Members are reminded to consider the categories of interest in the Code of Conduct for Members to determine whether they have an interest in any agenda item and any action they should take. For further details, please see the attached note from the Monitoring Officer.

Members are reminded to declare the nature of the interest and the agenda item it relates to. Please note that ultimately it’s the Members’ responsibility to declare any interests and to update their register of interest form as required by the Code.

If in doubt as to the nature of your interest, you are advised to seek advice prior to the meeting by contacting the Monitoring Officer or Democratic Services

No declarations of interest were received at the meeting.

(a)          Item 3.2 Older People's Care Homes - Support During the Covid-19 Pandemic

v  Reminded the Sub-Committee that there had been a discussion on the Support for Older People’s Care Homes during the Covid-19 Pandemic with particular regard to review covered the period 13^th March – 30^th June 2020. This review had identified the following areas of good practice (i) The Councils proactive response that frequently going beyond national guidance and anticipating future guidance bulletins; (ii) Positive partnership working at both the strategic and operational levels; (iii) A strong commitment to multi-disciplinary and multi-agency learning; the lead GPs and Infection Control Nurse in particular were highlighted as key resources by the care home providers; and (iv) Embracing of digital and online technology as a new way of working.

v  The review also made the following recommendations (a) Build on the good partnership working to develop a multi-agency and multi-disciplinary Covid-19 or pandemic pathway with detailed and clearly defined roles for different agencies to address any future wave of the virus or new pandemic as part of the Tower Hamlets Outbreak Control Plan; (b) Develop a formal communication strategy to promote the pathway to a range of agencies and to families and carers, identifying a clear role for the voluntary sector in engaging with and hearing the voices of service users and their families who are necessarily powerfully impacted by the situation.

v  Finally, that the key priority over the coming month would be the implementation of vaccinations; the focus being on increasing uptake amongst staff and agreeing timelines and logistics for the administration of second doses.

(b)          Development of Scrutiny

v  Members should be aware of the work of other committees and boards, as there are many crosscutting issues.  Members need to continue to be mindful of any equal opportunities and sustainability issues and how equality and sustainability have been considered during the Covid pandemic such as any mitigating action taken to support delivery and or access to provision of services in light of the pandemics impact and the increasing need for reinvestment in resources and services, e.g. health and social care to education and infrastructure.

To confirm as a correct record the minutes of the meeting of the Health Scrutiny Panel held on 8^th February 2021.

The Sub-Committee confirmed as a correct record the minutes of the last meeting of the Health Scrutiny Sub-Committee held on 23rd July 2020.  The Chair was authorised to sign.

The Sub-Committee received a draft Health and Wellbeing Strategy 2021-25 that had been refreshed and outlines the vision, priorities and action agreed by the Health and Wellbeing Board (HWBB) to improve the health, care and wellbeing of local communities and reduce health inequalities for all ages.  The questioning on the main points of the discussion on the Strategy may be summarised as follows.

The Sub-Committee:

v  Remarked that the consultation phase of the Health and Wellbeing Strategy 2021-25 had been launched on 16th April 2021 and noted that it is scheduled to last around eight weeks.

v  Expressed interest in looking further into the ‘safe social spaces’ ambition as set out in the draft Strategy 2021-25 so as to help shape the final strategy expected to be finalised in the summer of 2021.

v  Commented that it wished to see the consultation giving consideration what is being done to address residents’ concerns (i) following the murder investigations that are underway following fatal stabbings in Poplar and Canning Town; and (ii) in regard to addressing the high incidence anti-social behaviour in Tower Hamlets.

v  Remarked that the Board is working with partners across the borough, including the Council’s Public Realm team and housing associations, to reduce traffic levels and make the best use of local land/spaces. The Board wants to ensure that all residents are owning and using local open spaces to lead active, social lives – whatever their age, sex, ethnicity, health condition or locality.

v  Was informed that the Board will work with health, social care, and wider community services across Tower Hamlets to improve/create networks across organisations and improve visibility and proactive communications between services and those who need them most.  Therefore, the aim is that anyone needing help will know where to get help and they are supported to find the right help.  The Board will facilitate this by the creation of networks across organisations and improve visibility and proactive communications between partners services and those in greatest need of these services.

v  Noted that there have been dramatic improvements in air quality, especially for nitrogen dioxide (NO2). However, the Borough still has multiple pressures on health and wellbeing particularly for children and pensioners who have poverty rates 3-4 times above the national average and the highest rates of poverty in London; toxic air pollution; poor diet and limited activity.

v  Commented that there are multiple pressures on health and the toll from these pressures is dramatic, and particularly impacts girls and women in the Borough e.g. girls born in Tower Hamlets have just 56.6 years of healthy life expectancy, which is 7.3 years less than the England average. Whereas boys have 60.5 years of healthy life expectancy, which is 2.9 years below the England average.

v  Noted that organisations, resident groups, and community leaders have led impressive programmes to combat these issues. However, more needs to be done and the Covid pandemic has resulted in a recognition that the Council and its partners will not change  ...  view the full minutes text for item 5.1

This report provides a summary of the work undertaken by the Black, Asian & Minority Ethnic Inequality Commission and provides details of some of the main findings and recommendations from the health theme of the Commission. The questioning on the main points of the discussion on the Strategy may be summarised as follows.

The Sub-Committee:

v  Acknowledged that Tower Hamlets has always been a borough committed to creating a cohesive, fair, and inclusive community. One of the Borough’s’ biggest strengths is its proud history of fighting racism and fascism and its continued commitment to diversity. With over 137 languages spoken and 43% of residents born in over 200 different countries Tower Hamlets is one of the most diverse places in the country.  However, recent events have once again shone a spotlight on racial inequality and has required that everyone including leaders of public, private, faith, voluntary and community sector organisations and institutions, to consider their position and what more must be done.

v  Noted the disproportionate impact of Covid on the Black, Asian and Minority Ethnic population has exposed the severe consequences of the unacceptable structural disadvantages and discrimination faced by these communities especially in key areas such as housing, employment, education, and criminal justice.

v  Noted the constraints of structural racism are most apparent when considering health outcomes of the Borough’s Black, Asian, and Minority Ethnic residents which are worse than those of White residents in many areas, with many Blacks, Asian and Minority Ethnic residents suffering from a higher burden of multimorbidity.

v  Observed a considerable emphasis needs to be placed on improving the partnership approach to tackle the wider determinants of health, with too many Black, Asian, and Minority Ethnic residents experiencing poorer employment and housing conditions.

v  Indicated that access to health services needs to be improved by ensuring services meet the cultural needs of the Borough’s diverse communities and developing strong and effective relationships with these community.

v  Was reminded that digital exclusion is a prevalent access barrier, exacerbated by the pandemic, alongside ineffective communication, and inadequate translation services.

v  Agreed that the need to work with the local Black, Asian, and Minority Ethnic communities should be at forefront of the Boroughs recovery agenda ensuring that Tower Hamlets using good ethnicity data to provide targeted programmes  is able to deliver real improvement in health outcomes.

v  Noted that whilst Black, Asian, and Minority Ethnic children are achieving good academic success however this has not translated into careers in the professional, corporate world.

v  Commented that many children from Black, Asian, and Minority Ethnic families lacked the confidence and networks to compete with their White peers. Too many young people from Black, Asian, and Minority Ethnic families are unfamiliar with the testing and recruitment processes employers undertake, and have not been exposed to the professional, corporate world.

v  Indicated that key local employers must consider how they can develop pipelines, structures, and support to engage Black, Asian and Minority young people and how they can accelerate the  ...  view the full minutes text for item 5.2

The purpose of this report is to give an overview of the progress update on health and social care integration in Tower Hamlets, including (i) An overview of developments within the Northeast London Sustainability and Transformation Partnership (STP) arising from the NHS Long Term Plan; (ii) Successful service transformation to deliver integrated health and social care in Tower Hamlets; (iii) Changes to the borough based partnership Tower Hamlets Together and local governance arrangements; and (iv) Future proposals for enhancing integrated health and social care delivery in the Borough.. The questioning on the main points of the discussion on the report may be summarised as follows.

The Sub-Committee:

v  Was advised that the system has undergone some significant change recently, especially at the CCG and system levels, due to implementation of requirements set out in the NHS Long Term Plan.

v  Observed that the first part of the report focused on the direction, achievements, and ambitions of the THT Partnership, with the second part outlining the new structures that are now in place.

v  Was informed that THT partnership pools together £760 million across partnership and Council’s contribution is estimated as £120 million

v  Requested to have breakdown of the budget and overspend to review and discuss further

v  Noted that THT is a formal subcommittee of the Health and Wellbeing Committee

v  Noted that with regard to its role in this area that it has a responsibility to ensuring that health services are held to account at the local level and are answerable to local communities. These include requiring representatives of NHS organisations and providers of NHS services to attend meetings to provide information from NHS organisations about their commissioning or providing strategies, plans, budgets, and activities.

v  Noted that an integrated care system in Tower Hamlets will improve patient outcomes and ensure quality care at the minimum necessary cost.  It will also provide more responsive, coordinated, and proactive care and to enable high-quality care that responds to patient/service user needs rapidly in crisis situations.

v  The integrated health and social care system will also empower patients, users, and their carers; enable patients and service users to live independently and remain socially active; establish education and self-care programmes for patients; and personalise care to patients’ and service users’ needs and preferences.

The Chair Moved and it was RESOLVED to:

1.            Thank all those attendees for their contributions to the discussions on the integrated health and social care system in Tower Hamlets; and

2.            That these discussions would form the basis of any feedback to be submitted regarding the integrated health and social care system in Tower Hamlets.

3.            Request that THT meetings to be listed on the Council calendar with agenda to be made public

4.            Request that the Committee be provided with a breakdown of the council’s contribution to THT budget with a better understanding of overspend to review and discuss further

REASONS FOR URGENCY

The report was not published five clear days in advance of the meeting. This is due to the additional time required to review the report in order to provide the necessary clearances.

Adults Learning Disability Scrutiny Report_final 27.04.2021.pdf (towerhamlets.gov.uk)

The Sub-Committee noted that a Health Scrutiny Challenge Session had taken place on the 10th of March 2020 reviewing “How health and social care is supporting adults with a learning disability to live independent lives in Tower Hamlets”. The questioning on the main points of the discussion on the Strategy may be summarised as follows.

The Sub-Committee:

v  Noted that this scrutiny session had focused on three main areas of the Learning Disability Strategy: Health, Accommodation and Employment.

v  Noted that the challenge session report had been compiled providing documentation of the sessions and including recommendations to be actioned upon, however sign-off of the report was delayed due to the outbreak of the Covid-19 pandemic in the UK.

v  Raised concerns around the scope of reports when substantial departmental changes occur.

v  Noted that the priority action plan should have recommendations attached, but due to capacity of the team it was tabled as circulated.

v  Raised concerns around mortality rates and screen numbers.   

v  Noted that due to the profound impact the pandemic has had on the country, this report has been updated against the 10 March 2020 position and includes an impact assessment of the pandemic for the learning disability population. Following discussions on this at the 8 February 2021 meeting, a number of new recommendations have been added to the final report.

As a result of discussions on this report the Health and Adults Scrutiny Sub-Committee RESOLVED to:

1.            Note the report which included the spotlight session held on 10 March 2020 and following scrutiny meeting held on 8 February 2021.

2.            Note the final report and recommendations

3.            Agree to delegate decision-making on any final minor amends or additions to this report to the Chair of the Health and Adults Scrutiny Sub-Committee.

4.            Request that an update come back to the committee in 6 months

Nil items