Transcript

Good evening and welcome to the Health and Well-Being Board Meeting. My name is Councillor Gulam Khibriya Choudhury, cabinet member for Health, Well-Being and Social Care and I will be chairing this evening's meeting. This meeting is being filmed for the public website. Those participating in the meeting will be included in the footage. Should a technical error occur that prevents remote attendants from participating, I will decide if and how the meeting should proceed after taking advice from our officers. I would remind members at the meeting to only speak on my direction and to engage and speak clearly into their microphone to ensure that their contribution can be properly recorded. Participants, please have your mobile phones on silent and virtual participants keep microphones on mute except when speaking. Those in physical attendance have their microphone turned on only speaking. If those joining remotely wish to speak, please raise your hand function, please do not use the remote meeting chat function as it will not be seen by those of us in the physical meeting. I would remind members at the meeting to only speak on my direction and speak clearly into their microphone to ensure that their contribution can be properly recorded. Any apologies for absence have been received? Good evening, Chair. Yes, we have received apologies, a couple of apologies of absence from Khosru Udin, who is our Tower Hamish Housing Forum rep, and from Councillor Amy Lee. And I believe we have several members of the Board joining us remotely, who can be seen on the screens. Thank you. Do members have any declaration of disclosable pecuniary interest? When making a declaration, the member needs to state the agenda item title of the report. If the interest is not their register of interest, they must give an explanation for each declaration. Thank you. Our last two under-restricted minutes of the meeting are presented for agreement. Do members have any comments at the minutes agreed? Agreed. Agreed. Thank you. Before I go to the agenda, I want to make one announcement, because a lot of our members, they have another commitment tonight. They need to go early. Despite today's plan, I would like to recommend to the Board that we defer our item 2.4, improving alignment between Health and Well-being Board and Tower Hamish together, because the Mayor is interested in taking more time to examine how the Health and Well-being Board can go forward working with our partners in the future. And I believe that time should be allowed. Will the Board agree to defer this paper? Now, I ask our officers to present this item, and we will open for members' questions after the presentation. Thank you. Thank you. Great. Thanks very much. I think board members will remember, I think over six months ago, we had an item in which we talked about how the Be Well, the new leisure service, could be an opportunity to develop better information. on pathways, on pathways, on pathways, on health and care pathways, across the system, and Emily at that time presented quite a comprehensive action plan of things that we were going to do. And those sort of arrangements between different clinical groups and high risk patients, and the new opportunities around leisure services was really welcome. So we thought it would be good to talk a bit about some of the progress and have a discussion about what more we can do. So I'll just hand over to Emily. Thank you. Yeah, thank you, Shulman. Today's presentation really is in kind of three parts. As Shulman mentioned, I'll do a brief reminder of what was covered in March 2024 when we came to present the leisure health promoting theory of change. Then I'll provide a brief snapshot overview of some of those pathways and targeted intervention that have been implemented, including an update on the free swimming. And then for the last part, I've got kind of colleagues and partners that help bring this presentation to life and provide a bit of an update again on some of the initiative that we're working on. I have a few slides though that I have shared and I just wondered if we're able to put them on the screen. Can you hear me? Can you hear me? Can you hear me? Can you hear me? Ah, yes. Yeah, sure. I'll do that. Sorry. Okay, great. If I can move my slide. Okay, so just really briefly, as you'll be aware, the leisure services were brought in-house in May and the new BeWell service was launched, taking a phased approach to its implementation with the first year being all about reviewing, piloting and planning new initiatives. And really the aims or one of the aims of bringing the leisure in-house was to think about how we can develop a more inclusive and holistic offer and to really think about working more closely with health and social care partners. And so we co-developed a theory of change to inform this work and to really guide how the new BeWell service would deliver health and wellbeing outcomes. And this was the logic model that was presented back in March. And again, I'm not going to go through it in great details, but we talked of some of the input activities that we mentioned was around collaborative partnership, the co-location and co-delivery of services, the leisure rebranding, which was reflected in the new name, BeWell. But also investment in staff and workforce training and development, particularly from the health sector, as well as commitment to invest and commission relevant physical activity for our priority groups. And our priority groups were identified using kind of local health intelligence and data. And we had a range of groups in the community that we thought should be prioritised within the new service, including older people, women and girls, particularly thinking about intersectionality, children, young people, people living with severe mental illness and learning disability, as well as people living with long-term conditions. So, just kind of moving on to the update, this slide, and I apologise, I realise this is really small, but I wanted to provide an update on kind of four different initiatives that have been implemented since the launch of the new service, just to give you a bit of flavour about the work that has been happening. Just a bit of a caveat, given that the service is only six months old, we don't yet have full kind of evaluation or data on some of these initiatives. But the first one is that we now have a pilot for children and young people who are supported by the youth justice and care leavers. So, it gives those children access, free access to be well. And this has been funded through children services. The leisure staff are working in collaboration with youth workers to support, to identify those children and support those children accessing the offer. So, we currently have 16 young people on this scheme. We have a programme for, a free weekly programme for pregnant women in collaboration with Bart's Maternity Service. That has been funded through Bart's charity, but we are looking to expand with public health through family hubs. This has been really well attended, and again, you can't really see the feedback on the screens, but all the women that have used the service say that it really helped with the physical and emotional health, as well as prepared them to labour. We also have a pilot for children and young people that live with type 2 diabetes, and that has been developed with Bart's Pediatric Endocrinology Service. So, it's a relatively new offer that was launched about four weeks, five weeks ago. Initially, the clinical team wants to focus on women and girls and expand to boys in the future. The clinical team has been working really hard to get their patients engaged, and engagement has been relatively low. But for those who have been attending, they're having a real positive feedback around improved fitness, as well as a broader lifestyle improvement, including nutrition and food choices. And then the last one is actually new as of today, but our leisure staff have received training around severe mental illness. So, we partnered with Rethink Mental Health and Sport England to provide a training for leisure workforce to be able to work more effectively and to be more, I guess, confident and competent with supporting people living with SMI. Another initiative that I'm sure you're all familiar with is the free swimming offer. So, that was a major priority, and it was launched in the summer, and the aim was to reduce the financial barriers for women and girls and older adults to access the leisure services. We've had around 14,000 members that have signed up since July. And out of those, 93% are female, 18% are over the age of 55, and the majority of participants are from a Bengali background. We've asked a few women to share their experience of the free swimming and how it has impacted their life. And I'm probably not going to do the best justice, I guess, to their feedback, but given that it's quite small on the screen, I'll just read some of the insight that we received from those women. So, one said, both me and my mum have attended the weekly free swimming since September. We look forward to attending, and the program has given us the motivation to stay physically fit, as well as improve our mental health. We are extremely grateful for this opportunity, which has allowed us to get back into swimming and develop our skills free of cost. Another woman said, the free swimming initiative is a brilliant idea. It's been particularly beneficial for my younger cousin, who are a university student, and for all the family members who cannot afford a gym membership. A great example is my mother-in-law, who hasn't swarmed since she came to the UK at the age of 16. Hearing about the free swimming, especially the woman-only session, has motivated her to stay healthy and improve her physical activity. So, I think these are just a couple of examples that showcase the potential that the free swimming has on improving the health and well-being of the community. The service or the offer is only a few months old, and there has been some operational challenges, and we also received some constructive feedback. So, for example, the booking systems currently, bookings are released a week in advance and get fully booked pretty immediately. So, I think that stops kind of access and reach in terms of new joiners. There has been also feedback around capacity and overcrowding of the swimming pool, with booking being made for the free swimming and for paid services. As well as kind of sharing the pool with different activities, so for the free swimming, but alongside children's swim sessions, for example. And finally, the technical or IT barriers for older people. So, if the free swimming are booked up a week in advance, if you can't access through the digital booking and you have to come and book in person, you're more likely to not have a spot. So, I think all of those things are currently being looked at by the leisure team to really improve the offer and make sure that we have kind of a broader reach. And just to say in terms of kind of the, I guess, impact of those challenges, we know that this being reflected in our kind of booking versus attendance. And as you can again see on the screen, we've had about 20,000 bookings, but only 8,000 attendance. So, there's only 41% attendance at the moment. And all of those kind of challenges that are being experienced by residents, you know, are likely to be the reason for this kind of no-show. A good, like a positive news, though, in relation to the free swimming and really understanding its impact is that we have been successful at getting an NIHR-funded evaluation for the offer. So, Be Well, in collaboration with Public Health, we'll be working with a fully funded research team to really help us understand the impact of the scheme and inform kind of future practice. So, I'm going to, you know, stop here and bring some, just a couple of my colleagues to kind of bring to life the other two initiatives that we have been looking at. So, I know that Tiffany is online. So, Tiffany is a cardiac rehabilitation clinical nurse at the Royal London, and she'll provide a brief feedback of the cardiac rehab work that we've done together. Thank you very much, Emily. I'm Tiffany Popkiss, and I'm a clinical nurse specialist for the Phase 3 cardiac rehab at the Royal London Hospital. And we provide cardiac rehab sessions for patients who've had a cardiac event or intervention or have heart failure. Now, after COVID, we lost the use of our hospital gym, and so we're using Whitechapel Sports Centre for all our sessions now or offering a hybrid programme. We also include Bengali men and Bengali women-only sessions with Bengali advocates to offer and encourage the uptake of cardiac rehab within the borough and for inclusion as well. We also offer patients free Phase 4 sessions, which most other boroughs don't offer. Most other boroughs, people have to pay for those sessions. And when the patients have finished their Phase 3 and Phase 4 sessions, we promote them to continuing with self-management of their exercise regime. And this is where we signpost them over to your local council services. So we encourage them to use the free swimming. And we're very grateful that you've been able to offer us a reduced membership in the gym. So we usually have 124 patients who attend face-to-face in Whitechapel Sports Centre who've completed their cardiac rehabilitation. And that was last year's figures from 23 to 24. So we have 11 hours a week of protected hours where we do and run sessions over in the leisure centre. So this provides the patients with these chronic heart conditions the opportunity to get familiar with the leisure facilities. But they're also being supported safely while they're exercising as well. Cost is a significant barrier for a lot of the patients to engage continuously in leisure and physical activity when they finish with us. 44% of all low-income households have a disability or long-term condition. So it's really important that we're inclusive and we do offer resource to people who are financially disadvantaged. So the new exit pathway into BeWell for patients who've completed a cardiac and pulmonary rehab programme through a reduced disability membership of £25 a month over 12 months is really, really welcome. I'm very pleased to say since we've been able to offer this to patients with BeWell over the last couple of weeks, we've had two patients who've joined and two other patients who are about to join. I think they wanted to wait till after Christmas and then benefit from the offer. But we are able to now promote it. So we're very grateful for this local initiative. Thanks very much. Thank you so much, Tiffany. And I'm now going to hand over to Isabel and Dawood who will provide a brief overview of a scoping initiative that we're looking at for people with learning disability. Hi everyone. My name is Isabel Forshaw Daniels. I'm the new Health Commissioner for Learning Disabilities and Autism. This is quite a new project, but it's been a really exciting opportunity for commissioning to work so closely with public health and ICM. Amelie and her team, well before I started working with them, have obviously put so much work into initiatives that support the need for active recognition of those with a learning disability as being a vulnerable group. And bringing together our local priorities in commissioning and public health to focus on one project has been a lovely opportunity. One example of commissioning's local priorities comes from the learning disability needs assessment that was produced this year based off of work done by ELFT and produced by public health. And a couple of the main takeaways from this were one of the key recommendations was to build capacity and resources within local non-specialist existing organisations that work with adults with a learning disability and their carers. The second takeaway was that people with a learning disability are at a much greater risk of premature mortality than the general population. For some perspective, the average age of death for someone with a learning disability is about 28 years less than the general population. And 42% of deaths are considered avoidable and preventable. One of the biggest contributing factors to this is obesity and the conditions that can stem from this. Tower Hamlets has higher rates of obesity and other comorbidities like diabetes compared to the general population. When you put these factors together, it makes sense that we create a project that is ideally centred around physical wellbeing, weight loss and accessing mainstream community services as part of that. And one large way that we can do this is through leisure centres. Therefore, in line with these local and national priorities, we're commissioning a programme that firstly aims to look into the specific barriers borough-wide for those with a learning disability to access regular exercise within existing provisions. So in the short time that I've been in this role, I've been sort of inundated with information about the amazing initiatives in this borough and the ways that individual organisations have supported those with lived experience to remain healthy. This project is going to look into how we reduce or remove these barriers across the borough by bringing together the work the individual organisations are already doing. We are aiming to reduce these barriers through places like leisure centres by learning disability specific training for leisure staff, creating an activities timetable across Tower Hamlets and ensuring that these have built in peer support for sustainability and motivation for those with lived experience. In terms of the actual work with implementing this, that's something that's going to be much better able to be explained by Dawood from ICM. I'm going to hand over to him to speak about the experience and the opportunities that this will bring service users. Have I done that right? Can you hear me? Okay, sorry. Yeah, my name's Dawood Marsh from ICM Foundation. We run a project for adults with learning difficulties and disabilities in the Attlee Centre called Core Projects. So what we did this summer was quite a unique kind of project. We called it Connecting Communities Roadshow. And it came out of the idea that there are barriers to people with learning disabilities getting into leisure centres and always the discussion is really around going to the gym. I'll be honest with you, a lot of people, I don't know about anyone in here, will put their hands up to say, yeah, I'll go to the gym. Not a lot of people with learning disabilities want to go to the gym, but they want to go to the leisure centre. They want to have an opportunity to use the kind of mainstream facilities to meet with people they know and to do things they're interested in. And they are very interested in doing active things. So we tried to kind of broaden that discussion about what they could do. The Connecting Communities Roadshow provided over 40 sessions across the borough. And we did actually use some of the leisure services. So we also started a unique programme called Wheel Walk Run. So people who are wheelchair users, people that can walk, and people that are able to move a bit faster, went round the Mile End Track. And that project was based on the model for the Park Run. I know the council has worked with Park Run before to try and get residents active. And they absolutely loved it. We got lots of organisations coming, going round the track. We had Clara from Planet Hoops with music and hoops and lots of enthusiasm. People really went round that track and enjoyed it. We had other sessions around karate, boxing. We also did chair-based exercise. We did dance and movement. But we also broadened the things that people could do around cooking, gardening as well, which is quite an active thing. And also mindfulness and aromatherapy. So we got people to think about there are different ways in which they could use the leisure services. We saw it as having a blank canvas. If you have a room in a leisure facility, you can provide anything in that room. And you bring people into the leisure service itself. And then once they're there, there's lots of other things that they might be interested in doing with support. So the idea of the summer roadshow was to just get people talking about what they would like to do together. And we co-developed the roadshow with people's ideas about what they wanted. And I'm telling you, the feedback has been amazing. The tutors that ran the session said those people involved were incredible. I was taking part in one of the karate sessions. I'm a purple belt in karate. And there were three people there. It was at Bromley by a boat. They were like, we're not doing it. We're not interested. By the end of it, they were trying to punch the sensei out and trying to do some moves. They really totally enjoyed it. And they engaged because of the way it was run. So there's lots of opportunities there for adults with learning difficulties and disabilities. And I think this project really gives us an opportunity to kind of have that discussion, not just with people with learning disabilities, about how they want to be supported, to be taken into different parts of the borough. But also, we have a group that we run on Thursday that have been doing for many years, training frontline healthcare staff how to make reasonable adjustments for patients with learning disabilities and to communicate better with patients with learning disabilities. So we're in a position where we can run training with leisure centre staff to help them understand how to support people to come to the leisure service with learning disabilities. So we've got lots of opportunities there. The other thing is, I just wanted to, sorry, I'm going on. When I spoke to the Parkrun people, because I go and do Parkrun as well, I had a long conversation with them. They were really prepared to have people to go in there as volunteers with learning disabilities. And when we've done the wheel, walk, run, our group, our sports group, helped people walk round or wheel round and run round and they were there engaging and being active in getting people to participate. And I think that's the other thing that Isabel was talking about, getting people to, like, be champions, people with learning disabilities being champions for their own community. And that's the other thing that we want to try and introduce. Is that it? I'm sorry. Do members have any questions or any clarification, please? Yeah. Just to wrap up, really, I just want to say thank you to everyone. And that there's lots of future hope that gives you a bit of a flavour of the work that we have been doing. And there's a lot of future opportunities to really continue to strengthen the work, I guess, between the physical activity sector, leisure, be well, and health and social care. I'll stop here. Thank you. Thank you, Chair. Thank you very much for your presentation. But I'm particularly interested in understanding in terms of how are you monitoring when it comes when it comes to the issues in your service delivery, when it comes to specifically members of the transgender and binary community, and how are you going about meeting those targets? Also, in terms of the groups, you've mentioned about the swimming. Predominantly, you said the intake has been of the Bengali community. That's brilliant. That's really good to hear. In terms of the other communities that are accessing this facility, how do we bring that up to get the numbers up and what is being done? And also, in terms of the obesity stuff, I keep on hearing, I've been hearing about obesity being a big issue within the bar for a long time. Having the leisure facilities coming in-house, how are we in terms of doing to tackle that aspect of it, and how can we go even further to basically tackle that? Because that is a big issue across the board. I think that's something that we really need to focus on. And in terms of the different partners that we're working with on the report, they said we're working with the NHS, HCV and other community groups. What is it specifically that they're providing in terms of the outputs that, you know, the service? Thank you. I'm going to try and remember all the points that you've made. I think the first one was around inclusivity for transgender and binary. I'm not aware that we had any kind of requests or queries around this. I'll bring this back to the leisure operation team. This is where it would have been useful to have a colleague from leisure. So I'll bring this back or ask colleagues to provide feedback on that. I think the second one was around target audience with Bengali community and different community. I think for the free swimming, we have a comms team that can support us to get the words out. I think there will probably be a lot of work to do around kind of outreach of a range of community. You might not have seen in the way that we capture data, but ethnicity was not a mandated box initially in our leisure management system, which means that we're doing a lot of catch-up in terms of understanding our current cohort. So Bengali are the first one and the second one is actually no ethnicity recorded. So we need to do a little bit more understanding around this. The third question. Sorry, I forgot now. Yeah, I think there's a lot of opportunity to work more kind of in a more integrated way with a range of kind of partners to support people at risk of living with obesity. We've had lots of conversation with our commission weight management services who are doing a lot of signposting as well into be well as exit pathways. I mean, obviously obesity is a multifactorial condition and there's lots of range of things that, you know, will influence. Certainly from a kind of physical activity perspective, there's lots of opportunity to work more collaboratively together to increase physical activity. Community groups working in the community, what are the specific outputs? Yeah, so I think it really depends on the initiatives. For example, with Dawood and the ICM Foundation, they will be at the forefront of coordinating and delivering activity for kind of target group for people with learning disability. And there's other community groups where be well works more kind of in partnership with. And we also have a kind of emerging place based partnership in Tarrhamnes, which is kind of a sport England and London sport led initiative to support the borough working in more place based way. And that has representative from kind of partners across the board, including lots of VCS organization that will, you know, help us deliver and lead on that. Thank you. Yeah, I have a few questions. I mean, it's been, what, five, six months now we've taken in, you know, in house or in source. The whole idea of taking in house was to tackle inequalities, provide better facilities, better service. So I just want to understand what are the, I mean, now that we're providing free swimming, we're providing the facilities, we're investing a lot of money into it. I just want to understand, you know, what are the barriers now? What there must be, there are, there are various barriers. So I just want to know from you, what are the barriers now from stopping people to join these, those sessions or those opportunities. And also, I want to understand what work are we doing with parents through the schools, if we're doing any work with parents. And also about the high obesity, I mean, we know that. Are we doing any work with the schools? If we are, what work are we doing to tackle that? Because schools are so important, tackling these inequality issues, obesity issues. And also, how are we monitoring? I mean, it's been five, six months now. How are we monitoring the inequalities? I know it's, it is a difficult area, but are we monitoring, unless we monitor, I think, you know, there's a lot of things we need to learn from it. It's still early, but are we monitoring it or how are we monitoring it? And also, my final one was about 3.12. It's saying there was a bid put in July 2024. And it says October with potential investment starting from November. Have we, have we got that bid or have we achieved it? Do we know anything about it? Thank you. Yeah, so just to answer your question about kind of monitoring and impact and some of the barriers. I think for the free swimming especially, it would be really valuable to have that kind of independent evaluation coming in. And so that that would be able to kind of help us understand, you know, what are some of those barriers. We know there's like high bookings, but there's also a high no show. And so I think, you know, having, being able to kind of, you know, speak to residents who are accessing the scheme or not accessing the scheme to really understand what are the further barriers. I think that would be really valuable. In terms of kind of broader groups, I know, again, from speaking to Isabel and Dawood, some of the barriers for people living with learning disability, for example, was, you know, the lack of targeted session specifically for these groups, which is something we're looking at to kind of overcome. So, again, barriers will look differently for different people. And this is all of the challenge as well is having an offer that meet kind of a wide range of needs. In terms of schools and the work with schools, yes, again, I'll ask my colleagues who kind of work with kind of juniors in school to provide a bit more of an update. I know there's lots of work going around kind of the swimming and learning how to swim with schools. Within the place-based partnership, kind of children, young people in schools are kind of one of the core group. So, we have kind of representatives for education on that board, which leads to your last question about their funding. So, the partnership is formed. London Sports, who kind of leads the partnership in the borough, should have a conversation with Sporting England this week. So, we should have kind of the green light before the end of the year, but there has been a few delays, I'm aware. But we're very confident that we'll be moving forward with this into the next year. Thank you. Thank you. Councillor Bellard, please. Thank you, Chair. Thank you very much. Thank you very much for your presentation. I have one question. You know, I've received a number of phone calls from my resident. Their membership, gym membership, has gone up after the council takeover. I don't know why. Could you explain to me why should you have gone up? Yeah, again, I'm probably not the best person to talk to her, but there has been lots of conversation in terms of kind of fees and charges that has happened within kind of the leisure operation. I can, again, provide a bit of an update from my colleagues because that has not been kind of part of kind of the public health side of this work. But, you know, I'll provide an update. Yeah. Thank you. Thank you. Thank you, Steve, please. Thank you, Chair. Just a couple of quick points going back to the question around trans and non-binary individuals. The Tower Pride, the staff network in the council, I know they have been raising some issues with the leisure service and are in discussions about how they can make some adaptations and improve our approach around that. Just to support the point around the work with schools. I think there's a real opportunity between schools, leisure, and our developing Young Tower Hamlets Youth Service. There's a real opportunity around there. I also think we've been receiving some updates from Matthew Quinn in public health around healthy weight strategy. So there's a relationship between healthy weight and obviously the sports and leisure. I really enjoyed hearing about the inclusive approach that you've described. And I think we've got a new central inclusion strategy for young people. And the sixth priority is about a borough that's really inclusive. So some of that inclusive approach to physical activity is great. And finally, just on making offers to children in care and care leavers and giving them free leisure passes. Myself and deputy mayor really want to see a lot more of that. So that would be great. Thank you. Thank you, Chair. I'd just like to talk about, well, in some cases we know that people, some people are lazy to even in their daily lifestyle. And in some cases even they're lazy to go to even gym, you know. But what I'd like to know is how hard we're trying to get to those people that, to aware of them that there is something available for them. Not only them, it's for every general public residence. In order to invite them and encourage them to join the facilities that we are providing. Yeah, it's on. Okay. And, you know, it's not only about like cooking and not having anybody to, not anybody inviting for a meal. Just cooking the food and living on the table. So how well we're doing in order to invite those residents to use the facilities. How, I mean, what's the, what's our target and what are we up to now? Thank you. Basically it's hard to reach people, yeah? Yeah, thank you for that. I think in terms of be well is how can kind of the leisure work really collaboratively with other partners who would be in regular contact with those groups of people. And so, for example, social prescribings. We've had, you know, lots of conversation with them. They will obviously be supporting more vulnerable groups in our community. And so how they can have kind of the supportive conversations and help them, signpost them or kind of refer them into leisure. I think this is also where the collaborative work with kind of VCS organization that work with those kind of targeted groups is really important as well. I mean, David is a perfect example of kind of advocating for physical activity and access. So, yeah, I think it's probably kind of that, that way forward. Speaker, yeah. Sorry, okay. Yeah. Yeah, that's what, that's what I mean. In order to, to tell, I mean, how are we approaching the people? I mean, I know you are advocating and this, that providing this, someone is willing to listen to you or someone is there. So how do we get to them? For example, where I live, I mean, I haven't seen any lift flats or anything. To come through my door or anybody knocking my door saying that these are things available for, you know, for so-and-so people. Is there anybody interested to use these facilities? You know, like, it's like a teamwork, you know, to get to those people who are ignoring us. Yeah, thank you. I mean, there's probably a lot more that we can do to reach everyone. And the Greek comms, as you mentioned, lift it in and it's probably something, I mean, something that has happened. And we do have a comms team that's working on the be well. But yeah, I take your point about maybe doing more and more of this. Thank you. Thank you, Councillor. Kobir, please. Yeah, I was just going to pick up on Councillor Sulukh Ahmed's point. And I think one of the areas where we probably got limited number of people accessing the services, those who aren't digitally savvy. And again, I suppose that's where Councillor Sulukh is saying he's not seen any literature come through his door, any sort of, some may call it aggressive advertising, but, or may not have exposure to the services that are being provided. Those who have, say, younger children or those within the household that may have access to IT facilities are able to book their parents in or grandparents and so on and so forth. But those who are isolated and the more vulnerable, it may be a method of communication, though it may not be digitally sound, but if we're targeting a particular group, we may want to think about approaches and advertising like that. Is it okay if I add a comment? Sorry. In terms of reaching or getting to those hard to reach people, I think the project around encouraging adults with learning disabilities to come into leisure centre would be a really good way of kind of looking at how to approach people. Because what we want to do is get people to come into leisure centre because there's something that they're interested in. Like I said earlier, not many of us want to go to gym and maybe some of us are not confident to swim or we can't swim. Having a blank canvas or a room in which lots of things can go on brings people into a centre, into a space with people they know, doing something they like. And I think that's a really good way of getting people in and then the conversation starts and becomes like a kind of a butterfly effect that other people get to hear about that. But there's another kind of group of people that may be not so easy to reach and I'm one of them. I can go and do the free swimming, but I've got family and I do running and I do other stuff. And if there was a running group at Myelin Leisure for people like me and my age, I'd be there. But the swimming thing, I'd love to do swimming, but it's about the time and the motivation. I think there's different levels of people that are hard to reach that we need to maybe be more imaginative about approaching. And I'm hoping that maybe the project we do could show us some ways in terms of how to communicate information, how to raise that interest in people and bring them into the leisure centre. And then once you're in, then you've got all the kind of stuff that's there that might encourage people to come back again. That's just a thought. Yeah, it was just it was just to say, I think just on that issue, I think there's work that we do with voluntary sector and housing associations, in which we work with people who are particularly at risk of cardiac, diabetes, heart disease. And that's kind of on the groundwork in which it's not necessarily about leaflets. It's about people feeling safe to go to leisure services. You know, so people who what we found is that particularly with women, they want to go to the leisure services, but they don't want to go on their own. So it's like, how do you get groups to come together? And it's actually part of the work I was talking to Councillor Waid about is how you tap into the networks in the community. So it becomes a social thing and people feel safe going because, you know, we even though be well is kind of trying to be inclusive. There is the sort of perception of leisure services as not being for the community. And I think that's what can deliver that change. Thank you. Thank you. Thank you for bringing this presentation to the Health and Wellbeing Board and for sharing all of the important steps that we are taking to ensure that our new laser service is a tool for increasing physical health locally. And regardless of age, there are strong scientific evidence that being physically active can support people leading healthier and happier life. The World Health Organization estimate that the regular physical activity reduces risks of many types of cancer by 8 to 28 percent, heart disease and stroke by 19 percent, diabetes by 17 percent, depression and dementia by 28 to 32 percent. I am currently in the process of reviewing our new long-term framework for preventing the major causes of long-term health condition in our most vulnerable communities. And it seems to me that this physical activity plan fits perfectly into that work. Thank you once again. Thanks. Sorry. Can we please agree the recommendation in this report? We have six recommendations. Please. Yeah. We agree. Thank you. Thank you. Thank you. Our next agenda is 2.2, Safeguarding Adults Board Annual Report 23-24. Every year the Safeguarding Adult Board publishes an annual report to set our progress, achievement and learning over the previous year. The attached annual report for 23-24 is presented to the Safeguarding Adult Board for agreement and will be published on the Council's website. Our Corporate Director Georgia Simbani is online. She will present this report and she will have only seven minutes to present before we open up members' questions. Thank you very much, Councillor Chaldry. Actually, it's our independent chair, Sue Ross. If I can introduce our independent chair, Sue Ross. She is our chair for Safeguarding Adults Board. So I will defer to her. Sue? Yes, thank you. Yes, thank you, Georgia. And thank you, Chair. And thanks for the opportunity to present this to you tonight. And I will be brief. I have to apologise. First of all, I'm struggling with a head cold today, but I'm not hearing terribly well. So I'll do my best to power on through the report for you. The report is presented to you and it covers the period for 23-24. And I think the first thing to say really in relation to this is that we are beyond that period now and it has been somewhat delayed in presenting this report for a variety of reasons, which are set out in the foreword of my report. I became your independent chair in July this year. And so much of what's in the report covers the period before my taking over the role. But nevertheless, I'm very, very pleased to present it to you tonight. So just moving on through the report, the page, which I don't think is numbered, but if you can take us to it, Ranjit, which starts off Safeguarding Adults Board Summary for 2023-24, I think sets out the key areas that I would want to put over to you tonight. You'll see in this report. You'll see in this report that some description of the volumes and trends of safeguarding concerns, which are slightly up from the previous year for 2023-24, but very much in line with what we can see in national data in relation to adult safeguarding concerns and numbers. You'll see again that the numbers of inquiries, that's referrals that go further than just initial concerns, but into inquiries and investigations. Again, it has increased slightly from the previous year, as with the national data, neglect and acts of omission remain the largest single type of abuse investigated across the borough. And all the agencies represented in the board are involved in looking in many ways at the way that neglect and acts of omission are represented in safeguarding. The biggest, the majority of safeguarding issues, as you can see, take place in the victim's own home and, of course, in care homes. And lastly, in terms of volumes and trends, the numbers of deprivation of liberty safeguard. This is where an individual lacks capacity to make decisions in respect of some of their own matters and have to be restricted in terms of their liberty, which is a very serious thing to do to an individual in human rights terms. The numbers requiring deprivation of liberty safeguards in law has increased in the 23-24 period. And again, this is all I can say to you that the Tower Hamlets trends are very reflect other other boroughs and national data. So just turning to the activities of the board and just to remind members of the health and well-being board that the board is a statutory responsibility under the CARE Act, which is led by the local authority, but shared across health and the police as the key statutory agencies. And I, as independent chair, bring together that work on the board in relation to its statutory requirements. We have three statutory requirements which we must fulfil every year as a board. One is to produce an annual report, and that's what you have in front of you. The second one is to produce a business plan, which covers the strategic requirements of the board. And the third is to commission any safeguarding adult reviews where an adult has died and abuses or neglect is suspected or proven. Or where an adult with care and support needs has been seriously harmed, potentially as a result of neglect or abuse. So in relation to 2023-24, the achievements of the board, which are set out in the previous slide, there was a safeguarding adult review published by the board under the title of Mrs. N and Mrs. O. There was a safeguarding conference which looked at homelessness and substance abuse, which are key areas of leading to safeguarding adults' reviews. There was a joint working relationship, developing priorities and objectives across the partnership and summarised in the executive group. So you'll see that there was a successful self-neglect and hoarding and escalation resolution procedures. And obviously, the board going forward will be keen to see how that is implemented. And lastly, you should note that the Safeguarding Adults Board was mentioned positively by the peer review that was undertaken in the year. So some very key areas are picked up. The report that you have circulated to you tonight also sets out the structure of the Safeguarding Adults Board, how it's set up, and what the priorities of the subgroups, which form the real engine room of the work of the board, have been involved in over the 23-24 period. Going forward, and this is really important in terms of my position as independent chair, in future reports, we want to make them somewhat easier to read, somewhat less complex, and we want to include more information which is drawn from the authentic experiences of adults going through safeguarding procedures. We really want to make sure in future reports that I bring to you that the voice of individuals experiencing safeguarding services is much louder in terms of the future reports. And that's all I want to say tonight, Chair, but I'm happy to take any questions and hopefully deal with any queries that you might have. Thank you. Thank you. Thank you. Thank you. Thank you. First of all, we welcome our new independent chair, and I am confident that you will take initiative to change positively, and anything good for the resident and good for the borough. Thank you. Any clarification? Thank you. Thank you, Chair. Thank you to our independent chair, Dr. Suzanne Ross, for your first annual report. It's very useful. Thank you for that. My first question is around the implementation and learning from safeguarding adult reviews. I just wanted to know who actually monitors the review. And my second question is around, you know, we say that safeguarding is everyone's responsibility. So I just want to understand, you know, how you feel, do you feel that there is a safeguarding culture throughout the Council? I just wanted your view and your opinion on that. Thank you. Okay. Well, two very important questions, Councillor. I mean, two very important questions, I mean, in relation to the first one, I mean, is the Board's responsibility to, and particularly through the statutory partners, the council. your opinion on that thank you okay well two very important questions uh council i mean in in relation to the first one i mean it is the board's responsibility to um and and particularly through the statutory partners the council health and the police to uh to monitor the implementation of learning from safeguarding adult reviews how we do that currently uh on the board is through the quality assurance and performance subcommittee which tracks um the the the implementation of learning um from safeguarding adult reviews not just those that are carried out within tower hamlets but also those that are relevant from uh from from other uh london boroughs or from other parts of the country um nationally there has been over 500 uh safeguarding adults reviews um published um and there has been a very important uh piece of research um which has been carried out uh by um by michael preston shoot um and other um researchers in this field who have been looking at the recommendations across all of the safeguarding adults reviews that have been published uh which as i say are over 500 um in the country since the uh implementation of the care act in 2014 and many of the recommendations it won't surprise you to know are are similar um many of the the the at the areas of learning that come across um are are repeated in different parts of of the country and it's really important from this point of view that we not just look at the learning that comes from the ones that are carried out in tower hamlets but also um uh nationally and that we link to those so um that that that's really um important through the tracker and the use of the tracker which i believe was introduced um by your board uh just before um before i i took over as chair so that that that that's in relation to the implementation of the learning um in relation to the question you ask about safeguarding is everyone's responsibility and that's repeated again and again in all the guidance and all the documentation in relation to safeguarding that's produced um i mean it's a challenge for every every um every organization every statutory body um to make sure that it's right up there because it's the hardest responsibility that you carry um as as a council and as and as partners um in in tower hamlets um responsibility for vulnerable people who um for variety of reasons are subject to abuse and neglect um is that is the hardest responsibility for all of us um and i i think whatever we can do to um to make sure that that culture is across the whole of um the council activity not just something which is fundamental to the work of adult social care um but actually um is is reflected in everyone's uh activity across the council i mean i've enjoyed the presentation tonight about the leisure service and the the activities of people with learning disabilities and in the leisure service well that's a you know we know so so um so um only too well how people with learning disabilities um are more subject to um risk from safeguarding um uh allegations um and abuse um and and sadly are over represented in terms of um safeguarding adult reviews so this is really important that it's a whole council uh response um and i i can only assure you that uh on on behalf of the board we will do everything we can to make sure that um that that is reflected in uh the culture not just in terms of what the board is is involved with but more widely across the whole of tower hamlets thank you thank you do members have any question if thank you hi um i just wanted to commend uh you and the members of the board uh on on the report that's been produced um just the report said safeguarding is everyone's responsibility uh but do you feel that there is a safeguarding culture throughout the council the council has the lead responsibility for the um the work of the board but it's a shared uh it it is a shared um statutory obligation and you'll see in in the report um the the number of organizations that reflected um on the board um the the the council is the lead agency to to um to bring those uh agencies together but it's but safeguarding is across all of the agencies that you'll see represented through the logos in in the in the report um i think that there's always as as a newcomer um i have to say to tower hamlets i think there's always um more work that we can do to bring safeguarding to the fore in terms of our considerations and and uh chat i i would challenge you in that um because um it's never easy these often the the people that are at risk of of of abuse and neglect or are sadly subject to abuse and neglect often uh do slip under the radar do fall um in in in into areas that are difficult to see sometimes difficult to hear sometimes difficult to face um but um you can never say that you've you've you've completely got the culture right but i think that the work of the board is important in the leadership of that um perhaps with the the um the the the pressures on on the the leadership and across the board there have been some delays in in making that possible i think i refer to that in um in um in my report but i think there's a lot of um i've seen a lot of commitment and uh genuine um or real commitment and and um uh uh and uh dedication to safeguarding and i'm i i i certainly wouldn't i wouldn't want to be the independent chair of anywhere that um that that that wasn't true of so i i think that the the culture is is certainly there thank you thank you i have a question to you you have a slide which lists how you are implementing what has been learned from safeguarding reviews who monitored this progress of this and how okay as i say the the it's the responsibility of the board ultimately to um to monitor progress um in in the in uh the the recommendations of reviews um and that is done as i say through the um through the quality uh assurance and performance group uh subgroup of the of the board um and reported into the board through um through um the the use of the tracker it may be that um that you want more information about uh about about the tracker in its use but that's certainly where we uh we make sure that um that the recommendations that are followed from reviews are um there is progress against those recommendations thank you thank you for bringing this report to all of our attention and i know that this has been a complicated year for the safeguarding adult boards with both the chair and the relevant corporate directors living at different points i would therefore like to comment everyone involved for keeping this crucial board doing its job through difficult times and i look forward to seeing the incredible work you will be able to the next year thank you yeah just please yeah can you please agree the recommendation in this report every member please yeah thank you thank you thank you thank you that's fine now our agenda item is 2.3 is safeguarding children's partnership annual report a steep ready corporate director children's service will introduce this item and you will have seven minutes before we open up members question please constant the time um thank you chair um the children's safeguarding board annual report um has been ready for a while and has been approved by the board and has also been to council cabinet and shared across partner agencies but i think it's quite helpful to see the adults and children's annual report uh next to each other on the agenda and hopefully that's helpful to to members i'll just pull out a couple of things uh to flag um you will see um on page 65 of the papers in terms of the introduction who the lead partners are there are some differences between children's and adults arrangements so one of the uh lead partners chairs the actual board and we have an independent scrutineer who sits on the board and we're quite fortunate because uh sue who uh presented the um adults board as the chair has actually been acting as our scrutineer on the children's board which is really helpful um so you can see myself i'm currently the chair and i'm joined by um lead from the integrated care board and metropolitan police um a couple of other things uh we have the statement from our independent scrutineer that's on page 70 um uh laurel who uh has moved on and we've just uh recently appointed a new independent scrutineer but also just your draw your attention to page 71 which is uh we feel a really positive development that over the last few years we've had young people employed as young scrutineers um who are really helpful in terms of engaging with other young people and listening to their concerns around safeguarding and page 72 you've got the testimonies there from two of our two of our young scrutineers uh which hopefully you'll see uh finds interesting there's a few pages around data and levels of demand um and then there's a couple of pages 80 and 81 around some of our uh progress and achievements um eight page 83 uh in terms of what our current priorities are anti-racism peer-on-peer arm neglect and infant safety and there's a work stream um led led by an individual partner um on each of those areas that we're progressing at the moment um sue mentioned the adults uh reviews and you'll see page um 86 some of the uh children's reviews um just to reassure you it it's a healthy sign that issues are by are being escalated to the safeguarding partnership and what happens is that the rapid review review group uh looks at those issues that are escalated and decisions are taken as to whether a serious case review uh should be carried out and you can see we've had four rapid reviews and one children's safeguarding practice their review and the learning from those has been shared um i think that's all i was going to say uh if that's okay chair but happy to take any questions yes do you remember to have any questions please thank you so um as some of you may be aware i work within substance misuse so on a regular basis um as a matter of process we do mass checks um how well do we communicate with substance misuse services particularly around issues of hidden harm and also the impact that children may have and safety issues as well um i mean recently i think it was in norwich there was a case where a 15 year old drank died as a result of that so there are serious cases like that um a number of years ago a young child accidentally drank methadone and passed away i mean we have protocols in place such as safe storage boxes and so on so forth but again it's services uh in order to facilitate the safety of the child um how can we better create a more uh inclusive approach in targeting and dealing with those issues yeah um thank you council for that question um i think when you see in both the adults and the children's reports the the breadth of partners who are involved and through the subgroups under each of other boards you can see how um different providers of services voluntary sector and other key partners are involved but i would say um we can always do more to improve that communication um so you might have provided representatives engaged directly in our safeguarding board but are we doing everything we can to ensure that they are then communicating messages out to all providers and also ensuring any learning from case reviews i think we do uh do some of that but we can possibly uh improve on some of that communication um i think you also pick up a really interesting point which is across adults and children's and when you are dealing with an adult um for issues substance misuse or other issues mental health domestic violence um in terms of that link between adults workers in social care and safeguarding and children's workers i think that's always an area we can improve on and i think joint training is is a good way uh forward on that as well thank you thank you steve uh because our cost of living crisis is definitely affected families and those children they are very vulnerable and do you have any specific thoughts for these children um no it's a really important area and one of the four uh priorities for the board is neglect um you know it's really important to understand the impact of uh the relationship between poverty and cost of living but also being clear that that doesn't automatically result in uh children not being cared for just because families are struggling and living in poverty but i think um the the the partnership and the council particularly is doing a lot on on cost of living and i think um we can be quite proud when again when you look across and benchmark what other areas are doing you know we heard today about leisure services offering lots of free services um i think across the council um uh we can see examples of free services and support being provided and ambition to do more um but i think um one thing i'm particularly think is strong is our early help offering our family hubs and seeing the launch of a lot of our family hub service this year one of the key areas they're addressing is is child poverty and how that can impact in terms of neglect and i think what we hear from our families is they want they want support and i think the council again with wider partners is doing a lot in our area to to support families who are struggling members don't have any question thank you thank you uh we have recommendation here do the members agree this recommendation thank you please just just one final comment to reassure uh health and well-being board members um we've had a significant of stead inspection of social care services recently and the report is public on the 7th of january and but the feedback we've had is really positive and including um the ofsted colleagues looked in detail at our approach to safeguarding talk to our safeguarding board uh board uh who you hear from today so um i think um obviously we're not allowed to reveal the results of that publicly till the 7th of january but i'm i'm really hopeful that the health and well-being board will be really assured when they hear um what ofsted think of our practices locally thanks thanks steve do you want to add about the young scrutineers we've recruited new ones so sorry yes um yeah just to confirm that we have a um in terms of our uh independent screen here we've recruited a new one who will be uh starting permanently with us in the next couple of months and also our young scrutineers our new young scrutineers have started as well thank you thank you our next agenda item is vision for tower hamlets strategic vision for tower hamlets thanks very much and ranjit are you able to just put the slides up um so i'll just introduce this item so i've been asked by um the uh council team that developing this strategic vision um to just get some feedback from the health and well-being board so um just just a bit of context um the council is looking to work with partners um to think ahead to 2035 um think about how the council can really um develop its partnership working and how plans can be aligned to each other how we work even more collaboratively with residents and how we really deliver on develop and deliver our ambition um so the goal is to across the system develop a vision a really ambitious vision uh for the borough um can just get the next slide so the the approach is to build on the um existing partnership plan that has been developed um through um the partnership executive group um which which already has um five calls to action and i think some of you may be um familiar with this already people who sit on the partnership executive group um but it is about being inclusive there's one specifically around mental health and well-being um there's one about housing um employment and um a child-friendly borough where um children can achieve their potential so those are the sort of those are the five key calls to action that partnership executive um agreed working with communities and i think just for for the board today i think a number of you may have been involved in this process already um but it's just to provide some feedback uh to the team from the health and well-being board about the sorts of things that uh the board will want to see in 2035 but also thinking about um what are the what how do you work better in partnership because the health and well-being board sits within a sort of wider system of partnerships and how do we work together um and um i think those that yeah and and and where do we address the gaps and what you know what are the options and opportunities so i think it's quite a broad um sort of question but i think what what they were looking for is just some sort of thoughts and uh pointers from um from from the health and well-being board so anything that we'd want to feed back to them i think also i think it is worth bearing in mind that um we will also be looking at um our future health and well-being strategy over the next year because the one that we have runs out in 2025 so i think this our health and well-being strategy could kind of sit within the context of of this wider vision so um yeah really good to get um members thoughts on a what what do we want to see but b what can we do to to to work better in partnership and what are the gaps uh that we or obstacles that we might need to think about thank you i'm not sure how much i should comment on this as i also wear the other hat as a counselor yeah i've seen it so i think i think i think uh help and well-being yeah yeah so i think i think partners should also have an opportunity to comment on this but i think the general outline of what we're focusing on uh fits in well with what we want to deliver uh in terms of vision um and like the way uh the key priority is you put call to action that that's got our driving force behind it as opposed to just you know aims or targets you know drive to action has a snappy kind of attention to it uh and just highlight in terms of the community engagement um you know 700 people participated in it um there are certain consultations which take place and you get like 10 20 responses so that's that's quite um a robust uh you know feedback you've got in relation to that so just want to commend the work that was done on it and hopefully we get a journey going forward of inclusive uh partnership work uh which is integrated and supports the residents of the borough and be well you know that's a prime example of how both through the nhs the council and uh community services we integrate work together in order to deliver direct impactful benefits for residents of this borough thank you thank you thank you well so where am i um health and well-being uh board um you know member um it's good that we had 700 um i just want to echo what councillor could be said but i just want to um i'm not sure in terms of um consultation or survey have we worked with our um elderly community or elderly focus groups has there been anything done to get their feedback because that's quite important as well um i'll i'll follow up with the actual team um that's that's called but they have targeted various groups and voluntary sector organizations across the life course because this is for the whole borough but i can get more on what they've actually done okay thank you so i agree with what people are saying um and i say yes to to strong partnership working of course um and i just wanted to following on from what shaman said acknowledge the role of the voluntary community sector in tower hamlets as a really important part of a thriving uh tower hamlets borough so we i think we all agree on that i think one of the um obstacles is some of the things that are happening in the voluntary community sector at the moment and i put funding at the top of those those challenges um so there are real barriers in voluntary community groups being uh equal partners in this and i have a list of funders who are changing their strategy who are spending out who are closing and that's going to have a real impact on the borough and i think i've really welcomed some some open conversations about how we might tackle that and how we might work in partnership and value the the contribution um of the sector and and think about how how we can um you know hear the voice of the voluntary and community sector because that's not very easy we know that there's by one estimate 1300 voluntary and community groups in tower hamlets so there's lots of really small groups who do amazing work but they're they're tiny often volunteer led so how how do we get their voice around the table um yeah that's it really thank you chair i've i have fed some of this in in some of the forums i'm just going to take the opportunity in front of some colleagues to say this as well um just on the calls to action and the child friendly borough should be the first one just i would say that wouldn't i um a couple of colleagues have said that the climate um issues isn't and young people have raised the climate in the environment that they're not in the in the calls to action um and and i think the what what i thought was really positive is the um an inclusive anti-racist borough picks up a lot of the the work we're doing around anti-racism but also our new sen and inclusion strategy about making young people with sen feeling really part of the borough so seeing that as part of this this future vision document is really important um and i think just on that theme of resources a real shift to prevention i think there's some great examples um within the council and partner agencies where we're putting more investment in prevention and and i think if you said to me what would make the difference in 10 years time it's to to build on that and that real preventative approach for children and families particularly um but yeah i'm really grateful for the opportunity to comment as well thanks um i was just going to say just a few observations it builds on what you're saying counselor Ahmed which is that it's it's interesting in tower hamlets if you get the conditions right you can get consultation with thousands of residents you know you can really connect with residents and then sometimes you do a consultation and there's five people um and it shows that if you can get it right you can have a real proper dialogue with residents on an ongoing basis so i that i think there might be something to feed back on like how do we build on what's really good in what we do around resident engagement and how do we support those areas where we're not getting that kind of engagement so i think there's there's there's a lot of sort of richness and learning around that um the other thing my observation which i fed back to um the team is that whilst it is really good that they're in the calls to action they're talking about good mental health and i think it's really important to highlight that and make sure it's got equal parity is we shouldn't ignore the like real significant inequalities in physical health as well you know so which are really glaring when you look at the data so i was very much my thought about it was actually good mental and physical health i mean it's very broad thing but i think we should be thinking um about both of them i think it would be helpful uh to think i mean because this is a health and well-being board maybe to think of the right to have the opportunity to be healthy so you can often look at inequalities through the lens of a right to have the opportunity to be healthy but not everyone having equal ability to enjoy that right and i think that's quite a helpful framing of inequality so those are some of the things that i was going to feed back if that again if that feels right thank you shuman thank you definitely it will align with the tower hemorrheds partnership plan 2023 to 2028 to create thriving equitable and sustainable water and we are glad that this bold and inclusive plan has been brought to this board and i look forward to being a part of a workshop and that will contribute to bringing this plan to life thank you and do the do members agree with the recommended conclude the meeting thank you everyone for your participation sorry sorry sorry sorry yeah just if we don't have any other business we can conclude now thank you for your participation members thank you

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