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

The Board noted apologies:

v  for absence from Tracey Stanley; Joe Hall and Andrew Attfield; and

v  for lateness were received from Cllr Sirajul Islam; James Thomas; and Warwick Tomsett.

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

The following Member for transparency declared a potential interest in relation to the Item 5:

v  Councillor Denise Jones as her Grandson was in receipt of special educational provision from Tower Hamlets.

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.

Subject to the inclusion of Randal Smith (Healthwatch Tower Hamlets) in the list of Board Members present.

The Board noted following:

Dr Sam Everington (Vice-Chair):

v  Indicated that those items he wished to refer to were included in tonight’s agenda e.g. Covid-19 - latest news with reference to the vaccine programme.

Councillor Rachel Blake (Chair):

v  Referred specifically to the Better Care Fund (BCF) and how the Tower Hamlets Together Partnership (THT) works together in terms of the formal 2020 - 2021.  It was noted that the current proposal from the national BCF Team is that an end of year review with be submitted by the THT outlining how the pooled budgets had been spent to support health and social care services work in the Borough.  Noted that the BCF are well placed to account for how those budgets have been spent and that the future programme will include the winter pressure funding.

The Board will receive a verbal presentation about the impact of ‘digital service delivery on service users’.

The Board received a presentation that outlined how the move across the partnership to digital service delivery is impacting on users, also a number of residents talked about their own experiences including access to devices, access to the internet and their skills in using devices.

The main points arising from the discussion on the findings and learning across the partnership may be summarised as follows:

The Board:

v  Were advised how the Tower Hamlets Community and Voluntary Sector (CVS) has been delivering a digital project commissioned by Tower Hamlets Together (THT) covering community insights, training, access to devices and personalisation.

v  Commented about (i) the innovations such as the smartphone applications for those who are living with a hearing-impairment; (ii) how they have helped Deaf BSL patients; and (iii) that in hospitals and in general practice the pandemic has highlighted how important it is to ensure that appropriate reasonable adjustments must be made to ensure that the required digital infrastructure must be in place to support patients with a sensory impairment.

v  Wanted to see all service providers to taking steps or make “reasonable adjustments” to avoid putting any patient with disabilities at a substantial disadvantage when compared to a person who is not disabled.

v  Expressed concern that not all health care professionals in hospitals/general practice apparently were not fully aware of (i) the BSL interpreter booking process or how to use; and (ii) the BSL online remote access that allows persons with a sensory impairment who use BSL to use video equipment to communicate with voice telephone users.

v  Wanted assurances that the right technological solutions were in place to support all health care professionals in hospitals/general practice in in Tower Hamlets and that health care professionals were aware of the available infrastructure and how to use it.

v  Expressed concern that the myGP app that allows people to book and cancel appointments is not apparently accessible for all patients with a sensory impairment.  Which is a real barrier and requires the patient to set up an online account which required the patient to have an e-mail address. 

v  The Board indicated that it wished to see that appropriate adjustments are made to ensure that (i) the required digital infrastructure is in place; and (ii) staff trained and made aware to support patients with a sensory impairment.

v  The Board wanted to see the promotion of BSL as a language in an education setting” with each child starting primary school in LBTH to learn BSL from KS1 to KS4 as additional language.  The Board wanted to see key stakeholders from sign language and from education to explore how BSL could be sustainably taught in the Borough’s mainstream school with the aim for an inclusive community where Deaf BSL pupils can communicate in BSL with their friends, peers, and staff.

v  The Board wanted to see ways to address the digital divide in the Borough the pandemic having highlighted that those who are unable to access the internet find  ...  view the full minutes text for item 2.

The Board will be provided on how the vaccination programme is administering vaccines to residents, NHS and social care staff of Tower Hamlets.

The Board noted (i) that the local GP Care Group had been given the green light to commence COVID-19 vaccination in Tower Hamlets from Monday 14^th  December, 2020 as the first wave of the primary care based COVID vaccination programme; (ii) the details of the types of vaccinations available in the Borough; (iii) who had had the COVID vaccine first and in what order; (iii) the details about the vaccination centre in Mile End and new centres; (iv) the experiences of people receiving the vaccine; and (v) the ongoing support from partners and next steps.

The main points of the discussion on how the vaccination programme is administering vaccines to residents, NHS and social care staff of Tower Hamlets is summarised below:

The Board:

v  Noted that the programme aims to complete the following priority groups 1-4 by 14th February 2021: (i) residents in a care home for older adults and their carers; (ii) all those 80 years of age and over and frontline health and social care workers; (iii) all those 75 years of age; and (iv) all those 70 years of age and over and clinically extremely vulnerable individuals.

v  Noted that there are currently 3362 Individuals outstanding with over 4000 appointments available via primary care (excluding pharmacy and mass vaccination centre)

v  Were concerned that although overall that there is a high level of willingness to take up the Covid-19 vaccines, marked differences do exist by ethnicity, with the Black population the most likely to be Covid-19 vaccine hesitant followed by the South Asian community.

v  Commented that people are having concerns about the currently available vaccines or that they are intending to wait for the introduction of other vaccines that are more effective against later strains of the virus.

v  Commented that it is important to recognise that a key factor for residents in the older age groups that they want to go to community-based vaccination sites.

v  Noted that going forwarded it is intended to use the community-based venue such as the: (i) Mile End Leisure Centre; (ii) London Muslim Centre; (iii) GP Practices; (iv) care homes; and (v) visits to housebound residents.

v  Noted that those individuals who are not taking up vaccine will be contacted to talk through if they have any issues about the vaccines and how those issues can be resolved.

v  Stated that Board Members should ensure that their agencies are utilising their networks to promote effective communications to overcome vaccine hesitancy and to encourage increased an uptake of the available vaccines.

v  Noted that from the 1st of February 2021 a Vaccine Helpline funded by LBTH and supported with training and resources by GP Care Group has been established and is now open 7 days per week, between 8:00 am to 8:00 pm with multilingual staff to (i) answer queries; (ii) contact those who are vaccine hesitant; (iii) book appointments to local clinics and mass vaccination centre.

v  Agreed that the impact of COVID-19 on communities would rely  ...  view the full minutes text for item 3.1

The Board will have opportunity to consider progress to date and consider next steps.

The Board received an update on progress to date in developing the Health and Wellbeing Strategy, key messages from two workshops in early January to test principles and priority areas the remit of the Strategy and emerging priorities, as well as next steps and obtain feedback from experts, leaders and public on the priorities set out in the Strategy and insight on how priorities can be delivered with desired impact/outcomes 

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

The Board,

v  Noted that in Spring-Summer 2020 a review had taken place of key health and wellbeing data, alongside public engagement to hear residents’ views on key issues.  Following this, interviews with Health and Wellbeing Board members had taken place throughout October 2020 to gather their views on the role and remit of the Board and its Strategy, and what the priorities of that Strategy should be. 

v  Was reminded that on 17th November 2020 they had agreed priority health areas: the health impacts of poverty, Mental Health and emotional wellbeing, and healthy diet and exercise.  Then after this, there were two workshops (January 8th, 2021 and January 11th, 2021) that had brought together Board members and stakeholders to discuss: the wider determinants that impact these health priority areas across the life course; the mechanisms to impact those wider determinants; and what role the Board should play in driving forward change across both wider factors and health and wellbeing support services across the Borough in the next five years.

v  Commented that culturally competent staff are important for a variety of reasons. Firstly, as the Borough becomes increasingly more diverse, as it attracts residents from all over the UK and wider international communities.  The Tower Hamlets population is mobile, relatively young and is expected to increase by around 20% over the next six years health care professionals are progressively seeing patients with a broad range of perspectives regarding health, often influenced by their social or cultural backgrounds e.g. patients whose first language is not English and have different thresholds for seeking care or different expectations about their care, and beliefs that influence whether or not they adhere to health care staff’s recommendations.

v  Health care staff need to be (i) aware of these issues and how to address them; and (ii) acknowledge that a ‘one size fits all’ approach to health care will not suffice.  In addition, local communities face some unique health challenges, with significant levels of poverty and high premature death rates amongst adults from circulatory disease, diabetes; cancer; vitamin D deficiency; 25% of teenage girl’s self-harm; and respiratory disease. Our population as mentioned is also growing fast, which will lead to even greater challenges if we fail to act now.

v  Wanted to see more adults’ accessing dental services and to have improved oral hygiene e.g. reduce the incidence of gum disease.

v  Commented that a healthy weight and good nutrition in childhood sets  ...  view the full minutes text for item 4.

The Tower Hamlets SEND Improvement Plan sets out the programme of improvement work for the council and partners in relation to SEND, and SEND related, services. It identifies priorities, actions to be taken, lines of responsibility and timescales for delivery. The plan includes the detail of how the Tower Hamlets SEND Strategy 2020 – 2024 will be delivered.

The Board received a presentation from James Thomas - Corporate Director, Children and Culture that outlined the programme of improvement work for the council and partners in relation to Special Educational Needs and Disability (SEND), and SEND related, services. It identified priorities, actions to be taken, lines of responsibility and timescales for delivery. The plan included details of how the Tower Hamlets SEND Strategy 2020 – 2024 will be delivered.  The main points of the discussion are outlined below:

The Board

v  In response to questions noted that work has been underway over the last few months to refresh the improvement plan and this will continue as it is an iterative process. Noted that as part of this process feedback will be sought regularly to ensure that the views and contributions of a wide range of stakeholders can help to strengthen the approach being taken.   Work is underway to strengthen and make more systematic the views of children, young people and parents/carers, and the direct involvement of their representatives in driving forward our improvement.

v  Was advised that a range of activities have been taken place over the last few months to review and revise the SEND Improvement Plan including workshops with senior managers and with parents and carers and young people representatives.  More recently capacity has been constrained across all services, and in particular health services, as the current wave of the pandemic has worsened, and staff sickness or redeployment has become more of an issue.    

v  Noted that the aim throughout has been to ensure that the plan is an effective tool to drive improvement work. Work continues with strategic leads to refine and   sharpen the focus of the plan. Particular attention continues to be on identifying the most pressing items for improvement, rationalising content to avoid duplication and confirming actions are ‘SMART’ (specific, measurable, achievable, relevant, and timely). Also, that a set of priority areas for indicators have been identified, and these are currently being reviewed by the SEND Improvement Board. These will help to clarify the focus of attention for the improvement plan. The proposed indicators are set out below with details of how the improvement plan addresses them.

v  In response to the presentation noted that the Partnership has started to work to ensure that procedures are in place to agree a plan of action to secure SEND provision in line with the statutory responsibilities to meet the needs of young people as part of the local offer and captures the range of health services available relevant to children and young people with a disability. The intention is that local health practitioners will bring those children who may have SEND to the attention of LBTH so they can consider whether an assessment is necessary, and work with parents on this. Then the health practitioners will contribute to any co-ordinated Education, Health and Care (EHC) Assessment. As well as ensuring that (i) health care provision as specified in the EHC plan is made available; (ii) the  ...  view the full minutes text for item 5.

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