Agenda and minutes

Apologies for absence were received from Cllr Larry Culhane and Philippa Johnson.

The Chair will carry out a roll call to confirm attendance. Members also have the opportunity to declare any relevant interests.

If a Member of the Board, or any other member present in the meeting has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.

At meetings where members of the public are allowed to be in attendance and speak, any Member with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter.  The Member must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where members of the public are not allowed to be in attendance and speak, then the Member with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Members who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Members are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Audit, Pensions and Standards Committee. 

None.

(a)   To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health & Wellbeing Board held on 29 June 2021.

(b)   To note the outstanding actions.

RESOLVED

That the minutes of the meeting held on 29 June 2021 were agreed as an accurate record.

For the Board to consider the borough’s Draft Dementia Strategy which

has been prepared with community input and the support of the

Dementia Action Alliance.

4.1           Councillor Ben Coleman welcomed the work undertaken co-producing the dementia strategy which supported the intention to become a dementia friendly council and borough. Working collaboratively with residents, community partners and local groups there was a strong commitment to improving services and support for all residents living with dementia and their carers.  Acknowledging that it was World Alzheimer’s Day, Councillor Coleman thanked the Dementia Strategy Task and Finish Group and commended them for their unstinting support.

4.2           Jo Baty added that the draft dementia strategy had been co-produced with stakeholders most expert in the needs of people with dementia and their carers and represented a renewed hope of becoming a dementia friendly borough . There were currently 570 dementia friends from the Council, CCG, CAN and from local stakeholders and residents. It had been necessary to navigate some difficult conversations with carers, families and stakeholders across the community, private and public sector to examine the key issues they face in delivering and receiving services and support in their respective roles.  This evidenced based approach had identified gaps and helped map areas to further develop, utilising online surveys and data evaluation over 16 months .  This was a critical opportunity for the ICP to have significant impact on people’s lives at a local level and embodied the principle of “nothing about us without us”. 

4.3           Peggy Coles underlined the importance of a data driven approach to accurately reflect the diversity and demographic of the borough where diagnosis of dementia was the second lowest rate in London at 57.6%.  While diagnosis was dependent on self-referral, there needed to be a greater focus on public health messaging and prevention, recognising that dementia was linked to risk factors.  Embedding co-production and the establishment of a dementia partnership board, with representatives from community groups, council and NHS, were the key recommendations.

4.4           Providing brief insights on what were perceived as systemic barriers around dementia diagnosis for black and Asian minority ethnic groups, Jazz Brown acknowledged that there was stigma associated with dementia.  There was a lack of understanding and of safe community spaces where information was accessible.  Previously, community memory outreach groups had achieved a positive success rate with self-referral and diagnosis, but a clinical route was often avoided by choice.  Dr Christopher Hilton confirmed that the provision of dementia services fell within the remit of West London Trust (WLT). He welcomed the report and its recommendations and explained that they would be exploring outreach work with organisations such as Nubian Life. 

4.5           Paula Linan commented that a great deal had been learned about the work of each organisation represented on the Dementia Strategy Task and Finish  Group and added that a collaborative approach would be very positive for those with dementia and their carers, especially in terms of respite care. 

Dr James Cavanagh welcomed the initiative and acknowledged that difficulties in dementia diagnosis were partly attributable to stigma and the lack of effective outreach programmes.  However, the report inferred that the prevalence  ...  view the full minutes text for item 4.

Update from the Director of Public Health, Director of Covid-19 and NHS.

5.1           Councillor Coleman set out the three elements of the verbal presentation which comprised of: the borough’s ongoing response to the pandemic; an update of the flu vaccination and the ICP’s role in this, and Covid vaccination.

5.2           Dr Nicola Lang reported that the rate of new cases was 203 per 100,000 people and that this was gradually decreasing and that the rate was consistent with the rest of London. There had been a number of outbreaks in local schools which were being actively managed. Linda Jackson reported that there had been a spike in cases amongst the over 60s cohort, but this had not resulted in a significant impact. The government had recently published its winter plan and the borough was well placed to respond as it continued with vaccination, testing (the highest rate in London), and the contact tracing pilot project. The government had also written to people who were clinically vulnerable and advised that they were no longer required to shield. The borough had continued to maintain contact with this group and currently had no plans to end this support. Generally, the borough continued to maintain low level and essential support.

5.3           Councillor Coleman enquired how well schools where managing, given the widely expected spike in cases at the start of term. Dr Lang responded that the schools had worked well and in partnership alongside Public Health England with an early and interventionist and upstream approach.  The Public Health team had taken a proactive approach to prevent outbreaks in settings such as schools and schools with special needs where there were vulnerable groups by implementing mitigating measures such as restricted movement, mask wearing and hygiene control.  This had been seamless, and the schools had done a great job. 

5.4           Jacquie McShannon felt that this was a measure of how much confidence schools had with the borough’s Public Health and Children’s Services teams and that they continued to have engage brilliantly and have good contact with the council. Dr Lang regularly met with schools to maintain strong links. Much time and energy had been invested in this work which would remain unfunded by government and supported by the council.  The removal of contact tracing  was a concern and Dr Lang explained the changes in contact rules for a young person under 18.  Schools were having mature conversations with parents about measures and there had been a highly sophisticated response in finding ways to navigate complex public health concepts.  It had been heartening to see trained school professionals doing public health work.

5.5           Councillor Coleman enquired about the quality of support offered by government in respect of quarantine hotels and travellers returning from abroad. Linda Jackson explained that there had been one large quarantine located in the borough which had been well supported and organised by the Department of Health (DH).  A number of Afghani refugees were being housed in temporary bridging accommodation.  Random checks by council staff indicated that the sites were well run with the exception of  ...  view the full minutes text for item 5.

The Health and Wellbeing Board to receive a report from the

Hammersmith & Fulham Integrated Care Partnership (H&F ICP)

updating on how the ICP is developing and the progress made up to

date.

6.1          Lisa Redfern welcomed the opportunity to provide an update on the work of the ICP and covered the two broad areas of the four campaign groups (health and well-being, frailty, diabetes and mental health) and the work of the PPL partnership.  The four campaigns were all at different development stages and of these, the diabetes group was the most advanced.  Sue Roostan highlighted that in the context of dementia, reintegration and reablement they had mapped and identified areas where there were service gaps.  This was an evolving process and they hoped to report on the deliverables in future.  PPL had been engaged to help support and develop the partnership with a focus on engagement.  There were three key themes: how to deliver services, create change and the development of a shared identity.  Section 4.5 of the report referred to key findings identified through engagement and the dementia strategy work was a good example illustrating a model of how to engage with people and what could be achieved.

6.2          Merril Hammer referenced the mental health campaign work which she felt took a linear approach compared to the dementia work which had been broader and inclusive. It was observed that if the ICP was committed to being inclusive they needed to address how engagement could be extended to proactively include residents as part of the process.  Lisa Redfern recognised the work that was needed and that this point was a key finding by PPL. The ICP needed to build a shared approach to co-production through an assured and well-planned delivery process. The new ICP was emerging, and Councillor Coleman said that this would be the focus at future meetings of the Board and how engagement would be taken forward.  In response to a point made by Jim Grealy, Lisa Redfern offered an assurance that the ICP would be responsive and would be able to include within the different campaigns areas of emerging interest.  Sue Roostan concurred and referred again to the example of the work on dementia and also, the mental health of children and young people as part of the mental health campaign group. There were so many priorities that an initial and tight focus around four campaign groups and the five key areas was thought to be more flexible and deliverable.

RESOLVED

That the Board noted and commented on the report.

For the Board to consider a joint report of the H&F Clinical Commissioning

Group and the council which provides an update on local flu vaccination plans.

7.1           Councillor Coleman introduced this item and explained that it would also encompass Covid vaccination, jointly presented by Linda Jackson and Sue Roostan.

7.2           Sue Roostan reported that this was a joint piece of work across the ICP, CCG and local authority.  Notification of the delivery schedule for the booster programme had been issued and some people had already received text messages, if they were aged 50+ and had immunosuppressed conditions.  There were four sites available across the borough: Brook Green Surgery, White Cite Community Centre, West Kensington Tenant’s Association Hall and Hammersmith Surgery nominated as the Primary Care Network (PCN) sites. Brook Green and White City would go live shortly. 

The local authority and CCG had been campaigning for additional pharmacy sites within the borough which would increase to 11 and so offered an additional 7 sites.  The booster programme had commenced in care homes and work was ongoing with CLCH to deliver the vaccine to housebound residents.  

7.3           Commenting on the vaccine delivery programme to schools for 12-15 year olds, Sue Roostan reported that national protocols and guidance would be issued that week.  It was important to issue a clear, local message that people would not invited to book their booster jabs until 6 moths had elapsed from a second vaccine dose.   There had been significant work undertaken to encourage and support vaccine take up with a range of hyperlocal initiatives including a vaccine bus on sites such as Charing Cross hospital and the Claybrook mental health facility.  Vaccine uptake for mental health patients had increased although actual numbers were low.  Helen Mangan added that vaccine bus had been situated at the site for 5-6 weeks, capturing 12% of the unvaccinated population.  There was a long list of patients with a range of issues that meant that an integrated approach was preferable to support vulnerable residents in gaining the confidence to be vaccinated.

7.4           Sue Roostan explained that NWL were recruiting teams of mobile vaccinators as the mass vaccination hubs were being decommissioned and it was confirmed that the intention was to have 100 full time vaccinators for pop ups.  The issue of vaccinating those that were house bound was raised, which was distinct from making vaccines locally accessible through pop ups and similar initiatives. Councillor Coleman responded that the borough’s needs were not being met and sought clarification about what more could be done to address the low rates of vaccine take up that was historic within the borough. Sue Roostan stated that it was not possible to deliver vaccines at home due to other operational priorities. They had successfully lobbied for additional pharmacies which would soon be operational. 

7.5           Merril Hammer expressed concern that H&F, an inner London borough with one of the lowest take up rates nationally, was not receiving greater support. The implications of this had been raised with the board of Imperial College Healthcare NHS Trust. The view of the Trust was to adopt a hyperlocal, street by street approach and speak  ...  view the full minutes text for item 7.

The Board is requested to consider the items for inclusion in the work programme and suggest any amendments or additional topics to be included in the future.

In discussing the Board’s work programme priorities, Councillor Coleman highlighted the reluctance of many black and Asian ethnic minority communities to be vaccinated and acknowledged that there was an historic lack of confidence or trust of the NHS as an institution within these communities. The Board felt that the following items could be considered at future meetings:

• Long Covid – to better understand the condition and how residents could be better supported in managing it;
• GP surgeries – practices and GPs were under immense pressure and post Covid, patient / GP interactions were challenging, to be considered for the March 2022 meeting.

The Board is asked to note that the dates of the meetings scheduled for the municipal year 2021/2022 are as follows:

13 December 2021

14 March 2022

Monday, 13 December 2021.