wellbeing Board.

1.2       RESOLVED that Cllr Paul Bell be appointed Vice Chair of this Board for the municipal year 2024/25.

1.          Minutes of Last Meeting

1.1       RESOLVED that the minutes of the meeting held on 17 October 2023 be confirmed and signed.

1.          Declarations of Interest

1.1       There were no declarations of interest.

1.          Joint Strategic Needs Assessment (JSNA) Update

1.1       The Director of Public Health introduced the report and advised there is a statutory duty on local health and care partnerships to jointly produce and publish a JSNA and develop a joint Health and Wellbeing Strategy.

1.2       The Public Health Intelligence Specialist addressed the Board with the aid of slides ‘A Picture of Lewisham – Joint Strategic Needs Assessment 2024’. The JSNA Steering Group has been merged with the Lewisham Population Health and Care Board due to overlapping membership and to strengthen the links. Any future JSNA priorisation processes and intial sign off of needs assessments will be presented to the newly merged group before being presented at the Health and Wellbeing Board for approval and full publication.

1.3       The below observations/comments were made:

·       A Board member commented it was an interesting document and referred to page 35 detailing deprivation affecting children by ward and noted it would be worthwhile to give thought to anything more that could be done collectively.

·       The Public Health Intelligence Specialist noted Evelyn ward is one that quite often stands out on deprivation data and is worth highlighting and to be aware of.

·       A Board member referred to page 46 – inequality in life expectancy – and queried why it is getting worse for women. The Director of Public Health advised the exact reasons or cases locally are not yet known; when greater clarification is received, they will report back to the Board.

·       Cllr Sheikh expressed thanks for the comprehensive report and presentation and asked if there any breakdown available on health check take ups within the community and how accessible these are within communities. The Director of Public Health advised they get breakdown by geography and ethnicity on the NHS health check programme. The Public Health Intelligence Specialist informed the Board there is good representation from women primarily, but the programme has been getting a good male uptake also and commented the dashboard could be published as this is public information.

·       It was noted the recent cyber-attack could impact results going forward.

1.4       RESOLVED that:

(i)      The report and presentation be noted.

(ii)     When greater clarification on inequality in life expectancy is received on exact reasons or cases locally, this will be reported to the Board.

1.          New Health and Wellbeing Strategy Update

1.1       The Director of Public Health presented the report and advised as part of the Health and Social Act 2012, it is a requirement to produce a Health and Wellbeing Strategy; Lewisham previously had a ten-year strategy which expired in 2023. The Director of Public Health highlighted the key aims and objectives of the new strategy and advised the ambition is to have a finalised Health and Wellbeing Strategy in December to be presented to this Board for approval.

1.2       The below observations/comments were made:

·       A Board member welcomed the engagement with all the wider determinants in health and asked what the systemic plans are for public consultation and engagement. He also referred to poverty proofing and asked the Director of Public Health to ensure this does not get overlooked. With reference to engagement, the Director of Public Health advised their vision is to have workshops where data will be reviewed and consultation will be carried out. The next step would be to have Task and Finish Groups and thought is being given partnership of these to help with the broadest range of input.

·       A Board member referred to digital exclusion and work done on cost of living. He commented that some people welcome going to a space where they can get material information that they are unable to access online.

·       A Board member welcomed the focus on determinants; with reference to poverty proofing, she stated she would be keen that on the health side this is looked at and tested in one or two services. The Director of Public Health agreed with that approach. A Board member noted he would be happy to engage in this piece of work.

1.3       RESOLVED that:

(i)      The report and presentation be noted.

(ii)     The Board endorse the draft wider determinant actions outlined in the Strategy.

(iii)   Final version of the Health and Wellbeing Strategy be presented to this Board for approval at their meeting in November 2024.

1.          Housing Directorate Briefing

1.1       The Executive Director for Housing presented the report and commented the Housing Directorate welcome the opportunity to connect with Public Health and work together. The Executive Director for Housing informed the Board the Housing Directorate came into being on 1 October 2023 following the transition of Lewisham Homes to the Council.

1.2       The Executive Director for Housing informed the Board the Council were served with a Regulatory Notice from the Regulator of Social Housing (RSH) following a self-referral by the Council. Seventy percent of the Council’s homes were not meeting decent homes standards. RSH have served Regulatory Notices to several housing providers which shows there is a common theme.

1.3       The Executive Director for Housing advised another high-profile issue across London is disrepair cases being brought forward by tenants; there are number of solicitors who are offering tenants a service on a no-win no-fee basis whereby the Council are having to offer compensation. The Housing Directorate are encouraging tenants to contact the Council direct which will avoid the need to pay solicitor fees; the Council will offer compensation as necessary and get the repairs completed.

1.4       The Director of Housing Strategy addressed the Board with the aid of slides noting the demand for social housing is high.

1.5       The Board were informed the stock condition surveys undertaken to date on approximately 6,000 homes show that approximately 29% were non-decent. The Council have joined with 19 other social housing landlords to put together a report saying more funding for investment is needed because the housing revenue accounts are stretched.

1.6       The below observations/comments were made:

·       A Board attendee commented that poor housing conditions can have a profound impact on pupils. In terms of mental health, children can be fearful of where they live, fearful of having visits, lack of facilities in the home – all of which have an impact. He stated he would like to see a much easier referral process to housing.

·       A Board attendee noted social determinants of health are the causes of problems; it also affects those who are more vulnerable in our society. From a primary health perspective, a lot of time is spent talking to people; they are sent back into conditions that are making them sick and asked how their concerns of people can be escalated noting there needs to be a mechanism of communication with housing providers.

·       The Executive Director for Housing advised that from 1 July this year, every privately rented property has to be licensed by the Council. This gives the Council more leverage on good quality homes. There will be increased resourcing to do this work; the Council will move towards enforcement where there is no interaction from landlords.

·       A Board member referred to page 97 and growth in temporary accommodation and queried what the pre-covid levels were. The Director of Housing Strategy advised in 2020 the figure was approximately 2,500. The figure rose during covid and is now at approximately 3,000 which is high  ...  view the full minutes text for item 6.

1.          Annual Public Health Report – Cost of Living

1.1       The Director of Public Health presented the report and advised the Board the Annual Public Health Report can be on a topic of choice; this year the cost-of-living crisis has been chosen.

1.2       The Public Health Specialist Registrar addressed the Board with the aid of slides and gave a brief overview of the cost-of-living crisis from a Lewisham perspective noting it is important to highlight the risk and impact on Lewisham residents. People are at increased risk of worsening health, malnutrition, increased days off work and school. The Public Health Specialist Registrar stated the team are looking forward to considering how they can support and take forward the recommendations outlined in the slide presentation.

1.3       The Director of Public Health noted we have become quite dependent on things like the Household Support Fund and Health Support Fund and highlighted that the Household Support Fund runs until September 2024 with the Health Support Fund ending next year. It is not yet known what will replace these.

1.4       The PMO Programme Manager advised that a source for families to access free and low-cost food has been put in place; families ae being informed what is available. The PMO Programme Manager to share this information with meeting members.

1.5       RESOLVED that:

(i)      The report and presentation be noted.

(ii)     The Board endorse the recommendations outlined in the presentation.

1.          Pharmaceutical Needs Assessment (PNA) Update

1.1       The Public Health Intelligence Specialist presented the providing an update on the PNA and the proposal to issue a Supplementary Statement.

1.2       The below observations/comments were made:

·         Cllr Bell offered thanks for the report and asked if the information on pharmacies in Lewisham will be updated to include opening times and 24-hour pharmacies. Cllr Bell noted that a number of pharmacies in Forest Hill have closed and inquired whether there can be a track on these. It was noted that Boots have also closed a number of pharmacies.

·         The Public Health Intelligence Specialist advised that NHS have the information on pharmacies; this should be easily extracted and included in the Supplementary Statement.

·         Cllr Sheikh queried when a pharmacy closes how it impacts on providing prescriptions via home delivery.

·         The Public Health Intelligence Specialist advised the PNA is for NHS England to understand the needs when someone applies for a licence. In terms of what different levels of services are provided; this will need to be considered.

1.3       RESOLVED that:

(i)      The report be noted.

(ii)     The Board approve the publication of a Supplementary Statement.