Transcript

chair of the board, and we're both responsible for healthier unity. I'll just go through some notes, just to remind people that the meeting is hybrid, so that if you're online, please mute your microphones when you're not speaking. The meeting microphones are permanently on, and it could detect minimal noise, which will be broadcast. For those joining remotely, please keep your cameras on for the duration meeting. Head sets are usually quite good in terms of are being able to hear you via the sound quality, and if you wish to speak, please indicate using the hand wave or the chat function, and only use the chat function if you indicate you wish to speak, or to bring an urgent matter to the chair's attention. Democratic services will monitor the chat during the meeting. Importantly, attendees should only use the chat function to indicate they wish to speak, or to bring an urgent matter to the chair's attention. That's a repetition of the previous phrase, but anyway, tonight's meeting will be recorded by the authority and will be broadcast live online. The recording may also be used for quality and training purposes, and it's important to bear this in mind, and to be aware of your surroundings. So, we're about to start the meeting, really. And so, as I said, welcome everybody to this evening's Health and Wellbeing Board, and I'm Councilor Jackie Dyerchair of the Board. Some board members are attending in person and some online, and if there's any technical issues requiring the meeting to be adjourned, and it can't be restarted within a few minutes, then we'll post updates on the Council Democracy Twitter account, which is @LBLDemocracy. Fire exits from either door, and there is an acceptable toilet outside this venue. Okay, so any apologies? We've received one apology from the Councilor Donner Harris. Councilor Donner Harris? Okay, so people are not in the room expecting to be online, is that what we're saying? Yeah. I'm Richard Dyerchair, I'm Director of Accessure Care at Accessure Care. I'd love it if you could speak a little bit louder, because me, I'm out of debt. I'm Richard Dyerchair, and I'm Director of Accessure Care, and I'm here. Wonderful, thank you so much. All right, okay, so I will introduce the board members in alphabetical order by surname, so I'll go around Councilor Jim Dix, Councilor Jim Dix. Thanks for Jim Dix, and Cabinet Member for Healthier Communities, and I don't have any interest, speak later. Thank you. Aye. Councilor Bankine, I'm Cabinet Member for Children and Families, and I have no interest. Better. Andrew Carter, Corporate Director for Children and Families and Education, I have no interest in it. And Richard, you've introduced yourself on behalf of Fiona Glonelling, and you have no interest to detail, and I'm interested to correct. Hey, what? I'm Ruth Hart, I'm Director of Public Health, but I'm also here today as Acting Corporate Director, and ICB Representation for Women's Affairs. Thank you so much. Acting. Thinking, I think that, did you say Aikin? Aikin, yeah, Aikin. Okay, I'm Diet Aikin, GP, and Clinical Co-Chair of Lambeth Together, Local Care Partnership Board, no interest. Thank you. Thank you. Mitra. Hi. Yes, good afternoon. Dr. Raj, Mitra, I'm the GP, I'm the Clinical Lead for Children and Young People. Thank you. No interest to speak for them. Bland? And Andrew Bland is on the agenda today. Aye, say. Joseph Keitha, from King's Health Box. Apologies to my knowledge, unless he's online. He may arrive at some point there. Ile? Eight. Maria? Online. Oh, sorry. Maria Healy, Chief Executive Health Watch Lambeth. And Jarvis? He and his Jarvis, Director of Operations and Partnerships from guys and St Thomas' here representing Sarah Austin in her absence of head of Louise Dark, starting with us on the 6th of June. Okay, thank you very much. Thank you very much everybody. I just want to say something before we start going on. I know that I have difficulty pronouncing certain names and words, and I'll it'll all be different according to the week or the day or the month. So I don't want anybody to take that personally. It's just part of how my neurodiversity operates. So just bear that in mind. We are after all the health and wellbeing board, which is about being inclusive. Yeah. Okay, thank you for that. Okay, so if we could start the proceedings, I wonder if we could agree the minutes of the last meeting, if we could take them as agreed unless people have got something that they want to raise. Read, read, read. Thank you so much. So we could proceed. Sorry. Sorry. Sorry. I had my hand up. I had something I wanted to do. I don't know if a hand, so I'll look at your computer. It's clean. Sorry. Thank you. Yes. Yeah, I was going to say my name's spelled wrong. And several of the other board members names are spelled wrong. I think Raja's name is spelled Ray and Ben Bess is spelled bumpy. So I suppose just from an EDI perspective, you know, I just think we just need to be careful when we're spelling people's names, particularly when they're not English signed in names. So if we could just pay attention in the future in terms of how we're spelling people's names. Thanks. Thank you. And thanks for that. I think we can take an action to update the names, the spelling of the names for all people that are present being the meeting. That would be really wonderful. It shouldn't be the case by the next meeting that we can be more accurate. Thank you for that. Yes. So Ruth, I wonder if you could introduce the best start in life theme. Thank you very much. So we have themed our health and well-being boards over the last year in line with our health and well-being strategy, which we signed off last year in around March time. And so our theme for today is ensuring the best start in life. We have some specific outcomes, which we looked to work towards over this life, the strategy. And just to remind people, they were a few children affected by poverty, poor children with a good level of development by age five, an emotional well-being of parents, caregivers, they, these children and young people, was supported. So today we have a number of different presentations around different elements of that best start in life, including maternity. So we'll kick off with the maternity elements. We've got colleagues from Leith Lambeth Early Action Partnership, talked about the work they do and then some from the mental health support teams that are in the community and into schools. And then we've got impact on urban health as well, who are joining us to talk about some of the projects that have been working in the borough. We are going to be quite time constrained. So I think Jackie might be quite smooth with her opportunity for the presentations so that we get time for discussion as well in questions. So I'm going to hand over to Simon to take us through the maternity element. So Simon is a project director for the Children Young People's Alliance. So Simon, over to you. And there I just, Simon, I am going to be really quite meticulous with timekeeping. So I'm actually going to use an alarm, a clock. Because of my new diversity, I'm actually time blind. So this is my jar, you, but this is me. So in your item, it's 15 minutes, if you could take 10 minutes to do your presentation. And we have five minutes for questions. That would be ideal. Thank you. Yeah, absolutely. Can I just double check? Can you see my screen? Yeah, okay. So, yeah, thank you. And I'll keep the time. And thanks for introducing me, Ruth. So I'm joined today by Mitra and Claire from King's College Hospital and guys in St Thomas's Hospital, respectively, just to talk about maternity inclusion initiatives that are provider led. And just before I hand over to them, I just wanted to reassure the board that the things that we'll be talking about today do align and support with overarching strategies, specifically with more children achieving a good level of development by age five and how good maternity care support supports that earlier development and the emotional well-being of parents and carers, babies, children and young people. We also have a specific outcome as well in our health, our land birth, the five-year health and care plan around women and birthing people and positive experiences of maternal health care under different actions that are published under that. And we think that the things that we'll talk about today will demonstrate delivery against that outcome and that we're achieving those aims we'll do over the next four years to

1. So without further delay, I'll hand over to Mitra. Mitra, would you be able to fully introduce yourself and to talk about some of the initiatives that Kings are delivering in this space? Yes, good afternoon and my name is Mitra Bakhtiari, I'm the Director of Midwifery, Ghana College of Nursing at Kings College Hospital and that's as you're aware, we've got two maternity sites, one at Denmark Hill, which is a tertiary unit. So we have a number of referrals from further field with managing complex pregnancies and then we have our sister site, which is based at Orpington, so two maternity sites are very different demographic, which actually gives us an opportunity for the richness in the way we provide our services. And as Simon says, we have many initiatives, but one of the key things that as maternity providers we need to be really mindful of is listening to our families and that's when we're not, we need to do better, we haven't always got it right unintentionally, but one of the drivers for us to do that and do it well and effectively through our complaints procedure. So we have a weekly meeting, so very much around listening to them and really asking how they would like their issues raised and reassuring them that regardless of which route they take, we will fully investigate their concerns and actually we meet, we set up meetings on the phone and meet and face-to-face or sometimes they just want to have a response. So that is in place since I've started with the Trust in March and I believe this is really effective and it gets us to the outcomes that families are happy to with our responses often. Often they're not and they will have to come back and have more questions. So the first slide is really about that complaints procedure and of course in the spirit of open and transparency, we always give them that option to go to the ombudsman and so that is something that is the last resource really. The other aspects of governance and accountability is that obviously, you know as a core draft work, the clinical director for maternity and gynecology services, myself as the director of midwifery and general manager, we attend those meetings and we run through the things and just so we can actually use that as learning that we could then feed back into the system and whatever we need to do to try to change the experiences for families who may have have the same experience. So if we move to the next slide, please and this actually tells you about really how we are really focusing our minds about outcomes for our families from Black, Asian, minority and there are several groups out there that bring back feedback from various groups through maternity voices, partnership groups that we meet with monthly and I believe they've had a really diverse event recently and then they actually explain about what it's like through their lens of different community groups in terms of language and how they would like to be contacted, spoken to the interpreting services so that is recently happened and we attended that and again whatever we learn from that will bring back into our system and then I think the other aspects of it if I go into the next slide is what we are really trying to do is as you are aware we have moved into EPIC which is our digital system and what we want to do with that system is to create a quality diversity inclusion dashboard so we can actually understand how some of these work is changing the outcomes is it improving so I think that's really important for us to be really focusing on the so what bit the curiosity bit because there's a lot going on out there but are we starting to see green shoots are we starting to see different outcomes so beyond the really good robust risk assessment process we have specialist services we have interpreting services so I think if we have a really good robust EDI program we can actually optimize and agree some of the deliverables that clearly help us change the outcomes for our family so I'm going to stop there and hand over to Claire because some of the work that is happening within the system at St Thomas' is very similar so I'll let her do that bit about St Thomas' thank you. Hi everyone thank you Mitra. I am Claire Spencer I'm a clinical care and professional leader for Lambda together for maternity and I'm also work clinically at DSTT hence I'm representing DSTT today because the senior team weren't able to attend. Looking the kind of highlights from the St Thomas' and guys on St Thomas' is that we've implemented the new patient safety incident response framework also known as PSERF and that's different it's a shift in how we are learning from our serious incidents so rather than writing memes of reports it is more of a collaborative approach and as a clinician those involved in incidents get to be part of the process of understanding the learning and then there is also a chance to look at how the system has influenced the incident and how we can do recommendations to change the system so that's relatively new it was implemented in December so we are working through that with themes that are coming out from our risk reports. We have a capital midwife initiative called the ARIA group which is the anti-racism framework and we were successful in our bronze accreditation last year so we're working towards our silver accreditation. We are a group of frontline professionals from all types of all disciplines within maternity working towards making sure that staff do not suffer discrimination and also that our women don't as a kind of concurrently working together so we do training as part of our mandatory training for all of our maternity staff so we're finding that we're having a more of a larger voice within that area for our staff which as Mitra says these ideas will hopefully have green shoots for the future. In the next slide please Simon. We've created the provision of 24/7 accessibility to translation services via a video application to make sure that we've got interpreters available continuing our non-English speaking classes and we also are the host for the maternal medicine hub for southeast London and some parts of Kent so that really helps identify those reduced health inequalities for women who are with complex pregnancies and in pregnancy. Particularly looking at reducing care disparities I've mentioned about the anti-racism group and we are also looking at that triangulation of complaints and incidents birthing people's feedback so that we can really understand what the themes are and the trust overall is implementing the equity delivery system from the NHS England and maternity has got the initial focus from the trust wide. Next slide please Simon. The future for guys in St Thomas' is that we are developing our five-year maternity strategy and that is being co-produced by women and birthing people from Lambeth and Southwark. They've had lots of events over the last year so creating an implementation plan along for year one of the five-year strategy so once that's finalized it can be shared. Well sorry to intervene as you're in off but with time no worries we can turn the 10-minute mark if you just got a couple of minutes or so to complete that would be an ideal. Yeah no it's fine it was just to say about EPIC the most important thing that we need data from our EPIC system and that is currently being prioritized and optimized for both St Thomas' and for Kings and that's going to make a huge difference in the coming year and that would be it. Thank you so much. And back to Simon I think although we finished a week. Yeah I think my last slide is pretty self-explanatory and has been covered so I'll hand back I can hand back to you. So it's an opportunity as it's said in your slides for questions. Yes yeah so the opportunities that we think moving forward are going to be key is the development of the reporting metrics of the back of EPIC. We're working with Lambeth Early Action Partnership as well because we want to try and embrace and make sure that we keep hold of some of the work that they've done in looking at the wider determinants that impact maternity health in early years. We are feeding into local maternity strategy as Claire alluded to now that we've got links with Mitra and Steven with Manus as well he's the new head of Midwifery at Kings so we know that we're going to make waves there as well and continue to support our partners our provider partners by letting them use our governance structure in the Alliance and making them aware of different opportunities funding opportunities for different initiatives that we know they're going to impact and benefit our Lambeth women and birthing people. Thank you and that's that's the end of our presentation. Sorry have you ever run? Are there any questions or any feedback or comments? Okay good I'm glad to give you some time. How are we going to take this now? I don't know who's underway at all first but if we okay? Well this is for my own service chair you know when we're social to staff we get more problems and complaints so my questions are on staffing of maternity units so how is it is it and if we short are we tapping into the local talent in numbers? Can we know that local people stay locally? I'll be doing a webinar in schools, on holidays to get more local people to go into service. Thank you and thank you I'm going to take some from the audience. I have two questions I'm a former maternity voices partnership chair for St Thomas hospitals I've been a bit cheeky here but there was two one around Kings so I believe that you were saying something about the complaints procedures and about how women are or families are knowing more about the complaint procedures but what I would say is how well are families aware that there's a complaint procedure that actually exists already? Question and then what work has been done to actually just prevent the need for families to even use that service in the first place so just basically have them better maternity care and then also you said about translators and one of the key issues is that you can imagine for women's in labour they're just meeting their translator for the first time so when we're looking at continuity of care for midwives is there any kind of plans to have a continuity of care for translators so that at least pregnant women already have met their translator or the team or translators that they potentially could have so that when they go into labour there's already that awareness of who will be the person that we're translating for. Thank you and I'm going to ask everybody when you are asking a question there's actually a question and you try and be really brief with what you can set a little context for a minute there there and then you ask your question because that then makes it really kind of helpful for me as to share to be able to share the meeting so thanks for those very pertinent questions there and I might ask that you respond to that one online who this online business as well but it's great go on please online I'll take that and then I'll take you to here. Shall I go yeah yes can you can you not hear me do I need to speak up yeah I'm sorry I wasn't sure it was me just a quick point yeah we recently did a report health watch lambda and we were commissioned by southeast London ICD and we really identified a number of inequalities and in particular around the translation so it's really positive to see around the video about 24/7 and I just wonder how long has that been in operation for and have you seen you know good kind of results for it thanks okay so I'm going to ask that you respond to the questions I'm not going to repeat them and take up time you've heard them can you please respond. Sure thanks for those questions so the first one was around staffing and maternity units. Mitri you had your hand up did you want to come in on that yes absolutely you would be glad to know that we have one of the lowest vacancy rates amongst our midwifery and nursing workforce the piece of work that we're doing is to make sure they're at the right time at the right place and to make sure that we cover the gaps we have actually a really robust what we call a safety huddle so we add two touch points in the day we kind of a horizon scan to make sure that we move staff where they need to be and in terms of guidance and promises I used to work at guys in St. Thomas's and I know that midwives Q to go and work at guys in St. Thomas's and so what we have done recently is within our system we are planning to actually recruit to the system midwife as opposed to midwife of guys in St. Thomas's or Kings because what we find if we can't accommodate them they actually go and leave London and that's what we don't want to do want to retain our stuff so I think from the perspective of keeping our midwives we're doing really well within the system because we provide such good opportunities for our midwives this day too and internationally renowned maternity services so that attracts people who want to really learn particularly with our junior workforce within the medics so but as you said we're not complacent there are programs we do go to school we run community recruitment centers and we try to attract staff from our local population because you know if your local population match your staff then the families will have a better experience and I would love it if you could keep your responses really brief of course if we can actually be very precise in how we respond to some of these questions otherwise we're not going to get through this agenda and we've got a very tight agenda so if everybody could take responsibility for how they are contributing to how we're collaboratively working through the agenda that'd be so helpful it really really would thank you for your response there about that taking that systematic approach to recruitment around the workforce and I'm wondering if the other questions could be asked around the different ways and the continuity of care around translation and the recommendations that came from the house was which also mentioned that and I've got a couple of questions and it's like we're going to plan all these things you know so if you could start with some brevity your response to these questions I'm getting into this now right so let's get with the program here right so if you could really respond with some brevity that would be most welcome thank you to those other points you've got your hand up again I do want to cover the complaints procedure at King's and how I just want to pick up on two things really quickly continuity of care we actually have we've kept them going both the guys themselves and kings so we're very lucky that we do that we do do that I think we've got two teams and so that's covered and we apply the principles of continuity of care across all other teams the second point I want to make you about language language is a challenge because there are over 130 different languages spoken but by all means if we could have a specific interpreter we do do that but the epic system I just want to point out that creates a my chart and the my chart enables different translation that the families have access to and then we have the interpreting system on our ipads as we have in contact with our families that's how we use the interpreter so because interpret thank you I just want to thank you the next question response please Simon can you call it please thank you yeah sure so I know that King's developed their complaints procedure and that has been published recently and we took that to a previous forum and discussed it there and I think as well in the maternity improvement plan held by King's that feeds into the local maternity and neonatal system there is a piece of work around developing reading materials for families just to make them aware of those procedures and everything in hand just to make sure that awareness is there and those services can be accessed the other question was also around translation services and I think that was from Marade now how long has the video translation services been offered Claire would you mind picking that up if you if you know Marade I do not know the answer but I can find out for you I think it's relatively new probably in the last year but I can get confirmation before you okay thank you then um I wanted to echo that the question I'm sorry I missed your name three Agnes Agnes asked about complaints can there's nothing in the report about the number of complaints that you get so we the board members have no attempt to be able to get an understanding of exactly what the level of complaint is so can somebody just outline very quickly and I might have a follow-up chair to that the number of complaints that you're getting about maternity services we've brevity please that's true did you want to come in yes as I said I'm only very new to the trust and I've been attending the complaints meetings and it looks like on average we're looking at around seven maternity complaints that are ongoing as a formal complaint and then we have three or four that are and this is weekly meetings that it's reported on and then we do do a triangulation of our complaints themes alongside our compliments and patient experience as in its entirety and we report that to the board on a quarterly basis so we can get that information for you not a problem thank you it would have been helpful to have within the context of the report yes thank you and because my concern like yours about whether this was just reliant on the number of complaints and not necessarily the real experience there it's partly based on how does the point that you made about whether people even know that the complaint systems they're in the first place but also actually the real experience of people's lives that they're not ready to sit and make complaints in the months after a traumatic birth you don't sit there and suddenly think I'll take that piece of literature Simon thank you very much and read through it all about how I can make a complaint and often this is something that only comes back to you as an individual later comes back months later and I talk about this from direct experience of my wife and her birth of our second daughter at Kings a traumatic birth no six to eight week follow up no follow up from any of the the people in the room but also how do you then take into account the first partner that was in their own because I was in the room and nobody paid any attention to me when you know my child was was on the research table so nobody did anything like that with me so I've got a bit of a concern that we're reliant on just the complaints so let's just bother and if you could just respond with some gravity because some of this work some of what's been indicated I think that we need to follow up with some further information to reassure the board that'd be really more so welcome yes so what's your immediate reflections on that with with some questions yeah absolutely and thank you what I could do what I could what I will do is we did circulate a report earlier in the year to the adult scrutiny subcommittee around maternity services and I did have some information around complaints numbers of complaints and thematic analysis as well there was also which I didn't have for today but I can get this moving forward local reports based on the 2023 maternity survey the CQC Commission maternity survey as well and that's a really helpful piece of work because I think it covers off a lot of the points that we've just discussed here in terms of what is important for user experience during each aspect of the maternity pathway and the areas that we can move forward and improve upon as well so chair with your permission I can get that information and perhaps circulate it after the meeting yeah we will need that and I might ask more questions to that just a minute just gonna make a point that the questioning of maternity services happens at southeast London so we have a little bit to it but the I guess the reporting the assurance happens at southeast London ICB so a lot of the things that you're talking about around monitoring complaints and how they're followed up and quality and so sorts of things will be monitored by the southeast London NHSICB so whilst we bring it here because it's we know that it has a massive impact actually on the on the best diet in life the clinical I guess bits around it I think are reported elsewhere and the other point I wanted to make was around maternity voices because maternity voices partnership should be exactly the place where that lived experience of women who go through our system actually can be reflected and reflected back also to services and partnerships and perhaps that's something that I think scrutiny I think the chair of it did come to scrutiny when they came recently but that is another place where some of that gets reported to yeah I hear that I think that it's one thing having the reports at such an eye level at southeast London that is and that's good that they scrutinize it in that way and I'm monitoring in that way but actually I think it's what the local experience is saying and therefore what the local reassurance needs to be and so there's something about finding a way where we're actually getting that information as well so that we can be reassured whom are living living examples of going through maternity services that actually so far away at southeast London monitoring that isn't sufficient for us to feel confident and reassured so we need to find a mechanism where we're feeding back more locally so that we can feel respected in this regard I've got a friend of mine who's gone through a terrible birth experience at Kings and actually what's been sort of outlined and when I look at this report it says one thing over there and then I look at anything that's not helped nothing to do with my my my friend's birth experience it's been absolutely horrendous and the dragon of feet around responding to the complaints the ducking and diving very shocking so we need to be like much more honest about the realities of what's actually operating on the ground that therefore feeds into influencing how we're shaping things and I think that that bit there around how do we do elevate the voice of lived experience and community experience into this sort of process it's really vital I find the same challenges happen around any other clinical area and it's particularly pertinent in mental health where the voice of lived experience has been so far removed from the reality of service improvement or service delivery so there's something about how do we put processes in place to really better value all of that I'm sorry I'm gonna have to not I can't take any more questions on this topic but I did want to just add some questions for me and I don't want you to respond but in the sort of subsequent report or something that you feed back to board members I would like you to answer this so what's the number sorry this is 2.2 so it says what's the number of pregnant women who come into maternity services by Annam it helps us to kind of contextualize some of the issues when we know the numbers not the percentages and then we can work out what the complaints are in relation to the population it helps us to think better together to provide intelligent feedback not something that's disproportionate from the reality yeah that's one thing but what one experience is one poor experience is one too much that point also remains and what's the demographic makeup of this cohort where we're attending so that's in my questions on 2.2 and I also wanted to really ask how does this work link with any work on perinatal mental health what is our strategy and are they interlinked or cross-causing where is that because I see no articulation of that here and clearly for me perinatal mental health mental health of maternal mental health is something which is of critical significance so those were that some of the additional questions that I want to get attended to when you do feedback that would be helpful would that be okay board yes thank you for the time it's highly possible thank you so much Claire was that Claire I think I heard that yeah you're always the loudest on there other ones are not as I'm not doing very well on time yet at all and use the not helping me neither right um okay so the next agenda item will be um leap so we have Laura McFarland hi Jackie and also Sophie who's the assistant director thanks I'm just gonna try and share my slides here here we go just let me know if you can see them is that okay can you see them yes lovely thanks thanks very much for inviting us back again to the health and wellbeing board we're very happy to be here and update you on leave just to give a bit of context to people that might not know too much about leave we are a 10-year program that's been funded by the big lottery to work in land birth to um provide services for pregnant women and children up to their fourth birthday and today really we're looking at how we engage families very broadly in terms of making sure that we make an offer and make contact with all of our communities in land birth Sophie's gonna then look at the data and shoes and data in terms of what we do with our data to understand our population and who's accessing our services and then we're going to touch on pairs we've been very ambitious we will try and be quick but also meaningful so this is the overview of what we want to cover in the next 10 minutes or so as I said the broad overview of leave is about transforming lines of babies and toddlers we work in kind of three key springs so improving diet nutrition social and emotional development and communication and language development and our portfolio has been built around these three child focused outcomes we are providing along with a range of partners enhanced early services a broad and large community engagement portfolio working with the workforce in terms of various offers in terms of development and and and change we aim to have an impact on the system and I'm going to say a little bit more about how we are going to share our learning as we enter the final part of leave because sadly we will be finishing quite soon and we've made over four million pounds worth of investment in the capital earliest state so in terms of engagement I mean obviously engaging with parents in all earliest services is really critical one of the key things that parents tell us quite a lot and I think Laura Griffin will agree is around getting the right information to the families at the right time and these are overall kind of intentional engagement aims so we want families to engage with leap activities and services initially then we want families to be able to sustain their engagement so obviously continued attendance of a particular service and then obviously to uptake multiple other leave services of which there were many and then thirdly our role is to connect families to further early years provision outside of leap where necessary and just to give you a sense of the type of services that we are bringing families to so there's a universal offer which is open to everybody say things like chat time which is speech and language service and baby steps which is a parenting service there's a targeted offer so that's based on eligibility criteria and that's either identified by use of data so maternity colleagues you know that we do use maternity data to identify families to come into the CAM program and caseload and then there's specialist pathway and I would talk about pairs and parent-infant relationship service there so just to give a sense of this type of services that we are bringing families towards so that this really kind of you know conveys that in a slightly different way our approach and particularly through our community engagement team is to develop relationships with as many local early-year settings and other settings other voluntary and community settings one of the big successes of leap is the creation of what we call first five lambas which is a consortium of voluntary and community sector partners some of them may not have considered their offer to earliest families thus far and by bringing them together we have encouraged them to reach and they have reached for us families that are kind of further away from services that they may need obviously signposting is critical and being very clear practitioners being clear about what services they can signpost families to and be being very informed about those services and then there's referrals to and from leap partners and then obviously lots of services around there doing what they can through various comms methods and outreach methods and connecting methods to bring families closer to services again i'm not going to read off this but you know i've kind of exemplified some of that you know what we found is our hyper local approach so running kind of small sessions very locally honest states in community venues where families go to has enabled us to reach a wide range of the community and offer and bring them closer to activities and fun activities as well as services as well we've invested in connector time and you know what's been very interesting most recently the recent evaluation of of short start and really focusing on the possibility and the potential of outreach services those view that no short start and children send as well we were able to fund that activity and i think through leap we're starting to see that that activity helps parents access the services that they actually need parent voice is very key and again this is now beginning to be exemplified and demonstrated in the start for life offer through parent forums and really keeping a strong sense of listening to parents about what they want and also creating a sense of belonging and as i said building local partnerships with small smaller organizations and so driving leaps engagement so again i you have these slides i'm not going to read them all but you know through the work with lead trusting relationships kind of if we can have consistent people out in the community that communities can build relationships you know really helps in terms of bringing people you know more toward services that they actually need having responsive provision so you know making sure that we are responding to needs as they arise and developing awareness so i know that's a gallop through i do want Sophie to go on to how we then use data so this is how we kind of encourage families to utilize services and then once they're with us and in services we have data to help us improve thank you Laura my i interview you it's gone over time now so i don't know where we're going to go for the next few minutes that we've got for this agenda item what might you suggest to prioritize to feed back on well if i thought we had 10 minutes if we had 10 minutes already okay um well should we just do this i mean we just wanted to share with you the work that we the number the the reach number that we have and then maybe Sophie if i we do the next slide and then we go on to pairs yeah absolutely thanks Lauren and good evening also if you were to assistant director of leap um and so in terms of that overall reach figure since 2015 up until October 31st 2023 the program has been able to reach and engage close to 30 000 individuals and that looks in terms of families that's 15,374 families in terms of the data on the next slide we can see the what's been really important to leave and what Simon alluded to earlier well this is sorry the reach over time so you can see how that's evolved and then on the next one as well we've just got a bit of how leap has approached um data in terms of informing service quality and ensuring that um the services are actively able to reach those that families that they were intending to reach back over to you Dora thank you thanks Sophie uh i'll leave you to look at that particularly we've been working uh got some information there on oral health just wanted to draw people's attention to our pair service we're very proud that we were able to uh sorry establish and um set up apparent infant relationship service um just to give you a sense those we co-funding service with Lambeth at the moment so uh staff life offer is a group work um reflected supervision um and we are really pleased to be able to say we are we'll be funding that at the one-to-one clinical work until March of next year and that service is now being offered bar a wide um and for children up to five years old so that very much enables close collaboration with mental health support team in schools and we are just about finishing an external evaluation of that work so you know we are moving in the right direction in terms of hopefully embedding that service and just very finally uh as we're entering the final stages obviously our lens is turned towards um our learning from leap you will see in the report a number of reports that we are have finished or are completing and we will be using that learning to host this event on the 11th of September uh at the assembly hall so um please do let me know if you would like to attend that thank you thank you so much for that overview of what um is much success really of the leap program i meet myself being aware of it from its inception in around 2014 and to see it go from strength to strength is uh attributed to your leadership laura um and leaves a legacy behind in the borough which we hope that we can find ways to continue some of the good work that has emerged from from it uh not least to continue to cultivate the relationships that are prioritizing engagement with community members um and and and enable us to be more responsive to their needs i don't know whether anybody's got any comments or questions on that this particular item but i would want us to all celebrate really the success story of leap um and make sure that that is recorded um i've got ben and then i've got please pronounce a name for me my read meringed with help thanks hi laura hi ben um just uh i deco absolutely jucky what you were saying about positive work that's done and i'm lucky as a ward counselor to have benefited laura in tools hill from from the work that you've done and the work that Lora Griffin and the rest of the team have done from within the council by community being very grateful for it i was interested in something you were talking about a second ago laura about uh the ability to reach people in different ways and get out to people in different ways there was obviously there was a big focus a long time ago on hubs uh you know when we started doing show start the idea of one location getting people in we still in fact there's an authority in a service in in lambith and so that we're obsessed with hubs new hub for everything um but obviously one of the great things leap has done is run a lot of programs out there in the community including for a period of time during covid online i did some dad's cooking classes online for instance uh long before it's a cabinet um so i'm just wondering where you think the balance of those two things are as we go forward yeah i mean i do you know obviously we are in a very challenging time i'm gonna ask you hold on a minute i'm going to take another couple of comments and then you can ask go answer the questions in the round time is of the essence i thought did i see it another hand did i if not the race yeah thank you i knew there was another do you want to say your point yeah yeah i was actually going to pick up on the point you raised jackie around um obviously it's coming to an end and and i suppose i'm really interested in curious about um your thoughts on the sustainability and how the work is going to be kicking forward and and the legacy i suppose of the last ten years that would be really great to hear your thoughts and well done yeah thank you um i mean i think the issue about hubs i mean and obviously the opportunities for you know carrying on or you know maintaining that that reach i mean obviously working very closely with laura and her team and it links the sustainability as well i mean the staff of my funding has enabled some of what was started in lib to now be continued and expanded worldwide so infant feeding uh elements of the uh parental sorry my cat's taking me uh the parent infant uh mental health work um and as home learning environment as well so we're fortunate there i mean you know i don't want to get political but obviously you know we we wait to see in terms of what uh continues in terms of a focus of that work um beyond that funded period um i think then you know your question about outreach and again i think you know kind of really considering and laura you might be able to clarify this you know uh staffing in terms of the family hubs and the staff for life offering really considering how outreach and and reaching out to families is is in built in that as i mentioned in the presentation and i can send some information about there's something that we that kind of grew out of league was first five land birth which was a small group a group of small voluntary and community sector partners that came together with some bits of funding from us but under their own steam we've now formed themselves into a consortium so and very much focused on early years so in terms of the kind of vcs element and reaching into communities that might not ordinarily come to services there is a strong bedrock there that of legacy that we leave in behind with them thank you so much thank you oh did you want to add very briefly laura just in terms of the outreach point so one of the key things that we've taken forwards from leap on a brother ride basis is our parent champions program um and those parent champion coordinators and the parents that they work with play a really key role in engaging other parents and bringing them into our centers that's wonderful and i'm looking at and it's really helpful for me to be aware of some of the different community groups and activities taking place because there are also mechanisms where we can have conversations about other aspects of health including mental health which i don't think has permeated the fabric of conversations within our communities as yet and yet we have massive opportunity to influence and shape those mental health service provision so i'll be following through with that maybe i'll have a conversation with you laura about that and well more is actually would be a good step forward um thank you so much thank you for the work that you've done and the and the legacy that that has yielded that's really great and if we could move which is which is actually a nice item to follow on from that work which is around the mental health support teams which i'm also eagerly looking forward to hear about so that laura that so i'm going to introduce that now it is laura that's right jakey i'm going to introduce this so as a paper that we've circulated gives an overview of the national mental health support teams program which is an NHS funded program um to give you the local context of that though my colleagues mostly and charan have prepared a few slides so they will talk through some of the key things about how the mhst's as we call them are working in lambus and then linked to that my colleague Janice will touch briefly on the role of school mental health leads as well vocally i'll hand over to you i'm conscious we've got 10 minutes in total so please focus on focus on the most important slides thank you thank you thanks laura i'm not sure who will present our slides for us if you're able just to share the slides vocally i could share those for you i'll do that now so i guess i'll just quickly introduce myself my name is rosily south parma and i'm the clinical lead for the mental health support in school's team and my colleague on the call this evening is charan akiki and she works as a supervisor in the mhst so laura are you able to quickly go to slide two apologies miss poth miss rosily if you could speak it's a little bit high uh more high up that'd be great okay thank you so if we go to slide two please versally i don't know which slide you're you're wanting from me so need to go back three go back three so one two it seems to be frozen it's not moving to me anyway if you're having trouble i can do so okay thank you first slide thank you so i will try to be as quick as possible so the mhst was created out of the transforming care and young people's mental health green paper back in 2018 where we there was a um where it was found that there was a gap between national camp services and children's mental health within schools and so a lot of these children and young people were not meeting the threshold for camps so as a result the mhst was created to support early mental health and well-being within schools so lambda was awarded the funding in 2021 so the mhst was established in 2021 which jointly with South London and Maudsley and when the service started we we we were working with 14 partner schools and today we have 20 we are currently working with 28 schools and these are primary and secondary schools and back in general when we did a review of of of our reach we are currently reaching 50% of the children across the borough which is really good um which is really positive for us and so by december 2025 we uh we will be extending the service again to um unadditional i think about 22 or so schools so uh so the service so by then we will be at least meeting more than half the population of children and young people across the borough next slide please and so just a little bit of strategic oversight of what the mhst looks like so we have the clinical lead we have supervisors and specialist practitioners and these practitioners are experienced mental health practitioners with years of experience we have an art therapist in the team we have seen a well-being practitioners we have education mental health practitioners or administrators we collaborate with the educational psychology services so we have a 0.5 ep within our service and we have supervising practitioners as well and we also get trainees from yearly so next January we'll have a set of trainees and we collaborate with kings so they will be doing the training course at kings and having the experiences within our partner schools next slide please so um we're currently going through a process so what the this onboarding process looks like we send out expression of interest to all the schools in lambda so this information gets sent out to headteachers send co-cinemant health lead pastoral leads to uh invite them to apply to be part of mhst especially those schools who are not part of mhst and once we get those applications back we meet uh as a I guess a decision-making panel with various people across lambda so we would have someone from eps we will have someone from the health and well-being team we will have um someone from black thrive we will have someone from two of our current hub schools and um and other community members joining that decision-making so we have a robust picture of the levels of need within schools and what that looks like to determine the best fit and the schools that are all and so we also look at the schools that are interested one of the key part of that is that they are expected to have a similar mental health leading schools because that person is quite important to be our link and they would have a a strategy oversight of what mental health provision within their school system is like already and so we form a partnership with them so we currently going through that process now for next January so we've just gotten our expression of interest back and so we will be meeting after the May half-term to start thinking about what the school selection will look like so by september all the schools who have been uh offer the space to work in partnership with mhst will be told next slide please you are aware sorry may i i'm going to use my hand and then that'll help you to know that um i'm sort of calling time um you are aware that you've got about 19 slides so if you could just really prioritize the key points that you want to articulate to the board um you've got less than three minutes left okay all right could we could we skip through please so i think um what i can what i can actually say is that the mhst has three functions so function one is whole school approach work so that deals with one-to-one interventions in primary and secondary school so behaves as that challenge fears and worries low mood anxiety and um yeah and so and then function too is whole school work so we support positive mental health and well-being across the whole school community so we support teachers we support parents and we support the pupils and this support could be um targeted groups are universal groups are universal workshops coffee mornings mental health well-being champions within school peer mentors within schools and so we're just thinking about how to reframe the narrative around positive mental health and get the conversation happening in schools so that that people i guess the community is not so fearful when they hear the word mental health so they're able to start having those conversations next slide please and this this the next couple of slides is just information about what the the expectations for the scene and policy what that might look like and what the the work that we're trying to do it so it's about prevention early support identification and making referrals to the appropriate services so we did talk about functions one two and three so we could skip that slide and we could skip that because they're talking a little bit about the what the mhp work so this slide is about the social graces so we we are quite mindful that we are working in a very late virgin society so we're talking about mental health sexuality age gender ethnicity cultural ethos financial ethos all of these things come together to form the social graces so it's not just about race and culture or neuro diversity it's just it's a lot more and so we try to to hold all of this in mind when we're having a conversation so the child is not the problem the problem is the problem and so we ensure that the systems are coming together to have that conversation and shift the focus from the child next slide please so this one is just part of working in an mhst the expectations and what it ended is so it's just about reframing language about positive mental health and just ensuring that this conversation is happening we don't subscribe to the idea of hard-to-reach families services are hard to reach families are not hard to um families are not hard to reach so it's just about how are we working to engage the community so that it's meaningful and that they actually want to engage and that's something that we constantly thinking about next slide please so i guess we could go um we can just skip to getting some some challenges and opportunities i think i think yes i work in the service and i and i am going to study services amazing because i'm part of it but equally what it does it offers as schools an opportunity to make a difference within the school community and with and with the wider community as well it's just about supporting positive mental health in school it's the early intervention so it's before um crisis develops so that children are being referred to come so they come to us we don't operate a waiting list so the early intervention thesis is if we get a referral within two weeks of getting the referral and it's suitable we will make contact with the family or with a young person and offer them an appointment if it is not suitable for us we do self-hosting some of the challenges sometimes it's around the i guess the systems within schools because there's a lot of focus on behavior and so and i think some of the schools haven't got the message yet that if the school is not mentally wealthy mentally healthy children will not be performing at the level that they're supposed to in terms of their academics so sometimes it's that our challenges that buy in um that we that we that we struggle with so the schools the schools are on a different page and sometimes it's just about mental health within sometimes within school is very bothered and so that's something that we're working really hard to change and sometimes the interventions is not really suitable for what we're offering because it's a CDT informed approach but there are also amazing opportunities because we're providing a space that is psychologically safe and we are bearing witness the some of challenges that families are coming with and enabling them for flourish and so i say that MHC is a really positive intervention for the borough and for families and for children thank you so much to close on that note that it is a positive intervention and it's precisely how i'm sure the board see it just a couple of minutes because we've got as i said the equally important items on the agenda and if there's any questions or comments once again with brevity to feed back to this presentation. Marie do you have your hand up? Oh somebody else online. Yeah we'll start with Marie. Thank you very much yeah really great presentation just a couple of really quick questions. First of all just in terms of the selection of schools I suppose we all know that often the schools that have the highest need and the areas of the highest deprivation might not have the capacity to apply at such a good application compared to some of the other well-equipped schools so I suppose just to what extent is that is that factoring in the selection process around social deprivation and need. Second question was around characteristics do you have data in terms of who's in terms of uptake of the service break and bring a broker down by race and by other characteristics have been really helpful to understand and some of the experiences and feedback depending on characteristics and then the third one was around and obviously we know a lot of mental health issues with young people it's intergenerational so I suppose is there a kind of family approach in terms of engaging with the parents as well that we really help fully understand thanks. If you could take those three questions because they mirror some of my questions so and there is very three precise questions there that I'd like a response to. Laura I will start and respond on school selection and then I'll hand over to Rosalie so we're doing our school selection process for the new wave at the moment we absolutely agree that the schools who might be most able to express that interest might not be the ones who need it the most so we use a combined approach we look at lots and lots of data related to the school population related to things like fixed term exclusion or long-term absence as well as deprivation data and general school take-up data. In addition to that as we're now the programs more established in the borough our evaluation panel has a kind of agreed principle that we will test the working of the MHSTs with one of our special schools and that we also would like to look at that with one of our colleges so there the new providers that we're bringing on board we're also considering that for our alternative provision in terms of the place where our most vulnerable children are and so we're really moving forwards with that. Rosalie can I ask you just to talk about the characteristics of the children and families taking up the service and then that into generational aspects as well please. So actually we when we we do have data and it's it's all of your first slides so I'm sure these slides will be circulated to you you'll get a chance to see that and if you have any additional questions feel free to email us and we will respond accordingly but in terms of data when we look at it we actually have an equal mix between white British, Black Caribbean, Black African and other white European so there's there's it's almost an equal mix in terms of people families and young people being referred to the service because what we what we have said to all our schools when we meet with them we have what's called case consultations which is fortnightly meetings and so what we when we look meet with the school we ask them to to share with us what their goal is for the school year to look at what their levels of need are so there's some questionnaires that we ask them to fill in so once they identify what their level of need is and the area that the most need where the areas that's most need we will create a plan with them about how to establish that so I guess one example of one of our schools recently and I could say that the school this was Alan Edwards and part of them there was what Nicola identified was that the Portuguese community was not engaging as she would have actually as she would like so that was part of our or EDI goal for the year with with Alan Edwards and so we we we created a coffee morning and an event just for the Portuguese community so we had interpreters we had lots of all things Portuguese letters were sent out and so we all the whole team turned up at Alan Edwards and in fact the parents to come and have conversations with us and so and and it was it was a positive turnout so which was and so that's that's so I think that helped us another event was engaging communities more so we just had a community's fair just that couple weeks ago and this was lots of different services from the community coming forward and so all the parents and teachers were available to have conversations you're the other question about engaging families and into the generational trauma I'm a systemic psychotherapist we have another psychotherapist training in the team we have a drama therapist and our therapists and the music therapist so we recognize that not every family finds talking easy so we have to look at other ways to engage them so we ensuring that we are meeting families where they're at we've just started we don't call it a family therapy clinic we're calling it a family support service and so we've just we've just started piloting having family therapy sessions for different schools so we're piloting different schools at the moment so we're piloting at Bonneville we're piloting at Heathbrook and we're never going to be piloting at Henry Folsett but we we're offering families that other opportunity to meet together to think about what the relational aspects are how is that getting in the way of engaging with service how is that getting in the way of establishing and strengthening their family relationships as well so fingers crossed um we haven't completed a piece of work yet so we will be with us again thank you thank you thank you thank you so much lots of people thought there um I don't know that was there I really want to make sure that we give your respect to the items so I'm really going to ask for brevity in your question or comment is that here and then Jim and then Ben yeah mine's really quick thanks very much thanks very much the program it's brilliant and positive you say that I think by the end of this year there'll be 69% rollout or certainly the end of the latest wave when will we expect a hundred percent rollout that's a really lovely question I hand over to Laura to answer that because yeah Laura could you please answer that question at the moment um Councillor the rollout is as enhanced by NHS England so we're very lucky to have funding under wave 12 of the program we haven't had confirmation of whether there'll be further waves following that at the moment um we are looking at what we are sorry to other schools sorry thank you you answered the question okay thank you chair I got a question and a and a request for them yourself well it's about so much of this is about relationship and sex education reproduction reproductive sexual health education how much is the government's announcement yesterday on changes to that sexual education going to impact the ability to deliver this work in particular going on what Jim was just saying about rollout so is that going to change it is it going to release capacity for mental health cover those or is it going to jeopardize the funding because the DFE say you can't do it anymore and a request share it your discretion for health and well-being board request for Ruth and Andrew and the teams to work together on a response to those proposals because it seems quite undermining the work that we're talking about today for instance that suggestion that you can teach an 11 year old about revenge board where you have to wait to be 13 to be taught about sex yeah Ruth so on the agenda we did have Janice who is who is online in our healthy schools coordinator who's going to talk specifically about the PSHE that currently is delivered by I think the point that you make like how kind it is pretty important yes actually we lose something that we is one actually yes and how we respond to that and what our local response versus any sort of national feedback in terms of what that might mean for us is that we take offline but yeah we can take offline and we'll take an action in that regard because it's vital we're not going backwards we're going forward and then so Jim what Jaws was I thought Jaws was responded to great so we can move on to the next item we can celebrate the work that the mental health support teams are doing I do have quite a lot of other questions but I think that I'm going to take them offline in relation to that and look to speak with somebody because as the job sharing in terms of healthy communities I have a particular interest in mental health so I'm wanting to make sure that we're maximizing and optimizing the work that we're doing in the borough in a very cross-cutting way and not siloed which is and I'm not saying that we are siloed I'm saying that we want to further improve that I were going forward okay so that's excellent thank you so much for your contribution this evening we could move on to the next item impact on urban health and we are looking at Julian's side the lead on this item hi Julie car welcome thank you so much for having us I'm Yuli Kanihos I'm a portfolio manager at impact on urban health and I'm here tonight with my colleagues Mary and some of our partners Curtis from class 13 and Agnes from Global Black maternal health we'll try to keep to two and a half minutes each so you're here from all of us so the children's mental health program is one of four 10th year long impact on urban health programs we're currently in our fourth year we invest three to four million per year into children's mental health in southern gambit and we focus on ages 0 to 13 and children's families you've received your slides and details I'll just pull out a few few points at this point and our work sits at the intersection of poverty based on mental health children worst hit by the intersectional racism and structural poverty are currently not being added to be supported by the systems designed to support them and their mental health a focus of our work and our intervention is therefore improving those systems of support our focus is on the environment not the child we work with the children with the center for mental health and research that helps us better understand the experiences of families in Lambeth and Southern and heard from them that they felt like they were swimming against the tide as they tried to get adequate support in the context of why does this demigant structural risk such as low pay insufficient benefits housing and crippling child care costs so currently it is far too common to blame children rather than the toxic impact of inequality and environmental stresses we work with parents carers and trusted adults as active positive agents in children's lives research based on the millennium cohort study and research recommissioned identified that parents and particularly those on low incomes are often problematized in narratives around children's mental health they're portrayed as the source of children's mental health difficulties despite evidence to the contrary as a result interventions tend to focus on individualizing and fixing the parent rather than offering support and fixing the system that causes distress to both them and their child how we worked really important to us we've learned that food provide support is as important as the report that is provided and that it works on trust and services is essential we focus on community-led interventions and involvement of children young people and families in service design thanks you okay so hi everyone i'm Maris indeed i'm a portfolio manager in the children's mental health team so i'm going to talk to you briefly about our nurturing environments area which is a key focus area for our investments in children's mental health within under this nurturing environments strand we invest in three priority areas we look at schools school communities alternative support systems within communities and improving statutory provision so what do we do in schools and numbers so we know that the wider context is really challenging and we believe that it's really critical that we explore the roles of schools as community anchors so in these really sort of trying times families and for schools we think that there's really to support schools to ensure that their experience is safe and nurturing by all children and this for us means moving away from pieces of approaches to behavior and really troubling things like exclusions we also look at community and statutory support systems so we've learned from families and communities partners like partisan who i'll tell you about a little bit later but traditional mental health services and support office office are not accessible or trusted by the most marginalized families so we ask how can we influence statutory provision to reduce inequities and meet the needs of the most marginalized and but we also know that statutory services can't meet everyone's needs and there is a need to have safe community-led and based provision for those marginalized children families so some examples of what we currently fund so we're currently funding an evaluation of the nest in sub-book and we know that the well-centred lamp is also being evaluated so we're really looking at this evidence base and what we can learn about what works for young people in southeast London and what good looks like in this context we're also working on a really a project with partisan who are a small black-led kick born out of a need in the community for accessible and culturally sensitive mental health and well-being support it's led by clinical psychologists and psychotherapists and their ambition is really to inspire more community-based early support for families and also to influence um influence community leaders in their commissioning so how can we approach preventative approaches and how can we feed into and this interest would change within SMM and southeast London ICB who are talking about prevention and working with communities so just some really quick examples from our community from our school community partnerships we fund the Oberlin and Brixton and Brixton collaborative and Wimbledon school clusters with a focus on whole school approaches to mental health and well-being and we've seen through having a dedicated paid cluster lead who works for a charity that this can allow schools to access support that they wouldn't otherwise have access to we also fund the old Kent Road family zone which is a community led initiative that aims to create conditions for children and families living in the area to thrive so this has led to several initiatives that are co-created with communities and includes a monthly marketplace host of the school and a new very even new club so what we learn is that community leadership is really key and it takes time and it's celebratory in its approach and it builds on local assets and strengths and the South London ICS is committed to scaling this approach in the family zone across the area so we should see growth and impact in Lambeth as well as in Southwark and so thank you so much for the time to share our work I'm going to hand over to Agnes and Curtis Agnes leads global black maternal health which is black led organization building resources and empowering black communities in South London and Curtis leads class 13 who work with school communities to develop policies and practice that actively challenge systemic inequity so yeah you're using the time well you really are so we need to continue that that would be great please um so yeah I'm from class 13 Curtis the founder we're based in Lambeth so I'm going to tell you a little bit about our newest project that we're looking at we're really excited about which looks to challenge the three the three main challenges in education so teacher retention mental health and children being excluded we look at those as really interconnected so the more that we kind of don't support teachers the more that they're leaving the profession which means that we have to double down the behavior which then means we exacerbate the mental health which then means we exclude more young people so what we're planning on doing is working with two schools in Lambeth from the oval cluster we want to embed ourselves within the schools for four years working with parents working with teachers working with governors and what we're looking to do there is to start a support with with the parents like so engaging with the parents so they're definitely part of that of that practice then looking really to support the teachers because we believe if we support the teachers then and support them to kind of have a focus on building relationships with children young people then we create an environment which is more a famine to those young people where it's therefore reduces the mental health which therefore reduces the need to exclude young people and how we do that so class 13 has been going for four years and in those four years we've done lots of research we've done lots of having lots of conversations with teachers and parents and young people and what we've come up with or what we kind of distilled is that there's like four key principles to our work and that's what we really really want to focus on in the schools and the four key principles are pretty simple as well it's a farming so making sure everybody within the environment feels affirmed making sure that critical thinking is central to the work that we're doing so critical thinking in terms of engaging with parents or in terms of teachers engaging with young people building community so every interaction we're trying to have with young people or with parents is about even strengthening that relationship or or building more relationships and if we're going to do that then it's going to have to be democratic so what we actually believe from that is that every policy and every decision that's made in the school can be made using those foundations so that's what we've been looking to do over the four years with the two schools one primary one secondary over the four years just really embed that practice so it's all very slick thank you very much and that was succinctly presented hi everyone my name is Agnes I'm the founder of global black maternal health um so global black maternal health was founded with the key purpose of putting research back into the hands of black communities as leaders and change engines a lot of the time when we're talking about work on health inequalities and when we're looking at the data and the research who want to do in the research it's not usually people that look like me that are leading on the research and we really wanted to change that because we fundamentally believe that if the research is flawed all of the implementation and the policy that comes out of that is flawed and then you're kind of having money that is not going into the right place but as you can see we started off with black maternal health and it expanded because there's a lot of different challenges that we face in the community and that's how we came about with black child send um black child send is also about my own lived experience being a mother as well and my own personal experience but it was really about looking at um the accessing special education and e support for black parents and looking at what ways different challenges are um i was really happy to hear about talking about lived experience anyone about mental health but what we know is that a lot of children are felled very early on in in the system we know that the same system is broken full stop but we know that children that are coming from black and minoritized communities, Roman gypsy communities and different um communities that are facing overwhelming disparities are also severely impacted so we conducted a mixed marriage qualitative and quantitative study over 18 months and i'm not going to go into so much of our findings because that's why i had it at an executive summary really exactly the full report here um but the long and short of that is from our recommendations we are now um proposing a a hub i love the fact that Ben said that but a citizen's advice a special education needs citizen's advice bureau aimed specifically at supporting and black and minoritized parents and this is because in the uk law is that parents are responsible for the education that children receive however the senate provision is not adequate so it's it's like you're saying we should make sure that our children have the adequate education but then you're not giving us the adequate tools to make sure that our children are having those services in addition to that there's cultural barriers and nuances around send around autism around ADHD and so forth and so that the hub will come and work with impact and over health and the national lottery to develop that and to make sure that we have that in rambles as well thank you so much how wonderful between four of you we've managed to packing quite a lot in 10 minutes so well done um i'm going to open it up to questions or comments and also with brevity if you may Raj. What's the delete program you heard about that's also a 10-year program very early on we uh looked at sustainability once we finish the system to pick up energy to work with us early as commissions and missions and others but people like Simon and the Alliance so that you do it with your good work it doesn't just disappear in that kind of carry on in that kind of you feel like you're a bit out there i'm a separate and when you're not with us it comes to this system let's change that thank you please we'll pick up separately here we have in the notes as well that he said that we should be working clearly okay so that's how we're working more closely with the children and your people of the Alliance there's been a okay a gym and then i'll just really quickly um so all brilliant projects really pleased that they're you know that you're working with us on them you're drawing investment in for obviously understanding how we can change systems and then look to try and mainstream them after the project's over um is there any way perhaps it's for Julia more than anybody else is there any way we can develop our relationship with impact for urban change even more strongly so we can increase the flow of projects in in key areas that are in line with our health and wellbeing strategy yeah that's yeah so that's something that i suppose the reinforced of the point that Raj said so if we could just take that away as an action that would be ideal that's quite obvious really um the thing that did you okay good not anybody on the screen i like to ask people before then i make okay so i would just um like to comment on the fact that a lot of people today have made reference to mental health in what it is that they are talking about and in a borough like Lambert's particularly when he comes to children and young people and adults of working age and all the people we've got an over-representation of people of from racialized backgrounds with mental health challenges we see that in our schools we see that in our the criminal justice system we see that in it we see that most personally in our mental health hospitals and even the acute hospitals but actually what is the work that we're doing that we're learning from along the pipeline people ending up in a massively over-represented nature particularly from black communities in mental health services Lambert has got one of the most over-representations in the country and it speaks to the fact that we don't do things much earlier in the pipeline so this is welcome work but equally so is the other elements of work that it is that we're doing and to make that coordinated whole and there is a significant opportunity that we have which i've heard nobody speak to and that makes me aware that actually it's not communicated into the system as yet we have got nationally the first anti-racism framework for racialized communities known as the patient and carer race equality framework this is all about working with communities to influence the shape and nature of mental health service provision wherever it's located that includes mental health support teams in schools that includes mental health services wherever the public purse is being spent on such provision and i've heard nothing refer to that so actually what we need to do is significantly up our game about how we are engaging with communities to influence and to help shape because it is a participatory anti-racism framework and it is mandatory right and it's been mandatory from April this year right and i'd would really like to see lambas representation in about how we make sure that lambas has a really good version of of of the p correct and and so all of the contributions that have been made today need to speak to that agenda going forward so i want to see a coordinated approach about how we engage with our communities so that they are the change makers on this agenda in helping us to transform services and innovate services that are actually responsive responsive to our populations needs particularly those that experiencing the worst brunt of inequalities for decades and the worst brunt of disadvantages for decades because of structural and systemic inequities so that's the a call to action that i want to make and would like to see that i'm hearing going forward um and i say that as well because i lead on the development of the pcraft nationale so i'm going to be looking for where are the good examples across the system right that demonstrate that we're able to do that otherwise we're operating in quite a fragmented way not seizing the opportunity to be able to do the change in an intergenerational way from the cradle to the grave for our population okay so that's that one i want to move into the i want to thank you for your time and your contribution that was most welcome yeah and we're looking forward to the work that we're going to conduct together going forward thank you um will we move on to the next item please which is the orange autism strategy and we're looking is this michelle homer that's going to present this item thank you so much i'm so sorry for the time maybe you've got about 15 minutes yeah you can have a bit more so yeah okay to just give you an explanation about the land of all eight and change the goal and action plans to improve services into a therapeutic field handling and managing in the world and if you can go on to the next slide you've done some extensive consultation um and co-produced this strategy which is take place including people we've bought it early parents, carers, GSTTs, the voluntary sector and surveys, workshops and forums there are a total of seven priorities and you're going to hear about some of the priorities through the people that we collaborated with and they're going to talk about their lived experience and how hopefully this strategy will impact their lives i've got three people we'll be doing three minutes and i hope and collaborators with me today i've got somebody and mariama and martin who's online martin are you there we start with martin online okay no problem for certain martin thank you over to you martin hello can you hear me yeah yes hello everyone i'm martin i'm the coach of national autistic starting land birth but i'm also steering committee member for the land of parent forum i'm also a parent to two autistic children one diagnosed and one waiting for a second assessment i'm also on the waiting list for autism assessment i was asked to speak about autism acceptance and student seats they're meant to health awareness week i thought i'd try and tie in by for them autism acceptance is nine that autistic people have challenges that neurotypical people don't have and accepting that autistic people need adjustments to fit into the environment that isn't necessarily built for them acceptance is also autistic people have communication difficulties that might have alexithymia which is the inability to describe emotions suppressing natural autistic identities and behaviours can put strain on mental health causing anxiety depression and emotional exhaustion which leads to burnouts and meltdowns elevated risks of depression anxiety and stress are common among autistic adults this can lead to addiction uh protect burnout eating disorders compulsive behaviours post-traumatic stress disorder misdiagnosis especially with a upd bipolar schizophrenic that can also increase poor mental health in autistic people this can lead to self-harm suicides and long waiting times for autism assessments can also impact poor mental health but the statistic from autistic are today is that 80% of autistic people have experienced poor mental health in their lifetime life expectancy for autistic people is 30 years fewer than neurotypical people the largest cause of deaf and autistic people is suicide and PTSD in autistic people is up to 45% higher than the general population at the moment there are 1,380 people 1,380 autistic people detained in mental health hospitals and the average stay for mental health therefore autistic person in mental health hospital is between four and five and a half years recent studies suggest 40 around 43% of autistic students in the UK experience persistent school absence and there's less than 30% of autistic adults in employment so there needs to be an autism focus across the board from adult social care health and well-being education, employment, housing, age-friendly strategies, violence against women and girls in disabled communities and the way to do this is to speak to autistic people and organisations representing autistic people and use their insights to make lives easier for them for engagement and co-production on top of this training all staff that all staff needs to have at least a basic of what understanding autism is thank you back to Michelle thanks Martin thank you Martin just going to hand over to the family now hi I'm Sammy 17-year-old teenager who's diagnosed with autistic pain disorder from the age of three being a high-function side of the spectrum formally referred to it as as dispurgers for a long time I've seen that autism has been treated as a medical condition or an illness above all by the very least I always felt like I was treated differently from the average what was called neurotypical in this brief talk I would like to share my experience with this autism is not a disease nor is it a disorder as some people may call it it simply encompasses a different way of thinking however to diagnose some with autism they will group together common symptoms that a person may possess diagnosed them with it but that does not mean that we are all the same to be labeled with autism as I was does not necessarily mean some of these include shyness low level communication skills and avoidance of eye contact and even repetitive behaviors and body language such as walking from side to side and fixation you may even have heard of the phrase autism is super power yeah that's us as diagnosed 14 years ago I am one of them some of us but less very through these symptoms as we either grow some behaviors as we age or never showed any signs of them in the first place indeed there is autism class autism is class as a spectrum and that is to merely reiterate how everyone is different and therefore each and every one of us thinks differently for the improved training in health care and education about autism I think this is a great start autism has too many myths and it's important to dispel these misconceptions around autism and help to understand what it's like to live with it and all big changes start off small invite experts and even autistic people themselves to share these experiences share their experiences which can lead to a greater understanding of autism within our society and it is a good start I also admire the idea of raising awareness for autistic people which can branch out into schools in the form of drop down days which are all day awareness events to understand it in greater depth but oftentimes I think very little is accomplished neurosical individuals may not engage with it as it but doesn't directly affect them from my experience at school awareness programs such as anti-bullying week and don't actively engage with young people as they are taught through SMSC or PSH sessions in a superficial way with there was a time given to explore this topic this is still a good thing to consider however but in my opinion scheme should be co-designed with autistic people to make the sessions as interactive as possible as well as getting the opportunity to bond with someone who has autism this could help people to get to know their autistic peers better and understand how they want to be viewed. Understanding their strengths is of the utmost importance of the other ideas pitched not only because it ties into the other plans listed but also because each and every autistic person possess a unique strength even though they may find it difficult to demonstrate them in social spaces. This is especially important when it comes to applying to jobs as employers can gain an understanding of hiring some their own unique talents as well as how to best accommodate them understanding that strengths oh sorry having just done my GCSEs and nearing the end of my air stage at my A levels I would like to note that some mainstream state school settings aren't the most equipped spaces a cater for autistic people. At sixth form schools encourage you to strive for independence in more of your academic life than ever before including three hours to study fewer subjects in a larger more elaborate workload. To me this hasn't been an effective way of helping autistic people to pursue their passions rather quite the contrary from the get-go they expect us to do five hours and dozens a week on top of the signed homework additional work and making time to do extra academic activities preparing for future studies for employment. All of these are expected to be done in the span of an academic year with very little support on their end. Being near the end of this year it has really taken away from the enjoyability of the experience that I have felt overwhelmed by the initial load. It was really demotivating to have all those expectations put on you and negatively impacted my opinions of sick form the overall scheme and my future ambitions. So in my opinion the best way to help an autistic person is to get them to say how they feel in a supported environment where they're able to truthfully express their needs and future plans. I speak for myself where I grew up at a mostly neurotypical family that's blamed me for my preferences and behaviours on my autism and honestly that's always been hurtful. Maybe someone's behaviours on a made different way of thinking or opinion and making the outlets and illness or something wrong with me. Even if your remarks aren't intended to occur such as referring to it as a superpower which comes from us as patronising it can make someone feel isolated in the world where autism should be accepted as a nepotal difference in their lives. I appreciate your time. Thank you. I appreciate your contribution. Thank you. We're going to make this time. Hello buddy. My name is Mariana and I'm coming from Autism Voice. I'm a autistic adult. I'm in my 50s and have survived life up to now and so I had an autistic son many years ago in England Beth and we struggled in his school time and wherever I went to look for help in terms of autism I wasn't seeing people like myself. I saw people either they're black and they can speak English very nicely with the English accent and it tends to seem like wherever I went I was struggling because I lacked understanding. I've just moved to England and the way English fuckspence can speak English. It was too much for my ears and so I ended up in a place where I couldn't understand so we started Autism Voice. So I'm here as an individual myself as an autistic adult with Michelle and the team on the strategy and as an organisation as well because Autism Voice has gone on to be not only in Lambeth these days we've gone on to be in Southwark and in Croyding and the way a national charity. So my here being here today is to talk about improving the young people, children and young people access to education and supporting transition into adulthood the experience. So at Autism Voice in the back of the old strategy thing we've now started working with three schools in Lambeth with their Senko in terms of supporting parents of black and ethnic minority who are really according to the Senko they had to reach people because they're not cooperating because of trust, lack of trust between them and the folks that bring their children to school and all these new systems that they have of having children in school fun are too because of the demands of their behaviour which in our humble opinion is a communication, a behaviour is only a behaviour can be both ways a negative and a positive and so in terms of so in any case we go there to bridge between the school and the parents so we do that advocacy and nine out of ten chances in the times we've gone to school the children stay in school and they are given because we bring education both to the side of the school and on the parents side in bridge, bridge, bridge in bringing them together. Also at Autism Voice we run transition services. When I went to university my expertise on which I trained was transition so I thought we are focused mainly on having young people both from primary to secondary school helping the school and the parents on how they could have a smooth transition into secondary school and also the young adults into the younger people from secondary school into adulthood so we run a craft school which is an NOC NOC N which is a national open college accreditation of an A-level certification in self-employment skills in craft making which is run by professionals who come and teach them jewellery making, sub making, things that they can do and be self-employed because we also run a partnership with Southbank University and Birmingham University and the job centres in Lambeth and in South London so we have access to a pool of young people who find they don't have any place like not in education not in in any training or in employment so we bring these young people to our centre in Clapham and now in Sarac as well to train them to have those skills to better themselves and the process psychotherapy to critically support them in their mental well being to be able to sustain life in workplace or as a self-employed person I think I've gone too much. Wonderful, thank you so much. So just round up I'm not taking too much more of your time so to help implement this program this strategy we've been funded given 240 000 pounds from the NHS which we're going to make into grants so people from the community can have access to the grants to help them to bridge the gaps where we can't they can do work themselves to bridge the gaps and reach out to autistic individuals and their families we just want to make sure that we raise awareness so we've got a three-year strategy and action plan and the first year we're going to be raising awareness and understanding of what is in the second year in heart and inclusion and laying infrastructure and ground ground work and the third year consolidating infrastructure with continuous improvement that we intend to do we want to continue to evaluate to learn and reflect and refine as we go along but ensure that we have our collaborators on board to help us along the way to make sure that we're actually bridging the gap and enhancing the lives of in autistic individuals in lambda. Fantastic I hope you're working with Black Tribe lambda in relation to this. Yes and also I met Agnes today who was also brilliant so thank you and we're going to have to link up with people together we've got to we've got to start tying things off not silo business so we're in a good place in having this conversation today and once again I see here a real serious thread about how are we addressing all ages in relation to mental health it's a significant agenda item that we have to really surface more transparently about how we're grappling with that so I'm going to pay attention to that it's a wonderful strategy and I commend our development in it but I'm mostly important there I'm really looking forward to its implementation to improve um improve lives in this in this regard fantastic what else can I say I don't know what other people want to say but I am proper yes so we can have one or two comments we've got five minutes people I don't want to extend the time and yeah so we might just squeeze past the half hour I don't know we're doing that yeah squeeze just just a little squeeze just to reassure you the last three items I think you'd be taking really yeah yeah yeah so can we take the questions or comments on this item please sir I'm going to start outwardly here is that is that was that you Raj yeah everybody online yeah admire it one I'm not sure about part two but you haven't started with part one first so we've got to start sorry I never even heard that what was that one of them are going to train is there mandatory all of them are going to train me to some right yeah but there's a part two that hasn't started yet I was wondering when that's going to happen okay so there's a timeline in relation to that you can answer that when you take a few more questions rather than individual time trying to be efficient here okay violent rate or never if I could say this right so I'm sorry it rhymes with parade like my right parade I just can I just gonna say look um it's really brave of all of you to speak I didn't like really heartfelt thank you because it's it's not easy to do that so thank you so much um we would really echo at health watch lamb that's what you said around the transitions it's something we hear a lot about and you know in terms of gonna be adulthood where the this sort of support drops off and from a personal level I lost my brother at a young age he was autistic and actually it's it's that loss of routine when they leave school it can be really really difficult and so I would really just sort of echo that and and you know the the fact that it's a 30 year less life expectancy we have to do something about that it's just not good enough and so really excited about the strategy and you know really interested in doing what we can to support you know making things better thanks thank you so much um I'll take the other two points as well actually all one time Jim Jim I just really quick I just wanted to thank Ty Wu and Michelle and the whole team really for putting this together there was a real I think a real determination to engage the population who were affected by the strategy I attended a couple of the workshops and was very moved by the experiences of people there who had found the system incredibly difficult to navigate um and had had experience really bad outcomes as a result I think if this strategy helps to resolve some of that it will have been a real success I just wanted to quickly ask perhaps Martin who might have a national overview on this how our strategy here kind of matches up to what's going on elsewhere is there anything we've missed is there anything more we need to do as we roll out to kind of shall we say meet best practice elsewhere okay and and Ben again thank you I agree with everything Jim and Jackie that you've said my quite and thank you Martin Murrow, Sammy for your contributions kind of what you were saying something I picked upon was about where we're getting to in the delivery of this strategy rather than just having a strategy what we're doing about the delivery bit of it and in particular about diagnosis because we're still so I'm wondering if there's someone from South East London that's on the call that can talk about diagnosis because for instance we've been speaking at the Children's Services Improvement Board about 18 month delays for diagnosis and quite frankly it's appalling that we're at that point it's appalling that we're Andrew will correct me a million pounds for the two extra consultants I think it was that that went into that service to try and address that and no dent at all chair in terms of the ability to change that around quite what's going on from South East London CBICS in that context of where the investment's coming for this because it's great to have a strategy but if we haven't got the people to be able to then deliver it so much of what you were saying hinge is on successful diagnosis and then that links Curtis does stuff you were saying about behavior yes you know this is all cyclical this is all wrapped up in the same stuff okay thank you very much Michelle join the next time so all of them are down on training that training we want to start rolling out across all the acute and also to the staff here and across the council and across like I said the cute so that will be hope hopefully happening and starting probably from this year or next year so we want to start rolling out that training soon and somebody's talked about transition we do have a preparing for adult framework which will hopefully have impacts on people who are transitioning from secondary school going into employment we've got we're working on employment strategy also so people can have better understanding more opportunities and improving employment opportunities for people with autism someone spoke about the delivery of the strategy the next one well we work on reporting our progress against action plan making sure asking the questions is it working what can we do do we need to change course and we monitor our progress from regularly reporting through an all-range autism working group that we plan to set up which will be reporting through to the learning disabilities and autism steering group but we plan to report quarterly and have a annual report as well and um council of crime I think he spoke about diagnosis unfortunately this is a national issue that we're dealing with as well however um our colleagues in children's um are hoping that we can do something about you know shorting in the time for diagnosis it's only if i want to bring you yeah David you need to come to the table no I just thought what I was going to say is that I can I know Dan the colleagues of children's and we now don't be aware that there is say um the question said both the national issue and local issue in terms of waiting signs for assessments for and diagnosis for new identity issues including ADHD and also it is being worked on I will take back to Dan just to come and come back in terms of what the current picture is for children and we can play something in in terms of um what work is to be done without us that we're going to be kind of feedback to to colleagues here okay thank you yeah they're linked to also as well as a raising awareness the good work they're doing we're not doing the GP as a in one referral week to children's autistic services for assessment so as one GP at the 300 lambos you can see the debit for increasing demand for assessments is adding to the waiting list so you it's a good thing you're raising awareness but then that creates more demand everything got the capacity to do that but we have the data about the levels of demand that is going into the system everything in that data collecting is ever increasing right I understand that but we are collecting that data right a lot the profile do you start waiting a lot the profile of that waiting list looks like as well would be really useful to understand in terms of the demographics and then the waiting times in relation to that that would be correct yeah not quite yeah we are keeping track with the the demand we keep in track of but the response in terms of actually meeting that demand is not present this is the problem so massive waiting times essentially because they are increasing demand right okay good um any could I have more response just ask more to the question oh yeah yeah yeah Martin please yes thanks yeah I just wanted to answer I think it was Jim's question about how land before we did some strategy relates to nationally I think it's important to not to compare what land birth is doing to other boroughs and other cities other areas because speaking with Taiwan this is the first proper all-age autism strategy land birth has had so this is just a starting point and as long as there are yearly reviews or regular reviews to always keep improving whatever is published for this one I think I think it's important to do not to compare this strategy with other ones with other ones yeah okay I hear that point I also I hear that and I think that's what we want some I shall tell you we it is a very repressive strategy it is better than the number of other local authorities I know parents carers for and tell me they don't live in other other authorities living in the land birth but one of the significant things throughout the strategy and throughout the plan is actually that focus on multitudes in fact it was co-produced yeah a lot of other stuff is about people telling people with yeah just expect from neurodiverse is what they need this one does not cover everything but it covers the priorities that more community have said matters to them yes and that's the wonderment of it when you go down the road of being really inclusive in how you develop responses to people's needs so most welcome and I think that I will actually take this as an action for myself to bring this strategy to I am a member of the mental health learning disability and autism team in NHS England and the mental health equality's advisor for that team so I will be bringing this strategy to that table for them to peruse and see what we can learn from that at that level so I will do that I hope you can launch at the end of this month hopefully that gives everything you can see yeah so thank you so much and thank you right okay so I was so reassuring actually as a as an item I feel really inspired from my first time I'm chair of the health and what we involved and I was fine that's good news is it not okay so if we could just go really briskly with the gym do you want to introduce the annual report that will be involved as on paper that I thought you was going to introduce it and then also it's going to speak to me so I think just to note this is a report of what we've done over the last year and the outcome of the um I think we need to we can take questions on it if anybody has any but it's just there into the record and it will go to speak to it at full accounts as well okay did you want to add anything to that you know fine from overlay quietly uh well again um it's there people have comments questions very hard to take feedback but there's no requirements as to go through it um it's a reflection of the work over the love quarter of public health team working with other colleagues in other parts of um lambith as well um and actually it's a quite much reflection of how we're working in community and really growing some of the sustainability in terms of some of the programs we started over the last few years thank you and the health and well-being strategy implementation progress report I think that is online but again I would suggest people are able to look at the document we do pick this up I mean we report through staying healthy board and in other places it's here because this was our theme for today so it's sort of wraps up what the things we said we were going to do are and are in that strategy so again we're happy to take questions on it other work we can take things outside of the meeting if we want to follow up and thank you for everyone who's contributed to the update as you tell bimph is anything you want to add I can see the screen no but very happy to answer questions if everyone anyone's got done your questions everybody's seen it well take it as red anywhere and we think it's amazing so with that without further ado may I draw this meeting to a close and thank everybody for their participation