The Tower Hamlets Health and Wellbeing Board met on Thursday 20 July 2023 to discuss the Better Care Fund plan and co-production principles. The Board also considered proposals for the local plan to maximise health impacts from development.

Livable Streets and Co-production Concerns

A resident, Ted Maxwell, raised concerns about the council's approach to livable streets proposals in Bethnal Green, questioning whether the process had been genuine co-production. He highlighted a lack of public involvement in developing plans and detailed a petition with over 3,000 signatures that called for the council to halt its proposals. Mr. Maxwell also asked if health professionals on the board believed their views had been considered and if a health impact assessment would be required before any decisions were made on the future of livable streets.

Councillor Kabir Ahmed, Cabinet Member for Regeneration, Inclusive Development and Housebuilding, responded to Mr. Maxwell's points. He clarified that while the petition was significant, it was not the largest the council had ever received, with a previous petition regarding the mayoral system attracting more signatures. Councillor Ahmed explained that a second consultation on the livable streets proposals was still being processed by officers, involving various stakeholders including emergency services. He acknowledged that there were multiple experiences and lived experiences reported, with some residents and services experiencing negative impacts like increased crime or slower response times, while others reported the opposite. He stated that a decision had been made to continue camera enforcement in some areas, but the more complex proposals for other areas were still under review. Councillor Ahmed emphasised the council's commitment to empowering all voices, not just the loudest.

In response to Mr. Maxwell's specific questions directed at the Health and Wellbeing Board, Councillor Gulam Kibria Choudhury, Chair of the Health & Adults Scrutiny Sub-Committee, stated he could only speak for himself and was unsure of individual members' stances. He noted that a report on the matter would be beneficial for informed decision-making. Dr. Somen Banerjee, Director of Public Health for Tower Hamlets Council, confirmed that the council has a health impact assessment policy and that its application would be considered.

Better Care Fund 2023-2025

The Board considered the Better Care Fund (BCF) plan for 2023-2025. Suki Kaur, Deputy Director of Partnership Development, explained that this is a two-year plan, an update from previous annual plans, with an opportunity to refresh it in the second year. The plan includes a 5.66% uplift in funding for social care and community services, which comes via the Integrated Care Board. Progress will be measured against five metrics, including a new one for falls. The plan requires national sign-off by 3rd September and a formal Section 75 agreement¹ between the Integrated Care Board and the local authority by 31st October.

Questions were raised about the equalities implications of the fund, with Councillor Maium Talukdar, Deputy Mayor and Cabinet Member for Education, Youth and Lifelong Learning, asking how data is monitored to ensure fair spending. Suki Kaur explained that each scheme within the plan has key performance indicators and tracks spending, with finance groups reviewing spend and activity quarterly. National quarterly reporting will recommence from autumn.

Concerns were also raised about winter pressures, inflation, and market uncertainties. Charlotte Pomery, Chief Participation and Place Officer for NHS North East London Integrated Care Board, highlighted the importance of supporting people to stay well at home, including vaccinations and falls prevention. She also noted that while there is an uplift in funding, it is not in line with inflation. Denise Radley, Corporate Director, Health, Adults and Community, and Deputy Chief Executive, expressed concern about rising pressures on adult social care budgets, particularly for mental health services, and stated that current grant funding is not meeting the borough's needs.

The Board was recommended to approve the Better Care Fund for 2023-2025.

Co-production Principles

John Williams, Engagement and Community Communications Manager for NHS North East London ICB, presented an update on co-production work in Tower Hamlets. He explained that a task and finish group, chaired by a local resident, had mapped existing co-production efforts and held three events to identify barriers and opportunities. Key barriers identified included time and capacity, lack of feedback, the need for reward and recognition for contributions, and difficulties in understanding information. Opportunities highlighted were the existing expertise in the borough, a commitment to sharing power, and the focus on health inequalities.

The group developed nine principles for co-production, including sharing power, embracing diverse perspectives, respecting lived experience, ensuring benefits for all parties, going to communities, working flexibly, avoiding jargon, building long-term relationships, and ensuring adequate resourcing. The principles are based on the ACT Early programme, which focused on children's services.

Councillor Saied Ahmed, Cabinet Member for Resources and the Cost of Living, asked how the council would overcome barriers for hard-to-reach residents and those with language barriers. John Williams responded that these individuals are not hard-to-reach but rather that the council needs to actively go to communities, listen to their needs, and resource issues such as translation and interpretation.

The Board discussed how co-production principles could be adopted by the Health and Wellbeing Board itself, with a proposal for a further meeting to explore this.

Local Plan and Health Impacts

The Board discussed proposals for the local plan to maximise health impacts from development. Katy Scammell presented statements for the Board to consider, which included prioritising high-quality, affordable, and accessible new homes, designing for community cohesion, and understanding local health needs through health impact assessments. The proposals also emphasised protecting residents from poor air quality, enhancing green spaces, supporting active lifestyles, ensuring safe play spaces, tackling the over-proliferation of hot food takeaways and betting shops, and robust community engagement.

Councillor Maium Talukdar raised concerns about overcrowding and its impact on mental and physical health, suggesting that the statements should explicitly address suitable or larger homes and the quality of the indoor environment, including issues like damp and mould. The Board agreed to submit the proposals into the local plan consultation with these amendments.

Other Business

The Board noted that the item on the terms of reference would be deferred to a later meeting due to concerns about statutory voting and representation requirements. Amy Gibbs, Chair of Tower Hamlets Together, provided a verbal update on the organisation's work, as detailed in her monthly briefing within the meeting papers. The Board also acknowledged the retirement of David Knight, Democratic Service Officer, after 40 years of public service.