Health and Wellbeing Board - Thursday 27 February 2025, 1:00pm - Wandsworth Council Webcasting

Health and Wellbeing Board
Thursday, 27th February 2025 at 1:00pm 

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  1. Webcast Finished

Good afternoon. Welcome to this meeting. I am Councillor Graham Henderson and I am the
and health and well -being board.
Members, as usual, I will now call your names
in alphabetical order.
Please switch on your microphone
to confirm your attendance.
Once you have confirmed your attendance,
please remember to switch off your microphone.
Jeremy De Sousa.
Abby Carter.
Good afternoon.
Mark Creelman.
Good afternoon.
George Crivelli.
Councillor Crivelli, are you present?
OK, not in the room, but OK, well...
Robert Gile, who I believe is joining virtually.
Good afternoon.
Oh, good afternoon. Excellent.
Stephen Hickey.
Welcome.
Thank you.
Shannon Crivelli.
Philip Murray, I think we are expecting him to join us at some point virtually.
He does have a conflict in the meeting.
Mike Proctor.
Apologies.
OK, fine.
Dr. Uwaka Shah.
Good afternoon.
Good afternoon.
Kate Slomek, I think also joining virtually.
I apologize for being
virtual today.
We have the CQC here
today.
Yes, and
thanks, Councillor
Kate Stock.
Thanks,
Jez.
Please, can I ask, as
usual, when you are
speaking, please could
you refer to the page and
number at the top of the
page and the pack and the
paragraph number so the members of the public
can follow the discussion.
Please, I also indicate if you wish to speak
in the usual way by raising your hand,
I will be reliant upon Laura to tell me
who is people who are sitting behind me
because I don't have eyes in the back of my head.
Rather embarrassing bald patch
but not eyes in the back of the head.
And again, once you have completed speaking, if you can, turn off the microphone.
We also have a number of officers present who will introduce themselves when they address
the board.

1 Apologies for absence

So the first substantive item, well, apologies.
and apologies for absence have been received
by Dr. Arianna Chigaya, Dr. Nicola Jones,
Emma Popovici, and Brian Ryan,
and also TMR Orban.
And I think we had one other from Michael Proctor.
So moving on to item two,
Actually we're just dealing with members present and Councillor Crivelli has just
joined us. I will take that as you being present thanks a lot. So if you can move

2 Declarations of Interests

to item 2 which is declarations of interest. So are there any declarations
either pecuniary of the registrable or non -registrable interests? Please declare
or any interest quoting the item and paper number
in which you have interest
and are describing the nature of your interest,
including whether or not you'll be taking part in the item.
Can I ask if there are any declarations of interest?
Excellent, thanks.
So we can now move to the third item,
the minutes of the last meeting on 21st of November,

3 Minutes of the meeting held on 21st November 2024

the minutes
of the previous meeting held
on the 21st
November
agreed
and can they be
signed
as a correct
record?
Any comments on the
minutes?
I do actually have one
being a
fully paid up
member
of the
union,
I did notice
that Mr
Markle's
name
was spelt
incorrectly.
Apart from that minor change, I think we can take the evidence that's being read.
Abby, sorry, yes.
I share your pain of having your name constantly misspelled.
My name is always misspelled.
But my, it was kind of a question really, there was an action for Isabel Shawcross to
come back to me on something about why no autistic people have been registered as dying
in Wandsworth, which hasn't happened.
and I'm just wondering about the process that that should go through to ensure that she
does come back.
Should I, I would assume I shouldn't have to contact her directly, but is that the way
to do things or does it go through Laura, for example?
Thank you.
Thanks, Chez.
Good, okay.
So I think I can sign the minutes as a true accurate record.
So I think we're now on.
Do you want to do that?
I think I have a black pen.
Very good.
Thanks, Dr. Yes.
Okay, thanks.
Cheers.
Right, so the first substantive item on the agenda is the joint local health and well -being

4 Joint Local Health and Wellbeing Strategy: Live Well Update (Paper No. 25-74)

strategy and the Liffwell update paper number 25 stroke 74
on pages 13 to 36.
This is a report by the director of public health.
So I'll ask Shannon Cattia to introduce the report.
There are quite a number of officers who may be presenting
in relation to the various topics.
I won't read out all their names
because it's actually quite a long list.
But anyway, over to you, Shannon.
Thank you, Chair, and thank you, everyone.
We're really pleased to present this afternoon
for the first time an update on the Live Well section
of our joint local health and wellbeing strategy.
And for this afternoon, you are presented
with four of the steps within that section
covering adult immunizations, cancer screening,
climate change, and air quality.
I will ask our STEP leads to maybe just briefly introduce
each of the highlight reports in turn,
and then hopefully take questions.
And I also want to extend my thanks to the STEP leads
and the STEP sponsors for all the work they've done
in preparation for the report.
So if we're okay, we'll start off with adult immunizations.
and I think we've got Holly Stone and Puja Kircher
joining us, thank you.
Thanks.
Apologies, we've got Melissa who is here in person
to present that one.
Melissa.
Thanks.
Thank you, Shannon.
I'm Melissa Barker, I'm a Public Health Lead
at Richmond Wandsworth Councils.
I am also joined by Holly and Puja,
they are joining virtually, they are the step leads on this.
To give a couple of headlines about adult immunization,
this update focuses on the 2023 winter vaccination program,
in which despite a declining national trend,
Wandsworth actually saw higher flu vaccination rates
than in the previous year.
And within the individual eligible cohort groups,
uptake was similar to or better than rates in London. In the 2023 program, a
number of activities were delivered by the public health team and by the I. C.
B. To improve coverage of this vaccination program. This included
comprehensive community engagement to bring vaccines into our communities,
um, with over 80 outreach sessions delivered through the public health bus
and through community clinics and community lens with just over 580
vaccines delivered to create an accessible vaccine offer for residents.
Thank you Melissa. I mean we do have a number of different topics adult
immunization, cancer screening, climate change, air quality etc. I think it will
Probably if the board agrees,
if we take each topic in turn,
otherwise I think the discussion
may get rather complicated.
So if we can first of all take the report
on adult immunizations, a very comprehensive report.
All of the topics are covered by quite
comprehensive report in the appendix.
So can I first of all take any questions or comments
in relation to adult immunizations.
Stephen.
Thank you very much for the report.
I just had a question on the page 24,
where you give the statistics about Wandsworth,
which look, as you say, very encouraging.
My question was, do you have data about
areas or ethnic groups, as it were,
relatively deprived, because I'm conscious that
the averages in one's worth can hide
where the real problems are.
Yeah, Melissa.
Thank you for your question.
That is data that we hold internally,
but it's not publicly available data,
so each year we carry out an evaluation
within the public health teams to scrutinize
and evaluate the data that we see in this program,
and that covers things like ethnicity data.
And we use that internally when planning
for the upcoming year's program.
So for example, that's the kind of data
that we can use when designing outreach clinics
and the location of those clinics
to ensure that we're putting them in spaces
where those offers are most required.
That's encouraging that you've got the data.
I just wonder whether maybe in future reports it would be useful to have the sense of spread.
I mean, you know, the average can hide a multitude of sins.
It would be useful to have some sense of, you know, where, what's the worst 20 percent,
best 20 percent, something like that, either by area or whichever ethnicity, whatever metric
seems most useful.
Yeah, certainly, Stephen.
I mean, we can sort of discuss the sensitivities
of the data, but certainly for future reports,
I think at the very least, we can actually send it
to board members in confidence.
But obviously, between now and whenever we come
to discuss this again, we'll have discussion
over any sensitivities that may exist around the data.
But certainly, Steve, and I'll entirely accept the point.
Abby.
Thank you, and yeah, thank you for your report.
I've got a few questions, but that's because I found it so interesting.
And so first up, I'm the voluntary sector rep.
So this is some feedback or I was kind of interested in your insight that
based on feedback that came from some partners yesterday
who have been partners in delivering immunization in the community.
And there's a feeling that
Covid is immunization is really putting people off.
And there's a high sense of fatigue amongst
kind of really at risk members of the community.
And like because of the I guess the reputation of the Covid vaccine,
for want of a better word, that's also putting people off
things like measles.
I was just wondering, I appreciate that this data
is actually from like up to now two winters ago,
and this might be, that feedback might now be a bit more
upstate and relevant, but I just wanted to understand
if that is something that you recognize,
and if it is, what your thoughts are on improving that,
and if it's not, then would it be helpful to maybe,
for me to be able to provide a bit more
on the ground insight into what people are seeing.
So to help you kind of get as you go forward.
Thank you so much for sharing those insights.
Firstly, it's really helpful to hear
what's being seen and discussed within our communities.
So it would be very
welcome to hear any further insights that you have and any other detail around that.
It's certainly something that we are aware of with the fatigue around Covid.
And it's certainly something that we have seen reflected in this year's campaign as
well from the early data that we are seeing.
So it's certainly something that we are aware of and will be considering going forward
with the spring campaign and with this year's autumn campaign as well.
There's – at a London and at a South -West London level, there's a host of communications
and outreach that's being done around the winter vaccines.
And that's certainly something that I think we need
to be looking at further when considering future planning
for these engagement activities.
Thank you.
Okay. And then the second thing, sorry, I'm going to go
around, is I was kind of just really interested, I guess,
in if whether you think you're happy with the results, I suppose.
It's good that the trend in Wandsworth is kind of going
against the national average which is going down.
that's good, but obviously in ones that are still significantly, in some demographics,
still much lower than the national average. But for example, I was looking at kind of things like
the number of sessions delivered in the Health Bus Community events, and it wasn't clear to me
kind of how long those sessions were and whether, for example, a return of 58 vaccines being
administered in seven Health Bus sessions is something that you consider to be successful
and good return on the time and resources or or not that just that kind of that that
now I wasn't quite sure about it be really helpful to understand a little bit more about about that.
Um I think that's a really um helpful comment that you have raised and I think
particularly when we think about the health bus it's really um valuable to think beyond just the
number of vaccines that are delivered at these events.
The health bus has many benefits that by bringing these vaccines into community locations and
for the health bus specifically, those locations are selected based on areas where we've seen
lower vaccine uptake or where there might be less provision available in that area.
So they really help to improve that accessibility.
They also, we've received feedback where residents have used that opportunity to get vaccines
when their GP had run out of any vaccine provision.
So it provides a convenient way for them to get vaccinated.
It also, there's other benefits such as there's no requirement to get a vaccine on the health
there's an opportunity for people to come forward and have a discussion.
And so that might not be showing in the numbers, but
it's that opportunity to have a conversation in a convenient and
in an accessible location.
As well as also catching people opportunistically, for example,
at a community event where they're already in attendance, that they might
not otherwise be looking or thinking about vaccines that that offer is there.
So I think that the help us offers a really wide package of support and a range of benefits that extend beyond
The number that are specifically delivered at those events
Thanks, um Kate case I'm back
Thank you
And thank you. That's a really good report
In fact, my one of my questions is very much along the lines of our bees around because I think it's roughly eight
vaccinations per session for the health, so I was interested to know, but as you've rightly
described, it has a wider benefit. So I think that's really good to hear. And I suppose
my other reflection was obviously we've seen a lot more flu, sorry I should have said I'm
the managing director of St George's, a lot more flu coming through the hospital this
year, a significant rise compared to previous years. And it'd be interesting to see whether
that has a positive impact on vaccination uptake in the next season because I think
a lot more people have been affected by it, it's been a bit more in the news etc.
But yeah, so just wanted to make those two points.
Thanks. I saw Shannon next. Okay, George.
This has been addressed partly by some of your answer, but I want to ask you about the
the point you make on page 22 about the wards
that you've targeted in the borough.
You mentioned five wards, Gravely, St. Mary's Park,
Roehampton, and Queenstown, and Latchmere.
My interpretation of that upon reading it
is that the social deprivation goes hand in hand
with low rates of immunization.
Have I got that right?
Or is there anything in particular
that I'm missing there about that?
Your understanding is correct.
We see that correlation with areas of deprivation,
but also see a trend between vaccination rates
and ethnicity as well, which also correlates
with those areas of deprivation.
Thanks.
Kate, Councillor, Kate Stock.
Thank you.
Thank you very much for the report and the update.
I'm really pleased to see kind of us
outperforming London and England in terms of pregnant women
and two and three year olds.
I was just interested in a little bit more information
about what the barriers, it's still less than 50 % in both of those categories.
So still kind of what the barriers are there, are they some of the issues that we've already
touched on.
And then a second half really just looking if there is correlation between pregnant women
and two and three -year -olds and some of the awards that you've highlighted on page 22,
Whether there's been any consideration about expanding the offer into our family hubs and
our satellite children's centres or co -locating the health bus, there is an alternative offer
of bringing the offer out into the community, as you've highlighted on page 23, whether
that's been explored at all.
Thank you.
So, starting with your first question, there are a real range of reasons why, barriers
as to why people are not coming forward for vaccinations.
There's also specific London factors.
We see that London has lower rates of vaccinations than across the country.
And reasons for this includes the vaccine fatigue that's been brought up earlier, also
includes factors such as mistrust. In London there are specific issues related
to population mobility which means that people miss invites for vaccination and
are less likely to be registered with a GP as well as a trend around lower
uptake amongst people from ethnic minority groups as well. So there's a
real range of different reasons that are preventing and causing these barriers to
In terms of your second question, this isn't any analysis that we have carried out to date
in terms of specifically looking at the eligible groups of pregnant women and two to three
year olds and the location, but it's certainly something that we can seek to investigate
this year within our evaluation when we are carrying that out with the programs and certainly
something that we can look into in terms of co -locating
those community offers in spaces such as the family hubs
going forward to help drive that up.
If I may, I just wanted to add a bit more context
around the co -location.
Public health have been linking in with children's services
to talk about additional services that
can be supported by the family hub model
and what we can put into there.
I think there is a bit of a complexity and a challenge
around the immunizations, because obviously
the local authority is not in control of some of the
operational and logistical arrangements around that.
It's certainly something we would look at.
I think the other complexity as well,
particularly in relation to the help bus,
is the sources of funding that are supporting the help bus
then determine what are some of the priority areas
for the help bus to go into.
but as we're looking at the procurement
of a permanent help bus model,
we'll definitely be looking at further opportunities
to support wider coverage and uptake.
At the moment, the help bus only goes around once or twice
every couple of weeks, so there's not a lot of scale,
but as we're scaling it up,
we'll be looking at those opportunities
and the funding as well.
Good, thank you.
Oh, Mark.
So, thanks for the report, and it's really encouraging to see that one's worth the kind
of bucking national trends.
I suppose the reality there is we've got two -thirds of people kind of immunized, which leaves
a third unimmunized.
And we know just in terms of whether it's the 10 -year plan or the new administration
actually moving from treatment to prevention, and immunizations is the way that we can prevent
ill health.
So it's really, really important that collectively everyone gets behind that kind of vaccination
message.
And just to support Kate's comments, really.
We've had a winter of extreme pressure in acute services and community services and
GP practices.
Actually immunizations is one way to help relieve some of that so actually those services
can cope.
I did see
Abby and Stephen
ask questions.
Obviously I will have to move on at some point.
As you say,
this is a very important issue
and goes very much into the heart
of the preventative agenda.
Abby,
I will take
back.
I will take back.
Thank you very much. Thank you very much for a great report. We've now got another vaccination
called the RSV the respiratory syncytial virus night. Just wanted looking ahead, whether
you will be adopting a similar strategy, as you've done with flu to improve the uptake
of this vaccination. And again, in subsequent years will be have access to the kind of data
that you presented in respect to flu.
Thank you for your questions.
In terms of our approach to the RSV vaccination
going forward, we will certainly be incorporating that
into our kind of package of activities,
particularly communications around this
to help encourage uptake.
In terms of data, I think that's a question
that we can take away.
it would be a national decision as to how much granularity of detail.
We currently receive data at a national and at a regional level for the RSV program, but
not borough -specific data as of yet.
But we can certainly take that question away to find out if that's something that could
be made available.
Thank you.
Thanks.
Abby, Steve, and you.
Go ahead.
I do have one final question.
Sorry, I'll be quiet soon.
Obviously one of the things that seems to have gone well
is the fact that you've been delivering
in community settings and with charitable partners,
which is great.
I guess the question, whether it's for you
or for NHS colleagues is kind of how much
planning ahead happens there because if it does work,
it's obviously super helpful for charities to know,
you know, going forward, that they'll be recommissioned
for that or not, because there was some uncertainty
around that when we spoke to colleagues in the childhood sector yesterday. So that was
just a request as to how far ahead you know, like who you'll be partnering with.
Thank you. I think that is a question that would be best answered by our ICB colleagues. So I don't
know if my colleague Pooja is online. I don't know if you have any comments or otherwise we can take
this offline and provide an answer in the minutes.
Thank you, Melissa, and thank you, Abby, for your question.
So we received funding from the immunization team,
did receive some amount of funding for Wandsworth Care
Alliance this year.
But having said that, this funding
came from a port that the IMSS team applied for.
And this, unfortunately, we don't know if it will be repeated.
and there has been a cut in the access and inequalities funding as well that may impact on the outreach that we are able to do.
But we would be trying different avenues to get funding from the different parts of funding from NHSC.
Thanks, Preet. I don't wish to curtail our discussion. This is a very important topic as I think we all agree.
it's good to see that all improvements in the rate
of immunizations, particularly of young scoundrels,
but clearly there is considerably more work
that needs to be done, and that is obviously something
that we are fully committed to doing.
But anyway, Melissa, thank you very much for coming along,
presenting the paper, and also answering various questions.
If we can move on to an equally important issue,
in fact they're all important,
but certainly cancer screening.
Shannon, who have we got who's presenting on this issue?
Thank you.
So for cancer screening, can I call on
Sophie Ruiz and Dr. Lucy Sneddon?
Hello, hello.
My name is Sophie Ruiz.
I'm the program lead for early diagnosis.
And Lucy Sneddon unfortunately can't attend today
but we do have the GP cancer lead for Wandsworth
which is Dr. Maria Wallace.
So you should hopefully be able to see her in the corner
of the screen that you have up there.
So I'll start off with just a few key points.
Really, our partners working collaboratively with the ICS,
we have developed a dashboard
which provides really granular information about those populations that are not accessing both bowel and cervical screening.
We are looking likely to have something similar in place for bowel cancer screening.
So we'll be able to really, really delve into and work with those communities that we know that aren't
participating in those screening programs.
By the update that I've provided, provides a sense of actually a lot
of robust community engagement pieces that have been happening
across all three screening programs.
So our health promotion specialists at St. George's that work for and that work
on bowel screening as well as breast screening have been really proactive around working
with specific community, specific communities in Wandsworth as well as general practice
around raising awareness around the screening programs, around bowel and breast screening
programs per se. We also at RMR partners commissioned our own grants program, again working with
communities to raise the profile of the importance of all cancer screening. And we had 10 community
organizations in Wandsworth delivering a range of activities to support their communities.
And lastly, in relation to both bowel and breast screening, our GP colleagues did have
an inclusion within their contract around how they can support greater uptake for both
bowel and breasts and working on those specific patients that hadn't previously responded
to their invitation.
So, yes, in my report, I provided some of what those insights are around the populations
that we know that aren't accessing balance and cervical screening. And we want to move
– we want to take this information moving forward in terms of proactively working as
a system as part of our new prevention and screening agenda to really understand the
barriers that these communities face,
but also understand how we can work with them
in order to improve their understanding
about the importance of screening.
Thanks.
And I'll pause there.
Thanks, Lyle Safey.
I suspect you'll probably have a few questions to answer.
So, comments or questions from members of the board?
Oh, perhaps I'm wrong.
Shannon.
It was more just an observation and explanation because I know the question has come up on
page 26 where we've got the proportion of people not screened.
What is presented there is the Indus of Multiple Deprivation, deciles 1 to 10, where 1 is the
least deprived and 10 is the most deprived.
So you can see that there's a correlation in terms of the number of people not screened
being more likely to be from deprived areas.
I just wanted to head off that question.
Yeah, so index IMD one and two are the most deprived
and 10 is the least deprived.
So for bowel screening, there seems to be a correlation
between those that are in the most deprived areas
not accessing bowel screening and that's the pattern
that we're seeing across all boroughs in southwest London
as well as in northwest London,
which is the other ICS that we cover.
So we really want to do something about how we work
with the most deprived communities in order
to increase their awareness of battle screening
because we often see that actually it's those that are
in the most deprived communities that are actually more likely
to develop a colorectal cancer diagnosis.
Say hi to them.
Yes, certainly.
Any further questions on cancer screening?
Abby.
Thank you.
I kind of noted that people with disabilities are consistently at the bottom of the pile
when it comes to percentage of people being screened.
And I was wondering what measures are being put in place to try and improve that rate.
Sophie?
Yes.
I mean, indeed, it's the case across all of the screening programs.
So I know that for breast screening, in particular our colleagues at St. George's Screening Services
are proactively engaging with learning disability, patients with learning disabilities and their
carers about how they can access breast screening.
It's something that our GP cancer lead here, Maria, who talks to our PCN and GP colleagues
around cervical screening, is keen to stress that actually that patients with learning
disabilities do have as are able to access cervical screening as much as any other patient.
I think there is a misconception that patients that have a learning disability aren't having
sex naturally, you know, the fact that they're not having sex doesn't mean that they're not
still at risk or if they're not, you know, they're not still at risk. So there's a greater
awareness amongst the GP community around cervical screening per se. In terms of bowel
screening. Again, our health promotion specialists at St. Georges are working in those communities
and are wanting to stress the importance of how it's important for patients that have
learning disabilities to access bowel screening. And I know that our health promotion specialists
have been working with organizations that support learning disability patients to take up the offer.
So it's something that we are definitely aware of and that we want to improve on.
I was just going to add that all patients with learning disabilities should be having an annual health check at their general practice.
So I've been really trying to enforce that every contact matters and that screening history really should be kind of questioned when patients are seen.
And if they haven't taken up the screening offer, really encouraged to do so.
Thank you.
Thank you.
I feel I should know the answer to this as the Director of Public Health, but I don't.
I just wondered from your perspective, it's slightly unusual for Wandsworth to be near
the bottom in terms of any indicators when compared to the rest of South West London,
but obviously that is the case for bowel cancer screening, and I wondered whether you had
any potential insights as to the reason that might be?
Does that relate to any differences in our population
or any other factors that you're aware of?
So the target for bowel screening is 60%.
So although one's worth is towards the bottom end
of performance in southwest London,
you are actually exceeding the targets
for that NHSC has put in place for this area.
I think, you know, and I think the report
or the population dashboard demonstrates what communities
or what specific groups we most want to target.
And again, it's almost like a similar position
across all other boroughs.
So, yeah, I'm not sure how quite to answer your question.
question if I'm being completely honest, but I think it's more emphasis that's needed in
relation to those specific cohorts that our population dashboard provides us with insight
on as to who is not participating in bowel screening. So much more focus on those groups
that is something that we're keen to do.
We mentioned kind of learning disability patients, but also SMI patients, patients with severe
mental illnesses. So I'm trying to engage with the mental health workers
that are in general practices at the moment because they are often having
more contact than the GPs are just really again promote screening in this
population. Yeah thanks, thanks a lot. I mean looking at the statistics and clearly one would
need to delve into them in greater depth.
But it does look as if those boroughs
which do have significant levels of deprivation
somewhere in their borough are at the lower end of the list.
Fortunately, they're all above 60%,
but clearly yet again, there is a lot more to do.
I am aware, I think, we have at least one,
possibly two representatives of UCM.
which is a charity and organization
which is very much at the forefront
of promoting approaches to cancer,
including cancer screening.
I'm always pleased to see people,
this isn't a formal delegation,
but I'm always pleased to see people from the public.
I just wondered if you have any comments of your own
you maybe should make?
Good afternoon.
My name is Michael Samuel.
I am here from the Can You See Me project, project funded by Mac Millan, and which he
which is hosted within the Croydon BME forum.
Now, good to see the information
that has been published here, which is all very good.
Now, some of the things that I have picked up locally,
which I would like to see,
is when it comes from the information coming out
about the demographics and where the people are,
I think I've got it here in my notes.
Yeah, Stephen Hickey pointed this out,
it'll be good for me to know where the areas where the immunisations are taking place
because that will enable me to plan and target where I should be going to
and where I should be raising that future awareness
also to understand in which areas of the PCNs they sit into.
Now I know earlier on it was mentioned, and I've left it on my other piece of paper,
there by Sophie, where Sophie Ruiz regarding the work that RM Partners may have that detailed
information. So it would be good for me to actually get access into RM Partners and actually
speak to them how that's being done and how we can work together and then also more importantly
how the community groups that are all working together. Because I work with a lot of community
groups and we're all doing our own different thing but I really want to bring that all
together so we can all help and help the people
within the community and at one sort of,
and it's good to see that in the report
it has mentioned the Can You See Me project in this.
I know, Chair, that you were able to be our main speaker
at the start of that event, so thank you very much for that.
Well, thank you Michael, and particularly for,
so it can prompt you, comment, et cetera,
but those points are very well taken.
And certainly I thought the conference
was very well organized and clearly focused
on a whole range of issues, clearly engaged
with a very wide range of different organizations
all committed to doing that up,
to try to prevent cancer and also provide responses to it.
But can I just ask of any immediate reactions
to Michael Skarman -Sittel from the members of the board.
George.
Can I just ask, I'm interested,
can you tell us the sort of things that you do?
Just give us a couple of ideas
about the sort of things you do
to address the sort of things that you're aiming at.
I know what you're aiming at,
you're aiming at health inequalities,
particularly so for BMAC,
but if you just give us an example
of a couple of things that you do to promote that.
Yeah, so some of the key things that we do
is trying to break down those barriers.
So I have got some very good links
with Royal Marsden Hospital directly in Sutton,
but I've also got some great links with St. George's,
speaking to the head of nursing there,
and what we are doing working together
is working out where I go and speak to communities.
I am having workshops with them
where they can come in and drop in
and see me at certain places.
So I've got a place in Battersea, another place in
Roehampton, where I pick up the information from the
communities, what are their barriers, what is not working
for them, and then I'm able to feed that back into the
health community and make sure that we're working
together.
I think one of these things that we've got in the
community now, there's a bit of push and pull, is that
there are some things in the community where they are maybe
reluctant to understand what needs to happen to get their things done, but also from the
health community, and I'm trying to bring those both together.
And I've got some things I'm working with now with the role models, which I can't really
talk about in great detail, but there are lots of initiatives that we are doing, and
it's going down.
I think one of the key things, this may be not fit, someone did mention, especially from
the community which deals with the charitable community, is about the funding.
I'm quite fortunate my funding is there for three years,
so I'm one year into a three year project.
But that uncertainty doesn't help the groups
that I'm working with.
They're not always gonna know can they continue
the work that they're doing with me
and can that be sustainable in the long term.
I know how difficult it is,
but that's one of the key things.
Thanks, Art.
Again, another very important sort of discussion
on a vitally important topic.
And again, I think it does indicate
there is still a lot more that we need to do,
but we will work with health partners
and community organizations
to try to improve the rate of cancer screening.
So if the board members are content,
thank you very much, Michael, that was much appreciated.
So the next item as part of this report
is on climate change.
And again, Shannon, or if the officer
would like to identify themselves, thanks.
Thank you, Chair.
I'm Andrew Hagger.
I'm head of climate change and sustainability.
And I'm here to talk about the climate change step.
So just a little bit of background
is that the work that we do around climate change
is really, really closely linked to health.
There's some really big health risks that come from a changing climate.
If you think about some of the things we're likely to see in a changing climate is things
like increased flooding, which brings health repercussions there.
We're looking at extreme weather events, and we're looking at also overheating and drought
and things like that, which will obviously have severe health consequences for populations,
especially vulnerable populations.
There's also wider system things that we can see in a changing climate around food instability
and other knock -on impacts as well.
So a lot of the work that we do really closely ties in with health.
So for example, if you think about air quality and health and carbon emissions, air quality
and pollution and sources of carbon emissions are very closely linked.
And I saw that my colleague Jason Andrews is on the call, and he can talk a lot more
than I can about that sort of stuff.
He's very knowledgeable about it.
If you think about retrofits and energy efficiency of homes, that's really needed to drive down
carbon emissions that come from homes.
but also you get warmer healthy homes as a result of that which definitely improves health outcomes as well.
There's also active travel which is part of reducing carbon emissions, but also has wide health benefits.
And then if you think about green spaces, nature and biodiversity, there's lots of links between that
improving those and access to those and increased physical and mental health as well.
And so one of the things I wanted to highlight, a few things I wanted to highlight here
that are set out in the update you've got
is the Seth Wesson ICP Green Plan,
and that has been refreshed to go through until 2027.
So Wandsworth has been involved from a council perspective,
so I go along to meetings there to contribute.
Public health, obviously, go along as well,
and also NHS providers are involved.
So for example, St. George's go along to that
and contribute to that plan,
and that brings together the whole health system together.
In terms of what we're doing as a council,
There's the ones with climate action plan and that is reported on annually.
It went a couple of weeks back to the Environment Committee where we provide an overview of
what we've delivered.
There's been some significant progress on lots of different actions generally around
climate change.
But two particular areas are on retrofit and we've developed a retrofit strategy for the
borough and again this really kind of drives forward the strong links between energy efficient
and health, if you think about addressing cold homes
and the knock -on impacts from that, damp and mold
and things like that can be reduced
through improving properties and then also reducing
carbon emissions from that and tackling climate change.
Another one that's got a really strong link
is adaptation and resilience.
So we've created an adaptation and resilience strategy
and that sets out the strategic approach
we're gonna take as a council to improve
the resilience of the borough.
It also uses climate risk mapping,
which factors in health.
So we've worked very closely with public health colleagues
on creating the climate risk mapping.
It brings together different risk factors
around flooding, overheating, access to green space,
alongside socioeconomic factors,
such as indices of multiple deprivation,
and then also things like health as well,
to really identify which communities are the most at risk,
and then base our actions to increase resilience
and put in adaptation infrastructure that's data -led
and it's risk -led as well.
And within the update, you've got a great example
of some of the work that we do as a team,
which is the Warm Home Packs.
So this links together cost of living
with health and well -being, with energy efficiency
for reduced carbon emissions.
And so that's funded via cost of living funding,
but it delivers on multiple different things,
which is one of the things that we are trying to do
with the climate change approach,
is it's not just about reducing carbon emissions,
it's about the co -benefits that come
and can really help take off multiple priorities
that we've got as an organization
and also the wider health system as well.
Thank you.
Thank you, Andrew.
Any other comments?
Shannon.
Thank you and thank you, Andrew.
One of the things that we have discussed
around our climate change step in this strategy
is to look at some of the work that was done
by the UK Health Security Agency a couple of years ago,
where they looked at potential indicators and metrics
that we can measure in order to track
the progress in terms of climate adaptation and mitigation.
So we know we've got several indicators,
whether that's around infectious disease,
or whether that's around impact of heat waves on social care
services during the summer and those kinds of things.
So we have had a conversation offline with Andrew
to start thinking about whether we
to look at some of those metrics and perhaps find
a small sample of key metrics that we can start
to incorporate into our reporting
so we can track the change and the impacts.
Just to add on that, that's one of the actions
that's been identified in the adaptation
and resilience strategy is to,
so we've made sure that's included there,
to try to look at how can we pull together
a set of indicators so we can track this a bit better.
Thanks. Any further questions? Stephen?
Thank you very much. The recognition of the significance of good housing, good homes,
from a health perspective, I was going to raise this actually in the later paper on
mental health, but it actually goes wider than mental health. I just wondered whether
there is a system at the sort of individual level. If I'm, which I'm not, a doctor
dealing with it's with mental health or a physical health
case, and I am concerned about an individual patient,
in particular about the quality of the housing,
whether they've got warmth, and so on and so forth.
Is there other mechanisms for the health at that level
to deal with, to reach people like you or whoever it is?
I don't quite know who it is.
Because at aggregate level, it all makes sense.
But actually, to the individual level,
I just don't know whether there are mechanisms in place
where this is a real concern to a clinician.
Andrew, do you want to comment on that?
I mean, I could say a few things as a counselor,
but you're obviously much more played
into the overall strategy.
So I think in terms of a health practitioner,
especially say a GP, I'm not entirely sure.
I've got to be honest.
But there's definitely work that we do,
so for example, the Warm Homes Packs,
there's information that goes out around that.
I think that maybe we can improve getting information out
to health services perhaps, to make sure that they are aware
that there is that service there.
We do have eligibility criteria,
but they're not massively strict.
It's kind of like, if you present an RA need,
then you can get some help.
And there's opportunity to access advice,
as well as actually getting a warm home pack.
And what we're doing this year is adding in
sort of deeper interventions, such as sort of
dehumidifiers and things like that,
other sorts of things, lagging boilers,
doing a bit more support around draft proofing
and stuff like that.
So those sorts of levels of support are available
via the warm home packs approach.
So I think that maybe linking in a bit more
and getting more information out there
is something that we can do.
I mean, certainly from the council perspective, I mean, clearly, can depend upon the actual
sort of age of the accommodation.
So many people who are council tenants, certainly you have or should have a very sort of direct
of contacting the housing department
and the area housing teams to actually rectify
those particular matters.
I mean I think you're quite right Stephen,
in raising housing it is a critical issue
which impacts on all aspects of health
and we certainly recognize that.
In relation to private rented accommodation
it can be a bit more tricky.
Obviously in extreme cases,
the new regulatory services could get involved,
but we obviously have less control
over the private rented sector.
We certainly are aware of a number of problems do exist.
I think what we can do is to ask housing
rather than me sort of talking on behalf of a department
that I'm not a cabinet member for.
I'm aware of a whole range of things
which they do actually engage in.
But I'm happy to ask Housing to give a more comprehensive report.
Mark.
And I suppose, Stephen, just in terms of, I think within primary care, if housing is
identified as an issue, there are many referrals and support that the GPs provide to that person.
I think the other thing to mention is that South West London ICB and South East London
working together with housing organizations about how we improve the link between health
and housing and actually Wandsworth Housing Department are part of that conversation.
So there is a strategic piece of work about how health and housing might work even closer.
Yes indeed. I think Kate, you have a question or comment?
Yeah, it was more a comment really because obviously environmental sustainability, obviously
running one of the biggest organisations that sits within Wandsworth, we take this really
seriously as an organisation as well, the broader piece around environmental sustainability and what
we as a big organisation that can contribute negatively to that can do positively to support,
we feed into the South West London ICS group on this which is really active and proactive,
So it would be good to be able to sort of feed some of that into the reports as well,
because I think as a borough I think we do pretty well, but obviously there's lots
more that we could be doing.
So – and I'm very conscious that as an organization we sit firmly in Wandsworth borough.
Thanks.
Raka.
Thank you very much.
I'm really grateful to you for including data on air quality.
I found that really illuminating.
I just wondered if I can trouble you for a definition
on the World Health Organization guideline
and also the definition of the World Health Organization
interim target.
I just wanted to get a sense of what that means.
And then after that, I just wondered if I can get
your narrative on our performance of air quality
over the years and any projected future gains in performance.
Actually, like I think that's the next topic
that Jason's talking to,
but at least you have pre -warned Jason
and start, you will be asking.
So I'm sure he'll appreciate that.
Yeah, I appreciate obviously climate change
and air quality are very closely linked.
But any more comments specifically on climate change?
If not, I mean, I think the importance of this topic
is to actually demonstrate,
I think Stephen was certainly suggesting
the importance of a very joined up approach
across a whole range of different departments.
Clearly all these things ultimately come down
to the economic and social determinants of health.
And it is vitally important that we as health
are being brought on to simply focus upon,
shall we say clinical approaches,
but looking much more widely in terms of the societal impact
upon health and obviously working together cooperatively
to address that and clearly climate change
and we're gonna hear about air quality in a minute
but clearly those are very important determinants of health.
So thank you, thank you Andrew for coming along
and talking about climate change.
Moving swiftly on, air quality, Jason Andrews
from our regulatory department,
but I'm sure you can introduce yourself, Jason.
Thanks.
Thank you, Chair.
My name is Jason Andrews.
I work for the Regulatory Services Partnership
and I manage air quality and contaminated land.
We are one year into our new Air Quality Action Plan
that was built on the recommendations of the Citizens' Assembly.
We were one of the first boroughs in London
to formally adopt the interim World Health Organization targets and Councillor I will
answer your question on that towards the end. When we built the plan we made sure that there was
the clear links to health and climate and we think that the plan actually is covering those
three areas really well. The Ecology Action Plan has some 60 measures, everything from our
that into a few slides.
Every year we produce what's called
an annual status report that
basically reflects on the actions
that were taken over the past year.
Also looks at the measurement in
depth around
locations in the borough.
So it's really difficult for me to
put all that information into a few
slides.
But what I have done is I've given
some information on the
nitrogen dioxide
over the past few years and
the direction it's heading in.
And I'm happy to talk to that further.
This isn't all of our monitoring sites.
This is only a few locations.
And we do challenge ourselves in the borough.
So these are locations that are quite polluted.
So these are main roads.
We don't select back streets to monitor
and say everything is fine.
So a couple of highlights from me,
with secured funding to update our Love Clean Air website,
which should be able to give information
and maps on local air pollution
that are a little bit more live than we do at the moment,
so people should be able to see what their area looks like.
We do have some training,
and this probably touches on the Councillor's point earlier.
We do have some training sessions lined up
for healthcare professionals and home visitors
looking at internal air pollution, including mold,
so they can identify that if there's any problems
in their clients' homes and give advice.
We do a number of engagement function.
I think we've done about 50 events this year aimed at different parts of the community.
We've also installed our new air quality monitoring stations, which is great news to the borough.
It was a good capital investment.
Now we're starting to pick up PM 2 .5.
One piece of work that we're doing at the moment that's gaining traction is working with the South West London ICB
and seeing if we can link in internal air pollution to asthma care plans, because we do have monitoring
and we do actually actively investigate complaints of internal air pollution.
And the more you dig down into that, the more alarming it becomes. So there are some homes
that are actually quite polluted. So I'm going to stop there, but I will answer the question
about the World Health Organization guidelines. The World Health Organization recommends,
let's say for nitrogen dioxide, a level of 10 micrograms per cubic meter.
The UK current objectives that haven't changed for about 20 years recommend 40.
And there are interim steps in the World Health Organization guidance,
simply because to go from 40 to 10 immediately would be almost impossible.
So we have to have an incremental step change.
Pollution in the borough is getting better.
This doesn't include the 2024 data.
We're working on that at the moment.
We've got to put all that information together
because we love our data.
And we are predicting that we are going to see
improvements in the borough.
So I'll stop there and see if there's any questions.
Thanks.
I'll walk you content with your reply.
I think it's working,
and work in progress in lowering the threshold.
Shannon.
Thank you very much, Jason.
I just wanted to follow up on the update you gave
in relation to indoor air pollution and asthma care plans,
just to try and understand a little bit more
whether that's the result of sources
which are internal into the accommodation
or they're external sources that are affecting people
with their indoor day -to -day living?
Indoor air pollution is made up from outside air pollution when you open your
windows and from inside. However there are activities, commonplace activities in
the home such as cooking, using candles, burning incense, using wood burners that
actually cause excessive levels of indoor air pollution. So it's not
necessarily the case you can have a house in a nice quiet back street with nice external air
pollution but if you start monitoring inside there are activities in some properties that are causing
their own pollution. So it's just trying to educate and make people aware that certain activities if
you are going to do them and that's absolutely fine as healthy adults it's you know it's probably
not going to impact but if you do have people that are vulnerable then those activities could impact.
So what we wanted to do was do a study around looking at the link between asthma incidents
and internal air pollution.
But it's not always the occupiers fault, but it's a mixture of both.
But the more we look into it, the more interesting it becomes.
Thank you.
Thank you.
Any further comment?
Yeah, Stephen.
I just wondered if you could say anything about how Wandsworth compares with other boroughs,
either is it central London that's particularly vulnerable or where would one of the fit in
London terms?
Are we talking about external pollution?
If that's the case, we are basically similar to many boroughs in London, although we do
challenge ourselves and we do monitor in some of the most polluted locations, but we have seen
reductions. And I think last year we saw Putney High Street start to become compliant, which is
quite a great step. But there's lots to do. I think I don't like to compare one borough to
another because you're looking at their monitoring networks and not monitoring networks can differ
between boroughs. But we are, I think, we're doing well and the picture in
London is improving because we have things like the U -Liz and clean vehicles
and electric vehicles. So we are about the same as most boroughs I'd say. Thank you.
I think we've had a really good discussion, a whole range of issues under
that live well agenda, I think, reflects
the very considerable amount of work
that very many people across a whole range of agencies
have actually been engaged in.
So I would certainly like to thank them for that
and also the very cooperative working
which they are working to try to address
some of these issues.
I think we've heard there's quite a lot of work
in progress, clearly we can improve,
we need to improve the range of different areas.
But it is at least good to see
there are so many different agencies
that are working collaboratively towards that given end.
So if the board are content,
after all that discussion,
the action is simply for the board
to agree the recommendation to note
the delivery outputs as set out in the report.
Can we agree with that, please?
Thank you, excellent, okay.
Well, it's quite good timing moving on
to the Southwest London Mental Health Strategy,

5 South West London Mental Health Strategy (Paper No. 25-75)

which is paper number 25 to 75, pages 37 to 48,
because Tom Coffey, who's the ones with clinical need
for mental health children and also other people
matters, et cetera, is actually available until half past two from two to half past.
So welcome, Tom. I think you have joined us. Are you sort of leading off?
I am, yes. I'm the sole person here. I think the Mental Health Trust have got a very busy
day today. So I'm really talking to this strategy. It's just very much to give an update.
Excellent. Please carry on.
So first of all, thank you for allowing me to join you and being flexible about the timing because of my clinical work.
So I do appreciate that. It's very much to talk about the strategy, which is a very much a five to 10 year strategy, but focusing on four themes.
and what I want to do is talk about four themes, but also try to give you a ones with flavor of
what we're doing in those four themes and also take questions from you because you'll be probably
much closer than I am to concerns from the community about where things are going well
and where things are not going so well. So the four key themes are around prevention and early
support, bi -social social model, inequalities and then timely access. So there are four themes
And so I think you've got a presentation,
which I'm going to kind of like use as the basis
of my presentation.
And in essence, this started a couple of years ago,
when the reason these four areas were chosen
was because of the feedback from the community.
And they were areas where people thought
we were a bit challenged with.
So what I'm gonna talk about first
is the area of prevention and early support
and talk about it from a Wandsworth perspective.
Also very, and we work closely with three or four
main partners, the Mental Health Trust,
but also the voluntary sector,
which in Wandsworth are a big provider of services.
Also St. George's as an acute trust,
you know, has a lot of patients coming through
their A &E department with significant mental health needs.
And they really do offer quite a big part of the service
to our patients.
And then of course,
as a fellow commissioner,
it's a local authority.
And you, your public health team led by
Shannon and Graham Markwell
as a public health consultant.
And Carolyn McDonald from
your mission to team,
our key partners with us,
how we can commission and collaborate
together to provide services.
So prevention and early support.
What I'd like to talk about, I suppose,
is what's called the transformation model.
The ones that are now are in year one.
And on prevention and early support,
what we've really developed is an increasing number
of peer support workers.
These are workers who are based in a community funded
by a ring defense budget.
The money goes to the trust.
The trust has commissioned a local voluntary sector
like sound minds, the care center, et cetera,
to employ these peer support workers
to support people essentially
with severe mental illness in the community.
So when people are now referred into the trust
and they feel the Trust's Assessment Center
feels they can benefit from supporting the community,
they're referred to one of these organizations.
We've got about six peer support workers in Wandsworth
and they are new in the last 12 months.
Also, what we have
It's very much the carer center.
If you look about the carers are
a key part of our community.
And they provide many more services
to us as clinicians do.
So the carer center now has
worked really well with the local authority
to have what's called carer centers clinics.
So rather than randomly referring people for
a carers check via the social services,
the social work lead comes to
the carer center every month and
it lists as a clinic.
by the carer's centre will book in a number of people
who get their carer's annual check and review
from the designated social worker.
And that goes really, really well.
In the prevention and early support area as well,
I have to mention MHIP,
our Ethnicity Mental Health Intervention Project.
We now have two hubs,
one working with the Afro -Caribbean community
in North Tooting,
and that's so far South Tooting
working with our South Asian community.
many women in that area.
There's two hubs, very much they have peer support workers,
they have primary care plus workers.
They also have a new welfare support service.
Because what we recognize is many patients with mental health needs
have additional welfare and social needs as well.
And so the welfare worker is based in these two hubs
and takes referrals to try to address the many needs
of people with a significant mental illness.
We also have other excellent early intervention services in Wandsworth.
We've got our tall Cornsworth service.
We've got our mental health primary care network workers in general practice along with the primary care plus workers.
And this allows the trust to discharge patients to the GP surgery because now the GPs have got two types of workers who are designated just to work with our mental health patients.
On the biosocial model, what we've recognized is that the increased mortality and morbidity
in this patient group isn't always about the mental illness, it's about the physical illness.
These patients are much more likely to get diabetes, heart disease, strokes, obesity,
arthritis and fall over.
So we've got two or three things that we try to do in this area.
The first is what's called Active Wellbeing Project, and the partner for us is Enable,
which is part of the local authority, making sure all patients with an SMI are able to access a personal trainer to improve their physical wellbeing.
Secondly, we have a service whereby all the SMI patients get an annual review by their GP, and that's doing quite well in Wandsworth.
Thirdly, the Well Center, which is a service we've joined from Lambeth,
make sure that they offer holistic services to children and young people,
both physical health and mental health.
So therefore, the services based around a counselor and also a GP looking after those patients.
On inequalities, the key thing for us is the issue regarding our M -HIP services,
but also making sure that we try to embed services where the need is greatest.
And a good example of that, I feel, is that we've got the Torquonsworth services now based within our food banks.
And what happens there is that when the patients come,
when the clients come in,
if they've got a mental health need,
rather than have to send them away
or diverting them to the GP,
the Court Wandsworth service is now actually
providing services in our food banks.
And the welfare advice I've mentioned before
is in conjunction with the trust has onsite
a welfare advice service which we work together with.
I have to say access is probably our area of biggest challenge.
When you talk about access,
although we try to increase access by increasing capacity in the Liaison Mental Health Service,
in the urgent services run by the trust,
in the urgent services run by the single point of access,
and similarly for children and young people,
it really isn't enough.
And the biggest complaint I get from patients, carers,
GP, social workers, is that they struggle
to get urgent access for their clients.
And they also often struggle to understand
the urgent access system.
A new system on the block is the one -on -one hash two line.
So one -on -one now, if you bring up
and have got a mental health concern,
there is a dedicated phone line via 111.
This is in conjunction, obviously,
with the emergency line that we have for the trust.
And you can see how people get confused,
which one should they ring?
Or should they go to St. George's
for the liaison psychiatry service?
Or do they ring the spa who's got an urgent service?
So it's a slightly confused picture.
The reason that confusion has arisen
is because everyone's always trying to build capacity,
But by building capacity, often you build complexity.
If I were to talk to my social work colleagues who do the mental health assessments,
what they would say is we find it really hard to arrange a mental health assessment.
And when it's done, to find a bed for that patient.
And so I think that in access, we have tried to do so much more.
It's still an area of concern.
the children of young people equally,
you know, as well as adults.
The capacity that we've tried to increase in schools
at the moment is we've got a fourth trailblazer site
in schools covering Tootingham -Ballam.
So this has happened in the last kind of a few months
to improve the capacity.
So we've got an early intervention
and increased timely access.
But I have to say, no matter how hard we work,
there still is a mismatch between capacity and demand.
By the transformation approach,
the single point of access has given GP direct phone contacts
to the on -call consultants.
So we can do that and bringing rather than throwing patients
in equally there's a new advice and guidance service
for the trust to give timely access.
So a lot of work is happening in this place,
but probably is still insufficient.
This strategy is a five -year strategy,
and I wouldn't expect us to have nailed everything now at this point.
So what I'll try to show you today are the four main themes.
I'll try to show you where we've made successes, but also where there's ongoing challenges.
And also very clear, this is a partnership approach with the Mental Health Trust,
also St George's as an acute trust, the voluntary sector, the local authority, patients, carers and users.
Thank you very much, Councillor.
Thanks, Tom,
for a comprehensive report.
You should have received
the attachments, etc.
I think in the original papers that came out,
because of formatting, some words may have been chopped off,
but I think Laura has produced some
where you can read the entire report,
which is good.
and focus is upon focus areas for 24, 25, et cetera,
also sets our intended outcomes by 2032, 33.
Any comments on anything in the report
or anything that Tom has said, please?
Kate Sloaneck.
Thank you and thanks Tom. I think it's a great strategy, I really support it. I just had
a question and not necessarily answer for now but thinking about how we measure success
over time. Clearly it's too early to do that, I appreciate that but have you got some thoughts
about what good looks like and how you'd know that this is making a difference?
Yeah so for one moment when we try to measure our success we do it in access, experience
and outcomes.
And so they're the three main aims
of three areas that we look at.
So the access,
yeah, there are obviously clear KPIs
which are in the guidance very much around
people seeing within 24 hours for emergency,
seven days for urgent, 28 days for non -urgent.
The other one is a key one is patients
who are in their first episode of psychosis,
but they get assessment within 14 days.
Thirdly with the IACTalk WANSA services,
again, it's very much around, you know,
how quickly people are seen for their first assessment,
but also as an outcome, what is their recovery?
The target really is to get 50 % of people
going into recovery.
And often you get that real dynamic whereby
as you increase access, you often reduce recovery
because people are just going through too quickly.
You're trying to make a match or capacity to your demand
and not giving people sufficient numbers of appointments.
So it's always a balancing time.
All the areas that we look at,
either our NHIP program, our truly young people's program,
all have that evaluation of those similar areas.
We are doing an evaluation of some of the programs,
especially our transformation program.
and we're trying to get an evaluation partner,
and also the program about how we address
some of the changes within the trust.
The two key areas are culturally capable workforce,
and reducing control and restraint in the trust.
They are kind of being evaluated as we move.
So each project has got evaluations,
usually in those three themes,
experience, access and outcomes.
Thanks.
Any further questions, comments?
Abby.
Thanks.
And yeah, just to say there was a lot of very positive feeling
about the strategy yesterday talking to charitable
organizations, which is really good.
One of my questions is that it seems that kind of inequalities
or health inequalities have a major theme running through it.
As you've just said around inequality of access outcomes,
all sorts of things we know negatively impact some people's experience of mental health
service to others. How does that sit alongside the fact that health inequalities funding is being
reduced or ceased, should I say, elsewhere? It seems that those two strategic things are
in contradiction to each other. Yeah, so what's happened is that we were getting an inequalities
Fund, which although very useful, was difficult to use because it was a non -recurrent basis.
So what happened was that we would get a certain amount of money each year in southwest London
and we'd have to find non -recurrent projects where in fact, as you probably well know,
most of the work we do involves staff being recruited, which require ongoing funding,
or services developed for patients, which require continuity. Starting a service which
last for 12 months, no matter how good it is, is a disaster. So what we've done instead in South
West London is try to look at how we get our funding and if you look at the three priorities
we've set out in South West London for the use of our growth money, the MHIS money in 25 -26,
it's regarding children and young people access and inequalities. So to ensure inequality is not
lost as a priority just because that ring -fenced non -recurrent funding is lost, we've put it as
of our top three priorities for the M -HIS money overall, which as you know is the percentage
growth given in the overall budget applied to mental health services and the baseline for 24 -25.
So that way I'm reasonably confident that the focus of inequalities will remain
and also will remain and receive recurrent funding project fundings.
Yes.
Yeah, thanks.
Thanks, Tom.
That's extremely important.
Jeremy.
Yes, so thank you.
It's a really comprehensive update.
I've got two points.
One of them, you highlighted really positive work
around carers and with the carers center.
So I suppose the question would be is
what more can we do to support our carers
of people with mental,
mental illness.
And the second point was really just to highlight
some really positive work that's supporting the work
around people with complex needs that's taking place
in social care.
And that's a successful pilot around
mental health reablement,
which is funded by the Better Care Fund.
That's had some really positive outcomes
in terms of helping, supporting people,
and in a way prevent, helping to prevent
and reduce ongoing care needs.
So I know that some of the work on that is continuing.
So just wanted to highlight that.
But the question was about carers, thank you.
Yep, so thanks for that.
So when I speak to the leads of the Carers Center
and Wanted Care Alliance, the key thing they say,
they want to make sure that every opportunity is used
to first of all make sure when people are admitted
or under care that the carer is identified and wherever possible the carer is involved in the
planning thereafter. What often happens is a patient is admitted and then there is an
insufficient active approach to identifying their carer and involved in their carer.
So therefore when we have a partnership meeting between the trust and ourselves,
the level of authority and the ICB commissioners, we really push that. Can they make sure
every single assessment that they asked first of all, do you have a carer? And can you please
give us consent to approach and use the carer? Thirdly, once the carer is identified to make
sure all the pathway reviews that carer is involved because what we all know is 99 .9 %
of the time the patient is in the hands of the carer, not the health services. So we push that.
The second thing, and that doesn't cost any money,
that is just an approach.
Second thing is about capacity and funding.
The Carer Center is very much dependent on funding
from ourselves as an ICB and yourselves
as a local authority to maintain and keep that funding going
because the Carer Center obviously does care
for young carers, for carers with physical illness,
but probably their biggest work is with mental illness.
And I think making sure that funding is there.
One thing that the public health team at Wansworth do is commission a mental health first aid.
This, whenever it's offered out, and like we say, 30 courses, it's like Glastonbury tickets.
They go in a few minutes. So it really is to make sure that we have as many mental health first aid courses as possible offered in Wansworth.
And secondly, rather than a first come, first serve, perhaps we target them to certain groups
which we know need that kind of support.
So that would be really useful as well.
So there are three things I would mention.
Greg, Stephen.
Thanks very much, Tom.
Very good stuff.
I wonder what's your view about the capacity and access in terms of mental health beds,
acute beds.
Obviously, we've got the new hospital at Springfield, and I know in Tolworth they're about to start
developing there.
But we obviously do get concerns that actually there's been a reduction in number of beds,
and this is leading to continuing problems.
What's your assessment about the need for acute beds in this world?
So first of all it's kind of it's quite hard initially to quantify the needs.
You know how many beds do we need because sometimes the beds you've got are not used
very efficiently because let's say you've got patients in there who could be discharged,
length of stay is too long, who perhaps kind of thing has have got an ongoing non -mental health
knee which needs to be addressed before they can discharged. So you might have let's say 100 beds
and of those beds 20 people are occupying those beds where they could possibly be elsewhere.
However making the assumption that we are where we are, the barometer that I use is how many
patients are waiting at any time in A &E at Georges or Kingston let's say requiring a mental health
bed and there isn't a bed available. Secondly how many patients who have had a mental health
health act assessment and are unable for that act assessment to be deployed because there's
no bed. And thirdly, how many patients are in non -NHS beds because there is inadequate
beds in the system. If those three areas are significant, it means we've got inadequate
beds. Now, what we can always try and do is reduce length of stay, make sure patients
are moved more efficiently through the system. We've said that for 30 years and the reality is
that yeah no matter how hard we try there is always issues where it's much more difficult
than we imagine. So I would say probably at the present situation there are an inadequate number
beds. Right, thank you indeed Kate. Thanks very much. From my perspective really
welcome the report Tom, thank you very much and really the focus on improving
mental health for children and young people and really welcome what you've
been able to add today about adding capacity into our schools with the
and forth, Trailblazer area and Teuting and Balham.
I noticed kind of in the year to date,
you've highlighted that we've been able to publish
CAMS waiting lists, and I think that's helpful
in proving kind of carers and parents' understanding
of how long they're going to have to wait,
and that can focus on waiting well.
But I noted what you said about the mismatch
between capacity and demand.
So I was just interested in a bit of an update
to know what the direction of travel currently is on our waiting lists and linked to that,
I know our ambition in totality for the strategy is really to increase the overall proportion
of funding directed towards children and young people's mental health specifically and how
we were going to change that proportion of funding directed towards young people?
Yeah, so because I don't work for the trust, I don't have at my fingertips the waiting times
or the various services. So just to kind of expand a bit, so therefore we have a single point of
access, but by patients are referred initially and there the majority do get contact within 48 hours
and the majority, and I mean 90%, get seen within 14 days.
Then what would happen is they are either discharged,
referred onto the family consultancy service,
which is run by the Mental Health Trust,
and that has only been a few weeks.
The areas whereby they get perhaps a significant
waiting time is when they're referred on to tier three,
and that can be a number of months,
where they're referred onto their neurodiversity assessment,
by that end to be quite a long time.
And also, although for eating disorders,
the waiting time has reduced.
And the reason that we are focusing on children
and young people is because we know
there is inadequate capacity.
The funding in 24, 25, which went to children
and young people, went to the tier three service
in Wandsworth.
So they have got extra funding this year,
but our ambition is to, it's really to hit
the 18 week target to make sure for all services
be it eating disorders, general tier three,
neurodiversity, no one waits more than 18 weeks,
but we're not there yet.
Yeah, thank you.
Mark.
I suppose it's linked to previous conversations as well
just in terms of particularly diagnosis for autism and I mean the good news is that we
secured almost half a million pounds to address the diagnostic waiting list.
Now Georges and Kate who's on the line are currently working up that service and recruiting
into it.
So I think without getting into complexity there are a number of different funding streams
and it goes to Abbie's point as well, kind of at play here.
Okay, thank you.
Again, this is an ongoing issue,
which I think all parties across all agencies,
the voluntary sector, et cetera,
are working very hard to address.
This is simply an update on the mental health strategy.
Tom said it is a five year program,
but can we accept the report please?
Thank you very much indeed.
Thanks.
And thank you Tom for coming.
Coming along.
I think we kept you about five minutes over time.
Bye.
Okay, thanks.
Bye.
I think I'm a Glastonbury ticket spell.
Bye -bye.
Well, I mean, on the same theme, the next item, culturally mindful, paper number 2576,

6 Culturally Mindful (Paper No. 25-76)

pages 49 to 56, I mean, does sort of bring together some mental health issues and the
Glastonbury factor of culture and arts and other similar type of things.
So I think Sara, excellent, thank you.
Thanks.
Thank you.
Thank you, and sorry I couldn't be there in person today,
but my colleagues, Lelya and Jamilia
are hopefully in the room with you.
So yes, thank you very much for inviting us back
to report on the work we've been doing.
So when we were developing the bid to be London Borough of Culture, we came to this board to tell
you about some of the projects we were exploring and we were delighted when the board then welcomed
and endorsed the approach that we were proposing to take and that helped us win the bid to be
London Borough of Culture. So at its core our year as London Borough of Culture is focused on using
the power of arts, culture and heritage to transform people's lives in terms of health,
happiness and ensuring equal access to opportunity. And the Cultural Mindful programme that this
paper focuses on is our main project and has been designed to address the issues identified
in the Enough is Enough report as well as to build on the learnings from the cultural
prescribing pilots that we funded over 2022 to 2024. So at its core, culturally mindful
is about addressing health inequality by embedding culturally relevant creative health interventions
where they can be most impactful, so in secondary settings and at the heart of communities.
We know that underserved communities, in particular from global majority backgrounds, often face significant barriers in accessing traditional health services.
And our artists are, we hope, will be playing a central role in bridging this gap by offering a breadth of culturally relevant activities and by gaining participants trust through commonalities in lived experiences,
embedding these programs within grassroots organization and through a co -creation process
with the targeted communities who have that lived experience. So the program will support
10 professional global majority artists who will be paired with host organizations including
secondary care settings, so St George's Hospital, Queen Mary's, Springfield and the Royal Hospital
of neurodisability and within community charities,
where they will co -design
and deliver creative health programs
tailored to the needs of vulnerable groups
as part of their paid residencies.
Each artist together with their paired counterpart
within their host organization
will undergo structured training,
shadowing and action learning
to enhance their practice within creative health.
Through these artists residencies, we are ensuring that creative health support is delivered
in ways that are culturally competent, engaging and accessible. And these artists will bring
lived experience, artistic expertise and cultural knowledge to create a space where people feel
seen, heard and supported. Ultimately, we want this work to be focused on empowerment
in giving artists professional development opportunities
while enabling communities to access creative health activities
that resonate and are relevant to them.
It will also ensure that each of the partners,
the community organizations will be equipped to deliver
a legacy creative health program
as one global majority staff member within each of those organizations
will have been trained alongside the artists.
We believe that this model will not only improve the wellbeing outcome, but also lay the foundation
for long -term change in how culture and health intersect within Wandsworth. And we hope that
should this programme be successful and we've been having very positive conversations with
our surrounding boroughs, but that this can be rolled out and explored across the rest
the boroughs within the South West London ICB. So yeah, Lelia, Jamilia and I look forward to
discussing this further with you today and any questions? Happy to take any questions.
Thank you, you stole my line but yeah any questions?
Thank you very much for the report, sorry, thank you very much for just adding at the end there
a little bit about legacy, because I don't think that was in the report.
And I was interested just to understand a little bit more about that.
Great that we've got the program now during the years of the borough's year of culture.
But yeah, just a little bit more on the legacy.
I'd be interested to hear.
Can I ask if Lelya is in the room?
So if Lelya has been leading on those conversations and has been leading within the team on creative health
for the last two and a half years.
You want to pick that up?
Thank you very much, Sarah.
So in terms of the legacy, I would say they are kind of for us,
four avenues for legacies.
Sorry about this.
One is the fact that 10 artists from the global majority based in Wandsworth
will have been provided with this training, which will include mental health first aid
training, supervision and trauma -informed practice. So those local artists will be then
available to work across the borough and across the region.
The second aspect of the sustainable legacy is the fact that within those ten host organisations,
one member, one permanent member of staff will have undergone the whole training together
with the artist, which will hopefully have created some opportunities for skill sharing
so that even without much funding, this creative health work can continue and focus on addressing
health inequities amongst targeted groups, especially focusing around prevention and
early intervention.
The third aspect of legacy is that we're hoping that we have ring fenced as part of
the budget, correct me if I'm wrong, Sarah, there, £100 ,000 to allow for 10 legacy residencies,
a creative health residency to happen, although I have to put a caveat there that it's dependent
upon match fundraising from throughout London Borough of Culture. But the idea is that there
will be some legacy commissioning taking place to continue the work that we've been doing
ever since 2022. And the fourth aspect is that we've been having conversations for
the past two years now with Mary Ado at the Integrated Care Board and with the GLA, Great
London Authority, and we're hoping, as Sarah said, that we might be able to come together
to fund, to roll out this pilot, this Once -Worth -based pilot to the Hall of South West London so
that the funding can be shared and the practice can be shared because artists and residents
are mobile. And obviously initially we were looking at the health inequalities funding
for this and I understand that this is not being continued.
However, as we've been reassured that health inequalities will continue to be one of the
top three priorities and at the moment we're working with the GLA and the ICB to bring
together the five boroughs as part of the South West London to try and have a joint
up approach on creative health and see how this can address prevention and early intervention
on mental health but also on the other priorities of the South West London Health and Care Plan.
We're hoping that we'll find a sustainable model to keep on training people and diverse.
The idea is to diversify the offer so that it's more relevant to the people who need
it most and to diversify the workforce so that we kind of save time on the establishment
of trust.
Because as we all know, change and social change in particular happens at the speed
of trust, or rather the speed of relationship, which themselves happen at the speed of trust.
So, developing a culturally diverse workforce, we believe, could go far in terms of encouraging
people who would not normally access NHS services to kind of have a personalized approach to
their care through social prescribing that would be culturally relevant and provided
by people who have commonalities in their lived experience.
Thanks, I'm very comprehensive.
I just wanted to come in and add to that to say that we've been speaking to Croydon, Kingston,
Merton and the Richmond culture team who are all really keen to explore this and they have
initiated conversations with their public health team to see how this could be something
that they could get involved with depending on funding going forward. But yeah, so far
it's been really positive feedback.
Indeed, yeah, hi.
You sure?
I think that's very, after you, after you, you're so English of us.
Thank you for the call and I was very excited to get an email from you the other day about
calling out.
The call out question is really around how does that work for the voluntary sector, like
Is it a case that it will be open to all and people will know to apply?
Or is it that you are targeting specific groups?
Or specific providers, should I say?
So how open it is really.
Hi everyone.
My name is Jamelia. I'm the newly appointed Creative Health Officer.
We are having a two -front approach.
So it will go out as an open call on the website and it will go into the marketing strategy.
But we're also having conversations with organizations we feel would be well placed to deliver the
residencies so that they know it's happening as well and are being encouraged to apply.
So yeah, both will be happening.
If I may come in just to add things is that we are aware that the demand will outweigh the number
of residencies because we have 10 residencies in total, 4 in secondary care settings, only 6 in
grassroots organizations across the borough. So we will have to be mindful of having a good
geographical spread, but also target the most vulnerable
communities.
And there will be kind of a natural selection in the fact
that because we want to upskill the grassroots
organizations, they will need to be able to delegate a full
member of their staff to attend the training together
with the artist and to shadow the artists throughout their
residencies.
So it does take, I suppose, for the grassroot organization to be large enough to be able
to support this.
However, we're very keen for all the organizations who are interested to apply because it will
also help us demonstrate the appetite on the need for this type of work, which hopefully
will help us continue fundraising for it, bearing in mind that the GLA and the Arts
Council of England and several other organisations are also supportive of this concept.
Divina.
Hi, Divina Smith, Senior Community Safety Consultant for Richmond and Wandsworth. I'm
covering I'm Caring, Vacable, For, Stronger and Safer.
Just again, sorry, just move the mic.
Is that better?
Yeah, okay, sorry.
I won't repeat my title again, sorry.
Hope you got that in the minutes.
Just, yeah, echoing the same as earlier by Abi,
like it's really good to see these reports.
And my question was more around the contingency
because I've seen potentially in other boroughs
where they've been, you know, very optimistic
with the kind of delivery and obviously the sign -up
has been maybe very fruitful, but potentially as the project
delivers and rolls out, sometimes there's drop -off,
changes in staff.
I just wondered how you'd thought
about that in terms of managing the project
through its lifecycle, in terms of the initial sign -up
of those 10 artists in residency,
and potentially if there is some form of drop -out,
how can others maybe be weaved into a program
or some kind of buddying system?
You might have already thought of it.
I'm just making some suggestions.
Sarah, do you want to take this or shall I take it?
I think you're probably better placed than me, Lelia.
Okay. So thank you very much for this question about contingency.
It's a question that we try and address in all our London Borough of Culture programs,
because obviously each project is carried by one member of the team.
However, we tend to work and we're very experienced in working in partnerships.
So we have some very strong partnerships on board.
So St. George's Hospital Trust and St. George's Parity are on board and they have experience
of organizing artist residencies in both St. George and Queen Mary's Hospital.
and the Springfield is also on board, and they're going to support us with not only by hosting one residency,
but also by offering some first aid mental health training.
We're working very closely with the GLA and the Integrated Care Board and the Social Prescribing Steering Group,
so that they're all very involved.
And obviously we've just recruited Jamelia
who is very experienced.
She's the director of one of our creative health partners,
Organizations in the Borough.
She also works for London Arts and Health
who are one of our partners on organized a similar program
called Artist Recovery,
represents Recovery Network and Jamilia coordinates this program also.
And we also in conversation with Battersea Arts Centre who are going to be some of our place -based delivery partners in Wandsworth.
I'm sure I've forgotten some partners there.
I think in relation to your question about contingency of staff and commitment to the program,
That's going to be part of the questioning as well as in the interview process before
selection.
Having worked on the Artists Represent Recovery Network and taking the learning from their
program when they were on the second cohort, the first cohort didn't have any dropouts
and currently has been 100 % attended, I think it is about making the right selection and
being very open about what the commitment is.
So on the website and when the call -out goes out,
the dates will be listed so that people have a sense of
when and where it's going to happen. And I think conversations with
the organizations that are interested and us having
webinars for people to drop in and talk to us about what it would cost them to be
part of the program
will help them to know whether they can sustain
commitment to being involved. I think it would be quite difficult
to if a partner drops out to then have a partner come in like midway because they
would lose out and but it might be possible if a partner drops out for an
artist to go to another partner like a bigger organization such as one of the
hospitals to continue their residency and so yeah we're being very mindful
about risk and being very open and transparent about what people will need
committee. Thank you. Can I just add, just on the artist side, we've talked about the organisation
and in fact ourselves, but within the artist part of the reasoning for why the paid training post
and paid residency is in order to ensure that those artists are being recognised and that
that will hopefully ensure that they can continue
throughout the duration of the programme.
Thanks.
Thanks, I'm sorry.
I mean, this is quite clearly an important topic.
And yesterday we had a very successful launch
of the London Borough of Culture,
which attracted a considerable amount of publicity.
And certainly in the last week,
I attended an extremely interesting webinar
organised between the local government association
and the arts council around the topic of creative health.
And we do of course have a health and well -being board
seminar on the 4th of March.
And so it is my intention to actually raise that there
as a future priority that we should actually look into
or certainly to ensure that our overall strategy
it ties in with that.
So I think there's certainly plenty of further opportunity
to talk about creative health.
I think it does have a major role to play.
So can I thank
and also Sara for presenting to the board.
And the decision is, do we agree
with the recommendations and notes
and comment on the culturally mindful program,
which is part of Wandsworth's London Borough of Culture
25, 26, can we read that please?
Excellent, thanks.
Right, well on the one hand, I'm being a very poor chair
because we've still got a few things to get through
on the agenda.
I'm in your hands actually, I mean I think we have
some really rich conversations here.
And for as long as we're actually talking
about positive issues, I'm more than happy to continue.
So about the next issue,
potentially chunky pieces of work,
the NHS Tenure Health Plan Consultation,
paper number 2577, pages 5768.

7 NHS 10 Year Health Plan Consultation (Paper No. 25-77)

This is the response to the consultation and the chairman.
Over to you.
Thank you, chair.
I will try to help with the agenda by being very brief.
This paper is highlighting the health and well -being board's joint response to the Council's
to the government's consultation on the 10 -year health plan for England and the submission
that was drawn from Health and Well -Being Board members,
and then summarized into a single submission
in December of last year.
I'll take the submission as read,
and just move very quickly to highlight the timeline
since the submission.
According to the government's Change NHS UK website,
in January of this year,
they would have been updating the website
and contacting people who registered so far
with the activities.
I don't believe we have received a response
as a health and wellbeing board,
so that's probably something we could follow up on.
And the idea in February was that they'd be launching
more workshops with staff,
taking place all across the country with organizations
and local health systems,
and running workshops to get some final insights
by the 14th of February.
So again, I think that suggests that they may be running behind a bit with that because we've not had any further information
The intention according to the website is to hold a national summit in the spring
With the selection of public and workforce people drawn from the regional
Events to help to finalize the plan. So that's all the detail that we have to date
Thank you
Okay, thank you. Any comments at all? I must be getting there to three o 'clock. Stephen?
It's, I mean, everything one reads about the 10 -year plan is all excellent stuff. I've
not seen anything which one could disagree with pretty crudely. My worry, and this is
what's been me, is sort of the elephant of the room, which came up when we talked to
Tom Coffey just now, which is about acute hospitals.
I mean, obviously, trying to get people out
of acute hospitals as far as possible is highly desirable
for all sorts of reasons, including clinical reasons,
leading aside finance.
But as Tom actually indicated when we just talked just now,
people have been talking about this and trying seriously
to address this for many, many years.
And curiously enough, the challenges are still there.
And we see it not just here, and we see it all
is a national issue, clearly, with corridor care
and all that stuff, ambulance services.
And it does worry me that the 10 -year strategy
doesn't really address that, because deep in my bones,
I have this awful gut feeling that,
despite all the efforts to get people moving
through hospital faster and all the rest of it,
the community and all excellent stuff,
Nonetheless, the need for more capacity, crudely, at the acute sector, whether it's mental health
or physical health, actually is a real challenge.
And in some ways, and we see it obviously with Centelia recently, it's going backwards
rather than forwards.
So I have no answer to this.
I recognize if I was the government, I wouldn't have an answer to it either.
But it does worry me that the major 10 -year strategy, I don't – I think we should keep
keep an eye on it as a minimum,
that we don't lose sight of the need for acute,
good quality acute care as well as all the rest.
Yes, I mean, like you know,
ministers all have focused upon that,
Stephen Kunnick in particular,
who's a sort of care minister,
and the importance of, as we discussed,
trying to free up beds in acute settings.
settings, it is obviously a challenge.
I think the purpose of the 10 -year strategy
is to try to look at these longer -term issues
and to eventually address them.
Some of the issues, clearly around sort of
discharge of payment of patients,
on some extents are covered in the next item
and a better care fund.
But yeah, I take your point entirely, Steve.
It's a very challenging agenda,
which is why I think the government developed the consultation on the ten -year strategy.
It is important we get societal sort of buy -in from every quarter.
Mark?
I suppose the strategy is not out yet, is it? The strategy, we're expecting it kind
of at the end of April, I think, around that time.
And Stephen, I take your point and I take Tom's point, but I suppose there is a counter
to that is that we mustn't stop trying to make that shift, because we know actually
that people do stay in hospitals longer than they need to.
They stay in the mental health acute wards longer than they need to.
And what we need to do as a system is that we need to be working together so that actually
It's a seamless kind of transition from acute to community or acute to social care.
And we are working very hard on that.
We haven't got it right yet by any means.
But I think that's the thing is that we can't lose track of, we also know it's better for people to be at home.
They have better health outcomes when they're at home.
So I just wanted to kind of put that caveat.
I don't think it is just about extra beds.
I think it is about us working as a system more efficiently.
Yeah, thanks.
Thanks, Lof.
Clearly this is also a work in progress.
I'm sure we would be happy to actually get
the final response from the government.
We can have a further discussion about it.
But yeah, there's a lot of work to be done, et cetera.
So having said that,
Can we, let me see what we're doing here.
We agree the recommendations to note the submission
of the NHS tenure health plan consultation response
submitted on behalf of the health and well being board.
Since it's already been submitted,
I don't think you've got much of a choice, frankly.
But you know, nonetheless, can we at least agree that?
You know, we've had at least our fundamental disagreement
since the contents.
Okay, thank you very much.
Moving swiftly on Better Care Fund, Lynn.
Shannon?
No, I think I'm being pointed at, Chair.
Brian, sorry, my apologies.
So like my colleague Shannon,
I will presume the paper has been read

8 Better Care Fund Quarter 2 2024-25 Update (Paper No. 25-78)

and I will then just highlight a few things if that's okay.
There was an ask from the Health and Wellbeing Board
about impact and some of the Better Care Fund metrics
to actually demonstrate some of the impact now.
So if I just, if I point you towards point nine,
with a lovely blue, blue and yellow table.
So there is a piece of work within the Better Care Fund
that looks at, that looks at intermediate care
demand and capacity.
And as part of this, so and this isn't a metric
as we were understanding, a BCF metric,
but there is a average response time
to, from referral to discharge,
which actually we can see has reduced from the baseline,
which was set at 23, 24, yeah, 23, 24,
is reduced by a day and a half on average
across almost 2 ,000 people.
So actually what we have seen is actually
an efficiency gain via the Better Care Fund
in terms of hospital discharge.
This is across all Wandsworth residents,
adult residents, regardless of which hospital,
when obviously St. George is about two thirds of that.
The other thing I think is probably worth noticing as well
is on that same table below,
urgent community response,
there's about a 30 % increase in people
being supported and kept at home.
So, and this is, these are reasonably big amounts of people
being supported by the urgent community response service.
But we're still not achieving
the voidable emissions metric.
So regardless that we're actually supporting
a lot more people, actually there's still work to do
in terms of supporting those people.
Although some of those people are managed
for our same day emergency care.
So actually their stay in hospital
is actually very, very short.
And finally, there is, so and Jeremy mentioned
the sort of mental health discharge and re -abrogant pilot
which has actually seen an impact of over a day
Just to add to that, so there's a Southwest London scheme supporting step down from mental health
and that's seen a lot of people being supported across Southwest London
or across the five Southwest London and Georges facing boroughs
and being supported to either as part of the crisis pathway
or to actually get them out of acute secondary mental health beds.
and we'll pull that report in the next time that's happening.
Just very, very finally, at the moment we are planning
for the 25, 26 Better Care Fund round.
There's been quite a lot of changes, I suspect,
in line with what will be coming out in the 10 year plan.
And partners are absolutely working on that
as hard as they can to meet the regional
and national deadlines.
The regional deadline is Monday.
The national deadline is the 31st of March.
Thanks, Brian.
Comments?
Just, firstly, to name and shout out for Brian in particular.
So I think Brian has been doing work across Wandsworth and Richmond, particularly on the
data.
And actually, this morning we called, it was a Brianism.
and we talked about Brianizing all the data
across all the BCS across Southwest London.
So I just wanted to really call them out
because actually the level of data
that we're now reporting on is a step change.
I think the other thing to say is though,
is that we do also have to reconcile with that,
with our data sources around,
whether it be our acute colleagues, et cetera.
I'm sure Kate will agree.
because actually we need one version of the truth and we need the whole pathway
kind of measured and so it's just fantastic work and I think we still got
a way to go as Brian said. Yes agreed entirely.
Any further comments from anyone? Well thank you very much Brian for
sitting in and presenting the report. I think you know some way to answer some
of the points that Stephen raised but clearly again you know we do face
challenges and but it's important the work that we're actually sort of doing
in this area so thank you very much for that. A lot of these things of course are
overlapping interchangeable etc so hopefully you found the rest of the meeting
and helpful and useful.
Good, okay, so the recommendations
on this particular paper,
so we note the BCF spend and outputs activity
for those schemes reported on for the period
April to September 2024 as appendix one,
and also to note the outcomes and impacts
of the BCF on hospital discharge,
as demonstrated by the intermediate care demand
and capacity reporting.
Can we agree with that, please?
Thanks a lot, excellent, good.
Moving swiftly on the health and wellbeing
board work program, Lynn.
I'll go right this time, Lynn.

9 Work Programme (Paper No. 25-79)

This is me, and really I'm going to take it as read,
It's fairly obvious.
The big thing I want to highlight
is, as Councillor Henderson already said,
is our seminar on the 4th of March, which is really
about shaping the board so that we all understand why we come
here every quarter, and that we get the most that we can out
of this really important strategic partnership.
And it will be run by the LGA.
it will be here in person, so please do come.
And then finally to say, as I always do, if you have papers which are relevant
to the work of this board, please let us know and we can put it on to the forward
plan and to encourage partners to share information here. That's it.
Excellent. Thank you.
Brevity. Much appreciated.
Any comments at all on the e -Work programme?
Excellent. Good.
So can we, let me see what we're doing on this one.
We're noting items of information.
Does the board note the work programme?
So thank you.
Right, that.
So, I'll move this on to the date of the next meeting,
which will be held on the 26th of June of this year.

10 Date of Next Meeting

But just to say, to re -emphasize,
that we are holding this very important seminar next week
on the 4th of March, starting I think at 10 o 'clock, etc.
It'd be great to see as many of you there as possible,
because as Lynn said,
it really is an opportunity for forward looking
to determine where we want to focus our attention, et cetera,
as well as creating understanding.
Not that I think actually we necessarily need a great deal
of additional understanding as to why we're here
and what we're actually trying to achieve,
but hopefully it will be a very collegiate opportunity
for us to come together.
and two, talking about things, our priorities, interests, etc.
in a fairly sort of open way.
So I look forward to seeing as many of the board members
and one or two invitees to that meeting
on the 4th of March.
I've been told that Laura hasn't been notified
of any other business.
I would say if anyone does have any other business
that hopefully should be a fairly important issue.
I can't see anything.
Presumably no one behind me is indicating.
So that concludes the meeting.
Apologies it has sort of on the paper,
you know there were some really meaty items there.
And as usual, we've had some really rich conversations
and a range of issues,
a lot of very pertinent questions,
which we will certainly take into account
and develop responses to, et cetera.
But I think it is a measure of setting the challenge
we face across a whole range of areas,
both willingness of all partners to come together
to actually meet those challenges.
So can I thank on behalf of Wandsworth Council
to thank absolutely everyone in the room
and everyone who can actually make it
for a very positive and significant contributions
to try to improve the health and wellbeing
of the population of this borough.
Thank you.