The Sub-Committee received a presentation that provided an overview of Public Health a summary of the points raised is set out below:

The Committee:

v  Noted that Tower Hamlets puts health and wellbeing at the heart of everything it does through helping people to lead healthier lives, both mentally and physically. The Council does this by (i) commissioning a range of services from providers from different sectors to create as integrated a set of services as possible; and (ii) the way it operates the planning system, policies on leisure, key partnerships with other agencies for example on children’s and young people’s services, and through developing a diverse provider market for public health improvement activities.

v  Noted that the Council wants to ensure the health needs of disadvantaged areas and vulnerable groups are addressed, as well as considering equality issues.

v  Noted that through Adult Social Care the Council aims to help people stay independent, safe, and well so they can live the lives they want to. This includes people who are frail, have disabilities or neurodiversity, mental health issues as well as the people who care for them.

v  Noted that the Council provides information and advice about care and support to all residents, offers short term help and options for longer term support if people have more complex needs.

v  Noted that through Adult and Social Care the Councilaims to promote people's independence and wellbeing, through personalised care and support that focuses upon their strengths, the outcomes they want to achieve and enables choice and control (e.g., the provision advice services designed to help people solve issues early from employment to support for people with disabilities).

v  Noted that the Council has a number of key aims to this vision, including (i) empowering people to meet their own needs, (ii) enabling people to meet their aspirations for the future, (iii) ensuring that support improves the health well-being and quality of life for those working to Co-produce services and care with people that use them, seeking to simplify the system, making it easier to understand and access, (iv) ensuring that the Council provides the right support at the right place at the right time, being flexible in the support that we offer so that it's grounded in outcomes that matter to people, (v) delivering value for money, making best use of resources and spending within the Councils means, and (vi) developing, supporting thriving communities.

v  Noted that these aims align with the Tower Hamlets together Partnership and promote a system wide approach to improving the health and well-being of people in Tower Hamlets.

v  Noted that to achieve this vision and aims, Tower Hamlets has developed 10 key work packages. These include how information, advice, and early help to adults is provided. Including the work with Tower Hamlets Connect, the Carers Centre and Linkage Plus.

v  Noted that with regard to how the Council supports people this includes (i) working to develop staff; training and supervision; (ii) approaches grounded in person centred interventions; (iii) the focus on care at home, where the Council are working with care providers to reimagine care intervention via outcome based support planning; (iv) housing with care where the Council are focusing on reconsidering the range of options to support people such as extra care, sheltered accommodation and shared lives care; (v) financing, direct payments and aim to raise awareness of the positive opportunities and outcomes for people using direct payments by reviewing the Councils policy and practice to support an efficient, easy and a timely intervention for people that the Borough works with: (vi) a focus on technology and innovation and a commitment to develop a refresh vision on how technology can support people with their needs and independence; (vii) support outside the home and how the Council are extending opening hours for dementia day service to support carers that weekends, as well as improving the offer to create day service for adults with learning disabilities so that support is better connect within their community, enter employment and develop skills; and (viii) a focus on working with others and to strive to continue to develop an integrated approach with partners and to also develop a stronger approach to working with people with lived experience.

v  Agreed that this strategy is needed as we recognise that some key factors and challenges in the service and the Borough, including that Tower Hamlets has a very diverse Community and the Council needs to ensure that services are accessible and understandable to all.

v  Noted that Tower Hamlets (i) is the 50th most deprived borough in England with 44% of older people living in income deprived households (ii) have savings to make and demand for adult social care is set to grow; recovering from the pandemic which has had an increased negative impact on people's mental health, finances, and overall well-being.

v  Agreed that residents whilst find that it can be difficult to understand what support is available and how to get it, Tower Hamlets is a hugely abundant borough with lots of community opportunities for people to engage in and people with care and support needs should be encouraged to engage in such opportunities.

v  Wanted to see advancement of partnership working to ensure that a holistic view of people's needs are taken forward and to encourage practice which is grounded in strength-based approaches that recognises people can achieve and inspiring alternative trajectories for people's futures.

v  Noted that sitting alongside this strategy is an action plan with detailed information on the actions with details of who will do this and what difference it will make.

v  Noted that the strategy was co-produced with people who would be impacted by it over the summer and autumn of 2021, including people who use social care services and their carers, social care staff and staff working within the NHS, health services and the voluntary sector.

v  Agreed that the important point to consider is that key to this strategy is that it is grounded in compassionate person-centred practice that seeks to improve outcomes and experience for adults and care as in our community.

v  Commented that whilst the amount of money that is invested into people's care and support does not necessarily always equate to the outcomes and improvements in people's experience. The Adult Social Care survey has indicated that people are experiencing a high quality of a good quality of life in relation to their care and support.  Although that needs to be considered against the challenges in relation to the financial sustainability of adult social care, not both within the Borough but also nationally which is a massive challenge and there will be further challenges in relation to social care reform.

v  Welcomed the commitment to return to free home care as well as investment in the provision for adults in Tower Hamlets for care and support.

v  Noted that there has been a period of development around providing choice and control to adults and carers in the Borough that have care and support needs which has been developed over many years and with the introduction of the Care Act in 2014 this has further been advanced.

v  Acknowledged that Tower Hamlets has one of the fastest growing populations in the UK, which is projected to rise to 341,000 by 2023 and 376,300 in 2029. This is equivalent to 14 new residents every day for the next ten years.

v  Noted that by 2029, the number of age 65+ residents is expected to grow by 39 per cent, compared with a 17 per cent increase in working age residents and a 5 per cent rise in school aged children.  Which is likely to lead to even greater pressure on frontline services for vulnerable adults and children and is a major challenge for the Council and its partners who will continue to ensure that they consider every penny that they spend.

v  Recognised that the SARS-CoV-2 virus brought all stakeholders together and should be replicated with when looking at other widespread occurrences of diseases in the community that are affecting many persons such at the same time mental health heart disease, diabetes, cancer, obesity, these things are really impacting on local communities and the relevant agencies need to look at these diseases in the way that they have looked at dealing with Covid.

v  Agreed that it was important to disseminate the information in a way that tells residents that other long-term diseases are just as life threatening and will really impact on people's lives, because if stakeholders can identify these conditions earlier, we can really impact on people's health and well-being.

v  Acknowledged that it comes down to a balance between the action that can be taken by the Council, including regulatory action, and individuals taking responsibility for their own health.

v  Recognised that these health issues need multiple and complex solutions that need action from all sides.

v  Agreed that the longstanding issue is really about addressing health inequalities – the social and economic determinants of health – and this is deeply enmeshed in wider aspects of council policy including things like social mobility, poverty, education, and early start in life.

v  Agreed that Tower Hamlets should be a borough where all individuals value the importance of their own health, and that there needs to be an emphasis on instilling fundamental values in the Borough’s children and young people so that they grow up putting the maintenance of good health at the heart of the way they view life.