The Health and Wellbeing Board met on Wednesday 20 March 2024 to discuss updates on the Harrow Borough Based Partnership, health protection, preventative health strategies, and the 'Right Care, Right Person' initiative. The Board noted reports on these key areas, with discussions focusing on service integration, public health challenges like measles, and the implementation of new policing models for mental health calls.

Update from the Borough Based Partnership

Lisa Henschen, Managing Director of the Harrow Borough Based Partnership (BBP), presented an update on the partnership's activities between December 2023 and March 2024. The focus during this period was the implementation of the Winter Plan to manage increased demand and ensure system flow. Key priority programmes included the integration of children and young people's services, integrated neighbourhood teams, and integrated intermediate care services. The Healthy Harrow Programmes are progressing, with plans underway for delegated funding for inequalities in 2024/25 and for the Partnership Delivery Programme. The Board heard that service integration is working in some areas, particularly for older people's services, but requires further embedding. Discussions also touched upon the geographic elements of social care referrals and the reporting of discharge rates, with an update promised for April 2024. The Board also learned about programmes to mitigate children's tooth decay, including supervised dental programmes in schools. The Board resolved to note the report.

Health Protection Update

The Board received an update on health protection in Harrow, which encompasses measures to protect individuals and populations from infectious diseases and environmental hazards. Carole Furlong, Director of Public Health, highlighted that there had been approximately 650 cases of measles across London, with 19 confirmed in Harrow, including a recent case in a school. Low Measles, Mumps, and Rubella (MMR) vaccination rates were cited as a reason for the infections. Outreach programmes and vaccination clinics at schools have been implemented, showing encouraging uptake. The report also noted that flu vaccination eligibility criteria remained the same as the previous year, and at-risk residents were encouraged to get vaccinated. The Board discussed the timing differences between national and local measles vaccination programmes, with assurances that both aim to reduce infection. It was noted that North West London has the highest number of measles cases among children, with Harrow, Brent, and Ealing being the most affected, partly due to demographic factors influencing targeted messaging for vaccine uptake. The Board proposed using methods like the Gold Bulletin newsletter to encourage vaccine uptake, and the Chair requested the Director of Public Health liaise with the Communications Team to include this information. The Board resolved to note the report and presentation.

Health & Wellbeing Strategy Update: Prevention in Partnership

This report outlined a preventative strategy, using physical activity and falls as examples, and emphasised the role of partners in identifying prevention opportunities. The Prevention in the Partnership programme assesses local opportunities for residents of all ages to prevent adverse health outcomes or the worsening of existing conditions. The strategy is structured around three tiers of prevention:

• Primary prevention: Reducing the incidence of disease through universal measures or targeting high-risk groups, such as promoting healthier lifestyle choices and increasing physical activity.
• Secondary prevention: Early detection of disease and intervention, such as identifying individuals at risk of falls and encouraging exercises to improve strength and balance.
• Tertiary prevention: Managing the impact of ongoing illness or injury to improve function and quality of life, such as systems to minimise injury for frail residents.

The approach aims to identify gaps in prevention initiatives and will initially work through Integrated Neighbourhood Teams. The Board discussed data on falls, noting that most occur at home, but some happen on public footpaths, which are reported to the Council's Highways Team. A proposal was made for an awareness programme, particularly for elderly residents, including distributing literature in places of worship. The Chair requested the Director of Public Health liaise with the Communications Team to include information on these proposals in the weekly newsletter. The Board resolved to note the report and presentation.

Progress of 'Right Care, Right Person'

The Board received an update on the progress of the 'Right Care, Right Person' (RCRP) initiative, implemented by the Metropolitan Police Service on 1 November 2023. Detective Superintendent Alastair Vanner explained that RCRP aims to ensure that individuals with mental health, health, and social care needs are attended to by the appropriate professional, rather than defaulting to the police. This model has reportedly led to reduced demand on various agencies in other areas. The initiative involves a threshold to help police determine when it is appropriate for them to respond to incidents. Since its go-live, statutory partners have been working closely to ensure safe implementation. The Board was presented with statistics and data indicating positive outcomes. The Board resolved to note the report.