The Havering Health and Wellbeing Board met to discuss a pharmaceutical needs assessment, a healthy weight strategy, and suicide prevention, as well as to receive a briefing on the NHS's 10-year plan. The board delegated authority to the Pharmaceutical Needs Assessment (PNA) steering group to approve the final report, and agreed for the Tobacco Harm Reduction Strategy to proceed to cabinet for adoption.

Pharmaceutical Needs Assessment

The board reviewed the draft of the Pharmaceutical Needs Assessment (PNA), which is required every three years under the NHS pharmaceutical services and local pharmaceutical services regulations 2013. The PNA is used by NHS England to decide where to commission community pharmacy services. The last PNA was published in October 2022, and this revision is scheduled for publication by 1 October 2025.

Kurt Ramsden from NEX, a commissioning support unit, presented the key findings. Since 2022, two 40-hour pharmacies in Romford have closed, but Havering still has 40 40-hour pharmacies, and three 100-hour pharmacies. Havering has 16.6 pharmacies per 100,000 people, a little lower than the national average of 18.3. Most residents can reach a pharmacy within 30 minutes by public transport, even after 7pm, and a recent survey found that over 80% of residents are happy with pharmacy opening hours.

Pharmacies also provide NHS advanced services, such as Pharmacy First and flu jabs, and locally commissioned services for palliative care, self-care, stop smoking, needle exchange, and emergency contraception. There may be opportunities to encourage additional provision and raise awareness of these services.

The PNA found no gaps in essential services during or outside normal working hours, or expected in the future. It also found no gaps in advanced, enhanced, or locally commissioned services.

The board was asked to approve the process for finalising the report, as the next meeting is after the publication deadline. Councillor Gillian Ford, Deputy Leader of the Council and Cabinet Member for Adults and Wellbeing, proposed that the board delegate authority to the PNA steering group to approve the final report once they are happy with the consultation results, and this was agreed.

Vicki Kong, NHS Clinical Director, raised concerns that the public may not understand what services like Pharmacy First, new medicine services, and contraceptive services offer. She also noted that the PNA does not cover palliative care and end-of-life medicines.

Mark Ansell, Director of Public Health, said that the PNA would be kept under review and could be refreshed before the deadline if needed.

Healthy Weight Strategy Annual Report

Luke Squires, public health strategist, presented the annual report on the Havering Healthy Weight Strategy, which aims to eradicate childhood obesity in 20 years.

Councillor Gillian Ford said that the strategy was a collective task, and the annual report acknowledges the contributions of different partners. She noted that childhood obesity rates are static, but hopefully slowing down.

Luke Squires said that obesity shortens lives, reduces quality of life, and increases demand on health and social care services. In Havering, overweight and obesity are high, and prevalence increases from childhood to adulthood. By ages 10 to 11, children in Havering are above London and England averages.

Obesity is more common among certain groups, such as those experiencing poverty or with limited access to healthy food or safe places to exercise. Where people live also shapes their health choices. Obesity is highest in Harold Hill and Rainham, which also have the highest levels of disadvantage.

The strategy employs a whole systems approach, bringing together schools, planners, health services, housing, transport, and the community and voluntary sector. The vision is that by 2044, childhood obesity will have been eradicated, and Havering will be a healthier place where making the healthier choice is the easier choice.

Achievements in the first year include:

• Establishing governance structures
• Improvements in food options at Barking, Havering and Redbridge University Trust (BHRUT) hospitals
• A high fat, sugar and salt advertising policy
• 400-metre exclusion zones around schools, restricting new fast food takeaways
• Increased free school meal uptake
• A food alliance established by Tapestry care, to tackle food insecurity
• More venues signed up to the breastfeeding welcome scheme
• New tier two weight management services for families, adults, and adults with learning disabilities
• The Live Well website and the Joy app launched, signposting healthy weight services

Priorities for the coming year include:

• Developing an action plan for improving healthy weight in Harold Hill
• Working with the planning team to further restrict fast food takeaways and encourage healthier options in corner shops
• Increasing the capacity of tier two weight management services
• Supporting the Food Alliance
• Working with transport planning to increase walking and cycling
• Making healthy weight part of every relevant officer's personal development review objectives
• Developing a training package for decision makers
• Focusing on prevention and early support

Councillor Gillian Ford suggested lobbying C2C and other transport providers to restrict unhealthy food advertising. Lynn Hollis suggested balancing support for individuals with creating a community that doesn't encourage overweight and obesity. Andrew Blake-Herbert suggested thinking outside the box to get children interested in physical activity.

It was noted that Luke Squires would be leaving his post shortly, and he was thanked for his contribution.

Suicide Prevention Annual Report

Sam Westrop presented the 2024 Suicide Prevention Annual Report, noting that the content may be emotionally challenging.

On average, there are 18 registered deaths by suicide a year in Havering, or one every three weeks. In 2024, there were 17 deaths by suspected suicide. A larger proportion of those who died were female than expected. Almost half of the deaths occurred in a public place. The average age of those who died was slightly younger than the national statistics, and the average index of multiple deprivation was higher than the Havering average.

The council has implemented a process for safeguarding referrals, and three cases have been referred to adult safeguarding colleagues, resulting in a suicide-themed safeguarding adult review. A site-specific investigation was undertaken after two suspected suicides occurred at the same location within 12 months, resulting in five recommendations to encourage a safer area.

The recommendations from the 2024 annual report are to adopt and implement a local all-age suicide prevention strategy, continue to review each suspected suicide, gain clarity on the outputs of reviews conducted by wider systems partners, scope additional data sources, work with GP practices, and implement the agreed action plan.

The council has a wider stakeholder group with over 175 members, a suicide prevention strategy steering group with 50 members, and a lived experience advisory group with 11 members. A conference will be held on 10 September, and a public campaign to reduce stigma around suicide is planned for September.

Vicki Kong asked if the Local Pharmaceutical Committee (LPC) was involved, as community pharmacists may be the last point of contact for people using medication in recovery from substance misuse. Sam Westrop confirmed they were involved in the consultation, and that there could be further work around providing training for pharmacists in suicide prevention.

Mark Ansell commended Sam Westrop and Isabel Grant-Funck for their work, saying that Havering's approach is as good as anywhere else in London.

NHS 10 Year Plan Briefing

Luke Burton presented a briefing on the NHS 10 Year Plan, which aims to reinvent the health service while maintaining its core principle of being free at the point of use.

The plan leverages digital health, genomics, and AI to deliver three transformational shifts:

• From hospital to community: More care closer to home, with neighbourhood health services and co-located centres open 12 hours a day, 6 days a week. Two-thirds of outpatient appointments will shift to digital alternatives, and 95% of complex patients will have universal care plans by 2027.
• From analogue to digital: A single patient record accessible through the NHS App by 2028 will become the front door to the NHS, supporting AI-powered diagnostics, medicine management, and care planning.
• From treatment to prevention: The plan aims to create a smoke-free generation, tackle obesity, reduce alcohol harm, and eliminate cervical cancer by 2040, while increasing access and uptake of screening services and scaling genomic and predictive analytics.

The plan also includes five enabling reforms: a new operating model, enhanced transparency of quality of care, workforce transformation, innovation and technology, and financial sustainability.

Andrew Blake-Herbert noted that the NHS 10 Year Plan mentions local government on page 86, and that the capacity to do place-based work is being reduced. He also raised concerns about the lack of local political representation on Integrated Care Board (ICB) boards.

Luke Burton said that the ICBs will be there to set the tone and the strategy, and that the delivery element will happen across places and across neighbourhoods. He added that the ICBs will be working with local places around the person's voice.

Councillor Gillian Ford said that she was disappointed that there was going to be so much change instigated on people, and that it was going to impact a lot of things that were going so well. She also raised concerns about IT systems not allowing carers to manage multiple accounts with the same email address or phone number. She suggested setting up the people in charge of the money to ask people what they want, and to let them see those responses.

Lynn Hollis shared Councillor Gillian Ford's concerns about the potential for services to go into silos again, and for people to be fighting for a bit of money. She also expressed concern about the loss of Healthwatch.