Agenda and minutes

Health and Wellbeing Board - Thursday 17 October 2019 5.00 pm

Venue: Committee Room (B6) - Lambeth Town Hall, Brixton, London, SW2 1RW. View directions

Contact: Adrian Bentley, Democratic Services Officer  Tel: 020 7926 7162 Email:

No. Item


Declarations of Interest pdf icon PDF 146 KB


    There were none.


Minutes of Previous Meeting


    The minutes of the meeting of 04/07/19 were approved as an accurate record.


King's Health Partners five-year strategy development


    Jill Lockett, Director, Performance and Delivery; Professor John Moxham, Director, Value Based Healthcare and Joseph Casey, Deputy Director, Programme Delivery of Kings Health Partners (KHP) Presented an update on Kings Health Partners’ five year strategy.


    There were four key themes for the strategy:


    • High impact innovation;
    • System-wide quality improvement and outcomes;
    • Population health; and,
    • Workforce innovation and sustainability.


    The criteria for this were to:


    • be of value to each of the partners of King’s Health Partners;
    • contribute to developing a skilled workforce;
    • be something that KHP are uniquely positioned to do better than others;
    • contribute towards a sustainable partnership and system; and,
    • be of value to improving population health, locally and globally.


    Themes and criteria had been discussed though eight workshops with partners.


    The Strategy had moved from having a purely bio-medical emphasis and had proved successful in building relationships.


    In response to questions from the Board it was noted:


    • There was work to do in terms of the London Living Wage, although there was confidence that this would be more feasible than previously.
    • It was a concern that local children did not seem to be interested in future careers at KHP. Thought was being given to how these relationships could be strengthened. Lambeth Made were examining the possibility of running apprenticeships at Kings, and Guys and St Thomas Trust (GSTT).
    • Paediatrics was seen in the strategy through the lens of developing care for children. There was a commitment to child mental health in Lambeth.
    • Whilst Datanet had been a very useful asset for understanding work on a pan-London level, discussion was needed as to how this data could be used in a joined up way. Datanet’s work on hypertension had been impressive.
    • Tests on the Vital 5: smoking, alcohol, obesity, blood pressure and mental health, would be carried out across the population for all 40,000 KHP staff.
    • Discussion of hypertension had taken place with Cllr Dyer and Black Thrive, as this was a significant issue for young black men.


    The Board commented:

    • KHP were a huge asset to the community and it was great to see the continuation of work being done with partners.
    • The Board thanked Professor Moxham, noting that this would be his final Health and Wellbeing meeting.



    That the Board noted the report.



Lambeth Safeguarding Adults Board Annual Report


    Sian Walker, Chair of the Adults Safeguarding Board (ASB), presented the Annual Safeguarding Report to the Board. Work had been done to make the report more readable in order that it could be useful to the general public.

    Master classes had been held in Lambeth with good attendance, and neighbouring boroughs had been invited to these.

    The Board commented:

    • The position had improved greatly, but Sian Walker noted that, whilst this was the case, people should not feel satisfied with the drop in numbers and work should be put into the ‘front door’.
    • Safeguarding adults was dealt with very differently from safeguarding children.
    • Carers and family carers were very important in safeguarding.
    • There was a need to ensure that everyone in the organisation was clear where safeguarding lay.
    • There was a need to work more with the provider sector, including looking at how the message of safeguarding was passed to small provider organisations.



    That the Board noted the report.



Lambeth Together - Integrating Health and Care in Lambeth


    Andrew Parker, Director for Primary Care, CCG, presented an update on key areas of progress with Lambeth Together and the proposal to establish a Lambeth Together Interim Strategic Alliance Leadership Board from November 2019.

    Work was moving into an implementation phase. The first phase would concentrate on those with three or more long-term conditions. New ways of working were being developed.

    In September and October there would be new service delivery models around short-term and Integrated Focussed Support.

    There was a need to do more on engagement and co-productive ways of working.

    Leadership and governance arrangements were being strengthened and the Partnership and Committee in Common meeting would be merged from November.

    The Board commented:

    • The document should be open to everyone’s understanding and at present there were too many acronyms.
    • There was a need to ensure that work reached under-represented groups.
    • It was suggested that the children’s focus be more fleshed out and be tied into the Children and Young Person’s Plan.
    • The Health and Wellbeing Board would be looking at its role and discussions would take place about what how Board would look and operate going forward.



    1  That the Board noted and endorsed the progress made to date in developing and implementing ‘Lambeth Together’.

    2.  That the Board supported the proposal to stand up the interim Strategic Alliance Leadership Board from November 2019.


South East London ICS response to the NHS Long Term Plan


    Andrew Bland CCG Chief Officer at NHS South East London Commissioning and Andrew Eyres, Strategic Director Integrated Health and Care (Lambeth Council) and  NHS Lambeth CCG Member/Chair, presented an overview of South East London Integrated Care Systems (ICS) response to the NHS Long Term Plan.

    In January 2019, the NHS Long Term Plan (LTP) was published, setting out direction of travel for integration and collaboration for the next ten years to support people in starting well, living well, and ageing well. The Plan was discussed at the March Health and Wellbeing Board.

    A narrative would be developed explaining how proposals were taken forward and implemented over five years. Technical and workforce planning also needed to be examined.

    The plan included prevention and increased use of digital technology and data. This was a NHS plan even though it did talk about the wider system. It did not address specific issues of social care or wider health funding.

    Aspects identified in the 2016 plans were now national priorities for the NHS.

    A number of core foundations had been laid out in the Plan for systems across the country. There were also a number of prioritised commitments with increased local flexibility as to how these were achieved.

    There were a set of five conversations that were needed:

    1.          Setting out the governance and delivery of the ‘System of Systems’, focussing on place-based delivery.

    2.          Redesigning how services are commissioned in south east London.

    3.          Testing hospital group model approaches.

    4.          Testing integrated care approaches through the development of primary care networks at the core of the delivery model for fully integrated community-based care.

    5.          Exploring delegation of specialised services commissioning to the ICS.

    There were five national financial tests in place:

    • Test 1: The NHS (including providers) would return to financial balance.
    • Test 2: The NHS would achieve cash-releasing productivity growth of at least 1.1% per year.
    • Test 3: The NHS would reduce the growth in demand for care through better integration and prevention.
    • Test 4: The NHS would reduce unjustified variation in performance.
    • Test 5: The NHS would make better use of capital investment and its existing assets to drive transformation.


    In answer to the Board questions it was noted:

    • The NHS People Plan had suggested that whilst the NHS looked after people well it was lacking in the way it treated its own staff. It was hoped that this could be improved with the LTP. This was hoped to be a model for building win/wins into local communities by employing local people and improving payment.
    • It was thought that internal markets had not served the NHS well. There was now a commitment to bring together alliances of providers that responded to outcomes rather than activity based contracts.
    • The 4% uplift would not compensate for activity growth. The increase in demand would mean that there would be a need to achieve more than the stated 1.6% productivity growth.
    • There were severe timescales for this work and there was a need to plan  ...  view the full minutes text for item 6.


Better Care Fund submission 2019/20


    Liz Clegg, Interim Director, Integrated Commissioning, Adults, joined the meeting and presented the submitted template for the Better Care fund 2019/20. Government had requested more detail for this submission, which reflected the large page count.

    It was noted that there had been a dip in performance with targets not met for Better Care Fund Metrics; notably on non-elective emergency admissions and reducing Delayed Transfers of Care (DTOC). Some of the DTOC issues were related to poor quality in provider markets and showed an unavoidable need to support the social care market.

    Funding had been increased for GP cover for nursing homes and GPs had been asked to provide support for more complex needs.


    That the Board ratified the submission.


Update on Health in all Policies Workshops


    Bimpe Oki, Consultant in Public Health, presented an update on the Health in all Policies Workshops.  Two workshops had been held and had provided opportunities for people to engage with colleagues. The first workshop had taken place in July and had been well attended. Work was also taking place through LEAP and Brixton Neighbourhood projects.

    A homelessness strategy was being developed following the workshop and clear actions had been identified.

    Larger workshops around poverty and health were being run.


    1.    The Health and Wellbeing Board noted the update on the Health in all Policies workshops that have been conducted so far.

    The Health and Wellbeing Board agreed the proposal that the Staying Healthy Partnership Board was responsible for overseeing the delivery of the prioritised actions that emerge from the “Health in all Policies” workshops.


Eat Them to Defeat Them national campaign


    Bimpe Oki, Consultant in Public Health, provided an update on the Eat them to Defeat them campaign that was run earlier in the year.

    Cooking sessions in schools had proved to be the most popular activities. The vegetable ‘invasion of Lambeth’ had been very popular and there had been a 1.7% increase in vegetable consumption amongst participants, and 90% had discovered a vegetable that they had not tried before.

    It was hoped that there may be an opportunity for all schools to enjoy the cooking sessions, but at the present time this was limited to 20 schools. Volunteers from the Board were welcomed to go to schools when future cooking sessions were being held.


    The Board noted the report and supported its recommendations.


Quarterly Report of the Director of Public Health for Lambeth (July -September 2019)


    Ruth Hutt, Director of Public Health, presented the Quarterly Director of Public Health report.

    The report provided the link to the 20 minute suicide prevention training. It was requested that as many people as possible should take this training and the Board was asked to cascade to staff.

    Measles was an ongoing issue and there had been a recent outbreak. An MMR action plan was in the place and there were efforts to address the issues of immunisation.

    There was a HIV campaign in place and rates of HIV continued to fall.

    Flu vaccinations were being offered to all staff. It was important to publicise this.

    The Board added:

    • Drug related deaths were rising at a high rate, and Public Health England was developing a London wide approach on medically assisted treatment facilities.

    The LGA had recognised the Three Borough sexual health work.


    That the report was noted.


Lambeth Children's Partnership update


    Annie Hudson, Strategic Director for Children’s Services, introduced two reports from the Children’s Partnership Board. The work being done was beginning to pay dividends and a community-developed approach around adolescents was in place.


    That the reports were noted