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

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

There were no declarations of disclosable pecuniary interest were received at the meeting.

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

The Chair Moved and it was: -

RESOLVED

The unrestricted minutes of the last meeting were confirmed as a correct record and the Chair was authorised to sign them accordingly.

Dr Sam Everington (Vice-Chair) provided the Board with the following:

The Board noted that:

• The vote of the Borough’s GP members practices and on the back of a declaration of some noticeably clear principles has seen move towards the merger of the 7 Clinical Commissioning Groups (CCGs) and the enhancement of the local offer by providing good value for the local population; and

• Tower Hamlets is in the midst of planning Covid vaccination and the message to all is to encourage people to come forward and have the vaccine. All the evidence provided about the vaccine indicates an extremely high chance success and it is important to get this message across to save lives and get everyone's lives back to normal.

Councillor Rachel Blake (Chair) provide the Board with the following:

The Board noted that:

• collectively has won an award from the Local government Chronicle for its work on asthma and how it is helping children to overcome and manage their asthma. The Boards work has demonstrated just how damaging asthma can be you can experience it severely or not severely, but it can really hold you back and the partnership working on Tower Hamlets is something that every Board Member can be proud of and role model for others to follow; and

• The Council has received funding to tackle holiday hunger that through the Christmas and February half term and the theme of child poverty and mental health will come through in some of the topics the Board is considering tonight as it is a key piece of work.

The Board will receive a verbal presentation on this item.

The Chair introduced this item that provided an insight into the Borough’s health and wellbeing story regarding those who are struggling with homelessness, children’s education, and their own health.  The Chair then welcomed Seema Chotye (Team Manager, Statutory and Advocacy Team) and Aisling Heading (Guest Speaker).  The main points arising from the discussion on this item may be summarised as follows:

The Board noted:

• The prompt action by the Tower Hamlets Intervention and Housing Services had, had a massive positive impact on Aisling’s family’s health and well-being.
• That the Services had given the family 110% support encouraging and motivating them, they had been also been put in touch any other agencies/services that could support the family.  However, Aisling stressed to the importance of being willing to act upon the advice and where possible taking the initiative.
• That the family had been supported by the National Autistic Society who had assisted Aisling getting a designation of a “Key Worker” and was working on obtaining a for grant for Aislings daughter to support the family.

• That the recovery of the service post Covid-19 has provided the opportunity: (i) for a different customer experience; (ii) to achieve a higher rate of prevention; and (iii) reduce temporary accommodation placements and associated costs.
• That those seeking help should as mentioned earlier be able to understand the help on offer and access such help through a range of channels, including to self-help, whether on the web or over the phone or from alternative service settings.
• That the presentation was a positive example of collaborative working between Housing; Adult; and Children's services and how they can understand how to work together for the benefit of the communities that the Council and its partners seek to serve; and
• That the physical mental health of families is so interconnected with their environment.

In conclusion, the Chair thanked Seema Chotye and Aisling Heading for their presentation and contribution to the discussions on this issue.

The Chair then Moved, and it was:

RESOLVED that it wanted an update at a future meeting.

The Board will receive an update.

The Committee received an update from Somen Banerjee – Director of Public Health regarding the latest news in respect of Covid-19. The main points of the discussion maybe summarised as follows:

The Board noted that:

• The Borough has three local test sites, Watney Market Ideas Store in Shadwell; one in the Arts Pavilion; and Jack Dash House on the Isle of Dogs.
• Tower Hamlets is to be part of a pilot to deploy new mass testing
• Working with the police identifying areas where those issues around social distancing and responding so that places like markets; parks; and some faith settings in ensure Tower Hamlets was addressing those issues that may arise with a focus on particular settings e.g. care homes.
• There are weekly webinars with residents to talk through the key messages and to hear what the what issues residents are facing.
• The Borough has commissioned engagement work with specific groups of people through Bangladeshi, Somali and disabled people’s organisations; and
• It is important to recognise that the levels of covid-19 in people learning disabilities has been six times as high as rest of the population nationally, so it is important to work with that community.

In conclusion, the Chair thanked Somen Banerjee for his update.

The Chair then Moved, and it was RESOLVED to note the update.

• The Borough has implemented a local test and trace programme which has been commissioned from general practice.
• The other real priority is the clinically extremely vulnerable since going to lock down the advice to then has changed so they were previously advised they could go to work with precautions but now the advice if they do not go to work. Therefore, it is important to be clear about what the advice is going to be for them.
• Tower Hamlets had amongst the lowest levels of testing in London, so it was an important priority that local testing sites are developed.
• Testing sites need to be in those areas where there were lower levels of testing e.g. Shadwell was identified as such a location.
• There are limitations on the places that can be used as local testing sites as they need to meet certain criterion and the Ideas Store in Shadwell was one of those places which has met the criterion of the Department of Health.
• In other places they had been difficulties around queueing therefore there is an exceptionally good queue management but also that people could only attend the site if they had booked a test.
• When you book a test, you are given very clear advice about how you protect yourself and how you protect others e.g. wearing face coverings.
• There has been an issue around access by families to their relatives in care homes and the mental health impact that is having not just on the families but their elderly relatives as well. Accordingly, there has been a pilot in which they are using a rapid testing to enable visitors to see their loved ones.

In conclusion, the Chair thanked Somen Banerjee for his presentation.

The Chair then Moved, and it was RESOLVED to note:

1.    The current use of the Grant; and

2.    The Equalities Impact Assessment.

The Board received an update on progress to date in developing the Health and Wellbeing Strategy, the remit of the Strategy and emerging priorities, as well as next steps and a timeline for finalising the Strategy.

As a result of discussions on the presentation the Board discussed the emerging priorities, and these are summarised as follows that:

• Whilst the partnership does not have all the levers in respect of poverty as it is such an underlying driver of inequality and poor health outcomes
• As an issue across all age groups consideration should be given to mental health and emotional wellbeing.
• Healthy activity and life expectancy should be a priority as it has been shown that physical activity ties into many of the other issues including that of mental health; healthy weight; general health and social isolation. Whilst the Council could take the role of a strategic lead it would be a priority that would include many partners including those in the private sector;
• The importance of social isolation and the impact on mental health needs consideration.
• The Board needs to ensure that all individuals and communities, including the most disadvantaged, have access to and use of Information and Communication Technologies (ICTs).
• The ability to influence access to high quality on time health and social care; and
• As delivery organisations Board Members need to look at how they deliver services to make change happen e.g. what projects and interventions will be needed to set up or enhanced to make those changes happen.

The Board received a presentation from Christabel Shawcross (Safeguarding Adults Board Chair) on the Safeguarding Annual Report 2019-20 that set out the progress, achievements and learning over the previous year. A summary of the discussion is set out below:

The Board noted that:

• Last year we had about 1115 concerns raised and that is a key statistic because looking back in 2016 we only had 720 concerns raised and it is important that awareness is raised by people to report abuse as it is felt that there is still under reporting particularly around domestic abuse.
• There are more concerns about those from the White population and we need to continue to focus on community engagement to raise awareness e.g. where people can go to get advice and support.
• Self-neglect is becoming a growing area of concern
• It is about working with the person and promoting their independence but equally looking at what the person wants to achieve
• There whilst were 6 Safeguarding Adult reviews reported and published last year that does not to mean that there were six incidents last year. These go back several years but there are key issues to be identified from them and brought through to multi-agency learning this year particularly around working in a more systematic way to help those who lead chaotic lives.
• It is important to raise awareness among professionals to share expertise and advice on how to go forward.
• Since the start of the pandemic health and social care has (i) had a focus on safeguarding because clearly safeguarding people being isolated is a key issue; (ii) ensured that people with learning disabilities have support; and (iii) made sure people continue to get their advice from the health service.
• Safeguarding Adults Board has a 5-year strategy that will run alongside that of the Health and Wellbeing Strategy; and
• Going forward one of the key areas will be around developing links with the Children's Partnership e.g. looking at those issues for adolescents coming forward into adulthood.

In conclusion, the Chair thanked Christabel Shawcross for her presentation.

The Chair then Moved, and it was RESOLVED to note Safeguarding Annual Report 2019-20.

The Board received a presentation from James Thomas (Corporate Director for Children and Culture - LBTH) on the Safeguarding Children’s Partnership Annual Report 2019-20 that describe a year of transition into the new safeguarding arrangements for children following a change in the law and the statutory guidance. A summary of the discussion is set out below:

The Board noted that:

• The first of the key changes was that leadership of the Safeguarding Children's Partnership is now a shared by three of the statutory partners and namely the Council; Metropolitan Police Service (MPS); and the Clinical Commissioning Groups (CCGs).
• The second key change was the requirements are for an Independent Scrutineer who provides experienced support and challenge to the partners and is involved in many aspects of the work to ensure the partnership is working in the best way to deliver better outcomes for children and young people in Tower Hamlets.
• The third key change is that the Partnership will continue to manage risk for children and young people in the Borough primarily through a supportive response. Also whilst statutory reviews will be undertaken it will be in a new and different way, scrutinise policy and procedures of partners, set priorities for the partners where the partnership will work collectively to improve areas across safeguarding, provide multi-agency training and guidance and be a platform for partnership.
• The Partnership will continue to manage risk for children and young people in the Borough primarily through a supportive response.
• Benchmarking shows relatively low rates of children in care or subject to protection plans and there has been a particular focus in the past year on (i) education safeguarding; (ii) joint domestic abuse training; and (iii) the standing priority around an exploitation with sexual and criminal exploitation of young people.
• The Partnership will build on those foundations and bring more rigour to its work with a particular focus on the use of data from all partners. Also, more use of quality assurance findings from multi-agency audits and learning reviews and more rigour in the use of the voices of children young people.
• The Partnership is currently setting priorities going forwards and that, that work is going well in engaging all partners as well as the views of young people and their families.
• The 2020-21 Annual Report will be clearer in its analysis about (i) what the Partnership are doing well; (ii) where there are areas to be developed; and (iii) clearer about the evidence of the impact; and
• The action planning that has gone on in the Partnership demonstrates (i) a commitment to partnership working in the fullest sense of the word; and (ii) an ambition to make it make a real change.

In conclusion, the Chair:

• Thanked James Thomas for his presentation; and
• Then Moved and it was RESOLVED to note Safeguarding Children’s Partnership Annual Report 2019-20.

The Board received a presentation from Amy Whitelock-Gibbs (Chair of the Tower Hamlets Together Partnership on the Annual Report. A summary of the discussion is set out below:

A summary of the discussion is set out below:

The Board noted that:

• Tower Hamlets Together is really a core partnership group across the Council, the Clinical Commissioning Group; the voluntary sector, the Mental Health Trust; The Royal London Hospital; and the Borough’s Primary Care Networks.
• The response to the pandemic by the Partnership was rapid and an impressive demonstration of effective partnership working a testament to everyone involved.
• The Partnership saw real change driven by the front-line staff and barriers to integrated care were unlocked within a matter of days and weeks e.g. issues around on financing; staffing; data sharing and information sharing.
• In the light of those lessons the Partnership has revised its governance arrangements with an executive group to focus on strategic priorities and a broader operational group which owns the winter plan for both health and social care keeping inclusion and the users’ voice at the heart of all the work in the partnership.
• The Partnership had funded some digital inclusion work a co-production product to test different ways of working within partnership with the voluntary sector and service users.
• The Partnership is reviewing the priorities that need to ensure are being delivered over the winter partly because they are winter priorities but also as the Borough is in the middle of the pandemic. Especially making sure the management of demand on services (e.g. social care; hospital services; care homes; and end of life care). Whilst in the medium and longer term will look at how services need to be resigned.
• Operational senior operational staff have expressed a real concern about not losing some of the benefits of the response to the pandemic as mentioned earlier such organised coordination of patient care and address the practical barriers. As the Borough has epidemics of non-infectious diseases e.g. cardiovascular disease; diabetes and cancer as for many people this will have far more far-reaching impacts on people's health. Much can be learned about how the partnership can work together a core lesson from the management of the response to pandemic.

In conclusion, the Chair thanked Amy Whitelock-Gibbs for her presentation.

The Chair then Moved, and it was RESOLVED to note Report.

The Board received a presentation from James Thomas (Corporate Director for Children and Culture - LBTH) providing an update on the forthcoming SEND Inspection. A summary of the discussion is set out below:

The Board noted that:

• Too many families struggle to get the services that they need in a timely way.
• There have been delays in completing assessments for Education Health and Care plans which although primarily a Council responsibility depends on contributions from partners to complete those assessments.
• There are issues with exceptionally long waiting times for Autism Spectrum Diagnosis (ASD) diagnosis that primarily is a Health Service responsibility.
• The Council is working with its colleagues together to develop innovative new models of delivery e.g. virtual online platforms.
• An increasing number of referrals into the ASD pathway which means that this is always going to be an oversubscribed service and requires an investment of time and money.
• The is a need to develop Multidisciplinary teams (MDTs) to enable practitioners and other professionals in health and social care to collaborate successfully. As MDTs can be effective in meeting the needs of some groups e.g. elderly terminal care and those with complex care needs.
• The Health and Well Being Board can help to assist these developments by holding the to hold Corporate Director for Children and Culture and those partner agencies to account until it is confident that some of the areas of concern have been addressed
• Whilst the Council and its partners are operational under financial constraints it needs to be recognised that effective solutions are not always about additional money it is also about time; prioritisation; multi-disciplinary working to develop an innovated and fully integrated response to meet the needs of those that they seek to serve.

In conclusion, the Chair:

• Thanked James Thomas for his presentation and the contribution of Board Members to the discussion on this item.; and
• Moved and it was RESOLVED to note the update on the forthcoming SEND Inspection.

In conclusion the Chair thanked everybody who has contributed this evening debate which has provided incredibly positive guidance on the next steps in the development of integrated services; partnership working and 

pooled budget arrangements.

Finally, it was noted that a Covid Champions webinar was due to start, and all Board Members were encouraged to become champions themselves and encourage their staff and service users to become Champions.