Health and Wellbeing Board - Thursday 29 February 2024, 1:00pm - Wandsworth Council Webcasting

Health and Wellbeing Board
Thursday, 29th February 2024 at 1:00pm 

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  1. Webcast Finished

can we start the meeting, please, folks, we're gonna start webcasting in a second, he would take your seats.
this afternoon everybody can we commenced the meeting, please would you like to take your seats.
so I might not work in an assessment.
welcome everybody.
my name's Nicola Jones, and am the Vice Chair of the Health and Wellbeing Board and just to explain why I'm sitting in the Chair today so I'm our usual Chair Councillor Henderson and wasn't able to attend the whole meeting so he's asked me to take the chair he is actually here but he's gonna be having to leave after it was so we thought it would cause the least disruption if if I did chair the whole meeting, so can I just ask if members of the border in agreement with that arrangement great? Thank you very much, thank you, so I'm gonna call people's names in alphabetical order.
so when I call, could you switch on your microphone and confirm that you're here and then remember to turn your microphone off again, OK here we go so Abby Carter.
after everyone present.
Mark Creelman, yeah.
Jeremy D'Souza, his virtual, I guess, good afternoon, I'm joining alone.
Jimmy Doherty?
Good afternoon, I'm here as well, I mean I'm Jeremy Hello and Graham Henderson.
yeah, thank you, thank you, Nicola for agreeing to our travellers' meeting Franks are welcome, thank you, Stephen Hickey.
here, Shannon Katya.
president of Georgia.
is Gemma Orban here?
I think not, we weren't quite sure whether it was gonna come on up, Mike Procter is absent.
Councillor Mick,
present and Kate stock Hello.
think that's it, thank you.
and so can I ask when you're speaking in the meeting then that you can please refer to the page number at the top of the agenda pack and the paragraph number, and that's so members of the public who are joining us can follow the discussion and please just also let me know by raising your hand if you wish to speak and then remember to turn the microphone on before you speak and then turn it off again afterwards.
OK, we've got some officers present at the meeting who are going to introduce themselves when they address the board.
so.
apologies.

1 Apologies for absence

we've got apologies from George Crowley, Mike Jackson, Philip Murray and a pup of Itchie and Wacker Shah.

2 Declarations of Interests

and I'll just do the declarations of interest, then so are there any declarations of interest either and pecuniary or other registrable non registrable interests if you have an interest, please quote the item in the paper number which you've got an interest in when you and describe the nature of your interest including whether or not you'll be taking part in the item does anybody have any declarations of interest I'm always so relieved to have got through that without falling over my own teeth sorry just to give people time to speak for him.

3 Minutes of the meeting held on 23rd November 2023

no, no OK, thank you very much, let's do the minutes of the last meeting, which was the 23 of November, that's on pages 5 to 14 of the pack, and so can you let me know if the minutes of those meetings are agreed so that we can sign them as a correct record everybody's in agreement, thank you.

4 Combatting Drugs Partnership Annual Report (Paper No. 24-76)

Hang on a minute, we've got a bit of duplication of the pages here area, so I think we are in a position where we can go on to the substantive agenda items, so our first item is on combating drugs Partnership annual report and we've got here Natalie Daley consultant in public health, introducing the report and Ross Little who is a public health leader in attendance in case you've got any questions as well, so Natalie do you want to start and you can assume people have read the papers but give us a brief introduction and then leave plenty of time to the discussion.
thank you Chair, so it's actually going to be Ross who is presenting the report if that's OK, no more, both help with any question that's great. Thank you. Thank you, great-grandchild, actually I'm referred to a public health, lead for substance misuse at Richmond and Wandsworth councils. So the purpose of this paper is to provide relief another day of the the progress of the Wandsworth and Richmond combating drugs partnership. That's been established since September 2022, and it was created as a response to recommendations in the government paper that was published in 2021 calls from harm to help a 10 year drug strategy.
the CDP combating drugs partnership abbreviated to CDP, is currently jointly chaired by a public health and the Metropolitan police, who also both hold joint senior responsible ownership roles as well.
the partnership meets quarterly and is currently met six times since its first meeting in September 2022 and it was decided early on based on the the the the guidance from the Office of Health Improvement and disparities that in this instance we should have a combined Wandsworth and Richmond partnership given that the the the nature of the services and the organisations that will be involved rather than doubling up having two separate partnerships having Wandsworth and Richmond working together in terms of the membership initially the membership started with representatives from things like public health commissioning.
Safer, stronger, safer communities and the the ones worth community drug and alcohol service, but membership is an ongoing process that's developing and becoming more established and as it as time has gone on, we've added representatives from mental health probation or acute medicine and as as time continues to go on we need to kind of look to fill some gaps around primary care and also lived experience as well, so we're continuing to kind of look for representation and membership there.
one of the key things that there were the CDP has worked on over the last 12 months is establishing a strategic delivery plan which was consulted on developed and then approved by the the CDP over income transport, with two or three meetings with that that process happened and that we're at a point now with that strategic delivery plan is being delivered, the actions and objectives are starting to be delivered and we established midway last year that that will be done in the first instance by former forming four subgroups of the CDP.
those sub groups are breaking the supply chain or continuity of care in hospitals, continuity of care in prisons and children and young people. So for the first six 12 months throughout 2024, those for subgroups will be working on actions and objectives based on the strategic delivery plan to work towards those and those those those four sub-groups. Each have a chair who is part of the CDP and the work that the sub groups do will then feed back into the CDP via the leads and the chairs. So it's a case of taking the main strategic delivery plan dividing out into those sub-groups and then then working working towards those over the first 12 months. The progress of those sub-groups will be assessed against what's in the strategic delivery plan, and there is also a set of strategic outcomes framework which is set by a hit. That's where we will see the the the the the the the key developments and the the the key progress made against the data within within that framework and, as I say, the the the the sub-groups feedback to the CDP on a on a on a quarterly basis,
policy. In 2023 we did carry out some kind of or a short evaluation to read to assess how the partnership was progressing. We we we, we did some some evaluation with the members to get an idea of how they thought the partnership was progressing and what we had done to date and the feedback was really positive, and that is in the that is in the reports of Polish that I don't have the report in front of me, so I can't direct you to the page, but the the results are in there, so we are really pleased with how the first 12 to 18 months have gone for the partnership, and I guess in terms of what happens next. It's a case of looking to continue to develop the membership in the gap that we've identified around primary care and lived experience, allowing the sub-groups to work towards the objectives and actions that they've identified as ones they want to work towards, and as 2024 nears near the close we will start to look at how we want 2025 to look, because there are other objectives that don't fit into those four sub groups that will need to start to look at as well, so it's a case of continuing to do what we're doing, but also looking ahead to the future as well, and that's why that's where the the CDP is. Thankfully, that's a good sort of summary of the paper and latterly and are happy to take any questions. That's great. Thank you very much. It seems like this. There's a lot to do here, isn't there really an 8 look like you've put a really good price in the same place to start to tackle some some really really big issues
I'll open it up for people to have questions and comments.
thank you, it's a really good report from the and obviously all the joining up that you are trying to do, it is the complexity of this, you mentioned this, the Chelsea and Westminster model, and I was just wondering what that was and if you could elaborate,
I must have brackets on that particular model.
not to.
so thank you for the question, that's around the continuity of care in hospitals.
work, so there's there's a working group that has been in place for some time and that have we have used to continue some of the work of the CDP, that's been looking at those alcohol care teams in hospitals and and how that can work for us locally.
so that that's what that's in relation to him and that.
I believe that group has now looking at their next steps for what needs to be done locally, so we need to draw out what some of the key actions are going to be to take, taking that forward from the learning that they have from the Chelsea and Westminster work around alcohol care teams to see what is appropriate and feasible for us locally.
so is it more about joining everything are continuing because obviously we have our alcohol care teams within St George's, and I assume it is trying to knit all of that together, shared learning NGT approach, and then and how will you come out of hospital?
that?
one month, yeah, and when people come out of hospitals, how that continuity is maintained with services, with Sir substance misuse services in the in the borough, because the moment when we know that there are some
concerns around continuity of care with hospital than with prisons as well, so we've got two groups and they're looking at those areas.
yeah, thank you, Natalie I was going to comment on that actually because so for once with primary care in terms of the prison service, obviously with Wandsworth prison being in in the borough.
I think we, we are in a position where we have people coming out of the prison and and therefore they need primary care services really very quickly, because if they don't get that, actually, that can lead them down the wrong path right from the very beginning or on a path that they probably wouldn't wish to be on.
and and I think that is why you flagged plus the ENI primary care input into this group, and I know you've been liaising with our clinical lead for a mental health.
and and children, which is kind of also relevant in this in this, the wider piece of work as well, and I think it is really important that we do some joining up there because I think it can be very hard as a GP receiving someone who is, you know, you're trying to give careful in a very early after they've been discharged from prison and I think for primary care needs supporting how to do that to get people plugged into services to make sure that they
they can get support the person to get what they need, and then just the other thing on the same lines as Kate, really just the the continuity of care thing. So the communications between the services with this is absolutely critical. Isn't it, and I think this if it can knit together substance misuse services with the social care and primary care and mental health services. That's got to be that there might be others that we need to look at there, but there is a really important links on the yeah. Absolutely sorry, yeah, absolutely that's crucial, and I think is especially when we know that Keogh co-morbidities exist, then people
with substance misuse services. We think about mental health problems, for example, and as he said, that need to link in with primary care and have that role. Join up in the communication does not. It is absolutely crucial because I think it's really easy for people to fall through the gaps, for example when they're released from prison and then they they don't have that kind of clear pathway into services and then they just get lost to the system and I was just going to ask about education as well because I are in the report it says you were looking for, leads in education, which seems really really important to me and is have you got that now?
so we do have some representation from education, I think it's another one that we're still working on and and trying to find out where people need to sit, so we've got the main CDP partnership group, but we've also got the sub-groups, so we're looking at who needs to be in the children, young people subgroup for example from education and then who needs to sit at a more strategic level.
if we're hugging anybody else want to ask Mark.
so fantastic great to see all set out, so my first one is, I don't think it's any coincidence that this morning I saw a call for a kind of clinical leadership passing my e-mail. So I think that primary care length is is we're working on that to ensure we've got the right representation, so watch this space and then this second one's a slightly cheeky question because this is quite lots of actions and processes. When might you anticipate
reporting on some of the metrics when do you think 0 window EMI or you know how what have we achieved?
year noted there is a good question mark and one we've been asked before and I think because it's always taken quite a long time to set things are potentially it's been quite a long process, so the groups are still somewhat in their infancy and so a lot of these actions are very processes. Ross mentioned the outcomes framework that overhead have put together, and that's what we
will be reporting against going forward, as well as these actions on our strategic delivery action plan, so I think over the next 12 months now that we've got groups established, we can start to look at those kind of outcomes and for the so on not our next meeting which is in just a couple of weeks but after that we want to have a bit of a review of the metrics I'm gonna see where we are with things sort of what 18 months now down the line of the the CDP.
as he wrote, Shannon wants to come in and so are Shannon, please.
thank you. That's a really pertinent question, and actually I think it was myself will prompt it's time. We looked at the metrics because our partnership has been running for just over a year and now I think it's also important just to note that some of the metrics, although they're not presented here, are not new metrics for example the numbers in treatment and an end recovery, but also just to highlight that we've got some potential challenges that we've been looking at. In addition of some of the data that were required to to evidence in terms of our outcomes, and that particularly relates to police data in terms of the number of disruptions of
you know some of the gang activity that related to the drugs, so I think our were kind of disruption and the enforcement sub-group is meeting next week for the first time and you know hopefully we'll be starting to get a clearer picture in terms of some of that added data that's not currently reported anywhere else you know what it is that we can access then we can use to demonstrate progress.
right thank you, and I just wanted to make one other point really, which is about them.
it's so you mentioned that you would like someone involved, who's got lived, experience of substance misuse and and and that's fine and really really important, but I suppose it about the whole programme really.
at making sure that this group of leaders is MP and involve people is able to ensure that we have lots of people engaged in, you know, services at ground level and an MA and the one at the front line really to just have the approach that we're working with people you know in communities who,
affected by drug use in lots of different ways. You know that it has to be direct drug users, but I have a feeling the impact of that on our communities and society really are said to have that approach, I suppose, is what I would be looking for yeah definitely and and it's not when we say lived experience, we're not just thinking about people who use substances or have you use substances themselves, we're thinking about their family, for example, carer, you know it's broader spectrum, then then just that person
and we don't.
we were not necessarily looking at it being OK, we've got one representative, who's got lived, experience, they'll sit on the CDP, and they'll just come to meetings we want. We've been very conscious about it being meaningful engagement, so you know what will what we're thinking about is how do they feed into those sub-groups, where where can we get relevant engagement with them through that work? So we want, we've taken quite a long time over the process because we want to make sure that it's done properly, but we know that things will come up with through the subgroups where that lived, experience engagement is going to be really important, so we're thinking about OK when we do have those areas, how do we engage, someone who is the right person to engage, how do we work with them? On those actions, I think it should be even more than as someone, I think if you want to talk about how we might continue to care happen outside of prison discharge, then you have to talk to quite a lot of people, about their experiences, to find out what it is, we should be sorting out, so it's it's more to infiltrate that approach right through the whole work. Really
absolutely and I think wherever.
wherever we need to do that, we will await its, it's not meant to be just a we've spoken to one person, and that's it, but I think in particular areas of work like you've said, if we need to speak to lots of people to do that then then certainly that's the approach that we want to take because then of course not people who would automatically be there don't answer surveys and things like that you know you have to go and go to them but really I think that's quite important Shannon,
thank you, I think the point that you raise is a really important one, and just recently I attended a CDP event for senior responsible officers at City Hall, and it was really interesting to hear what other areas are doing in this regard, because I think if you're going to systematically,
engage with people with the lived experience, you need a whole programme and package of support because you've got to support them to come forward and then equip them with the skills of how to contribute in the most meaningful and relatively way and and because of attrition as well you know with people then it means that you need to have kind of that rolling programme and I definitely think that's something that we should be looking at you know as a partnership, whether it's Health and Wellbeing Board or,
you know the the place committee thinking about how we can establish a system wide set-up to support more engagement with people who've got lived experience and wasn't asking a little question there was irony in that and then that that was exactly my point was just about if you've got lived experience we need to support them to participate, don't we are and the other thing just just in terms of this?
the interventions that we have with the people affected are we or our community groups and organisations, kind of embedded in that in terms of it can you know, if you can throw a banner of NHS above something or you know social services or the police and that may not actually be that attractive to people to engage with so I'm just wondering the role of community organisations.
though there is a community arm as part of the service, and we have a representative from them who sits on the CDP as well.
Stephen
it's just it's really building on, I think, points already made, but I just want to pick up on page 22, where you refer specifically, I think it's in the prison context to mental health and
the establishing a rehabilitation pathway for people with substance, abuse and mental health I just wanted to do I, I agree with that, obviously excellent, but just wide another bit to people with mental health and or drug and alcohol need not not through the prison service and,
I wasn't quite clear whether or not you have got a particular aspect of the work focusing on on that particular need.
thank you, so there is actually a.
what's the word?
there's a group, that is he.
I've lost him, I've lost my English right now, sorry, there is a group that is looking particularly at people who have a diagnosis of mental health conditions and substance misuse, so there is a whole work stream that is happening around that anyway, yeah.
again, then, my question then would be, when would you look at the likely to come forward with propositions, and you know actual plans and implementation following that work stream so that group has just been restarted quite recently, actually so I think the next thing is going to be looking at how that feeds into the combating drugs partnership as it establishes what work it's going to do going forward.
that will also work closely with the drug and alcohol-related death panel as well, and where there is a lot of focus on Keogh, mental health and substance use issues, and that's that also we've also worked closely with the CDP, so there are a lot of these groups joined up and will be moving forward together.
all right, thank you.
super, thank you very much, it's clearly loads and loads of work going on wet, when will we bring this back here, then to get an update, but when would you suggest would be timely Shannon?
thank you, Chair, I would have presumed maybe an annual report to to the board would be would be the best sort of frequency, bearing in mind that the partnership meets only four times a year and wants to have the mic for May I really want to thank Ross Little and congratulate him because these partnerships I knew came with a lot of guidance and actually the fact that the partnerships met for the last.
you know for the last year and has good partnership action plans and subgroups to deliver, that is testament to some of Ross's work, thank you.
certainly I would I would echo that it seems like a very good process being put in place and we were all very keen that we want to see results, don't we, but you have to get this bit right so you've started at the right hand, so thank you very much both of you for your work and thanks for coming today, thank you.

5 South West London Child Death Overview Panel Report 2022-23 (Paper No. 24-77)

delegate, OK, let's go on to the next item now, which is away, we're just noting that our actions to note the progress of the report, I think we did that fine actually.

6 Intermediate Care Health and Wellbeing Board Seminar held on 6th December 2023 (Paper No. 24-78)

OK, we're on since 0 yeah, because the sentiment there has got to OK, OK, let's do item 6, then, so that's the Intermediate Care, Health and Wellbeing Board seminar which was held before Christmas, and Lin, are you going to tell us about this, thank you.
yes, thank you, I mean we can all remember, I think most of us were at a seminar on the 6th of December, it seems like so long ago, doesn't it?
it was a really positive seminar talking about intermediate care and an, and I think we, we highlighted some of our challenges, we all, I think, understood a little bit more of what we mean by intermediate care, and there were some recommendations around what we as a partnership may might do to support the development which were things like to further develop the model so that we all agree in a on our model that we raise awareness about services and probably that was primarily focused on.
a community and primary care partners being aware of what the provision is, that doesn't just sit somewhere as an out of hospital service and to also just highlight had regular veins talking about matters that pretend to and intermediate care, think the report is all there with some pretty pictures so I think I'll leave it there.
great thank you, then anybody have questions or comments or recollections about the meeting anything they wanted to say.
so you're sorry, yes, Stephen.
yeah
adhere take away from students' francophones.
this what's going to happen next, what sort of timetable, how new is the plan going forward, I guess, is what I want and if I missed it.
didn't quite see.
when when what's going to happen, when and when are we gonna see something?
and I think, as was Stephen two parts, to that, the first being that there already is something so let's be yeah assured about that is what we want to do is to create a more integrated something, and we're working on that. We do have a working group, is what you're gonna some of do you want to talk, okay, we do, we do have a a working group looking at how we align more closely the local authority provision with the community health providers provision and that we join that into a part of the journey out of hospital and are part of the journey that prevents people going into hospital. So it's trying to knit those. I think they're four elements together
because the prevention of admission has to start in our community interventions when people begin to show to need help before they end up in in-hospital at the GP.
so the this kind of just growing what we've got, I am hopeful that we can do that in the next year bring bring closer alignment, it's never easy, because we've also had a little bit of difficulty as we've had big re structures in some of the partnership organisations.
no.
I think Stephen, you probably raised a really important point or matters, we talked about intermediate care models, we talk about discharge hub models, we talk about we talk a different language really don't we and we've got all these different different bits of the pathway that we are trying to integrate and that's exactly the right thing to do, but what we do need to do is we need to thread that narrative together.
for everyone to completely understand, because it can be quite confusing, what part of the pathway are we talking about which bit of integrated neighbourhood teams are we're talking about, so I think there is something about this work linking up with the other strands we've got and then in the not too distant future which is very specific of me isn't it?
is t for us to come back with a kind of this is how the Wandsworth system works yeah, and I think that's really important that we also, not just for ourselves, but actually for the people that use it, were able to describe what that system looks like and help people access good care.
Stephen, did you want to come back, yes, I mean I I entirely agree or the what I mean I have no problem at all with any of the propositions is just a sense of milestones and when will we expect to see you know, but it does that's all moving it from a concept to something that's going to happen in some you know at some dates that might be my recognise.
apply.
I I am I'm offering you that we should have something or a plan before then, but at least some changes happening in how we deliver things within the year, because I think we've pretty much got a plan, we now just need to get on with the implementation there are, and I suppose it's important to say that this is like one piece of a jigsaw out there and that in a way, is why it's so kind of difficult to to pin down, sometimes for patients and for people working in the system to understand what fits where, and so this is really just letting the Health and Wellbeing Board, know that we recognise that and that there's work going on to clarify, review, reassess what we're doing and make sure it all fits together, because so many things are changing all the time actually in these pathways, and so it it's more more for our information into one to flag, to all our partners, that we're that this is ongoing work really
but and I understand the first for you know, where have you done by when and what's it resulted in no, I think that that needs to happen in the broadest sense, because it's quite difficult to isolate particular things from this, actually small service really isn't it that needs to knit into the rest of the system.
or are in.
firstly.
I was unfortunately unable to attend with the notice given for the event, but I read all the subsequent e-mails and workshop notes and certainly was a bit gutted, I was a part of that process.
I think it's been mentioned that primary care really do do have a big part to play in this, and I think you'll find a lot of enthusiasm, I was just wondering, do you have a primary care involvement on your working group and please do keep primary carer abreast of everything that's going on because,
I think we'd very much like to be involved,
at the moment, no, I think we rely on Nicola telling us things but sort of outside of the group, but I that is a good offer and we will take you up on it, so thank you.
can I just add in lesser we, as well as restructuring within the ECB, we are also redefining our clinical leadership model, so actually we can take that away just to make sure that we have got proper links in.
any other questions on that okay, so I think are our action here really was to.
a lot less for this decision really just to recognise what the direction of travel is with this really and.
and and and agree with the recommendations, which is about the levels of involvement that we need partners to have, which was established through the workshop.
so I don't think there's really a decision to be taken on this, everybody happy with that approach.

7 Health Inequalities Fund 2022-25 (Paper No. 24-79)

great thank you, thank you, then can I win back or keep going forward, keep going forward, OK, so we are going on to Item 7, which is the health inequalities fund, this is the 20 to 25 paper number 24.
79, that's pages 87 to 104.
and Mark are you going to present on this, is it marries Mary?
Alan Murray wheelchair and apologies for not being there in person, so the report, as the Chair noted, is pages 8 7 to 104 essentially gives an outline of what's been happening with the inequalities fund for 22 25.
affordable to note Walsworth received just over 1.6 million.
and the purpose of the inequalities fund is really to improve access outcomes and experience of our patients and residents.
on page 88, section 3 outlines the 15 projects that were given funding between 22 23.
section 4 outlines the existing projects that were given to additional funding for 23 25, and one is still awaiting confirmation.
low Bone Further Two projects were scaled up, which started in Wandsworth 20 to 23 and would be scaled up across south-west London.
on page 92, section 5, it outlines the plans for the new inequalities fund.
just noting new projects are estate art, community interest company and Wandsworth, Caroline's and partners are looking at delivering support for the wider determinants of health around a welfare and legal right and on page 93 onwards in the Appendix 1.
details a case study reports just outlining some of the impacts and the range of the projects that have been delivered if the board can note the projects have really been a success, I think it's really demonstrated how we've empowered and enabled our voluntary and community sector organisations to continue to support some of our seldom heard communities.
it's really enhanced collaboration between our statutory and non-statutory organisations and really just for the board to note and join me in thanking the organisations for the fantastic work that they have been delivering, thank you.
thank you Mary, so just a second, what you just said about that, the organisations that have been involved in this.
it's actually not that easy just to fill in all the paperwork to even get in this process in the first place, for some of the small organisations you know it means majors is as straightforward as possible, but it is quite an and alien thing for some of them to do. They're used to getting on with the business of what they do and and then just to all the delivery that's happening. I mean there's you know, there's quite a lot of process described here for something that's really there's some really inspirational stuff going on some of the case studies are grey, aren't they really enjoyed reading them and Mary thank you for your involvement in this. You've been absolutely pivotal in, I can't look you in the eye, I am afraid you behind me, but when you've been really really grey, thank you so much, you've you've worked like it, you know it's so hard on this one, but I just want to give the board the opportunity to talk a bit about it, because one of the things that we need to do is make sure these aren't just things that we, we do. We put money in and then they just fizzle. They have to be springboards for how we continue to do things, how we learn and grow and make things better in in and for our communities and and to understand where, where that can grow and grow their own really is. I suppose what we want to see out of this. Isn't it just for it to have have a life of its own beyond rounds of investment? I think I think that's kind of important as well,
so yeah, just comments and and and questions on that really abaya.
hi yeah, I also want to echo thanks to Mary who answers e-mails. Every hour, God sends about random stuff from people like me. Thank you so much. You have been amazing energy and drive behind this, and I speak as someone who looks after an organisation that has, in part of the the fund, a couple of things that I just wanted to feedback Mary. You know someone there's any way, but just for the kind of minutes et cetera, I'm just gonna with regard to kind of making sure that we do because of I guess, important at all, or as much as possible. So we are genuinely targeting, not the usual suspects, but those organisations that might not always have the capacity to yet fill out loads of paperwork. Go to those meetings, et cetera, some feedback from a voluntary sector. Colleagues, just around things like making sure it's clear kind of what kind of levels of funding you can apply for, because some organisations didn't apply because they just had no idea where there was 10 grand or 100 grand kind of thing, and so just making it really really clear, and I know it's been kind of a work in progress, and I think yeah Mary you've been clear around just kind of improving the process as he goes. So I know that you've noted that, but I just wanted to make that that clear,
and and also just kind of the work that's going on with regard to trying to establish new partnerships with the latest fund around legal rights and wellbeing and a CA that could provide some really, hopefully really good partnerships going forward over and above this fund.
but I think that one of the things that comes out time and again and and actually I realised it, was reflected in the minutes, was around just trying to have some longer-term view. It's great that was there's money round as awesome, but organisations do really struggle if they think it's kind of year year on year rather than knowing if it's like every minor three-year term or five-year term again, I know I'm not to marry, I'm not telling you anything, you don't already because it comes up time and again in voluntary sector forums, but it was raised last time with regard to just trying to give people a bit more shorty around longer-term for me because then, of course you could make much better plans and you can measure impact the stuff we're trying to measure impact on you're not going to see an impact in six months or maybe not even a year, because stuff takes a long time to kind of embed and land so we can do a better job if we have a longer term view and that's just kind of a request, not a not only request but just something to bear in mind going forward and for the design things like this,
yeah, I think I'll be so sorry, I think, is absolutely a note and agree, and if we could have three to five-year funding agreed, that would be fantastic, unfortunately this is dictated by NHS England, so at the moment we're still waiting to hear post 2025 what that fund will look like but absolutely acknowledge and he'll points around.
getting better notice and more clarity around the pots of funding available.
and I might have a bit more to say on that because it's a pencil mark says Mark.
so I think that there's a couple of insult so.
Mary
thank you very much just for we'll talk about how many thanks you got tomorrow.
no, she has been amazing and a driving force through this, and I am I'm taken aback by the breadth of of the work that's going on and just to say that once was continues to be a kind of coalface of them and innovation. So if you look at things like the Brazil model, will you know where women have only one or two kind of borrowers that are going forward, but that really focusing on kind of community development, I suppose, with the money, what we need to start thinking about is as we start these pilots. Where are we going to fund them from when they, when the pilot money runs out, because that's it's an age-old challenge to us, and what we need to do is we need to think about what happens after the pilot year and we don't win not just as a system, not very good, at that. We tend to run non recurrently
or and so we need to think about recurrent funding in the current financial environment, that's quite difficult, but it is something that we need to think about as we go through with all these projects.
I think, and there is that this is the challenge as well, isn't there, I suppose, because we have got quite a breadth of different projects going on and at some of them will work better than others, and it's really important that you know there is a a value for money thing, but sometimes things take three to five years to show their worth rather than the timeframes that we're working on, so that's challenging, and if you keep on funding everything that you're already funding, you can never do anything new, so there's that challenges to work out. What isn't quite a successful and then redirect that funding for something that might be just needs change as well in communities that they say this, it's all very complicated. I think what I'm really pleased about is that we've got this far and we're doing this, and there's there's clearly more to do and and looking forward to seeing the kind of as well as just the case studies some you know other markers of, or you know how this has gone really as as time goes on and Abbey,
I agreed. What would you say is always looking for something new is a bugbear for charities because we're like, actually we're doing some quite good stuff now, can someone just pay for it, please, it's actually quite helpful for organisations to riff. Obviously you don't want people in funding so that doesn't work, but to actually be like this works it's working with a really important group of people, so let's fund it, that that's that's really music to ears, it's just getting the balance right, isn't it of how, if we keep going with and what's new and yeah? I agree
Kate's did you want to come in.
most know most of what I was going to say has been picked up, where I wanted to thank my results, I think she created a very inclusive process for actually working through how you prioritise so many applications, I think Abbey's points really well made about needing time to be able to embed something we've learned that I think through this process having been through a couple of years now.
you can't just give an organisation money for a few months or once they get up and running and you can't demonstrate anything but there's massive power in the case studies isn't though it has made a real difference, but a lot of it is picking up unmet need. I guess and and I think your point mark is how we embed this into funding going forward is our big big challenge. I mean, is that a short term funding with an end is just a bit of a curse, as we know, if we had a sort of you're gonna get this pot forever, but you need to allocate it. That would be easier to deal with yeah. Indeed,
any other thoughts comments from anyone.
I just wondered kind of what conversations are happening about the opposite, thinking about the issue back on of longer term funding and the kind of alignment between this work stream of the NHS and the local authority, what conversations are happening about pooling or thinking about bigger pots that kind of it is for the voluntary sector to access because it's just one form one pot at what what kind of are we doing kind of working working together?
Mary do you want to say so, we've started those conversations haven't we just in terms of we know that one's worth a DJ, you've got a reinvigorated view of the voluntary sector really and actually so we've been meeting up about how we can join it up.
I think we often get distracted by you know.
backer in a business as usual, but it's really important, I think it's a really important principle that we do try to join up not just for the benefit of the voluntary sector because that would make it simpler, but also actually it makes sense that we do do that so we don't duplicate and actually we build on each other's successes and some of this becomes business as usual, so I think it's it's a, it's a work in progress
yeah, thank you Mark and absolutely agree, and I guess just building on Kate's point, I think whilst these funds are fantastic in terms of getting this work started, we absolutely know these inequalities have existed for some time in one pot or three-year pot money is not necessarily going to resolve it and so again as a system we need to start thinking about how and where we can move money into a more permanent pot to be able to support these communities but equally
knowing what we're all working with
challenged budget, but there's a real opportunity from a real, strong collaboration as a partnership, those conversations will absolutely continue.
I just wanted to offer an example. I think, of how some of the good partnership is helping to with the shared understanding around the opportunities for the different organisations that bid into this, and I think Mary through your very carefully considered planning. You ensured that there were different system partners around the table in considering these beds, and I remember some of the conversations that we had in. There were around using the knowledge around what is already funded within the local authority versus what is funded within the NHS, which helped us to have an improved understanding around the decision making, but going forward, I am also aware that the ICB is starting to look at an insight bank, which looks at how we share insights around all the activity that's happening within the voluntary sector, so that we're not duplicating and so that we're kind of looking at our resources and you know how we can combine them more effectively going forward. So I think you know, as Mark says, that that work is in progress
can I just add one other thing is that myself and Mario attended an event with South Asian women around cervical screening in Tooting and
which was quite kind of just mind-blowing in terms of of their ability to network out the message around cervical screening
and they were telling us that they probably have a network of 50 women, so if you get 50 women and they tell another 50 women about cervical screening, and that's where that was, you know, for one event that was relatively cheap to run, so some of these amounts are small but the impact can be really great because actually Councillor care is very expensive so that the the there's something about as thinking how can we start with small pieces and really elevate them?
good anything further from anyone.
right so.
Mary, thank you, we've noted the approach that you're taking and and thought about ways that will be keeping an ongoing interest in all of this work in the health and wellbeing board, and so thanks very much for bringing it, and we'll look forward to updates in the future.
he's still there
thank you.
nothing since Thursday evening.
thanks Mary good, okay, we are ploughing on with the agenda.

8 Better Care Fund Quarter 3 Update (Paper No. 24-80)

I was gonna do it again until she's got time so yeah, so we're gonna do the bit on Item 8 now and the better Care Fund Q3, update Brian, would that be you, I believe so yes, so so thank you admitting of having me back to talk about the better Care Fund.
so the better Care Fund, obviously is is.
is pooling and the national vehicle for working and and delivering health and social care integration, it's in its 10th year and the latest BCF plan was a two year plan.
so.
2023 24 2024 25 and we're in the middle of or committed at the end of the first year.
as such, we, we are required to report to health and wellbeing boards on a quarterly basis, and so this is the Quarter 3 report and
so there are, there are three aspects of this, so there so we had to, we had to confirm that national conditions were being met, so that's that's on page 1 0 6, paragraph 4
so that so that we are to paragraph 5, so we have a jointly agreed plan between health and social care, we have a plan to support people to remain independent in their home, we have a plan to.
to support people to receive the right care at the right place at the right time, which which speaks to hospital discharge, and a VHS contribution to adult social care, is maintained in line with the uplift to the minimum contribution, as well as that, we had report on the BCF metrics which can be found on paragraph 6, of which actually we're doing reasonably well, were unable to report Rahman, because that's an anal measure and we are at the moment the only one. We're not on track to meet target for is avoidable admissions, so that's the rate of avoidable admissions into hospital and avoidable admissions or ambulatory care. Sense of conditions are things like CBD asthma, heart failure, atrial fibrillation, diabetes, things that actually should be managed out and the wider community, so so as as people are admitted, with any of those conditions that via hospital systems, that's their own report, essentially, and we understand what that rate is, that that's that's been an increasing rate through Quarter 1 and then into quarter 2, so much so that the aggregate while we're hitting it in quarter, one is that we are, we are over our ambition in quarter 2,
and and finally, we had to report on any any scheme where, as part of the BCF planning, there was an output of some kind, so an activity either people, people supported hours of home care and so on and and obviously this is this is reporting between April and December we would he would assume we would spend up to 75% of of our of allocation and that's actually setting 86% partly because some of those
so the demands on on hospital discharge have been so great that actually it's the hospital discharge element that has has seen most of those funds already spent to date as part of the plan.
and are apart from that, I think.
all the documentation is here and the template is here, so I'll just move on to any questions, if I may.
thank you very much.
sorry, I promise I won't answer every quick, every paper, so I I'd just like to draw people's attention to page 107, paragraph 8, and that is this represents 50 million pounds worth of investment and what we need to be able to do is make sure that we are constantly aligning and constantly refreshing it and to tissue to enable us to get the most out of that significant investment, and I think that's something that we do do we, you know, we do actively look at it with our local authority, but that's something that I think as as we go through the next couple of years, we really need to focus so that we can maximise the effect of that investment.
thank you, Kate.
yeah, I mean, I obviously agree with that, I I, I just wonder whether we could have a bit more secondary care input into shaping the metrics et cetera, because I am on I sort of noticed on 7 there's point 7 on the same page as there's no secondary care, I know we talk all the time I'm always working around discharge and various things, but it'd be good to feel part of the as we are the recipient of when it doesn't work.
it would be good to be able to shape that, I think, a bit more directly.
by
yeah, I think that's a, I think it's a fair challenge, I think so so avoiding emissions is one of those areas where actually we've done pretty well in the borough.
but actually now we're seeing those increases. I think it's probably worth having a deep dive in terms and pulling primary care and secondary care personnel. I know not all of these people will go to and from St George's, but having a look at what areas we we feel are heating up and trying to get that system understanding and then work work, so I'll I'll arrange something, thank you. So I kind of be at pains to say really that the the BCF BCF itself is the the funding. Is the framework for how we do this work. Yeah, and that's what we have to report on the metrics are the metrics and it's all nationally prescribed actually doing the work which the BCF happens to fund is what we do all the time, isn't it
you know, the intermediate care stuff is kind of in amongst all of that and many, many other different work streams, so I think is you know this, this board gets the dry end of it, really doesn't it, because this site, which were going on and pay you that you and your folks are very involved in all of that? So I think that's important for us to remember it's like this is our job to do this bit, but actually there's so much going on out there Abbey
sorry on reflection, that this might tell me if it's too much detail. This is just from feedback from kind of voluntary sector that I had around just the weather, the the way that when patients are ready to leave and particularly if you've got time to go into residential care and obviously the delays around that which we know and it happens a lot, but whether there could be more standardization to kind of speed that process up, but I'm actually thinking that what you've just said might be that this is maybe the wrong forum for that, because that's actually the stuff that's happening on the ground rather than and then and the the system around making that a more streamlined process rather than it starting from scratch, it's something that would be discussed elsewhere. I suspect that that very, very important. If that's something that people yeah, it was kind of just like become the continual kind of like
it's just really difficult when you know you've got beds ready, and it's just there's just this constant delay to get people into them, and it's kind of the money is there and the beds there, but the bit in the middle to get them into it's not it's not happening so yeah, that was just a kind of, or a point made by a care home charity the other day, no understanding had that's great and there are lots of people here who will take that forward into the conversation, so thank you, yeah, anything else anyone wants to add on this
now, then, it's an our job, then, is to sign off this quarterly review and to note the progress towards all the deadlines, said, Brian, thank you for bringing that much appreciated, OK, and what do we do we have to or we are we agreeing to sign that off as everyone happy with that great, thank you all she keeps me right, thank you for doing the job.

5 South West London Child Death Overview Panel Report 2022-23 (Paper No. 24-77)

good right, we're winding back now to Item 5 on the agenda because Lorraine has joined us.
Lorraine either.
yes, good afternoon our great, thank you, that's good, we can hear you and I think yes, we can see you as well, thank you, so if I've just refined my page we're going back to item 5 and so this is the report is the south-west London Child death Overview Panel a really important re report that's come.
and so people will see that this report is on page 33 to 72 and there's also some supplementary information being sent that it has been sent round already there are 4 additional 4 or so additional slides as well, so Lorraine, everyone has got that Ryan, would you like to just talk a bit about the report and really I'd like to leave most of the time available for people to discuss our ask specific questions if that's all right but if you would mind just outlining what's here and and explained the importance of it that's fine, thank you.
with reference to the report, its very details and covering the 54 child death review.
cases that were reviewed during this operational year, 81% of them had no modifiable concerns, and there were 20 joint agency response meetings, those meetings are of unexpected deaths that weren't anticipated 24 hours before the incidents.
with reference to south-west London, 43% of all the jobs that's in the area are of black, Asian and mixed minority ethnicity, and the key priorities that we have laid out in the child death review report is we'd go under four categories public health and communicate the education, the improvements in organisational practice, training and for those that those are issues that affect London as a whole. So with reference to this year's report we
with reference to promotion of community education, it was to emphasise greatest innovative strategies for greater engagement of secondary age schoolchildren in communicate key activities to foster inclusion, equality and recognition as a valued member of the community to reduce self harm and youth violence with a focus on knife crime.
with reference to improvements in organisational practice, and this is squarely before the
issues surrounding the corporate parenting process across the area and assure that there have been improvements in the quality of care provision for looked after children in foster care placements, a revision in the selection process, recruitment, training and research of foster carers in the and their home environment and close to local authority supervision of private foster carers and carer arrangements.
the development of innovative ways to encourage greater engagement and to increase the capacity of mental health support advocates to address the increasing demands for referrals in the young people at secondary school level, to create strategies to identify children who are struggling with their mental health in the school environment before it results in an incidents of self harm.
an assurance that a synced referral system is in place for the CAMHS referral pathway, to ensure that referrals are a acknowledge and be confirmation to the referrer in a limited timeline, that the referral has been made with reference to A and E paediatric attendance and assurance at the paediatric sepsis tool is being used for all children 5 years and under who presents the A&E with a few days history of
fever or high temperatures and assurance that there is a procedure for simulation, training and management of urgent maternal admissions and declaration of obstetric and neonatal emergencies, with specific reference to Wandsworth.
where you have a few of the slides, you will notice that.
contrary to what a lot of people believe, these were, with the with reference to the 11 ones with child deaths.
reporting amongst that amounts that we have just declared earlier, that if you notice less than half of the actual deaths, take place at St George's hospital and that the debts are spread right across the south-west and west of London, that's another jurisdiction as well as our own
with reference to the
the actual deaths themselves.
it concurs with ever everything else in the area with reference to the modify ability, nine out of the 11 had no modifiable concerns but to had and with reference to the vulnerabilities with specific reference to once were it was an issue of children who present with episodes of fainting should have a DJ or GP follow up for the four or 12 lead E C G because in a number of these instances another family member has a heart condition and sometimes there is an anonymous anomaly within the family that hasn't yet been identified.
a guideline for fever for children less than 5 years of age notified to include blood tests with.
these types of presentation. You may be aware that the the paediatric, I think, they call it. The Pew system is now being rolled out at a number of acute hospitals that will manage the assessment of children. We, we have been asking some questions about the fact that it's being rolled out in children on the wards, but when we were looking to hear what the equivalent arrangement is going to be to be able to use this tool in A and E other issues identified during reviews and once work was delays in postnatal, follow up and PM results give up due to awaiting genetic tests. You'll see earlier in the report that we were doing more genetic tests in south-west London than anywhere else and as a result the chromosomal and genetic child deaths have increased and exceeded the neonatal child deaths because we are now able to identify genetic conditions
hospitals need to ensure that there is a clear line of accountability and a robust system for uploading advanced care plans, better funding for hospice and community services to take some of the pressure off the hospitals with our palliative.
children to ease the pressure on their services there, and the feedback is that we don't have enough psychological support for parents who have suffered child deaths because there's such a strain on the system.
and that is what I can conclude as the contents of the report that we have to answer any questions right, thank you very much, Lorraine is a really detailed report and thank you for giving the supplementary ones with information, because that's obviously important, although you know these numbers they are quite small, aren't they so it it's helpful to have that over south-west London and view as well thank you.
I've got a couple of questions myself just to give people time to think of theirs, so just on the D as a primary care input into the report.
well, poor prime minister for giblets everywhere Re review.
s, just in terms of putting the recommendations together, I was thinking of the general practice input.
I don't know how best to answer that because they contribute to every review, so, with reference to that one, with particular reference to ones were that was a once with the child.
and the GP had a.
can input in that, and they have been putting in the bereavement support for every family that suffers a job that, yes, of course, yeah yeah, just I, I think it might be worth my while just as as in my role as primary care lead for south-west London, I think after this perhaps you could just take it offline and have a discussion about what the recommendations are and how they might be implemented.
because I think that's quite important to get the clinical view on that, and there was just something I wanted to add about the sepsis tool in A and E, because I wonder if we should be thinking more widely about that because in general practice we use algorithms for managing patients Y N on-device specifically but all children for sepsis and we can probably do something around that, even if it wasn't specifically relevant in this case, as I can't tell the age of the child or the circumstances but yeah, that would be a really good thing to do anyway, it's something we should do from time to time, so I've just an offer of help from me with that in terms of getting out to primary care.
bridegroom, OK, there is a slight increase that we well, except it does come down a lot. Last year last reporting year, R R and Rachel infections was twice the national average. It's now just over the national average that's compared to London and England, so we would ideally like to have it below, so we want to have a good grip of how we assess children when they come into A&E or infection related issues, obviously, and if I'm just thinking, if they are present to general practice first which they may do, then we've got an opportunity to look at that angle of things, although it might not have been relevant in the cases you describe, I just think that we should extrapolate from the learning really to make sure we get the good things happening in our system.
get any other questions from anybody.
sorry, Jeremy, would you like to come in?
I mean, I've got nothing on Jeremy to say, as I'm an executive director, adult social care and public health.
on page 43, there's a reference to a vacant consultant paediatrician, it says it's been vacant for two years the ones worth post, and I just wondered what the impact of that and and what are the Is there any plans fulfilling that post or they didn't know what the consequences were of it being vacant so long well I regret to advise that nobody applied for it.
this is the I guess, because the that's just the stress and the strain and responsibilities of the consultants that's out there on an unstaffed, it is just so intense right now they are doing their best by sort of working to a rota system, temporary cover nearing the post but there has been no permanent.
applicants for the post, it's just about.
a symptom of the huge spraying consultants are feeling right now in the acute system.
to celebrate, is it correct to say that there is someone temporarily in that post in the role and a number of people temporarily?
that is being crossed covered by a whole room of clinicians year one and for the boards. If you remember, we had the safeguarding report last month and we talked about this issue because we flagged it then as well, so so we it's easy to not record all of this, but actually we did discuss that really really important to get a permanent member of staff in role, but it's been covered. Meanwhile, in the best way that it can be is what we were assured of last time, so clearly a cause for concern, but ongoing concern. But you know well, as you said around these, these things don't turn around that quickly. We need to recruit the right person
she was that right, Jeremy, yes, and Chair just one further comment, I think, of course is helpful to understand the learning across south-west London Luton and noting the small numbers, but I think I would find it helpful to understand more the local Wandsworth numbers in the report which I I couldn't say much detail about our local numbers.
well, did you get the supplementary information Jeremy, no, I do not know that there's if there are four slides, which came in addition, and it shows about those 11 children in Wandsworth, say you'd be able to send you OK, that's important yeah,
Shannon, I think, was next.
thank you Chair, and then there's one person behind the addressed as well.
I just wanted to welcome the report and you know particularly the recommendations, given that we received the report on an annual basis, I wondered whether it was worth us thinking about how we demonstrate that you know. Some of the recommendations have been addressed because I noted with interest, for example, recommendations on page 64 around public health education that a lot of that is work that we're already doing, but I think it's just around, you know going 3 60 and linking that back with the recommendations so that we can evidence that that work is already in progress and also in relation to some of the recommendations that have been discussed around accident and emergency services. You'll note that
the high rate of hospital admissions for children under the age of five is one of our priority steps in the joint local health and wellbeing strategy. So they already are specific actions within that to try and reduce the number of attendances, working with health, visiting services and so on. So sorry, I don't know necessarily where that would go in this system in terms of just kind of collating some of that evidence around how we're addressing the recommendations and then maybe for completion, present that back to the board yeah, to say just just to go back a step there, Shannon said because I absolutely agree with that will, I hope we're already working on these but Lorraine is it correct to say that, although there's a lag in the reports coming to the various committees actually, having had the recommendations made that they are already being actioned or you're taking them out to whoever can action, that means that is that yes, yeah, yes to my knowledge, that is, that is how it is being done, the the pizza system is taking care of the acute ones the actions as they really relate to acute services but
I have raised it at the ICS level that we don't have an equivalent feedback system from the other partners as in public health, social care, and we need to sort of incorporate, we know, we're going through a lot of transition as an ICS at the moment but we need to incorporate them with a similar system as what we use with pizza to be able to feedback the what is being done with the recommendations from child death reviews.
that's a really really important link in all of this, and the recommendations need to be actioned. And then we need to know what has happened. As a result of that, I think that's where you probably can't wait for next year or report to make sure no more children have died. That's not OK, is it? It's it's action in all of this, so there I know I'm I'm sure that is in progress, but maybe that's just that. The board would like to make sure that that is what's happened. I think that's important. Thank you
that's it.
poll behind me.
I just wanted to sort through actually saying that I personally and some others have been talking to Lorraine about how read how you do address some of these challenges already. So we had a conversation just this morning. We have a regular meeting that Lorraine attend with members of the ICS and, of course, and I I, I think he speaks behind him, where we're all kind of obliged really to kind of make use of our own networks to make sure this information goes out, so it is happening, but it could be more formal sign. I agree that that's something we need to come and look at and there is a children and young people's board and maternity board, which is sits within the ICS
perhaps that could be more inclusive.
it's been re revamped and rewound at the moment, so I don't know whether or not we've got public health reps on there, but it's absolutely key that they should be, we've got to provide us on there and we have GPs on there so that's that should be the right forum and thank you very much pull at Mark so just three things once a comment around workforce, I think it's just a generally it's
there was a bit of a challenge and paediatric workforce, probably less so in St George's than some of our other trusts, but we know certainly around community paediatrics there is a real challenge, isn't there, so it's just to note that the I I think that is that that's a problem across not just south-west London but probably nationally.
Lorraine, you mentioned kind of black and black children and children from ethnic minorities.
and I suppose I'll just have to need to to expand that comment a little bit, are we seeing a misrepresentation and those in those cohorts of children and linked to their on page 60 68, it's not linear it's linked, and it's not linked is we we talk about South West London being the highest number of child deaths of knife crime last year.
but I don't think that's in Wandsworth is that the the the the the there was just something about Lincoln, those bits of data so that we've got a kind of clear understanding on Jeremy's point that what does that mean in Wandsworth?
with reference to the ethnicity.
what the report is sort of pointing out that we are a very diverse area and that more than half of our children are minorities, and that's across all areas.
we have raised concerns about.
the serious incident investigations of some of these deaths.
because that proportion doesn't rip doesn't it's not reflected in the amounts of essays and investigations undertaken?
and in addition to that, one of our areas as in Croydon has the highest child population in London, but remember there are no walls or fences between the areas and the these children are moving between all of these areas, so these deaths can happen in any area.
the child that is just reviewed, based on the child's home address, but because the champions from Sacred, and that doesn't necessarily mean they died in Croydon, that sort of thing.
that failure is, I think, that's helpful context, thank you for that.
at your hinting at a town of under under reporting within particular communities there on.
or as in kind of investigations, not necessarily being picked up as much as they could be better.
does anyone behind them?
sorry, I can't say it's caring.
I
hi today I just wanted to add something around the violence piece as well, just to say that all community safety partnerships across London have had a statutory duty placed upon them, including ones with enrichment and all the other bills that you've raised there, so we've published our local violence reduction plan for both Richmond and Wadsworth by the end of January 31st we've also conducted our strategic needs assessment that we were obliged to publish as well and we do have a strategic delivery group around violence.
at which we coordinate through my team, so certainly I'll take back the parts of the report here around violence.
we work with the violence reduction unit in London, a trauma informed and proud approach, and some of the things that have been raised here have already been threaded through around good practice, but obviously we'll look at it in terms of our local area as well, so we can certainly take those parts back and communicate them through and we are very strongly LinkedIn around the public health approach around this thank you and good thank you very much.
any further questions will behind me anyone in the room.
Paul is an old hand at.
yeah, it is what sense, yeah.
I can isn't, because he wrote, it would have been good, I can do, I can, and I can sense I can sense the Chair sense.
jolly good Lorraine, thank you for bringing that report and my thanks to all the people involved in it and and of course you know it's such an important element of the work that we do with agencies, isn't it in our in our borough, you know there's nothing more important than protecting our children really, so a absolutely critical piece of work, so thank you you will welcome back for your time and we are required to note the contents of the report. Does the Board note the contents of the report? Thank you. We do
good can I just say one thing.
particularly wanted to thank Lauren for the efforts she made to break out the Wandsworth information or yes, it's really appreciated because it does give us that that local flavours, so I know it was more work, but thank you for it, yeah, I appreciate that the rain thank you I don't know if everybody else master plans for the once worthily which is gay,
the elderly carry out one of its Kelly, Kelly of Wandsworth, thank you.
Kelly wants to see our debt going down in history, thank you very much.

9 Work Programme (Paper No. 24-81)

OK, thank you, OK, let's go now to wherever we were, we were at our, is it our work programme is that right, am I right jolly good 1 1 7 2 1 20 so,
Lynn, are you going to just help us workout our little future this year?
I am so it says, as read I mean we have things planned for June and something for October I, I think we've added some elements to this where we might want some feedback from seadog action plan which probably look at somewhere like October and we are looking to do a little stocktake on how we're doing as a board and what we want to do as a as a deep dive in a seminar in July as ever can I say please if you want if their papers of interest topics that you want to see discussed here and offers to write papers.
do let us know and Lucas here now, as our new board partnership lead, and he'll ably look after you if you want to do something, that's great, thank you very much, and June looks a fantastic agenda and Councillor Henderson is welcome back.
can I say that because I think you might be challenging, Deering was there's a lot in that meeting, isn't there so one, but it will be really good, thank you.
and Luke, welcome as well India, thank you for all the help, all the work you're about to do.
Hefin good okay
so people to bring suggestions for agenda items in the round, if they would, that would be great okay, so am I safe to go on to the date of the next meeting and that is the 20th of June,

10 Date of Next Meeting

I don't have any other business that I'm aware of, so that concludes the meeting and thank you to everyone for attending thank you to any members of the public watching this meeting and thank you to everybody who has contributed to the work into making this this meeting work. Thank you very much go back.