The Health and Wellbeing Board of Merton Council met on Thursday 01 October 2020 to discuss significant developments in integrated care and winter planning. Key discussions included noting updates on the Health and Wellbeing Board's development, endorsing the Year 2 action plan for joined-up services, and noting the winter planning schemes for 2020/21.

Health and Wellbeing Board Development

Russell Styles, Director of Public Health, provided an update on the development of the Health and Wellbeing Board. Merton has been successful in securing targeted support from the Local Government Association (LGA) through a consultancy called Health Integration Partners. This support will involve a survey and interviews with board members, a development session, and the creation of an implementation roadmap. The aim is to enhance the board's capability to steer neighbourhood development in conjunction with the Merton Alliance and a committee in common. Councillor Usaama Kaweesa, Cabinet Member for Children's Services, raised the importance of involving youth voice, specifically mentioning the Young Inspectors, in this development process.

Merton Neighbourhood Health, Integrated Neighbourhood Team Development and Pilot

Rob Guile, Director of Operations for Southwest London for Central London Community Healthcare NHS Trust, presented on the development of Integrated Neighbourhood Teams (INTs). The INT model aims to bring together health, social care, and community professionals to work as one team around defined neighbourhoods, aligned with Primary Care Networks (PCNs). The pilot has already launched in the Morden PCN, with 10 referrals received on its first day. This initiative is a response to national guidance and aims to provide a more consistent, person-centred approach, identifying risks earlier and responding quickly to changing needs. Mark Creelman, Place Executive for Merton Place, and Terry Clark, Executive Director for Adult Social Care, Integrated Care and Public Health, both expressed enthusiasm for this transformational development. Councillor Tony Reiss inquired about the measurement and learning from the pilot, and it was confirmed that a suite of outcomes is being measured, with further details to be shared. Councillor Usaama Kaweesa also highlighted the importance of extending this model to younger demographics.

Year 2 Action Plan for Joined-up Services

Mark Creelman presented the Year 2 action plan for joined-up services, building on the Merton Health and Wellbeing Strategy 2025-2030. The plan focuses on extending the Integrated Neighbourhood Team model beyond the frail population to include children and young people, and those with mental health needs. It also aims to strengthen partnerships, develop the dementia action plan, and embed the carers' strategy. The Health and Wellbeing Board's role in neighbourhood plans was discussed, noting that this work aligns with the support provided by Health Integration Partners. Councillor Tony Reiss raised concerns about the number of initiatives and the availability of resources, asking for clarification on strategic priorities. Bev Hendricks, Executive Director for Children, Lifelong Learning and Families, responded that the overarching principle is to intervene at the earliest opportunity, with an emphasis on prevention and responding to need without waiting for a diagnosis. The Eat Well, Be Active plan, which includes addressing the location of fast-food outlets near schools and introducing cooking facilities, was also mentioned.

Winter Planning

Mark Creelman also presented the winter planning report for 2020/21, outlining schemes to strengthen urgent and emergency care resilience. Key initiatives include additional same-day urgent primary care capacity through two Access Hubs, a Therapy Supported Urgent Community Response (UCR) Service, and a Discharge Credit Card Scheme. These schemes aim to reduce avoidable emergency department attendances and admissions, improve patient flow, and support vulnerable populations. Councillor Usaama Kaweesa inquired about specific metrics for children during winter months, and it was clarified that while the focus of winter funding is on frail populations, work is ongoing to understand children's attendance at emergency departments. Councillor Tony Reiss raised concerns about the impact of freezing temperatures and high energy costs, which were noted as being addressed through wider council initiatives and a cost of living hub. Dr Sy Ganesaratnam provided details on the locations of the two Access Hubs: Wideway Medical Centre in the east and Nelson Health Centre in the west of the borough.

Look Ahead to Start Strong

Bev Hendricks provided an update on the Start Strong initiative, which focuses on children and young people. The plan includes actions related to being healthy and staying safe, with positive outcomes reported by the Children's Trust Board and Young Inspectors. The integrated strategy for child poverty in Merton is being finalized, and the Best Start in Life approach, which supports family hubs, is in operation. The development of a model balancing food and activity is also progressing, with a focus on nutrition and inclusive approaches to physical activity. A significant concern raised was the rise in adolescent mental health needs and the diagnosis of neurodiverse children and those with autism. Mark Creelman addressed concerns about waiting lists for autism spectrum disorder and attention deficit hyperactivity disorder assessments, stating that while waiting lists are significant in Southwest London, there is a work programme underway to invest in and transform these pathways, focusing on a needs-led approach rather than solely on diagnosis. Councillor Tony Reiss expressed concern about the number of initiatives and the availability of resources, reiterating the need for strategic priorities. Bev Hendricks responded that the overarching principle is early intervention, prevention, and responding to need.