The Healthier Communities Select Committee met on Thursday 26 February 2026 to discuss improvements to mental health provision, public health prevention initiatives, and the Learning Disabilities Implementation Plan. Key decisions included a recommendation that the prescribing of GLP-1 drugs in Lewisham be contingent on behavioural, dietary, and activity-led lifestyle support, and a recommendation that gambling be treated as a public health issue comparable to smoking and alcohol-related issues. The committee also agreed to structurally embed Equalities Impact Assessments into all policies and procedures.

Improving Mental Health Provision

The committee received an update on the development of the Lewisham Neighbourhood 2 Central (N2C) 24/7 Community Mental Health Centre, a national pilot site aiming to provide integrated, neighbourhood-based mental health care. This pioneering initiative, led by South London and Maudsley NHS Foundation Trust (SLAM) and its partners, is designed to offer prevention, open access, and culturally appropriate interventions, with a particular focus on addressing inequalities for Black communities. The centre, which will be located at 1 Heather Close from May 2026, has seen increased referrals to its recovery house, more face-to-face community contacts, and a reduction in Accident and Emergency presentations for mental health crises. Challenges remain, including team culture, balancing the new model with existing services, stakeholder communication, and building delays.

The committee also heard about broader developments in adult mental health services across Lewisham. This includes the redesign of community mental health centres, the implementation of the 24/7 N2C centre, and the establishment of an innovative voluntary sector co-operative. A significant change discussed was the restructuring of adult social care social work functions, moving them from SLAM teams into a new, council-managed Mental Health Social Work Service. This move aims to improve oversight, ensure statutory duties are met, and enhance professional identity for social workers, while maintaining close collaboration with NHS partners. The committee was assured that equalities impact assessments have been completed for these developments.

Public Health Prevention

A Whole Systems Approach to Obesity and Weight Management Medication

The committee received an update on Lewisham's Whole Systems Approach to Obesity (WSAO), with a particular focus on the use and resourcing of weight management medications, such as GLP-1 receptor agonists. Obesity rates in Lewisham remain high, with significant health inequalities observed, particularly in areas of greater deprivation. Hospital admissions directly related to obesity are higher than the national average and are increasing.

The report highlighted that weight management medications are generally available within Tier 3 specialist services and are increasingly being integrated into care pathways. However, the cost of these medications, such as Wegovy® and Mounjaro®, is substantial, with estimated annual costs across South East London running into millions of pounds. NICE guidance recommends that these medications should be prescribed alongside structured lifestyle interventions, including dietary advice, physical activity, and behavioural change support. A key concern raised was that individuals who stop taking these medications without ongoing support are likely to regain weight rapidly, often within 1.7 years.

Following discussion, the committee made a recommendation that in Lewisham, the prescribing of GLP-1 drugs should be contingent on funding for behavioural, dietary, and activity-led lifestyle support, rather than being solely medication-focused.

Gambling Related Harms in Lewisham

The committee discussed the significant public health issue of gambling-related harm in Lewisham. It was noted that gambling can cause the same chemical alterations in the brain as drug addiction and is classified as an addiction. Betting shops are disproportionately concentrated in areas of higher deprivation, and there is a strong correlation between gambling and suicide, with a significantly increased risk. For every high-risk gambler, an estimated six others are affected.

A new statutory levy, introduced in April 2025, will provide ringfenced funding for treatment, research, and prevention of gambling harms. Prevention funding will be channelled through the Office for Health Improvement and Disparities (OHID) to local authorities. Lewisham has higher-than-average rates of problem gambling compared to Great Britain as a whole, with an estimated local cost of £12.1 million.

The committee recommended that gambling should be treated as a public health issue, comparable to smoking and alcohol-related issues, rather than solely as a regulatory or licensing matter.

Learning Disabilities Implementation Plan

The committee received an update on the Lewisham Learning Disability Implementation Plan (2024-2029) and the work of the Learning Disability Partnership Board. The plan aims to improve the lives, independence, inclusion, and support of individuals with learning disabilities. The Partnership Board, which meets quarterly, has focused on improving accessibility, prioritising the voice of people with lived experience, and reviewing action plans.

Key achievements highlighted include the approval of the Reasonable Adjustments Housing Policy, which supports people with learning disabilities to access council accommodation, and the development of training programmes for GPs to improve the quality of annual health checks. Work is also underway to increase employment opportunities and weekend/evening activities for people with learning disabilities. The board has made efforts to improve accessibility through the use of PhotoSymbols and easy-read formats. Challenges remain in engaging younger people in transition and in ensuring consistent progress across all subgroups. The committee agreed to structurally embed Equalities Impact Assessments into all policies and procedures.