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Welcome, introductions and apologies.
Dr Di Aitken welcomed attendees to the meeting and informed them that Catherine Pearson was stepping down as Chief Executive of Healthwatch Lambeth, noting her many contributions.
Catherine Pearson reflected positively on her years in the role and thanked the Board.
Declarations of Interest
Members are asked to declare any interests on items included in this agenda.
Members were asked to declare any conflicts of interests linked to the items on the agenda.
Dr Di Aitken, Sadru Kheraj, Therese Fletcher, George Verghese, Penelope Jarrett and Adrian Mclachlan declared an interest in item 5, Primary Care Commissioning Schemes 2022/23, and were exempt from that item.
To approve the minutes of the meeting 26 January 2022 as a correct record of proceedings and review matters arising.
The minutes of the meeting of Wednesday 26 January 2021 were agreed as an accurate record of the meeting pending an amendment to Sue Gallagher’s apologies recorded.
Adrian McLachlan outlined the support that enveloped asylum seekers in the borough.
Helena McGinty, Operations Manager, and Head of Asylum Support presented the Asylum Support Service and noted her role as a coordination point between the Home Office, Department of Levelling Up, Housing and Communities, accommodation providers, CCG, voluntary sector groups, schools, commercial partners and internal Lambeth directorates.
Dr Shazia Munir GP, introduced the Health Inclusion Team and noted health inclusion clinics provided Homelessness and Refugee and Asylum Seeker Services, and those with no recourse to public funds.
It was noted that asylum seekers and refugees at Initial Accommodation Centres IAC, Contingency IAC and Bridging hotels were registered with the local practices for consistency in the community health core offer and there were five General Practices that supported two IACs in Lambeth. The Health Inclusion team worked with local practices to ensure families were registered at the same practice and received all services, such as vaccination and general health checks.
In discussion it was noted:
· There was difficulty knowing exactly how many people were supported by the health inclusion clinics in the last six months due to a population of undocumented migrants, not included in home office figures.
· To manage demand and remain flexible, staff had been recruited recently.
· The “dispersal” project was partially driven by accommodation issues, whereby those arriving would be moved to places they felt more comfortable, and the health passport moved with the patient, while it may create uncertainty for an individual knowing they may move.
· Trauma-informed training could improve the lives of those arriving.
· The local Voluntary Sector was involved and complemented the work that was done. These groups met every six weeks and went beyond healthcare, to provide activities such as varied pottery, boxing, or cooking courses in dynamic ways to improve mental health outcomes.
· There was a focus on inequalities throughout all the work.
1. To note the report.
To listen back to this item, refer to 1.06.15 to of the recording.
The presentation accompanying this item, refer to pages 9 to 40 of the reports pack.
Garry Money, Director of Primary Care and Transformation at SEL CCG Lambeth, presented the report and noted two items of primary care commissioning business, transacted by the Lambeth Primary Care team within SEL CCG.
The first related to the extension of contractual arrangements for Extended Access Hub services in Lambeth for a further 6 months from 1 April 2022. The extension was necessary due to a delay in the mobilisation of new national contract arrangements for “Enhanced Access”, to be commissioned via Primary Care Networks, a requirement for all CCGs in England.
The second concerned the continuation of Local Enhanced and Local Improvement Services commissioned from GP Practices in Lambeth into 2022/23, without the need for procurement.
During the discussion, it was noted that:
· Regarding the national contract arrangements for “Enhanced Access”, NHS England confirmed there would be no further delay from the end of September 2022.
· Funding to London CCG would go directly as a payment to Primary Care Networks, which would determine how to allocate the funding.
1. Endorse and note the decisions taken concerning Primary Care Commissioning Schemes for Lambeth in 2022/23.
The presentation accompanying this item, refer to pages 41 to 48 of the reports pack.
Sophie Taylor, Lambeth Together Programme Lead, presented the review of the Covid-19 Health and Care Recovery Plan which the Lambeth Together Board, its Delivery Alliances, sub-groups and priority programmes has undertaken over the last few months. The plan reflected wider learning and opportunities, considering recent changes to Government guidance.
Tom Barrett, Assistant Director Covid-19 response, presented the Government Covid-19 response strategy that was published the previous month. The strategy provided four principles underpinned by population immunity, including living with Covid -19, protecting people most vulnerable, maintaining resilience, and securing innovations from the Covid-19 response.
Beyond 1 April 2022, free universal symptomatic and asymptomatic testing would not be provided to the public and the Angela Davies PCR testing site was replaced by a temporary mobile unit.
During the discussion, it was noted that:
· Letters communicating the new guidelines had been sent to all residents, with additional advice for those most vulnerable or at risk.
· The Local Outbreak Management Plan v5 was to be published on 1 April 2022 and would reflect the new guidance.
· There would be no additional funding and testing teams would be transitioned within the Council or Health System to maintain the response to the pandemic impact.
· Infection control had not changed in primary care settings and communications and expectations had to be managed, especially when working with vulnerable groups.
· Campaign messaging was displayed publicly, such as posters on the Highstreet.
· Business continuity planning took learnings from having to work with minimal information at speed, and this collective learning had already been applied to the Ukraine crisis response.
· This review informed system design, plans and strategies going forward, with a prevention and population-based approach that addressed inequalities presented through the impacts of the pandemic.
· The Health and Wellbeing bus was used as an example of community-led health.
· Dr Sadru Kheraj suggested that conversations could continue around redeploying Covid-19 staff to General Practice contracts and this network was key to neighbourhood response to health and wellbeing going forward.
· There had been 140 local volunteers at Montgomery Hall vaccination centre and learnings taken from vaccination delivery could be applied to the autumn flu vaccination programme.
· Staff stress and anxiety was acknowledged, and it was suggested that reflective spaces with psychology colleagues could be established to support staff and a special statement made as part of the plan to recognise their resilience.
· It was noted that on page 12 of the review, the work of health and social care colleagues was recognised, as well as residents who abided by restrictions.
· Nationally, a lot had been learnt about day-to-day anxiety management and it was suggested that Primary Care Networks maximise approaches to helping people manage anxiety.
1. To note the next phase of the Covid-19 response, including Lambeth’s responses to the publication of the Living with Covid-19 strategy.
To view the presentation accompanying this item, refer to pages 49 to 75 of the reports pack.
Alex Jackson, Lead Commissioner (Health & Wellbeing Hubs & Health Improvement), introduced the report and noted the pilot focused on three localities to improve inequalities with a community-based approach. The pilot built on core health services, in collaboration with partners and additional funding, to support people to maintain healthier lifestyles.
Catherine Kironde, Guys and St Thomas’ early intervention manager provided a summary of the twelve-week programme, designed for those registered with a GP in priority areas and delivered at suitable community venues in collaboration with community organisations.
Chris Thomas, representing The Mosaic Clubhouse, outlined collaboration with Heatherington General Practice that offered monthly walk-in health check clinics to promote healthy lifestyles and signpost patients to the Weight Management Community programme. The Mosaic Clubhouse offered affordable meals made from fresh ingredients, as well as weekly walk-in groups, yoga and keep fit sessions and the feedback had been positive.
At this point in proceedings, two service users addressed the Board:
· Denise had lived in Brixton for 26 years and had self-referred herself to the programme after attending a healthy living seminar at Brixton Library. There had been eight people in her first class, which reflected Lambeth’s diverse population and she felt valued as a pensioner. The trainer was highly qualified, and emphasised the course was not solely to lose weight but head in a healthy direction for both body and mind.
· Michelle explained that she had had an unhealthy relationship with food, which worsened during the pandemic. The importance of the programme’s social aspect was highlighted; however, it took place online during the pandemic and did not return to in-person classes. Michelle had now started a walking group and planned her meals, losing weight and gaining friends.
The service users thanked everyone for their work.
During the discussion, it was noted that:
· Men constituted one third of those on the weight management programme and were not as willing to engage. To address this as an issue, men’s health groups offered taster sessions and new models were applied.
· The programme acted as a lever to improve health outcomes generally and as the Council’s leisure services came back in-house, opportunities to add value to health in the borough increased.
· This programme connected to Active Lambeth, the approach to increasing participation in physical activity and sport in the borough and could be used to support individuals within the wider sports strategy.
· Food poverty was an issue in deprived areas and the programme could benefit young people who could be taught how to cook nutritious meals from scratch.
· The importance of group accountability was highlighted, and 26 weeks was seen as a long interval for group conversation.
· It was suggested that mental health discussions take place to compliment the programme as not all service users had poor mental health or found it difficult to share this with a wider group.
· Those who missed a class were contacted, sometimes returning after reasonable time and officers would consider the reasons for the 40 people that had left the programme, to provide ... view the full minutes text for item 8.
· There was uncertainty around Integrated Care System legislation and budget funding.
· Datex information informed risk and this did not tend to change from previous reports, but was considered, revaluated and updated periodically.
1. To note the report from the Lambeth Together Assurance Sub-Group and the associated Integrated Assurance Report for March 2022.
To view the report, refer to pages 89 to 132 of the reports pack.