The Health and Wellbeing Board met on Tuesday 05 December 2023 to discuss the Better Care Fund spending, the Big Conversation on health and care priorities, and the Combating Drugs Partnership. The Board also reviewed the winter plan for 2023-2024 and received an update on the SEND and Inclusion Strategy.

Better Care Fund Spending

The Board received a presentation on the Better Care Fund (BCF) spending from Suki Kaur, Deputy Director of Partnership Development at NHS North East London. The BCF, which aims to integrate health and care services through pooled budgets, currently stands at approximately £62 million in Tower Hamlets. However, three out of the five national performance metrics for the BCF are currently off track. A review of the BCF programme will commence in January 2024, focusing on how spending aligns with national requirements, identifying opportunities for reallocation or reduction of funding, reviewing intermediate care and falls pathways, and conducting a detailed review of the Disabled Facilities Grant. The review will also aim to develop a strategic framework for identifying future BCF schemes, potentially aligning with the strategic objectives of the Tower Hamlets Together partnership: building community resilience and wellbeing, maintaining independence, and reducing hospital and care home stays. Councillor Amy Lee highlighted that while adult social care demand is a driver for being off track on admissions metrics, Tower Hamlets performs well compared to London and national benchmarks in supporting people at home. Omin, a participant, requested that the review explicitly address inequalities within the metrics, which Suki Kaur agreed to incorporate. The review is expected to be completed by March 2024, with a lead appointed for an 18-month fixed-term contract starting in January 2024.

The Big Conversation

Charlotte Omri, Chief Participation and Place Officer at NHS North East London, presented an update on The Big Conversation, a process to gather public views on health and care priorities across North East London. The initiative sought to understand what good health and care looks like to local people and what makes a difference to their wellbeing. Feedback was gathered through surveys, place-based events, and focus groups, with efforts made to include diverse voices. Key themes emerging from the conversation included a holistic approach to babies, children, and young people, focusing on access to primary care and self-management for long-term conditions, community-based support and reducing social isolation for mental health, and navigating employment systems for workforce development. Four main themes emerged regarding the delivery of good care: competence, person-centred approaches, accessibility, and trustworthiness. Councillor Amy Lee suggested that Health Watch Tower Hamlets' data could provide an additional layer of insight into local residents' specific concerns, particularly regarding access to information, which was a higher priority for Tower Hamlets respondents. Layla Richards, covering director for commissioning and youth in children's services, noted the resonance of the themes with the new children and family strategy, Accelerate. Denise Radley questioned the scale and representativeness of the Big Conversation in Tower Hamlets, to which Charlotte Omri responded that it is an ongoing dialogue rather than a single event, with further engagement planned through the Seven Equalities Networks.

Combating Drugs Partnership

Adam Price, Strategy and Policy Lead for the Health and Adult Social Care Department at Tower Hamlets Council, provided an update on the Combating Drugs Partnership (CDP). The CDP is working to implement the government's From Harm to Hope strategy, which requires local needs assessments, drug strategies, and performance frameworks. The partnership focuses on three key areas: breaking drug supply chains, delivering a world-class treatment and recovery system, and reducing the demand for drugs. Local priorities have been identified through stakeholder engagement, including tackling exploitation of young people, diverting individuals into services, improving the visibility of drug dealing, making services more accessible and person-centred, promoting awareness of help, and targeting specific harms. A draft strategy document is expected to be presented to the Board in the new year. Helen Wilson, representing Clarion Housing/THHF, inquired about engagement with housing associations, noting their close contact with issues on estates. Adam Price acknowledged that direct housing association representation on the partnership is not currently in place but committed to exploring further engagement. Carrie Kilpatrick, a commissioner working on the treatment and recovery pathway, highlighted that alcohol misuse, youth violence, and health pathways are key areas of focus for the system improvement group, with efforts underway to improve young people's access to treatment and address alcohol-related harm. Councillor Saied Ahmed raised concerns about alcohol misuse, noting that Tower Hamlets is an outlier with high hospital admissions for alcohol-related issues, particularly within white and Afro-Caribbean populations. He also stressed the importance of engaging with local activists and third-sector organisations who are dedicated to combating drug addiction.

Winter Planning 2023-2024

Ben Gladstone, Head of Ageing Well in Integrated Commissioning, and Julie Dublin, Senior Programme Manager, presented the system-wide winter plan for 2023-2024. The plan is a collaborative effort involving various partners, including community and mental health trusts, acute trusts, voluntary sector providers, and council departments. Key priorities include engaging proactively with the community to help people stay well, optimising patient flow through different healthcare settings, and strengthening alternative pathways to reduce attendance at urgent and emergency care. The plan is supported by NHS England funding, central government funding, and additional Tier 1 funding due to the borough being identified as under pressure. Initiatives include flu and COVID-19 vaccination campaigns, a public communications campaign, a transfer of care hub, and enhanced community multidisciplinary teams. Additional capacity is being provided for the Take Home and Settle service, which supports individuals being discharged from hospital. Councillor Charlotte Choudhury noted the connection between the winter plan and the Better Care Fund report, particularly regarding falls prevention, which is a significant reason for A&E attendance among older people. There was a discussion about the challenges in vaccine uptake, particularly for COVID-19 among the Bangladeshi population, despite previous high uptake rates.

SEND and Inclusion Strategy Update

Layla Richards provided a verbal update on the SEND (Special Educational Needs and Disabilities) and Inclusion Strategy. Following a local area inspection in 2021, intensive work has been undertaken with the Department for Education (DfE) as part of their Delivering Better Value programme. A sufficiency strategy is being developed to ensure all children and young people's educational needs can be met. The new Children and Family Strategy, Accelerate, which was approved by Cabinet, includes supporting children with SEND and their families as a key ambition. The development of a new SEND and Inclusion Strategy for the partnership is underway, with a focus on the wishes of young people and families. A new joint strategic needs assessment for SEND is also being prepared. A draft strategy and the SEND JSNA will be presented to the Health and Wellbeing Board in April 2024, followed by a period of consultation with young people and residents before seeking sign-off in late summer 2024.