The Health and Wellbeing Board and ICB Sub-Committee met on Tuesday 10 September 2024, discussing a range of critical health and social care issues for Barking and Dagenham residents. Key decisions included the approval of the Adult Social Care Prevention Plan 2024-2034 and the publication of the Joint Strategic Needs Assessment 2023/24. The meeting also provided updates on specialised services, maternity and neonatal services, child death overview, and winter planning.

Focus on Specialised Services

The Board noted a report on the delegation of specialised services from NHS England (NHSE) to Integrated Care Boards (ICBs) from April 2025. This delegation, which will see London ICBs jointly commissioning services with NHSE for another year before full delegation, aims to improve population health management, tackle inequalities, and ensure better value for money. Specialised services, which are costly and cater to rare or complex conditions, currently represent about 20% of the NEL commissioning budget. The delegation is expected to allow ICBs to integrate pathways, address inequalities, and manage future demand more effectively. While risks associated with delegation, particularly financial ones, were acknowledged, the move was generally welcomed as an opportunity to improve outcomes for residents.

Adult Social Care Prevention Plan 2024-2034

The Board approved the Adult Social Care Prevention Plan for 2024-2034. This ten-year plan outlines the council's commitment to preventing, reducing, and delaying the need for adult care and support. It focuses on prioritising technology, culture change, early help, and community-driven support. The plan aims to identify and engage residents, reduce crisis demand through early intervention, and increase independence and well-being. The approval signifies a commitment to meeting the statutory prevention duty outlined in the Care Act 2014 and aligns with broader partnership priorities for health and care.

Joint Strategic Needs Assessment 2023/24

The Board approved the Joint Strategic Needs Assessment (JSNA) 2023/24 for publication. This statutory document addresses the population's health needs and informs strategic commissioning. The assessment highlights that healthy life expectancy in Barking and Dagenham has not improved in the last five years, lagging behind neighbouring boroughs. Factors contributing to this include a growing and diverse population, widening health inequalities exacerbated by the cost-of-living crisis, and the need for a more integrated, system-wide approach. The JSNA emphasizes prevention as key to addressing these challenges and proposes a new approach of refreshing the full JSNA every 3-5 years, with interim deep-dive assessments.

Maternity and Neonatal Services Update

An update was provided on the case for change in maternity and neonatal services across North East London (NEL). The report highlighted a growing population, an increase in complex pregnancies and births, and rising health inequalities as key drivers for service change. NEL ICB has been working with stakeholders to understand how services can better meet the needs of women and babies. The case for change identified opportunities to improve early booking, antenatal and postnatal care, and to address variations in quality, access, and experience across different hospitals. It also stressed the importance of reducing health inequalities, particularly for Black and Asian women who experience poorer outcomes. For neonatal services, the focus is on ensuring care is delivered in the most appropriate setting, managing high occupancy levels, and enhancing transitional care and home support. The report also noted the significant pressure on the workforce and the need for innovative approaches to recruitment and staff well-being.

Child Death Overview Panel Annual Report 2023/24

The Board noted the annual report from the NHS NEL Child Death Overview Panel (CDOP) for 2023/24, which reviewed child deaths in Barking and Dagenham. The report indicated a significant reduction in the number of notified child deaths compared to the previous year, though caution was advised due to the small numbers. Male children accounted for a higher proportion of deaths than females, and the age range of 0-27 days saw the highest number of notifications. The report also highlighted the need to reinforce safe sleeping messages and improve multi-agency working to reach vulnerable families regarding Sudden Unexpected Infant Death (SUID) prevention.

Winter Planning 2024/25

An update was provided on the development of the Barking and Dagenham Winter Plan for 2024/25. The plan has been developed collaboratively with all partners, drawing on local understanding of winter pressures and challenges from previous years. It aims to complement existing arrangements and focuses on three overarching themes: proactive population health and care to keep people well in the community, optimising flow through acute, mental health, and community trust sites, and strengthening alternative pathways to reduce pressure on urgent and emergency care and primary care. The plan prioritises improving communications to residents, increasing support for those with respiratory needs, and taking a proactive approach for targeted groups, including those affected by the cost-of-living crisis, the housebound, and those at risk of frailty and falls. The plan is a live document and will be managed through place-based governance arrangements. A non-recurrent funding allocation of £723,000 has been made to support the plan, with specific allocations for proactive care, falls prevention, respiratory hubs, and discharge support.