Presentation Slides attached.

The Board received a presentation that provided a progress update on the work being undertaken to develop a new Health & Wellbeing Strategy for the Borough. Members were provided details of the engagement work that has been completed to date, and proposals for amending the approach to the next phase of strategy development considering the Covid-19 coronavirus. The discussions on this presentation maybe summarised as follows.

The Board

• Noted that prior to Covid-19 Tower Hamlets was on a pathway for developing a new Health and Wellbeing Strategy and the principles were around coproduction locality focus and delivery. 
• Noted that health data was considered, and strategies were reviewed
• Was informed that there had been several workshops with providers; and service users. Healthwatch also had conducted a resident conversation at local level to identify the issues that mattered to residents. It was intended that prior to the pandemic that there should have been a summit to bring all this together and think through priorities.
• However, Covid-19 has changed the landscape therefore it is recognising that that has been a lot of work that has done bit for which obviously we do not wish to lose.
• Recognised that we need to think slightly differently about our vision and especially around the inequalities that Covid-19 has highlighted in our society. This can be seen in several ways but the most obvious from doctor’s perspective is the disproportionate number of people affected in Black, Asian and Minority Ethnic (BAME) communities. E.g. in the medical community across the country 90 percent of the doctors who have died were from BAME communities. It is therefore very stark, and analysis has identified several reasons (i) poverty. (ii) overcrowded housing (iii) specific diseases like diabetes and obesity that clearly play a factor in all of this. Therefore, there is a whole raft of risk factors which fundamentally go to the core of preventative medicine and how we intervene at a much earlier stage both an illness but also to prevent the illness.  For example, if you take something like diabetes, we are in a very good position probably one of the best positions in the country because we have been running a project on preventative proactive work with patients with diabetes. Tower Hamlets has patients with diabetes who the best cholesterol and blood pressure control in the country.  You might say what has that got to diabetes the answers these things are all interrelated and the key to diabetes also to is not just the drugs prescribed that is a very small part of managing diabetes fundamentally the food one eats; the type of food the amount you eat; your weight; the amount of exercise you take are all critical and sometimes more important.
• Noted that this process has highlighted the inequalities that have been highlighted in this process. Therefore, fundamentally what we should do what will be the long-term legacy to Covid-19 as with the Second World War the biggest legacy was the foundation of the NHS. That came as a result of the stark challenges that the Nation faced between 1939 to 1945 and we need to think about in terms of the Covid legacy
• Acknowledge that we need to fundamentally improve healthcare. Such as in every single practice in Tower Hamlets has a multi-disciplinary team that meets monthly including psychiatrists; Macmillan nurses; district nurses; social workers and a whole raft of different people that proactively manage the 5 per cent of our population that are housebound; have complex illnesses; that are terminally ill.
• Noted that this is critical mainly in improving their quality of life because when people are this ill you can do something about length in life and in some ways most important to his quality of life. Hence an example of something we are doing already but what can we do more? In the school-age children the statistics are stark with about 40 percent overweight or obese by the age of 11. which is double the rate compared to the age 5 which tells you that schools can play a major role in trying to turn this back. Self-harm greatly increased in teenage years mental health generally increasing in this age group let alone the additional mental health that we discovering as a result of Covid-19. Diet 50 percent of children are vitamin D deficient vast majority of children are malnourished.  Therefore, a child can be normal weight or even underweight but has major issue around nutrition. The children who are going to suffer most will be in the lower socio-economic groups. Most governing bodies of schools do not have somebody with health expertise who can drive the issue of health
• Schools, health agencies, parents, and communities share a common goal of supporting the link between healthy eating, physical activity, and improved academic achievement of children and adolescents. Evidence shows that the health of students is linked to their academic achievement, so by working together, we can ensure that young people are healthy and ready to learn. Public health and education professionals can share the link between healthy eating, physical activity, and improved academic achievement to engage stakeholders in working together to support healthy school environments.
• Considered how can we get young people involved in doing more around co-production around a health and preventative health
• Agreed that we need to think about how we do (i) work together;(ii) make sure Council messages are being disseminated in general practice; (iii) share our data systems more effectively.
• Agreed that addressing poverty as the underlying cause of so much of the inequality especially as it is likely to be worsening due to the economic impact of Covid-19.  Therefore, we need to look at employment; housing conditions; school providing the space to eat well; learn well and live well.
• Noted that Act Early programme which aims to improve the life chances of children by focusing on improving the environments that influence their health. Three themes will be examined: (i) on healthy places, considering the environments in which children live and attend school, and examining how these could increase physical activity, reduce obesity, and improve mental wellbeing, for example; (ii) healthy learning, focussing on how learning is linked to place and community interactions that facilitate learning; and (iii) healthy livelihoods, considering what is good for children’s learning and social engagement. The research will extend the applicant’s work in Bradford and include Tower Hamlets in London, two ethnically diverse areas of the UK with high levels of child poverty. The two sites are intended to enable testing of the replicability of research approaches and generalisability of interventions.
• Agreed that there should be a real emphasis about co-production and co-production where people feel that they oversee their own lives.

In conclusion the Board

Agreed that the next step is a discussion between Councillor Rachel Blake; Dr Sam Everington; Denise Radley and Dr Somen Banerjee to develop an action plan for consideration at the next Board meeting.