Health and Wellbeing Board - Thursday 4 December 2025, 1:00pm - Wandsworth Council Webcasting

Health and Wellbeing Board
Thursday, 4th December 2025 at 1:00pm 

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  1. Webcast Finished

Good afternoon and welcome to this meeting of the Health and Wellbeing Board, obviously
the last one of this calendar year.
My name is Graham Henderson.
I'm the captain member for health
and also the chair of the health and well -being board.
Thank you particularly for attending
and I hope you parked up your boats
and managed to somehow survive the downpour.
It's a, anyway, thanks.
So members of board, I will now call your name
in alphabetical order.
please switch on your microphone and confirm your attendance. Once you have
confirmed your attendance, please remember to switch off your microphone
and that's obviously it is in if you can keep to the course of the meeting when
you're speaking. So Abby Carter. Present. Mark Creelman. Present. Councillor George
Trevely. Present. Judy Gasser. Leave her apologies but she said she may join
remotely. She is. Hello, good afternoon everybody. I'm here online.
Okay, thanks, Judy.
Robert Gire.
Present.
Stephen Hickey.
Present.
Ariane Jogia.
I think he's all in this way.
Shannon Couture.
Present.
Philip Murray.
Present.
Diemma Aubin.
Diemma?
Oh, okay.
And Waka Shao.
Present Chair.
All right.
So we have apologies, for instance, from my Proctor.
Great.

1 Apologies for absence

Okay.
When you are speaking, it certainly would help myself,
I think everyone else and any members of the public
who may be listening, if you can refer to the page and paragraph.
as usual if you wish to speak and write and if you can simply raise your hand.
Thanks. We do also have a number of offices present and a number of them are
and actually in our presence and some who are online they will introduce
themselves as they come to speak.
So in addition to like Proctor, we also have apologies from Jeremy De Cesar,
Nicola Jones, Anna Popovici and Andrew Travers.

2 Declarations of Interests

Decorations of interest. Are there any decorations, either pecuniary, of a
registrable or non -registrable interest? Please declare any interest, quoting the
item and paper number in which you have interest
and describing the nature of your interest,
including whether or not you are taking part in that item.
So can I ask, are there any declarations of interest?
None, excellent.

3 Minutes of the meeting held on 25th September 2025

So we can move on to the minutes of the last meeting,
which was a couple of months ago,
in the next couple of months, on the 25th of September.
Are the minutes of the previous meeting
held on the 25th of September agreed,
and can they be signed as a true and accurate record?
Okay, thank you.
There should be no matters arising from the minutes,
so I think we can proceed to the main agenda.
Due to commitments on the part of some of the presenters,
there is a slight change of agenda.
So for example, I know Shannon has to be away
for another meeting, I believe around about one o 'clock.
So we do actually propose to take the adult social care
health study first, and then the safeguarding agenda.
the Adults Board will be considered
following the joint local health wellbeing strategy
start well update.
So if we can move to the paper on
adult social care health study,

6 Adult Social Care Health Study (Paper No. 25-431)

paper number 25431,
pages 105 to 130.
This is a report from the director of public health,
Shannon Catillo.
Shannon, would you like to introduce it please?
So thank you.
Good afternoon, and thank you, Chair,
for adjusting the order of the agenda.
I'm here to present the findings of a study
that we carried out on people receiving support
from adult social care services in Wandsworth.
I'll just highlight the main purpose of the study
and just remind the board of the key findings.
And the purpose of this report is really
to have a discussion in relation to the contribution
of several long -term conditions
to the increasing demand and burden
on adult social care services,
and to have a conversation about the opportunities
for prevention that are presented.
So we carried out this study
because we wanted to understand
the health -related drivers of adult social care demand,
both to inform service planning
and potentially resource allocation
in relation to prevention opportunities.
The study included over 9 ,000 people
who were known to Wandsworth as the responsible authority
for adult social care services over a 15 month period.
I'll just caveat that in terms of the numbers of people
who were included in the study was for practical reasons
in terms of how we were able to source the data.
So it doesn't represent the number of people
that might be looked after at any one particular period.
We were able to look at primary care data using the
quality outcomes framework and those of you who are
familiar will know that it essentially indicates
how common a condition is within a practise patient
population and compares against
national prevalence estimates.
However, there is variable performance in terms of
the quality outcomes framework and the levels of
detection of different conditions,
so it is not to be taken as an estimate
of the true prevalence of any one of those conditions
within the general population.
In terms of our main findings,
the key things that we found is that the proportion
of adults receiving support from adult social care
increased markedly from the age of 45 upwards.
Obviously, you've got people from the age of 18, 19,
all the way through to the late 80s,
But after the age of 45, there was a steep increase
in the total number of disease registers
on which people known to adult social care
are recorded, generally ranging from about two conditions
to some people who had a total of 10 conditions for which
they're being managed on the disease register.
Compared to the borough population,
people from Asian, black, and mixed ethnic backgrounds
were statistically overrepresented
among adult social care clients,
whilst those from other and white ethnic groups
were underrepresented.
And with the hypertension was the most prevalent condition,
for which people known to adult social care
were known to their GP for,
about 43 % of all the people that were included in the study.
There were several other conditions as well,
such as diabetes and depression
that were highly prevalent within the population.
A caveat on the study is because we undertook the study
at a particular point in time,
we cannot tell obviously whether those people
had already been diagnosed with a condition
when they became known to adult social care
or whether they became diagnosed
after they were known to adult social care.
And obviously this becomes increasingly complex
for those with severe multi -morbidity.
As you will note from the study, the projected trend
in terms of the cough prevalence for some of the conditions
is projected to be increasing, so this might mean
that we'll likely see more demand if current trends
continue in terms of those particular conditions.
So in summary, the findings of the study present
opportunities for us to reduce the burden
on adult social care by focusing on prevention,
whether that is primary prevention for people who haven't yet developed conditions, who are residents
and part of our population, or for people who are already known to adult social care
in terms of maximising the opportunities to identify how well they can be supported from
stopping their conditions from getting worse once they're already known.
And also I think the findings support a combination
of both universal and targeted approaches
based on disease risk factors,
or targeted approaches based on a combination
of age, ethnicity, and geography.
And I think this will require close working
with primary care, with the voluntary sector,
public health, as well as adult social care.
I will stop there and take questions.
Thank you.
Thank you, Sharon.
Yeah, an extremely interesting and potentially very, very useful report.
But can I ask the board if you have any questions or comments?
George.
Thank you for the report.
It's very good with the breakdown and analysis of the, in effect, the disease register that
you've produced there on page 117.
I wanted to specifically ask you.
I was quite surprised to see that dementia is
as high up the table as it is, that it's in fifth place,
as being the proportion of clients that you have
as adult social care clients there.
Anecdotally, I've seen a lot of stuff
that's been reported about an increase in diagnosis
of people with dementia who aren't the category of age
that you would expect.
It's more late, middle -aged people now being diagnosed
with dementia in effect an increase in people who previously weren't in effect within that
susceptible age range.
First and foremost, I was going to ask you, is that the case in Wandsworth?
Are you seeing more people late middle age being diagnosed with dementia?
And secondly, I assume that if I've got this correct, it must be presenting quite a significant
challenge for adult services overall.
Thank you for that question.
I am accompanied by another colleague
who's more of an expert on this,
but nationally we know the trend in dementia
is an increasing one in terms of it being
one of the leading causes of death nationally.
And with an ageing population at a national level,
we're also aware that we're likely to see
more people being diagnosed with diabetes.
And I think what is interesting as well
is that in terms of the targets that
the NHS has in terms of dementia diagnosis,
we know that there's a significant gap still
of about a third of the estimated population
that we think has dementia who are yet to be diagnosed.
I don't think, in my view, it's unusual
to be seeing dementia featuring so highly
because we know that some of the risk factors
that increase the risk of developing dementia
are some of the ones that are already listed here, including things like hypertension.
Thank you. Just to say welcome, Ariane.
Turning up and braving the weather, etc. I know you also had appointments as well. So, excellent. So any further
questions, comments, etc? Abby.
Thanks, Chair, and thank you, Shannon, for the report.
Was there any investigation done into the benefits of an early intervention compared
to later ones?
So in terms of think about the voluntary sector and organisations that are providing essentially
statutory services through the voluntary sector, was there any looking at kind of the essentially
the outcomes of people who access those services compared to those who don't get referred and
and maybe ending up kind of interacting with the state
at a later stage, but potentially when things are worse.
I was just wondering if any research
would be done into that.
So within the scope of this piece of work,
these are the initial findings.
So we've not done any other work, for example,
a kind of cohort study that you might do
to follow people who've been through
the adult social care pathway and try to work out
what are some of the kind of differences in their outcomes,
depending on the level of early intervention.
But we know this already from kind of public health practise
that if you do intervene early,
then potentially you would be able to prevent some people
from developing conditions,
or at least stop those conditions worsening,
which then tips them into needing more care and support.
But we would welcome suggestions
you know, suggestions in terms of next steps and actions
around this piece of work in terms of what additional value
we can get from it that we can implement
back into the system.
Thank you.
Mark.
So I suppose two comments.
I think just going back to the dementia,
historically actually one's worth of the other,
there's still a third undiagnosed.
It does benchmark relatively well
as compared to other boroughs.
The diagnosis rates tend to be higher in Wandsworth,
which is a good thing, but there is still a gap.
And then secondly, great report,
but you'll know that we also are developing
the clinically led strategic plan,
and actually reading some of the outputs of that,
there is such an overlay about how we work together
in treatment, in prevention,
and there is a great opportunity in some of the disease
categories for us to enhance what we do.
And I said I'd drop this in, is that we will also
be writing a neighbourhood plan for April draught July final.
We need to build that in because the health and well -being
board need to sign it off.
But actually, this is a piece of work
that I think we should do collectively
around kind of the further analysis of the data,
matching up data sets and see actually
what that shapes the interventions to be.
Yes, I entirely agree, and of course I would have
quite a good discussion at the Health and Care Committee
on this, but yes, I entirely agree.
We need to be joined up on this.
Lynn.
I wanted to try and answer your question,
about early onset, so that sort of 50 -year -old cohort.
So I think it is a growing thing.
Philip may be able to speak a bit more on that.
Sorry, Philip, just hand the ball to you.
But it is certainly, and as Shannon says, its roots are in those lifestyle modifiable conditions
which create the opportunity for early onset dementia.
And it is certainly something which is one of the challenges for adult social care in terms of finding the right level of care for people whose presentation is exactly the same as an 85 year old with dementia.
it.
If I had one question for board members would be, we've started talking already to ICB colleagues
who are linked to primary care in terms of where we could take some of the findings of
this report because there's a lot of work that's happening around long -term conditions.
But one of the challenges that we've already encountered, I think, because of the change
in the system and how it works,
there's potentially not sufficient resource
for some of the things we might look at doing.
So to give an example, many, many years ago
in public health, we actually worked with practises
in terms of active case finding
and trying to increase rates of early detection
and diagnosis, and I think there might have been
several schemes around that as well in terms of support.
but my understanding is currently maybe some of those arrangements don't necessarily exist anymore in terms of
you know, the additional capacity required to go into a practise support combing the registers
and and doing some of that work, so I'd be interested in any
Comments or suggestions around that thing
Thanks
Julie, Councillor Gather, behind me you have had your hand up.
So please go ahead.
Yes, thank you. Thank you, Shannon, for the report.
It's interesting, it's not surprising to me, except some of the wards which high prevalence is surprising.
For example, in Cheating Bet, we've never really thought of that as a problem ward before, but maybe we need to think about that.
But I'm interested in, yes, in joined up working.
I mean, this is all about health inequalities, isn't it?
And I know St George's is doing a piece on health inequalities,
which may be what Mark was referring to or it may not.
That may be an other piece of work.
So it all needs to sort of join up together.
Also, St George's does good work on young onset dementia.
So just checking that everybody's working together on these initiatives.
Yeah, thanks.
Thanks, Judy, entirely agree.
So someone sort of laid out the challenge.
Anyone prepared to sort of pick it up?
Yeah, Philip, thanks.
Well, I haven't got the answer because if I had the answer, it wouldn't be a problem for Shannon
because we'd all have the answer, but I think as Councillor Gasser said, the findings aren't unsurprising
and I suppose in a way gratifying that they support the government's trajectory and targets,
i .e. the fabled left shift.
And in a way, the issue is pump -priming money, if you'll excuse the phrase, because if we
can start to shift people left so we prevent people needing more, greater input from health
and social care, we will of course save money by treating them earlier, and then that money
in theory can be reinvested in doing things differently, and therefore in my mind it's
the pump -priming money.
How do we as a system, that's not just social care, it's health care as well, think about
But how do we get some of that money to start moving it?
And then hopefully there's the snowball effect and it starts to become self funding.
And I suppose the one thing I noted, which is supposed to be a bit parochial with my
Mental Health Trust hat on, is that three in the top seven are linked to mental health.
And of course some of the other things probably have a mental health subset, so lots of long
term conditions do.
and therefore thinking how do we get, how do we use some of this data to invest in the
areas where we might get a bigger relative return on our investment than we might do
by being quite niche in a particular pathway.
And I think that's the challenge for us all because it's hard to step back and not be
as parochial as we might sometimes be.
Yeah, I totally agree.
You want to answer a point, yeah.
Yes, I just wanted to respond because in thinking about this work, one of the things that we
think is needed is not necessarily additional investment
or a shift, but we think that some structural changes
just in terms of making every contact count approaches,
so for example, smoking cessation,
because the prevalence was quite high around that.
We already have the services to support people
that are already funded, but it's just about how we use
all the touch points within the system,
whether it's to make a suggestion
that people get more support with being physically active,
or stop smoking, or how we can make it easier
to identify problem drinking and refer people into services
that we already have in existence.
So I think some of the issue is just structural,
how we work across health and social care
to maximise on those opportunities.
Also, I'm sorry which one, very polite between the GPs.
I just wanted to provide some historical context
in case it might be of any use,
just to supplement what Shannon was saying.
In 2012, David Cameron, the Prime Minister at the time,
gave the dementia challenge to increase the prevalence
of diagnosis of dementia detection across the UK,
and with that came a lot of funding.
Within Wandsworth, I was privileged enough
to lead on a dementia committee, funded and project managed with the CCG at the time.
And the detection rates of dementia in Wandsworth in 2012 were 38 percent.
We established the memory clinic in its current iteration, which works through the Southwest
London St. George's Trust.
It was collaborative with the cognitive neurology service at St. George's, picking up younger
dementia patients and also in collaboration with the geriatricians who also pick up Brailler
patients within a hospital setting.
As a result of all that work, the dementia clinic has been running ever since, and the
detection rates went up to 67%, which was a coup at the time, but fundamentally that's
a third missed diagnosis.
I would like to say that it's not a linear path to the 100%.
And what we face in real terms is all of the dementia buy -in
has to come from patient agreement and involvement
and desire to want to actually be diagnosed with a dementia
diagnosis.
And there's often quite a significant resistance
on that front, too, in terms of patient choice.
There is the capacity to visit patients at home.
There is the capacity to where there
there are clinics that are running.
But that will be an ongoing limiting factor.
And now all of the resource that was ploughed into that
had come to an end around 2016, I think.
But the fact that it's maintained at the two -thirds level
is at least some comment that there are some
very positive things to be said about the system.
Yeah, very interesting area indeed.
Yeah, very useful background.
Thank you very much, Chair.
I have to say I found the report really revealing and very interesting, and I thought it was
a great report.
I just wanted to make a comment on your report, Shannon, if I may, which is that I think this
report is a trampoline for huge optimism, in my opinion.
I think when we look around us today, we see so much more alignment in what we want to
try and achieve than we've ever had before.
And really in 2025 we have such a synergy and I think I was reflecting on that when you were speaking Shannon.
The impending neighbourhood working, the hubs and the teams that are going to be developed,
I think have the most tremendous potential to realise the ambitions that you have highlighted in your report.
And I think these neighbourhood teams will be the workhorse that will do the heavy lifting for our aspirations.
The national tenure plan also aligns to exactly what you found and are
aspiring to and as we heard from Mark the integrated care boards long -term
plans and long -term conditions working also aligns to this and also the
clinically embedded strategic plan that the ICB are developing I think will also
lend itself to some of the work that you're doing. We've got a new GP contract
coming out shortly.
The details are yet to be revealed,
but I think there will be a lot more on prevention
and picking up conditions upstream
so that the complications are reduced.
And I think that has to be a good thing.
And also we're going to have a spew of quality indicators
and quality standards that'll come out from NICE,
the National Institute for Health and Care Excellence.
And also there's the desire for fiscal husbandry as well.
And I think we will end up saving
as well as providing much better care for patients.
I think the resources are probably there
in the system somewhere.
They're buried or intertwined in other structures,
but I think the resources are there.
We may not need additional funding.
We just need to find the pots of money
that are hidden somewhere.
And I think the appetite today is different
to any other time before.
And there were so many drivers of change.
I think your report gives me huge optimism.
I just wanted to share that with you, Shannon,
and share that with the board.
I mean, it's great to hear that positivity, and I think that's come through from other
contributors in the discussion.
Mark, I can see your head nodding when it came to resources.
Oh, I'm not.
No.
So it just goes back to Shannon's challenge about how we then work together, yeah?
So we know that from our health data,
there's about 35 ,000 people with comorbidities in Wandsworth
and about 3 ,500 who are at risk of hospital admission.
Most of those, two thirds of those,
are known to some services already.
And then there's the 800s that aren't.
So I suppose what I am saying is
we need to collectively kind of prioritise,
because that's a very long list of conditions. And I think you're right in
terms of capacity we might have to prioritise and go through the list in
a kind of systematic order. I do think I agree with WACAR, I do think there are
resources there that we need to point the resource to the right place rather
than trying to do everything at once. And then what also struck me was just
around the ethnicity of those that are known to social care, so end up kind of thicker
and iller, and that goes right to the very heart of prevention, doesn't it?
We need to target our prevention, particularly around particular geographies, but also particular
ethnicities.
So I think it's really exciting if we marry all our data sources up, come up with those
priorities, and then go for it.
Judy, I gather you would push to come in again.
Yes, me again. So again about partnership working because, well, I know Shannon and
his team work closely with the leisure team because we've got a, well, I used to be a
member for that team, so there was a big initiative about how do we keep people healthy through
sports and leisure and it might not be running around, it might be walking, it might be gardening.
So there's a whole piece of work to be done with the leisure team and they're keen to
work and they should be brought in.
And then there's the voluntary sector.
So organisations like, average organisations like the Community Empowerment Network used
to do mental health work and also diabetes, CRPD work and going to the places where people
are.
So if you want to involve a certain community, go to the place maybe where they worship or
they gather or whatever.
So it's more of that.
I mean, we're doing good work, but that needs to be part of the whole conversation is how
reach people where they are and help them stay healthy.
Yeah, entirely agree. Phil or Philip.
Thanks, Chair. Just picking up on Graham's point and in Shannon's report, these are individuals
known to social care. What we're not doing is looking to see are they known to health
and social care because then we might have identified different and or increased opportunities
to intervene with those individuals in different ways.
And I feel that's one of the things we're lacking when someone turns up in A &E.
We don't know exactly who they're open to.
Is it social care, only primary care, all of us?
And therefore, how do we do what Shannon's challenging us to do, think about the pathways
differently?
And I think that's the extra analysis we need to do if we're to land a pathway that will
work, rather than that we think will work.
I've got an answer for you, Phil.
So it was quite interesting because in order for us
to conduct this study, we had to use social care data,
take it up to a data set that's submitted
into national NHS England, follow it through to the ICB
to link with the primary cough data.
So absolutely all these people are known
to both health and social care.
Stephen.
Yeah, thank you.
I was just a reflection on what, there's two agendas going on here, I think.
One is the people who are known, and I can entirely see how neighbourhood working could
be a key to really advance on that front.
I can sort of see how that works.
But the exam question I think you were asking at the beginning was how to get earlier upstream
from that the people who aren't currently in the system.
And that's a different challenge.
So I think in terms of where we go from here,
I think it's helpful to just distinguish between those two.
Because by definition, stopping people coming into care
means somehow identifying who ideally,
who is at risk, who we don't yet know about.
And that's quite difficult.
I totally agree.
And just, yeah, thank you.
Just to follow on, maybe it didn't be more explicit,
But the kind of point I was trying to get at was we constantly have an interaction,
as I say, with counsel around referrals.
And my hypothesis would often be referring earlier to organisations like SHARE and other
organisations does in the long term save money because if we don't refer, then conditions
get worse and then people end up in the criminal justice system or A &E and all those places
you don't want anyone to be.
But I think that often, and for sometimes understandable reasons, that understanding
about where the money is best spent as early as possible is not something that's always
front of mind or able to be front of mind for the people actually on the ground.
And so I guess what I was kind of trying to get at and I appreciate, I'm too early in
terms of your report, is how to kind of start defining a bit better where we invest with
say for example the Vondra sector earlier, even if it means more people going in early
because actually that saves in the long run people accessing much more intensive, extreme,
and probably not harmful, frankly,
services later down the line.
That was the point I was trying to get at earlier.
Certainly, actually, thanks.
Would it be helpful to bring together a small working group
to analyse the pathway for those people who are known
to prevent, so to Stephen's point,
how might we prevent the need for social care services,
how might we be able to prevent illness becoming more severe
and then work back from there?
Would that be a helpful thing to do?
As you can see, I'm kind of jumping up and down with Joy
because that's absolutely the next step for us
in terms of this piece of work.
So we have already, for example, started talking to the ICB
but would like to talk to community health services and primary care as well in terms
of that task group, we'll definitely take you up on that.
Excellent.
Kat.
Thanks.
It's a reflection, because whenever I read about adult social care, I always think about
when adults were little people once.
And when we talk about prevention and early intervention and actually where there's an
opportunity in terms of some of our initiatives about working with children's health as well
and thinking about commissioning through the life course as well,
and commissioning through some of our children's programmes as well,
and how that can, in terms of improving outcomes through the life course as well.
So I know we're already joined up in those conversations.
I think that will help to feed into this as well.
Indeed, we're having discussions about Starwell and how we're approaching it.
You know, you absolutely need to take a whole life approach to this.
Nicky.
Thank you.
This is a really good discussion,
and it's nice to see Shannon leaping up and down
with one hand.
It reminds me of something I attended yesterday,
and they were talking about the difference
between healthy life expectancy
and the fact that the work we've all been doing
trying to increase healthy life expectancy
is actually decreasing.
We're not necessarily seeing the outputs we want
and the frailty.
Life expectancy is increasing.
What really struck me yesterday
that perhaps might also help with this
in terms of building on Kate's point
is the fact that when they triangulated
the outcomes later on in life in certain areas,
they found that in the census data,
the areas where people had already said
they lived in poor health,
because like they were the ones later on those same areas but that's where the people were coming from
and it got me thinking that there might be something we could do we're trying to think
about who's likely to be ill and the stuff we're thinking about to do that piece of work.
I only heard about it yesterday and I haven't got the slides but what we're talking about today just
brought that to my mind and a lot of work's been done and we would know where we have you know our
and the areas where people have described themselves
as not being in good health,
and begin to do some proactive work with those areas,
knowing that in 10 years time,
they are the ones who are going to be probably most ill,
or needing health and social care.
Thank you.
Excellent, thanks.
I think if there are no more,
oh, sorry, I'm sorry.
I'll ask one more thing.
Thank you very much, Chair.
This is a really fascinating discussion.
I'm really enjoying this.
I just wanted to make a comment on what I've heard,
and just say that we are about to be handed a gift soon,
which is the gift of data.
Across the country, we've got this federated data platform
that has started, and it's collecting essentially
health data.
it now routinely collects data from hospitals
and integrated care boards,
but there's paucity of data from primary care
and community sources.
But this year, 2026 will be different
because the federated data platform will be populated
with huge amounts of data from primary care and community.
And I think this is exactly the kind of data
that we need to promote the work of this new working group
that's going to be established
and actually give a credibility to a data -driven approach
to the work that we've suggested.
So again, this is just on the cusp of within our reach.
And in 2026, I think we will have access
to some great resources,
and I think that will be really helpful.
I don't know whether local authorities
have easy access to the FTP data,
or there may be some sharing agreements
that we may need to think about,
but I think it would be really beneficial
for the local authority to be able
to access this information.
Thank you.
Yeah, thank you, Wack.
And can I endorse what you said?
I think it's been, as usual, an excellent discussion.
Extremely interesting.
But the value of any discussion or debate around the table
is in terms of what it actually produces.
And the report itself indicated recommendation
that it should be an action plan.
And I think, sort of given the multi -agency,
multi -faceted approach of this,
I think certainly that you suggested
a lot of some type of working party or working group
would certainly be very useful and very sensible.
And I detect from what people have said
that there's certainly a willingness
to work together collaboratively on this,
which is most required anyway,
and where they can to share data.
I think it is an incredibly timely report
because there is so much happening.
I do think this is excellent precursor
to the establishments of the neighbourhood health hubs,
et cetera, and also means of fostering greater collaboration
across all the partners represented here
and one or two who perhaps couldn't actually make it.
So the formal recommendation is actually to note the report,
but perhaps we can also endorse the recommendation
for the development of an action plan
to implement of the assessment as actually found,
and leave it up to Shannon as the director of public health
to consult and agree with partners as appropriate,
possibly in the form of some type of working party
or group, and obviously we will look forward
to that report in due course.
Is that acceptable?
Yeah, everyone happy with that?
Yeah, I mean you're looking a little sceptical.
Oh no, no, sorry.
Okay, great.
Okay, well thanks, that's excellent.
Yeah, that's a really important piece of work
and extremely timely, so thank you, Sharon,
and do thank your staff and all the other people who participated in this.
As you said, the statistics come from far and wide.
So I'm sure it was quite a mammoth piece of work.
Excellent.
OK.
And I think Shannon now has to dash off.
So if we can move to the next item, which on the rearranged agenda

5 Joint Local Health and Wellbeing Strategy: Start Well Update (Paper No. 25-430)

is the joint health and wellbeing strategy.
The start update, paper 25430.
This is on page 81 to 104.
It is in the name of Jeremy, who of course is absent.
But I think it's broken down.
I don't know if anyone's giving a general overview,
but there are four different presentations.
So perhaps if we proceed with them.
Yeah, okay, so the first one is on self -harm
and mental health.
And we have Temi Faziga,
who is the Interim Senior Mental Health
Transformation Manager,
one's with ICB, I believe is attending remotely,
and Graham Arquell, who is Wandsworth's
senior public health lead, who is at the end of the table.
So welcome to both of you,
and I'm sure you'll sort it out, who's gonna go first.
Thanks.
Thanks very much, Chair.
Oh, apparently we only have Mark.
Oh, sorry, Graham, sorry, yeah.
Yeah, sorry.
Okay, I'm gonna go solo, so I'll do my best.
Thank you, Chair.
I think the first thing to mention is that if we went back 20 years ago,
we would see that in our children's population between 5 and 16,
about 1 in 10 with a recognised mental health disorder,
we're in a very different place now in 2025.
And the most recent survey from 2023 has identified
that this is increased to one in five children with a probable mental health
disorder. So that's quite a significant change and our mental health needs
assessment really picked up on that and through that needs assessment we
identified a whole range of recommendations and these
recommendations from a process perspective it's been really helpful
because they fed into the local joint health and well -being strategy. So
So there's a solid evidence base behind what we're doing.
The key recommendation from the mental health needs assessment was around primary prevention.
And having a key focus on reducing the number of children with mental health disorders and
increasing resilience within our community.
Quite simply because it's not sustainable the way things are at the moment with the
the increased demand on services and the pressure, the increased demand on services and
the increased prevalence of mental health disorders within the population.
So we've been working really, really hard over the past year,
co -producing, working with our communities, working to develop a cross -counsel approach.
Because we believe, and in fact we know that the wider determinants of health
has more of an impact on health outcomes than just the access to healthcare.
And so what Healthy Minds, which was recently taken to the Health,
Overview and Scrutiny Committee, and will be going forward to cabinet in the new year.
What Healthy Minds sets out to do is recognise those protective factors that the council
has real agency in terms of housing, education and skills, access to play, sustainable employment,
safer communities, access to leisure and culture, transport and social cohesion.
And you recognise that they sit across our directorates.
And so what we're working towards with Healthy Minds
is a clear demonstration of where the council sits
within a partnership, within a system that sits with health.
Now we are at the very beginning of this,
but there are lots of programmes already happening.
But what I would say is, as we move forward
with the joint health, local health and well -being strategy,
We will see more of those programmes feature in the report.
So that's just a horizon heads up for you guys.
That's on its way.
I wanted to pick up on the fact that we have seen
our mental health support team coverage increase,
and we are moving, in fact we have 100 % coverage.
I think there are some technicalities
in terms of footprints, but most, if not all schools,
have access to support around mental health.
And we've also seen the embedding of whole school approaches through,
particularly the paths programme, and you'll notice that we've got some
both qualitative and quantitative evidence within
the packs around the impact of paths. And this is a social and emotional
literacy programme and it's a universal programme. So this is
not targeted, it's for every child.
And the outcomes are really positive.
I'm just going to segue on to self -harm quickly,
because I think it's really important to recognise
that self -harm in itself is not a disorder,
it's a coping strategy for psychological distress.
And so we've seen this increase of prevalence of mental health disorders
in children and young people,
and we've seen an associated increase in terms of self -harm.
And it's clear that our schools are facing unprecedented levels in terms of self -harm,
and are holding more and more children with more and more complex needs.
And we've recognised this, and we're supporting this in a number of ways.
Firstly, through the development of a self -harm and suicide prevention pathway and toolkit
called PORTUS, which is on the council website.
And that includes a number of resources and pathways to support teachers and the
wider universal and targeted services to recognise the importance of swift
intervention around these issues. We're also rolling out training, have rolled
out training and are continuing to roll out training, evidence -based training to
help schools with safety planning around children
that are most at risk.
And the uptake's been fantastic
and the feedback's been really positive.
We'll evaluate that in due course.
So I'd probably draw it to a close there,
if that's okay, yeah.
Thank you very much, Graham.
Excellent piece of work in progress.
Comments?
George.
Can I ask a question particularly around young people in schools for self -harm and
mental health prevention. I don't know if you've seen the news recently about
Australia which is in introducing this very unusual ban about banning social
media for under -16s and they're quite adamant that they think that this is
going to have some sort of, I thought it was unusual, but they think it's going to
in tackling mental health for young people, in particular things like self -harm and bullying.
And I'm sure we're all aware of things like cyberbullying, which when I was at school
we never had because we didn't have mobile phones and things like that. But have you
got a focus on the sort of things that happen with social media which seem to be very prevalent
in affecting the mental health of young people in general?
Yes, in George, in fact, this morning I couldn't sit for the whole two hours, but it was actually
a seminar on Social Switch, which was part of the 16 days of activism around Thorg, but
particularly focusing a lot on the risk to young people of online activities, harm expounds
of recognising the risk, et cetera,
and obviously, it can wrap them, which I think
is an important area.
But Graham, I don't know if you want to answer that.
Thank you for the comment and the question,
Councillor Crivelli.
I absolutely recognise that social media
is implicated to some degree in the worsening mental health
of children and young people.
Well I think children and young people recognise that themselves and I hear quite frequently
quite astute and wise comments from young people recognising the impact that it does
have on them.
I know within our self -harm and suicide prevention toolkit there's extensive sections on use
of social media and also we're aware of new threats, for example, sextortion where young
people are groomed online and used to access inappropriate pictures.
And then that in itself is being used as a blackmailing device.
So we're addressing things like that absolutely.
I know that children's services would probably have more of a comprehensive
view in terms of what our schools are doing.
I'm aware that there are certainly schools that are moving towards mobile free spaces
and environments within the school day.
Thank you.
Judy, Judy Gasser.
Yeah, just to build on that.
So I was also at that online training about online harm and it is terrifying to all of
us in this room.
We have no idea what's going on out there for young people and it does all need to join
up so we need to join up with the experts and with the schools and with children's services.
There's a lot of people doing bits of work in this area. It's all got to be absolutely joined
and it is very important for mental health. But, and you're right, Graham, there are other
determinants, but to sort out housing, that's going to take a long time. We're not yet, I'm afraid,
and some of those other sort of social determinants as well. And I'm concerned that we
we're seeing a rise right now. Wandsworth has got really bad figures according to the report.
So I mean, is there more we should be doing right now to support schools, to support parents?
Because we're in a terrible situation, our children are really suffering, some of them.
Graham, before you answer that, I think I'll ask Kat to contribute.
Thanks, yes, I was just going to pick up on the back of Graham's comment in terms of,
so recently the DFE published new guidance around the RHSC curriculum for schools and
And through children's services with our education teams and with our colleagues in public health,
we're actually working with schools around revising their RHSC curriculum, which would include about online as well.
And I know, as Graham's mentioned, some schools are actually moving towards removing phones in school buildings as well, restricting phones coming in.
So, but certainly through the work we've been doing at the Task and Finish Group for the Violence Against Women and Girls,
it's come up around obviously online as well, the influence of online.
And actually what we've heard from young people is it's having those conversations about online as well,
Rather than just saying it's happening, actually how do we encourage parents to have those conversations with their children,
what they're looking at, rather than it all just being about the school environment as well with regards to that.
Just one other reflection, I think if the schools were sat in this room, they would probably say that they are struggling with this.
And there is a lot in terms of trying to support children and young people.
I think it links with Judy's comment around that we have seen a rise in Wandsworth,
but we also have quite a breadth of offer in terms of supporting our children and young people.
What we heard from schools recently, one school in particular that tragically the child took their own life,
was about the visibility of the offer.
And I think there's something for us as a partnership just to think about how can we ensure that actually
our communities, our parents, our children know what's available
and how to access that support in a way that is culturally and contextually informed.
Yeah, excellent.
Tiley Graham.
Councillor Gasser, thank you again for that observation.
And I would agree that, you know, we are facing difficult challenges.
I think I'm right in saying that what we're setting out to do in Healthy Minds is absolutely
ambitious, but it's also got a strong evidence base behind it.
and I'm confident in terms of the working
across directorates that already is happening,
that we can give it further focus and really hone in.
And I think the case studies, which you'll see
in the Healthy Minds report, highlights where housing,
social care, children's services, safety,
are working together in a joint way
that's maximising the impact.
So I'm confident that Healthy Minds will help us
to focus on further working well together
to reduce these issues.
Thanks.
The way that the report is set up
is for different briefings, et cetera,
in relation to start well with an overall recommendation
to note the actual report.
But specifically in relation to healthy amounts,
can I just take the mood of the meeting,
the people around this table.
Is this something that you think is actually very positive
and we should support?
Kat.
Absolutely, we should support.
I think for me it's about making a commitment
as a partnership though.
I mean, Graham's made reference to kind of internal
local authority, the ones who talked about schools.
I think there's something about how collectively as a partnership we take forward this piece
of work as well, ensuring that we're lining up so that the programmes that we are commissioning
are visible and accessible to our communities, that we're thinking about those wider determinants
as well, how we're working with schools.
So it really is a partnership.
We're all committing as a partnership today.
Excellent.
I mean, if everyone broadly agrees with that, Wacom.
Thank you very much, Graham.
Excellent report.
Just anecdotally, as a clinician working in Wandsworth and running a GP practise, I have
to say the offer that Wandsworth provides is actually excellent.
My reflection only is that when I speak to parents and children who are affected and
who are in need of some of the services that Wandsworth offers, there's sometimes an issue
of visibility, of not being able to know where to turn to to access the resources.
But I think the resources on balance are very good.
And I think there's something about self -promotion,
there's something about just signposting people
to where they are.
And even as a clinician, I sometimes have difficulty myself.
And unless I do some detailed research,
I may not know myself.
So it's across the board.
But I think the offer is excellent.
It's just about communicating that offer
to the people who may benefit from it.
But thank you for your great reports.
So, thank you for your further comments.
Can I say, I think, you have our full backing
in terms of pursuing Healthy Minds project.
I agree also, this is quite innovative, it's striking,
it could make a considerable amount of difference.
And again, very much so requires working
in conjunction with partners, et cetera,
which I know you will do.
and so, on behalf of the Health and Wellbeing Board,
all power to you at Albo,
and we look forward to receiving a report on progress
in terms of the developments of Healthy Minds.
Thanks.
Great, so that's the first part.
The second presentation is in relation
to childhood obesity, which we all know
is a particular problem,
And I gather that Talul Ali Ade is due to give a presentation.
And Talul, I think you're behind me on the big screen.
I am, yes. Thank you so much, and thank you to everyone.
So obviously, I gather that everyone's had a look through our report.
I think one of the things that I definitely want to highlight, even just going over it right,
looking at the report myself is that obviously we've got two sections here that talk about how
we're tackling different childhood obesity and that's kind of split into the elements of
the promotion and support of breastfeeding and healthy learning across the...
I've literally been talking this whole time and it's been on mute. I'm so sorry everyone.
Where did I get cut off or did you actually hear me at all? Yeah we did hear you. Oh wow okay,
I have no idea.
So sorry, I'll start again.
So I'll be covering the childhood obesity step
and just looking at what has been submitted,
what I've submitted for the report.
It's been really good to see some of the areas
where we've been able to support families,
especially our families,
some of our more vulnerable families
through some of our community work.
For example, the Breastfeeding Friendly Scheme,
which has I think minimum right now about 53 plus venues signed up including Battersea
Power Station. So it's really good to see that different aspects of our local communities
are willing to support families when they need to breastfeed at their venues and community centres.
We've also got really good work happening with our family hubs and they're pursuing their UNICEF BFI
and just seeing that training being rolled out
and that enthusiasm as well to support families
at the family hubs.
I think another element that's been,
a positive element has been through
some of our local partnerships as well
and we've got together a very small task
and finish group that's looking at how we support families
at risk of experiencing food insecurity,
particularly if they've got an infant under 12 months and just what needs to be put in place to
support families at various points whether they're deciding to breastfeed or infant feed or mixed
feed so that's been really good to work with different partners as well. And just moving on
to some of our family weight initiatives obviously we have our Wandsworth programme Health for Life
and at the moment we've been looking at just a brief looking at some of the
reviewing the programme and just looking at some of the impacts and how can it be improved
and more integrated to some of our local initiatives such as Access for All, the play strategy
as well. And then we've got some update here from the HAV programme as well, which has
seen I think an increase of unique children and young people that have been integrated
with the programme and again it's just proving that we've got, it's good to have different
businesses and groups that are willing to sort of promote nutrition for young people and sport as
well, especially those who are coming from different backgrounds. So I'll leave it there
because I'm not sure we have a few questions but just wanted to hand it back over and just
what the board has to say.
Tony, thank you for that useful introduction.
Collins on obesity.
So are we all happy with the approach?
Philip.
I am absolutely happy with the approach.
I suppose what I was thinking is
the comorbid links with the healthy mindset
in a lot of these things, you know,
if you've got an issue in one place,
you're more likely to be subject, as Councillor Gasser said,
to some of the online bullying things,
other things like that,
and then that bounces back into healthy minds.
So I suppose what I couldn't pick up is
how some of the steps are interfacing with each other,
or if they need to?
Yeah, absolutely.
I mean, so much of this,
although we break them down into nice, easy,
sort of compartments or topics and realities,
they all interact with each other.
Judy?
Yes, I agree with that.
And also we were discussing adults earlier on, weren't we?
And if we can sort out these issues now,
it will help the adult service later on.
But I'm interested in this Health for Life mini.
Sounds like a great initiative.
We've got percentage, not numbers.
I wonder how many children were doing it,
whether we should be encouraging more children.
Again, colleagues in the leisure services
are very much encouraging children to get active,
for checking that you're working with them as well.
Yeah, thank you for that question, Councillor Judy.
And so the Health for Life Minis is part of a wider tier
two programme that targets postnatal mums who have been
identified as obese.
And we've also looking at children who are three to five,
which is the health page for El Minis,
and then also Kickstart, which is targeting children 10 to 11,
so year sixes.
So what the programme does is it follows on from the NCMP, the National Child Measurement Programme,
that identifies children who are either overweight or very overweight,
and they get signposted or referred into this programme.
So at the moment, the numbers, so as I mentioned, we are looking at sort of how we, the impact of the programme.
So we know that we've, so the reports come on a quarterly basis.
So the numbers, we're still trying to compile how much that impact has been made over the last couple of years.
But it is integrated, as I mentioned, we are doing a review and we are looking to integrate more into our leisure programmes and access for all.
So, yeah, it's just part of some of the things that we're trying to do right now to improve the alpha.
We know that there are families that are currently being targeted, coming from areas of higher deprivation, also from Black, Asian, ethnic minority groups.
So what we're doing with that is finding out what other groups that potentially need to be targeted with this programme through our review.
Great, thank you. I mean it looks like some people now are having huge amounts of activity,
if that's right, 1 ,800 is that minutes a week? That's loads isn't it? Yeah, yeah. Running
around all the time, that's great. Yeah, it is and from what we're seeing, we are seeing
a good impact but it would just be good to see more about population numbers as well and just
if we're targeting the right people and if we're getting to everyone as well.
Mark.
So really supportive, really good services.
A little question around, so when you say targeted, how do we target children?
That's a side question.
But there is a theme today, isn't there?
There's a theme about there's some really, really great stuff going on.
And it's not just about the commissioners knowing about it or the service providers
knowing about it is how do we make all the voluntary sector know about it? How do we
make sure every school knows about it, every GP, etc.? So for me there is a bit of a theme
today coming through about information and access to services that are already there,
yeah? We just need to make sure that the right people are hitting.
Absolutely, perhaps I'll sum up at the end about that.
Any further comments concerning obesity specifically?
Kat?
It's not a question, it's more of a comment actually, because it's a step sponsor for
this.
It's something I'm going to be passionate about, but actually I think again just picking
on what's happening in Wandsworth in terms of the half programme and the huge success we've seen in terms of that targeted reach
to those families through our access for example and actually how we've
The numbers have grown in terms of our reach around half and actually with the government's commitment to a further three years funding
How we'll be able to continue with those programmes
But actually we took the opportunity in Wandsworth because those programmes only run during the summer the winter and Easter
Actually, they don't run at October or February half term. So we've actually secured funding to run programmes
for several hundred children through half during those weeks as well,
which was hugely successful in October and we'll be running it again.
And that's very much around that, around food, healthy food,
but also some of those key messages around social interaction,
being off your mobile phone, for example, being active.
And obviously with the Year of Play as well,
we've had huge success in terms of some of our play activities.
We're out to recruit at the moment for our play ranges.
Again, they'll be out and about in our communities,
engaging with communities, promoting play with that.
And we've just piloted our play packs in some of our most deprived areas in Battersea through our schools
and about encouraging parents and families to play.
And actually the feedback has been phenomenal in parents saying actually it's brought back memories from my childhood about playing.
And just, I actually understand we've had our first complaint from a housing estate as well about chalk drawings on the pavement.
So we'll take that if that means children are out and about playing.
So, yeah, it's narrow.
We're genuinely really passionate about ensuring children are out
and about playing and moving.
That is excellent.
It really is all the...
Ignore the chalk paintings on the pavement.
But I mean, it is great to see young people sort of play and go out.
And I wouldn't wish to impose my childhood
upon other people.
But I think people, young people,
just simply getting out, interacting with each other,
enjoying themselves, that is the most important thing.
And, dare I say, much more productive
than sort of looking at something on a screen
for apparently an average of six and a half hours.
Apparently young people spend,
according to the seminar this morning,
and spend six and a half hours every day
looking at social media.
Anyway, as George said, these were the type of things
we didn't have to face in our day.
So, thank you for that, Tullu,
if we can make that report,
and I think there's a lot of approval
in terms of what your talent needs for doing,
So please do continue to do so.
Our next presentation relates to childhood immunizations,
which are also something of a challenge.
And I gather we have Melissa Barker, who
is the Senior Public Health Lead.
And it was just Melissa who is presenting
on this particular topic.
Thank you very much and good afternoon everyone.
Yes, so the immunisation step is a joint initiative between,
it's jointly shared between the council and the ICB.
So I'm here today to present this update.
My colleague Pooja from the ICB was unfortunately unable
to join us today, that has contributed to the report
that is in front of you.
I firstly wanted to reflect on how this work on childhood immunisation is being driven
forward by multiple organisations over and above the Council and the ICB who are leading
this step.
It's a real partnership piece of work involving ourselves, the ICB, NHS England, primary care
have been really crucial in this,
as well as our school immunisation teams
and the voluntary sector amongst many others.
And the report in front of you highlights the extent
and breadth of the work that has been taken
over the past year to progress this step.
This spans strategic action plan development
and community engagement,
as well as workforce development, outbreak preparedness
amongst others.
Details of those are all highlighted in the report,
but there's just a couple of specific initiatives
that I wanted to bring to your attention
in the update today.
Firstly, since April 2025,
a dedicated immunisation coordinator for Wandsworth
has been working with the South West London ICB
and with GP practises to provide support
into their GP practises with things like data quality
and coding to improve the accuracy of immunisation records
for children, as well as providing training
on call and recall processes to help boost immunisation rates
and reduce inequalities.
Secondly, ourselves at Wandsworth Council
have been working really closely in partnership
with the South London Children, Young People, Community
immunisation service, school immunisation team,
as well as council education teams
to strengthen our school immunisation programmes,
delivering a range of different initiatives over the past year,
from strategic communications, including targeted outreach,
to groups of children where we know
the uptake of school immunisation programmes is lower.
And in addition, during the current flu vaccination
programme, we've also been working directly
with some of the specific schools
where we've seen lower uptake in previous years to help them
with some of the specific challenges
that they face individually within their own schools.
South West London ICB have been leading initiatives
to make childhood immunizations more accessible
by integrating pharmacies into immunisation delivery.
They have delivered a Making Every Contact Count initiative
in 27 community pharmacies in Wandsworth
to support with conversations around
childhood immunizations and particularly the MMR vaccine,
which resulted across Southless London
in over 5 ,000 conversations about
childhood vaccinations with parents.
And building on this initiative,
Pearl Pharmacy on Mitcham Road was commissioned
to deliver MMR vaccines to children
age six to 19 years until March 2026.
And from this autumn, nationally,
there has been an initiative to enable pharmacies
to provide flu vaccinations for children
aged two to three years as well.
So increasing that accessibility of the offer
within community pharmacies.
And finally, across the system,
proactive steps have been taken to minimise
the risk of outbreaks and strengthen local preparedness,
particularly with the national increase in measles cases over the past two years.
Primary care partners have continued proactively outreaching to parents of children who
have missed vaccinations with support of the immunisation coordinator to practises
with the lowest uptake with their data coding and call and recall.
In addition, the school immunisation team have been providing additional catch -up vaccination
clinics to help catch up those who have missed their vaccinations and continue to offer the
MMR vaccine as catch up alongside their routine school immunisation programmes.
Across the system, preparedness and response plans have been updated and renewed to ensure
that we are prepared should another outbreak occur.
This breadth of initiatives really demonstrates the robust partnership working that's been
really embedded across the system
and to work towards improving access and equity
of childhood immunizations within,
to progress forward this step
and enhance the resilience of our local immunisation system.
And we look forward to building on this progress
over the upcoming year.
Thank you.
I'll move this questions, comments
in relation to the immunizations.
So I was reflecting there's an awful lot of activity but what I couldn't see is what's
the impact of the activity.
Have we seen a greater uptake, fewer outbreaks or anything like that because that's the key
making a difference, isn't it?
Yes.
And there are challenges with us being able to track the direct impact on rates and so
We try as much as possible to collect the evidence
within our individual initiatives.
But what we can see is that in Wandsworth,
rates of childhood immunisation are relatively stable.
And that actually sits against the trend
that we see more nationally with a declining
rate of immunizations.
So we can see that positivity.
But there are challenges with the data because
of at which points the data is collected across the child's life course that makes it challenging,
particularly with those catch up vaccines for us to track the impact of those into our
records.
Yeah, Abby.
Thank you. Thank you, Melissa, for attending our health and wellbeing board engagement
group the venture sector a couple of weeks ago. So this is a follow on question from
One of the questions there posed was around kind of vaccination clinics that are being held for adults and whether,
and often community settings and whether actually childhood vaccinations could also be included there,
and the assumption that adults may well bring children along with them would be good to capture.
And I was just wondering whether, A, you knew if that was happening, because I think at the meeting you weren't sure,
and if it isn't, would it be a good idea to try and roll that out?
Thank you very much, and yeah, I think it's a really good question, and I think it would
be a really productive way of us catching children whilst any adults are being vaccinated
as well.
It's a question that I have taken back to the ICB.
I'm awaiting a response, but I will get that to you once I hear back.
Steven.
I had the same sort of question in my mind as Philip raised, and I think this is an area
I'm writing to this area where there is actually data also for comparative
purposes with neighbouring boroughs for example in London so in the sense that
it'd be quite it should be possible to benchmark as it were how well we're
doing in relation to to neighbours and other comparable boroughs and that would
be helpful to give a sense of.
Yeah, certainly. I mean, I certainly London does, like behind the rest of the country,
immunisation rates across the whole of London are much lower. I think Wonsworth in relative
terms is doing reasonably well in comparison, but I mean, that's still probably about 30 %
less than what it should actually be.
But I'm less than I wish to comment upon that.
Any other comments?
Jennifer, Jennifer Taylor.
Thank you, Chair.
So I'm the consultant in public health
that leads on health protection.
Melissa is in my team.
And I just wanted to echo her point about this.
although we are seeing a plateauing of the data and we do take data to the Wandsworth
Health and Care Partnership on a very regular basis on the childhood immunizations. That
is in the context of much increased vaccine hesitancy and declining rates across the board
in other areas. So we do have that comparative data and Wandsworth is actually particularly
given that it is, you know, we do have high levels of deprivation in some areas compared
to other boroughs really not doing too badly on childhood immunizations.
There are always areas for improvement.
And obviously, the measles outbreak that we saw a few years ago just showed us how vulnerable
we can be.
The fact that we didn't see that kind of rise in cases last year, despite the fact that
there were pockets of outbreaks in London, is a positive indicator.
And I would also caveat the data is – should be taken with a pinch of salt, shall we say,
sometimes there is a lot of complications around childhood immunizations data, but generally
the trends are something that I think we can be relatively reassured by.
Okay, thanks.
No further comments.
I mean, clearly this is an issue.
It's not going to go away.
There is immunisation hesitancy, sadly, amongst a certain part of our communities and getting
access to them and persuading them the benefits of immunizations is obviously a challenge
and I think it's quite right that this remains very much within the Starwell section of the
strategy. So Melissa, thank you for your introduction and also for the work that you and your team
are doing in this very important area.
Thanks.
So the last part of this particular report
relates to A &E attendances and hospital admissions
caused by unintentional and deliberate injury.
And Ramya, I believe you are giving a short presentation
on this, hopefully.
I'll keep it short.
Don't worry, Chair.
So thank you, everyone.
So this step is on track and I just wanted to highlight some of the key achievements
over the last year.
So this step has three sort of key domains of action.
The first is working with our 0 -19 service to continue to embed accident prevention in
the health visitor contacts and training that they offer.
Then it's all around information, advice and guidance that we provide as a council and wider system, including the BCS sector.
And then the third element is the UNICEF Baby Friendly Initiative, which Tolly spoke to earlier.
So in terms of the 0 -19 programme, one of the key achievements has been recruiting a specialist health visitor who focuses on accident prevention and minor illness prevention,
who came into post in September this year and is familiarising herself with the system
and has already started working with colleagues and children's services, specifically the
family hubs, to look up what training offers can be provided to parents, carers, and frontline
workers.
Kind of building on that, we've done lots of training and campaigns and educational
or offers over the summer in particular.
So the ones where Safeguarding Children's Partnership
has done two bespoke podcasts
that target some of the key accidents
and causes of accidents.
So for example, a podcast was done on safer sleeping.
A podcast was also done on safe use
of baby carriers and slings.
And we've done two virtual training sessions,
both facilitated by the Child Action Prevention Trust,
which were free for the general public
and those working with or caring for children and young people
both had good attendance and really good feedback.
Children's services deliver a range of training
for parents and carers, and that has included
sessions on road safety, safe sort of choking hazards and safe introducing
solid food safely for infants, again which had really positive feedback and
we included some of that in the written report which you'd have seen.
Holly's already spoken to this but we've had great success in implementing the
UNICEF Baby Friendly Initiative which is largely focused on maternal and child
bonding and also improving rates of breastfeeding, which evidence has shown to reduce the risk
of Sudden Infant Death Syndrome. So that's a really important one. And we're also making
sure that we have longevity to our approach to accident prevention by embedding it in
the Best Start for Life strategy that Children's Services are leading on. So we recently had
a Best Start for Life conference and data around accidents where the greatest prevalence
of accidents and also the types of accidents was presented and to highlight that as an
important area for focus.
Just wanted to stress that we always consider where there are inequalities within this work.
So we are, for example, through our work with Family Hubs, making sure that training offers
are delivered in areas where there's greatest deprivation, which national data shows are
the areas or the kind of families most at risk of accidents occurring in the home.
And we're making sure to take a really integrated approach to this work.
So working across council directorates, so public health, children's social care, but
also really keen to work with the voluntary and community sector in both delivering training
and also other wide offers. For example, I know that colleagues such as CATT and Children's
Services have spoken to Little Village who are a voluntary sector organisation that could
potentially provide some free donated safety equipment, which is one of the main priorities
that was initially highlighted within the joint local health and wellbeing strategy
for this step. So that's just an overview and happy to take any questions or comments.
So thank you.
Thanks, Ronya.
Comments or questions?
No.
Councillor Gasser.
Councillor Gasser, yes.
Thank you.
Thank you.
That was a very interesting report.
I was trying to understand the graphs,
because I'm not really a data person.
But it looks like, so admissions are going down,
which is very good news.
But actual presentations due to injury,
we seem to have very much higher rate in Wandsworth
than other boroughs.
And I just wondered if we knew why that was.
It could be anxious parents, it could be anxious children,
or it could be something people not being safe enough.
So I don't know what the figures are telling us.
Yeah, that's a really, really good point.
And thank you for raising that as something to be discussed.
So, yes, so firstly, the graphs show separately A &E attendances.
So that's anyone coming into A &E where the reason for attendance
is coded as an injury, whether accidental or non -accidental.
And then the second set of graphs
looks specifically at admissions through A &E,
so anyone that had an inpatient bed
as a result of their attendance.
So in terms of admissions, which we would consider
to be those attendances where you have the most
serious types of injuries, that is very low.
And we can, I think, be quite reassured
that those are rare, which is really, really good.
I think it is really important to highlight
the overall attendances though,
which do appear much higher.
There's lots of challenges with interpreting that data
because that data was pulled from Southwest London,
sorry, St. George's acute trust.
So the way that they record their local data
and the national data that they're pulling
to do that comparison to London and England are different.
So the coding is more accurate locally than it is at a regional or England level.
So it's difficult to say if we're actually getting more attendances because of injury
or if we're just coding our attendances better. Which is why I wanted to include it because I
think it's important to not be complacent and assume it's just a coding issue but also have
the admissions underneath that so that we can see that actually in terms of the most severe
injuries we are doing much better. So it's difficult to piece it all together but I think
overall we are doing well but it's important to keep looking at the overall attendance data as
well. Hopefully over time when we've got more years worth of data we can see what the trends
are doing as well, so that will help us piece together
whether or not the attendance data is a true reflection
of sort of something not going quite right locally
or if it really is just as a result of differences in coding.
Thank you.
Thanks a lot.
If there are no further comments in relation
to this particular part of the report,
I mean, I'm back to something that Philip said a time ago,
the fact that so many of these things are overlying,
at least three of them, obviously.
Childhood immunizations may also impact upon things
like mental health, possibly obesity,
and deliberate or unintentional harm.
But what I think may be useful in the future,
And obviously our next report will,
should be in relation to LiveWell,
is if we can have a brief report,
if it's not too difficult,
on how the various work streams interlink with each other,
and how we try to achieve some diverse coordinated
sort of response, and obviously next time,
Star -Well are due to present,
I think that may be quite useful,
because there are quite clearly overlapping issues here.
So it's good rather than treat them as individual work
streams to have a much more coordinated approach.
If people are in agreement about this,
can I ask if the health well being board
agree with the recommendation to note the delivery outputs
as set out in appendix one to the report?
Thank you, cheers.

4 Annual Report of the Safeguarding Adults Board (Paper No. 25-429)

So I think we're now due to move on to the annual report
of the Safeguarding Adults Board.
Fiona, I hope you are here.
I know that you had other meetings
and you sent me on to this item at two o 'clock.
So anyway, Fiona, I think this is the first time
you've actually appeared before the ones
with health and well -being board.
It is. It is.
Well, welcome.
Very certainly it was.
You've sort of placed kind of short crossing,
did an excellent job for us over the years,
and I'm sure you'll continue to do the same.
So if you'd like to give the presentation
on the report, please.
Thank you.
So I'm Fi Martin. I'm the independent chair and I want to thank you for the opportunity to present the Safeguarding Adults Board review to the board.
Obviously sharing it as part of the required government process, but I think it will give you the assurances you need that safeguarding is being monitored and we perform well in this area.
We're also asking the Health and Wellbeing Board to perhaps consider opportunities for collaboration and sharing insights into safeguarding, keeping people safe.
Now, the thing with these reports is it relates to the financial year in 2024 -25. So it is
from last year, but it is a statutory obligation for us to publish it, outlining the actions
taken, sort of in relation to strategy and plan, summary and actions for the safeguarding
adult reviews that we've been doing, and the board's intentions for the year ahead. And
I do apologise for the blustering, but I'm outside because it was very loud where I was.
The report has demonstrated to me that the council's multi -agency approach to safeguarding
adults is really effective and robust.
I mean, I've seen through the work that I've been doing since I joined and from the report
that there's good collaborative working with health, social care, police, and community
partners, which does ensure that safeguarding practises are well coordinated, they're responsive,
and focused on achieving positive outcomes for adults with care and support needs who
are at risk. And I think that has been really borne out by the CQC assessment, which was
really positive about safeguarding practises in Wandsworth.
Found it reassuring that the vast majority of people expressed their desired outcomes
are being met, and most individuals report feeling safer following intervention. I think
that demonstrates really effective local safeguarding practise and that risk is reduced or removed
in almost all cases. A really important area to us is making safeguarding personal and
that is embedded in practise. The importance of ensuring individual voices are heard and
that people are empowered throughout the process is clear. And the report shows that our safeguarding
arrangements are really proactive, they're person -centred, they provide strong reassurances
regarding protection and well -being of adults across the borough. An area we're committed
to is learning. It's so important, continual improvement through SARS, the leader reviews,
the audits, that are driven by multi -agency reviews and reflective practise. And I think
it's really clear that learning together strengthens our effectiveness and consistency of safeguarding
delivery across the pace.
So just a couple of highlights before the wind gets too bad
here. Obviously say the joint audits of the transitions
pathway in Wandsworth demonstrated strong collaboration.
I focus on well being signposting and effective
information sharing for out of bar replacements, which is
always something we need to work on.
The.
sorry, we've delivered safeguarding training and improved self -awareness and self -neglect,
which is our most reported area of abuse and hoarding amongst, you know, that awareness
has gone out from professionals and the public to improve confidence in identifying and reporting
self -neglect. So we've done effective multi -agency working. We've had consultation with people
with care and support needs.
And that's led to the creation of accessible resources.
So easy read leaflets for staying safe online.
And that's supporting people with learning disabilities and autism.
And I think a final, you know, that work goes on
to kind of remove jargon from stuff we're doing,
to use accessible language and try and cut down on acronyms
because we spent half our time trying to explain what they mean.
So I think what I'm going to do is stop here and see if there's any questions you have,
but you'll have read the report and I think for me it's, I feel really reassured taking
on the role that the Safeguarding Adults Board is working well together.
Thank you, you know, I think that is certainly my very strong impression and thank you for
all of the work that you'll put in a relatively short
space of time since taking over the role.
So questions, comments, Fiona did throw down a challenge
which I think at the time available may be a bit difficult
to achieve but you shouldn't forget about it
which is the opportunities of collaboration
that there may exist across other organisations
in terms of their roles on safeguarding.
So can I ask any questions, comments?
Abby.
Thank you.
I'm not gonna take up the challenge for now
because I've had some questions first.
I have three questions.
I'm Abby Carter.
I'm the Voluntary Sector Representative.
I'm also Chief Exec for Disability and Autism Charity.
So I've kind of got two hats on.
First question was, there's a note,
I saw the 15 % increase in concerns compared to last year,
which seems quite a lot to me, but I just wondered from your point of view
whether that is a lot or not, and your view on why that might be.
Are people getting better at reporting, or is more bad stuff happening?
No.
Really confident for the way that the report's coming in,
that it's about learning and better reporting.
And what's actually interesting is that the conversion of...
is it remains at 29th, sorry, about 25%,
which is really in line with London.
So it's actually meaning the reports that are coming in
are good quality reports.
And I think it's just through the work
that Ali Smith's come online.
She's our amazing board manager and does most of this work.
And I think it's improvements have led to that,
which it shouldn't be seen as a negative thing at all.
Thank you, that's good to hear.
My second question was that you found that 80 % of people felt safer after the safeguarding
intervention and my comment on that was, is this acceptable?
Because that means 20 % still don't.
And also, do you know what the figure was last year?
Has that figure gone up, down or is it still around the same, that 80 % figure?
I'll throw that to Ali, she's just put her hand up.
Yeah, thanks.
Yeah, so since Fi joined us relatively recently, I don't want to put her on the spot too much.
So this question is actually difficult and we are still trying to go through and understand this a bit more fully.
And we are doing some deep dives in terms of referrals and outcomes and things like that for different areas.
However, it has gone down a bit, that sense of safety.
I can't 100 % put my hand up and say we know exactly why.
However, I can definitely say that this can be quite individual,
but also it can be.
So a lot of these cases are cases where things can't necessarily be improved
and where it kind of becomes a low risk management.
or for example domestic abuse cases where the person continues to live with the perpetrator
and things like that. So it can be a lot of these areas can be situations that where the sense of
safety is such of the individual which is quite, how do I say, not always as objective for example
as something of like yes this meets my outcome or you know it's kind of how do you feel is your
sense of safety increase can kind of remain with certain situations where
people, for example, who have capacity decide to continue to live with the risk.
So what we're doing about that is risk management effectively, so trying
to do that multi -agency risk management where we're continuing to monitor the
situation, seeing whether there are other improvements or other referrals we can
do either to voluntary sex or to kind of other services and kind of continue to advise and
monitor the situation, kind of provide whatever support we can.
So it's not always possible to be 100%.
That's what I'm saying.
Yeah, thank you.
Of course, I totally appreciate that.
It's just helpful to understand those challenges you've got.
Okay, final question, if that's okay.
This is very specifically with a kind of LD and autism hat on.
Because obviously I work with people who are vulnerable adults and it's quite complex to understand obviously when they're being neglected, abused and so forth.
And I just wondered, I saw that there's a lot of segmentation here around things like age, ethnicity, sex, but not specifically around disability and autism.
Obviously you've got your letter stats, but I wouldn't be surprised if that group of people is overrepresented compared to the general population.
in terms of the safeguarding issues they face, I might be wrong, but my question to you was,
do you think that group is worth segmenting as you do with other demographic groups, given
the potential risks and vulnerabilities they face?
That is definitely a good question. And I think we can go ahead and look at the data
actually for the next annual report and see whether we can see this. So we do try and
look at things like service user groups from the council's perspective, kind of, so our
people can support needs and their primary support reason and kind of the types of abuse,
for example, that they experience. And I think that from previous data and kind of from memory,
what we have found is that people with learning disabilities do experience quite a wide range
of abuse, same with people with mental health. And we're definitely happy to delve in a little
bit more into that.
Thank you.
So just to follow on from that, as a proportion, as a rate, which is what we don't often look
at, the numbers are arguably, we would say they are overrepresented in the figures, but
as n number, the number that is the biggest is older people.
So it's a, but you know, obviously equally, so is the biggest number of people that have
care and support needs, as Shannon's report mentioned earlier.
Yeah, interesting.
Stephen?
It was just a reflection, really.
I think these reports have been now running for a few years, and it would be quite interesting
into some future version to have a point where reflections on trends over time.
You know, are these numbers just, you know, going up and down in a sort of
semi -random way? Are there any trends that you can extract, you know, of what's
going on out there? Because I think that would enrich the report
quite quite markedly. And entirely, entirely agree. Welcome. Thank you very much indeed.
I'm just very curious about the balance between reactive intervention versus proactive intervention.
The report mentions very helpfully, and it's a great example of how on one occasion the
London Fire Brigade highlighted the plight of an elderly resident who was very vulnerable,
and of course the board leapt into action and did what it needed to do.
and it's a great example of referrals coming into the service.
I just wondered what degree of activity,
or what percentage of your time is spent doing proactive work,
actually finding people who are vulnerable
and then sort of acting in the absence of a referral
to sort of case find patients.
The reason I say this,
or the reason this question's really interesting to me
is as a resident in Wandsworth,
walking around, driving around, I'm sure that I've come,
I see people who may have entered into modern day slavery.
I've seen people begging on street corners
and sometimes I think I see their handlers turning up
to meet them from time to time.
So I have a high degree of suspicion
that that may be happening.
The question is what do we do as a community
to explore that possibility?
And if there are people who are vulnerable,
how do we then leap in and protect them?
So that's why I was really, really curious about the balance between proactivity and
reactivity.
I think it's a very interesting one, but I see the role of the board as to be having
the assurances that the agencies are working together and effectively in partnership and
they're doing it properly.
The board's role is not to be doing individual cases and investigating individual cases.
So if you're saying that you think there's a particular problem in a certain area, then we need to take that to the agency that would be most suited to deal,
and then make sure that they're working collaboratively with the other agencies and the other partners to address that particular issue.
If I can also jump in to say that the board also has prevention and intervention as one of its overarching priorities.
So on the business plan, we often, well, each year we have some sort of action where we
do some proactive outreach about awareness raising.
So for example, we've gone to the Wandsworth Carers Centre and done awareness raising with
the Asian Carers Group and kind of tried to target kind of individual community groups.
We're very happy to do that outreach.
We've recently made connexions with the Voluntary Sector Forum in Wandsworth that are run by
colleagues in stronger and safer communities. I've also done some outreach work with the
faith forum so that we can kind of go and talk to faith communities a little bit more about
safeguarding, kind of awareness raising. We often team up with our trading standards colleagues
because I have to be honest safeguarding as such does not draw the crowds in.
It is a difficult topic, abuse and neglect, and we struggle to get numbers, for example,
of people attending.
So we look for ways to team up with other topics, for example, trading standards do
a lot of talks around scam prevention, which really draws the crowds in.
So we kind of do a bit of a double, kind of doubling up so that we can have the crowds
and also talk to them on how this links and what safeguarding is as well.
Thank you very much.
Sonya, on that particular issue, you do suspect in modern slavery.
Sonya, have a chat to me, but you can take it up through community safety as well.
But Lynn, I think you wanted to...
I did want to come in very briefly, I promise.
But it is important to say, and you know this, Becca, as a GP, safeguarding is your business.
It's everybody's business around this table.
We've all got that responsibility.
and it's only the local authority who have the peace which is doing the reactive peace for the rest.
It's down to all of us and about the strength of how we work effectively in partnership to keep our residents safe.
Yeah, I entirely agree.
In terms of, or question, I don't think we have enough time to talk about how the various
partners, agencies represented around the table can necessarily contribute to safeguarding
of this particular meeting.
But I think, you know, maybe worth a useful subject for a seminar or some future discussion.
Certainly in the last week we have had separate meetings on this.
So perhaps something you may like to consider.
Excellent.
So, thank you to Fiona and Ali.
Can we – oh, sorry.
Could I very quickly jump in just to say as final remarks on that topic that I was actually
very interested in the earlier report that Sharon presented around adult social care
health study because a lot of the things that he was saying apply to adult social care applied
to safeguarding and what we're seeing in our data including ethnicity and areas of deprivation
and things like that which we are starting to look into now.
So I think my ask would be actually to,
for our colleagues around the table and our agencies
to think when they're doing something like that,
also maybe to link up with safeguarding
and how does that link in with stuff.
Because we've seen, for example,
that if someone's financially abusive,
there is a scam or something like that.
This can really increase vulnerabilities in other areas,
including not going out, including like health.
it can affect health and things like that.
So I think I will leave the board with that.
Think about it.
Yes, Sanny Ali, thanks a lot.
And so much of the work we do interlinks,
which is why I think we've heard this afternoon
the quite genuine and determined efforts
on the part of everyone to achieve much greater
collaboration, closer working, exchange of
information, data, ideas, et cetera.
And you know, Ali's certainly something
very much work in progress,
and ultimately should give us the resilience
certainly that us in order to tackle
very many of these particular topics.
That said, can we please note the report?
Obviously, with thanks to Fiona, Ali,
and everyone else involved.
And I'll leave it up to Fiona and Ali to consider how to take on the question of opportunities
for collaboration and sharing insights.
And we'll certainly come back to that in due course.
Is that agreed?
Okay.
So if we can now move on to another statutory report, the one with the pharmacy of the core
needs assessment 2025.

7 Wandsworth Pharmaceutical Needs Assessment 2025 (Paper No. 25-432)

Now I have thought about taking this line by line, but unfortunately there aren't enough
minutes in the rest of the year to actually do that.
But that's not a reflection upon the enormous amount of work that goes into it, as is the
statutory report.
I know that Nikkei and her team have put a lot of effort into this.
So if you could give a fairly brief report, Nicholas, I think it probably speaks for itself.
I'm sharing it.
Can it be seen?
Yes, that's the three things I want to say first.
One, it is quite boring in terms of I can understand the oh, my goodness, do we have
to do this?
So thank you very much for everybody who read it.
But what I want to remind you is if all our pharmacies closed down, we would all know
about it.
It would cease to be boring, and it would take up a lot of effort.
So we put the effort up front in ensuring that market entry, what the needs of our residents
are being met, they can go to get their medication.
And it's really important when we start thinking about prevention and this whole thing about
not needing social care and care and all these things that we've spent quite a lot of time
talking about today.
This is what this is at the forefront of.
I'd also like to thank my colleagues who supported with it.
I'm not going to go through everything
in the pharmaceutical needs assessment.
I'm hoping you've read it,
but we're also sending out a summary
so you can get a sense of the robust methodology
with which it is done.
It is also consulted on twice.
We do a 60 -day consultation with residents.
We took on board the comments from Health Watch
and tried to make it as inclusive as possible.
It is quite a challenge.
When you look at the ethnic breakdown and some of that,
it still doesn't reflect our population demographics
the way we'd want to.
But the numbers go up each year, so it's good.
The last one was 2023.
Once this is signed off, it will go onto the web.
We had 237 responses to the survey.
Last year it was 188.
So we found there are 60 community pharmacies
in Wandsworth.
We lost one.
However, that's fantastic when you compare to what's happening nationally, and our average
still remains higher than the England rate, and it is in line with the average among south
west London.
We do know that pharmacists are another breed that, you know, there's a lot of shortage
and a lot of stuff that needs to happen.
The consultation, which is what you really want, the conclusion is we have no gaps in
our pharmacy services.
So that's fine in terms of, and if you look on the slides,
we lay down all of them, essential, future, all of that.
So that's good, I will pick that up as an item.
The consultation did highlight some things,
which I will touch on in the next minute or so.
But I wanted you to have a sense of how far reaching we,
once we got the comments from Health Watch
about reaching other groups that they felt we'd missed,
and carers, additional steps were taken
to really see how we could get it out there.
We also had an easy read, so it is a challenge
for people to fill everything in.
However, what we are aware of is if there was a gap
or something people were not happy with,
they would find a way to feed that back.
The items to note were 91 % had a regular
preferred local community pharmacy.
This is from the consultation.
Most people went to collect prescriptions for themselves,
A third were intercollected for somebody else.
They reported they used the most convenient or closest pharmacies.
I think it's page 50 something that shows you that we do have, in terms of our access,
most of our, I think all, I would need to read it, I didn't cut and paste it, but they
all have access to a pharmacy within 20 minutes using local transport or just walking.
about 80 % reported they used the most convenient,
and as I said, walking.
Some of the things that we found,
which were not necessarily within the gift of the PNA,
because the PNA is for market entry,
where there was some concerns about,
what I would call concerns is a strong word,
there was some assumptions about the fact
that because nine elms is being developed,
it then needs another pharmacy there.
But the PNA showed that it doesn't,
in terms of, and that as well is in the document,
I can tell you the pages after.
What they did find is, and that's a number of reasons.
One, you bring in more pharmacies,
you just stabilise the other pharmacies,
and they close down.
So you still end up with a lack.
The other thing is the Nine Elms development
starts in 2026.
So until people actually move in,
and there's a lot more people in there,
there is no need for us to start
putting additional pharmacy now.
So by the lifetime of this PNA, given the PNA's every three
years, we will be able to pick it up in 2069.
The whole process will happen again.
And if there's a gap, it will be identified at that point.
But there is no gap now.
But there's the understanding that the population will
increase.
And as it increases, there might be more to do.
And individual commercial pharmacy interests
lie outside the PNA.
So we did have local pharmacies interested
who were sending leaflets and trying to get the population.
But that's not to do with the PNA process.
So those are the key things from there
that I wanted to highlight.
No gaps, we are aware that there's an increase.
And that's really it.
And once you're happy with it, we will be publishing it.
It'll go onto the website.
We'll take down the one from 2023.
Thank you to everybody who read it.
There are key pages and headings.
If you look under future need, that's the heading for the nine
ELMs and the work that was done with that.
And the other thing I wanted to note
is we did acquire one GPS, one distance, something,
distance provision pharmacy.
So as compared to everywhere else, we're doing quite well.
I noted just when I came in that I
said the learning from the PNA.
So can I just rattle off the learning?
So when Councillor Henderson says that, you can all nod
and say yes. The learning was that it was really good working across Southwest London
with other Southwest London partners because that made a difference in terms of what was
working and if anything happened we were quite clear if it was just us, if there were others.
It was really good also ensuring we linked very early with the market entry and we linked
with the ICB in terms of ensuring this conversation about 9 -Elms and it was also excellent that
we were able to bring things to the health and well -being board early.
So that was our learning that we can carry forward.
Thank you.
Thanks.
Thanks, Nicky.
Very, very helpful and succinct.
Stephen.
Excuse me.
Yeah, firstly, thank you very much, Nicky, and HealthWatch was, as she said, quite closely
involved with this.
I did want to just flag two things, really.
One was indeed Nine Elms.
I mean, it's as important.
There was a lot of feedback.
about concerns on Nine Elms, and the response does say that the situation will be monitored.
And I think it's really important that it is monitored closely and kept under a quite
active review because there is clearly a concern in that area.
The other question I had was, in the consultation, a number of issues were raised, not a sort
of – which were not directly answerable by the PNA, not really for the PNA almost,
about quality. I'm thinking about rooms, accessibility, hours opening, those sorts of issues. And
my question was where do those sort of issues get fed to, because they're not strictly for
the PNA, but I think they shouldn't be lost, as it were, when the PNA process is complete.
May I respond? So absolutely yes. In terms of quality, I think that does get looked at
picked up because the local LPC are on there. I can go away and get more detail, but the quality one,
I'm less worried about the rooms. I will have to go and cheque, but that didn't hit our radar as an
issue. What did hit our radar was the concerns about safety. People were worried about going to
the pharmacy, not the pharmacy itself, community safety type concerns. People didn't feel safe.
So we have escalated that to the team in the council that would be looking at that to see
what we could do to support that.
But what we can't do is just put more pharmacies,
because people are scared to go to one pharmacy if it exists.
But I can come back about those specifics you asked,
even because I don't know the answer,
because it didn't leap out at us.
But that doesn't mean that they were not raised.
I think they were raised across the whole of southwest London.
So when we looked at them, we just looked at them in the round,
as opposed to what is this saying about Wandsworth.
So it didn't seem to be a once worth problem, and it was probably low percentages, but it's
still worth me going back to cheque and give you a robust answer.
So apologies, I haven't got the detail.
Thanks.
Mark?
Just a really quick clarification.
So although the ICB holds pharmacy contracts, it does not manage the market entry process.
It's just so that everyone's really clear about that.
That is a national process that run nationally.
Oh, sorry.
And just on the nine arms, I absolutely agree that we need to track it.
But it is interesting just in terms of the Battersea,
perhaps when we are designing the new GP practise,
which is about to open in January.
But we're not seeing the level of registrations
that we thought we would see.
And that's about kind of the migration into the area
and the kind of population demographics
that's been moving into the area.
So it is worth tracking.
Yeah, I think, I mean, I've raised the issue
of so many concerns reflected by some people
about the provision of pharmacies in the nine alms.
There is apparently a chemist in the power station,
but it doesn't administer NHS prescriptions, et cetera.
But I mean, I thought all boundaries are artificial.
And the boundaries commission would probably say otherwise,
but they are completely artificial.
And my understanding is that there are a number
of pharmacies which are located very close
to the border of nine islands,
particularly the southern part of the border.
as they may not necessarily be immediately adjacent
or obvious to people living on the Batsy power station site,
for example, but nonetheless,
they are apparently reasonably accessible.
And I think the standard is a pharmacy
within 20 minutes walking, isn't it?
So, but nonetheless, clearly the population
in that area is likely to come up.
So I certainly agree we need to monitor that.
So yeah, Philip.
Thank you, Chair.
Thank you, Nikkei.
I suppose the thing I was reflecting on, just thinking back about when my mother was old
and infirm, is – and I couldn't see it in the reports, but probably it was in there
– is thinking about what needs we have in our population, whether they're met in terms
of things like delivery services,
but also I'm assuming all of our primary care colleagues
are signed up to an arrangement where they electronically
send the script out to the pharmacy,
so I don't have to remember not to lose it
and take it with me and things like that.
And I was just trying to think of that element of society
that might have issue with access.
So that is covered, I can't tell you on the page.
And we in Wandsworth, I think we,
I think that's, we didn't have any before,
but we have one GPS so I would need to like I said forgot what that stood for
but we don't have I don't think it's mandatory and we don't have as many I
noticed as there's another area but again it doesn't constitute a gap so
it's probably not an essential service but again that's something I would have
to because it's a big document I'd have if this was early I might say I'd look
and tell you later but it is something we looked at it didn't come up as a gap
and there is one, I think it's some places have direct postage, some people have collection,
but I think we've got one now in Wandsworth, yes.
Okay, thanks. So, if there are no comments in relation to the e -pharmaceutical needs assessment,
the recommendation is to approve the final P &A report, which was published in October 2025,
And secondly, I think we've discussed the learnings
arising from it.
So can we approve the pharmaceutical and the use assessment?
Thank you very much indeed.
So I've been very bad at chair,
I do try to keep things up to time.

8 Work Programme (Paper No. 25-433)

My excuse is we've had some quite weighty issues to discuss,
but I think we're on to the really last item,
which is the work programme.
Lynn?
Thanks, and I will promise to be brief because you've all read it.
You know what the forthcoming attractions are.
As usual, my usual plea, guys, if you want to put reports here that are going to add value to this partnership,
do let Rosie know and add to it.
I also wanted to invite colleagues.
On the 5th of February, we're doing a seminar which is about a whole system approach to weight management, nutrition, and movement.
We've talked about that a bit today.
And I think some of my colleagues in public health
wanted to do a plug.
Am I right, Rosie?
Is it?
Who is it?
We've got Joanne on the call who's
going to quickly briefly say a few words about some
pre -activities that we're all going to engage in.
So Joanne, over to you very briefly.
Thank you, colleagues.
I realise I'm coming at the end of a long meeting.
So just to brief you that the Health and Wellbeing
Board had requested a deep dive on obesity and healthy weight. We've taken on this on
board and so we're proposing to you a workshop on uniting the system around healthy weight,
nutrition and movement. We have a peer review tool that we'll be sending out. Lucy will
send it. Since we're out of time, I won't flush it on the screen. But just to encourage
you all to open that up. We'll open the tool for review and if you can send it back within
the month we will be able to take that on board and it will shape the discussion that
we have during the deep dive seminar. So if there's any questions or comments on that.
Thanks, Jo. Any comments, questions? Can we note that? Yeah, thank you. I think that's
So, I think if we can and note that, as Lynn has said, this is a living document.
If you've got any ideas as to things you'd like to put on the agenda, that would be most
welcome.
Nikkei?
Sorry to be naughty.
I hope you can see.
I have put it on the screen so people can see that it's very easy to fill in and just
fill in your own section, please.
That's all.
Just to back up to Joanne, because I'm
very aware when I get things like this,
I don't always necessarily fill them in straight away.
We were hoping you'd have some time to spend two minutes
today.
So that the deep dive is relevant, meaningful,
and interesting to you, please fill it in so we can tailor.
Because obesity, as you know, if you
think of the Foresight report, we
could be talking about all sorts of things
that you could sit there bored thinking,
why are they telling me all of this?
Thank you.
Thank you.
Thanks a lot.

9 Date of Next Meeting

So that brings us to the end of the substantive items.
The date of the next meeting is scheduled for the 12th of February of 2026.
So this now concludes the meeting.
Can I thank everyone for attending?
My apologies, the meeting has overrun entirely.
I thought that I also wish everyone here and any residents who may have been listening
to the proceedings a very Merry Christmas and a Happy New Year.
Thank you.