Issue - decisions

Refresh of Lambeth’s Health and Wellbeing Strategy

23/09/2016 - Refresh of Lambeth’s Health and Wellbeing strategy

The Cabinet Member for Healthier and Stronger Communities (job-share), Councillor Jim Dickson, introduced the report and noted:

·           Health had witnessed dynamic change since the 2013 strategy, such as an increasing number of UK hospitals running deficits, significant cuts to public health funding and a much greater focus on integration of health and social care.

·           Since 2013 primary care had changed and more work was being done at a regional level, so the Strategy needed to fit in with other boroughs. 

·           The key objectives remained the same: health and wellbeing improvements for all, but fastest for those in need; and, that everyone could reach their full potential, safe from harm, to play a part in the community. 

·           This would be achieved by tackling issues such as life expectancy (including healthy life expectancy and improving quality of life); reducing the prevalence of diabetes, chronic obstructive pulmonary diseases (COPDs) and reducing sexually transmitted infections (STIs).  The Council was making progress on these, but more work was needed.

·           Housing was now under the Council’s direct management, and it was noted that much UK housing was not warm enough in winter and this could contribute to health and wellbeing issues.

·           Lambeth had a good track record on areas such as mental health, the Living Well Collaborative, and its focus on prevention; but there was further room for improvement. 

·           BME groups remained over-represented, but this was being targeted, with Councillors Ed Davie and Jacqui Dyer’s work with the Black Health and Wellbeing Commission praised.

·           Emergency admissions were down, with innovations in sexual health workallowing decreasing costs whilst being more user-friendly.

·           Gains were being made, and the Strategy was a harbinger of further ambition, working with hospitals and other providers to do better and address people’s health in new ways.

·           More work with communities and quickening solutions to health problems was needed; for example, through better use of joint strategic needs assessment (JSNA) data, or ascertaining how to effectively use the Health and Wellbeing Board and how its impact translated into positive outcomes.

·           The Strategy was a step in the right direction, and focus was now on implementation.  He offered thanks to the health team and paid particular tribute to Valerie Dinsmore, Integrated Lead for Customer Engagement and the Health and Wellbeing Board; and, Maria Millwood, Director for Strategy and Commissioning Children, for their work.

 

Councillor Ed Davie, Chair of OSC gave the following representations:

·           OSC had a legal duty to scrutinise any substantial variations in health services, and recently considered a proposal by the South London and Maudsley NHS Foundation Trust to close a ward at Lambeth Hospital, not because of cuts, but because excellent and innovative preventative work meant the ward was almost empty.  Examples such as this and the Alliance Contract showed what could be achieved by empowering people to help themselves. 

·           The February OSC had raised concerns that savings from integration were not as great as anticipated, and highlighted the temptation when reducing budgets to withdraw collaborative funding  instead of sharing resources; he did not believe this was happening in Lambeth but noted OSC wanted to see further and faster integration.

·           Investing in parenting and young people would help tackle Lambeth’s rising youth violence and childhood obesity, and save money later on.  The Child and Adolescent Mental Health Services (CAMHS) had seen their waiting lists decrease from 50 to 12-13 weeks, which generated better outcomes and less costs, although this still required improvement.  He also urged the HWB to develop the Perinatal Mental health pathway and strategy.

·           The representation on the Black Wellbeing Partnership was proactive in getting engagement from those not usually represented.

·           Public health cuts from central government made no economic sense, with the greatest burden falling on addiction services, and urged Cabinet to protect those services.

 

The Strategic Director for Adults and Health, Helen Charlesworth-May, added:

·           The Health and Wellbeing Strategy fitted together with the Borough Plan, as health inequality reinforced other forms of inequality and vice-versa.

·           The Strategy was ambitious, but not aspirational, in tackling health inequalities, and built upon the prevention work and that of the Health and Wellbeing Board, from what people said they wanted.

·           Embedding public health in all policies was necessary if Lambeth was to successfully address issues.  For example, housing services, which the Council was investing heavily in, had the most effect on citizens’ life chances through supporting and improving health and wellbeing.  

 

The Cabinet Member for Environment and Transport, Councillor Jennifer Brathwaite; the Cabinet Member for Adult Social Care, Councillor Jackie Meldrum; the Cabinet Member for Families and Young People, Councillor Jane Pickard; and, the Cabinet Member for Housing, Councillor Matthew Bennett made the following observations:

·           The Strategy crystallised the work on childhood obesity in Gipsy Hill ward, through community involvement and bottom-up changes, recognising the message was not as crucial as the messenger.

·           Disability affected all citizens eventually and the Strategy was a good step forward.

·           The almost completed first audit of council buildings was praised so that persons knew which buildings they could access. 

·           The list of strategies in the report was commendable, noting the forthcoming Carers’ Strategy would help Lambeth’s carers help people stay in their own homes for longer and reduced costs.  A key issue was collecting information, and the strong information theme in the Strategy aided persons to find peer support across health and voluntary sectors.

·           The Strategy was laid out more clearly than before and emphasised work on early action and prevention.  It was noted that one of the problems with Lambeth’s Early Action Partnership was the lack of supporting evidence of effects on later life, but using National Lottery funding to strengthen evidence bases, trialling new intervention programmes, and learning more from other countries and perspectives around the world, should greatly improve this.

·           Housing formed a large part of the Strategy, and bringing housing back in-house in July 2015 conferred a huge advantage in addressing the interrelated issues of social care, housing and health.   The building of thousands of new homes in the borough, many purpose-built for disabilities needs, would further address health inequality in borough, which could already be seen in declining admissions for breathing conditions.

 

The Cabinet Member for Healthier and Stronger Communities (job-share), Councillor Jim Dickson thanked attendees for their contributions, and noted the clear commitment from executive directors and portfolio holders. Lambeth could pull off these objectives and remained ready for the challenge.

 

The Leader of the Council, Councillor Lib Peck reiterated Cabinet’s thanks to Valerie Dinsmore and Maria Millwood for their outstanding work.

 

RESOLVED:

1.    To approve the refresh of Lambeth’s Health and Wellbeing Strategy.