Health and Wellbeing Board - Thursday, 3rd December 2020 at 3:00pm - Lewisham Council Webcasting

Health and Wellbeing Board
Thursday, 3rd December 2020 at 3:00pm 









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1 Minutes of last meeting and matters arising
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2 Declarations of Interest
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3 Update: Local COVID-19 Outbreak Engagement Board
4 Delivery Update: Lewisham System Recovery Plan
5 BAME Health Inequalities Update
6 Sexual and Reproductive Health Strategy 2019-24: Local Action Plan
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7 Lewisham Safeguarding Adults Board: Strategic Business Plan 2020/21 and Prevention Audit
8 Information Items
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  1. Webcast Finished

shouted to him
OK thank you good afternoon everyone thank you so much for doing the health and wellbeing board we got apologies from the Damien Egan as unfortunately he's got clash this afternoon so I'm going to chair the meeting I'm Councillor Chris best I'm the Deputy Mayor and Cabinet member with lead for Health and Adult social Care and with the agreement of the Vice Chair Farouk I'm going to lead through this afternoon and looking forward to

1 Minutes of last meeting and matters arising

An interesting afternoon and hopefully a report back from our health partners on where we are at this point in the pandemic and of course initiatives that I hope are going to take us through to a safe and secure future if I may start then with the minutes if we go to agenda item 1 can I take take it back pages and shout out if there's any amendments or anything you wish to pick up a number of the items are of course on the agenda
I'll use the untrusting you've all got the hands up function if that works for people if it doesn't just wave a on-screen but we're over 2 screens so I think it might be better either take yourself on mute and call or use the hand and I'm not seeing anything so I'm going to agree the minutes thank you very much
any declarations of interest this afternoon

2 Declarations of Interest

3 Update: Local COVID-19 Outbreak Engagement Board

not seeing any so if I then take us to agenda Item 3 which is the Local COVID-19 outbreak engagement board and starting with you Catherine
thank you thank you Chair thank you and so am for this reports and you would see in your meeting papers is an update I am of the Health about being bored acting as our local COVID-19 outbreak engagement Board and so I have two main things I wanted to highlight from this report I am the first and it's just the background data you've seen section 2 of the report I'll giving an update of where Lewisham is in terms of COVID-19 since the start of the pandemic back in February so you'll see in figure 1 the clear to peaks of infection in Lewisham and you'll see the first peak happening in April early one this year and the second wave that we're now in the middle of up until November there so that's just by way of background for where we are in terms of covert 19 in the borough
I am the next point I wanted to highlight spends number 3 points out next funds to highlight is in response to the outbreak your remember that in May of this year we developed a local Koba COVID-19 outbreak Prevention control plan and this I am was developed by all local authority areas to outline the way that's I am you and partners am in a local authority area would coordinate your response to Pope in 19 to prevent outbreaks am and was funded them appropriately
I'm so Lewisham I am we wrote our plan we publish that online and with his entered that too I held the Molby Board in September and I am there since as you know been our own a large number of updates to the national response and regional responses to COVID-19 and so we have therefore updated are local outbreak a local credit lines in outbreak Prevention control plan
with lots of the national developments including changes in the way we're doing testing and local enhancements to contact tracing which have launched in Lewisham so on and so forth the to own national tiers of restriction so there was being included in this update annual see that's erm again appended to and the support in your meeting papers
since we published that's over as part of the meeting papers there had been yet further updates which will have to be reflected in this plan and but will do that in due course and again circulate that two members of the Health and Wellbeing Board for approval before we then go on to publish on the Council website
slash the second point from the report and that the third point from the report is around our communications so you know that one of the key roles of a local Covid 19 engaged a board is to make sure that am local residents are kept up to speed kept up to date with what's happening with the pandemic and by a number of communications and engagement channels since the start of our COVID-19 response we have had to erm a well-developed communications and engagement strategy am but we've had again further developments in that and one of them the key development since the last time we met as a Health Law been board has been the launch of Our Lewisham covert 19 community champion and initiative I am and this initiative mirrors and other similar initiatives that were launched I'm in air Newham in London in Birmingham elsewhere in the country I am but in Lewisham I am we've launched our own we've recruited over 100 am COVID-19 Community Champions to date and the main ethos of this initiative is to make sure that we're getting an appropriate messaging and information to all communities am and the diverse range of communities I'll be having Lewisham and so we feel it's important to have people recruited as champions who will act as I am conveys of information to the particular communities that they're in touch with so it's great that with recruited am some people to date and were joined at this health and wellbeing board by three of our Champions who am I here to share some of their experiences of what it's been like to be a champion how they've I am played a part and played a role in getting communications out to the community that they're in touch with I am so that concludes a summary of the report and I'd now like to invite I am our Committee Champions who had been invited to the meeting today and that's Alexandra kameez Leslie Allen and Timothy Bradley to share some of their experiences being part that Lucian craved Manton Community Champions initiative
certainly forward start off with an Alexandra
I hello
to me it is being
community champion is just adding another little bit on to what I already do I ran a network on behalf of our PPG sampling grew practice where our Chair that the patient group and we are very active working with the surgery etc. that's one my routes I've got several hats on and I found it's been extremely useful even this morning I had somebody asking the about moving from one tier into another particularly over the Christmas period and and how they would fare and I have put a question through to the COVID Champions e-mail I'm waiting for a response it may well come back by now but I haven't been able to check for the last half hour but even at the beginning I have few people asking me questions and I was able to put them through and then answer them and I found one to the questions have been useful enough for me to actually that workout so I just neck the the network them as a question and answer thing so but the information 70 is very useful have do and then dipped before it sent out sometimes as it's not always relevant it's of some time trend of in just to the Champions but on the whole I think it's worked really really well and the fact that I'm able to ask questions direct and get answers direct within a short space of time has proved extremely useful
thank you so much Alex and if I can then hand until lately
as high everybody I yes I'm Leslie Allen and I called an 8 the Diamond Club and the Bring Me Sunshine project in Catford and I connect with their 200 elders are regularly so becoming a covert champion and this all started and has been really useful because it's meant that I've had up to date information to share at immediately with these 200 elders and
we send out a magazine once a fortnight and it's got lots of information in its on we're able to summarise the information that I received through the court the champion e-mails and also through the webinars we have a webinar every fortnight at that Catherine Leeds under and that Sir been very useful as we've been able to ask questions there and get the answers have for full detailed information and then the next day then pass it on to our recipients and farrar 200 elders who Mo Ali a lot of them aren't connected to internet it's very very important that I can summarise this into an written word put it out in the magazines and it gets delivered to people at their doorsteps or posted to them so that's been very handy in the infant the questions we asked we get answers back very quickly so that's been very 30 indeed thank you
thank you very much Leslie and then hand onto Timothy Bradley
I think Tim seem as if you're mutes I think you're an with us
it Sosa's on the core
Tim as if we may have lost tip there I'm
give it one more moment if not then I will
Catherine is microphone is showing as being needed are right Tim do you want to and yourself
no through technical hiccups there see what I hear from him OK so I'm but thank you so much M Alex Leslie and Tim for joining us and so that concludes own this report but happy to take any comments or questions
well thank you very much Catherine and I'm just looking any hands up indications in your moulds to ask anything I I attended one the Community Champions within hours with a really helpful and I think spreading the word is just so important I'm also encouraging other councillors to join I know Councillor Millbank has found it very useful and I can see councillors Muldoon and Howard wrong the call so encouraging everyone really to spread the word about our Champions OK I can now see some hands found you want to kick off I go first thank you you and I really just wanted to say was a massive thank you to Catherine and her team and everybody in the Council for what you've been doing putting all this together because I know both of my Audi t hat on my youth first hat just how an enormously helpful it's been and I think one of the things that's really evident from the report you produce it just how much work is going on in the background that I think quite often the public doesn't say so it was just really to say thank you so much at particularly with that your wellbeing Champions Cup wellbeing Champions because people being able to get out and get those messages across arm it it's really really useful so wasn't really it wasn't really a question it was thank you
well thank you so much Val it's great to get the feedback I've got for route next and then Coral
and thanks in fact I think valid third was as good to say but some it really is pleasing to me that you got so many community champions particularly because of the level of concern have had in terms of misinformation in the community about the effects of the vaccine and done people wanting to avoid it so I think it is really really good work and well done
plaudits all round and Councillor Corrall Howard
thank you thank you Catherine and justice are wondering if you would all all still looking for other people to join I am quite willing to help and patch get other people from Downham to become champions as well
great thank you very much there we go first call to action began to so fabulous OK thank you very much and Alex's that term a legacy hand but do you want to come back in now I just wanted to say the other little benefit that I'm finding is that when we're getting the updates for the Community Champions after the meetings were also being in fact it to different training sessions which I've signed up for one is regarding Hansa particularly that I was interested in and I'm finding that very useful I don't or how are we going to work with that in the future and I'm hoping that will lead
that sort of thing will will lead somewhere so that we can help more but thank you for Catherine for arranging these training sessions which I get to come so we'll see how we move on the

4 Delivery Update: Lewisham System Recovery Plan

great but thank you so much everyone and earned obviously thank Catherine and particularly all the hard work I know you and the public Health team have been putting in over these past months I know it's been fantastic so we're was going to come back to another item they to on but I just wanted to record that because I think we all appreciate and indeed all our health partners the work to push this along is just been enormous with that said if I take us to the next item which is the delivery update and Lewisham system recovery plan and I think Amanda you're going to lead us off on this one
I thank you Councillor best absolutely I'd we have a lot of contributors to this so I've done a varied that summary set of slides and hoping everyone can flesh it out what a better that's OK I'm such as a little bit of a recap and the documents are on page I think it's 77 of your pack we first presented the recovery plan to the health and wellbeing board back in the 3rd of September it was signed off at formally in Lewisham on the 22nd of September the planet's I'll sets out 18 months' worth of priorities and activity that everyone has committed to as part of the recovery from Covid and the plan for Lewisham forms part of the south-east London Integrated commissioning system and the Lewisham council respective recovery plans so it's a part of a big picture if you like each partner in Lewisham is responsible for delivery of their aspect of it and in the first and slide you'll see at the sort of slightly complicated picture of the different boards and groups that make up the governance and the system delivery within health and care in Lewisham we get different reports on delivery going to the notion helping her partner board and on the third and 24th of November we had report specifically from their mental Health Alliance Group and the carrot home Alliance Group the recovery plans themselves have been informed by quite a number of different engagement events and which took place between August and November and we held tender from focus groups with different user groups
and came up with a set of seven high level themes coming out of that and the all the comments were fed back to different provider and delivery via groups as we received them we then held an event on the 3rd November to share the learning and that we had and to update on the responses and I believe the the path is now co-ordinating a US of you said we did type report to feed back on that in a more formal way to the groups that we've engaged with so going through the slides then I would we did erm I I added Poplar slides in the first was rounded the system governance on the boards and the groups that deliver the services and then a slide that just a bit of recap on what the recovery plan was and in the recovery plan
if everyone remembers we had set out a number of different priorities around primary care frailty planned care specifically respiratory and eye Beattie's prevention mental health children young people and community resilience and course it goes without saying the inequalities were a high level priorities well and that forms an integral part of each delivery area
the plan itself was divided into different sections 1 was around a what would we do to protect residents from the second wave but the second was what are we doing round restarting of key services and the third was how can we learn from what we've been through a in order to build services back better
each delivery Plan sorry each delivery partner has reported on the specific commitments they made in the recovery plan and this presentation is really a summary of those elements if it's OK I will now pass on to Vicky Scott to talk to the acute recovery plan delivery
Good afternoon everybody and and Vicky Scott and the Programme Director for the recovery programme the elective recovery programme at the issue in Greenwich Trust and I both just pick out a few key points from the sly that you have before you on recovery in terms of acute activity so you'll be aware that elective activity non emergency pathways have been up and running since the summer
and we set a set of recovery trajectories for Phase 3 so yeah indicating where we want to get to in terms of delivering procedures surgery outpatients diagnostics etc that at the fishermen Greenwich and we have over the past few months significantly increased our elective activity and we are meeting broadly are trajectories that we said that we are not at pre Kohli level so we we regularly compare ourselves with how we're doing against the levels of activity at the same time last year and and we know we're not going to be able to necessarily meets what we were doing before covert struck because of course we have some things we need to pay attention to in this in this in the current world namely what we need to do around infection the trial how we need to redesign pathways literally in at what what's her or what sort of doors and was and things we need to have within our trust sites to keep people safe on the one hand and on the other hand of course we have issues with staffing
a number of our staff are absent because either because they they have COVID or because they have been in contact with curvy positive people be they patience be they you just let people in the community so we always knew that that was going to be in charge having said that and we are doing well on outpatients actually and we're actually not only achieving our trajectory in terms of outpatients appointments but also achieving the levels of outpatient appointments that we were achieving this time last year and I think are quite a bit of that is to do with the fact that we have gone from
very much into the digital sphere as we all know anybody who has been involved in healthcare ever over the last few months will know that a lot of activities now virtual and I put a figure than their of 55 percent of October outpatients appointments were virtual expect to be a similar figure and for November as well now of course virtual isn't for everybody or every conditions that we need to make sure we have that balance and we have face-to-face appointments available for people a key element of which impacts on our delivery of activity of course in in the trust is at the swabbing that we have to do with anybody coming in for procedure in the trusts of the way that works is that we have a swabbing appointment to a test for Covid and then patients Nieto are going to self isolation for three days after that pre admissions swapping it of obviously that's introduced a whole new process that we've never had before and it's going to be a particular challenge for us over the Christmas period I know that they the board would be entrusted in knowing how we are planning for Christmas and New Year period and of course we have we are planning very carefully for that period of tax traditionally elective activity tends to go down over Christmas and nobody really wants to come in for an operation at the Christmas and in now of course nobody particularly wants to come in for a pre admission swab and then have to self-isolate for three days you know over the Christmas period so we we're we're working with that we're looking at what staff we have as well because clearly no hard working frontline staff across all our organisations of course also need a break at Christmas and we need to balance the needs of needs of staff with trying to get as much elective activity done as possible so that we making sure that those are we seeing as many patients of the as possible getting through our backlogs for when we had to stop elective activity earlier in the year
so I suppose the final thing to say just by way of summary is that we haven't had to sit or stand down any of our collective capacity yet and very pleased to say we don't know how went pressures are going to impact on that over the next few weeks and going into the new year but we have plans for that but I'm pleased to say we haven't had to do anything along those lines just yet and the messages out to patients and the public that we are absolutely open for business and we want to see patients and and to get them treated as quickly as possible
thanks very much Becky I'm going to pass on to now to Sandra is candour to talk to the community services high everyone I'm Sandra Scanda from the strategy team there's from Greenwich Trust just a couple of points to flag about community services so clearly our services continue to focus on keeping people at home and in the first wave largely our community services continued by using virtual and telephone appointments as Vicky alluded to in acute services so our focus is to continue and and keep that pace up so it's a slightly different picture them from acute services for Christmas are services also continue run weekend level services to cover the Bank Holiday so urgent all are community staff and referral referrers can access urgent community services should they need to through the usual routes one of the things we've noticed is that there has been quite a bit more pressure on district nurses over the last few months and that continues largely probably to support people who are shielding and spending more time at home so that's something we keeping a close eye on and district nurses and other community teams continue to support people in care homes and are taking on additional responsibilities as and when we can for example to support Cavour testing in the community so so all that continues I think probably two areas that is what our worth flagging to the board as as new developments are we are developing our urgent to our community response service so that means people will be able to access a multi disciplinary community response within 2 hours to avoid an admission if they need to and that should be up and running by spring next year so we're doing a lot of work to get that going now and secondly we've also been reviewing our discharge processes working on discharge to assess with partners in the council and social care and in Reablement to make sure that that is as slick as it can be that we have sufficient capacity to meet demand and to support people getting home as quickly as possible so I think I'll stop but happy to take any questions at the end if necessary
thank Sandra we were going to move on to Ashow shortly to cover of the Primary Care slide but unfortunately or rather fortunately I should say he's very very busy dealing with the roll out of the vaccine so he couldn't be here
I got a last-minute apology so just to pick up a few points on on Ashley slide from primary care immunisations health checks and cancer screening is now fully operational again I've already talked about the preparations for delivery of the Covid vaccine
the hot hub and transport continues to be in place for a covert suspected patience at flu vaccinations are being rolled out at the moment and over 3 hundred laptops were deployed to practices to support remote working and that's just some of the many bullet points that have been raised by primary carried response to that they delivery against the recovery plan
I'll move on also to children and young people I don't know finicky a few want to say anything or if you're happy for me to to talk to these slides I'm
a fine so again just a few points from the children Young people Services immunisation programme in schools restarted in September the weight management offer is in place and being Cathy targeted at those who most need all screening programmes of restarted and are being scaled up now
mental Health link workers are in place to support schools with children's mental health needs and of course we did see quieter a surge in demand for some of the mental health services that were being offered by children and young people's services since July referrals to the Safeguarding Hub have been about 400 more than average so quite a significant rise there they also saw a surge in demand for for chilled children and adolescent mental Health Services and the use of coos dot com
which is an online counselling service and the CAMHS crisis line have both increased but I believe demand is currently being met for those
I'm going to pass on now to Donna to talk to the mental Health slide on I hope that's OK with is accountable yeah that's absolutely fine thanks Amanda just to say if you lose me we having a bit of power issues in East Sussex because of the thunderstorm so if I suddenly disappear that's why I'm so just to save it am all our all arm into how services are are open we continuing to do a variety of virtual consultations but also seeing people face to face and that's particularly important in our secondary care provision because we recognise that a lot of our patients we do actually need to see face-to-face rather than virtually
all our crisis services are open and they will be open throughout the Christmas and New Year period that includes the 24 hour crisis line the home treatment team services that tend to go out and see people on if not daily sometimes twice daily I'm we've got a rapid response service that's available 24 hours a day in that rapid response is if somebody
gets into a mental health crisis instead of needing to come into hospital to see that person with a mental health nurse at goes out and sees them in terms of wherever they might be
we recap quite a successful pilot in in three where we are working much closer with our GPs and using their EMI system for for getting in contact with people who experience her or mental health of difficulty and we've managed in entry to reduce our waiting times from something like up to six weeks to 48 hours and so were planning to role to continue to roll that out across the other neighbourhoods and we were in discussion with GPs at the moment around the potential to offer it's an additional psychological support for people that are recovering from COVID and are continuing to have symptoms and we're we're looking at that potentially going live very quickly within we could mobilise that service very quickly our Black and Asian minority ethnic insight work continues and this is being done through the mental Health Alliance and currently there surveys being collected from our vein service users to understand what their experiences their cultural experience of our response in regards to mental health in that continuing in we're expecting to to get more information and in that in improbably that that the new year now
just a little bit around the liaison assessment unit that we burn stood up in the lady well in response to try to ease pressures from the emergency department
numbers of very very low into that assessment unit and were working with our colleagues in Lewisham and Greenwich trust to see what else we might be able to provide because we don't think it's it's got the through put that that we would be expecting however the triage function which is the function we have at the front door to help people who walk into the emergency department in a mental health crisis and we're managing to divert 48 percent of patients and giving them what we think is a a more appropriate offer for their mental health and when they come into into the day and so I guess the might my main messages really that were open were staying open and our crisis services open or be available throughout the Christmas and new year period
feinstein and I've got I've got a slide on the Carers action Plan because we care homes as one of the areas that we were quite concerned about early on in a wave 1 of the pyramid
and there was a a very detailed action plan and developed which is now delivered pretty well and the action plan identified five key areas they were infection Prevention control PP testing clinical support care homes and workforce support and I'm pleased to say that all of these areas are delivering quite well there is no dedicated nursing resources been recruited to support care homes with infection Prevention control
I'm in terms of PPE providers have their own supply chain but there is local mutual aid agreed agreements in place across the system and so if any go short they can apply for help testing is now available for all staff and residents on a regular basis and as clinical support provided care homes through one health Lewisham in terms of workforce support support there's an infection control fun that spin a very
useful in terms of limiting transmission so supporting care homes with any specific they need they have around their workforce and infection control and finally flu vaccination all eligible old raddled residents have received free vaccination as part of the winter preparedness programme and by weekly meetings take place with care home managers and public Health to respond to any queries and issues and provide ongoing training and support
and as part of phase two covert support a named care home in Lewisham has been identified to become what's called the designated place for the discharge of people with a positive COVID-19 diagnosis from hospital before they then return when there are no longer infectious at back into their own care home
the final slide is covers both the collar council and voluntary sector and I think he is going to talk to the council elements and I've asked Philippe then to come in after day and to talk to some of the voluntary sector and the activity that's going on there too I can pass have today
yes thank you Lucinda
Will as the thrust of the system adult social care continues to perform all of its key functions were managing to keep the discharge to assess pathway working enablement is working well and we're also putting in place and delivering our C C recovery plan because people may be where the genuine healthcare assessments were suspended during the first phase of coping so people who were discharged from hospital during that period 90 2 half a continuing healthcare assessment all of that Simplice and and working well and the big health way which was a very different offer this year because it was a digital support for people with learning disabilities and accessing health service was was hugely successful and and large numbers of people with learning disabilities in engaging in that I daycare opportunities continue not to be building this to be provided in a different way and are debt commission J care providers have put into this a number of innovative things to support people in in the community
and again will it might want to cover this as well but we've done quite a lot of work with our carers organisation in looking at a different offer for carers and we've done Vale done that very much in partnership with our our carers and the people who think they cared for I think those are the same the key things
Amanda just less than that we are now what Brian Marsh a minute just to secure the final arrangements for the opening of our designate a care home the other big pieces of work that are happening at the minute are around supporting our care homes to rural I testing of visitors and care home so that people will be able to see their loved ones and relatives in a way that they have been able to do really for the last kind of 9 months happy to take any questions
thank you so much day and the Philippines is hoping that you might be able to add something from the perspective of the voluntary sector you're on mute by the way
am I able to share my spinner to
heaps I'm not sure
the and enough to this afternoon OK I am now that they're not that's good I can see your screen you see can you see him the provisions of the Christmas
OK so basically so this is really our websites and with combined and a number of of of venues people offering as this is really about food of a Christmas this quality working up to Christmas and even some during Christmas biscuit novelists against updated on our everyday because
New things appeal at this this one the electrical and silks affirming Catford as offered to do a Christmas meals and so it is it OK quite a lot going on and it's it's cameraphone north the south and east and west of Lewisham's that is good
are proportionate them delivery during during the period there will be some places are closed
between Christmas and New Year because basically the not a sector has also have a bit of a shutdown and recovered from amount of work of the been doing endlessly since the mid March I will put the link to into the chat room I can't because I have had problems and today to the websites but you will see on our website as well that we have also put down a referral forms were and other organisations can refer people to an very services but is not recognised well I'm and also we have evere sale or doing services yet you can get their son access there are during the Christmas period and Bevere sales of providing quite a few parcels and even sorry which is now and happens with might internet today I'm so yeah so basically we have got quite a lot of provision society I'm struggling with my you can it I'm but there's a good cover and so I think we can be CWAC offer dance that are we have provision girl people if the were very concerned actually about the homeless and there's not allow provision for homeless people not stats a bit of a gap and is difficult to to find a solution to that because you don't aware they are where there would be an when it's it is a bit of a concern but otherwise where report well kitted out
thank you so much fully and and thank you to everybody and as you can see we kind of brought together a lot of people to the never their reports and I hope that was useful
well that was so impressive Mander an just shows the amount of work that's going on and that partnership really came through at with all our health partners working together the third sector I know tremendous amount of works been going on and I was very keen that we got the update for Christmas and it's really giving confidence that you know there will be provision and it's great that we can direct residents because I think what we can do from this fully particularly as rolled that out members because we will be contacted just to make sure what's on offer but it's fantastic to hear that the screenings back up and running and I'm happy if anyone wants to ask any questions I can't see any hands up but I just think it it was impressive vow
thank you Crowe sorry getting in there again at just at just a few comments on points for a may I mean first one and it slightly buried away in the report but I thought we ought to ready noted at the board is that to see on the our primary care slide the use of the Cerner population how system which will recall we talked about probably a year or so ago and we've had quite a lot of conversations about it over the years whose me in terms of the benefit we hoped it would provide an thing certainly from a hospital perspective and I understand speaking to some primary care colleagues as well is really now starting to be of use so I thought that was worth us all
noting I also wondered if it might just be helpful particularly in terms of assurance for community partners given the concerns of people have had enough reported in the past about not wanting to come into hospital because of the risk of covert was to just give you an update on the numbers you know vacationed sound of very kind to give it a really good description of of what we're doing to get elective work and planned work running but if we think that back to the the first peak we were looking at over 300 covert patients across our trusts that of a bed stock of 900 as of today the numbers 75 so it's been around 70 to 80 for the last week or so it bounces up and down it's probably about two thirds one third Queen Elizabeth her to Lewisham has to say isn't they're not all local people people may have read in the press that North Kent in particular is under a lot of pressure and the NHS shares the workload out so that no hospital would keel over
and of that 75 we currently have 14 with Kobe in intensive care so significantly lower numbers the we saw in Wave 1 and speaking to the intensive care staff
recovery rates are much much better so the mortality rate this time around is significantly improved arm from way one that's because of the massively increased awareness around treatments and house it had to manage covert so it is a completely different situation her to a we were Southall that might be useful and also to mention that of course nor earlier we testing patients coming in for planned care but are staff on what we call the Green pathway so the surgery pathways for quite some time now have had regular swap testing and as of this week we're rolling out a slightly simpler way of testing the people staff who want to can do it twice a week at home and that will happen for all front line staff and we hope will pick up those asymptomatic cases so where people don't know they're carrying covert and we do that and then of course obviously with our planning for vaccination as and when the vaccine comes through and the guidance on that
is coming out thick and fast and we would expect something to start and happen for staff and impatience or possibly our patients over the next few weeks and then just my final point and it it's a bit of a liver taper penalties on the course I'm sure have in place or hope of in place to to hear this not directly in the recovery plan but we know that vulnerable young people have have suffered massively through certainly through the phase 1 lot down
and to all of the restrictions and so in my youth first hat on I thought the poured might just be used keen to know the after the end of the first lock down the youth clubs and adventure play grounds all opened up they remained open they remained open through the second lockdown and they continue to be open in fairness then or open act anymore they are restricted invited bottles but they are continuing to provide a service for vulnerable young people and a really good initiative funded by children in need will be fully established in January is Justine to roll out that's about providing a street by service so we're really proud of that and we're hoping that as we go into winter and
vulnerable children are out on the streets that they can access services they can accessing his work or wherever they are so not quite within my or more remote far thought was too good an opportunity to Mr. Coulson some really good news I think
YouGov thank you very much I can see pinnacles in the chat room saying very happy to follow through and joining an online group earlier in the week so isn't it amazing all this activities really carried on despite the difficulties shall we say with the pandemic to put it mildly if there's no other hands up I can't see any I just wanted then thank again Amanda in the team I think that was really useful really comprehensive and you know will steer us through the Christmas period into the new year and honesty though I'm sure as first set further announcements on the vaccine and hopefully next time we meet it would be a much much improved picture well thank you for that if I take a some then to Catherine and the urbane health inequalities update please

5 BAME Health Inequalities Update

thank you Chair serum
this paper and provided an update on our existing work around tackling Black Asian minority ethnic health inequalities in the barren and soap then Bizzle remember that we then started this STRAT strand of work or areas of work in July 20 18 and that was to tackle the significant inequalities that we've seen in our Black Asian minority ethnic communities for spree three specific am priority areas and those where I'm years of mental health cancer and obesity and we've since developed an action plan around those three areas by in light of the COVID-19 pandemic this year with also added an additional strand of work specifically around COVID-19 and how we support our communities throughout this particular year
so that action plan you could see has been updated for this particular updates appended to the report and I just wanted to pick out two specific areas of progress since we last met in September so you will know that we had started a collaborative piece of work with Birmingham City Council and that's looking at specifically black African and black Caribbean health inequalities across both Birmingham's and city and Irish local authority and we've embarked on this piece of work and and this was following on Birmingham and ourselves being charted of his to Charles' blazer science I am at some point last year and as White was then conceived vertically as I mentioned in light of the COVID-19 pandemic I'm so this is an 18 month piece of work that will be a review will be looking at published peer-reviewed evidence I am but also looking at some grey literature other information sources to have a look at AGM for any evidence of what works to tackle health inequalities in the specific am ethnic population groups across the two areas we then will first way that will be overseen by an academic Advisory Board those insights will then be passed on to an external advisory board which will consist of well it's been recruited to and consists of community members or crop across both Birmingham in Lewisham who will bring their lived experience to the table to say to grapple with the evidence and and saleable this lamb intervention actually work on the Brown to tackle health inequalities and so will have that review cycle for approximately eight to nine specific topic areas looking at AGM health and equalities arm across his population groups so this work started I'm pleased to say I am in November I'm so we had our first cycle passing to the academic advisory board that's been recruited to the external advisory board and were just now summing up some of the recommendation some of the discussions I've happened by HBOS I am to boards and our first topic cycle looked at the specific impact of racism and discrimination for black African and black Caribbean groups and the impact of those of Raison's rumination on health inequalities and so am the Chair Councillor best I attended amongst only advisory group I am and I think you would agree with really insightful really powerful discussion am looking at the evidence that came through from the academics so really pleased I am that our first topic cycles worked because some feedback some refinements to make the process but I am a really good start for for what will be a really interesting 18 months and hopefully something that Wall I am
fair very concrete action orientated I recommendations that we both are applicable locally for Lewisham and bearing them but hopefully also have some national significance as one slot was the first update as part of the action plan
and the second is around a health inequalities tool kit that we've been working on this has been in the works or being progressed over the last 12 months and we are very close to ICT I finally being published for have against a few refinements to make and what we hope is that this talk it will be able to be published circulated to community groups to really give us an EIA concrete baseline of some of the key and Equalities for Black Asian minority ethnic groups at Lewisham that community members statutory partners and will all have as agreed baselines of the picture or status of health inequalities am at this moment in time so
that is being progressed and I am will be published I am some point in the new year bring that back to the next meeting of the Health and Wellbeing Board I should mention also about the tool kit and that was still working on trying to get as much information and from partners I am in the health and wellbeing board I'm to make sure that all kids I am as comprehensive and as user-friendly as possible so the two main update I wanted to mention as part of this work happy to take any comments or questions
there were many thanks for that Catherine and I can see for exclude his hand up I yes Chair thank you and Catherine and really helpful update well I wanted to do is just well I know we're consumed with Covid at the moment but just bring together some other aspects of health and wellbeing one of my roles is to Chadli quantities committees south-east London CCG
and what had been aware of cressida Dick the police commissioners put out statements which sham at sometimes a little bit conflicting with each other so one of the issues is young black men and boys stopped and being searched and
the chances of that is between 9 and 19 times that of a white person at the same time of any of those groups picked up or one in four will have some sort of issue and that is across all races so there and question here is doing now what the statistics for Lewisham are and what the effects are now I'm aware that we have GPs and we have professional staff at Lewisham hospital who have been subjected to stop and search both as adults and children and I think the mental health effects of that are very long lasting and this is something I wondered whether we as a Health and Well being Board as mental health commissioners as social workers and also the health service and we can get to grips with and really look at as it as really
very significant issue that defines the health and well being or a very significant termed segment of our population which doesn't get really looked at properly and I know that some we don't have this on the agenda at the moment but I just wonder whether we could pursue this and get some statistics and for this group
if I can
come back on that I could see Pinnock is comment there about them at statistics so M. Everett this I think is a really important issue that you raise and this work is part of them a wider piece of disproportionality work that sits under the Safer lowish Partnership Board at the moment so again pre covert we had a whole workstream looking it I am a whole range of disproportionality is for for specifically black ethnic minority groups in the barren around criminal in interactions with the criminal justice system I those that part of our youth offending service and those who are stopped and searched etc so I am there are a whole range of statistics I am sitting underneath a pollution Partnership Board that I think some colleagues including Penycae myself can work with other council colleagues to potentially bring back as it had Enzo item here I think a second point is really aligning some of our work streets you I would say that education interacted with criminal justice system are part of a whole range of wider determinants of health that impact on health and wellbeing Fir I am though the Lewisham population but in specifically black ethnic minority groups and so I would say that again as predate the cover just about air when the pandemic was kicking off the we brought and a paper to the health lobby to look at developing am a refreshed has the mobbing strategy that looked at the wider determinants of health that looked at community input and contributions and to hell so we looked at lots of different strands
I am as a way of refreshing our strategy to make sure that we're building in wide as to permanence into that so I would say that's am as we pick that up again in the new year looking at the development of that strategy education interaction with criminal justice should be part of that and hopefully we can then align what we're doing here as a health and wellbeing board with other statutory work happening either under the Save Lewisham partnership or elsewhere in the borough
finally just recently became aware that there was an organisation called list L WIIS T that used to support let families in the sort of situation with social support as well as just general support around what to do when something like that happened but I I believe that the funding for that has been significantly reduced an unjust wondering where whether that was a good decision but some yeah I'm happy to to have things brought back
thank you did you want to say a little more than Penycae yes happy to sobering cha
Houghton issue for because you know and we have discussed it and I think Catherine's given assurances that we can get a further report I think we do have some data and I know my cabinet colleague at spend Daicos has been doing quite a bit of work with the police on this so it is a hot topic but I'm happy Pinnock if you wish to say
what the what more we can do well I think you've probably said it so I don't have the statistics in front of me at the moment but localist attrition Lucian is no different from the rest of London says have definitely initially here and when I talk to young people they though they referred snazzy development same point will review first as well there is a group now that this has been established particularly tackle the over representation of black young people being stopped and searched which involved the police and also council officers and Councillor best is correct that her colleague Councillor tax is also involved in those discussions as well but I think it's fairly early days around that I can say that the Youth offending Service is absolutely coppice on on its agenda and an across children young people services we could a particular focus on disproportionality so this is something that were actively cannot looking to to address but it's an issue it's not right and things need to change so you're item that thank you

6 Sexual and Reproductive Health Strategy 2019-24: Local Action Plan

thanks for the work and I can't see any other hands up so can I thank you Catherine for the update and as you know I'm excited to see our to locate in the new year and I know partners are going to we contributing has it I think it'll be a really useful piece of work and a note some it quite detailed and it takes time and energy in and obviously we've been thrown a bit off track with other priorities but I'm hoping when it does come back it will be really really help us and get under some of the data in terms of the narrative about how we can start to change things so can I just dumb thank you Catherine of his day and I'm quite involved in the work with doing that so if I may take us forward to our next item which is on sexual and reproductive health strategy and Miriam I think you're going to present this
I thank you Chair F good afternoon everyone I'm the needs some nights in front of my screen I can't see hands out for an after-dinner questions at the end so as you'd seen in your papers in 2 thousand 80 illusion part way Lambeth and Southwark to loan Shay tri-borough joint by the air and sexual repression rid of reproductive Surrey Health at Our strategy and a shared action plan to accompany this but recognising that there should residence would be better served if we develop the plan and for some more vacant in borough specific action planning and redevelop the local action plan and it's about that were asking you to endorse today and note the progress that we've made in delivering the tri-borough as our IT strategy to date so the plan or plan for strongly say a rampages 100 22 hundred before of your papers so as they plan to go through it in detail now but by way of over the EU it's built around four pillars which he can see on page 108 your papers in table 1 and the action plan flows from means so the pillars are around healthy and fulfilling sexual relationships are good reproductive health across the life course mean that people are able to manage their fertility and regret the path effectively understand impacts on it are and are able to access contraceptives
high quality and innovative STI testing and treatment and with the aim of reducing the local burden St eyes in the population and particularly among those who are affected disproportionately I must be living well with HIV harm as we meet with achieving and 0 8 HIV-related stigma as their HIV transmission and theory HIV related gap
for the same table shows some of the progress that we've made say on these annual fee that a strong focus on working with communities on bringing in patient and service delivery and allowing services to reach more people and also building our understanding of population health needs and growing the evidence base three different needs assessments are across the three boroughs
I am also on page 208 in your papers you'll see reference to the impact of Covid an Ofsted made are catered spectacles have assessed and anticipate that sexual health services an exception we've completed a rapid impact assessment to understand how people's use of services changed due to the pandemic and also due to lockdown though before we went into lockdown and sexual health sensors made a number of adaptations to ensure service continuity as best they could and whilst sexual health services absolutely available to people throughout lockdown perhaps not surprising name Shaw quite sharp reduction in in-person services during the months of an we saw this particularly in pharmacy and in sexual health clinics however was positive with that we saw a corresponding increase in online our service activity that was aborted sent more STI test kits ordered online during the month of lockdown compared to the months immediately before it and so we can be somewhat reassured that a lot of activity has been diverted effectively to the digital service which was the intention
so now we can see you at Woking and sand if changes to pathways and had had a disproportionate impact on said access for people to kill grapes especially Ann Black and minority ethnic evidence M people need that sexual into patient data
and the service user data doesn't in and of itself indicate disproportion impact to somewhat reassuring and that nonetheless we made to our way of sexual health inequalities and addressing this addressing needs remain a priority of its trust to be an action plan came forward the impact assessment was really useful nothing is unsound the and EJA impacts that catered 19 had access to services and guide as move through and tastefully beyond and the pandemic but because it just looked at service use data doesn't tell us to you much about underlying behaviours or about people's experience an of the changes said if at 5 am and say because of that will be undertaking some say called research to understand patient voice and caved impact on sexual wellbeing and am Pavia Anssi can't get that from services data alone a that's one of our priorities are months and we also have several third at that are approaching the end of their contract and were reviewing options for permission amaze working in partnership with our colleagues and US LSL and so continue to progress delivery of the Local Ocean plan while supporting strategic delivery across the three boroughs are we making particular progress around perhaps they breaks they to prophylaxis and HIV testing and I don't have anyone so our LGT colleagues on Channel 4 News this week as speaking by 80 8 Oby testing at Lewisham hospital on World AIDS Day I'll we also have a are working their programme of change Board has a fakes additional transformation and we are going to be any health network to spot what reduced SA asset shelf equalities amongst other minor yet as meets
that was still that I wanted to go three really Sunbury happy to take any questions are only that or on the plan as in the papers

7 Lewisham Safeguarding Adults Board: Strategic Business Plan 2020/21 and Prevention Audit

little thank you very much Meriam and certainly it's a detailed action plan that's appended to in papers so I think it shows there's a whole range and of course it's quite interesting how people are responded to have those online test which is something we have been talking about for some time and when push comes to shove it just shows what can be delivered in an effective way and I think that that that really has been quite positive and certainly hope good things across the three boroughs so I'm I'm not seeing any hands and and this does the other reports were really for noting and this one is also to endorse the Lewisham Local Asoro each action plan so a trust I take it that that's endorsed and thank Mariam in the team for all the work that's gone on in this sexual health planks I think it is a very important piece of work and again helping to keep our communities safe so thank you very much and I'll final report for the afternoon is for Michael on the Lewisham Safeguarding adults Boards fatigue business plan and a warm welcome to Michael who are comes along periodically but is doing fantastic job on Charing adult safeguarding board and certainly brings a sharpness in in his role as an independent chair
so over to you Michael thank you Councillor best good afternoon everybody and thank you for and the invitation Martin Crowe who is the Safeguarding Adult Board business Manager is also in the virtual meetings afternoon so with your permission Chair when I've when I've shut up our Justice Martin with regard anything to add before I take any questions or observations
I'm really glad actually the I'm going last as it were because it's been fascinating listening to the discussion thus far and I think there are some clear resonances between as the activity going on that has been reported to the board this afternoon and priorities that are in the Safeguarding Adult Board Strategic Plan so in one sense I'm I'm reassured the we are making a contribution alongside alongside other people doing sterling work I think I flag up to things the have really struck me about resonance is afternoon and the first is the use of Community Champions
as part of the response in Lewisham to the pandemic
the Safeguarding Adult Board has also used the notion of Community Champions to raise awareness about adult safeguarding and different types of abuse and neglect and how people can keep themselves safe so it strikes me that a are community champion should be linking with your community champions and and and perhaps your Community Champions my receive some input from Martin myself and others about the different types of abuse and neglect that they may uncover in in their work to support people through through the pandemic the second resonance that really struck me was the emphasis in a number of papers around health inequalities unconscious bias disproportionality and and so on the emphasis for example per through the qualities committee in the Clinical Commissioning Group and stop and search and how that can impact both on young people and indeed on adults the emphasis on mental health and clearly the very real challenges that face jury during the pandemic and a focus on disproportionality inequality ethnicity and so forth is a second strategic priority that the the safeguarding adult board has which you can see in the papers the paper look was presented full it for this afternoon the purpose for seeking an invitation and a few minutes of your time was twofold firstly the Care Act 20 14 requires the Health and Wellbeing Board to receive a copy of the Safeguarding Adult Boards annual report and indeed I'm very grateful Councillor best for your regular attendance at the Safeguarding Adult Board and your promotion of adult safeguarding in your in your role as Deputy Mayor
but the second purpose was was really to flag up that the work that you're doing as a Board has clear resonance with the work that we're doing a support and or to to seek conversations about how we might align our efforts more closely particularly around awareness raising and tackling inequality and preventing abusive neglect and protecting people from abuse and neglect when they experience it
so I hope once I shut up and Martínez said whatever he wishes to add we can have a short conversation about how we might align the work of the two Boards even more closely than they clearly are already thing that's all I want to say by way of introduction the report is within the papers no doubt you will have read it but if I make a chair I'll just ask Martin whether there's anything he wishes to add Martin her what should I have said that I haven't
nothing you've covered everything my going really you the only next step perhaps his just to we've already discussed about strengthen the membership of the lotion safeguarded spod and were working on a plan of how we might be able to do that and as already very strong connection between the Health and Wellbeing Board and the the Lewisham Safeguarding adults Board anywhere in the membership in this group today underlines that really this the so many people in this mean today that are already members of the lotion serve Canals Barbara I think there might be some key additions that we can consider that will connect specifically the work perhaps at Katherine was talked about earlier in terms of that that health inequalities action plan
so I think we made there may be some room to discuss that really in just expand membership to just formally connect the worker a little bit little more strongly perhaps I was the only the only point I would bring up we others there's a report that will be coming to the Lucian safeguards board in January that will that will reinforce that to be a little bit further
thank you Martin and last point from me Councillor best thank you very much for your e-mail earlier on this afternoon her letting me know that the full council has supported Lewisham's engagement in national Adult Safeguarding Week which is routinely in November and it strikes me the as we plan for next November's adult safeguarding week Martin and I should liaise very closely with you and colleagues on the board to make sure that the priorities for the Health and Wellbeing Board where they overlap with the priorities of the Safeguarding Adult Board are clearly for grounded in in whatever we arranged virtually or otherwise as the case may be when we get to November 20 21 thank you I'm happy to take comments or questions then thank you for your time
well thank you very much Michael and Martin I'm mum looking for any hands because it's it's so important the work we do on safeguarding and thank you I was delighted to take the lotion to Full Council because I think working with partners we can really push safeguarding week next November and have a bit of leading to how we might promote that further and I think certainly you know we we've been talking about more of this to across the Borough so I do feel we could work together and I will give further thought on because as you say I attend both and I'm sure there are initiatives and as you refer to further members that will enhance the safeguarding working particularly the Community Champions I fully agree if we can get more people in the community and really picking up or more often people don't recognise is an issue and we know there was report earlier this week wasn't there on the abuse of it was in the Telegraph I think on financial mismanagement with older people and often that's not seen perhaps as a safeguarding issue but clearly at working within families there are some difficult times there so I really wanted to thank you for all the work you've put in we've then got a couple of other own

8 Information Items

items I can see there's something in the chat on Martin you want to were just person when the work will do basically on the week so we'll get you know we got time and time enough as I sit here and hopefully come November week we we will have some face-to-face events that thank you know it would be nice it will be an us so just to finish off we've got a couple of information items one is the a Royal British Legion basically it's a briefing note from them calling on local authorities to improve the measures they take to help members of the armed forces with feeling lonely or socially isolated and certainly it is work that term we've looked at previously when we have another look at the Junior center I'm sure we can include their comments in that and then the second information item is we received the full report from Healthwatch back in September and we've just got some updates on that Michael you've been quite quiet this afternoon I don't know if there was anything you wanted to add
I'd I'd I think it's one of those days Fareham operator in the limelight but time just to say that Healthwatch is continuing it roll out and I was pleased to hear in the report earlier where the trust was talking about increased number of digital arm appointments and what have you but they are taking action to main Shay maintain access for people who may not be so kitchenette digitally savvy or provided so well done on that
well thank you so much so that's the end of the business I just want to thank everyone for attending this afternoon and I also want to give a special thanks to Stewart who has been our Clerk for many years and he's now moving on to a different role within the Council so I hope glum we will give Stewart a virtual applause and thank you for all the work and making sure the papers go out in advance and in I've really thank him for the support he's given to us and to me personally thank you to everyone and look forward to seeing you at the next meeting in the New Year have a very safe Christmas and you know brilliant work from all of you and I think we've all learned a lot this afternoon so thank you