Agenda item

5.1     This item was discussed after item 6 Additional information savings proposals A14 and A16.

5.2     Sir Steve Bullock (Mayor of Lewisham and Chair of the Health and Wellbeing Board) introduced the report. The following key points were noted:

·      The strategy of the Health and Wellbeing Board (HWB) has been refreshed. The Joint Strategic Needs Assessment (JSNA) was carried out when the HWB was not formally set up yet but functioning in a shadow form. The JSNA has been the foundation for HWB priorities so far.

·      The HWB is still a very new creation, and the relevant legislation has left some maters unresolved. HWBs functions as a, for local government, strange hybrid between executive and scrutiny functions. This concern has been identified across London during events about HWBs, so this is not simply limited to Lewisham.

·      HWB has had to identify priorities, and it easy to say everything is a priority. The question for the HWB now is how to take matters forward. In the strategy refresh decision has been made to focus on three areas: (a) the integration of health and adult social care; (b) preventing ill-health and promoting independence; (c) supporting our communities to become healthier and more resilient. Given the financial pressures for the Councils and its partners in the health sector, these areas have to be prioritised, especially the integration of health and adult social care.

·      The remaining question is how the HWB can add value, as he HWB does not control any resources directly. But relies on the resources and work of its constituent parts to deliver against the HWB’s priorities.

5.2     Danny Ruta commented on the report. The following key points were noted:

·      The focus of action in the next couple of years would be on how to achieve long-term outcomes. The aim is to act on the levels of the population, community and individuals. In addition it was important to make each contact count with a health care professional or other public sector worker in Lewisham.

5.3     Sir Steve Bullock and Danny Ruta answered questions from the Committee. The following key points were noted:

·      The HWB is a hybrid of executive and scrutiny functions. The Board has a duty to scrutinise the workings of its constituent bodies, as well as having executive powers. The Healthier Communities Select Committee can add value by looking at whether the priorities for action have been delivered against by the constituent bodies of the HWB. It may be less useful to look at the work and output of the HWB directly.

·      The universal free vitamin D scheme mentioned under Priority 1 Achieving a healthy weight in the report, was intended to contribute to healthy nutrition and consumption of healthy food overall. Officers are unaware of a direct positive link between consumption of vitamin D and a healthy weight.

·      BSG immunisation is currently provided to babies a couple of weeks after birth by health visitors. There are currently discussions undergoing as to whether midwives should be trained to administer the vaccines to improve uptake.

·      The government has decided that the in-year cut to the Public Health Grant should go ahead, and that each local authority should save 6.2% of their allocated Grant for the current financial year. Officers are looking into how to implement this saving, which will be difficult as there are only 3-4 months in the financial year left. An added difficulty is that a large part of the Public Health Grants is spent on contracts that have been signed so the Council has already committed itself to spending this money.

·      A initiative is being developed London wide to encourage supermarkets to provide check-out areas that don’t contain junk food. Price promotions in supermarkets and other businesses selling food often provide deals for food with high fat and/or high sugar content. Meal deals offered by businesses often lead to situations where a sandwich is cheaper if purchased alongside crisps or a sugary drink. There is a debate on-going about whether food and drink that are high in sugar should pay a 10-20% sugar tax.

5.4     The Committee made the following comments:

·      The rate of uptake of immunisation is when vaccines are administered almost directly after the birth of a baby as compared to months down the line. It would be good to see early administration of immunisation provided in Lewisham.

5.5     RESOLVED: the Committee noted the report, and that the Committee be kept up to date with the plans to implement the 6.2% in-year cut to the Public Health Grant.