This meeting was scheduled to be a joint meeting of the Waltham Forest Health and Wellbeing Board and the Health and Care Partnership Board. The meeting was scheduled to discuss topics including the partnership’s joint business plan, the Promoting Wellbeing workstream, the council's response to the recommendations made in the Waltham Forest Marmot Review and a quarterly report on the Better Care Fund.

Partnership business plan

A report included in the meeting pack for the Integrated Boards described the background to the partnership's joint business planning, and reviewed the progress they had made. The report described how the Boards had worked with the King’s Fund since May 2024 to develop a programme of partnership working to create a system of health equity in the borough, and how they had chosen three areas to work on. These were: the mental health and wellbeing of Black boys and young men; childhood obesity and diabetes, particularly amongst children from the global majority; and long-term conditions and the early onset of complexity and frailty¹. The report went on to describe the work that the partnership had done on the Promoting Wellbeing workstream, covering topics including: strengthening the partnership with the voluntary and community sector; the Borough of Sanctuary scheme; Community Health Champions; mental health promotion; locality hubs; employment support; and housing and health.

Promoting Wellbeing Workstream

The report pack included a report on the Promoting Wellbeing workstream. This report included a status report summarising the workstream's five priority areas. The status report for ‘Strengthening the partnership with the voluntary and community sector and faith groups’ described the work that the partnership had done to increase the involvement of the voluntary and community sector across the system, and said that a specific health and social care VCS strategy was in development. The report described how the partnership had been working with a consortium of senior leaders and community advocates from the sector, and how they were exploring a range of procurement opportunities that would enable consortia to bid for work with the council. The report described how the partnership had made good progress on addressing the needs of migrants, refugees and individuals with insecure status under the Borough of Sanctuary scheme, and how they had established holistic support initiatives including an expansion of the Migrant Hub at Lea Bridge Library.

People seeking sanctuary experience a range of structural health inequalities when compared to the general population. Our Borough of Sanctuary action plan aims at tackling these and ensuring that we have health services that acknowledge and effectively support the needs of migrant residents, including refugees, people seeking asylum and those with insecure status.

The status report for the ‘Community Health Champions’ workstream described how the partnership had been working to integrate Community Health Champions into the council’s Legends of the Forest platform and the Ground Works London platform, and how they had promoted the scheme.

Community Health Champions are volunteers recruited from our marginalised and racialised communities that are keen to facilitate sustainable health related change within their own communities. They have the ability to convey our message to audiences in regions where we are typically not present, and to deliver it in languages and frameworks of reasoning in which we lack proficiency.

The report described how the partnership had developed a Mental Health Promotion strategy, and how they had delivered work under this strategy's four strategic themes. The report described how the partnership had held a workshop to enhance the mental health and wellbeing of Black boys and young men in response to the recommendations made in the Waltham Forest Marmot Review, and how the workshop had resulted in the identification of a range of areas where action was needed. The status report said that, in early years settings, over 220 referrals had been received by the Parent and Baby Emotional Wellbeing service. It described how the Mental Health Ambassadors programme had been commissioned with Ground Works London and would recommence in 2025. The report described how the Make It Happen fund had commenced and had invested £100,000 in creative health projects to promote good mental health in Waltham Forest. The report also described how Coping Through Football, a project commissioned with NELFT in partnership with the London Playing Fields Foundation and Leyton Orient Trust had been delivered and would continue. The report said that challenges persisted with under-representation of some groups in mental health prevention and treatment services, in particular a lack of engagement from young men. The Promoting Wellbeing report described the progress the partnership had made on building Locality Hubs. It said that they had chosen Coronation Square as the site for the first hub. The report described how the partnership had held a workshop with key stakeholders to scope out the operational model and the required space for the hub.

The first locality hub site has been identified as Coronation Square in the south of the borough. This building is due to open in October 2026. The schedule of accommodation has been completed and NEL ICB’s Executive Management Team have approved that Coronation Square goes ahead.

The report described how the partnership had begun community engagement around the Locality Hubs, with over 230 responses received to an online survey. The report described how the partnership had developed the Waltham Forest Health Equity Alliance, and how they had secured funding from the Health Inequalities Fund for each of the borough’s Primary Care Networks (PCNs) to carry out health inequalities projects. The report described how the partnership had been working to maximise employment support. It described how they had provided support to 210 individuals and were continuing to work to improve employment outcomes for people with long-term health conditions. The report said that the partnership would launch ‘Connect to Work’, a funded programme for people with long-term health conditions, in 2025. The report described the work that the partnership had done on the priority area of Housing and Health. It said that work was ongoing to integrate health into key housing strategies, and that the Housing Team would be working to develop a new Supported Housing Strategy, and would run a pilot scheme for homes for older people.

Waltham Forest Marmot Review

The report pack included a summary of progress that had been made in implementing the council's response to the recommendations in the Waltham Forest Marmot Review, which was published in December 2022.

In early 2024, LBWF made a series of public commitments on action to address health inequities in the borough, responding to Professor Sir Michael Marmot’s report on health, equity, and their drivers in Waltham Forest.

The council's Marmot Response identified three broad priority areas, good work, better health; healthier homes; and greener and healthier places, with two ‘accelerators’ in each area, making six in total.

The report summarised the work that had been done on the accelerator area ‘Good work for residents with disabilities and long-term health conditions’. It said that the council had been working through its Employment, Business and Skills Team, to deliver coaching, training and in work support for people with long term conditions and disabilities, including through an IPSPC scheme. The report said that the council had secured funding for 'Connect to Work', a DWP programme to help people with long-term health conditions and disabilities into work, worth up to £9m over five years. The report summarised the work that had been done on the accelerator area ‘Good work for South Asian Women’, describing how the council had been working to provide language, learning and employment opportunities to South Asian women. It described how they had launched a council-wide Inclusion Action Plan, including actions to improve the fairness of the workplace for people who identify as ethnically diverse. The report described how the council were working to help businesses become accredited London Living Wage employers and that they were aiming to increase the number of accredited employers by a third by December 2025. The report summarised the work that had been done on the accelerator area ‘Healthier Homes for private renters’. The report said that all of the actions committed to in the council’s Marmot response had been included in the new Private Rented Sector Strategy, and associated action plan, approved by Cabinet in November 2024. The report described how PRS licensing officers were being trained on how to support people to access smoking cessation services, and how the council was planning to use health data to target its enforcement activity on properties posing a risk to people’s health.

The report described how the council had established a cross-council fuel poverty working group, and set up a health referral pathway, to help deliver the accelerator area ‘Healthier Homes for older residents’. The report described how HEET, a local charity, had been commissioned to deliver community outreach and home visits, and had helped 100 residents to make applications to retrofitting and energy support schemes. The report described how a specialist damp and mould team had been established in March 2023 to carry out inspections of council owned homes, and how the service had been integrated into a general repairs task force.

The report described the progress that had been made on the accelerator area ‘Greener and healthier places for communities in the South of the borough’. It said that the council had been working to embed the improvement of green space into its SANGS strategy. The report described how the council had agreed to deliver a ‘green link’ between Sidmouth Park and Coronation Gardens to Leyton Jubilee Park and Hackney Marshes.

To note: the original wording in the Marmot response referred to refugee and asylum-seeking communities, but this has now been removed due to the closure of the contingency hotels in the South of the borough. A range of activities to improve the migrant experience still take place through the Borough of Sanctuary steering group, and this includes consideration of health concerns.

The report summarised the progress the council had made on the accelerator area ‘Greener and healthier places for residents most at risk of food poverty’. It described how the council had launched a food innovation fund, and funded 7 projects, including projects focusing on food co-operatives, improving youth employment, improving community resilience, and providing education on food growing, cooking and meal planning.

Better Care Fund

A report included in the meeting pack for the Integrated Boards provided an update on the Better Care Fund, a national programme that aims to further develop integrated health and social care for residents. The report described how the Boards had submitted their plan for the fund in July 2024 and how it had been approved by NHS England in August 2024. The report included a series of updates and recommendations for the Boards, including: approving the Better Care Fund Quarter 2 report; delegating authority for the Deed of Variation of the Section 75 agreement to the Integrated WF Finance Oversight Group; and discussing the in-year uplift to the Disabled Facilities Grant at the next meeting. The report also described a number of metrics relating to the plan and how they were performing against target.

Avoidable Admissions: The actual performance for avoidable admissions in Q1 was 185 and in Q2 was 87 (data available only for July and August 2024). Waltham Forest is currently at 43% of the planned overall target and is on track to meet the targets for both Q2 and the overall plan, despite surpassing the Q1 target.

Discharge to Normal Place of Residence: The actual figures for discharge to a normal place of residence were 94.82% in Q1 and 94.5% in Q2 (data available only for July and August 2024). Waltham Forest is currently on track to meet the overall target.

Falls: The actual figures for falls were 435 in Q1 and 218 in Q2 (data available only for July and August 2024). Waltham Forest is currently on track to meet its overall target, with 42% of the annual planned target already achieved.

Residential Admissions: The number of permanent admissions to residential care from April to September was 47, compared to 60 during the same period last year. Therefore, the actual performance measure—rate of permanent admissions to residential care per 100,000 population (65+)—is projected to meet the target.

The report described the hospital and community discharges from April-September 2024, including a decrease in the number of new clients for the short-term domiciliary care pathway 1, and an increase in demand for social support and urgent community response. The report described how the system had put in place plans to meet this demand, including by funding additional capacity.

Resident voice

The report pack for this meeting included a paper about involving local people in the work of the partnership. It described the importance of incorporating residents' voices into the partnership's work and made a distinction between resident insight, resident stories and resident voice.

Engaging with our residents in Waltham Forest has been integral to our work as a partnership so far and will continue to be embedded in all areas of our work.

The paper proposed that resident insight be brought to board meetings through continued partnership working with Healthwatch Waltham Forest; through regular updates from the Waltham Forest Health Engagement leads group; and by ensuring that any key programmes or pieces of work being brought to the board for decision making had considered resident insight in their planning. The paper proposed that resident stories could be brought to Board meetings by arranging for residents to share their stories. It suggested that the partnership should implement a range of measures to make this possible, including: a clear forward plan of topics for each meeting; a designated member of staff to source individuals and support them to share their stories; a process for ensuring that it is appropriate for an individual to share their story, and that there are no ongoing investigations relating to their circumstances; adequate time set aside within board meetings; a budget for reward and recognition; and a clear process for action arising from the resident's story.

When considering how we bring the voice of residents into our governance structures within the partnership a distinction needs to be made between resident insight, resident stories and resident voice.

The paper went on to describe the importance of incorporating resident voice into the partnership's work.

Incorporating resident voice to board meetings is a longer term aim and focuses on truly involving local people in governance structures across the Health and Care Partnership Board in Waltham Forest.

The paper set out a table that described three options for achieving this: establishing a ‘community advisory group’ to work with the boards; hosting public community meetings to discuss specific themes; and recruiting a lay member onto the boards to represent residents. The report proposed that if any of these options were taken forward, a checklist be developed that outlined the principles of resident involvement.