Agenda and minutes

Health and Wellbeing Board - Thursday 21 October 2021 6.00 pm

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

Contact: David Rose, Democratic Services,  020 7926 1037, Email: drose@lambeth.gov.uk

Note: Information on how to access the meeting is set out on the agenda. If you want to participate in the meeting please copy and paste this link into your browser: https://bit.ly/3BIgvr9. However, if you just want to watch the live broadcast please copy and paste the following link into your browser: https://bit.ly/3BFTrJx. The video will remain available to view for 180 days. 

Items
No. Item

1.

Declarations of Interest

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    Under section 3 of the governance arrangements for the Health and Wellbeing Board, Board members are bound by the Members’ Code of Conduct as set out in the Council’s Constitution (Part 6 Section B).  Where any Board member has a Disclosable Pecuniary Interest in any matter to be considered at a Board meeting they must withdraw from the meeting room during the whole of the consideration of that matter and must not participate in any vote on that matter unless a dispensation has been obtained from the Monitoring Officer.

     

    Minutes:

    There were none.

     

2.

Minutes of Previous Meeting pdf icon PDF 184 KB

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    To approve the minutes of the meeting held on 08 July 2021.

     

    Minutes:

    The minutes of the meeting on 8 July 2021 were agreed as a correct record of proceedings. 

3.

Public Notice Question

4.

Health and Wellbeing in Housing and Estate Regeneration pdf icon PDF 347 KB

    • View the background to item 4.

    (All wards)

     

    Report authorised by: Andrew Eyres: Strategic Director of Adults and Health

     

    Contact for enquiries: Bimpe Oki, Consultant in Public Health,

    020 7926 9678, boki@lambeth.gov.uk

     

    Special Circumstances Justifying Urgent Consideration

     

    The Chair is of the opinion that although the report had not been available for at least five clear days prior to the meeting, it should nonetheless be considered now as a matter of urgency. This is due to it forming the themed item of the October Board meeting, allowing the discussion and hearing of health and wellbeing perspectives from a housing and estate regeneration theme, which could not be deferred to the next meeting.

     

    Minutes:

    Councillor Jim Dickson, Cabinet Member for Health and Social Care (job-share) and Chair of the Health and Wellbeing Board; noted that the Health and Wellbeing Board (HWB) used themed discussions on borough issues with members of the public and professionals able to input.

     

    Bimpe Oki, Public Health Consultant, introduced the report and stated:

    ·           Housing and estate regeneration were key areas for residents and the Council.

    ·           There was a strong relationship between housing, regeneration and health.

     

    The Board heard the following representations from Anthea Cook, Anthea Cook Consulting; Tony Coggins, Thrive Consultancy:

    ·           Estate regeneration could be designed to build social capital and in turn health and wellbeing.

    ·           Health Impact Assessments (HIA) were evidence-based processes that adjudged policy impact on health and wellbeing, alongside the environment and other important factors, and sought to formulate recommendations to mitigate negative impacts, ensure resilience and improvements.

    ·           The Clapham Park Regeneration HIA that was conducted several years ago was discussed, noting that most health benefits arose from good quality housing, adaptations for disabilities and ensuring the nearby relocation of neighbours.

    ·           Negative impacts could include isolation in high-rise buildings, poor access to health and care services, and building and construction generating dust, noise, and disruption.

    ·           Positive impacts of regeneration could include improved respiratory health from solving damp issues, independence and improving stress on young families with better facilities, reduction in crime and fear and community network improvements.

    ·           The Clapham Park recommendations included considering bult environment, community safety, service/leisure access, suitable housing provision, maintaining neighbours and managing relocation and construction phases.

     

    The Board next heard from Alice Orr-Ewing, Head of Resident Commitment and Re-Housing, on how health and wellbeing was considered during regeneration:

    ·           Homes for Lambeth (HfL) undertook a person-centred approach, where health impacts and outcomes were considered from inception, acknowledged that residents’ needs changed and had a wide scope to support broader determinants of health, such as employment and skills. 

    ·           HfL was dependent on joint working and incorporated best practices from across the UK and the NHS Healthy New Towns programme.

    ·           Health was integrated into the estate regeneration masterplan process (initial phase of development) to its outcome phase, by establishing a health profile baseline and reviewing how estate design addressed challenges and provided mitigating actions.

    ·           It was essential that relationships were established with residents.

    ·           HfL contained a social value programme to improve digital access, reduce social isolation, benefit community development and organisation, promote enterprise, and support employment.

    ·           Current residents who were to move to new homes were given occupational health assessments, with the results of these incorporated into developers’ design briefs, such as ensuring overcrowded households were moved into right-sized homes. Help was also provided with a packing and unpacking service and moving residents in their neighbourhood groups where possible.

     

    Theresa Agyeman, Resident and Community Centre Manager for Metropolitan Thames Valley Housing (MTVH); and, Dr Andrew Boyd, Clapham Park Practice GP; gave evidence on the outcomes of Clapham Park Regeneration Plans:

    ·           Moving home involved change, but the benefits arising from new facilities such as community centres and  ...  view the full minutes text for item 4.

5.

Update: Child and Adolescent Mental Health Services in Lambeth pdf icon PDF 431 KB

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    (All wards)

     

    Report authorised by: Merlin Joseph: Strategic Director for Children’s Services

     

    Contact for enquiries: Dan Stoten, Integrated Associate Director of Children, Young People, Maternity, CAMHs and VAWG Commissioning, London Borough of Lambeth & NHS South East London CCG (Lambeth), 07920 545689, Daniel.stoten@nhs.net

    Minutes:

    Dan Stoten, Integrated Associate Director of Children, Young People, Maternity, CAMHS and VAWG Commissioning, updated the Board on Lambeth’s Child and Adolescent Mental Health Services (CAMHS) since the July report, noting:

    ·           Service referrals peaked in May but dropped in August to match previous years, reflecting national statistics, largely resulting from Covid-19, and average weekly waiting times were stabilising.

    ·           Leaflets had been distributed to children and families on services and triaging.

    ·           Children’s case complexity and case numbers were increasing.

    ·           It was essential to engage with wider networks to enhance support as other bodies, such as schools, were likely to know of additional needs, but this increased complexity.

    ·           There was increasing acute accident and emergency presentation of those with mental health needs, which was being monitored at weekly Gold meetings.

    ·           Over 18 weeks’ waiting was slowly improving, but over 52 weeks had significantly improved (24 down to nine individuals).  Tackling recruitment issues would improve this further.

    ·           There were eight Tier 3 South London and Maudsley (SLaM) Trust vacancies, of which five were not due to be filled soon. Recruitment challenges were a national problem, and mental health trusts were attempting to recruit from the same small pool of practitioners and SLAM were doing all that was possible.

    ·           No SLaM staff were on long-term sickness and all had access to health and wellbeing support.

    ·           CAMHS staff were being encouraged to hold hold their clinics and appointments face-to-face.  Using GP surgery space was under review and CAMHS were due to move to St John’s School in Angell Town by Q4 2021-22.

    ·           Significant investment from the CCG and SLaM would support mitigations and meeting the wellbeing needs of children and young people.

    ·           The Alliance group were reviewing CCG and SLaM investment options; alongside an evaluation January 2022 of mental health support teams in schools.

    ·           The statutory Autism Strategy covered all ages, which remained an issue with this casework (migrating between age-based services) but would impact on CLAHMS caseloads.

     

    It was noted in response to questions from the Board that:

    ·           All mental health providers had the dual challenge to encourage people into services and to encourage local communities to service them so that they reflected those communities.

    ·           It was encouraging that SLaM arrangements were being repeated in other mental health trusts.

    ·           The biggest challenge was the provision of a skilled and representative workforce.

    ·           Partnership working was good, but the wide array of emotional health and wellbeing services on offer were not necessarily well communicated to residents.

    ·           Services needed to meet both community needs and types of need.

    ·           Further co-working with children, schools, Youth Council and others would reduce pressures by lowering demand, but – such as early help approaches – comprised long-term work-strands.

     

    The Chair recorded a degree of confidence that Lambeth and partners were managing challenges to this important service but noted the severe pressures.

     

    RESOLVED:

    1.         To note the report.

     

6.

Developing our South-East London Integrated Care System (ICS) - Proposed Transition Arrangements pdf icon PDF 287 KB

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    (All wards)

     

    Report authorised by: Andrew Eyres: Strategic Director of Adults and Health

     

    Contact for enquiries: Andrew Parker,Director of Primary Care and Transformation, NHS South-East London CCG (Lambeth), 07956 677348, andrew.parker6@nhs.net

    Additional documents:

    Minutes:

    Councillor Jim Dickson, Cabinet Member for Health and Social Care; and, Andrew Eyres, Strategic Director for Adults and Health, updated the Board on Integrated Care System (ICS) development:

    ·           The Health and Care Bill, containing integrated care provisions, was in the Parliamentary committee stage, with the Act expected in advance of April 2022. 

    ·           South-east London health and care partners would implement a series of arrangements in advance of the 01 January 2022 go live date, following received guidance.

    ·           Arrangements included not just ICS, but also disestablishing existing CCGs and establishing governance integrated care partnerships and a new Board.

    ·           South-east London had engaged with people to design the ICS, noting the:

    o    key role of an integrated care partnership, building sustainable systems that extended across existing structures, reduced inequalities and improved health outcomes;

    o    focus on working together to improve collaboration; and,

    o    clear commitment to subsidiaries and delegation, developing provider collaboratives and Lambeth Together as a local care partnership in the wider ICS system.

    ·           The Lambeth Together Strategic Board (LTSB) was reviewing arrangements but Lambeth was well placed to operate under new local care partnerships from April.

    ·           The November LTSB would hear final proposals, but these were building on a set of behaviours and partnerships that were already well developed.

     

    The Chair thanked officers and noted the considerable structural changes being delivered alongside partners, strengthening these bonds and empowering partners to improve citizens’ health outcomes.

     

    RESOLVED:

    1.         To note the contents of this paper.

     

     

7.

Board Development Day Session Feedback Report (September) pdf icon PDF 224 KB

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    (All wards)

     

    Report authorised by: Andrew Eyres: Strategic Director of Adults and Health

     

    Contact for enquiries: Ruth Hutt, Director of Public Health, 020 7926 7196, rhutt@lambeth.gov.uk

     

    Minutes:

    Ruth Hutt, Director of Public Health, introduced the report, noting:

    ·           Feedback to themed meetings and inclusivity of the hybrid/online meeting arrangements was good and had increased attendance.

    ·           An inclusive Joint Strategics Needs Assessment (JSNA) was needed that captured individual experiences within the borough before, during and after the pandemic.

    ·           Proposals for a Board refresh would be brought back in 3-6 months for further discussion prior to the 2023 refresh and would be a co-worked with partners.

     

    The Chair offered support to a community focussed JSNA to drive improvement and confirmed that Healthwatch and other partners would be central to the hearing of people’s voices.

     

    RESOLVED:

    1.         To note the contents of this paper.

     

     

8.

Better Care Fund (BCF) 2021/22 Planning Requirements and templates pdf icon PDF 492 KB

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    (All wards)

     

    Report authorised by: Andrew Eyres: Strategic Director of Adults and Health

     

    Contact for enquiries: Jennifer Burgess, Integrated Commissioning Manager, 07771 344372 jennifer.burgess@nhs.net

    Minutes:

    Councillor Jim Dickson, Cabinet Member for Health and Social Care (job-share); Jane Bowie, Director: Integrated Commissioning (with CCG); and, Jennifer Burgess, Integrated Commissioning Manager, noted:

    ·           The Better Care Fund (BCF) was established in 2015 to support the integration of social care and health. A new planning template has now been released and the required submission is by 16 November.

    ·           Lambeth had met all national conditions for the BCF.

    ·           The BCF supported people to remain independent in their own residence.

    ·           Continued development through the Lambeth Together partnership and delivery alliances would ensure local person-centre services that improved health and wellbeing, including inequalities.

     

    In discussion it was noted:

    ·           The BCF was a good example of how Lambeth met integrated health care outcomes by pooling budgets and would be the vehicle to improve local persons’ outcomes.

    ·           The Government had altered data collection metrics which could present challenges.

    ·           The BCF had oversight and monitoring arrangements funded by different aspects within the BCF.

    ·           Most metrics were on the evaluation of commissioned services and not primarily on inequalities.

    ·           The Chair noted that equality impact assessments and monitoring remained issues to pursue.

     

    RESOLVED:

    1.         To note the report.

    2.         To delegate the formal sign-off of the Lambeth BCF 2021-22 to the Health and Wellbeing Board Chair and Vice-Chair, to be finalised before 16 November 2021.

     

9.

Quarterly Report of the Director of Public Health for Lambeth pdf icon PDF 345 KB

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    (All wards)

     

    Report authorised by: Andrew Eyres: Strategic Director of Adults and Health

     

    Contact for enquiries: Ruth Hutt, Director of Public Health, 020 7926 7196, rhutt@lambeth.gov.uk

     

    Additional documents:

    Minutes:

    Councillor Jim Dickson, Cabinet Member for Health and Social Care (job-share) stated his approval of the new Office of Health Improvement and Disparity launched by the Secretary of State in Lambeth, using Lambeth’s example of community partnerships to achieve outcomes. Ruth Hutt, Director of Public Health, introduced the report and noted:

    ·           The Public Health team had delivered well in the last 24 months at considerable pace.

    ·           Whilst the team had concentrated on Covid-19 response, there would be a return to some business-as-usual functions, such as the JSNA.

    ·           The report detailed work undertaken on schools, food, and other activities, and future work to be undertaken over the winter.

    ·           Attendees were asked to help advertise the winter HIV prevention programme as part of HIV London Prevention Partnership and Lambeth’s Health Intelligence Team.

    ·           It was essential to work with partners to remain resilient over the winter months, whilst deploying capacity into other workstreams, such as JSNA, in the coming year.

     

    Andrew Eyres, Strategic Director of Adults and Health recorded the Public Health team’s Lambeth team of the year award and the local government Chronicle Awards, praising their dedication serving the people of Lambeth during this extraordinary time. The Chair also thanked officers for the report and to the wider Public Health team and Bimpe Oki on delivering the Black Community Public Health Day, the 30 September Board Development session, and the themed event for this meeting, alongside core workstreams.

     

    RESOLVED:

    1.         To note the report.