The Chair:

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

v  Welcomed Fran Pearson the new Chair of the Safeguarding Adults Board to this her first Board meeting

v  Advised the Board that due to unforeseen circumstances and consequent exceptionally busy demands the primary care partners are joining online which means that according to the current formal terms of reference the meeting is not formally quorate and as a result the status of this meeting will be recorded as advisory. Nevertheless, it was noted that since the Board has no executive decisions to take it would not affect the determination of any of the business to be transacted at this hybrid meeting. In addition, the Board agreed that this hybrid meeting provided an opportunity for the Board to learn and to take stock of its terms of reference and the format of its meetings.

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 interests received at the meeting.

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

The Chair Moved and it was:-

RESOLVED

That the unrestricted minutes of the meeting of the Board held on 6^th April, 2021 be agreed subject to formal ratification at the next Board meeting (Appendix 1 Refers).

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

The Board noted that:

v  The consultation on the Health and Well Being Strategy for the period for 2021-2025 had commenced last month and currently had received over 100 responses to the to the consultation.  Although this was a  positive step it was intended (i) to undertake a number of more in-depth conversations with some particular groups; and (ii) that all members of the Board should continue to use their own networks to promote the online survey and that it was important to have a genuine dialogue throughout the consultation.

v  The ambitions outlined in the Strategy can definitely be delivered through the Tower Hamlets Together life course work streams that are already well established and demonstrates a clear link between the strategic direction established by the Health and Wellbeing Board e.g. “Ambition 1 To all access safe, social spaces near our homes, so that we can live active, healthy lives as a community”  To achieve this the Board will work 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 the Borough’s land/spaces.  The intention being to ensure that all Tower Hamlets residents are owning and using the open spaces to lead active, social lives – whatever their age, sex, ethnicity, health condition or locality.

v  The outcome of Black, Asian and Minority Ethnic Inequalities Commission inequalities report had been considered at the last meeting and it was accepted that the Board must take ownership of the recommendations. Accordingly, this will be followed up over the next couple of months so that the Boards action plan will be ready to be implemented e.g. if there's any particular recommendations that partner organisations would like to champion.

v  The Health and Wellbeing Board terms of reference and the membership are now the subject of a refresh as (i) several members organisations and organisational structures that have changed; and (ii) there is a need to address challenges regarding about how the Board is representing the whole Community in the diversity of health and social care professionals and other leaders across the NHS, the Council, and the voluntary sector who are working together to solve problems and lead change to benefit of residents.

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

The Board noted the following critical issues that:

v  There is continued disruptive impact of the Covid pandemic on NHS care. The latest available data indicates that the shutdown of most non  Covid services in the first wave, combined with drastic changes in patient behaviour, mean the NHS is facing a large backlog of non - Covid care, thereby storing up greater problems for the future.

v  As the infection control measures and the ongoing diversion of resources towards Covid services during the second peak of hospitalisations has meant that this backlog of care will take even longer to work through as it continues to  ...  view the full minutes text for item 1.4

The Board received a presentation and a report providing an update on the work being carried out on the Home Care re-procurement programme. The main points raised during the discussion may be summarised as follows:

The Board:

v  Noted that the adult social care system could not survive without the contribution of paid and unpaid carers who provide vital support for thousands of people every day and preventing people having to go into primary care.

v  Noted that the Safeguarding Adults Board in its focus to ensure that safeguarding arrangements in the Borough work effectively has a particular interest in care at home and the quality-of-care services.

v  Agreed that with regard to the paid care workforce there is need for a review on pay, training and development, career progression and professionalisation and recognition.

v  Agreed that any service provider needed to the based locally and to provide local jobs and making a real contribution to the local economy.

v  Noted that within the re-procurement programme (i) contract management has been strengthened; (ii) hospital discharges are to work as smoothly as possible; and (iii) reviews are now happening in a timely way.

v  Agreed that (i) it had a key role as an anchor institution to support  communities and home care providers in Tower Hamlets; and (ii) the Tower Hamlets Carers Centre can facilitate the identification of carers,  improve care, and support and increase public confidence in care.

v  Observed that many carers do not think of themselves as carers or are not identified by health and social care professionals as such (so called ‘hidden carers’) and do not know about the support available to them.

v  Noted that feedback from various sources has indicated that partnership working has vastly improved since the advent of locality working with improved collaborative working and innovation that has made best use of the assets available in the Borough. This has built relationships and enabled key information to be routinely shared as necessary amongst stakeholders. This has led to improved quality of care and better outcomes for service users, where this model works.

v  Agreed that effective coproduction is critical to set the right delivery and contractual model to provide the right care, at the right time, which supports people to be as independent as possible.

v  Observed that there are a range of new market developments resulting from Covid-19 and a number of new models of Home Care that are now in place across the country.

v  Agreed that it is important that we consider these developments carefully and capture them in the new contractual arrangements and was pleased to note that work in the Borough is helping to identify best practice and viable models that could be a good fit for Tower Hamlets.

v  Noted that there may be a potential to link Service Provider payments to the achievement of desired contract outcomes. Whilst these arrangements need to be carefully considered they can incentivise better performance and alignment of Council and  ...  view the full minutes text for item 1.5

The Board received a briefing that provided an update on Special Educational Needs and Disabilities (SEND) improvement work, looking at the priority areas and the key issues, main activities, and current challenges for each. The main points raised as part of the discussion may be summarised as follows:

The Board:

v  Noted the importance of the transition for children and young people with SEND especially with regards to the provision for these students at key stage 3 and key stage 4 e.g. Young peoples’ annual reviews at Year 9 do not routinely make adequate plans for transition to adulthood and any appropriate services.

v  Noted that it is recognised that there is a need to improve the understanding of projected future demand for SEND and specialist education provision in particular has been identified as an area for coproduction with the parents and carers.

v  Noted that senior leaders recognise the importance of continued investment in the early identification and considerable joint work has been delivered in order that families remain known to services, to ensure that no child with additional needs is missed.

v  Noted that that effective processes are in place to ensure that vulnerable children with additional needs, including those where there are safeguarding concerns, are kept in view by services.

v  Observed however that SEND is not systematically considered as a relevant need by all parts of the workforce. This is borne out in how consistently services outside of Education monitor and record information around SEND status which has the potential to negatively impact on efforts to identify and meet need in a timely way.

v  Agreed therefore that it is important to keep the momentum going on the improvement journey. In particular Education Health and Care Plans (EHCP) are an area of concern as whilst progress has been made both in the working through the backlog that had built up due to Covid and the aim is to have all of those outstanding cases resolved by before the start of the next school year. However, the overall timeliness of plans issued is 27% (this includes the backlog) with the timeliness of plans since October at 53% therefore this needs to be considered as it impacts on the overview of this service and therefore the quality of annual reviews.

v  Acknowledged that going forward that it was important to (i) strengthen the understanding of SEND priorities for all partners across the local area so that all parts of the system work together to address issues and drive improvement; (ii) secure the commitment of partners around areas of work which are ‘in development’ and would benefit from a more joined up approach; and (iii) support partners to deliver key messages to wider staff and colleagues about their role in delivering the best possible services and outcomes for children and young people with SEND.

v  Noted that SEND Local Offer focus group with parents and young people is meeting on termly  ...  view the full minutes text for item 1.6

The Board will receive a presentation on the Experience and Ideas as a Tower Hamlets Resident, Mental Health Carer, Local Mental Wellbeing Small Business Owner and NHS ELFT Employee.

The Board welcomed Heena Patel who provided a presentation on her experience and ideas as a Tower Hamlets Resident, Mental Health Carer, Local Mental Wellbeing Small Business Owner and NHS East London Foundation Trust (ELFT) employee. The main points arising from the discussions on this item may be summarised as follows:

The Board:

v  Thanked Heena Patel for her reflections which provided a really strong meaningful challenge about (i) the board; and (ii) how online meetings perform in terms of people's access and engagement.

v  Accepted the need to consider access to the Strategy’s development and how it can establish and maintain a dialogue with the local voluntary, community, and faith sectors on the strategy evolution.

v  Recognised that getting care right is critical for residents and their outcomes

v  Agreed that activity at the local level should target the problem and develop collaborative ways of working that puts the patient/service user first, and cross organisational boundaries.

v  Acknowledged the ongoing importance of awareness raising around carers as there is much to do to recognise and raise awareness about what a carer is and what support is available for carers in all kinds of settings.

v  Commented that (i) with regard to the Carers Centre services as this is a commissioned service this can be monitored through the contract; and (ii) carers assessments and support plans should be about engaging in a dialogue with carers This is important as getting care wrong leads to poorer experience, poorer outcomes, and the costly use of limited resources, not just across the NHS but including social care, housing, and other public services.

v  Agreed that creating time for local collaboration and taking a systems-wide approach involving commissioners, providers, local government, and the voluntary sector remains essential.

v  Agreed that people want to be more involved in decisions about their care and those living with long term conditions want more support to manage their health and wellbeing on a day-to-day basis. Therefore, more needs to be done to involve people in their own health and care, to involve communities and the voluntary sector in improving health and wellbeing and to coordinate and personalise care and support including through personal health budgets.

v  Commented that by ensuring the people are heard meaningfully in all discussions about the quality of their care will improve and help people to make informed use of available healthcare and add value to their lives. This will rely on ensuring that all those working in health and care have person-centered and community centered skills, competencies, values, and behaviour.

1.    The Board noted the issues raised as a result of discussions on the presentation and agreed to incorporate the above-mentioned comments as appropriate within the Work Programme.

The Board will receive an update on the Local Engagement Board that was set up in response to the Local Outbreak Control plan to hold the Council accountable & support the strategic aim of addressing inequalities in the impact of COVID-19 on individuals and communities and ensure that our COVID-19 response is led by residents and communities.

The Board received and noted an update from the Local Engagement Board that had been set up in response to the Local Outbreak Control plan to hold the Council accountable and to support the strategic aim of addressing inequalities highlighted by the impact of COVID-19 on individuals and communities and ensure that the Borough’s COVID-19 response is led by residents and communities. The main points raised as part of the discussion may be summarised as follows:

The Board:

v  Noted that after an initial enthusiastic response to the Covid-19 vaccine the uptake by younger people has petered out, so it will take longer to reach the levels of vaccination seen in older groups – this pattern is seen across London.

v  Noted that the focus of the campaign is now on the 18- to 40-year-old cohort and was concerned that the NHS are seeing patients in this cohort who are fit and have no other medical problems in ICUs [intensive care units] due to Covid.

v  Noted that with in Tower Hamlets a high percentage of the population is made up of the young people and therefore much work is needed to be done to reach out to this particular age group.

v  Noted with concern that some residents feel that general practitioners’ surgeries want them to register before they receive a vaccination.

v  Stated that it wished to have the information provided to the Covid-19 community champions circulated to the Board and the Local Engagement Group.

v  Noted that there are multiple sites in the Bourgh where people can get their vaccine, so whether it’s at East Wintergarden, Westfield shopping centre, a local pharmacy, or the Art Pavilion in Mile End Book a Covid-19 vaccination - Tower Hamlets - Your details - Section 1 - forms

v  Agreed that it was important to stress to those residents aged 18- to 40-year-old should have both doses of the vaccine to give them the  maximum protection from Covid-19 and that they should book their second jab eight to ten weeks after their first dose. In addition, it was noted that partner agencies are advertising in advance what to expect and help answer any questions raised. They are also working with the local voluntary; community and faith sectors to understand how best to reach out to people within Tower Hamlets and to get them involved in the develop in the rollout of the vaccine programme

v  Noted that there are areas in the Borough where there is a really low uptake and there is targeted door-to-door testing in those areas starting in Mile End West

v  Noted that some of the reasons for this gap are practical and are being tackled with a more pragmatic focus on logistics. Hence why the vaccination programme has been rolled out into local and community venues to widen access and ensure getting a vaccine is as simple and easy as possible. Residents also need to be given adequate information as without clear and effective communication people  ...  view the full minutes text for item 2.

In conclusion the Chair (i) expressed her thanks to everybody who had contributed this evening; and (ii) welcomed the Boards willingness to take on health inequalities which was the biggest challenge in Tower Hamlets at present in terms of improving health and wellbeing.