The Board confirmed the minutes of the last meeting, approved the draft Better Care Fund Plan for 2025-26 and agreed to delegate approval of the final plan to the Section75 Agreement Management group. The Board discussed the draft Lewisham Health and Wellbeing Strategy for 2025-30, the South East London Integrated Care Board’s Joint Forward Plan 2025-26, and a request for a study of health needs in Forest Hill ward.

Draft Health and Wellbeing Strategy for 2025-30

The Board discussed the draft of the new Lewisham Health and Wellbeing Strategy for 2025-30, which was presented by Dr Catherine Mbema, the Director of Public Health. The previous strategy expired in 2023, and the Board agreed to develop a new strategy in March of that year. Two stakeholder workshops were held in September and October 2023, and a draft of the new Strategy was presented to the Board on 24 July 2024.

The draft strategy aims to:

• Improve the health and wellbeing of all Lewisham residents.
• Reduce existing health inequalities.
• Focus on prevention.

It identifies four key priority areas for action:

1. Taking action to address the impact of poverty on health and wellbeing.
2. Taking action to address the impact of housing on health and wellbeing.
3. Taking action to embed prevention for children and young people in partnership with educational settings.
4. Taking action to progress key prevention programmes within the borough, with a focus on embedding cancer and cardiovascular disease prevention across the Lewisham health and adult social care system.

The Board was asked to review and comment on the draft strategy document. They also discussed the next steps outlined to finalise the strategy, which include a period of stakeholder consultation to ensure that residents and key stakeholders have an opportunity to further shape the strategy.

It was also noted that a detailed action plan will be developed following publication of the strategy to outline the key leads/partners for delivery of each action and final indicators that will be used to monitor the strategy.

The board approved a shift in the timeline to present an update on actions and a draft of the Health and Wellbeing Strategy to their meeting in March 2025.

Better Care Fund Plan for 2025/26

The Board discussed the draft Better Care Fund (BCF) Plan for 2025/26. The BCF is a joint health and adult social care integration fund that supports local systems to deliver health and social care for adults. The plan sets out the conditions and funding for the BCF, and the requirements in terms of planned expenditure, objectives, and metrics.

The plan has been developed by the South East London Integrated Care Board (ICB) and Lewisham Council. It has been discussed with voluntary sector, statutory partners, and service users.

The plan aims to support people to live healthy, independent and dignified lives by joining up health, adult social care and housing services around individuals. It identifies two core BCF objectives:

• Reducing the need for care and support: This includes supporting people to maintain their independence and wellbeing, preventing or delaying the need for care and support, and reducing the need for long-term residential and nursing care.
• Ensuring timely and safe discharge from hospital: This includes reducing delays in discharge from hospital, supporting people to return home or to a suitable care setting, and preventing readmission to hospital.

A total of £53,440,286 has been allocated to the BCF, from the following sources:

• Disabled Facilities Grant: £1,884,795
• Minimum NHS Contribution: £32,348,460
• Local Authority Better Care Grant: £18,433,042
• Additional Local Authority Contribution: £773,989

The plan includes a number of schemes to deliver the BCF objectives, including schemes focused on supporting those in care homes, unpaid carers, and those with complex needs. It also includes schemes intended to reduce the need for long term residential care, prevent unnecessary hospital admissions, and improve the timeliness of discharge from hospital.

The plan requires targets to be set for achievement of the BCF metrics, and these are being worked on by partner organisations. The Board agreed to continue to delegate decisions regarding management of the Better Care Fund to the Section75 Agreement Management Group, who will also provide final approval of the plan.

South East London Integrated Care Board - Joint Forward Plan 2025-26

The Board reviewed and endorsed the draft Joint Forward Plan (JFP) from the South East London ICB. The JFP is a five-year plan that is refreshed annually, and sets out the ICB’s medium-term objectives and plans at both a “Place” level (for each of the six boroughs in the ICB area) and from the perspective of the key care pathways and enablers at ICS “System” level.

The first JFP was published in June 2023. The 2025-26 plan consists of an Executive Summary and a set of Appendices. The Executive Summary includes a plan for each of the six boroughs and each of the care pathways, with the Appendices providing more detail on the actions to be taken and the impact expected.

The JFP identifies two key priorities for the ICB:

• Improving population health and reducing health inequalities across the population.
• Ensuring the sustainability of health provision now and as demand continues to grow.

The 2025-26 refresh focuses on how the plan supports delivery of these two priorities, and how the actions planned in each of the six boroughs and for each of the care pathways will contribute to both.

The JFP identifies four priority areas for Lewisham:

• To strengthen the integration of primary and community-based care. This includes establishing Integrated Neighbourhood Teams (INTs¹) to provide proactive and preventative care.
• To build stronger, healthier families and provide families with integrated, high quality, whole family support services. This includes expanding family hubs and integrating children’s health services.
• To address inequalities throughout Lewisham's health and care system and tackle impact on health and care outcomes. This includes targeting poverty, housing, and education as social determinants of health.
• To maximise the roles of ‘anchor organisations’ as employers. This includes expanding local employment and training opportunities.

The Board noted the potential financial implications of implementing the plan, and the legal requirement for the ICB to produce a JFP.

Study of health needs in the Forest Hill area

A request from the Forest Hill Assembly for the Board to carry out an up-to-date study of health needs in Forest Hill ward was discussed. The Assembly is concerned about the lack of a GP surgery within the ward boundaries and has requested a study to see if there is a need for increased GP capacity in the area.

This request, originally made in June 2023, was noted by Mayor and Cabinet at their meeting on 1 November 2023. They agreed to pass the request to the Health and Wellbeing Board for a direct response.

The Board discussed the motion and noted the significant variations in health and life expectancy within the ward, with worse outcomes for those in the part of the ward south of the South Circular road. They also noted that Forest Hill ward is currently undergoing and has undergone considerable new housing development, which will increase the population and the demand for healthcare.

The Board was asked to respond to the Assembly’s request for a study of GP provision in relation to health needs in Forest Hill ward.