The Board received apologies of absence from Councillors Suluk Ahmed and Kabir Ahmed.

The Board noted the recent publication of The Independent Investigation of the National Health Service in England (Lord Darzi report). LBTH officers and partners from the ICB would explore how its findings and recommendations might impact the 10-year plan.

The Board noted a question had been submitted by a resident regarding provision of weight management services. The question and response provided by the Board, following input from the ICB, would be circulated to Board members.

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.

The minutes of the meeting of the Board on 10 June 2024 were agreed as a correct record and signed by the Chair.

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

There were no declarations of interest.

Why the report missed the statutory deadline

The report has been collaborative effort with input from the Local Authority and the NHS with ensuring key changes were updated and time needed for final sign off ahead of the meeting.

Why the report cannot wait until the next scheduled meeting of the Committee.

Following on from the new SEND Strategy and the Lead Member’s interest in this area its vital the Health Wellbeing Board are aware of Tower Hamlets commitment to improving outcomes for the most vulnerable children and young people, by targeting early help for adults living in households with vulnerable children, and by improving access to targeted support for these children, especially during transition to adult services,.

The Board noted and agreed the reasons or urgency as set out in the agenda supplement.

The Board received a presentation from Katie Cole, Associate Director  of Pub Health for Childrens & Families, and supported by officers from her team. The presentation included an overview of:

·         Key Themes in children’s mental health and those covered in the annual public health report

·         Partnership Response & Priorities

·         The ‘Thrive Framework’ and how it supported better services

·         The Current Offer

·         SEND and Neurovariance

·         The role and key achievements of the Mental Health Support Team

·         Suicide prevention and self-harm

·         Emotional Wellbeing in Youth Justice and Children’s Services.

Further to questions from Board Members, Katie and her team:

·         Explained how early intervention was key to reducing demand for more acute mental health services.

·         How schools could best support the work of the children’s mental health support team and what options the Council had to encourage all schools to participate in this work.

·         How integrating children’s mental health services with the  emerging Young Towe Hamlets offer would join up services.

·         Children who do not regularly access schools are at greater risk of developing mental health needs.

·         How mental health and emotional support was integrated into the Youth Justice Service.

·         How mental health services were co-pordiced with stakeholders including parents and schools. 

·         Demographic analysis suggested asian young people were proportionally lower users of the service. Understanding why this is so would be key to improving outcomes.

The Board made the following comments and observations:

·         Services could learn from voluntary sector initiatives trialled elsewhere, whereby young leaders conduct school visits. These can be culturally appropriate and feedback suggests they are valued by students.

·         There are strong links between poverty and mental health challenges. Linking to anti-poverty initiatives could help improve outreach.

·         Elected members can help promote awareness and signpost to services.

RESOLVED that the presentation is noted.

Steve Reddy, Corporate Director Childrens Services introduced the report that provided an overview of the progress and impact of SEND improvement work during 2023/24. The report shows how NHS Northeast London and the Council have been working together with other partners across the local area to deliver on priorities set out in the SEND Strategy and SEND Improvement Plan. The report includes input from children and young people and parent and carer representatives.

Steve explained that the Board were being consulted on this report which would also be reported to Cabinet. He outlined the 6 priorities of the emerging SEND Tower Hamlets Special Educational Needs, Disabilities and Inclusion Strategy 2024 to 2029, which he asked the Board to endorse.

Further to questions from the Board, Steve explained:

·         The emerging strategy would address all SEND conditions, including those on the autistic spectrum.

·         The priorities included some linked to age/phases. A specific one of these focussed on the post-16 transition period.

RESOLVED that the Board:

1.    Noted the contents of the SEND Improvement Board Annual Report 2023/24.

Representatives from NEL ICB and Barts Health provided a presentation to the Board on how maternity and neonatal services in North East London can meet the changing needs of women (pregnant people) and their babies in developing future services. The presentation summarised the work that has been carried out as part of the maternity and neonatal demand and capacity programme, including:

·         How the case for change themes were developed through the engagement with stakeholders, desktop review and analysis and modelling

·         Opportunities to ensure maternity demand and capacity are matched across NEL, and to strengthen pathways and models of care to remove unwarranted variation

·         Opportunities for neonatal services to ensure care is delivered in the most appropriate setting, which will improve quality and safety

·         How stakeholders have described significant opportunities to ensure workforce models optimise the use of resources and prioritise staff wellbeing

·         How care models were developed based on a combination of national guidance, best practice and stakeholder engagement

·         How the maternity care model is split into four key phases with details around each to be iterated further

·         The Key enablers for the effectiveness of the proposed care models

·         How the next phase of work will include engaging on the case for change and further iterating the draft care models.

Further to questions from the Board, the representatives of NEL ICB and Barts Health:

·         Discussed their thoughts on the MNVP Chair quarterly report, that had allegedly

·         Raised concerns around staff performance and conduct, communication and cleanliness.

·         Discussed the findings from the most recent JSNA on early uptake of antenatal care showing LBTH as an outlier. ICB representatives reported the data was somewhat out of date, though the need for change was recognised. New mechanisms were now in place designed to make it easier to self refer.

·         The LBTH Women’s Commissioner had been consulted.

RESOLVED that the Board:

1.    Noted the case for change and the approach NEL ICB is taking to engage with stakeholders. This includes an extensive public engagement, titled: Best Start in Life Shaping Future Maternity and Neonatal Services in North East London which concludes end of September 2024

Simon Smith, Head of Community Safety, introduced the report that asked Health and Wellbeing Board to note Tower Hamlet’s VAWG and Women’s Safety Strategy and appendices ahead of work completing the final stages of sign-off internally within Tower Hamlets Council, and for discussion thereof.

Simon provided a brief presentation on the work, setting out the background, rationale for and key priorities of the Tower Hamlets VAWG and Women’s Safety Strategy 2024-2029.

Further to questions from the Board, Simon

·         Explained how the new strategy aimed to focus more on partnership opportunities,; building resilience by having a broad focus that aimed to engage with the widest cohort of external partners and services.

·         Confirmed the draft strategy would be submitted for consultation next week.

RESOLVED that the Board:

1.    Noted the draft Tower Hamlets VAWG and Women’s Safety Strategy 2024-2029.

Eleea Islam introduced the report that provided the Board with an update on the review of the Better Care Fund (BCF), which aimed at bringing together health and social care organisations to plan, fund and commission integrated services. Eleea gave a brief presentation on the review that included

A BCF Budget Breakdown

Explained the objectives of the Review

Set out the roadmap for the review and progress to date.

Further to questions from Board members, Eleea:

·         Explained how funding approaches differred between 23/24 and 24/25.

·         Explained the key metrics for determining BCF performance and how these are set on a national level .

·         Explained how the BCF is built into the Tower Hamlets Together Plan, providing a localised focus.

·         Explained co-production was embedded in the formulation of BCF strategy.

RESOLVED that the Health and Wellbeing Board

1.    Noted the update.

Margaret Young, Director of Adult Social Care  and Emily Fieran-Reed, Programme Manager, ASC Improvement, introduced the report that The set out details of the Care Quality Commission (CQC) Local Authority Adult Social Care (ASC) inspections which would take place in all boroughs nationally from January 2024 to the end of December 2025. Margaret and Emily explained that they had no information about a Tower Hamlets inspection timetable, which could take place at any time.

Margaret provided the Board with a brief presentation setting out details of the CQC ASC Inspection Process, including:

·         Background

·         Typical Inspection Activity

·         The Care Quality Commission Assessment Framework

·         Partnership Working in the Framework

·         A summary of preparations to date.

Further to questions from the Board, Margaret and Emily explained:

·         How officers are preparing to get the message out to staff and partners regarding the inspection

·         How key stakeholder, including elected member and the Board, would be briefed once the inspection is announced

·         Efforts underway to prepare staff, including those new to CQC inspections.

Margaret explained that she remained positive about the outcome of an inspection, having since joined Tower Hamlets been impressed by the positive culture, examples of innovation, clear commitment and partnership working. She expressed hope this would be recognised through the inspection.  

RESOLVED that the Board:

1.    Notes the report and update.

The Chair advised that due to concerns of increasing duplication between Tower Hamlets Together (which is the Place Partnership body in the ICB) and the Board, further discissions were needed to ensure effective and efficient arrangements for formal health partnership arrangements and decision-making. He understood discussions on these concerns between partners had been delayed, but were scheduled to take place prior to the next meeting of the Board in December 2024. Accordingly he suggested this item be deferred until that meeting.

RESOLVED that the Board defers consideration of this item until the next Board meeting.

Why the report missed the statutory deadline

This Pharmaceutical Needs Assessment (PNA) was completed in 2022-23 and finalised in early 2023-24. Due to personnel changes, there was a delay in bringing this to the Health and Wellbeing Board for final approval. Given the statutory nature of the PNA it is important to bring it to the HNA for approval as soon as officers were aware of this delay.

Why the report cannot wait until the next scheduled meeting of the Committee.

It is a statutory requirement for a Pharmaceutical Needs Assessment (PNA) to be developed and published every three years (or earlier where significant changes have occurred) by each area covered by a Health and Wellbeing Board (HWB). Approving the PNA will allow the HWBB to meet its statutory requirement to publish a PNA and this would also enable appropriate regulation of any applications for new pharmaceutical services in the borough.

The Board noted and agreed the reasons or urgency as set out in the report.

Somen Banerjee, Director of Public Health, introduced the report that introduced the Tower Hamlets Pharmaceutical Needs Assessment 2023  (PNA) which aimed to assess and report on how the provision of pharmacy services can meet the health needs of the Tower Hamlet’s population over the next three years.

Somen explained that due to an oversight, this report had previously been reported to the Board, but this was a statutory requirement. He explained consideration of the Board of the PNA was a formality.

The Board raised some concerns with apparent gaps in provision, notably no Saturday evening provision and lacking provision in North-East and South-West localities. Somen indicated the Board could report these concerns to the local pharmaceutical committee.

RESOLVED that the Board:

1.    Notes the contents of the PNA.

2.    Approves the PNA for publication.