The Southwark Council Health and Wellbeing Board was scheduled to discuss a variety of public health concerns at their meeting on 14 November 2024. These included a new report on maternity services in the borough, as well as updates on air quality, the Healthy Weight Strategy, and progress against actions in the Joint Health and Wellbeing Strategy.

Southwark Maternity Commission

The board were presented with the recommendations from the recently concluded Southwark Maternity Commission. The commission was set up by Councillor Evelyn Akoto, Southwark's Cabinet Member for Health and Wellbeing, in January 2024 to examine the quality of maternity services, with a focus on the experiences of Black, Asian and minority ethnic communities. Its report included ten overarching recommendations that aim to reduce inequalities and enhance the quality of maternity care in the borough.

Over 750 local residents, voluntary and community sector representatives, and local maternity care providers and staff were engaged in the Commission.

"The UK is one of the safest places in the world to give birth, yet we continue to see appalling disparities in maternal deaths. And even more shocking is the persistent statistic that Black and Brown women continue to die at a higher rate than their White counterparts.”

- Councillor Evelyn Akoto, Founder of the Southwark Maternity Commission.

The report recommends leadership in addressing racism that leads to unequal maternal health and the development of a new national way of reporting maternal health data across all settings in a standard way to highlight and address healthcare inequalities.

Other asks of central government include a review of the capacity of the maternity workforce, including pay and conditions, and how the system supports resilience.

It also recommends that maternity services should review and improve existing services and develop new ones that work for residents with the highest levels of need and complex needs.

To empower families, the report recommends that services listen to families and create an inclusive environment where all family members feel heard and can access information that meets their needs. It also recommends strengthening communication between providers and families.

The report calls for Southwark Council, local NHS trusts and the voluntary and community sector to work together to raise awareness about pre-conception health, and use services and communication to ensure that women, particularly those at risk of poor maternal health, are in the best possible health when they start using maternity services.

The report also recommends that information and resources are provided to families “at the right time in the right way”, and that they are inclusive and culturally appropriate. In addition, it encourages providers to improve communication and information sharing across the perinatal period.

It further recommends that a joined up approach to families' needs be taken between Southwark Council, local NHS trusts, and voluntary and community sector organisations, and that a network be created for staff to share information, resources, and best practices.

Southwark Council is encouraged to consider their role in assuring the quality of maternity care and to work with NHS trusts to review and identify gaps in services. They should consider how their existing services such as housing support and cost of living interventions could improve maternal health.

Finally, the report recommends that Southwark Council work with local NHS trusts to review how feedback from both patients and staff is captured and acted on.

The Health and Wellbeing Board will receive annual updates on the progress of the actions developed from the ten recommendations, and will receive a full review of progress after three years in September 2027 and a final review after five years in September 2029.

Southwark Joint Health and Wellbeing Strategy 2022-27 Progress Update

The board was presented with a report on the progress of the actions that were set out in the Joint Health and Wellbeing Strategy 2022-27. The strategy outlines five priority areas for Southwark Council and the NHS to work together to improve the health and wellbeing of Southwark residents:

• A whole family approach to giving children the best start in life.
• Healthy employment and good health for working age adults.
• Early identification and support to stay well.
• Strong and connected communities.
• Integration of health and social care.

Of 53 actions, 28 have been completed and 15 are ongoing and on track, including:

• The Southwark Maternity Commission (action completed).
• Increasing the number of Mental Health Support Teams in Southwark schools (action completed).
• Supporting the development of a Health and Care Jobs Hub (action completed).
• Increasing the provision of nursing care in the borough, including through the opening of the Avon Unit (action completed).
• Extending the offer of motivational interviewing to parents whose child is identified as overweight or obese (action completed).
• Developing and publishing Southwark's first Sustainable Food Strategy, including an action plan to address the Right to Food (action completed).

The report recommended that a new action plan be developed for the years 2025-27. This should include fewer actions, which should be larger in scope, more ambitious, and aligned with Southwark's vision for 2030.

Healthy Weight in Southwark

The board received a report on healthy weight in Southwark. It included data on the prevalence of excess weight among children and adults, as well as information on the progress made in implementing the actions in the Southwark Healthy Weight Strategy (2022-27).

The report showed that while rates of overweight and obesity in the borough have remained high, they have been relatively stable over the last five years. However, there are inequalities within the borough, with children and adults living in areas of high deprivation more likely to be overweight or obese than their peers. Children and adults from Black ethnic groups are also more likely to be living with obesity than those from White ethnic groups.

The report described the Southwark Healthy Weight Strategy as a Whole Systems Approach to tackling obesity, which requires action to be taken at multiple levels, with multiple stakeholders working together to improve the food environment and increase opportunities for residents to be physically active. The strategy identifies five priority groups:

• Maternity and the early years
• Children and young people
• Black, Asian and minority ethnic groups
• People experiencing food insecurity
• Men aged 45 years and above

The report identified several potential areas for further development for the strategy, including:

• Developing a patient-centered referral pathway for clinicians for working with adults living with obesity who also have long-term health conditions.
• Supporting residents to be physically active, including women during the perinatal period, and ensuring that any physical activity services offered are culturally appropriate.
• Refreshing the Healthy Schools/Healthy Early Years programme in the borough, including promoting the Alive N Kicking programme.
• Promoting the BetterPoints Southwark app as a tool to support healthy lifestyles, and using the data from the app to understand how this approach addresses inequalities.
• Streamlining signposting to national and local weight management services, and working with providers to increase the number of services on offer, and ensuring they meet the needs of diverse communities.
• Increasing the capacity of tier 3 weight management services for children and young people in the borough, and across South East London.
• Working with partners to determine how weight loss drugs should be rolled out in South East London.

The board was asked to provide feedback on the proposed areas of development. They were also asked to discuss opportunities for systems approaches and collaboration to improve signposting and the range of services available for adults living with obesity.

Health Protection Annual Report 2023/24

The board was scheduled to receive the Health Protection Annual Report 2023/24 and to discuss the activity of the Southwark Health Protection Board.

The report, covering 1 April 2023 to 31 March 2024, describes the impact of the pandemic on Southwark's health protection, and how the health protection system was impacted by the effects of the pandemic in 2023/24.

It includes information on:

• Tuberculosis (TB)
• Sexually Transmitted Infections
• Food Safety
• Vaccination programmes (including the impact of low vaccination rates on rates of measles and whooping cough)
• Cancer Screening programmes
• Health protection in vulnerable settings (including adult social care and initial accommodation centers for asylum seekers)
• Environmental hazards (including adverse weather and air quality).

The board was also asked to agree to receive an annual report on health protection.

Air Quality Annual Status Report 2023

The board received an update on Air Quality in Southwark. It included information about Southwark's compliance with the national Air Quality Standards and Objectives, and described progress against the actions set out in Southwark's five-yearly Air Quality Action Plan (2022-27).

The report showed that Southwark is generally meeting the national air quality standards and objectives, except for exceedances of the annual mean objective for Nitrogen Dioxide at a number of locations in the borough.

The report also provided information on concentrations of particulate matter (PM₁₀ and PM_2.5) and Ozone (O₃) which, while not exceeding the air quality objective, were shown to be above the recommended guidelines set out by the World Health Organisation. The report confirmed that Ozone levels in particular had increased significantly over the last seven years.

The board was asked to note the contents of the report and to agree to continue providing oversight of the Air Quality Action Plan.

Pharmaceutical Needs Assessment (PNA) Briefing

The board were presented with a briefing on the refresh of the Southwark Pharmaceutical Needs Assessment (PNA).

The PNA describes the pharmaceutical needs of the population of Southwark, and is used by the Integrated Care Board to plan services to meet these needs. The board was asked to note the timeline, scope and process for the refresh of the PNA. The refreshed PNA is due to be published in October 2025.

The board was informed that a ‘task and finish’ group has been set up to oversee the PNA process. It will include members from the council, the South East London Integrated Care Board, NHS England, the Local Pharmaceutical Committee, and the community engagement team. The group will consult a range of stakeholders, including neighbouring boroughs and local pharmacists.