This meeting of the Healthier Communities Select Committee included a discussion about the development of Integrated Neighbourhood Teams in Lewisham, and a presentation on the Council’s budget plans for 2025-26. It also included a performance update on the Council's Physical Activity Strategy.

Developing Integrated Neighbourhood Teams in Lewisham

This report¹ outlined the national policy context for the development of Integrated Neighbourhood Teams (INTs), and described the progress made in Lewisham towards creating INTs. The report described INTs as:

multidisciplinary teams that deliver holistic, person-centred care, integrating services from health, social care, and the voluntary sector.

The report went on to describe the key aims of INTs, including:

• To improve individual health outcomes and to reduce health inequalities
• To improve care coordination
• To provide better access to primary care
• To support the prevention of illness

The report also provided a timeline for the INT programme, and gave examples of potential risks to the scheme’s implementation, including issues with data-sharing, staff training and stakeholder engagement. The report also discussed the importance of community engagement in the programme.

Budget Savings 2025/26

This report² set out the Council’s plans for addressing the challenging financial situation it is facing, including a forecast £36 million overspend in 2024/25. The report was presented to the Committee for review ahead of it going before the Council’s Public Accounts Select Committee later that month.

The report provided a significant amount of detailed analysis on the Council’s finances, including the context of national government funding for local authorities. It provided a range of statistics, noting (for example) that ‘the Local Government Association states that councils face a funding gap of £6.2bn over the next two years’, and that ‘Grant Thornton estimate that by the end of the year, one in five councils in England will be at risk of financial failure without additional income or further spending cuts’.

The report also provided an overview of the financial situation in other London boroughs, as well as in Lewisham. The report outlined the specific areas of overspend Lewisham is currently facing, including Children's Social Care and Temporary Accommodation.

The report went on to describe the actions the Council is taking to address this overspend, including a breakdown of proposed savings in different areas.

A total of 27 separate savings proposals were included in this report, ranging in their scope from deleting vacant posts to significantly changing how services are delivered. Each saving included details about which service area is responsible for delivering the saving, how the savings will be made, how much money will be saved, and the anticipated impact (positive and negative) of the saving.

Several of these savings were of particular relevance to the remit of the Healthier Communities Select Committee, including:

• Developing Integrated Neighbourhood Teams in Lewisham. This proposed saving aims to deliver £200,000 in 2024/25, £300,000 in 2025/26 and £500,000 in 2026/27 by ‘reducing unnecessary hospital attendances, outpatient referrals, hospital admissions, long term residential and nursing placements and care packages’.
• Reduction in employers pension contribution. It is proposed that the Council reduces its contribution to staff pensions by 0.5%, generating a saving of £650,000 from the General Fund in 2025/26.
• Reduced Leisure Concessions. It is proposed that the cost of concessionary memberships at the Council's Leisure Centres is increased, leading to an additional £80,000 in revenue in 2025/26. The report also included an Equality Impact Assessment for this decision.
• Integrated Community Equipment Service. This proposed saving aims to deliver £60,000 from 2024/25 through ‘improvements to the collection and recycling element of the service’.

Physical Activity Strategy Update

The final report³ considered by the Committee provided an update on the Council’s Physical Activity Strategy 2023 – 2028, which was adopted by Mayor and Cabinet in July 2023.

This strategy contains three core themes:

• Active People – which ‘aims focus on ensuring all pockets of the Lewisham community were provided with as many opportunities as possible to become physically active.’
• Active Environments – which ‘focuses on ensure that all of our residents have access to high quality, safe and affordable places to engage with physical activity, whether this be in a traditional gym/leisure centre or a non-traditional place like religious institutions and workplaces.’
• Active Systems – which ‘concentrates on the development of clear and effective pathways to improve childhood obesity, increasing levels of employment skills and employability and reducing crime and antisocial behaviour.’

The strategy was accompanied by an ‘implementation plan’, containing 60 specific outcomes that were planned to be achieved during the first year of the strategy.

This report presented a ‘RAG rated spreadsheet’, to indicate how well these outcomes had been delivered against. This spreadsheet showed that:

• 40 outcomes had been achieved (Green).
• 14 outcomes were in progress (Amber).
• 6 outcomes were not achieved (Red).

The report outlined the key successes of the implementation plan, including:

• The creation of a dedicated physical activity website Get Active Lewisham.
• The support given to Lewisham Indoor Bowls Club, which has led to a significant increase in membership.
• Partnership working with the Black Swimming Association to deliver programmes in Lewisham.

The report also outlined the reasons for the underperformance of several of the planned outcomes, including a failure to establish a stakeholder group, and a failure to deliver a community grant programme.

The report also provided an overview of Leisure Centre participation across the borough, highlighting a steady improvement in participation at the Council’s four GLL leisure centres. The report also discussed the lower participation at Downham Health and Leisure Centre, and outlined the support being given to 1Life to improve participation at the centre.