The Health and Wellbeing Board met on Thursday 1 August 2024 to discuss strategic approaches to meeting population needs, the work of Healthwatch Newham, actions on diet, the Newham Health Equity Programme, and the North East London Sexual and Reproductive Health Strategy. Key decisions included noting the progress on the North East London ICS strategic approaches, the Healthwatch Newham update, and the Newham Health Equity Programme, and approving the North East London Sexual and Reproductive Health Strategy.

North East London ICS Strategic Approaches to Meeting Newham Population Need

The board received an update on the North East London Integrated Care System's (ICS) strategic approaches to addressing population needs. This included work undertaken with PA Consulting to understand pressures from population growth and to develop key interventions. The development of integrated neighbourhood teams is a focus, with a system-wide working group designing their implementation. Primary care networks (PCNs) are being engaged, with Stratford PCN already involved. A workshop is scheduled for 21 August to further develop these plans, with a focus on scenarios for the upcoming winter. The final report from the PA Consulting exercise is still under review and will be circulated widely. Discussions also touched upon infrastructure needs and the importance of linking strategic plans with local place-based initiatives. The board acknowledged that while integrated working can have a positive impact, significant investment in primary care and prevention is crucial to meet growing needs. There was a call for the board to advocate for Newham to receive the necessary resources to achieve health mission goals.

Healthwatch Newham Update

Healthwatch Newham presented its annual report, highlighting key areas of work. This included a project to improve the experience of SEND (Special Educational Needs and Disabilities) diagnosis processes, where feedback indicated that 60% of parents and carers felt inadequately supported. Findings from this work are being used to identify service improvements and inform the All-Age Autism Strategy. The report also detailed work on continuing healthcare, specifically diabetes services, which received positive feedback for its holistic approach and clear communication. However, concerns were raised regarding access to dental care, with 90% of respondents waiting 12 months for an appointment, and issues with the communication and criteria for freedom pass and blue badge applications. The NHS campaigns advocacy service, subcontracted to Mind, has supported approximately 6,000 people, with efforts being made to increase accessibility through physical leaflets and posters in community spaces. The report also noted an increase in volunteer capacity, with six active volunteers supporting the programme. The board requested a work plan for the year ahead to facilitate proactive engagement.

Action on Diet for Better Health Outcomes

The board discussed several initiatives aimed at improving diet and health outcomes in Newham. These included:

• London Circular Food Procurement Commitment: Newham is a founding partner in this initiative, which aims to create council-wide solutions for sustainable food procurement. Tools are being used to benchmark carbon emissions from food, with Newham already performing better than sector averages. The commitment could be extended beyond council catering to other organisations with catering facilities.
• Fruit and Vegetable Consumption: Efforts to increase fruit and vegetable consumption include supporting food clubs and food banks, running school marketplaces, and a dedicated team focused on increasing uptake of the Healthy Start vouchers. Newham is among the top three boroughs in London for Healthy Start uptake.
• Fruit and Veg on Prescription: A pilot scheme is being developed to provide fruit and vegetables on prescription, initially targeting households with diabetes or at risk of diabetes. This initiative aims to make a significant difference to a vulnerable cohort and could stimulate good food retail and drive change among retailers.
• Healthy Food Advertising Policy: Newham has implemented a policy prohibiting the advertising of foods high in fat, sugar, and salt on the council's advertising estate. This policy has shown to reduce unhealthy food purchases. The council is exploring extending this policy to other anchor partners with advertising estates and has also expanded its policy to include advertising for breast milk substitutes, alcohol, gambling, and vaping.
• Great Great Great Revolution : This initiative focuses on using funding for sustainable urban drainage solutions to create food growing spaces. With nearly £625,000 invested, the borough has developed numerous small growing spaces in schools and GP surgeries, demonstrating the potential for health, climate, and economic benefits.

Discussions highlighted the need for greater awareness of these commitments, the potential for scaling up initiatives through partnerships, and the importance of culturally competent marketing and communication. The board also considered the impact of social media trends on young people's eating habits and the need for a hard-nosed approach to advertising on council estates.

Newham Health Equity Programme

The Newham Health Equity Programme (NHEP) was presented as a framework to ensure health equity is a central consideration in all council services and organisations. The programme focuses on prompting, nudging, and pushing organisations to improve their outcomes through deep dives into pathways and the provision of supporting tools. Key elements include a four-step process for deep dives (also known as QI projects), mandatory equity objectives in commissioners' Personal Development Plans, and a learning community.

A spotlight was shone on the NUH Route Map, a tool developed to help organisations assess their maturity in addressing health equity. This roadmap, which has three iterations for organisations, teams, and individuals, identifies poverty and deprivation, and structural racism as key drivers of health inequality. It also considers barriers related to cognitive abilities and health literacy. Newham University Hospital (NUH) used the roadmap to self-assess, finding it a useful tool for objective self-reflection. While NUH rated itself as fundamental in data collection, particularly ethnic data, it acknowledged areas for improvement across other domains. The roadmap has informed NUH's health equity plan, leading to improvements such as eliminating differences in waiting times for elective care based on ethnicity, gender, and deprivation, and reducing waiting times for patients with learning difficulties. The board was encouraged to consider their own organisation's position on the roadmap, with a focus on data collection, particularly ethnicity, and to consider how to embed equity as business as usual.

North East London Sexual and Reproductive Health Strategy (2024-29)

The board considered the North East London Sexual and Reproductive Health Strategy, which aims to address equity and system sustainability. The strategy acknowledges that sexual health impacts a large proportion of the population, including specific vulnerable communities. Key achievements highlighted include a 40% increase in the use of long-acting reversible contraception (LARC) since 2018, a threefold increase in access to PrEP (pre-exposure prophylaxis) for HIV prevention, and the development of one of the few trans-specific sexual health services in the country.

The strategy has been co-designed with communities, including a Women for Women project training ambassadors within the Black-African community to discuss HIV and PrEP. While progress has been made, disparities remain, particularly in PrEP uptake among Black-African communities and LARC use among women of colour and Eastern European women. The board noted concerns about long waiting times for LARC appointments in some areas and the integration of sexual health services with emerging women's hubs. The development of trans-specific services was discussed, with an acknowledgement of the need for more accessible prescribing guidelines and sensitive care. The strategy aims to bring together fragmented sexual health services across North East London and will be delivered through annual action plans at local and regional levels. The board was urged to consider how to accelerate integrated work and address unconscious bias within services.