The Health Scrutiny Committee meeting addressed the BHRUT Integrated Sexual Health and HIV Service and the early impact of a new healthy weight commissioning model. Key decisions included noting the update on the sexual health service and reviewing the progress of the healthy weight strategy, which aims for a long-term, population-focused approach to tackling obesity.

BHRUT Integrated Sexual Health and HIV Service Update

The committee received an update on the Integrated Sexual Health and HIV Service (ISHS) provided by Barking, Havering and Redbridge University Hospitals NHS Trust (BHRUT). The service, commissioned by the council through the public health grant, aims to deliver high-quality, accessible sexual health services and promote sustained improvement in sexual health outcomes. The current contract, which began in 2018, is up for renewal, with BHRUT undergoing evaluation by commissioners based on quality, value for money, integration, social value, and future service needs.

The service operates a hub at Barking Community Hospital, with satellite sites at Ilford Exchange Health Centre and Queen's Hospital, and a new site at Harold Wood Polyclinic. The HIV service, funded by NHS England, is co-located at Barking Community Hospital. Patient feedback consistently shows high satisfaction rates, with a 95.8% positive experience score.

Discussions highlighted the service's efforts to improve access, including a new triage process to reduce DNA rates and ad hoc Saturday sessions for long-acting contraception and STI testing. Outreach work is being conducted with hard-to-reach groups, including those experiencing homelessness, with four targeted engagement events identifying STI diagnoses and preventing onward transmission. Partnership working is extensive, involving primary care, voluntary sector organisations like Positive East, substance misuse services, maternity care, and digital testing integration.

In alignment with the HIV Action Plan for England, the service focuses on prevention, testing, treatment, and addressing stigma. They manage 1,300 HIV patients, with 450 residing in Barking and Dagenham, and have diagnosed 36 new HIV cases in the past 12 months. The service also provides post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) and participates in the Blood Borne Virus Screening programme in A&Es. Antenatal care for women living with HIV is coordinated between HIV and antenatal teams, with a focus on preventing mother-to-child transmission, which has a reduced transmission risk of 0.4% if protocols are followed. Routine opt-out HIV testing is offered to all pregnant women.

Early Impact of Healthy Weight Commissioning (New Model)

The committee received an update on the new healthy weight strategy, which moves away from traditional, individual-focused weight management programmes towards a population-focused, preventative, and community-led approach. This shift is driven by the unprecedented obesity crisis in the borough, as previous programmes only reached a small fraction of the population with minimal impact. The new model, developed in partnership with DDM Health, aims to achieve long-term improvements by intervening upstream and working with communities to support more residents in maintaining a healthy weight.

DDM Health has spent the first six months gathering insights from over 250 residents and stakeholders through surveys, focus groups, and a Healthy Weight Summit. Key themes emerging from this engagement include:

• Information and Communication: A need for a single, trusted access point for healthy lifestyle support, with fragmented information and over-reliance on digital channels excluding many residents.
• Practical Food Skills and Healthy Eating: Residents desire practical, hands-on food education that considers real budgets, cultures, equipment, and time pressures.
• Physical Activity: A need for local, low-cost, social, and inclusive physical activity opportunities, with safety and childcare being critical enablers.
• Cost, Transport, and Place: The impact of the cost of living, transport barriers, and the local food and activity environment on residents' ability to eat well and be active.
• Motivation, Confidence, and Behaviour Change: Residents need ongoing, supportive help to turn intentions into sustained change.
• Community Assets: A recognition of existing trusted community assets that are under-used and not well connected.
• Coordination, Sustainability, and Trust: A desire for a longer-term approach, moving away from fragmented and short-term provision.
• Community Leadership: Residents trust local people and want to be supported to lead healthy living activities within their communities.
• Inequality, Disability, and Underserved Groups: The need for tailored support for diverse needs.

The next steps involve finalising a Recommendations Report and a phased delivery plan, including pilot initiatives. These pilots will focus on areas such as utilising schools as community assets for cooking facilities, collaborating with Neighbourhood Networks for place-based solutions, engaging young people through youth services like Future Youth Zone, and developing a digital-first universal weight management offer through social prescribing. The aim is to create scalable, replicable models that can be implemented across the borough, with a focus on reducing inequalities and empowering residents. The central hub for this new approach is expected to be in place within the next six months, offering both self-referral and professional referral routes. The strategy will also be inclusive of individuals with severe mental illnesses who experience weight gain due to medication.

The committee noted the progress and the upcoming recommendations report and webinar.