To note any declarations of interest made by members of the Board. (See attached note of Monitoring Officer).

There were no declarations of pecuniary interests received at the meeting.

To approve as an accurate record the minutes of the Health and Wellbeing Board meeting 17 September 2019.

RESOLVED:

1.    The minutes of the meeting held on 17^th September, 2019 were confirmed as a correct record and the Chair was authorised to sign them accordingly.

Members of the Board noted that they would be receiving details via email regarding the new landscape in social care.  As in recent years, local authorities have reconfigured their social care, separating children’s from adult services and creating new forms of partnerships with Primary Care Trusts and other parts of the NHS. As a result, there is now a wide variety of organisational arrangements in place, and new ones on the way. A new landscape for health and social care is therefore being created.

The emphasis it was noted in the future will be on place shaping and the creation of healthy and sustainable communities; better commissioning and greater productivity are important drivers which have accelerated the pace of change.  There is now a much greater emphasis on prevention through local partnerships for health and wellbeing, and the children and young people’s plans also demonstrate this shift in focus.

The Board noted that every year, the Safeguarding Adults Board (SAB) publishes an Annual Report to set out progress, achievements and learning over the previous year.  It was noted that the attached Annual Report for 2018-19 was agreed at the 12th September Safeguarding Adults Board. The mains points of the discussion are outlined as follows:

The Board noted:

The Chair Moved and it was:

RESOLVED

To note the Safeguarding Adults Board Annual Report 2018-19

The Board received the Tower Hamlets Together – Bi-Annual update. It was noted that Tower Hamlets Together (THT) was established in 2016 and is a partnership made up of health and care organisations responsible for the planning and delivery of prevention, health and care services. The partnership is made up of;

London Borough of Tower Hamlets

NHS Tower Hamlets Clinical Commissioning Group

Barts Health NHS Trust

East London Foundation Trust

Tower Hamlets GP Care Group

Community and Voluntary Sector

 The main points of the discussion were as follows:

The Board:

• Acknowledged Tower Hamlets Together’ s shared principle mission to ‘transform people’s health and lives, reduce inequalities and reorganise services to match people’s needs’
• Noted that the three Workstream of Tower Hamlets Together are the key drivers in establishing system working;

·         Born Well & Growing Well (BWGW) - Children

·         Living Well  (LW) – Healthy Adults

·         Promoting Independence (PI) – Complex Adults

• That the ambition is for each Workstream to have its population segment as a shadow budget from all relevant partner service lines and will be responsible for understanding improvement opportunities to deliver outcomes and manage system performance risk. Over the course of 2019-20 the Workstream have continued to work towards the triple ask: (1) Understand and oversee what is happening now, beginning to use the overarching system outcomes as a lens (2) Deliver against the priorities set by the Workstream (attached to this report as an appendix) which includes developing the outcomes to be achieved (3) Continue with the quality improvement (QI) projects to enable learning about how to use this methodology within the Workstream population cohort.
• That the shared Vision and Priorities have now been agreed by the Board and circulated with the papers and an Independent Chair was recruited and will be in post for two-years.
• That the structure of Board meetings has been developed with the following items now coming to each meeting:

·        Systems Performance Reporting (currently as a dashboard) Community Participation and Voice

·         Workstream spotlight at which one of the three Workstream Chairs are invited to provide feedback on the work undertaken by the Workstream in the previous quarter

·         Enabler spotlight, a six-monthly rotation of THT enablers including; Estates, Workforce, Learning Disability Partnership Board, Mental Health Partnership Board, System Intelligence and Urgent Care.

That coproduction and community voice are both core priorities of the Board and a stakeholder engagement action plan has now been developed

The Chair Moved and Health and Wellbeing Board:

RESOLVED

To note and welcome Tower Hamlets Together – Bi-Annual update.

The Board noted that in 2017 the Cabinet had approved an Air Quality Action Plan (AQAP) that set out the action that the Council will take to improve air quality within the Borough over a 5 year period 2017-2022.  The main points of the discussion are outlined below:

The Board:

• Was advised that an Air Quality Partnership Board (AQPB) was created to oversee the monitoring and delivery of agreed actions;
• Noted that at Cabinet on 31 July,  2019 Mayor Biggs in Cabinet had resolved to move the governance of the AQAP to the Health & Wellbeing Board (HWB) which would then oversee the Air Quality Delivery Plan for the final years of the Air Quality Action Plan to address targeted action on the most affected areas;
• The Board noted that this report sought to inform the Board of the various actions the Council is taking to tackle poor air quality in the borough;
• Noted Evidence on the effects of long-term exposure to traffic pollution with especially for those living in areas with the highest socioeconomic deprivation.  The relatively greater vulnerability of the most deprived populations has important implications for public health in LBTH;
• Was advised that the LBTH the Liveable Streets programme aims to improve the look and feel of public spaces in neighbourhoods across the borough and make it easier, safer, and more convenient to get around by foot, bike and public transport;
• Noted that LBTH want to reduce people making ‘rat runs’ and shortcuts through residential streets to encourage more sustainable journeys and to improve air quality and road safety e.g. the increase use of bikes by patients or simply walking to the Health Centres instead of getting in their cars;
• Noted that LBTH and its partnerswill be looking at the practicalities of reducing journeys to hospitals, there evidence is needed that will drive that change;
• Wanted more information on the impact of 20 mph limit and raising awareness around the number of deaths due to pollution each year;
• Want to raise awareness to mounting evidence that vehicles provide little protection from harmful traffic pollution, and drivers and their passengers may even be exposed to higher levels than on the road outside.  It is especially important to understand the impacts of air pollution on professional motorists such as taxi and lorry drivers, who spend many hours behind the wheel each day;
• Want this report to be presented to the CCG Well Board;
• Agreed that the Council and its partners need to (i) look at how staff can understand how they use their cars for work too; (ii) consider why people will not’ exercise because of pollution; (iii) local people working to address pollution in their areas need to be listened to too so do not feel ignored; (iv) Look at the impact of population on the economy; and
• Agreed that it was important to recognise that many residents feel their children’s breathing issues are more the result of damp over crowed homes than pollution.

The Chair Moved and  ...  view the full minutes text for item 4.3

The Board received a report that presented the draft Tower Hamlets Mental Health Strategy and its associated evidence base for consideration. The main points of the discussion are summarised as follows:

The Board noted:

• The document was developed following the recommendation of the Health and Wellbeing Board in October 2018 to produce a refreshed strategy to cover the five year period 2019-24 to replace the existing strategy that was due to end in March 2019.
• The refreshed strategy seeks to move the strategic approach and understanding of mental health from a medical to a social model across both the Council and the wider Tower Hamlets Together partnership;
• That it had been revised following comment at the Health and Wellbeing Board in September 2019 to specifically draw out the experience of the Black, Asian and minority ethnic (BAME) population within the document.
• The work with Somali Taskforce on this issue and lot of consideration to access to services e.g. large number of Somali under treatment and cultural sensitivity and need to look at the experience of this community in UK; and

The Chair Moved and it was:

RESOLVED

To approve the draft strategy

This will be a verbal update with slides presented at the meeting.

The Board received a verbal update on the Health and Wellbeing Strategy.   The Board noted that (i) it will look at ways for residents to tell their stories around health and well-being; (ii) at the next scheduled meeting there will be a discussion the aims and future direction for the strategy e.g. looking at developing safe places where people can go for assistance.

The Chair Moved and it was:

RESOLVED

To note the verbal update and that there would be a further discussion on the Strategy at the next meeting

Circulated for information only.

The Board received and noted a copy of the Children's Safeguarding Annual Report 2018.  Which would be formally considered by the Board at its January meeting.