Transcript

Hi, Anu, can you hear any seals? I can. Hi, yeah, I can. Sorry, I can't hear you any longer. I heard you in the beginning. Can you hear me now? Yes, perfect. Okay, perfect. So I was just saying, we've just got to the point of the agenda where we're on the safeguarding report. If you're happy to give us a quick three-minute overview of it, we've all read it as well. Brilliant. Thank you so much. So thank you very much for receiving the report. I wanted to just open with some reflections on the partnership. So we've been together as a board, I would guess, for kind of three or four different iterations. There was the norming and forming as the partnership came together in the early years. There's the middle period where we were really finding our feet and leaning into a really important transformation and change objectives for our communities. Where we are now is that we're a really mature partnership and we're looking now to get really fine tuning some of the ambitions that we've been building on for the first five or six years as a partnership. Most of those are around understanding and delivering differently for our communities. So in the report, you'll see our three key areas, communication, partnership and EDI. These are the ones that we've focused really deeply into and done a lot of listening and learning because we know in certain communities, we probably haven't done enough over the years. And the depth of maturity in the partnership now means that we can afford to really sharpen up some of those areas. So I want to just start with that reflection on EDI. You'll see in the report that we've been very curious about the levels of impact and how they vary across our communities. So one of our subgroups around community engagement, community development has really been almost reaching into parts of Lambeth's communities that we haven't really felt that comfortable working closely with before because either we didn't have ingress or we felt that there was much more to do around building trust. So you'll see that some of the work we've been doing with our LGBTQ plus communities is really coming into its own. And then some of the data we've been looking at around underserving some of our communities, especially learning through some of the cross-borough stars we've had around mental health in our black communities, understanding more deeply some of those drivers have been a real focus for us in our subgroups. And in terms of the data, the data also tells us some good stories. So overall, we've seen a reduction in safeguarding concerns compared to previous years. I'll let some of my colleagues talk more about this, but we really feel that that's around the structural changes we've made. So colleagues have put in place a really robust safeguarding hub, which supports really consistent decision making that potentially hasn't been as strong in previous years. So really bringing that that intelligence together and that robustness has, we feel, demonstrated a real difference in the numbers. We've also got some really good data around conversion rates, which means that we know exactly where concerns and referrals are coming in and that they are going to the right place. Whereas previously, in previous years, we've not had the degree of specialism and support to really make sure that concerns and referrals are treated in the most appropriate manner, which has led to higher volumes. So we also benchmark really well against some of our other boroughs. But again, I will let colleagues talk more about the hub and the decision making tools that have led to some of that. But overall, the data is certainly telling us a really strong story. And I just wanted to finish talking about partnerships. So I talked about the maturity of our partnerships. So we have some really big players in Lambeth in terms of our NHS colleagues. And sometimes you see maybe a turnaround of staff or you might see a focus on the bigger picture rather than the communities or the neighbourhoods, because simply the size of the organisations. We don't see any of that in Lambeth. We've got amazing continuity of people leading safeguarding across our partnerships. We've got amazing attendance at both the subcommittees and the board itself. But more than that, we've really lent into doing things together. So you'll see we've, over the last few years, been really keen to look at issues such as self-neglect across all our pathways and all our partners, being able to demonstrate some real results there. And then looking into complexity, so tools such as the complex case pathway, you can't do that without partnerships making the time to actually lean in, to understand the problem, to create the right tools and resources, and then to take those back out to practitioners and make sure that training and support is in place. So we collectively, as an organisation, as a partnership and organisations, make sure that the differences that we've outlined in our strategic plans are actually being transacted. And so I'm going to end there. You've had a chance to read the report. I'm really happy to defer to colleagues for any of the detail around how we're delivering some of these. Yeah, and thank you to yourself and the board as well for pulling this together. It was a really, extremely comprehensive report, and myself and Councillor Mandy Brown have just taken on equalities into the brief as well. So it's really exciting to see the level of depth that is in there around some of the equalities markers. Sorry, apologies. Could you put your own thing on mute, please? Technical issues. That's the thought it's off. Great, thank you. And so, yeah, it was great to see a lot of those equalities markers there, and hopefully that can help shape the work as well going forward. And it's great to see such partnerships there. But I'm going to throw it open some questions there from the board. Anyone have any questions? Councillor Kynes. Obviously, the report is 23 to 24. It's May 25 now, which it says in the pack, 23 to 24. Is that just an error? And it's meant to be 24, 25? It's taken a wee while to get here. I'm just checking. Somebody give me an answer. Is it 23, 24? It's 23, 24. And then it's talking about all strategic plans for 23 to 26, which kind of is less than 12 months away. So I'm just wondering, when are we going to get the 24, 25 board report? And when are we going to be discussing the update for those strategic plans with relation to 2026 onwards, given Health and Wellbeing Board only has like whatever it is, four meetings a year, this formal setting. Probably I'm assuming that there's a full agenda for most of those meetings. Are you able to come back on that? Are you asking me? Sorry, I can't see it on my screen. Very happy to talk to colleagues about the right timetabling. We have taken quite a convoluted journey en route to the Health and Wellbeing Board. So we've been to a number of scrutiny committees en route to here. So maybe that is just a simple sequencing issue of the degree of approvals and where the report needs to go before it comes to Health and Wellbeing Board. But we can certainly take that on board for the next annual report. Can I just push on Council Kind's point of just when we'll expect the next one? Or when you'll be ready to present the next one so we can make sure you're on the agenda in good time? So we're in the process of writing that report and it will, I mean, I will defer to Democratic colleagues about the right time. But if you meet four times a year, we can certainly make sure that we come to you as soon as possible. So on the timescale, is that that it would be ready for the next meeting that we have? Is that is that what you're saying? When is the next meeting? 25th of June. No, it wouldn't be ready for then. It will be the one after we can we can certainly aim for the one after. OK. Great, Council Kind. Just whether officers can then explore a bit of clarity about how things need to move through the system, because it's a bit of a, dare say, I don't want to in a bad way, but a bit of use of our time tonight if we're going through this and it doesn't need to be tonight because it's been through lots of scrutiny elsewhere already. I read the papers for this to prepare for tonight. And I don't want to sort of like take up too much time if we don't need to. And I don't think all of those of you in the room want to do that if you don't need to. But I also don't want it to just appear that Health and Wellbeing Board is a place to just approve a report, given most of us that are on the board don't sit on all of the other parts of the process. On the timings, I think we can take that offline and take it myself and Councillor Manley Brown can take that back as well. Just conscious of time on that exact point. Does anyone have any other pressing questions on this item? Yes, Andrew Carter. I think it was a comment and a bit of a question again. It was just at the right at the beginning of the report. Very pleased to see that strengthening of the relationship between adult safeguarding and safeguarding for children and the recommendations. And I suppose once we get that updated report to see that work around transitional safeguarding. But were there any key developments in that area that you think the board should be aware of? Yeah, I mean, so just to bring a bit of detail in that, we invited children's colleagues to come to the adult board, not just to look at the issue of transitional safeguarding, but also cross referencing some of the specialisms and the practice approaches. So we certainly learnt a lot at the adults board from the I think it was an hour session with a number of different colleagues from the children's board. So so that that has certainly fed into practice development and the things that we then want to look at and hold in terms of our strategy. But also more than that, we then went to Lambeth together with the proposal that there are a number of boards, not just the two safeguarding boards, but thinking about community safety and some of the other learning and how we can better triangulate some of the findings across each of those boards and make sure that we're super serving, if you like, both communities and practitioners with that learning, rather than trying to do that in isolation through our individual boards. Thank you. Thank you. Thank you. Thank you. Any further questions? So at that point, so the Health and Wellbeing Board is being asked to note the contents of the annual report of the Lambeth Safeguard and Adults Board for 2023-24 to provide feedback on the Lambeth Safeguard and Adults Board and the contents of the report to guide and inform future reports. Is this agreed? Agreed. Perfect. Thank you. The report is agreed. So we're now moving on to the Health and Wellbeing Strategy Data Monitoring. For this report that we've got Rachel Scantelbury, Public Health Consultant. Are you okay to give us a three minute overview? I've seen the papers. I do have a few slides I can share. Shall I? Yeah. Let's do that. I'm just going to say, just speak up. Okay. Shout if you want to. So I'm Rachel Scantelbury, Public Health Consultant in the Lambeth Public Health Team, and I'm presenting this item on the Health and Wellbeing Strategy Data, which is a regular item on the board of these meetings. So each board meeting we present data from one of the priority areas of the strategy, and today I'm presenting on priority two, which is supporting people to lead healthy lives and have good physical health and mental wellbeing. So just as a reminder, the strategy has three priorities and under each priority are several outcomes and the outcomes of priority two are shown on screen. That's the first set of bullet points you'll see there, which are that long term conditions are prevented and further health complications for those with existing long term conditions are avoided. People are supported to live well independently for as long as possible and people at risk of and with depression, anxiety and other mental health issues access the right early health and resources. So the strategy has a set of actions that should help to drive change towards those outcomes and also a set of metrics and it's the metrics which I'm presenting today. And the purpose of the presentation is to give a high level overview of those metrics. It obviously doesn't tell the full story of everything that's happening, but if there's any particular areas that the board would like more details on, we can take that away and either come back to this board or come to the staying healthy board for a more full discussion. So the paper that you've had shows all the metrics and I'll talk through those now and also give a little bit of context to help with the interpretation of those. Because there are a large number of metrics for this priority, I won't talk through the detail of all of them, but you do have them all in the pack and I'll share these. I can share these slides as well to be circulated. So for each indicator, I will show the number of people affected, how Lambeth compares with comparators and how the measure has changed over time and where we have daily inequalities are. But also just to say that this priority area was last presented to this board in July. So where some of the indicators are updated annually, they may be the same as at the last presentation if they've not yet been refreshed. So the first measure is about NHS health checks. For anybody not familiar with those, the NHS health check is a health check offered to anyone aged between 40 and 74 without certain pre-existing conditions. And its purpose is to identify people at risk of heart disease, diabetes, kidney disease and stroke. And so this measure shows the number of eligible people who were offered a health check and who received a health check. The most recent data is for the five year period up to 23, 24. The reason that we show it in five year periods is that the health check is available to people once every five years, once they become eligible. So in any five year period, every eligible person should be offered a health check. And so this shows that 21,000, just over 21,000 people received a health check in the five years to 23, 24, which is around 27% of those offered a health check. And this is lower than the equivalent value for London, England. But if we look at the chart on the right, what we can see, the orange bars shows that the actual number of people who received a health check in that bar on the right hand side is higher than in previous years. But because the number of people who received an invite was proportionately greater, the actual percentage has dropped down. So the number of health checks has increased, but the proportion of those who were invited has decreased. And this measure shows the smoking prevalence in adults working in routine and manual occupations. The most recent data is 2022, which shows that there were nearly 22,000 people who reported that they were smokers from those occupation groups, which is equivalent to about 34% of the population and compares to about 13% of the general population. We do have to use a little bit of caution with this measure because the it's taken from a survey and the survey methodology means that there's quite this. The confidence around the precision of each point is quite broad, so we have to use a little bit of caution with that. But bearing in mind that caveat, the Lambeth smoking prevalence for adults in routine and manual occupations was similar to that for London and England. And was an increase compared to the previous time point. And in terms of inequalities, our local inequalities data shows that this group of four times as likely to smoke compared to those from other occupations. This data is on physically inactive adults, so this is a measure of the number of adults who are doing less than 30 minutes of moderate intensity physical activity per week. This data also comes from survey data and because it's measuring inactivity, a lower value is better. So the chart on the right shows that it's been decreased in the most recent year. So that's a positive. It's moving in the right direction. Again, national data on inequalities shows that people living in the most deprived areas were more likely to be physically inactive. People from Asian, black, Chinese and other ethnic groups were more likely to be inactive, as were people aged over 75. And people who were unemployed or whose working status was inactive. So I may not have said at the beginning the actual figures. So about 18% of adults in Lambeth were physically inactive. And so this slide shows the prevalence of overweight and obesity in adults. And this shows that in 22-23 more than half of adults, 53%, were overweight, including obese, which was similar to the London and better than the England average. And in fact, since the paper was put together, the more recent 23-24 data has been released. So that showed that the prevalence was actually just under 55%. So that increase. So this measure is on emergency hospital admissions due to falls in people aged 65 and over. And the latest data shows that there were 490 of these emergency admissions, which is lower than the London average and similar to the England average, and is decreasing, which for this measure is good. We want a lower number. In terms of inequalities, the national data shows that females are more likely than males to have an emergency admission for a fall. And this slide shows the number of deaths due to suicide and injury of undetermined intent. And the latest data is for period 2021 to 23, which shows that there were an average number of 18 of these deaths per year in that three-year period. The chart on the right shows that this has been generally decreasing since about 2003 to 2005. But the most recent time point shows an increase. But we just need to be mindful that these are small numbers. So a small number of increases or decreases means that it can look like a proportionate change. In terms of inequalities, males were more likely than females to die of suicide. And then this is my final data slide, which shows data on detentions under the Mental Health Act. Data for this indicator is available at ICB level only. So this is the data for South East London, not just Lambeth. And this shows that there were around 2,500 detentions under the Mental Health Act 2023 to 24, which was the second highest out of the 42 English ICBs. And in terms of inequalities, our local data shows that people living in the most deprived areas were more likely to be detained, as were people from black and other ethnic groups. And there were some differences also by age ranges. Thank you, Rick. Oh, finished or? Yes, finished. Just there is a slide there which will be in the pack of sorts of data in case people want to correct them. I'm just going to throw it out to questions, anyone? I'll go to Andrew first. Just on some of the data, it gets quite erratic as you get to Covid years. Yes. Are we seeing quite particularly about people, whether interventions are whether people to take them up or not, as opposed to some of the more prevalent ones? Is it getting harder to predict? Because previously most of the trends were quite predictable. Now they seem to be much more variable. Yeah. So I think the data that I shared on health checks, I think showed that quite well. I think there's always well, depending on the measure you're looking at, certainly for health checks, there's quite a lot that happens in a five year period. So it does get quite difficult to unpick exactly what's behind each trend. But Covid certainly has been a big part of that. We can see that when we look at other data kind of year by year. Yeah. And in terms of health checks, the uptake has now returned to sort of pre-Covid levels. But there have been other changes along the time in terms of the model of delivery of health checks. Is it still OK to take a more longitudinal view? Are the kind of trends holding up, I suppose, if you look over a longer period? Yeah, I think it depends on the measure and whether there have been other changes besides Covid. So I think you probably have to look at it case by case, depending on a particular issue. And if you, yeah, depending on the longer the time scale that you look at as well. Great. Constance. No, I don't think the presentation was circulated. It's not in the pack that I got. It's an overview of some of the data. Yeah. Oh, just it refers to it as being an appendix one in the report. So it's just it's difficult to look at some of it when it's fresh on the screen. But I had two questions. One is whether the figures on smoking includes vaping or if is it just tobacco smoke? Bimper, you're shaking your head. So I don't need an answer on that one. It doesn't. So then the second one is. There are increases there in smoking, mental health, detentions, obesity and so on. So I'm just wondering, given everything that we've discussed, admittedly, I know you went here for some of it. We've discussed over the last year or two. Do you think the strategy is actually addressing health disparities in long term conditions and outcomes across ethnic and socioeconomic groups? Because we know we've spoken about it here. They're some of the factors that are most prevalent in some of our more deprived communities. So do we think the strategy is actually doing anything to address that? The strategy is just shaking his head. Leave it at that if we think. But I think there's a big question there on that. I want to add to this. So we are well aware of the inequalities that exist in these indicators, which is absolutely why we're reporting on them. And in fact, things like smoking and going up is actually grim, actually, frankly. But the plans that all of our plans and the strategy were very much predicated on an inequalities lens and how we looked at that. The reality is the backdrop of some of the drivers of those changes have got worse. Cost of living crisis has got worse. You know, the challenges around things like housing are getting worse for people and all those things also link into many of the things that then become health indicators that we measure at the top level. So I don't necessarily think it's that we're not focusing on the right things. I think it's about how we orientate the focus in the context of the wider system that we're working in and the challenges that people are facing. But also really clear that the work that we do that's targeted to specific groups focusing on those equalities is the right work and that we're testing that and making sure that we're using the right evidence and understanding from our communities the impact that it's having. Of course, clearly that's not having the right impact. That's a real challenge. The other thing is most of these data are lag indicators as well. Very few of them are real time as such. So there is a lag in the reporting as well and where their estimates, I think like the survey data for smoking. So that's a bit challenging. So what we need to do is also probably overlay that with some very local understanding of what we hear back from our communities and how we engage around some of those particular issues. I don't know, Bimpy, if you've got anything else you'd add in that regard? No, I don't think. No. Follow up. Yeah, just on data lag. Am I to be expecting then that in 12 months time we come back and see the trends going down? Is that what you're telling me? I'd love to. Data is saying that or am I going to sit here in 12 months time and hear data lag was a factor in this and we don't know? Because I'm a little I guess my concern is with your everything you're saying is everything that we've ever discussed. All those other factors and comorbidities and how this all comes together. But, you know, we have a smoking cessation service. Is it is it stopping people from smoking? It's a survey. So maybe the data is not, you know, correct. But is the trend right? I don't know. I'm going on what I've been told. It's not. So what's going wrong at that point? And at what point do we sit there and say, do we need to change it? Do we need to review the strategy and whether or not it's doing the right thing? I think just building on that point as well. And you're going to like me for saying this. And in children's, we've worked really hard on a dash. It's on corporate parents and board. There's a really clear dashboard of all of the data tracked through like really, you know, laser light in terms of where the problems are and that type of thing. And that's really driven improvements in some of the areas, for example, people getting health assessments, that type of thing. I think potentially there might be a way we can take offline about how we track and monitor this data as a board to kind of see it through. And actually, it then makes it really clear that, you know, although the amount of people going to smoke and cessation interventions is going up. Actually, it's not matched against what we're seeing in the graphs or whatever. And then we might be able to do more of a drill down in that. Maybe that's something we take offline afterwards as well and see what we can do around that to present the data so we can have some real feelers on the ground of how the programs we are invested in are making a difference. Any final questions on that before I move on? Yeah. I was going to say, feel free to come forward. I'm just going to add that these are very much high level outcomes. And with the data lag, we know it's it's not real time, but we do have proxy measures. We've got our smoking cessation service data that we look at at a quarterly basis. And we do have the opportunity if the board wants to do a deep dive into any of these, we can always do that. But we are tracking what we're doing in terms of the interventions that we're delivering on. Obviously, we know that these issues are quite complex and it's not just down to the intervention. As he mentioned that, you know, we know those who've been facing inequalities have gone through even a tougher time and have not been able to be as resilient over the last few years. And particularly with smoking, we know that those who are still smoking are those who are highly addicted and also have lots of other challenging issues around them. But we do have a plan and we do have inspections. So we're quite happy to do a deep dive into any of the areas that we're interested in. I was going to say as an action point, Ben, I think what would be really good is we did drill down and if board members wanted to come to that, they could come to that to see what we could do around the data and make it more understandable, make sure we're tracking it in as much real time as we can. And I appreciate the challenges that exist there. And then we can kind of really get to the heart of if the strategy is working, where it sits within it, where improvements might be needed, that type of thing. So I think that's a good one to do, not in such a crammed agenda, basically, and actually sit down for an hour and go through that if board members are happy with that as an action point. Cool. Any final questions just on that item? Thank you very much. I know we have to note the report. Is that agreed? There we go. Thank you. The recommendation is agreed. And then we're going to move forward to item six on the agenda, which is the Lambeth Latin American Weight Management Programme. And this report is going to be introduced by Vidya Cunningham, Public Health Consultant, Maria Okijo. Hopefully I've got your pronunciation right. Please do correct me if I've got it wrong. And two participants of the programme, Jose and Doris, if you'd like to come forward. Thank you. Have I got it wrong or am I right? No, you're absolutely right. Oh, that's a gold star for me then. So if you guys can take it away just in terms of you're giving an overview thinking and then the participants of the programme are going to be giving some reflections, I think, aren't they? Cool. If you want to take it away there then. Some slides. Yes. Some of those. Yeah So my name's Mahita Cunningham. I mean, public health specialist with Lambeth Council, and we're here to present to basically to update the board on the actions that we've been taking to define a present to basically to update the board on the actions that we've been taking to develop and implement the Lambert adult weight management program for our Latin American community. The presentation is in three sections, and so I'm going to start with giving the board a bit of background, a bit of context around the evidence and some of the approach that we took to develop the program. Then I'm going to pass it over to Maria, who's going to talk about the delivery of the programs themselves, and then to two participants who have kindly joined us that will give us their insight from attending the program. So in terms of the background and context, so we know that obesity is complex. It's quite multifactorial condition, and we know that there are a range of different action that needs to be taken to address the condition. It's also associated with chronic diseases such as diabetes, cardiovascular disease, cancers, high blood pressure and musculoskeletal condition. As a Barra, we have high levels, relatively high levels of obesity and the local data for others show that more than half of our population in Lambert are overweight or obese. We know that some of our minority community groups are more likely to be overweight and obese. There's also this around inequality in relation to overweight and obesity. Comparatively, we have higher percentage of people from our Black backgrounds and Latin American backgrounds living with the conditions. So again, it's we also as a Barra have one of the biggest Latin American community in the UK. I think Southern King Lambert has the biggest Latin American communities. We the Latin American as a community. We're quite diverse, made up of many different countries. We also the this particular program was developed for our Spanish and Portuguese speaking Latin American community. We've actually mainly during the COVID period carried out quite a bit of research, local research with the Latin American community and findings from that show that the community faces quite a bit of precarity and financial insecurity. Despite very high levels of employment within the community, despite very high levels of employment within the community, the group experiences in work poverty shaped by low pay, insecure contracts, lack of awareness of people's rights. It also obviously the financial insecurity affects other aspects such as housing, education, which jointly can pose a risk factor around overweight and obesity. As I mentioned at the outset, it's it's a complex condition and it is impacted by a multifactor of risk. I'm certainly just saying to people that they should eat more healthier, do more exercise on its own doesn't work. We know it doesn't work. So just just also to share some of the data that we have. We know until recent we didn't use to collect ethnicity data for Latin American communities. So that remain quite hidden really within the data collection. And as I mentioned, the research that was carried out locally shows that as a community, they remain largely invisible in particular in terms of policy strategies and access to mainstream conditions. I mentioned services. Sorry. Sorry. So in developing this program, we use mainly data that were coming from the USA for Latin American community. But we also had a lot of insight, local insight from the delivery of her child weight management program in terms of Latin American community. data shows that a high percentage of the population is living with obesity and 44% and in particular with the women population. The USA data showed that nearly 80% are overweight and obese. We also recently have data from across Southeast London and again shows that that community tend to have higher level of obesity and overweight. This program that we're implementing and that we're sharing with you today, we feel it provided to the really unique opportunity to gain valuable evidence, local evidence of obesity amongst the Latin American community. So just to say that over the years, as I mentioned, we've carried out extensive consultation and engagement with our communities, including with our Latin American communities and around healthy weight as well. More recently, in 2004, in 2024, the public health team also carried out and co-designed a healthy weight program with the Latin American communities. The development of this particular program included as well engagement with the community. We work with one of our local VCS that would have liked to be here today, but couldn't be with Irma, and they are closely engaged with the Latin American community. And so we did some co-development work to support the development of this particular program. And I'm just wanting to quickly share with you some of the findings from the consultation and co-production, just highlighting some of what the community felt were barriers for them in terms of weight management services included things like language barriers. Also, most of the services are not available, obviously in Spanish or Portuguese, and that hinders their ability to know about the service, which also impacts on people's awareness of what's available. So there's, I mentioned economic constraint, a lot of the community work hours that are really difficult sometimes to access mainstream services from nine to five. Many of the work is done during shift periods. Many of the work is done during shift periods, so at very unsociable hours. So that's a particular concern with services. There's also an aspect of fear and distress and mostly about maybe not totally feeling secure with their migration status, and therefore not feeling that they could safely access services that might be seen as statutory services. So that's some. And then also just looking at some of the strategies. So they did just as part of the consultation and co-production, we also looked at what they felt would be effective in terms of them being able to access the services. I mentioned language, and I know Maria is going to talk about how that impacted on the uptake of this particular services. Also, the delivery of it kind of ensuring that there was a cultural alignment so that some of the activities, the messages were aligned with people's cultural practices. Again, using trusted channels to reach people. I mentioned the work that we do with some of our local VCS communities in ensuring that we are approaching and working with communities that are already in contact with the target audience. And again, I mentioned the importance of taking that holistic approach and looking at it from the multifactorial nature of the condition. And again, just just to finally reiterate the value of doing this in partnership. So in partnership, not only with the VCS community, but also with the community. I'm going to stop there. I'm going to pass you over now to Maria, if you want to introduce yourself for section two. Thank you. Yeah, my name is Maria Oguijo and I am weight management project officer for the Latin American Habito Saludaves program. I'm going to start by introducing our team a bit. what's, you know, who's behind the program and who's who. So our project leads Marcia, Marcia Dillon. Then I am the project officer and nutritionist myself. And then we have Pablo as well, who is our physical activity specialist, because that's how we organize the sessions. We have a part of nutrition and also a part of physical activity. So both in the same, the same session. part of. Yeah. So basically, I'm talking about design and taking into consideration the cultural connection and all that. We gather recommendations for, you know, local voluntary community organizations. Also, as Vida said before, we learned also from the previous management programs involving both children or and also Latin American community. like Ready Steady Go, as you know, she mentioned already. Also, the National Institute of Health and Care Excellence. Nice guidelines. We follow those, of course, for overweight and obesity management and principles of care and nice guidelines on behaviour change. Now, what did we do at the end? What we chose to do? So we chose face to face delivery, you know, to make it more, more personal, more closer. So that was important to us to do face to face delivery because it's not only about what we're delivering, but also the feeling that being together also delivering. We said to live this in Spanish was key to, you know, to our program. And so we decided to get Spanish speaking staff, but also Portuguese because we, you know, we are targeting both groups so that it was very important as well. So we have like Spanish and Portuguese speakers in the, you know, in the program so we can deliver both. And that was also very important. Also, we, looking at the physical activity side, we decided that it was important that we provide different options for them to, you know, we want to show them different things that they can do so they actually can find that the thing that really works for them. So we do varied activities throughout the program to make sure that they find that thing that they really like or they really enjoy rather than only one thing. So this is also something that we choose to do. Also, very important for us as well was to deliver, the content was culturally appropriate, was actually for them. And this is what we've been doing and learning a lot from, you know, the programs we've been delivering. Because at the end of the day, we had, you know, we're following the guidelines. But at the end of the day, we needed to know what they need, their needs were. So yes, this is where we, you know, we are delivering the contents. We make sure it's culturally appropriate for them. It's in line, but you know what their needs are. So this is, we're still working towards it because this is always, you know, learning and learning process all the time. Like we don't, we will never stop learning from that. Okay, great. So, um, I'm sorry. Right. So, um, what we did, um, to begin with was, um, a marketing campaign. So, um, we chose to do, um, this actually will be of. And flyers, uh, we decided to do them in three languages like, uh, English, Portuguese and Spanish. Have a look at that. Thank you so much. Let me just have those. I'm going to give them the three different languages. I think I'll have a look. Thank you. So we decided to do that on the three languages. And then also contacted, um, a marketing agency to advertise on, um, bus stops. Um, so what we did there was we focused on areas with the highest density of Latin American population in Lambert. Um, and also in proximity to places of interest to the community, such as shops, churches, restaurants, you know, places where they could actually access this information in their own language in Spanish. So you can see here a little bit of the areas we chose, where we chose to advertise. Um, and then also if you want to have a look at the, leave this in the three languages. If you carry on, we can be conscious that the agenda is tight. So I want to get to our residents as well. So I'm going to talk about what we cover now. So what we are doing is a tailored 12 weeks lifestyle and weight management program. You know, we include mind sessions. What I mean is like we, um, we, um, deliver topics like nutrition, physical activity, physical activity, but we also do all the things like emotional eating, sleep, stress, all the things that can have an impact on, on healthy living. Because at the end of the day, we, we want to be, have a broad, you know, a broad reach. So important, all those things that go together. So nutrition, um, um, you know, physical activity, but also other things as well. Four pillars of health. We, what we try to cover. Um, what we do is, as I said, um, 45 minutes nutrition content, you know, information, um, activities, and then also 45 minutes, um, uh, physical activity. So in all in all is one and a half hours a week during 12 weeks. Um. Of course, all we do is adapted to the Latin American culture. So they feel comfortable with what we're doing and it's relevant for them. So really important as well. We, out of the 12 sessions, we also deliver, um, some sessions that are like special different. So we have three different sessions. First of all is cook and eats. And we do like a cooking workshop and we focus on these workshops. We focus on them learning, putting into practice what we've learned. Very important also that they participate in what we're doing. Um, also, um. What's important for me for the, for the program is that we focus on, uh, budget. You know, food that is actually, um, healthy, but it's also available. It's relevant. It's defined, familiar and is actually on a budget is, you know, so really important that we focus on this, um, this points. Um, the other one that we do is a supermarket tour. After we've learned everything about reading labels and other things, we take them to the supermarket because I think it's important. They become familiar with everything like, you know, um, labels, label reading, but also where the aisles are. We do the tour, you know, that we, we do the tour around the supermarket where, you know, we should too fast. And then later, you know, you do, you go around the supermarket, the perimeter, and then we go inside to buy all the things that you will find all the fresh, fresh stuff on the perimeter. Anyway, so we focus on that. And then we do a gym induction as well. Sometimes it's nice that they lose this fear of going to the gym. Gyms sometimes are a bit scary. So what we do is just take them and we do a little induction so they know how to work the machines, how to also we give them a little, you know, a circuit or a little program to follow. So next time they go by themselves, you define it easier. So those are the three special sessions that we run as well. Um, each session is, uh, is different. Um, we access it. We deliver different topics. Um, but we also, um, provide behavior change support. So mind sessions regarding to habit change, which is also supporting, you know, all the, all the change. Um, and we, we try to for everyone to participate. If you can see the pictures, you know, uh, who can eat sessions, everything. We are a team. We do everything in a group and we try to, you know, to do everything together. So we emphasize the sense of community and I think it's really important for us. Um, just very, very quickly. Some headlines, important things that we've found, um, out of the two, um, the two programs that we've already run. Now we are delivering our third, third program. So, uh, the attendance has been very high overall. Let's say that we most participants attending over 80% of the sessions. That's been very, very good. Um, also we achieved like an average attendance of 71% or less. Um, and that indicated a strong commitment for most participants. So, you know, consistently attended. That's really good. Um, also 83% of participants lost weights. You know, with reductions ranging from 1% to over 6% of their total body weight. Um, we found very interesting because this is, we focus on, on, on weight, but also many other things. So we've, we've actually achieved that. And so all the changes as well, which I'll, I'll talk about in a minute. Um, also, um, of course, therefore, you know, they reduce their BMI as well, um, because of the weight loss. Um, and it's interesting to find that only one participant experienced, um, a slight increase in weights and BMI. Um, and this highlights to me the importance of consistency, you know, you know, the, you know, the person who, um, with full attendance, you know, is funny because she achieved the greatest reductions in weights and BMI. So to go to us, we found that consistency is really key and it really helps and does work. Yeah. Interesting. Um, so yeah. So there, we, there appears to be a positive correlation between higher attendance and rates, um, weight or BMI reduction. Um, some of testimonials of, you know, after the program, we, um, we asked the participants, okay, how was it for you? Because we learn every time every, with every session, but we also asked them, okay, what, what was it for you? What was good? What, you know, what wasn't that good? What do you need? You know, what else would have, would you, would have liked having that? So, um, the testimonies, um, I'm going to read a few just, um, so, um, the program has helped me to keep health in mind when choosing meals and to do more sport. That was one of the things they said. Um, it has given me a motivation I didn't have before. Um, the most important changes I have implemented are better breakfast and healthy meals, more awareness of the quality of what I eat. I think this is key that we're creating this awareness, you know. Um, now I can now read and understand the labels of products. Uh, and I have improved my weekly physical activity. So some things that we have learned from them and we have all the feedback they have given us. Okay. So, um, looking ahead, what we're doing is, well, of course, we're continuing the journey and learning, learning for us is this is very important. We are focusing on learning after each program and, you know, trying to, uh, find what we can change, what we can improve. Um, so what we're trying to do now is we spending our reach, you know, like, uh, trying to, um, we are actually already working with, uh, London GP practices, you know, social prescribers and also attending multiple cultural events so we can engage with the community. And it's working really, really well. I have to say, like, very quickly, we started with, um, seven people. The first program we, you know, our pilot was six people. Then we had 11, the next one. And now the one I've just started that two weeks ago, we have 15 and already a waiting list. So we're really, really, really proud of that. Um, that is actually working is, um, yeah. So also, as I said, and this is very important, ongoing evaluation and feedback. All this I'm learning and developing from experience and testimonials. because I think that's key. And yeah, sharing our model are some good practice case, of course. Okay, that's all. So over to the participants. So, um, I've asked, I've asked some, some of the people who attended the previous programs. I think it's very important that they actually tell us about it as well, how it felt for them. Great to him. Yes. So we started. Hello, my name is Doris. And so I'm trying to speak in English because it's very important for me to, to try and understand what happened here. Yeah. And I am so happy because I was involved in other workshops like this, but this was different. Yeah. because I, I can find more, uh, confident about myself because sometimes it's not about lost weight. It's about how I can eat or how can I, I stay healthy in my life. That was very interesting because, um, the, the team is wonderful. I enjoy every session, uh, about the food, about the labels, about the, the, the market. Yeah. You know, because in London, the markets are very, very big, but I understand, uh, it's important. I can choose what I can eat and the, every, every sessions about physical movements. Uh, I think is, it's a less time, but this is hard for us. Um, and, and I hope, I hope, uh, my community join in this, in this workshop because I can do it for the second time because there are, there are more people wants to enjoy this, this program. And only this, I am, uh, that was an amazing opportunity. And I heard about the Latin community and that is very important for me to, to pass the voice. And I said, the people is care about our community and I am so happy for that. Thank you. Uh, good afternoon, uh, everyone. Uh, my name is Jose Mosqueray from Colombia. Um, I would like, um, sorry for my English, but I will try. No, it's only because it's, for me, it has, I had amazing experience with the course because one time I was in the bus stop when I read the advertising for, Oh, okay. Okay. In Spanish. Oh, maybe good idea. Maybe not because I don't know if people in English because my English is not much, you know. When I was just as I, uh, my first class is like a, I feel curious, curiosity or why they say everything. When I don't know what happened, but I can connect it with Maria, with Pablo. Uh, my, my, my partners, my friends, my friends now. That's, uh, I started to motivate every week, every week. I waiting for every Friday, every Friday for going to the campus. Uh, for me, it's important because I know about the nutrition, but I don't, I didn't practice for me, you know. The dance, uh, was very good because in Spanish I connected and express my feeling, um, smile more constantly because my life is a little close. And then I say, Oh, it's very important. I, I would like to speak with Maria. When I have activity, physical activities for me, it's a little complicated. I say, no, no, thank you. No, I say when I started to make activities is when I connected with the group, uh, playing, smile. It's like in my energy coming inside me, you know. Uh, then also I had one class, one session was had a lot impact, impact in my life because, uh, I'm sorry for that, but I have problem with the alcohol, no? Alcohol, no? When Maria started to, to the class speaking, in the class speaking about the alcoholism, when I come back at home, I started to thinking in what, what I do. Because, uh, at the moment I take, uh, a lot medication plus alcohol plus my motivation was so hard to keep in, therefore that, uh, I keep in isolate, you know. That for me was very important to have the connection with, with, with the program, with the, the, my friends, Maria, Pablo, because then I understood, um, I understood it properly, not for full stomach or take my medication. But now I say, I, I, when I go shopping, I say, oh, that is good. I changed some habits and then I started to think in, um, in myself. This I say to thank you, Maria, um, for, for the program. And then I, I am very happy is join the course, joining the course. Um, um, I have, uh, different goals, but the, the main is reduce the alcohol. Is, uh, is possible zero for me will amazing because, uh, yes, I, I, I live in alone here in London because my family, all family live in Colombia. That for me is, my circle is some friends and me, where my friend is not here, just me. And then, but now I feel motivated for change. And then I, uh, I feel happy with the, with the course. I'm sorry for. That's great. Can I apologize? That's great. Thank you so much. I just want to start by saying thank you so much to both of you for coming today. It's, it must be scary walking into this building, into this room full of faces and everyone, everyone's suited and booted and, you know, and, and, but it really brings the program to life. And you can really feel the positivity radiating off you guys about the program and what it's done for your lives. So thank you so much for coming here today. It really helps us develop our understanding. Um, and I think also from the program point of view, it's really impressive to see the kind of co-design element. The fact that the voice of the community is, is really right the way throughout it. And that kind of holistic approach of like the old mind, body and spirit side of things, all of it coming together, which is so important for healthiness overall, not just in terms of weight management. So that's really positive to see. We're gonna use chair's prerogative and ask the first question. We've got about five minutes for questions, but what I really want to understand from you two is about retention. So on the program, loads of people are sticking on it and staying on it. What, why, why are people staying with the whole program? Why? Yeah, because, um, I think, uh, it's good. Yeah. You know, it, um, you know, the most of people from Latin America, uh, are working as a cleaner. That's life is very hard. Yeah. You know, because it's long hours is a lot of effort or body. But what happens when I can find some place, when, when I can stay alone, but with company, yeah, you know, I can, uh, the people understand what, uh, how I can feel. And maybe, uh, say, uh, is, uh, is, is, is better because I am confident with my body. I am no, I, uh, anyone is, uh, how do you say that? Judging me. Judging me. Judging me. Judging me. Judging me. Okay. And, uh, and I, I hope to the, I said before, I would like more Latin people come to the program and change the life. That is the moment I can stay again, but, uh, I follow eating. Well, I follow, uh, physical movements. Yeah. You know, because Pablo, uh, told me, uh, told, uh, as some exercise, what can I do at home? Yeah. You know, uh, movements in the morning, breathe, because we need that. Do it in the morning or maybe before go to sleep. And, uh, that is, uh, a small ideas, but works. That is the difference. Yeah. You know, because I don't need to, to lose weight. I need to, to be better with my, with my life and for my mind. Yeah. You know, because sometimes I say, I don't need to eat this, but it's impossible because I like. And Maria said, that's okay. You don't need to put a weight. Yeah. That's food, but maybe reduce the amount. I need a little bit, or maybe you need to think in a door, in another things, because maybe you are, you are eating for, because maybe you are hungry. Maybe you are sad. Maybe you are so exciting, but that is not good for your head. You need to eat because you are hungry. Okay. Yeah. Okay. Anyone else want to go on under? Uh, no, just want to echo similar sentiments, um, as my, as Councillor Bridgson. Um, it's really, really, um, encouraging. It's really, it's just excellent to, to see, uh, you know, a culturally appropriate, uh, weight management program and the positive impacts that it's having. So thank you so much for sharing your, your powerful testimonials, your experience, um, because absolutely it does bring it to life. And one of the questions I was going to ask, which kind of, it seems might, may have already been answered is around whether there's an opportunity for, um, for participants to join a second time. But you've just said that you have a waiting list now, which is, which is, which is a positive thing. And there are lots of, I think there's lots of, um, really good, um, learning, a lot of good practice that you've already put in place. And it's good to know that the program will be continuing all the way through to 2027. And I think for other, um, you know, um, other, uh, community groups within the borough that perhaps we haven't really started to tailor, um, interventions towards. This is a really good blueprint. I think a really good, um, baseline that we can, we can use going forward. So I just want to say thank you to, to you and the team, the great work that you're doing. Thank you again for sharing your testimonials. Um, and I mean the waiting list, how, how are we going to maybe address that possibly? And what, what's, what plans? We're thinking of, um, a few things. First of all, because of course there are people who are interested and at the moment we're delivering once a week. Yeah. So maybe we would have to look at, you know, improving, maybe making, maybe two groups a week or something. So we look into that already. That's good. Because of course we didn't know that this time has been successful. So we are already looking at that. And on the other hand, um, also, um, um, we allow people who missed a sessions to attend those. So they can come if she missed a session too, for example, she's welcome to join us on that, on that session. Um, well, I'm also thinking of, we also thinking of working on some workshops, like different things. Let's say, um, um, vitamins and minerals, for example, from food, how menopause, things like that, that are really, really relevant as well. Not for everybody, but you know, sort of different things that can have, can be a compliment to the, or to the 12 week. So this is the two things we're working at the moment. So maybe, you know, um, making more, delivering more sessions, more sessions a week, like maybe two. If we have people for it, for it, I think we probably will. Um, and also, as I said, all the things to, to, you know, to compliment what they already, and to also follow up, you know, what they've done. Okay. Okay. Okay. That's great. Perfect. Thank you. Cancel kind. Um, gracias por venir a hablar. Gracias. Your, your English is far better than my Spanish. Thank you very much. Which I try and say. Tu espanol de. Mejor. Mejor. I can't remember exactly. Thank you. Remember this has been filmed. So if you embarrassed yourself better. Thank you. Thank you very much. Um, the question I've got is about the marketing. Um, Danda was just saying about, like, you've got a waiting list, so you don't really need more referrals in. But you had a picture up about the marketing map, um, of where it was. And I think what you were highlighting, if I'm wrong, correct me, the blue dots were where the bus stop locations were. There's a pretty big gap around Clapham Park. And my understanding from some of the stuff that we've done is that Clapham Park had the second largest. Latin American community after the sort of Stockwell South Lambeth Road area. So I'm just wondering how it is for targeting. Not that you need more referrals in the moment. If you're incredibly popular, but how you are for targeting because. That community being based there just maybe they don't know. And I'm just wondering how you measure that in terms of geographic spread. We don't have data in here about the number of people, but I think it would be good. Not not to come back, but just to see what is the data about how many people are accessing? Where do they live? You know, this is Ferndale Community Centre. Do more people live closer to there? You mentioned, you mentioned IMO earlier. They do great work, but how do we make sure that we're doing geographic spread on this? So just to say quickly, the targeting uses a combination. So areas that we know people live, but also areas that we know people work in and also targeting some of those community centres that we know are the communities already involved. So some of the different religious groups that the communities might be attending or some of the other community VCS groups. So it's we're using a combination in addition to the the bus, the advertising on the bus. So so hopefully because I can't remember the map, but I'm sure we covered. Clapham. I'm sure it's there, but maybe our map needs to be updated. I'm just going to take a very. Oh, everyone's fighting for questions. We've got hardly any time. I've already said yes to you. So do you want to go for it again? Thank you very, very much for your testimonials. They're phenomenal and well done on what you've achieved. And I guess my my question or comment is you started it with stats. They're not really based here, but are based on American studies. But they're quite large numbers, 50% of the population, three quarters of the women. So it's about that cascade again. And is there an opportunity to because this will be your third cohort, you said, and you're thinking of more. So is there an opportunity now to give you the greater community ownership to it so that you actually go back to some of those people who've been successful and ask them to come along and train and as a physical support, the physical work, support the workshops, support just because we've got a very large population. 15 by 15 by 15 by 15 is going to take a long time. That's a great idea. And I think that we we've already talked about it with. Yeah. Yeah. We've already doing that a bit. Basically, he when we just this example, we did the eat and cook the cook and eat workshop and he is a chef. He's a chef. So he helped a lot. So he actually did all the hard work, I have to say. So we all, you know, did a few bits and pieces, but he did all the hard work. So that was great. So we've, of course, talked to him about joining us on the next one. So he can also help us with that because he has experience and he also has, you know, a very nice, you know, very nice way of, you know. So, yes, this is something that we are doing at the moment. So finding out what, you know, who could help us with that, who is willing to, you know, to help us, but also to give us their experience. This is most important. It's something that we focus on a lot, you know, on the sessions like, OK, we you learn from us, but we mainly learn from you. So feel free to share, to ask, you know. So this interaction is most valuable for us. I'm going to jump to the very last question. He didn't very forget this. We're so very bad. Children. We're noticing now practice lots of Latin American parents are overweight. So are the children in the workshop on children. Absolutely. Latin American children. Absolutely. Absolutely. Because we've got thousands of Latin American people. Really? A lot of them are getting diabetic. Yeah. Yeah. Yeah. Absolutely. That'd be great. Raj, we have the weight management program for children as well. They're ready, steady, go. And a lot of the... 99% entire ones. Okay. Criteria is too strict. Oh, from four to 12 year olds. Oh yeah. Yeah. Yeah. I'm going to move us towards the recommendation, which is the health and wellbeing board is being asked to note the actions and approaches being taken to support the Latin American community in number to achieve healthy weight through the delivery of the innovative co-designed adult weight management program. Is this agreed? Nice and loud. There we go. Thank you very much for your time. Much appreciated. Thanks for coming. I'm going to move forward. Yes. Move us forward swiftly onto item seven, which is pharmaceutical needs assessments. I have got Rachel Scanselbury, public health consultant and Catriona Crooks here to present. I'm going to be really tight on you in time and wise, just so we can call back some time. I, a lot of us have been briefed on this already as well. So can we just do a five minute overview? Just five minute overview. Yeah. Yeah. Maximum. That's absolutely fine. We won't go through all the slides. Yeah. Had the paper. I will just share one or two slides if that's okay. Sure. Cool. Yeah. Okay. So we are here to seek approval to go to public consultation with the Pharmaceutical Needs Assessment. I'll run through very briefly some of the findings, but it's all in the slides and the executive summary there. But just in case this is the first hearing of the P&A, it's a statutory document and all health and wellbeing boards have a responsibility to keep up to date and publish their pharmacy needs assessments for every three years. And our next iteration is coming up on the 1st of October this year. So there's more detail in the slides, but I'll just jump straight to what we found in our assessment. So in Lambeth, as you'll see on the slide here, we have a map showing all of the pharmacies in the borough. So there are 59 community pharmacies in Lambeth, 55 of those are 40-hour pharmacies and four have slightly extended 72-hour contracts. And then in addition, we have 56 community pharmacies within one kilometre of the border. So you can see on the map, those red dots are pharmacies inside the borough and the blue ones are just on the border. So we have 18.7 community pharmacies per 100,000 residents, which is slightly lower than average for London and England. But as you'll see from the map, everyone in Lambeth is within a maximum of 12 minute walk of a community pharmacy. And when we looked at public transport and every part of the borough is accessible to a pharmacy within 15 minutes by public transport, but mostly about five to 10. We also conducted a public survey while we were doing the P&A. So this helped us gather views of residents. So we found 87% of the 126 people that we surveyed took 15 minutes or less to travel to a pharmacy. So that kind of aligns with what we're seeing as a match to it. And so next, I'll just summarise what we found in terms of service provision. So we looked at essential services, which are things that every pharmacy has to do. So dispensing and those kind of activities. And we found that there is good coverage of pharmacies across the borough and sufficient access to these essential services during both working hours and outside of those hours as well. We also looked at advanced and enhanced services. So these are things that some pharmacies opt into providing, but they do include things like vaccinations and pharmacy first service. And we found that there wasn't any gaps in provision of these types of services. We also had to look at the impact of other types of services and how that might impact demand for pharmacies. And we didn't find that there was any gaps caused by other services. We looked at future needs to see if any changes in the population or the distribution of services might mean that a gap emerged in the future. But we didn't find that there was any gaps across any types of services that we looked at. And there was no gap that we identified which could be addressed by commissioning a new service. We also conducted a quality impact assessment and looked at whether there was any gaps in provision for people with specific needs who have protected characteristics. But we didn't find any gaps there either. So I'll just quickly touch on the consultation, which is the primary reason we're here today. So we want to take what we found at public consultation for 60 days. So that is a statutory requirement of the P&A process. And as I said, we've already done with residents in the borough through our survey. And we also did engagement with pharmacy providers through a survey as well. And the insights from that are all included in the P&A itself. So we will be going out for the 60 day consultation and the statutory consultees that we will be going to are listed on the slide there. So they include the local medical committee, Healthwatch, the local pharmacy committee, NHS England, ICB, Health and Wellbeing Board. And we're also going to include the equity and justice member panel in that list as well. And the consultation will ask questions like, does the pharmacy needs assessment reflect the current provision of services in the area? Do you agree with the assessments that we've made? Are there any gaps in provision that you perceive there are that we've not identified? Sorry, that was very fast, but is there anything we want to add there, Richard? No, I think that covers all that. Thank you very much. I just want to extend a thank you to the team as well. Myself and Councillor Manley Brown have had an in-depth discussion with you guys about the about everything that's in here. And you've also answered the questions that we had in advance of that as well, especially around the Vauxhall area, not Stockwell. Vauxhall area where there is some elements around the provision there. But I'm satisfied in terms of the distance of neighbouring areas and that type of thing. So I'm just going to move swiftly to questions, if that's OK. Answer kind. I was going to ask about Vauxhall, but I think you've already asked it. So a very detailed response I can forward to if you would like. You know, the pharmacy in three and a half thousand homes, but we go over that one and the where I have a question mark is about out of hours access. If it's past nine o'clock, you've got to go to Westbury down in Streatham or you've got to go all the way over to Victoria Station. And I'm not confident, actually, that the out of hours cover is there. And I'm basing that on feedback that I get from parents groups because parents out of hours trying to get stuff for their kids, find it even harder because they can't take their kids with them. And I don't know, Raj, you probably had this through the, you know, through the Young People's Alliance side of stuff. But that's a particular concern for me in my cabinet role for children and young people, because I don't know. You know, there's a lot of panic at that point and there's a lot of concern for a new parent and not knowing what to do. But surely we don't want to be pushing them towards emergency care, which is, you know, the only other alternative at that light hours. But I'd like for there to be some exploration again about the out of hours cover, particularly going north of Brixton Town Centre. I mean, it's it's tough to get from where I live in Brixton to get down to Westbury at half past 10 and it shuts at 11. So even then you're running at risk if you if you miss the bus and it's gone to night buses and you're probably a bit too late. So and it's not 15 minutes walk. It's it's right. Before you respond, I'm just going to bring you in as well as on this point. Oh, OK. Don't worry. Do you want to take that then? Yeah, so so you're right. We have as part of the full draft pharmacy needs assessment, we have an appendix which lists all the pharmacies and all of their opening hours. And there's I think there's two in the borough that are open till midnight. But yes, it's it's limited. So what we can do so we can have a look at the statements that we've made. So I think it explains this in the paper that the P&A is a statutory document. So it's used as a market entry tool, largely for NHS England to be able to make decisions about if a provider was to make an application to open a pharmacy or to relocate a pharmacy. So there are kind of statutory statements that we need to make about that. But in addition to those, we can make some comments and that might be something that we would like to add in as a comment that we've noted that the availability out of hours is perhaps limited geographically. But we could we can certainly look at that. Is that something we can add into the consultation potentially or is that? So the consultation has a set list. Well, we can add in questions about that. So this is what I'm wondering if we we proactively ask the questions about how to our services. Is that a possibility to add to the consultation? Yes. So also just to add to that, a prior stage to this was engagement with residents. So we did we have engaged with we had, I think, about one hundred and twenty five responses and we asked people about their satisfaction with. Correct. We did. We asked about opening as we certainly asked about. Yeah, we did. And we asked about access and travel times and so on. I don't think anybody flagged that as a concern, but that's, you know, one hundred and twenty six responses isn't fully representative of the bar. I appreciate that. But we can we can certainly look to add in a question about. I don't think you should hold back the consult, go into consultation, but I'm thinking it's an opportunity to put it in before it goes out and you'll get a much wider response then. Is that OK for you? Yeah, I think we should include it, if anything, because Rachel, the NHS website only lists one. Pharmacy in Lambeth that's open and that's that's Westbury and it's only open till 1130. So I think the problem is. If we don't put it in the market access side of things, the statutory document NHS England and the companies that are ultimately being commissioned to do this, they don't do it themselves. So do we need to prompt it by asking the question? Certainly, I think the north of the borough would benefit from having an out of hours service. OK. Yeah. Comments, could you also add a bit about encouraging pharmacies to do more than our services? Because we're under heavy pressure in primary care. For people to go to their pharmacy first and then there's immediate pushback saying, you know, we can't do that. Our pharmacies can. Yeah. So in our final consideration section, and I think we can work on going with the LPS, the pharmacy committee. Yeah. Around trying to increase the number of consultations of advanced services that pharmacies are doing. So we have noted that in our final considerations, but we could bring it out in more detail potentially. Great. I just wanted to add that the lack of pharmacists out of hours is also an issue for out of hours GP services. Yeah. And for secondary care, like the at home team, for instance, there's just nowhere to get a prescription out of hours. And I think it does increase referrals into emergency departments because you cannot get drugs. Yeah. Thank you. Ruth, you want to come back? So it was just to note that there are changes that are happening to some of the services that pharmacies provide that we currently commission locally. They will be provided nationally, which will increase potentially some of the provision. I don't know to what extent that's currently reflected in there. And the ones I know about most probably the sexual health ones, which currently we currently do locally. So that will change as well. And access will actually improve, I believe. And how we manage that and monitor the quality of it is probably a local thing. But just to note that as well. Right. I'm going to move us forward to the recommendation there then. And the recommendation is that the Health and Wellbeing Board is asked to approve the draft PNA to be published for formal public consultation for 60 days from the end of May 2025. But also to include within that a prompt around the out of hours service to proactively get responses on that. Is the board happy to agree that? Yes, I do. Perfect. Perfect. So thank you. The recommendation is agreed. And so we're going to move forward to item eight. So the annual report of Health and Wellbeing Board. And so we have Ruth, who's going to be speaking to that. And can I get you to do that in two minutes? Is that OK? I might get Bimby to come up as well if that's OK. Just on this. So we have an annual report of the Health and Wellbeing Board, which gets reported as part of our governance as a board. So I think the paper outlines what has come to the board over the last year and the priorities and strategy. So that's all in there. So that's all in there. We had a board development session, which we do every year. We had annual board development session last month or quite recently anyway. And on the back of that, we had agreed that there were some areas that we would look at. And obviously we now have a new chair, so we will pick up that discussion now to work out how we how we do that to monitor progress. Both of the strategy, picking up some of the things we've talked about earlier this evening as well. But we also need to go back through the Constitution and make sure that we've got the right things around for us, the membership. So that's absolutely fine. But one of the things that really came out of it was how do we increase community engagement element of the board? How do we make that potentially part of the board? So we're hearing from the public and the residents, whether that's actually in the board or whether it's in a different way that then gets fed in. I think we might want to discuss and hear that as a board. But that is sort of the overall summary for this this year. Thank you. Do you want to add anything to that or? I think that's sufficient for some time, but happy to answer any questions. Perfect. And we've all read the papers and noted it and we can see the vast, myself and Nanda can see the vast amount of work that's happened over the past year as well. So thank you for everyone who's inputted into that and ran sessions and brought patrons to the end of it. Yes. Best question. In terms of community engagement, I think if they had more time, it's more rather than spending the matter on the first bit. Yeah. How we, you know, use the meeting time in the room. You've got the papers already. We've read all those all over again, but they haven't presented and we need to hear their voice. Can they tell us what they need? I completely agree with you. I think from perspective, so myself and Nanda have walked into the portfolio a week and a half ago. So actually this has been a really good opportunity for us to shape it going forward. So I agree. I think everything should be taken as read and then we just then take on from that. To three slides. Exactly. Exactly. But also on top of that, if we've read all the context, we just need, and it's people who've received the service coming forward, then we can explore that a bit more and the people there to take questions. But I don't agree on that point. Yeah. And maybe just to add that we did talk about different ways in engaging with people because, I mean, it was great that both of them could come. It's an evening here in person and they had the confidence to be able to come. So I think that's important for the meetings. But I think outside of the meetings, we need to think about how we engage with the community both in terms of delivery of the strategy, but how we engage. It's not a question I can answer right now. I can take that away. It would be a good attendance at the library to be like Lambert Together Board. I think it's issues about broadcast. Yeah. Technology AMI, Tim. So yeah. Council kinds. I absolutely agree about resident, let's say engagement on it. I think Healthwatch Lambert is great to have you here, but I think it would be good to hear from you, especially on the items. A bit like we do a corporate parenting board where we have our young people and our carers speak first. I think it would be good to be able to hear directly from from Healthwatch Lambert, but also from residents to prioritize that. I do think there's an exercise that's needed. Being clear about what the structure is. We know if you want to stop somebody in the street or if you stop somebody at any of your services, they would have. I don't think they would know what the health and wellbeing board is and how all these things fit together. So we need to be better at communicating what it is, because that probably then says why people are not necessarily participating all the time. I remember from when I was on Lambert Together, it was the same people coming to sit in the audience, wasn't it? And it was it was, you know, that's part of the thing. So could we expand it? Could we get more? I think we could. Yeah, I would echo those sentiments. I think definitely review and possible refresh of the board to a degree and, you know, just doing a bit of reflection about the things that have been working really well doing that and the areas that perhaps might need further strengthening. Then look at improving some of those areas, but definitely amplifying the voice of residents and service users. I think it's really important and definitely hearing from Healthwatch and other community voluntary sector organisations that are at the coalface, you know, have those or the rapport and the organic relationships with communities. I think it's important to hear that voice front and centre throughout the board. And also just to add, we are very new in post, so if you do have ideas and thoughts, do reach out to us as well and happy to include that in there. I think you've all been here a lot longer than we have in terms of this portfolio. So put on a cap on slide, I'm here for it. I'm going to move us forward to recommendation if that's OK, which is the Health and Wellbeing Board has been asked to approve the Health and Wellbeing Board's annual report for 2024-25 and to recommend it to the council for final approval. Is this agreed? Agreed. Agreed. Perfect. Thank you. The recommendation is agreed. So now to the next item, item 9, is Lambeth Together Health and Care Plan. The report is going to be introduced by Warren Beresford, Associate Director for Health and Care Planning and Intelligence. So we've got around five minutes in total for this item. Can I squeeze you to do an introduction for two minutes so we can go to questions? Assume we've read everything. Yeah, no problem. Thank you. Can you all hear me OK? Yeah. Excellent. Excellent. So yeah, just to repeat, reintroduce myself again. I'm Warren Beresford, I'm the Associate Director for Health and Care Planning and Intelligence for Lambeth Together. And one of my roles within Lambeth Together is to lead on the coordination of the health and care plans across the partnership. So I'm here this evening to talk to you and ask the board to note two annual refreshes that have taken place over the last month. Around over two plans that span across the local authority and the NHS. So the first plan is the South East London Joint Forward Plan of which Lambeth contributes to. And the second plan is the refresh of our Lambeth Together Health and Care Plan, which is a specific plan to Lambeth Together Partnership. So both plans they started, they commenced two years ago and each year we undertake a refresh of those plans to ensure that we review progress against them and also fold in any new requirements in terms of any national guidance. So the health and wellbeing board were previously endorsed the plans, both plans in two years ago in 2023. And they received a similar update to what I'm giving now last year, this near, near enough a year to the day. So both plans are aligned to our health and wellbeing strategy and also support delivery of the Lambeth 2030 Boroughwide Plan. So in terms of engagement, there's been extensive engagement across both plans. They've been presented at multiple Lambeth Together board meetings and seminars over the last quarter. And we've also held a recent alignment exercise via our Lambeth Together Executive Group to ensure that the plans align with the national 2526 NHS operating plan guidance and priorities. So at the meetings we've engaged on, we have representatives from all organisations across Lambeth Together local care partnership, including members of the health and wellbeing board. So it's felt that there's been really good engagement and input from the board members on both the plans in advance of coming here today. So it's important to emphasise that the overall, although we've done these refreshes over the last few years, the overall vision and ambition of the plans have remained unchanged. And that health inequalities and prevention have remained a priority at the core of both those plans. So just to repeat what I'm asking the board today is just to note the refresh plan. So the South East London integrated care board jump forward plan and the refreshed Lambeth Together health and care plan. So I hope that's a quick update and happy to take any questions from the board. Thank you. Perfect. Thank you. Thank you, Warren. Any questions? Council kind? All right. This is for the 2526 plan. So I don't think there's anything Warren that I would say necessarily about where this is going, but I would want us to note that there are a lot of plans and strategies and a lot of frameworks and a lot of documentation that comes together that goes there that we spend a lot of time going through. And we get to the end of the year and we get to the end of the year and we're doing the same bit about the next bit and so on. And it seems never seems that there's enough time for any of those things to actually bed in, change something. So I would just hope that as we begin planning for what is then going to be 2627 and onwards that we can begin to perhaps lighten the burden in the number of strategies and focus on some deliverables. So within that, I hope that we could perhaps look at integrated neighborhood teams. I mean, huge amounts of this is just unknown to the general public that this stuff exists, but integrated neighborhood teams. I think we've discussed it before and Andrew, you'll recall when it came to my cabinet members briefing about younger people side of stuff, which is I'm not confident that that they necessarily cover the geography correctly. Because they are stretched to fit town centre areas, but some of the focus is a little bit further away and some of the GP practices that are involved represent different strips. You've seen the map, different parts of those areas themselves. And when you get drawn together in an area like South Brixton, for example, or Stockwell, where the areas combine, the practices are crossing over one another. People don't look at it as a line on a map. Consciousness isn't the item though. No, I know. Can I force you to the question? If we go further through the year, I think it'd be good for us to have a bit of a more strategic yes, isn't it, rather than just another go at doing the same thing and updating it for the next time. Any other questions? Right, I'm going to take us through to recommendations there then. So the Health and Wellbeing Board is being asked to note the refreshed South East London Integrated Care Board Joint Forward Plan for 2025-26. And also to note the Lambeth Together Health and Care Plan, our Lambeth, our health, sorry, the other way around, our health, our Lambeth, and your review for 2025-26. And the alignment to the SEL-ICB-drain four-wheel plan ahead of the formal approval at the Lambeth Together Care Partnership Board on the 15th of May 2025. Are we agreed? Agreed. That was a mouthful and a lot of acronyms. Thank you. The recommendation is agreed. We're moving forward to item number 10, which is the Better Care Fund, but quarter three report, 2024-25. Do we have Jennifer Burgess speak on the item? Okay, I'll leave. Oh, yes. Jen will come in. Can I ask you to do it in three minutes maximum, so we can go straight to questions and assume we've read everything. Okay, thank you. Thank you. I'm Jane Bowie. I'm Director of Integrated Commissioning for Adults in Lambeth. Board members are familiar with the Better Care Fund set up in 19th of 2015, and it comprises broadly of existing ring fence grants that were brought together. The current total pool fund for the Lambeth Better Care Fund for 2025-26, as of the intakers, just in excess of 56 million. We're bringing to the Board tonight two items. One is to ratify the submission of the BCF quarter three data due to deadlines that were given for submission to the National Centre. The previous chair, Councillor Dyer, took chair's action to sign that off to hit the submission date. And secondly, is to ratify the decision of the BCF plans 25-26. And again, Councillor Dyer helpfully took chair's action, similarly to sign that off to hit the submission date as well. So that's all I wanted to say to you. Perfect. Jennifer, did you want to say something on that, or have you done this summary for both of you? No, absolutely fine. Perfect. Thank you very much. So, questions from the room? Wow. Go on, Councillor Kine, off you go. I've got questions on every item. I mean, you know, I guess the point is about the processes of what is Health and Wellbeing Board for. The better care fund has tended in the time that I've sat in it to always come already approved as chair's action. So I can't disagree with it now. It was weren't even involved in it. So that then raises questions for me about what is the point of it coming here for some sort of democratic. process if actually it's, you know, we're not going to talk about what is in it in detail. And some of the things that I was in particular interested in go back to some of the earlier items that we had. Community resilience, enhancing intermediate care. We've spoken about that a lot before. Ruth, we spoke before about delayed discharges, capacity pressures, things like that. We don't have time. I don't have the information. What's the point? So again, if board members would like to dedicate a bit of time for a deep dive on this. I mean, as I said, you know, the, you've been, you know, the better care fund has been in existence for a number of years and iteratively it comes through. One of the conditions of it is that it does come to the health and wellbeing board. Unfortunately, we get the dates of submission late. So because the dates of the health and wellbeing board already set, you know, if, if there was a way that we could time it, we do. Um, but, um, chairs of the health and wellbeing board have worked with us and hopefully been very flexible in terms of supporting to help the democratic process. We always do take it through CMB beforehand. So our cabinet lead and specifically the chair does get a chance to have a look at it and go through as well. It's, it is quite a dense area. And I'm not sure whether this board has ever had the opportunity to go through in detail. Very happy to do that. If that be something that. Just at the moment to throw that out to the room with people. So we've already got one drill down potentially scheduled, but people want a drill down in the better care fund. Get it elsewhere. Yeah. So I was going to say, I think if there are members of the board that feel that they'd like the detail, we could organize a separate session on it. I'll buy one with them. Is that all? Well, I'd say collectively because probably less painful for the person having to go through it. Let's do it. Let's do it as an opportunity. I'll just say, I don't need a drill down on it, but I do think there's an issue with how we're structuring things. If it's got to come here and I'm not sitting on Lambeth together, you're asking me to just say yes in a second to 55 million pounds that I've not had any involvement with. So there needs to be a better way of making sure if it's coming here to this place that the people who sit on this board are involved in the process beforehand. I think also as an action, we can take that away and have that discussion about how we take people with us. Certainly we can give that feedback to the national team. I mean, we have given it previously because we have a clear decision. Either we submit returns late or we look at how we're able to do it. We try as best as possible to balance if it's within it. But if we can't hit the timelines to come to here first, we don't get the level of notice always to make that. If we can't bring it here, we will. I think we've heard that loud and clear tonight anyway, and we can take it back and work on that. Is there any more questions just before? Right. So I'm going to very quickly do the recommendations and then I'm going to extend the team quickly. So the Health and Wellbeing Board has been asked to ratify Councillor Dyer's decision as the former chair of the board to sign off the BCF 43 report to enable submissions to the BCF National on 14th February 2025. Are we agreed on that? Thank you. That recommendation is agreed. And at this moment, I think we'll only need like another 10, 15 minutes. But I'm going to ask, are we happy to extend the meeting for a maximum of half an hour? But I don't think we'll need it. I apologise. I have to leave on time for childcare. Are you happy in the notion that we carry on? Yes. I'm just apologising. I'm going to say that is agreed then. Happy with that? Cool. Perfect. So we're moving towards item number 11, which is the Better Care Fund Plan 2025-26. And this will be introduced by Jane Bowie and Jennifer Burgess. Can I give you three minutes again? Give me three minutes. This is the other requirement that we had. We had to submit the Better Care Fund Plan for 2025-26. We were given a national date to submit by. And we took it through a Cabinet member group beforehand. And the Chair's action to sign it off. So we take some information to submit the date. Perfect. Very quick. Well done. Does anyone have any questions on this item? Cool. So I'm going to move straight forward to the recommendations there. The Health and Wellbeing Board is being asked to ratify Councillor Dyer's decision as the former Chair of the Board to sign off the BCF Plan 2025-26 as Chair's action in advance of the submission on the 31st of March 2025. Are we agreed? Very good. Thank you very much. The recommendation is agreed. And we are moving forward to the last item of our agenda, which is item number 12, Director of Public Health quarterly report. So this report is from Ruth Hutt. See, this report is from Bimpy Oki because it was on her report. Makes total sense. Just didn't have it in front of me. Can I give you two, three minutes maximum? OK, so I'm Bimpy Oki and I've been the Acting Director of Public Health up until Tuesday. And the report in the papers is a record of some of the work that the public health team has been involved in in four to four. We tend to bring it's a non statutory reports which we bring to every board meeting and you would have seen the breadth of things that we've been involved in. And maybe I'll just pick two things. So really just to highlight the successful work that was done as part of the Health Checks at Work pilot, which worked with both big employers, so big trust, local authority and and other businesses, including smaller organizations like care homes. And we actually exceeded the target we had. We had just about six months and the team did a great job in being able to do that. But also just the really positive feedback from people who had their checks done, including some of our members who actually came back to us to say members probably should be having regular health checks. And then the action needed. And then the the other one is is really is the great Mental Health Day was on the 31st of January. January and there were events around the day, but I'm highlighting this mainly because next week is Mental Health Awareness Week. And the theme around this is is community and the really important sort of recognizing that being part of the community brings a sense of belonging. We've heard members of the community talk about feeling part of the community and we know what that does to both people's mental and physical health and wellbeing. We are have set out some activities, particularly for our staff and recognizing as well that the workplace is a community. And we can make sure that that's published for our colleagues, but also we will be putting out some communications to the members of the public around what services are offered to people, but also the opportunities to access some of our training like young zero suicide training, which is open to any member of the public. And also to our voluntary sector colleagues around some of the mental health awareness training that's available. But happy to answer any questions on. Thank you for that. I think also just a massive thank you on behalf of the whole board for all the work that you've done over the past year. I think we've been in this less than two weeks and your name has come up time and time again of someone we need to get to know and someone who knows everything and someone who is at the forefront of a lot of this work. So thank you so much. And thank you for stepping up when the borough needed you. So that's just a big warm welcome and thank you from us. And also to Ruth as well, who stepped over into the housing side of things and tried to help us sort that out. So very much appreciated in that space. Is there any questions for Bimpy? Yes. Good question. I think Bimpy is being a bit modest, though, around TVD assessment. So we're not only here our target, we're double next biggest borough. Yeah. We did fantastically well in that. And there's also reports in here about the bus, isn't there? And as part of Lambeth Together we offer for people to go out in the bus. We were residents, I'm sure we could open that up to Health and Wellbeing board members as well. Well done. Yeah, it's good fun. We've asked to go. Yeah, yeah, yeah. Scheduling visits in left, right and centre. So if anyone's got any, let us know. We're hoping to come to primary care as well. Drop us a note, bug it in. Yeah, let's go. Let's go. Comes the kind. Measles, we've discussed it here before. Good to see and I think we should pass our note to everyone involved that rates are going down. Given where it was for Lambeth in particular, I just wondered separate to this if we could get an update on vaccination. Because I think rates going down is one thing, but if we're still struggling to hit some of those markers on vaccination, we've discussed that a lot and the barriers and the challenges about getting the information out there. So I'm just having it in the context of falling numbers would be helpful. Is it because more people are getting vaccinated or is it for other reasons about how infection works? So. But to get the additional information at some point and then I was just wondering more in general about how. You know, high risk and marginalised groups are sort of getting targeted support based on the information that's in this report, because I think that's something that again, this is this is a report of what's happened. But how do we then use it to inform what's coming next from a public health perspective in particular? And I think also we can take that as an action on the vaccination point, whether that's we can work out whether that's information circulated or if there's a broader point that we might be able to bring here as well. Any other questions on that? No. Well, I'm going to take that through to recommendation then. So the Health and Wellbeing Board is asked to note the quarter for report and also put on record our thank you to BMP for all the work you've done. Are we agreed? Oh, we agreed.