The Wandsworth Health and Well-Being Board met to discuss a range of health and social care issues, including adult social care, safeguarding, pharmaceutical needs, and the health and well-being of children and young people. The board endorsed the development of an action plan to address the findings of the Adult Social Care Health Study and approved the final Pharmaceutical Needs Assessment report. The board also discussed opportunities for collaboration across different organisations to improve safeguarding practices.

Adult Social Care Health Study

The board endorsed the development of an action plan to implement the findings of the Adult Social Care Health Study (paper no. 25-431), which examined the health-related drivers of demand for adult social care services in Wandsworth. The study included over 9,000 people known to Wandsworth Council as the responsible authority for adult social care services over a 15-month period.

Shannon Katiyo, Director of Public Health, presented the study's findings, which indicated that the proportion of adults receiving support from adult social care increased markedly from the age of 45 upwards, and that people from Asian, black, and mixed ethnic backgrounds were statistically over-represented among adult social care clients, whilst those from other and white ethnic groups were under-represented. Hypertension was the most prevalent condition, affecting about 43% of all people included in the study.

The study suggests opportunities to reduce the burden on adult social care by focusing on prevention, including primary prevention for residents who have not yet developed conditions, and support for those already known to adult social care to prevent their conditions from worsening. Ms Katiyo suggested a combination of both universal and targeted approaches based on disease risk factors, age, ethnicity, and geography, requiring close working with primary care, the voluntary sector, public health, and adult social care.

Councillor George Crivelli asked about the prevalence of dementia among adult social care clients, and whether the council was seeing more late middle-aged people being diagnosed with dementia. Ms Katiyo responded that nationally, dementia is an increasing trend and one of the leading causes of death, and that with an aging population, more people are likely to be diagnosed with diabetes. She also noted that there is still a significant gap in dementia diagnoses nationally, with about a third of the estimated population with dementia yet to be diagnosed.

Councillor Judi Gasser noted that St George's Hospital¹ does good work on young onset dementia and asked that everyone works together on these initiatives.

Councillor Correale asked about the benefits of early intervention compared to later ones, particularly in relation to voluntary sector organisations providing statutory services. Ms Katiyo responded that the study did not specifically examine this, but that public health practice suggests that early intervention can prevent conditions from developing or worsening, reducing the need for more care and support.

Mark Creelman noted that Wandsworth benchmarks relatively well compared to other boroughs in terms of dementia diagnosis rates, but that there is still a gap. He also highlighted the opportunity to enhance collaboration in treatment and prevention, and suggested that the Health and Wellbeing Board should collectively analyse the data and shape interventions, potentially through the development of a neighbourhood plan.

Philip Murray suggested that some structural changes are needed, such as making every contact count approaches and maximising opportunities to identify and refer people to existing services for support with issues such as smoking cessation and problem drinking.

Dr Waqaar Shah said that the report was a trampoline for huge optimism and that there is more alignment in what the council wants to achieve than ever before. He said that the impending neighbourhood working, hubs, and teams have tremendous potential to realise the ambitions highlighted in the report, and that the national 10-year plan, integrated care boards, and clinically embedded strategic plan also align with this work.

Councillor Graeme Henderson suggested bringing together a small working group to analyse the pathway for those who are known to prevent the need for social care services and prevent illness from becoming more severe. Ms Katiyo welcomed this suggestion.

The board formally recommended the development of an action plan to implement the assessment's findings, and asked the Director of Public Health to consult and agree with partners about the possibility of setting up a working group to work on this where appropriate.

Joint Local Health and Wellbeing Strategy: Start Well Update

The board received an update on the Joint Local Health and Wellbeing Strategy: Start Well (paper no. 25-430), which focuses on improving the health and well-being of children and young people in Wandsworth. The update included presentations on self-harm and mental health, childhood obesity, childhood immunisations, and A&E attendances and hospital admissions caused by unintentional and deliberate injury.

Self-Harm and Mental Health

Graham, Wandsworth Senior Public Health Lead, presented on self-harm and mental health, noting that the prevalence of mental health disorders in children and young people has increased significantly in recent years, with the most recent survey from 2023 identifying that 1 in 5 children have a probable mental health disorder. He said that the council is working to develop a cross-council approach to recognise the protective factors that the council has agency in, such as housing, education, skills, access to play, sustainable employment, safer communities, access to leisure and culture, transport, and social cohesion.

Graham noted that mental health support team coverage has increased and that most, if not all, schools have access to support around mental health. He also highlighted the embedding of whole school approaches through the PAS² program, a social and emotional literacy program with positive outcomes.

Graham said that self-harm is not a disorder but a coping strategy for psychological distress, and that the council is supporting schools through the development of a self-harm and suicide prevention pathway and toolkit called Portus, which includes resources and pathways to support teachers and the wider universal and targeted services to recognise the importance of swift intervention around these issues. The council is also rolling out evidence-based training to help schools with safety planning around children who are most at risk.

Councillor George Crivelli asked about the impact of social media on the mental health of young people, referencing Australia's ban on social media for under 16s. Graham responded that social media is implicated to some degree in the worsening mental health of children and young people, and that the council is aware of new threats such as sex extortion. He also noted that some schools are moving towards mobile-free spaces and environments within the school day.

Councillor Judi Gasser said that online harm is terrifying and that there needs to be joined-up working with experts, schools, and children's services. She also expressed concern about the rise in mental health issues in Wandsworth and asked if more could be done to support schools and parents.

Kat Slemeck noted that the Department for Education (DfE) has published new guidance around the Relationships, Sex and Health Education (RHSE) curriculum for schools, and that the council is working with schools to revise their RHSE curriculum to include online safety. She also mentioned that some schools are moving towards removing phones in school buildings and that young people have said that it is important to have conversations about online safety.

Dr Waqaar Shah, a GP, said that the offer that Wandsworth provides is excellent, but that there is sometimes an issue of visibility and that it can be difficult for parents, children, and clinicians to know where to turn to access resources.

The board agreed that the Healthy Minds project was positive and should be supported, and that there should be a commitment as a partnership to take forward this piece of work, ensuring that programmes are visible and accessible to communities and that the wider determinants of health are considered.

Childhood Obesity

Talu Oliade presented on childhood obesity, highlighting the promotion and support of breastfeeding and healthy weaning, as well as family weight initiatives. She noted that the breastfeeding friendly scheme has over 53 venues signed up, including Battersea Power Station, and that family hubs are pursuing UNICEF BFI accreditation. She also mentioned a small task and finish group that is looking at how to support families at risk of experiencing food insecurity, particularly those with infants under 12 months.

Ms Oliade said that the council is reviewing the Health for Life Minis program and looking at how it can be improved and more integrated into local initiatives such as Access for All and the play strategy. She also noted that the Have program has seen an increase in unique children and young people integrating with the program.

Councillor Judi Gasser asked about the number of children participating in the Health for Life Minis program and whether more children should be encouraged to participate. Ms Oliade responded that the program targets postnatal mums who have been identified as obese and children aged three to five and 10 to 11 who have been identified as overweight or very overweight through the National Child Measurement Programme (NCMP). She said that the council is currently reviewing the impact of the program and looking to integrate it more into leisure programs and Access for All.

Mark Creelman asked how the council targets children for the program and how to ensure that all voluntary sector organisations, schools, and GPs know about the services that are available.

Kat Slemeck said that the council has seen huge success in terms of the targeted reach of the Have program to families through Access for All, and that the government has committed to a further three years of funding. She also mentioned that the council has secured funding to run programs for several hundred children through Have during October and February half terms, and that these programs focus on healthy food, social interaction, being off mobile phones, and being active. She also noted the success of the council's play activities and the recruitment of play rangers to engage with communities and promote play.

Childhood Immunisations

Melissa Barker, Senior Public Health Lead, presented on childhood immunisations, noting that the work is a joint initiative between the council and the ICB³ and is driven forward by multiple organisations, including NHS England, primary care, school immunisation teams, and the voluntary sector. She highlighted the work of a dedicated immunisation coordinator who has been working with GP practices to provide support with data quality and coding to improve the accuracy of immunization records for children, as well as providing training on call and recall processes to help boost immunization rates and reduce inequalities.

Ms Barker said that the council has been working closely with the school immunisation team and education teams to strengthen school education immunization programs, delivering a range of initiatives, including targeted outreach to groups of children where the uptake of school immunization programs is lower. She also noted that the ICB has been leading initiatives to make childhood immunisations more accessible by integrating pharmacies into immunization delivery, and that a pharmacy on Mitcham Road has been commissioned to deliver MMR⁴ vaccines to children aged 6 to 19 years until March 2026.

Ms Barker said that proactive steps have been taken to minimise the risk of outbreaks and strengthen local preparedness, particularly with the national increase in measles cases over the past two years, and that primary care partners have continued proactively outreaching to parents of children who have missed vaccinations.

Philip Murray asked about the impact of the activity and whether there has been a greater uptake or fewer outbreaks. Ms Barker responded that there are challenges with being able to track the direct impact on rates, but that Wandsworth's rates of childhood immunisation are relatively stable, which is positive against the trend of declining rates nationally.

Abi Carter asked whether childhood vaccinations could be included in vaccination clinics being held for adults in community settings. Ms Barker responded that she had taken the question back to the ICB and was awaiting a response.

Jennifer Taylor, Consultant in Public Health, said that Wandsworth is doing relatively well on childhood immunisations compared to other boroughs, particularly given that it has high levels of deprivation in some areas.

A&E Attendances and Hospital Admissions Caused by Unintentional and Deliberate Injury

Ramia presented on A&E attendances and hospital admissions caused by unintentional and deliberate injury, noting that the step has three key domains of action: working with the 0-19 service to continue to embed accident prevention in their health visitor contacts and training, providing information, advice, and guidance, and implementing the UNICEF Baby Friendly Initiative.

Ramia said that a specialist health visitor who focuses on accident prevention and minor illness prevention has been recruited and is working with colleagues in children's services, specifically the family hubs, to look at what training offers can be provided to parents, carers, and frontline workers. She also mentioned that the Wandsworth Safeguarding Children's Partnership has done two bespoke podcasts that target key accidents and causes of accidents, and that children's services deliver a range of training for parents and carers, including sessions on road safety, choking hazards, and safe introduction of solid food for infants.

Councillor Judi Gasser asked why Wandsworth has a much higher rate of presentations due to injury compared to other boroughs. Ramia responded that there are challenges with interpreting the data because the coding is more accurate locally than it is at a regional or England level, making it difficult to say if there are actually more attendances because of injury or if the council is just coding attendances better.

Annual Report of the Safeguarding Adults Board

The board received the Annual Report of the Safeguarding Adults Board (paper no. 25-429), presented by Fiona Martin, Independent Chair. Ms Martin highlighted the council's effective and robust multi-agency approach to safeguarding adults, with good collaborative working between health, social care, police, and community partners. She noted that the Care Quality Commission (CQC) assessment was positive about safeguarding practices in Wandsworth, and that the vast majority of people express their desired outcomes of being met and report feeling safer following intervention.

Ms Martin emphasised the importance of making safeguarding personal, ensuring individual voices are heard, and empowering people throughout the process. She also highlighted the board's commitment to continual improvement through safeguarding adult reviews (SARs), leader reviews, and audits.

Abi Carter asked about the 15% increase in concerns compared to last year, and whether this was a lot and why it might be. Ms Martin responded that the increase was due to better reporting and learning, and that the conversion rate of reports remained in line with London averages.

Ms Carter also asked about the fact that 80% of people felt safer after the safeguarding intervention, and whether this was acceptable. Alicia, the board manager, responded that the figure had gone down a bit, and that this can be due to cases where things cannot necessarily be improved and where it becomes a matter of risk management.

Finally, Ms Carter asked whether disability and autism should be segmented as demographic groups, given the potential risks and vulnerabilities they face. Alicia responded that the board could look at the data for the next annual report and see whether this was possible.

Stephen Hickey suggested that future reports should include reflections on trends over time.

Councillor Graeme Henderson asked about the balance between reactive intervention versus proactive intervention, and what the council does to find people who are vulnerable and act in the absence of a referral. Ms Martin responded that the board's role is to have assurances that agencies are working together effectively, and that the board's role is not to be doing individual cases and investigating individual cases.

Wandsworth Pharmaceutical Needs Assessment 2025

The board approved the Wandsworth Pharmaceutical Needs Assessment (PNA) 2025 (paper no. 25-432), which assesses the current and future pharmaceutical needs of the borough's population. Nikki, who presented the report, said that the PNA found no gaps in pharmacy services in Wandsworth, and that the borough has a higher average number of pharmacies than the England rate and is in line with the average among southwest London.

Nikki noted that the consultation highlighted some concerns about the need for another pharmacy in the Nine Elms area, but that the PNA showed that there was no current need. She said that the situation would be monitored and that the need for a pharmacy would be reassessed in the next PNA, which is due in three years.

Stephen Hickey said that Healthwatch was closely involved with the PNA and that it is important that the situation in Nine Elms is monitored closely and kept under active review. He also asked where issues raised in the consultation that were not directly answerable by the PNA, such as quality, accessibility, and opening hours, get fed to. Nikki responded that quality issues are looked at and picked up by the local LPC⁵, and that concerns about safety were escalated to the team in the council that would be looking at that.

Philip Murray asked about the needs of the population in terms of delivery services and electronic prescriptions. Nikki responded that this was covered in the PNA and that there is one GPS in Wandsworth.

Work Programme

The board noted the work programme (paper no. 25-433) and invited colleagues to put forward reports that would add value to the partnership. The board also heard about a seminar on a whole system approach to weight management, nutrition, and movement, which will be held on 5 February 2026.