The Health Scrutiny Committee of Waltham Forest Council met on Tuesday 16 January 2024 to discuss a range of health-related topics. The meeting's agenda included a review of the committee's action tracker and forward plan, an examination of strategies for protecting communities from drug and alcohol-related harm, and an update on maternity services at Whipps Cross Hospital.

Committee Action Tracker and Forward Plan

The committee was scheduled to review its action tracker for the 2023-24 period, which includes outstanding actions from the previous year, and to consider the draft forward plan for the current year. These documents are intended to support the committee's scrutiny activities.

Protecting Communities from Drug and Alcohol Related Harm

A significant portion of the meeting was dedicated to discussing the Protecting Communities from Drug and Alcohol Related Harm report. This report outlines Waltham Forest's Combating Drugs Partnership framework and delivery plan for 2023-2025. The strategy is built around three key pillars: prevention, supply, and treatment, aiming to reduce the health and social harms associated with substance misuse.

The report details the current landscape of drug and alcohol use in Waltham Forest, highlighting statistics on drug-related deaths, hospital admissions, and the number of residents in treatment. It also outlines the ambition of the partnership to ensure residents live free from these harms, with a focus on early identification, dignified treatment, and accessible recovery services.

Key aspects of the plan include:

• Prevention: Implementing universal and targeted actions to reduce substance use and related harms, integrating prevention messages into wider health promotion, and working with children, young people, and families. This also involves strengthening diversionary activities for those in the criminal justice system and upskilling professionals to identify individuals at risk.
• Supply: Relentless disruption of drug markets and tackling the harm they cause. This includes developing a problem profile of local drug markets, implementing a dedicated team through Project ADDER to disrupt drug supply, and targeting drug-related activity in housing estates. The strategy also aims to tackle harms associated with public space drug use and drug dealing, and identify vulnerable individuals exploited by substance misusers and drug dealers.
• Treatment: Ensuring all individuals with substance misuse problems are supported into effective, high-quality treatment services and achieve good recovery outcomes. This involves increasing capacity within substance misuse services, improving access to detox and rehab places, and enhancing continuity of care for those released from prison. The plan also focuses on delivering excellent quality within services, reducing drug and alcohol-related deaths through harm reduction strategies, and integrating physical and mental health support.

The report also details proposed communications strategies to support the delivery plan, aiming to aid prevention, promote treatment, tackle supply, and reassure and mobilise residents. The Combating Drugs Partnership framework itself was established in October 2022 and has been developed in collaboration with statutory and voluntary sector partners.

Whipps Cross Maternity Services

The committee was also scheduled to receive an update on maternity services at Whipps Cross Hospital. The report provided summary data on birth outcomes and services available to women choosing to give birth at the hospital for the year 2022-2023.

Key information presented included:

• Births and Ethnicity: In 2022-2023, 3,791 babies were born at Whipps Cross. The ethnicity of women and birthing people was predominantly White (42.6%) and Asian (32.8%), while staff ethnicity was predominantly Black (41.4%) and White (35.6%). The report detailed birth outcomes broken down by ethnicity, highlighting some significant differences, such as Black women being four times more likely and Asian women twice as likely to die in childbirth than white women, according to MBRRACE data.
• Birth Choices: Information was provided on the dedicated Home Birth Team, the Midwifery-Led Unit (Lilac Birth Centre), and the Delivery Suite. The report also mentioned the Ruby team for vulnerable women and the Consultant Midwife-led Birth Options and Birth Reflections clinics.
• Birth Outcomes: Data on stillbirths, neonatal deaths (NND), NICU admissions, preterm births, and babies below the 3rd centile were presented. For mothers, there were 15 ITU admissions, with a notable proportion from Black and Asian women.
• Patient Satisfaction: The report included patient satisfaction scores, benchmarking them against the rest of Barts Health NHS Trust and London. It highlighted areas of improvement and areas where scores were lower than the organisational average, along with actions taken in response to feedback.
• Improvements and Challenges: The report detailed improvements made in response to patient feedback, such as enhanced communication workshops, a maternity telephone helpline, and additional breastfeeding support. It also identified key challenges, particularly midwifery shortages, and outlined actions being taken to address these, including recruitment initiatives and support mechanisms for staff.
• Future Plans: Future plans for Whipps Cross Maternity Services included developing transitional care services, working towards Baby-Friendly Initiative (BFI) Level 3 accreditation, implementing the Capital Midwives anti-racism framework, and further understanding and addressing health inequalities.

The meeting also included standard agenda items such as apologies for absence, declarations of interest, and the minutes of the previous meeting.