Health and Wellbeing Board - Thursday 26 June 2025, 1:00pm - Wandsworth Council Webcasting

Health and Wellbeing Board
Thursday, 26th June 2025 at 1:00pm 

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  1. Webcast Finished

Hi. Welcome to this meeting.
Thanks in particular to all of those who have braved 370 pages
and probably tried to fit this meeting in between a lot of
important meetings. I will actually be addressing the question of the length of
the agenda and a number of papers later, but I thought I'd deal with the
preliminaries. First of all, for any members of the public who may be listening to this, I am
Councillor Graham Henderson. I am the chair of the Health and Wellbeing Board.
Can those art members of the board indicate their presence?
Depending on their microphone and turning it off, that applies to anyone who makes any

1 Apologies for absence

contributions during the course of the meeting.
First of all, Jeremy De Sousa.
Hello, good afternoon.
Councillor Judy Gasser.
Yes, good afternoon.
Stephen Hickey.
Hello, good afternoon.
Arielle Jogia.
Good afternoon.
Shannon Katiya.
Good afternoon.
And Mike Proctor.
Good afternoon.
Thanks. We do have a rather lengthy list of apologies which we will come on to in due course.
And also just a reminder to people that if they can indicate in the normal way if they want to make a contribution, stick their hand up, etc.
We do also have a number of officers present,
they will introduce themselves at all
when they speak to a particular item.
That applies to a number of officers
who perhaps quite sensibly are on the screen behind me.
Unfortunately, I can't see them,
so I'm very much resigned by the law,
and anyone else to point out to me
if they do actually want to speak on any item.
I think that probably comes, yes, quite a long list of officers.
So apologies, we have received apologies from Abby Carter, Mark Creelman, George Crivelli,
Councillor Robert Lyle, Nicola Jones, Philip Murray, Anna Pavovici, Michael Schall, Kate
Islamic, Andrew Travers and Lin Wilde.
Oh, T .M .R. Hogan.
Item two, declarations of interest.
Are there any declarations of either pecuniary,

2 Declarations of Interests

of a registrable or non -registrable interest?
Please declare any interest quoting the item and paper number
in which you have interest and describing the nature
of your interests, including whether or not you want to take part in the item.
So can I formally ask if anyone wishes to declare any interest?
Excellent.
If we get through all the items as quickly as this, we might actually finish on time.

3 Minutes of the meeting held on 27th February 2025

Moving on, minutes of the last meeting, the 27th of February of this year, other than
The case of the previous meeting agreed
as an accurate record.
Thank you very much.
Okay.
Before we get on to the actual main agenda,
I did just want to address the issue of the papers.
There are of course some reports which actually have to come
to the Health and Wellbeing Board,
But very many of these are produced over a much longer period of time.
I've had discussions with Jeremy De Sousa, the Executive Director, Laura Campbell, Democratic
Services Office, and a few other people about how we can actually improve in this situation.
Because I fully accept that suddenly receiving 370 pages a week before the meeting is not
particularly useful.
and frankly I struggle to deal with things like that.
We are looking to modernize and streamline
how Wandsworth Council generally operates
in the field of scrutiny.
And although Health and Wellbeing Board
is not a scrutiny committee,
nonetheless same principles apply.
What I'm suggesting,
and I'd be interested in your views on this,
and given the number of apologies,
I'm more than happy to write a paper
or democratic services to write a paper
to consult other members of the board on this.
But it's simply that when these reports are completed
and become available, that they are actually sent out
to two members of the board at that particular time.
Usually those papers we meet on a quarterly basis
will be produced over the preceding two and a half months.
And then we were suggesting probably a couple of weeks
or so before the main meeting that members of the board
actually sent a list of all the papers
which have actually been sent out with appropriate links
rather than printing the entire gamut
of whatever's actually been sent out.
Along with the request, two members of the board
as to what they want to discuss
because it is quite apparent to me that a lot of stuff you receive,
I mean, it's good information,
but a lot of it isn't particularly contentious.
And I suspect today, particularly because of the time pressures,
you won't really have the great deal of time to consider them properly.
So that is essentially what I am proposing.
There is a separate item on the agenda, of course,
which was the outcome of the seminar.
so we take that separately.
But I did want to address the issue of the agenda
first and foremost.
And if people think that that approach of sending out
the papers as and when they're available
and then giving members of the board the opportunity
to specify which ones they would most like to consider,
then that certainly would be helpful.
We haven't got time for a proper debate, I'm afraid.
but can I just simply ask, does that sound sensible to me?
Jason.
Thank you, Graham.
I mean, we've been having these conversations for years
and I think that sounds like
an extraordinarily sensible approach.
And I don't know whether it will work in its entirety,
but if we don't know, if we don't try, we won't know.
And I think the sentiment and the approach is very sensible
and will be much welcomed from not just the voluntary sector, but I think anybody who's
outside of the immediate environment where the papers are generated will find that hugely
advantageous.
Thanks.
Thanks, Jason.
Yes, Stephen.
Yes, thank you, Chair.
And I should note in passing, perhaps, that I thought the Secretary had been extremely
clever in having precisely the right number of pages to represent the English carry -on
follow -up on Monday vis -a -vis India.
So very well calculated.
370 was what they needed to win.
I entirely agree with the sentiments.
The only thing I would add is, if we're thinking about the papers, is increasing the focus
on what it is that the committee might focus on.
because a lot of these reports are sort of 30, 40, 50 pages
of information.
But what are the two or three issues
that are being particularly brought to our attention?
And what is it?
So we're given a bit more focus ourselves.
At the moment, if you receive the papers,
it's really up to you to use all native wit to sort of spot
on page 23 that there's some issue.
But I think we could be given a bit more focus in that way.
Yes, I entirely agree.
I suppose it comes from similar backgrounds in that respect.
I think we definitely need to do that.
And there are also other changes
to the way the health amount being bought operates,
which I'll probably raise under the requisitive item.
But if we can sort of leave it there,
as I said, I think particularly because
of the number of apologies,
is we should write a shorter paper
specifying quite clearly what it's about
to members of the board setting out what we think
is a much more sensible approach
in terms of trying to deal with the business.
So thank you for that.

4 Wandsworth Safeguarding Children's Partnership Annual Report 2023-2024 (Paper No. 25-210)

So can we move to the substantive items on the agenda?
The first one is basically children's safeguarding.
I believe we have Louise Jones,
who is the Assistant Director of Practice Standards
and Principal Social Worker to introduce the report
with Camilla McCallum, Service Manager
of the Safeguarding Children Partnership
to answer any questions.
So Louise, I can't see you.
So we've got Camilla at the end, still to introduce.
Oh, okay, sorry.
Who's?
Camilla McCallum.
Oh, Camilla.
Sorry, okay.
Camilla.
Thank you so much. I hope I won't extend your meeting much. I can give you a whistle -stop
tour of the WSCP annual report 2023 to 2024. I hope there wasn't anything contentious in
it. But to give you a summary of what we accomplished and to have context, I'm not actually the
service manager of that service anymore. Four weeks ago I moved over to head of cluster
and early help, but I was part of the service at this time and can answer any questions.
Our focus really was embedding our key priorities.
We do this through our executive where Anna Popovich,
Justin Roper and at the time Ian Cameron from the police
represented our executive board.
We have our serving groups, our safeguarding partnership,
LSEPR groups, training and assurance practice,
operational working groups and anti -racist practice and oversight.
They're the working groups that feed into the executives.
Our priorities for that period, 23 to 24, were embedding anti -racist practice, actions,
behavior, and culture across the entire partnership and within the organizations that serve children
within the organization as well.
Educational support for SEND and disproportionately affected groups, accessible early help services
for disadvantaged families, delivering inclusive mental health and health services, and using
multi -agency and data for our practice assurance.
And we were able to deliver on all of these items,
and I'm not sure if you want me to go over them,
but they're in our charts and outlined within the report
on how we were able to quantify and improve impact
of these priorities.
24 to 25 and beyond, we have new priorities
that we're focusing on.
We're looking at children missing in education,
for example.
We still have a really strong emphasis
on anti -racist practice, because although we think
we addressed it very early on in our work,
there is still a lot of work to do.
And we were able to really do this.
We held an anti -racist conference.
We had over 350 delegates that met in the town hall,
and it was a multi -agency conference,
and we used different platforms,
young people speaking about their experiences
as well in this time of being subject
to what we call as disadvantage circumstances,
like inappropriate stop and searches.
So one of our main focuses,
we were looking at actually viewing the footage of body -worn cameras from the police and determining
within us what needs to change within that force, within the service, how can we build
policy procedure to impact change.
We found that a really useful part of our work to really visualize the experiences of
our young people.
And we observed some disproportionality with black and brown children that are being stopped
in search in our community.
We use the voices of young people in our partnership.
We have young scrutineers, so they sit on our boards, our panels, our meetings, they review all of the work that we're doing.
They're actually producing a child version of this very long report at the moment, highlighting the bits that are important to them,
and that will be used in community and youth groups to translate what we do as a partnership to the greater community.
We have three young scrutineers at the moment, but in this period we have a young man, his name was Fabio,
He actually sat on some of the boards and he was able to example his lived experience. He'd come from a troubled
Contextual safeguarding gang related lifestyle and really wanted to use his experience to impact change
And we really used his voice to action a lot of what we were doing
To find out exactly what we needed to do and where we needed to be
So looking at the priorities what we let were led in the work that we were doing
Within this report you will also see we have the LSE PR reviews
We have practice assurance audits so for example we would pick ten families that we're working with currently in our
Children's services, and we look at what we could have done better for those children
Where are the gaps are the gaps in communicating information?
Which is often the case is there is one of the gaps not working on the same priorities?
Is it finances is it time?
training, and as a result we now have a separate training assurance group that
focuses on ensuring that just because you're not in children's services where
there's a priority in training that others have access to. We found there
are gaps. We found that our teaching colleagues do not have, for
example, supervision as part of their mandatory program of work and we find
that a difficult time when we're trying to influence reflection and anti -racist
practice because they were not given the space to talk about their needs and
their desires and about changing their practice.
So we're working with those multi -agency groups
to help them, create space for them.
We've created some reflective space
for our teaching colleagues, our DSLs,
to have that space to discuss safeguarding concerns,
which we think are really important.
We've received reports from the LADO,
the Child Death Overview Fact Panel,
Section 11 reports where we get feedback
from partners to reflect on how they are doing.
And we started to do more collaborative work.
So for example, in our last conference that we had, which is not in this report but the
next, as a result of this we realized we weren't working with our sister boroughs enough.
So we held a joint conference with Richmond and Kingston about neglect and the experiences
of practitioners, children, families that have experienced neglect in our area.
And that was really, again, very successful.
So that's one of the learnings that we've taken from this report and moved into this year.
And what's next is developing as a, oh sorry, wind it up, anti -racist practice and our priorities.
And I will end right there.
Thanks love.
Camilla, that was a very quick overview.
Excellent.
Yeah.
Any questions at all from the board?
Yeah, Judy.
In case you don't know, I'm the new cabinet member for Children's.
It's my first one of these meetings.
It's really good to be here.
Thank you very much for the report.
I mean, it's tremendous work that you're doing and it's really worthwhile and important.
Just the report is rather historic now, isn't it?
I just wondered if there's a reason why it's quite late now and it would be interesting
to know the current situation, as the colleague here said.
What are the two or three key things that we need to know right now?
I think that one of the key things I introduced earlier was the need to continue anti -racist
practice across the borough.
That's one of our very key priorities.
We noticed that the language that is used by professionals in a multi -agency setting
is not complementary, is not encouraging.
We're looking at workforce development for global majority leaders as well, encouraging
that.
That's very much part of the work that we do because a lot of the families that we work
with are from global majority families.
So we need to learn better to understand their culture, where they're coming from, how we can work with community resources.
And I'm noticing also what we're having is a lack of cohesion between voluntary organizations and statutory organizations,
and making appropriate referrals. There's lots going on in Wandsworth, but there it seems to be not an intersect in terms of the work that we do,
and being able to target them to those resources.
So it's about working better with our community organizations and statutory services to meet the family where they are and give them support they need
Yeah, I completely agree actually and we're going to be talking about health inequalities later on and I was in a meeting this morning talking about that
You know, this is all part of it, isn't it?
You know, we are not listening and meeting the needs of quite a few of our global majority residents
So we need to talk about that definitely
Thank you very much indeed for a full report.
My question was, the report correctly flags up, I think it's on page 40 of the PAC, key
learning from the various reviews and so on.
And I wondered if you could say anything about the challenges of that.
I'm speaking from a sort of health watch perspective.
we find that one of the challenges we have,
and we have very much at the moment,
is that because so many organizations are changing,
staff turnover is enormous and is going to continue.
Actually, embedding learning is quite difficult
because you have an engagement with a certain member
of staff or a team, but then six months later,
they've often changed.
And I wonder, A, if that's your experience,
and B, if so, do you have a handy answer
for how to do this?
Definitely that is our experience, especially for example an accident in emergency, there's a high turnover of staff
and even basic policies and procedures of referring into MASH where you might look at early help services.
We're struggling to educate everyone on what we have because they change so quickly.
But one of the ways in which I mentioned is we've developed a specific training practice assurance group.
So every representative now sends their training and support officer to the group.
They meet every six weeks to talk about what they have on offer, what they think in that individual service is the gap.
So for example, if it is health, is it confirming that that need is not or is being met?
But another way we're doing it in this quarter is doing a road show.
So we've got the multi -agency safeguarding, long title, safeguarding road show.
We're actually going to do training where staff are.
So I've got a room in St. George's, for example, in September.
So if we've got somebody on shift that can come down for two hours
and learn about neglect or safeguarding,
I'm meeting practitioners where they are.
We're doing it in school halls. We're doing it in family hubs.
So instead of staying here and saying, oh, come here,
we are now doing a roadshow to make sure safeguarding training
is where practitioners work, where they're most comfortable,
where they can access it a lot easier, and short bite -size sessions
instead of a whole day out, which is often not possible.
Thanks.
Louise, you have your hand up.
Oh, hi. Yes, thank you.
So I am here. I'm Louise Jones, the assistant director for practice standards
and have responsibility for the safeguarding partnership.
I just wanted to respond to Councillor Gasser's early remark.
I've got a question in comment in relation to the lateness of this report.
So effectively, this is on the report in year of 2023.
24. Just for context, there are various governance processes that the
partnership annual report needs to collect data from, from different
agencies which can delay coming in and then obviously our internal governance
processes, but we will ensure and we are already working on the annual report for
24 -25 so we will ensure that it's with health and well -being in a more timely
way this year. And then I just wanted to add to what Camilla has said in relation to the
response around learning and kind of system learning from serious incidences, serious
child safeguarding incidences. So we have statutory duty where there is a serious safeguarding
incident where a child has died or been seriously injured and where abuse and neglect is a factor
in working together. So we have to notify the National Child
Safeguarding Practice Review panel. We have to begin what's called a rapid
review. The nature of the word rapid means we have 15 working days to bring
together all of the agencies to report back to National Child Safeguarding
panel and also make a decision about whether it needs to have a local child
safeguarding practice review which is a longer process. And I think in the
partnership what we've been working is to be much clearer, much more analytical,
much tighter within that rapid review process so that we can take immediate
learnings back out and we can start to loop them back through to our named and
designated safeguarding professionals in the various agencies and commission
providers that will sit on the partnership. So I think there's been a
real strengthening of relationships to do that, notwithstanding the work that
Camilla has talked about back then. How do you get that learning back out to
wider workforce, how do you ensure that practice changes as well? Thanks, I think
I was allocated ten minutes for this subject, I mean clearly children's
safeguarding is vitally important so I've allowed it to continue. Can I suggest for
this item and indeed any others, discussion may be truncated that you
sort of writing to officers.
And indeed, you know, officers perhaps could
consider with those questions, you know,
it should be publicized to the rest of the board.
But if it's okay with the board,
can we move to the recommendation,
which essentially I think is to note the report.
And I should say, this is the classic type of report,
which I think will end this after being sent out early for much more sort of detailed consideration
in a much more reasonable time scale.
So can we agree to note the report, if, yeah, report is for information?
Okay, thank you.
Thank you.
Cheers.

5 Challenges to Timeliness of Initial Health Assessments and Review Health Assessments in Wandsworth (Paper No. 25-211)

Right.
So moving on to the next item, which I see we've been allocated five minutes.
The challenge is to the timeliness
of initial health assessments,
and Elizabeth Souter is going to introduce
the report remotely.
Elizabeth.
Hi everyone, my name's Elizabeth.
I am the Director of Children's Social Care in Wandsworth.
I will be quick, I hope,
which means we'll stick to the five minutes.
So the local authority Wandsworth Council is a corporate parent to usually just under
250 children currently as of today, 241.
We have a responsibility as their corporate parent to meet their holistic needs, including
their day -to -day care needs, but also their health and education and other aspects of
their well -being.
Health assessments, so the statutory timescales say that a child when they come into care
should have a health assessment within 20 working days.
And they should have a review health assessment at least once a year.
That's more frequent for younger children.
We have consistently struggled to meet our target in relation to initial health assessments.
And I guess that's why we bring this report today to make the health and well being board aware of those challenges. And you can see at the end of the short report that there's a kind of table setting out some of those interrelated systemic challenges
that we face our current actions against those challenges, and our ideas about how we might strengthen our action.
And yeah, that's my summary.
You hopefully would have read the report
and you will see what the key issues are.
Thank you.
Thank you, Elizabeth.
Any comments, any questions at all?
Yeah, Mike.
Just a couple of quick comments, Chair.
First, we're well aware of this issue within the NHS.
Just two comments briefly.
One is that in terms of the appointments provided by St. George's,
whilst there needs to be more flexibility in the way that is done,
and that's referred to in the recommendations,
the key issue is the pressure on pediatrician time.
This is a problem right across southwest London, I would imagine, everywhere.
So just as a bit of context, which I'm sure everyone's aware of,
it's something we struggle with constantly.
The second thing I was going to mention is that I very much like the recommendation
to involve the GPs more, subject to, of course,
existing pressures on their time,
hopefully for individual GPs.
With 250 children across the borough,
this shouldn't be too onerous necessarily,
because we have used this model with what we call together
clinics, which is about more general pediatrics,
rather than looking at the health assessments
for children looked after.
And it's very effective with doing things
which is generally beneficial for the young person involved
and their family, which is of course important in that sense.
But the same would apply for children looked after.
So it can be an effective model when
we work in that partnership between primary clinicians
and secondary care clinicians.
Michael, thank you.
Any further points on the report of Judge Judy?
Just really quickly, I mean, I think our corporate parenting
responsibility is actually the most important responsibility
we have at this council.
It is the thing I take most seriously.
So is it you that I must work with,
or the officers I must work with to make this happen, the GP
appointments, or who is it within health that we
need to really work well with?
I think our colleague from Children's Services
is already linked into us with St. George's principally,
But if you get stuck at all.
We're talking about GPs, because St. George's
is under pressure.
But to make the liaison with GPs happen,
that's all under control, isn't it?
Well, it's about how we commission the service
and whether or not we commission GPs in the way that we do for the Together Clinics, which
was the other service where we work together with.
So yes, it can be good with the ICB.
So yes, use me as a point of contact in the absence of me informing you of anyone better.
So...
And just to say, Mike, for your awareness, we produced this report in partnership with
but also in partnership with William Fletcher
and Justin Roper.
Thanks, Arin.
Thank you.
I'm just wondering about where in terms of stages
of progressing this matter we are, if anywhere.
And in terms of which organizations to approach
within primary care and commissioning such a piece of work,
I would tend to suggest the Federation would be a good vehicle to effect that change.
I was about to say it would be the Federation that we would go through, yes.
Thanks Ariane, and obviously good to have the input from GPs.
Jeremy?
Oh, sorry.
Yeah, sorry, I thought Jeremy wanted to speak.
If that is okay, then if we can move to the recommendations.
The first recommendation is to note the partnership challenges
in ensuring timely health assessments for children
and young people in the council's care.
But most importantly, recommendation two,
provide support in identifying ways that partnership
can strengthen working together to provide the best outcomes for children and young persons
in the Council's care.
So it's the second recommendation I think we may want to come back to and focus on in
the future.
Is the Board content with agreeing with those recommendations?
Thank you very much.

6 Annual Director of Public Health Report - Making Smoking Obsolete (Paper No. 25-212)

Right, now the next item is the annual report of the Director of Public Health, Thinking,
Smoking, Obsolete.
Very important paper, it's a great shame you've been allocated ten minutes to discuss this.
But Shannon, please, if you can introduce, thanks.
Thank you, Chair.
I'm also joined by my colleague, Mr. Benjamin Humphrey.
I'll just do a quick introduction and then I'll hand over to Ben.
This report was produced to coincide with the Tobacco and Vapes Bill, which as you know
is currently making its way through Parliament and is now in the House of Lords.
Smoking is still one of the biggest risk factors for ill health that is having an impact on
the NHS and also on adult social care services.
So we felt it was quite an important topic
for us to focus on this year.
We also recognize that although great strides
have been made in terms of reducing the prevalence
of smoking, which has almost halved in the last decade,
but still when you look at the total resident population
who smoke, it still has a significant impact
on people's lives.
So having said that, I'll pass over to Ben Humphrey.
Thank you very much.
Benjamin Humphrey, Senior Public Health Lead for the Council.
So following on from Shannon's good introduction to the paper there,
this is an annual director of public health report on making smoking
obsolete through people and partnerships.
And this really is the result of work that we did earlier on in the year,
talking to and listening to our residents and their experiences of smoking,
their experiences of trying to quit and successfully quitting in some cases.
And we also spoke to our colleagues both within the Council and the NHS
who support our local residents to quit smoking.
There are three key points that I would like to draw the Board's attention to.
The first one is we've done some really good work over the last few years.
In Wandsworth, we have seen our smoking prevalence decline significantly.
And we have a really fantastic, robust, evidence -based stop smoking service in place available to
our residents through various channels, primary care, over the phone, online, via apps, which
means our residents have access to this support 365 days a year, 24 hours a day.
Really good relationships, pathways with our partners,
particularly St. George's, both maternity services
and the Mental Health Trust as well.
Less positive, which I think has come out of the report,
is that although we are seeing the prevalence
of smoking reduce in the general population,
we're not seeing that translate in such a positive way
with our priority populations, and by that we mean smoking in pregnancy, routine and manual occupations, mental health and substance misuse.
At the same time, over the last few years, despite the prevalence coming down, we are seeing the number of people accessing the service and successfully quitting, reducing by around 50%.
So in order to reach this ambitious target to become smoke -free by 2030, and that means
lowering our smoking prevalence from its current position, which is 7 .8%, so that's roughly
8 in every 100 adults smoking, we want to bring that down to 5 % or less.
And what we can see in the report is the way to do that is to continue offering our universal
service but to increase the focus and strengthen the work we are doing with our priority populations,
to increase awareness among young people about the dangers of smoking, discouraging people
from vaping who never smoked and in general just increasing awareness of the impacts of
smoking and the local services that are available.
And then the final point I would like to make since the report was written, we have already
done a lot of good work locally with several new initiatives.
We've got a stop smoking needs assessment well underway.
We recently, in collaboration with St. George's Hospital Maternity Services, we implemented
locally the National Pregnancy Incentive Scheme.
And we are working hard with partners across South West London to develop a brand new awareness,
Stop Smoking Awareness Campaign, which we are going to be launching as part of our Stop
in October efforts in October.
So lots to celebrate, but the job's not done.
We need to knuckle down and really focus
on those priority populations if, as a council,
we are to achieve our ambition
of becoming smoke -free by 2030.
Thank you.
Thanks.
Any questions?
Comments?
I'll comment on my own report, if I may.
Well, firstly, I just wanted to comment that I think the report has been quite insightful
in terms of the fact that a lot of people are now quitting without necessarily needing support
because they can go and they can access the fates.
But for those people who still haven't quit, who have got more significant challenge,
I think this report really helped us to understand those insights around why people, you know, still
start and then continue to smoke.
And I think that's where the real sort of value of the report was.
So I just want to take this opportunity to thank Ben, the smoking cessation team, our excellent smoking cessation
workers, as well as all the people that supported us in terms of the case studies that are presented in the report. Thank you.
Yeah, thanks, Shannon.
I mean, this is an excellent report,
and quite certainly the only reason why you didn't have a flood of hands
can go up is simply because of pressure of time.
But this is clearly important.
It is a work in progress.
I mean, I'd just simply leave you with a thought as to how you take this forward,
particularly perhaps a seminar of some kind,
may be actually a very good way to publicize it.
Shannon's directors reports are very, very good
and they frankly deserve much wider circulation
and understanding and appreciation and implementation
than perhaps they necessarily get.
So unless there are any sort of,
I mean, question, sorry?
Temi online. Temi online? Yes I am. Yes I am. It was just, I'm Temi Fassia, I'm the
College Mental Health Transformation Lead working across in the ICB for covering one's
workplace and I'm just picking up the point mentioned earlier in the presentation about
some of those target groups that we need to look at which included mental health
and that's my wanting to explore with colleagues
from public health how we could target some of the
stop smoking campaigns to different groups of people,
residents experiencing mental health conditions.
While it might be appropriate sometimes to undertake
some of those things while people are in hospital
and admission, there might be opportunities to think through
where some of the targeted initiatives could be done
when people are in the community
and could explore that further with colleagues
outside of this meeting.
One second.
Any further comments at all?
Yes, David.
I was just going to ask about whether you are,
what you're doing to monitor the risk of vaping
as an entry to smoking,
as distinct from vaping as a way of getting off smoking.
I mean, there's anxiety clearly about young people vaping
and then potentially moving on to smoking itself.
Do you see that as a serious risk in one's worth?
Is there any evidence or data about this?
There is, but it's limited at the moment.
Local data specifically is very limited.
There's a little bit more national.
But as the number of people who use vaping to quit or just use vaping socially, then
that data field is going to increase.
What I can say is yes, we are concerned about it locally.
And one of the things that we are actively doing at the moment is working with our colleagues
in children's services to do some awareness with our young people in education settings
to make them aware of the dangers of vaping, particularly if people are taking up vaping who never smoked cigarettes.
Nicky.
Yes, hello.
So, I was just going to add to that, that while we're looking at it locally, at a national
level, it is an issue that comes up time and time again.
I think it's something that's very pertinent.
So we're really taking a watch -the -space attitude to see what comes out from UCSSA and from,
you know, people who are collecting it across the whole system rather than just at a local
level.
So we'll keep you updated with any new guidance or any new information.
Thank you.
Great.
Good.
And of course, a lot of things going on in relation to fakes as well, but we haven't
got time to discuss that really.
So, unless there are any further sort of pressing questions, comments, by all means, do contact
Shannon or Ben or Nikko about anything that you may have some lingering questions about.
But with that, can we approve the recommendations
for information?
The first one is essentially to simply note the report,
but I think we should also note that it is an exceptionally
good report.
And consistent with the other two that have been produced
whilst I've been the cabinet member,
nothing to do with me at all.
And to Shannon and the team.
And also to note the report has been submitted to the Association of Directors of Public Health
and is published in the council web pages.
I'm making a green back, thank you.
Good, okay.

7 Public Health Board Annual Reports 2023-2025 (Paper No. 25-213)

So ordinarily, I would say making good progress.
We've only got another 12 items to go through.
I'm joking.
Item 7, the Public Health Board annual report of 2023 to 2025, which we have been
allocated 10 minutes for. Again, it is a report from Shannon and I gather you're
going to introduce a report. Thanks. Thank you, Chair. I'll only give a very brief
introduction to try and help us with the time. The Public Health Board is
an officer -led board chaired by myself and attended by various partners from
within the council and also externally. The reason why we're presenting a
two -year report is last year for several reasons due to capacity we were not able
to produce an annual report as part of our governance that allows the Health
and well -being board to have the oversight of the work of the board.
I'd just like to highlight a few things within the report.
Firstly is the main roles of the public health board, recognizing that it's been two years
since we've issued a report, and the main one is to champion the role of the council
as a public health organization, and this is quite important because a lot of the delivery
of public health sits across the wider Council and also within the determinants of health.
The second one is to maintain oversight of the public health resources that are allocated
to the Council to ensure that they are used in the most effective way and addressing the
public health priorities.
And this links quite closely with one of the appendices, which is the Public Health Outcomes
Framework, which is the tool that we use at a very high level to track progress with public
health outcomes. And then the last objective is around health protection and this was born out of
the need to have what were I think called COVID boards during that period and then they transitioned
themselves into other health protection functions that are a responsibility of the council.
The Board is functioning really well since the last review of the terms of reference.
I think our partnerships have strengthened with various colleagues, some of them on the
call, and that has led, I think, to supporting better embedding of the Council's prevention
framework and also increased collaboration around those wider determinants issues such
as housing, transport, planning and so on.
So, while the report is here for noting, I suppose in keeping with the comments that
were mentioned earlier, it would be good for the board if they wanted to focus any comments
on whether they feel assured that the Public Health Board is providing reasonable assurance
on the public health functions of the Council, and also whether there are any particular
gaps or topics that they have noted that they might want the board to focus on in its future
forward program.
Thank you.
Thanks, Shannon.
Yeah, obviously, this covers a very broad range of different topics, and we haven't
got time to do it justice, unfortunately.
So I'd encourage people to write in concerning any comments or questions they may have to
Shannon and his team.
But having said that, can I ask if there are any immediate comments that anyone would like
to make, please?
Stephen?
It was just a query, a factual query, really.
In the, I'm looking at page 115, where you have a whole pile of overarching indicators,
and it goes on several pages of them.
And not surprisingly, most of the trends,
if I can read it properly, which I can't
because it's very small print,
I think are basically no change in effect,
which isn't surprising given the timeframe you're talking
about, do you somewhere else have long -term trends?
There seems to be a lot of these indicators
are more interesting over a 10 -year, even in some cases,
a 20 -year timeframe than a sort of, certainly a few months
or even a couple of years.
And I'm not saying they should be here,
but just want to reassurance that you
have got those indicators, because that
would be more interesting, I think,
than the very short -term ones.
Thank you.
Absolutely.
That's a really good question.
Obviously, the Public Health Outcomes Framework
has several tens of indicators and sub -indicators
going into the hundreds.
I can assure you that we do look at the trends.
So thinking about the indicators on that particular page, which
which is page 115, where we've got healthy life expectancy
at birth and life expectancy at birth.
We have noted, for example, that any improvements
in those indicators have actually stalled
within the last decade, so that's our current concern,
and that actually follows the national trends as well,
where the improvements that we'd seen in previous decades
in life expectancy have stalled.
So we do look at the trends, and they are in a more detailed
report which would have added to the burden of the reports that we have today.
Yeah, thank you.
Steven, good point.
I frequently ask similar questions, mainly about crime statistics.
Jeremy?
Yes, chair.
Actually, mine was related to that.
So I was just saying it was really positive.
It's a really comprehensive report, but actually it was positive to see that overview of the
public health outcomes framework here.
And I know that the board looks in more detail
at the areas we need to work on.
And then just also noting the point that Shannon made,
I think we've made considerable strides
in embedding the way we work across the council
to embed health in all the work we do.
And I know the public health board
is quite instrumental in that work.
And just noting that recently,
our prevention framework developed by Shannon
and his team has been recognized
by the local government association as best practice
as a case study which is really positive for us.
And, hey Jeremy, Shannon's obviously too modest
to mention and I was only going to mention as well.
But you also, you forgot to mention that
And then the Norwegians came to us to find out
how we operate the prevention framework,
which is actually quite critical to driving public health
across all departments and the concept
of health in all policies.
I mean, it is very much an holistic approach.
So excellent, and that's an excellent example
of how public health is being pursued in Wandsworth.
Brian, yeah.
Yeah.
Hi, thank you, Chair.
Davina Smith, Senior Community Safety Consultant here on behalf of Kilmer and Vagwell for Stronger
and Safer Community.
So just again, thank you for the report.
And like I shared earlier, it's really good to see the overall framework in its entirety.
I just wanted to add some context in terms of the slight increase we've seen around violent
crime.
It's also something which has also been noted across London and nationally in terms of that
violence increasing.
So there are a number of initiatives being delivered
alongside our community safety partnership
and we're also in attendance at the board
in terms of support, in the additional support
and oversight in this area.
So just as one of the areas which we would welcome being
continued to be monitored and focused on the board
is what I'd like to offer for the next.
Thank you.
Yeah, thank you for raising that.
It's always been one of my key interests
and particularly the reasonable idea
with community safety in addition to public health
and social care.
There are considerable synergies across the piece,
and it is important we do approach questions
of antisocial behavior and crime through a public health
approach.
So thank you very much for that.
I think Judy, you had something to say.
Thanks.
Yes.
Thank you.
And congratulations to Shannon and his team for all your work.
And I can attest that before I've
from the environment portfolio and we did lots of work on leisure strategy, air quality,
all sorts of things that we are working very well across the council now.
Just some of these indicators, and mine's in black and white so I can't tell what color
they are, but I think child obesity still seems to be a real problem, and diabetes and
all sorts of things.
I mean, we will discuss that a bit later on, yeah, because there's things that we're always
trying to combat, aren't we, and we still have problems.
Thank you.
Yes, I can definitely confirm that those two are priorities for
us still within our joint local health and well -being strategy.
And I know sometimes when people look at obesity, particularly childhood obesity,
relative to elsewhere in the country, they might think it's not such an issue.
But again, when you look at the data behind these high level indicators, and
you look at the increase in obesity between year one,
in reception when we first measure children,
then again at year six, and then into adulthood
where it becomes over 50%, then you can start to see
that it is a continuing challenge for the system.
The other point that I was going to make was,
sorry, I've forgotten now, reference to the latter part
of your question.
Dusting it later on in the various plans,
But then you have said that it's an absolute priority.
Good, excellent.
If there are no further comments, questions,
let's move to the recommendation, which is simply
to note the Public Health Board and a report for 2023, 2025,
et cetera, and the delivery areas attached as appendix one.
So if we can agree that, thank you.
Right, moving on to item eight,

8 Health and Wellbeing Board Seminar held on 4th March 2025 (Paper No. 25-214)

which is the Health and Wellbeing Board Seminar,
or held on the 4th March.
Vusi, you're going to introduce us, so thanks.
Thank you, Chair, I'll just reintroduce myself.
I'm Vusi Adecki, the Health and Care Partnerships Lead.
For members in the room who didn't attend the seminar,
just a quick recap, it was facilitated by a colleague
from the local government association
to really work with the board to sort of strengthen
their effectiveness.
It was really great to have the engagement.
And one of the things that was celebrated
was the prevention framework principles around partnership
and collaboration.
And you can see that reflected in our very rich agenda, which
covers the life course. But of course one of the challenges is really developing
those conversations which can be very challenging to do to allow you to
process the information. So I will hand back to the chair shortly and open for
questions because some of the recommendations was how do we strengthen
our relationship with our wider partners. What's unique with this particular board
is we have representation for carers as well as the voluntary sector. And I know
Jason will come in with some contributions shortly,
but we know that Abby Carter is our rep,
she represents a wider voice.
So we're really thinking about speaking to members
to think about how do we bring in those wider voices
so that we can get that richer engagement.
So I'll press pause and just hear any reflection
from any of the recommendations noted.
Yeah, thanks, Vuzi and Inferati,
to receive from Abby and I suspect that Jason may well be reflecting some of her views.
Jason.
Yeah, so thank you.
And I think just to iterate the point that it's not just Abby's views or my views, but
I think an amalgamation of a broad perspective of views from the wider voluntary sector.
And I think what I'd like to start off by saying is,
whilst I think it's difficult to disagree
with any of the recommendations made as they're laid out,
the issue with these kind of things is the devil's always
in the detail of how they're implemented,
and I think as well when.
And that's some of the things that we need to perhaps,
not necessarily bottom out today,
but make sure we properly consider.
And I mean, because there's different ways
to do different things.
I think actually, I mean, one of the things you mentioned
at the top of the meeting, Graham, about the papers
is an excellent example about some of the how
and how we might do things differently.
I think another example I might give as a small thing,
but a significant thing is, I mean, Brian came to the,
we have a, for those of you who don't know,
we have a voluntary sector health and well -being
engagement group, which happens sometime in that small working space between when the
papers are published and this meeting, which is usually on a Monday or a Tuesday, because
this is always on a Thursday.
And Brian came to the meeting and gave a really helpful and insightful explanation of how
the Better Care Fund works.
I know that's on the agenda for later.
But I don't want to talk about the Better Care Fund now, but I think it wasn't a huge
meeting.
I think there's a few more people than are in this room, maybe 15, 20 people virtually are in this meeting.
But that group of people from the voluntary sector really responded well and
really commented on how for the first time they got a reasonable grasp on what the benefit care fund was and how that worked.
And that took half an hour of Brian's time.
And I think sometimes that more proactive engagement and
and having that conversation and just presenting the details in a way which resonates with
people who don't necessarily understand why something exists or the politics with a small
p around how that exists, I think is really helpful.
And that helps bring wider partners, including specifically the voluntary sector, into understanding
the context and then that gives them a platform to better engage with the conversation, especially
if we can change some of the parameters, Graham, like you suggested earlier.
I'll stop there for the minute.
I might come back if that's all right.
Yeah, fine, Jason.
I'm certainly very, very sympathetic with you.
Oh, some above the end.
I think Steve and Shannon.
and I think my feeling is that most people outside a room
like this are interested in particular topics and areas
and issues.
And very few people are interested in everything
that's here.
I mean, even certainly in the Health Watch perspective,
our people are not interested in totality of health,
by and large.
They're interested in a particular area.
So I think that to encourage engagement,
We have to think about engaging on particular areas
or issues or topics rather than trying to sort of get
general views across the broad breadth.
And I think that in turn means thinking probably
about the nature of our discussions as well.
I've always felt that the most interesting conversations are
often in seminar mode rather than the formal,
here's a report which we note and pass on.
And if you have a seminar discussion, then it's good by definition that we focus on a
particular topic of some sort.
And you could, A, you can engage before that seminar more easily because you know who's
interested in that topic.
And you can, if you wish to, bring more of them into the seminar itself.
I mean, the seminar enables you to bring other participants into the discussion.
So my feeling is that that way might be practical.
Shun.
Thank you.
One of the other opportunities that I've explored in discussion with Vusi is to think about how we could take advantage of
artificial intelligence in terms of tools like Microsoft Co -Pilot, which can quite easily help us to summarize and, you know,
develop easy read versions of some of the papers for a start, just in terms of accessibility of the information.
And the other opportunity to explore as well is,
I don't know how you find it when you go on to
sort of the corporate website in terms of trying
to look back on some of the papers and, you know,
the individual topics, but I think there are opportunities
there in terms of the search function.
So if, as Stephen says, people are interested
in a particular topic that the Health and Wellbeing
Board discussed, they could find it more easy
to access on that specific paper.
Yeah, excellent comments.
Perhaps I'll just throw my, sorry,
Ariane, do you want to say something?
Yeah, please do.
Sorry, very briefly.
AI is here to stay and it's only gonna grow
and absolutely we should exploit that
to make easy read versions,
but I'm just mindful of the fact
with all the hallucinating and reinterpretation,
if we ever do go down that route,
I would want lots of reassurance
that some organic being has reviewed these notes.
A good point.
Oh, Jason.
Thank you. I think just an additional point is,
I think the other point when we're talking about broader organizations,
not exclusively, but again particularly the voluntary sector,
is many of those organizations are quite small.
I mean, I'd say 90 % of the voluntary sector, maybe more than 90 % are probably smaller than
Shannon's public health team.
And so when people have to engage in these meetings, the opportunity cost of engaging
with health and wellbeing board or any council strategy, to be honest, is greater.
the commitment of people taking the time to read the papers
and engage is disproportionate relative to...
And also, quite often, they're having to deal with a much...
I mean, I can speak from personal experience,
unless you're having to deal with a much broader spectrum of issues
rather than, you know, working in a bigger organisation
where you're particularly focused and knowledgeable about one thing.
So it's just that the...
I'm making that point that the call to arms, the cost, if you like, in time or in terms
of opportunity cost of organizations engaging with public sector agendas, whilst they really
want to do it because they care about this stuff just as much as everybody in this room
does, it's high.
And I think where we're moving into a world where a lot of voluntary sector organizations
are in a more financially precarious position because public sector funding has fallen off
quite a lot in the last couple of years and there's stronger competition for charitable
trust and people are having to look elsewhere.
The amount of time that organizations are having to spend on survival or business development
or in everything in between makes that even more disproportionately high.
So, I just wanted to point out those things.
Yeah, sure. And they're all good points, extremely well made. I mean,
from my view, which I think I have expressed this in some previous health well -being boards,
I would actually like, as far as we can, to move the board away from receiving multiple reports.
There are some reports we have to receive,
and obviously we have a statutory requirement
in relation to health and wellbeing strategy,
even planned pharmaceutical needs assessment,
you know, things like that.
But I would actually,
I mean, the best conversations we have in this board
is usually when we have a relatively light agenda,
and we can actually delve into topics.
And in that sense, Stephen is absolutely correct.
So this is my commitment to the board.
I certainly don't think that the issue of how we organize our work finishes with this
paper.
It is very much on my radar.
I certainly would like to fundamentally sort of change the way the Health and Well -Being
Board operates.
The Health and Well -Being Board is not a scrutiny committee.
It was certainly put in place a number of changes as to how effective scrutiny can happen
there.
I'm not expecting you to scrutinize papers,
but to use your expertise,
your knowledge and professionalism
to make positive contributions
to how we can actually take forward
the health and health and well -being
of our citizens in Wandsworth.
And I fully accept that even if we do send out papers
over a two and a half month period,
that's not necessarily advancing the goals
of health or health and well -being.
So my commitment to you, this is very much on my agenda.
And I'll be discussing with officers
how we can actually effectively take this forward.
Thanks.
That said, and can I just say,
I thought that some of us actually
have an enormous amount of energy.
And that's one of the reasons why I think
we do need to build on it.
So, I'm sure we'll be having conversations in the future.
Yeah.
That said, let me see, I think you asked to note
the outputs from the seminar and support the ongoing
developments of the health are being poured
through the option of proposed recommendations
and there will be so further.
People are members content to approve
those two recommendations.
Yeah, okay, thanks, now.

9 Joint Local Health and Wellbeing Strategy: Live Well Update (Paper No. 25-215)

Good.
So item nine which we have 10 minutes for is the joint local health and well -being strategy
the live well update paper.
Because of the timeline I believe I shall and you're going to introduce the report.
There are various offices covering particular topics
who are here virtually who are there essentially
to answer any questions which I'll raise with them.
So over to you Shannon.
Thank you, I won't do a long detailed introduction
because I think we'll take the papers as read
and there are quite a few topics to cover.
This is a report on part of our live well section
of our joint local health and well -being strategy.
I think most of the board members will now be familiar
with the style and how we report on this.
Today we're receiving reports on the areas
of type 2 diabetes, cardiovascular disease,
physical activity and healthy eating, smoking, alcohol,
mental health and suicide.
And as the chair has alluded to, there are several colleagues
who are step leads either in the room or online
to help respond to questions.
Thank you.
So, if any sort of questions, this obviously does cover quite a wide range of issues, type
2 diabetes, cardiovascular physical activity and health, eating alcohol, mental health
and suicide prevention.
So, any questions on any of those?
Steve.
I just wonder in relation to alcohol whether you have any evidence about the impact or
maybe lack of impact of what one reads as a trend towards less drinking among younger
people and the trend which is quite visible in supermarkets and so on to low alcohol or
no alcohol drinks.
whether, you know, whether that is appearing in any of your work at all, or whether this
is a sort of, you know, someone else.
Thank you.
I'll try and respond, but I know one of my colleagues, Ross Little, is online to respond
as well.
We are able to get some data locally that enables us to look at or understand what's
happening with children and young people in relation
to alcohol.
Public Health Fund, a health -related behavioral
questionnaire that goes out to local schools
and is a self -reported questionnaire that covers
several issues affecting the health of children and younger
people.
In terms of trends, because the survey is a local one,
and we don't repeat it every year because it's
quite intensive and costly, we're
just at the point where we're looking at commissioning
second survey, and it will largely follow the same format
as before, that will allow us to start looking at the trends
that you allude to, but I know as part of our
Combating Drugs Partnership, we do have,
which includes looking at alcohol as well,
we do have a work stream that focuses on children
and young people, and with the involvement of our
substance misuse service for children and young people.
So I don't know whether Ross has got any further information
on that point.
Thank you, Shannon.
Ross digital public health lead for substance misuse
that includes alcohol.
And not a huge amount to add to that Shannon, thank you.
But for what you've said that kind of
sort of covers it off mostly.
I think the only other thing we would add is the
in terms of local evidence and data,
it would be looking at our local substance misuse service
for children and young people and we could extract some data from just seeing how what the trends are
looking like with for the children young people who are accessing that service for alcohol related
needs as well would be something else we could look at and as Shannon says we do have the the
combat and drugs partnership which has an alcohol stream and the children and young persons
subgroup and there are a number of um there are a number of objectives and actions linked to alcohol
that in our new strategic delivery plan that's just currently being refreshed will be aligned
with what the local needs are so we look at the local data to try and make sure we align
the needs in relation to alcohol and children and young people with the work that we do.
Thank you. Any further comments? If not, the board is simply asked to agree the recommendations
to note the delivery outputs as set out in appendix one
and two into the report.
I mean, I would say, yes, or generally,
I think these updates on the 19 steps are very important
and this clearly is an update,
and so it won't be the last one in relation to live well.
But they are, I think, very useful in terms of monitoring
our progress of basically the core features
of the health and well -being strategy.
So thank you.
So moving on, it's with me, to item 10,

10 Wandsworth Health and Care Plan 2025-27 (Paper No. 25-216)

which is the Wandsworth Health and Care Plan
for 2025 to 27.
And we have 10 minutes for this.
And I think Mary, you're going to lead
on behalf of the ICB, thank you.
Thank you, Chair.
My name is Mary Doerou.
I am the Deputy Director over at South West London ICB.
I will take the papers as read and I should probably start with a big apology because
I think the papers are probably about a quarter of the overall papers.
But just thinking about the previous items, so essentially two years ago, or a year ago
when the joint health and well -being strategy was published.
We agreed as a system rather than to have a separate health and care plan.
The health and care plan essentially will be the two year version of the joint local health and well -being strategy.
So rather than repeating what's already in there, essentially this group will hear regularly around the updates.
Just for noting for this group.
So whilst the plan is essentially finalized, we just want to remind ourselves that it is
going to be a constantly evolving plan.
So where we are getting further insights from communities, organizations, systems may be
changing, we want to make sure that the plan is reflecting of that.
And this board obviously will have the oversight in terms of where there will be any changes.
Again, from a governance perspective, we do have a partnership meeting that meets monthly.
That oversees the operational delivery of the plan.
There is an additional document in the papers which is a thinking partners document.
And just building on what Jason was saying earlier, so where we want to say we are absolutely
considering the joint, apologies, the volunteering community sector as an equal partner, how
How are we actually tailoring the messages and making sure it's clear in terms of what we are wanting to deliver from a health and wellbeing perspective?
So we have a group called Thinking Partners, which we invite volunteering community sector partners to that group,
where we can understand health and care and different items for discussion.
And we took this plan and as you can see in the papers it was in two meetings, the groups were split up,
and again it was advertisers. If you're interested in these particular groups, please do come along, we're interested in your thoughts.
So again, we want to make sure we're using the insights from the voluntary community sector feedback
to make sure we are not only enhancing our delivery but also we are responding to our partners in terms of the feedback that they gave.
Just a big thank you to Tom Cox and Vusi Adecki.
This is absolutely, as I said, an evolving document.
And so at the moment we are very conscious, it does very much focus on outcomes.
We are working with the step leads and sponsors to make sure they're really clear
in terms of articulating what the output will be to be able to get to those outcomes.
And I know both Fussy and Tom have been working very hard working with the step please, which I know is not necessarily always easy.
But again, I think how we are empowering the step please, this is not a top -down approach.
This is what do you want to achieve for your communities and how best can you achieve that?
And I think that is actually a step in culture change to how we've previously delivered work.
So for this board, it's really just to note and approve the health and care plan and also
to note the work that we've done with the voluntary community sector.
Thank you.
Thanks, Mary.
Comments, questions?
Yeah, Shannon.
Thank you.
Mine is just a general reflection.
I just wanted to comment on how our collaborative arrangements across Wandsworth in terms of,
you know, linking up the health and care plan
and the joint local health and well -being strategy
have been particularly successful and effective.
And I think particularly the Health and Care Partnership
meetings, where the different step leads and the step
sponsors take a role, engage with the wider system,
including the voluntary sector, have really been a strength.
And again, not to beat our own chest,
but just early this week, FUSI informs me
that the Association of Directors of Public Health did publish a case study on one's worth
in terms of the collaborative effort around the health and care plan and the strategy.
Thank you.
Nick.
Thank you.
I want to seize this opportunity as well to acknowledge the items that I think in terms
of this work that has been demonstrated.
I think the first one is the really clear communication.
The reports are very easy to fill in.
They're very clear and the feedback is clear.
There's a very good reporting mechanism and performance monitoring that's actually
taking place.
I think it's an exemplar.
And finally, they've taken the prevention framework approach and really used it and
provide a platform for that framework to actually be systemized, embedded within the work we
do across the whole system.
I had a meeting with colleagues and health watchers even talking about how we can get
the prevention framework across all that they're doing.
So I really want to applaud and commend that,
you know, those two things that,
I've forgotten the two names,
the two items coming together,
I think it's an excellent piece of work.
Thank you, Mary and team.
Thanks.
Any other observations?
Stephen.
Yes, I think this is excellent stuff,
and I congratulate the team.
I have raised with Mary a question of,
it's quite interesting reading them back to back
in a sense of these things.
The treatment of the words, objectives, and outcomes
does differ quite sharply.
Some of them are activities,
some of them are statistical goals.
And so I think there is scope to improve
the articulation of what we're trying to achieve
and draw a distinction between the goal, if you like,
or use some different language,
and the activities that we're doing in whatever timeframe to achieve that goal.
At the moment they're slightly mixed up, I think.
But I think that's it.
Mary?
Yeah, thank you so much Stephen for noting that and I think you're absolutely correct.
I think where we have to acknowledge, I guess, where we came from,
and I think for some of the step leads and sponsors, they inherited a five -year plan which they didn't necessarily write.
and so getting them to really articulate and really vision what do you want to achieve in the next two years.
I think people were very focused on in five years' time this is what we want to do,
but actually how are you going to get there?
And I know that that has been in some cases quite challenging.
So again, please do accept that this is an evolving document and I think this is some of the work
we're absolutely working with the STEP leads and sponsors to be able to really clearly articulate
what exactly is your outcome, what do you want to achieve,
and what are the steps you're going to take
to be able to get there, so thank you.
Shum.
Thank you, sorry.
If I did have one question for my colleague,
it was to think, reflecting on the comments
that have been mentioned before,
around how we engage with the wider community
and the voluntary sector,
I think there's so much good work here,
and because it's all very topic specific,
I think it would be good if we could think about
a continuous mechanism where once these updates
have been published, they're somewhere where they're
easily accessible for people to go in and engage
with the topics, and actually if they want to engage
as well with the people behind the work,
they'll be able to make those linkages.
So I don't know whether that has been considered.
Yeah, Nick.
I think that's a really, really good point.
And one of the things that occurs to me is we need to start thinking about how we get,
I don't like the word community of practice, but that sort of concept.
So it's ongoing, it's there.
And we're capturing the resource, capturing the evidence, but providing a platform for
it to continue to be built on.
And I think now we have all these digital things.
Don't look at me, but people who know how to play with it.
I think that would work and it would feed into the points that Jason and Steve were
making where we have smaller communities, they don't have as much time.
And I think you started to explore that when you were trying to get us to write that bid
and when you also had, was it Share or the people who came from the children and all
those different parts I had never interacted with, but you brought us all together and
we all got fantastic learning that we could build on.
So I think we could think about that, how do you create a digital but more engaging
platform that we can continue to do this work on?
Thank you.
And apologies.
Can I just say, Jason, if we can take that outside to the meeting, because again, I think
where colleagues have mentioned things around how we can potentially use AI to maybe get
these reports a bit smaller, but also more accessible for some of our voluntary community
sector colleagues, maybe we can explore with yourself and Abby to test and trial some things
that can be sent out to the voluntary community sector.
Yeah, I'd be absolutely happy to do that and I'm sure Abby, you know, the formal role as
representative on this board would be too.
So yeah, we can catch up offline, Mary.
Yeah, that's great.
Yeah, I mean, I think all parts of the system can improve the way we work and it's great
we're adopting that in a collaborative way.
So, if we can reach a decision,
which I don't think is particularly onerous,
which is essentially to approve the
Wandsworth Health and Care Plan refresh for 2025 -27
as attached as Appendix I,
and in particular to note the recommendations provided
by the pondering community stakeholders
at the Thinking Partners meeting as detailed in paragraph four.
So can we prove that?
Thank you very much indeed.

11 Wandsworth Health Inequalities Fund 2023-25 (Paper No. 25-217)

Right, OK.
So item 11.
Wandsworth Health Inequalities Fund 2023 to 25.
We have sort of 10 minutes for this.
I think this is already being presented
to the One's with Health and Care Committee, which does have a broadly similar membership to this body.
But Mary, if you'd like to introduce it, thanks.
Thank you. Apologies, you got me again.
So this is just really just to remind colleagues, we had an additional pot of funding between 23,
25 to work with some of our seldom heard communities.
We had eight existing projects and two new projects that were funded.
Again, I would take the papers as read.
Essentially some really key themes came out from it.
So how we can be, sorry, how the organizations working with those communities can be more
potentially dynamic and agile than us as our statutory organizations.
The focus on the communities and the needs, but also again how they're working with the
communities, particularly around the wider determinants of health.
There are three organisations that potentially have gotten additional funding to keep going.
So Blind Aid, the funding has been confirmed.
Both Battersea Alliance and Roehampton Hub are awaiting confirmation of that.
One of the projects hasn't been formally reported because the work is still ongoing
and they're working with Roehampton University on the evaluation.
We're going to be closely looking at that because we're really keen to also understand
from a system perspective what's the value from the system, how we really, from a social
return on investment perspective.
So where anecdotally we know working with our seldom -heard and seldom -served communities,
those that are working more closely with those communities absolutely are saving us, the
statutory organisations, money.
but we are keen to be able to actually demonstrate that using a recognized formula process.
So we're going to be working with WCA who are working with Roehampton University
to help us think how we can maybe apply some of that learning to the projects that have already taken place,
which I'm sure will be very valuable, particularly for the neighbourhood health work that's imminent.
Again, a big thank you to those communities, not just the community organisations, so not
just the ones that were awarded, those that actually expressed an interest in the first
place, but particularly those that were awarded because the work that they have done has been
extremely valuable to those communities.
And also a big thank you to Taslim Sadiki, who works in my team, who is very, very supportive
and also has been working with those organizations in terms of their reporting and the impact.
And so for this group, it's really to note the activities that have been completed as
well as the impact and the closing down of the Health Inequalities Fund 2325.
Thank you.
Thank you, Mary.
And just to add one sixth penny worth, I mean, I thought the projects were all very, very
they ought to live if they had high outcomes.
Of course, it is unfortunate the money isn't available
to continue a number of those projects, et cetera.
I think a number of the organizations are looking
for alternative funding, and that's correct
because any funding which comes from any part
of the public sector should obviously be based
on the principles that the project should become
sustainable in the much longer term, but I do know that some of the organizations are
struggling a bit to fund some of these activities.
But having said that, any comments on the inequalities fund?
Jason?
First of all, perhaps I should have done this at the beginning.
I should declare an interest because, as Mary alluded to, WCA was a beneficiary of some
of that money and actually we actually distributed most of the money we got into other voluntary
sector organisations and I think whilst this fund has sadly come to an end, I think people
inside and outside of the ICB lament that.
I hope that this is, from the learning from this, we can actually use that as a business
case inside and outside of the public sector to really demonstrate the value of some coordinated
community approach to addressing issues in a way which is like what I would call the
Heineken effect, the places that other people can't reach.
And I think we have learned that from this work.
So I think it's great to everyone who's been involved on all sides of the statutory divide.
So it's a shame, but it's been great.
Yes, and Eve, your points are very well taken.
So this is essentially an historical report, and it has been through various other channels
before, so I'm sure it's not new to most of the people around the table.
If there are no further comments, can we agree to note the report?
But with thanks to all the organizations who used the money so effectively.
Thank you.
Right, good.

12 Better Care Fund Quarter 3 2024-25 Update (Paper No. 25-218)

So now on to item 12.
Twenty -seven minutes to go.
Twelve, Better Care Fund, quarter three update.
And I believe, Brian, this is your baby to talk about in the absence of Lynn.
Thank you, Chair.
So the first thing I'd like to introduce to my colleague, Sarah Rushton from the ICB,
so the BCF is a jointly delivered plan, and so we're hopefully jointly delivered these
two items.
I did hear 27 minutes.
Oh, beg your pardon.
So I'll take the quarter three item as read.
To Stephen's point earlier about showing impact, if I just point you,
this is the only point I'll make about this report, to page 306.
So point nine, which is a blue and yellow table.
And there's quite a lot of numbers there.
So, effectively, what that is showing is, compared to our plan,
In terms of people and responsiveness for intermediate care services, discharge people.
We saw the sort of numbers of people that we expected to see, which is, so for quarter three was about 1 ,000 people.
But actually what we did is we managed to reduce the average length of discharge lay by a day and a half.
And that's one of the things we're reporting to the center,
is actually we appear to be sort of getting better at things and we're using this as direct
evidence in terms of the effect that the BCF is having. Other than that I'll ask for any
questions at this stage and then I can move on to the, or Sarah and I can move on to the
25 -26 planning. Brian's done my job for me so any questions?
Okay, so we can skip the first here and move on to the second.
Wonderful.

13 Better Care Fund Planning for 2025-26 (Paper No. 25-219)

Okay, so in terms of 2526, so we had the instructions for the BCF that came out on the 30th of January,
And we had until the 3rd of March to put a draft submission in together, so agreed across health and care.
Until the 31st of March to actually have that agreed by the chief
exec of the ICB and the chief executive of the council.
So there are some changes in terms of the BCF for 25, 26.
So the objectives remained much the same, supporting the shift from sickness prevention and supporting people to live more independently at home.
So some of the funding was simplified, although actually the funding we saw in previous years, which was about 5 .6%, was heavily reduced.
And so we received 1 .7 % inflation on one section only of the BCF, which was the minimum energy
risk contribution.
So actually we saw a lot less growth.
And this is following 23 to 25, where we saw the discharge fund being part of the Better
Care Fund, which obviously created quite a lot of money to be able to support people
to be discharged with.
In addition, the metrics have changed, so no longer have we got avoidable emissions,
falls, re -ablement and discharge usual place residents.
Those have been replaced with overarching measures which are much more ingrained in
the total work of urgent emergency care, such as the reduction in emergency emissions for
people over 65 or 65 and over, and the reduction of the average length of discharge delay known
as a discharge ready date, as well as reducing the number of people going to long -term residential care.
So these are pretty ambitious targets.
It's about 5 .6 % reduction in emergency admissions for over 65,
17 .7 % reduction in average days delayed between when someone is ready to be discharged to when they are discharged.
So that feels pretty ambitious, doesn't it?
and a 6 .7 % reduction in people being admitted to long -term care in care homes,
as well as an overall reduction by pathways, as I described for the quarter three, building on that
reduction in discharge delay from the position, from the achievement that was reached in
at the end of 24 -25 onwards into 25 -26. So that's why I'll pause and I'll hand
over some of the financial elements to Sarah. Thank you Brian, Sarah Rochton, Head of Primary and Community Care Development and Delivery for the ICB
covering the Mettan and Wansworth. So we just wanted to give a flavor of some of the work
that the BCF funds in Wandsworth.
So we categorize schemes that are
supported through this funding.
And it is a significant amount of funding, nearly
56 million pounds in year, into various primary objectives.
So a large proportion of the money
is spent in the area of proactive care
to support patients, service users with complex needs.
And services within that might include rehabilitation,
rehabilitation, reablement services, support for care homes, Age UK, better at home services
are supported through that area, social care work into integrated neighbourhood teams.
Another large proportion of the funding goes into helping to reduce the need for long -term
care and money might go to schemes including such things such as supported living and home
care.
And as Brian has alluded to, many of the schemes
support timely hospital discharge.
So we're looking at things like our Quick Start reablement,
short -term bridging care for patients leaving hospital,
and hospital social work teams, as well as our rehabilitation
services in the community.
Another large area of spend for the BCF
includes the home adaptations and tech.
And in there are things like community equipment,
which is a significant area of spend for both health
and social care through the BCF.
And also through the Better Care Fund,
we support the unpaid carers work,
so services to support people who
are supporting others who couldn't manage without their help.
So we just wanted to give you a flavor of the kinds of schemes
that the Better Care Fund is enabling.
And we'll just open it out now to any questions.
Thank you.
Questions?
Comments?
Yeah, Judy.
Yeah, thank you.
I guess it's more of a comment.
I mean, it's really good to see all this.
And I've got to confess, I haven't read all the way
to the end of this report because there were so many pages.
But I think you're doing,
I've got a 91 -year -old father in Oxford,
and he is getting all this sort of support.
He's got polls, he's got walkers, he's got this,
he's got that, all these things,
which is keeping him out of hospital,
definitely keeping him out of care.
So it sounds like that's exactly what you're doing.
So fantastic.
Do you think you can meet your challenging targets?
And also somewhere in one of these reports, I noticed that we have a really high level
of falls.
So I wondered what we're doing about that, because that would feed into that.
So yes, absolutely, that's what that's for.
And we have a wide range of revision in Wandsworth.
I think some of the work around the Better Care Fund is ensuring that as joined up as
possibly can be and to manage that integration work so that actually
people like your father haven't got to worry about care coordinating
themselves, that actually integrated services can manage that
and that's the world we're moving into now. In terms of falls, so falls
prevention is funded by the BCF and the BCF is a step within health and
Wellbeing Strategy.
So there is a slight anomaly with the rate of falls
in the borough where, because we have quite a lot of people
moving between Chelsea and Westminster, West Middlesex,
they run two different clinical systems.
If you have a fall and you're admitted
into Chelsea or Westminster, and you're then transferred
into Westmid in the data, you're counted twice.
So which is a problem that I believe is talked about
as part of the health and care plans.
About 25 % of people are counted twice,
which we're trying to work with locally.
But putting that aside, we still have too many falls
in the borough, and we still need to work
with our care homes and our care and support teams
to try to mitigate and reduce that
as much as we possibly can.
So in terms of maybe reaching your really challenging
targets, are we likely to be able to?
So, I really hope so.
So, these targets were put together with St. George's and others in terms of building
on the work that's happening in the UEC program at St. George's.
So, it's around making sure urgent care,
urgent community response can manage people to avoid admission.
It's about LES, you know, C and T is about criteria to admit.
So does someone need to be admitted or can they have support to avoid that admission as they turn up in emergency departments?
So it's built around plans and plans that St George's Hospital have helped us with and agreed plans.
So there are plans and schemes and programs behind the headline numbers.
it's still a challenging target.
It's absolutely still a challenging target.
But it's, I guess the tricky thing is if we don't
set ambitious targets for ourselves,
we sort of end up doing what we always do.
Sean, Nico, and then Ariane.
Thank you.
So I am chair of the Public Health Quality Assurance,
and falls prevention and falls is something
That's very much on our radar.
And also I do support healthy aging.
One of the things I'm aware of is that the ICB funds two -thirds and the council fund
a third in terms of the work.
But there's been some changes in terms of us trying to really understand the plans.
I think my understanding from my team member is we're trying to understand the service
and the contract and the service specs.
So I just wanted some assurance from you around what's happening in that space.
How can we influence it and where there's been changes in personnel?
What kind of pathway we have and this is really in Wandsworth if I've understood this, right? Thank you. Thanks, Nick
I'll take that one. So I think we'll we'll catch up outside the meeting because indeed there have been some changes in
Personnel and so I think if we catch up separately, I think that would be useful to remake remake some of those connections
Thanks very much. Yeah, thanks. Actually, I'll be quite interested in that as well. I written
I just wanted to add in response to all the work that's being done from a primary care perspective, we also have additional channels.
There's a unique program to Wandsworth, or relatively unique, called the Rapid Response Program funded by the ICB,
which encourages GPs to make capacity to see patients within a two -hour call.
So as well as this whole new system of total triage, if a patient calls in for a home visit,
primary care is increasingly able to visit the patient, either through GPs or paramedics, within two hours.
And this again is aimed to support our colleagues who are using the Better Care Fund.
Within George's, you know, one of the services they offer is something called the OPAL team,
which again is trying to avoid admission for older patients using the senior health team.
And then in primary care where there are patients whose complexity is so great
that it's beyond our capacity working from our surgeries to look after them and prevent admission.
There's also the hospital at home or complex care team that are commissioned through CLCH.
And again, you know, their capacity is finite, but they will take on very complicated cases,
challenging cases where admission avoidance is the primary aim.
So it's multi -pronged.
It's really good to hear actually.
Yeah, please.
Yeah, thank you, Ari.
That was indeed.
Yeah, the Chancellor did actually announce in one of the two statements,
I think it's probably sort of an extra two billion pounds,
which was actually entitled to going to social care,
which is actually being channeled through the NHS
into the better care fund.
So needless to say, extremely interested
to see how that works out and exactly results in.
But on the one hand, it obviously sounds like good news.
On the other hand, of course, we need to ensure
that the money is actually directed
where it's actually needed.
So I'm not in this to say I'm all in happy
to get involved in that.
So, having said that, we have a report
from the Better Care Fund planning for 2025 -26.
This is for decision, such excitement.
So there are three recommendations.
and agree the plans for submission
to the Better Care Fund program in accordance
with national requirements, et cetera, et cetera.
Note the demand and capacity plans for intermediate care
and the ambitions for the BCF matrix in 2526.
And a thirdly note that the section 75 agreement
will be prepared to govern the pooling of the budgets
and embed the partnership arrangements
as set out in the report.
And that's essentially the pooling of funding
from local government and from NHS.
Can we agree those points?
Thank you very much indeed.
Right, now we move to one of the things

14 Pharmaceutical Needs Assessments 2025 (Paper No. 25-220)

which is very specific in terms of statutory duty,
and that's a pharmaceutical needs assessment 2025.
And Shannon, you're leading on this.
or Nikkei, Nikkei, thank you.
Thank you very much, and thank you very much
for adding that statement to the statute of function.
I will take the paper as read,
because what I would like to do is,
we are working at pace, so I'd like to update you
as to where we are right now.
So can I first check if there are any questions
from what we outlined in terms of the health
and wellbeing board, letting you know what we're doing
in terms of the date change, doing it sooner rather than later in terms of we were supposed
to be 2026 and we're doing it now later this year.
You're commended for the brevity of the report.
Thank you. So just in terms of, we're very aware, Councillor Henderson, we followed your
brief, you and Jeremy's brief, very aware of it and we aim to work to that very high
standards our boss gives us. So what I – oh, gosh, sorry about this. Now my phone goes
off. What I want to update on is that as you know, the PNA is a statutory requirement and
it's meant to be done within three years. We are doing one across all six boroughs,
five boroughs. One of them is not part of it. And we are leading that from a commissioning
perspective. So first of all, as Shannon would say, without patting ourselves on the back,
We've done really well in leading the whole process and getting all of these five PNA's
done.
So where we are now is that a draft PNA has been produced.
It has been signed off by the Director of Public Health, the delegated authority from
this, from the Health and Well -being Board.
And there were no gaps identified in Wandsworth.
It's currently going through its final tweaks and proofing in preparation for consultation.
and that draft PNA consultation will start on the 7th of July,
because we have to have 60 days consultation until the 7th of September.
So what we really want to urge the Health and Wellbeing Board, if we can,
and we're working hard on that with our comms team,
with the different groups we have who help us get information out,
is to ensure that consultation is as wide as possible in all our residents,
and we're working hard to also ensure that our,
what's the word I should use,
the places that where we don't get responses from,
we're really trying to get that.
And once that happens, we will have,
we'll update it, amend the document
and sign it off on the 17th of September.
And then it will come to you.
And once that's all fine,
it will then go out for publication
on the 1st of October, 2025.
So the key things I want to highlight here are one, we have a draft that has been read,
signed off, we've had a meeting two days ago to really go through all of it with a fine
tooth comb.
The next thing is to go out for consultation.
We are not producing an easy read of this particular PNA documentation because it's
very big and it's very expensive.
So what we are doing is using the PNA, the easy read we did that describes the PNA and
been asking people to let us know if they want an easy read or something or somebody
to talk, take them through the document. I think it's about 135 pages long and when we
just did a six page it cost about two thousand pounds so it would be quite expensive to do.
And to reassure you we had nobody want, nobody requested the easy read so we didn't have
anybody asking for the easy read. I'll just check my notes here to see if there's anything
else I wanted to add. Nope, and I think that's all we wanted to bring to your
attention today. Thank you.
Okay, thank you very much for that. Obviously this is something we should take everything seriously
cause, you know, this is a statutory requirement on health and well -being
board to assess pharmaceutical needs, which is absolutely correct because
certainly in recent years, pharmacies have certainly become a much more important cornerstone
of the NHS, something which I personally think should have happened a very long time ago
in common with a lot of continental countries.
So having said that, are there any further comments?
So sorry, one thing I should have mentioned, because we have Health Watch here, is I also
I also want to thank Health Watch,
the National Health Watch and the local Health Watch
for the attention they've paid and the support
they've given to really make PNA actually very local
and useful and reflective of the needs of our population.
They've gone, really put a lot of effort into doing that.
So I think they should be mentioned.
Thank you, Steve, and perhaps you're going to pass it
on to officers.
Do pass it on to officers, and Judy.
Yeah, thank you.
Just in terms of the easy read,
isn't that something AI can do for you?
Very quickly and free.
But actually my actual comment is how are we getting
this out to all the people that might be interested?
So can it go out to counselors and through our council comms?
Perhaps, I don't know if you have a mailing list.
Anybody that's got a mailing list.
St. George's has a membership.
I don't know how many, thousands.
but you know, it could go out to people that might be interested.
The answer is yes.
There's a whole comms industry around it,
and we also have to think of our neighbouring,
because if you live on the edge, you go to a pharmacy outside you.
So that's all part of this whole P &A process.
Our comms team are very much involved in it,
and yes, but having said that,
it's still always helpful to know if there's anywhere else
or any other mechanisms that you're aware of
that we can put this through.
So, yes, thank you.
If there are no further comments,
it should also, for decision,
the first is noting the approach.
Really, the main decision is the second one
to agree to delegate the sign -off
of the draft version of the PMA
to the director of public health, et cetera.
And to note that the Health and Wellbeing Board
will receive a final P &A version to sign off
for four publications.
And we'll come back to you.
But can we agree that action to delegate the draft
sign off to the director of public health?
Thanks a lot.
Cheers.
Right.

15 Work Programme (Paper No. 25-221)

an alternate item, five minutes.
The health and wellbeing board work program, Fousey.
Go on to this, you have three minutes.
Fantastic, thank you, Chair.
Just very, very quickly, I'm assuming that everybody
has had a look at the work program,
and hopefully you've been able to see
over the last few cycles of health and wellbeing board
that the meetings are starting to be themed
across the life course.
You will see that for the one in September there's a bit more of an emphasis on age well.
So taking on board some of the comments about specific questions and themes, Jason and team you might want to have a look at the work program.
There's an opportunity to bring forward some topics for our seminar.
So in September the voluntary sector are leading on health inequalities and learning disabilities.
but we've got a space for February the 5th for a theme so I invite members to
provide comments and contributions to Lin wild
thank you very much the anything I would say on that again and if we are going to
try to move away from receiving those of reports is obviously quite a number on
for the 25th of September.
But as I said, I mean, I think if we circulate them
as when they come available,
but I would certainly encourage all members
to give their opinion on which ones
they particularly want to discuss.
So hopefully we can actually develop
a sort of richer conversations around the key priorities.
But having said that, is there anything on that list of topics which people find need
to agree with the FUSI?
I was just going to say very quickly, so the plan for September is to share some of those
reports in the form of our board bulletin, but as in courage, we really do encourage
members to engage with that and really put forward questions.
So that would be a way of minimising the load at the actual meeting.
I wonder if at some point, possibly in seminar mode, I don't know, it would be sensible to
have a discussion about neighborhood health, which is clearly a sort of big driver.
And I think it's very material to this board because it is also seen as one of the key
vehicles for bringing health services, social services, and all the different players together.
So, but it's all very real, real term,
it's happening in real time.
So, a discussion of where we are
and how it's working out in Wandsworth
would be really useful, I think.
Yeah, I entirely agree.
I think that we will take this sort of list away
and as chair and I'll be having conversations with officers
as how we can achieve the best balance
between topics for discussion,
where we can do a bit of a deep dive,
and the formality of having to receive certain papers,
but yet I entirely agree with you.
This is, on the one hand, a very exciting development,
but we obviously need to give you some assurance
in terms of how it is being rolled out in Wonsworth.
Good, okay, so with that said,
And for the time being, if we can note the proposed
suggestions, draft agenda items for September and December.
And also the proposed seminar on September 11th,
health inequalities and disabilities.
And hopefully there will also be one
on February the 5th next year.
If we can agree that, we now move to item 16,

16 Date of Next Meeting

I hope it's not particularly controversial
because we've only got two minutes left.
So the next meeting will be held on the 25th of September.
And as I said, we will look at how the agenda
is actually sort of playing out.
So if we can note that, can I just simply sort of thank you
for your forbearance.
We have got to the end within two hours.
Is this something I'm sort of particularly happy with?
because we've received a lot of information,
a lot of important topics,
but I've always felt that the really rich conversations
that we do have in the health and wellbeing board
occur when we have fewer items,
when we are much more focused.
There's an enormous amount of experience,
professionalism around this particular table,
and I think we need to bring it together
in a much more focused way, rather than just simply
checking off the whole number of reports.
So, with that said, it's three o 'clock, two hours.
Thank you very much.
.
.
.
.
Thank you.