The Board agreed to add the Director of Housing and Safer Communities as a non-voting member, and to recommend to the full council that the Cabinet Member for Housing be added as a voting member. It was also agreed that the Chair would sign off on the Better Care Fund plan for 2025/26 prior to the next meeting.

Annual Public Health Report

The Board received a preview presentation of the Annual Public Health Report. The report, which is expected to be published in the coming weeks, focuses on health inequalities in the Borough.

The Board was told that the report was guided by the Marmot Principles, which highlight the importance of the social determinants of health¹.

Addressing inequalities is embedded in a number of council strategies including:

• The Greenwich Plan
• The Greenwich Support Strategy
• The Health and Wellbeing Strategy
• The Children and Young People's Plan

The Board heard that while life expectancy in Greenwich is similar to the national average, it is still lower than in London, suggesting room for improvement.

The Board was shown data that demonstrated:

• People of black and Asian ethnicity are at a higher risk of cardiovascular disease
• Obesity rates are estimated to be higher amongst people with autism, learning disabilities, or of black ethnicity.
• Greenwich has the fourth highest smoking at booking rate amongst London boroughs
• Nearly half of all residents in substance abuse treatment have an unmet mental health need
• Cancer screening uptake declines with increasing deprivation

The inequalities within those groups are persistent. - Aideen Silk

The Board was told that the council is working with a range of partners, including Lewisham and Greenwich Trust and local barbers, to address the issues.

The Board also discussed the impact of Adverse Childhood Experiences (ACEs) on health inequalities, and the reduction in children's centres provision.

Marmot always says, start with preconception and early years, the first 1,001 days of life being the most important in shaping the prospects for the future life of children and young people. - Steve Whiteman

The Board discussed the possibility of bringing in Sir Michael Marmot and his team to provide support and challenge to the borough on health inequalities.

Professor Sir Michael Marmot to come and maybe speak at a sort of mini-conference or something in the Borough... that might well be worth considering around raising the profile of what we could be doing more on this subject - Steve Whiteman

Better Care Fund

The Board received a report that provided an update on the Better Care Fund (BCF). The BCF is government funding that is used to support integration between health and social care services. It was noted that there had been a modest uplift in funding for 2025/26, but that this was unlikely to keep pace with inflation.

The Board discussed the challenges of the new national conditions that are attached to the BCF for 2025/26, as well as the very tight deadlines for submitting the plan.

It's a difficult settlement in terms of the BCF settlement. - Nick Davies

The Board also heard about the work that Greenwich has been doing to use the BCF to improve services, including:

• The development of home-first approaches to care
• Investment in assistive technology

We're at the cusp of launching a new assistive tech service across health and social care which is quite unique and that's going to happen in the course of the next month or two. - Nick Davies

Health and Wellbeing Board Review and Forward Work Plan

The Board reviewed the progress that has been made in reviewing the operation of the Board in line with its statutory responsibilities.

The Board discussed the draft forward plan for 2025/26 and agreed to focus future meetings on deep-dives into specific topics, including:

• Public health outcomes
  • Obesity and its determinants
  • Maternal health and wellbeing
  • Prevention in relation to musculoskeletal conditions
  • Addictions (drugs, alcohol, tobacco, gambling)
• Wider determinants
  • Domestic Violence and Abuse
  • Housing and health
  • Equality, diversity and inclusion
• Enabling work
  • Workforce challenges and opportunities
  • Further analysis into preventable deaths amongst women in Greenwich
  • More granular analysis of emergency admissions to hospital

The Board agreed to take one topic per meeting across a two-year period.

Additions to Board Membership

The Board discussed the proposal to add the Cabinet member for Housing Management, Neighbourhoods and Homelessness, and the Director of Housing and Safer Communities, to the Board as voting and non-voting members respectively.

The Board agreed to recommend to the Full Council that the Cabinet Member for Housing be added as a voting member, and agreed to add the Director of Housing and Safer Communities to the Board as a non-voting member.