This meeting of Hackney's Health and Wellbeing Board was scheduled to receive a range of reports, including updates on projects previously funded by the board and new proposals for the board to consider. Topics included the Homerton Hospital’s work on creating autism-friendly neighbourhoods, a proposal for a rough sleepers street stall, updates to the suicide prevention strategy, and a review of the council’s response to tackling obesity.

The Brunch Bunch Winter Proposal

The board were scheduled to hear from Healthwatch Hackney about a proposal for a series of events this winter organised by the Brunch Bunch.

The Brunch Bunch is a co-production group, facilitated by Healthwatch Hackney, whose members have experience of homelessness, mental health issues and/or substance misuse. They have already designed and distributed a leaflet signposting people to local support services. For the winter months they are proposing to run a monthly street stall to offer warm clothes, sleeping bags, toiletries, food, medical help and pre-paid mobile phone SIM cards to rough sleepers. The group is also looking to hold a Christmas wellbeing event in December to offer a wider range of services. The Brunch Bunch believe that rough sleepers will be more likely to accept help from people with shared experiences. They have requested support from the board to secure a venue for the event, donate items, time or skills, and potentially some funding.

The report identifies that this work aligns with all of the council's Health and Wellbeing strategy priorities:

● Improving mental health ● Increasing social connection ● Supporting greater financial security

and all of its stated ‘Ways of Working’:

● Strengthening our communities ● Creating, supporting and working with volunteer and peer roles ● Collaborations and partnerships: including at a neighbourhood level ● Making the best of community resources

Report on the Development session for the Hackney Health & Wellbeing Board

This report summarised a recent development session held by the board with support from the Local Government Association (LGA). The LGA had interviewed board members and then facilitated a session to discuss the feedback.

The feedback focused on four themes:

• Venue: The board discussed whether meeting in the council chamber impacted on its ability to function as a partnership.
• Public Engagement: There was discussion on how to improve public engagement. Suggestions included giving the public advance notice of themes to be discussed at meetings.
• Agenda setting: Members discussed how the process for agenda setting could be improved.
• Culture: The board discussed the need to improve its culture.

The LGA’s report recommended taking immediate steps to:

• Make the forward plan more visible, allocating time for discussion at board meetings.
• Find a new venue.
• Develop guidance for presenters and amend the report cover sheet to improve communication.
• Hold a joint meeting with the City & Hackney Health & Care Board.

The board were scheduled to discuss their response to the LGA’s recommendations. They were also invited to consider longer term issues such as their terms of reference, how to improve the culture of the board, and how to structure meeting agendas to improve engagement.

Population Health Hub Update & Health Inequalities Funding

This report provided an update on a number of projects that had been funded by the board. The board allocated £875,000 to eight projects in 2022/23 and £821,000 to seven projects in 2023/24. The report included monitoring data from six projects, with more reports expected.

The report included a summary of each project, a description of its progress, a summary of its evaluation data, and reflections on the project’s successes and challenges. For example, the “MATCH” project, which aims to embed health equity into health and care services, reported that:

Outlining a clear process to follow and developing tools and resources has been beneficial

The “Fit4Health” programme, which provides exercise after a stroke, reported that:

Based on our observations as exercise professionals we have learnt that it is not easy for the average person to maintain regular physical activity within their daily lives. The preservation of this habit is much harder for stroke sufferers, but once a client commits to Fit 4 Health they recognise the wider benefits of exercise and are keen to continue the programme for longer.

The report stated the board would be scoping how to best collate evidence for the cost effectiveness of the funded interventions, and invited members to provide input.

Review of the City & Hackney 'whole system' response to tackling obesity - including findings from the Healthy Weight Joint Strategic Needs Assessment (JSNA)

This report presented the draft findings of the council's 2024 Healthy Weight Joint Strategic Needs Assessment (JSNA) and reviewed the council’s “whole system” response to tackling obesity.

The report found that “there is a lot more work to be done locally to shift the dial on obesity, requiring a coordinated, sustained effort at multiple levels by partners across the system.”

It identified a number of interventions and strategies that have a good evidence base. It also highlighted some interventions with less robust evidence, including “the removal of HFSS advertising; ‘whole system’ approaches; health promoting planning policies; School Streets and Low Traffic Neighbourhoods; Healthy Start schemes; Healthy Early Years and Healthy Schools award schemes and the Daily Mile.” The report noted that some of these can be difficult to evaluate and this did not mean they were ineffective.

The report highlighted opportunities for local action and made recommendations that were summarised under a number of themes.

For example, on System Leadership, the report recommended that the board:

• Work with senior leaders to champion and prioritise the healthy weight agenda.
• Re-establish the Healthy Weight Strategic Partnership (or similar) to provide leadership.
• Develop a clear governance structure to ensure accountability.
• Refresh and relaunch the Healthier City and Hackney framework.
• Reprioritise resources to address the recommendations.

On Tackling obesity related inequalities, inequity and stigma the report recommended a focus on health inequalities by:

• Strengthening partnerships with key services who engage at-risk groups such as those on low incomes, those with disabilities and global majority communities.
• Developing targeted support for people with complex needs.
• Ensuring obesity related inequalities are at the heart of service planning.
• Considering how resources are allocated to ensure they meet the needs of those disproportionately affected by obesity.
• Developing a programme of work to tackle weight stigma.

The board was asked to give feedback on the report's findings and recommendations. It was also asked to consider how it, and its member organisations, could best implement the recommendations.

Suicide Prevention Annual Report

This report provided an annual update on suicide prevention in Hackney.

The report found that the number of deaths by suicide in Hackney has been relatively stable in recent years, but the rate has increased from below the national average to above it. It also found that most suicides were men, that hanging was the most common method, and that mental health conditions and substance misuse were common factors among those who had died.

The report included a description of a number of local suicide prevention services and resources. It also provided an update on the work of the Hackney Suicide Prevention Steering Group, which has recently been restructured to improve effectiveness. The group has four key priorities:

1. Improving awareness around suicide prevention among frontline staff.
2. Improving suicide prevention awareness and processes in schools.
3. Developing a process for reviewing and responding to suicides when they occur.
4. Developing a clear pathway for people identified as being at high risk of suicide.

The report suggested some areas for future work, including better support for people experiencing crises at home, improving the identification of those who have previously attempted suicide, reducing loneliness and isolation, providing better support for perpetrators, as well as victims, of domestic abuse, and better support for those struggling with housing, debt, bereavement, and physical illness.

The board were scheduled to note the contents of the report.