The Chair Councillor (Deputy Mayor and Cabinet Member for Adults, Health and Wellbeing) welcomed everybody to the meeting. 

To confirm as a correct record the minutes of the meeting of the Tower Hamlets Health and Wellbeing Board held on. Also to consider matters arising.

That the unrestricted minutes of the Tower Hamlets Health and Well Being Board held on 13^th January 2020 were confirmed as a correct record and the Chair was authorised to sign them accordingly.

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

No declarations were received.

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The Board received a presentation providing a summary on the Covid- 19 epidemic in Tower Hamlets and the current. The main points of the discussions may be summarised as follows:

The Committee noted that:

• The Covid-19 epidemic has dominated the Councils workload and priorities since the crisis began and the lockdown was in place.
• The Mayor John Biggs wished to place on record his thanks to all the health practitioners;  community activists and council officers who had been working hard on guidance for businesses on making workplaces 'Covid secure’.
• The Council are continuing to work with partners across Tower Hamlets to help tackle the spread of the virus and to make sure that residents, particularly those most vulnerable, are given all the support they need.
• Over the past few months, the communities of Tower Hamlets have come together to respond to an invisible challenge. However, it is at times of challenge that we also see the very best of the human spirit and in every corner of Tower Hamlets people have been working together from across the Boroughs diverse communities to tackle coronavirus have selflessly putting their hands up to help others;
• The local response to the pandemic has been second to none. It has been incredibly heartening to see so many volunteers, community groups, partner organizations and council staff working together.
• With regards to the development of recovery strategieswe still do not know precisely what that means in terms of the new normal. Therefore, there needs to be a dialogue about what we can learn and how we can protect our community. Especially when considering the anxiety about the differential impact on groups of people across the country e.g. older people with chronic health conditions and the differential impact of Covid-19 on BAME communities.
• The Council, stakeholders and partners need to consider how they can give guidance to people across communities to help recover from this pandemic.
• It is important to understand people’s circumstances e.g. their employment status; where they live; and personal health needs. Then to build a matrix of support for residents to keep them  safe and to prepare to address any future recurrences.
• With regard to Safeguarding adults (i) there has been a higher than anticipated deaths of people with learning disabilities; and (ii) there is a need to look at some of the reasons for people have been reluctant to come forward for their health checks; (iii) the Black Asian Minority Ethnic communities higher levels of health need is also an issue that needs to be considered; (iv) how to shield those in this vulnerable category;
• It is recognised that there is an ongoing risk of further waves until an effective vaccine is available. Therefore, it is likely that until then a combination of current measures will continue to some extent depending on levels of Covid-19 in the population (social distancing, hygiene, test and trace, shielding); There remain important unknowns e.g. likelihood of reinfection, transmission of people with no symptoms. Hence, the challenge going  ...  view the full minutes text for item 4.1

The Board received a presentation from Healthwatch providing a resident’s perspective on the health and wellbeing in the COVID-19 pandemic  A summary of the discussions is outlined below:

The Board noted that:

• Healthwatch was in the process of carrying out a survey online and on the phone.  They have also analyzed comments received from local people via telephone and email, NHS Choices, patient opinion, and social media.
• The internet plays a crucial role in how local people cope with the pandemic. Relatively few of those Healthwatch spoke to are digitally excluded; they tend to be older, more deprived, non-White and in poorer health.
• More than half of survey respondents used the internet to stay informed about keeping themselves safe during the pandemic.
• The Government website, the NHS website, BBC News, and social media were important sources of information. While most respondents found it easy to stay informed, some did voice concerns about contradictory or unclear advice.
• Online support groups represent a useful resource for local people to organise and offer advice.
• Access to food (including supermarket shopping among neighbours and support for vulnerable people struggling to afford food) is one of their main areas of concern.
• Patients hospitalised with Covid-19 reported a good standard of care. Although there were apparently reports of inpatients with other issues being discharged prematurely to free up beds for Covid-19 patients.
• Residents had found pharmacy staff to be helpful and supportive, but admin and communications problems happen, particularly in relation to repeat prescriptions and third parties picking up medicine.
• Primary care professionals, including GPs and 111 dispatchers, are not always able to answer patients' queries about Covid-19, as it is a new phenomenon and many aspects are unknown to the scientific community. This causes further worry to patients.
• Some community psychotherapy/mental health support services continue remotely via telephone while others are subject to cancellations. Patient opinion of telephone psychotherapy sessions vary. Complex patients under the care of Community Mental Health Teams can feel particularly unsupported.
• New and expecting parents are apparently experiencing disruptions to maternity and neonatal services, including some cancellations to antenatal and postnatal appointments, and delays in registering babies with a General Practitioner.
• Younger people living with a mental health issue, living alone or with housemates were more likely to experience social isolation.
• Those living with relatives other than their spouse and those experiencing financial precarity were more likely to have tense or unpleasant relations with members of their household.
• Most of the survey respondents who were in work worked from home. Some adapted without issues, while for others it was more challenging; particularly for those with childcare or adult care responsibilities and those who struggled with mental health issues.
• Affording their housing was a major concern for those experiencing loss of jobs or income; the economic downturn increased the risk of homelessness, which in turn meant higher vulnerability to Covid-19
• Consideration should be given to organizing neighbourhood-level grassroots groups to act as digital guides for the digitally excluded individuals who are shielding  ...  view the full minutes text for item 4.2

The Board received and considered the following questions from the public which may be summarised as follows:

• Many residents in Tower Hamlets live in a high-rise accommodation and are concerned about social distancing. Therefore, registered providers of social housing need to put up notices in the appropriate type face and reference the need to wear face coverings to limit the spread of infections through respiratory droplets.  In response it was noted that Tower Hamlets Homes have designed a revised safety poster in association with public health colleagues’ arm in consultation with residents.
• How does the Board propose to respond to the development of a primary care led Covid-19 Pathways to Recovery given that the latest reports confirm that particularly those residents with a Bangladeshi background are at much higher risk of severe illness and death? Therefore, Tower Hamlets urgently needs a local culturally sensitive test and trace system in addition to any arrangements made centrally by the government. In response it was noted that the Tower Hamlets scheme is a culturally and language appropriate scheme including (i) the swabbing of the nose(ii); the antibody test and (iii) vaccination for Covid-19 as and when it becomes available.  This local scheme has been developed in conjunction with the Clinical Effectiveness Group at Queen Mary’s, this multidisciplinary team includes GP clinical leads, clinical facilitators, data analysts and researches.
• Regarding the transition for dental practices towards the resumption of the full range of dental provision what is being done to support them to prevent a massive backlog of essential treatment;  In response It was noted that there has been national guidance around dentistry and optometry.  However, regarding the issue of ensure that surgeries are accessible this question will be raised at the regional level as the commissioning of dentistry optometry does not sit with the local Clinical Commissioning Group.
• A draft report from the Independent Scientific Advisory Group for Emergencies (iSAGE) says that the government track, and trace system needs a radical overhaul because it is “not fit for purpose.  Whereas in Tower Hamlets GPs have always been ahead of the game and they were thinking about contact tracing and tracking before it became a national programme
• Tower Hamlets needs to do is make sure the local programme aligns with what is coming through nationally.  However, together the Board Members and Stakeholders can develop a programme for Tower Hamlets that really works for residents and addresses some of the risks of and gaps of the national programme.
• Regarding the disproportionate effect of COVID-19 on BAME communities and risk assessments for the BAME employees. It was noted that one of the key issues is that whilst evidence indicates disparities between communities. It does not adjust for those residents who have a range of medical conditions. Therefore, in terms of risk assessments employers need to identify how people's specific vulnerabilities impact upon any risk assessment which is something that has been discussed by the Councils Corporate Leadership Team.
• It was important to make sure that we  ...  view the full minutes text for item 4.3

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