Correctly being and Wellbeing Board – 25/01/2024


Correctly being and Wellbeing Board - 25/01/2024

Day we can say that given next week is February but appreciate we may not all have seen each other um since the Fester Break um so just to run through a few housekeeping bits it's a hybrid meeting it's you be aware um we have uh quite a few people joining us online um as well as those in the room so just ask that if you are online if you can pop yourself.

On mute all the usual um housekeeping things unless you're speaking and we will keep a track of hands up um in uh in online but just recognizing sometimes with a hybrid meeting if um if I haven't clocked you or spotted you please do come in and then we will make sure that we um include your questions and comments so as I said if you're online.

If you can um pop your hand up in the chat if you're here in person um start with a small wave and then get get bigger and bigger as uh if if I haven't already seen you um and please just use the chat function for it um and administrative um issues if you do have questions or things that you want to comments you want to make please do pop.

Your hand up instead and thanks Andra just noted um noted uh that um so just I don't know if we have members of the public joining us um but just uh just remembering the similar housekeeping things um uh that I've just outlined to members of the board um we not currently corat understand from physical um attendance but we should be.

Later on in the meeting but we will keep you updated on that um hopefully that's all clear yes we might as well leave item one then ter a reference fine okay so we're just going to park the terms of reference uh just until we cor it because that was for um for a decision from the group we've got a number of apologies um which have been.

Noted Mary Clark DCS James Conway who I think is being represented by DCI Yasmin Lani y yeah great welcome um Steven Hayes Rosemary jaara Dal joall Paul Senior Shila Kathleen wedan councelor Williams and I think we have Jessica Lin who's joining us a little bit later great yes and councelor for Thomas.

Apologies for lateness thanks very much um so just any Declarations of Interest prior to starting the meeting uh from any of the gender items please do declare that now no okay so moving us on now to the draft minutes from the meeting from Thursday the 21st of um September which councelor Kennedy chaired at that point.

Just asked the board if the minutes are correct and if they if you're all happy to sign off the minutes as an accurate reflection of the meeting agreed yeah okay everyone's agreed on that okay so we can sign off those minutes now um so we have one question from the public which I will outline the question and and then.

Outline the response from the board so please do bear with me the response is um is a little bit lengthy but very comprehensive so I just want to make sure from the minutes and for the people on this meeting that we cover the response in full and so just bear with me while I go through that so we had the following question which was sent to the.

Board by Claudia Nera pediatric ENT consultant from Barts health and the question was what strategies are being used developing to help with the increasing number of children from Hackney that present a hospital with medical problems that arise due to childhood obesity that do involve sport so what are the strategies around this.

So the following response has been provided by Carolyn sharp consultant in public health and Jane Taylor who's also a consultant in public health so I'll just read the response now evidence-based guidelines highlight the benefits of physical activity in in improving health and well-being outcomes this includes preventing and managing.

Excess weight in children in order to reduce the risk of diseases later in life including certain cancers cardiovascular disease diabetes and improving mental well-being children and young people are encouraged to be physically active every day because of the health benefits physical activity can bring even if they.

Do not lose weight regular physical activity helps children develop strong bones and muscles improves concentration and academic performance supports better sleep and improves cardiovascular fitness heart and lungs children with excess weight are advised to do more exercise than the recommended 60 Minutes of activity a day as well as a wider.

Council provision theity and Hackney Public Health Team commissions various evidence-based programs that support children and young people to maintain a healthy weight through physical activity and having a health diet services for not to fiveyear olds include a healthy weight service for children age zero to five years and.

Their families offering healthy eating workshops promoting Healthy Start vouchers and Universal distribution of Healthy Start vitamins delivered by Henry healthy early year service de delivered by Hackney education supporting and capacity building of early year settings in achieving healthy early years London.

Awards led by the mayor's office the key themes in achieving these Awards include healthy eating physical activity oral health and early cognitive emotional and Social Development the Alexander Rose vouchers for fruit and vegetable service helps families with children aged 0 to four and pregnant women on low incomes to buy.

Fresh fruit and vegetables and supports them to give their children the healthiest possible start in life programs for young people aged 5 to 19 include supporting regular physical activity in schools through the daily Mile and personal best programs delivered by Young Hy power up is delivered by homon Healthcare NS.

Foundation trust and provides a tailored multicomponent weight management intervention for young people and their families the service supports young people and their families to make positive changes to their diet and physical activity habits to achieve and maintain a healthy weight and improve their health.

Outcomes we are not aware of any data on the number of children from Hackney that present a hospital with medical problems that arise due to childhood obesity that involves Sports all of our local commissioning decisions are based on available local and National Data and are informed by the latest evidence and best practice.

Guidelines okay and that's the response to the question so given we haven't had any more members arrive in person I'm going to suggest we move on to the next agenda item which hopefully we have Rory um here already um which is the city and Hackney safeguarding children partnership annual report including.

Child Q update report yeah we do I can see Rory you're on the you're on are you okay for us to move to your next yeah of course yeah okay um good afternoon everyone I'll be uh as brief as I can with this uh so uh the annual report uh is presented to you again this is a yearly uh thing that we have to.

Undertake uh and it's uh the health and well-being board consider this report annually uh it's 162 pages long it's covering the same structure as it did last year so uh the report details the governance accountability Arrangements of our local uh safeguarding partnership There's a summary of progress um uh both in terms of the partnership's priorities.

But then also uh what's happening uh specifically in Hackney uh it includes uh a narrative around the lessons we've learned the key messages for practice uh and a focus on our uh kind of training uh and uh priorities uh going forward um I may kind of touch a little bit more on the governance uh stuff as as I I go through um just some headlines if that's.

Okay um so some some positives that we picked out of this reporting year uh certainly the council's audit uh function uh did a bit of a test of assurance uh on the governance arrangements for the partnership found those to be solid uh effective management of risks a couple of small recommendations that we've uh taken on.

Board around the publication of uh minute summary for example uh there's been some changes in leadership um uh and as always with changes in leadership that can be a bit of a worrying uh time but uh I think things have been sort of uh broadly smooth from from Hackney's perspective uh good news in that we have extended uh our membership at the.

Executive layer so we have a much more kind of uh focused uh insight into education now so we've got Mark Emerson who's the CEO of the city of London Academy's trust as a member of the exact working alongside Jackie um and James from the police and our colleague and Diane from health and obviously our colleagues from.

The city as well um and also uh Mark is um complimented by uh Paul uh senior who ATT as Director of Education was already attending um so some of the progress uh areas against priorities health and stability of the workforce maintains a uh or remains a key uh Focus for partners without a healthy Workforce we're not going to be able to deliver.

What we need to deliver our self assessments and staff survey processes we undertook during this year uh you know reflected a message that staff were working hard they were working under pressure uh but actually feeling really supported from their line managers um so feeling like their organizations were uh holding them to effect and that's within.

The context U of of a very busy um uh and dynamic working environment there's some actions for us to reach out and better engage VCS organizations out of school settings and some of our social housing providers but broadly um a positive picture uh in terms of active anti-racism of course the child Q update report has fed into that as well and we.

Know that there's been subst subst substantial work been LED uh by the council in this space still work to do still work to do from a partnership perspective uh but that still uh remains uh part of our Focus going forward some some good work evidencing the engagement uh of the voices of children young people uh a concentration on making sure.

From a practice perspective uh the front line are getting the basics right uh and the appetite to learn kind of remains a really strong tenant that you see throughout all layers um of the system across all organizations from a data perspective things have basically been going up I'm sure everyone's aware of that and will have been feeling that uh.

You know from the early Health cases from the contacts referrals number of lad contacts number of marxs the trajectory has kind of been on an upward um uh uh pathway uh but there has been certainly in this reporting year reduction in CP plans and the number of looked after children uh number of hypotheses that you could juggle around.

In that context uh one of them would be that actually the earlier intervention uh is actually sort of helping whole families um uh before they kind of end up in the The Crisis Intervention of child protection plans are all becoming looked after um so the report itself kind of covers off uh a whole load of different boxes as you read through that.

Kind of detail the Assurance evidence impact and learning uh from from a learning perspective um there weren't actually any reviews undertaken in this reporting period as you know we have the child Q update report and there were um there was certainly one rapid review that we uh commissioned and learned some lessons from uh that related to um a.

Child who was fatally stabbed um over the Border in another London burough Hy child um so training just to probably just wrap up with that um again from a partnership perspective uh about 56 training sessions I think we held in this year so a slight increase over kind of 20 odd kind of.

Topics were covered uh and I think it was about 1,100 uh attendees and ordinarily probably well this was kind of this has been the same over kind of previous years but but 70% of those participants were Hackney based staff uh probably close to kind of 20% of them kind covered both Hackney and the city of.

London so um a good offer um that's that's been taken up uh by professionals and the front line and volunteers across the piece uh and we've got some good evaluations that are kind of evidencing that that is helping the front line understand what they need to look out for and what to do if they think they've seen it um priorities going forward.

Remain the same um and the executive and again I'm just mindful of time here but certainly the executive met this Monday you'll probably all be aware that there's new statutory guidance out in the system uh working together 2023 uh and the uh if Jim was here as the independent commissioner he does.

Send his apologies uh forgot to say that right at the start but if Jim was here he would probably uh be uh talking in more depth about his kind of opinions and his views on the revised statutory guidance it has some good things there's some other areas uh which are raising some concerns uh for us here locally um but also regionally and I would imagine.

Nationally as well and that really relates to how uh some of the uh proposed governance structures are changing um and not withstanding that the significant amount of organizational shift um that local areas will require to focus on um based on some of those changes um that's probably a topic for a different day um but again given time.

I'm happy to take any questions um I see Jackie's on the call if if she wants to come in with anything um uh she'll be more than welcome too thanks very much Rory Jackie is there anything you wanted to add no okay great no lot there's lots of pages there so I think it's the questions that maybe that I might have.

More of the up-to-date information in my head allegedly thank you okay so opening now to questions and comments so uh Francis are you on uh we can't hear you for some reason sorry I was on mute yeah great perfect thank you thanks very much RoR.

For that interesting and informative report however I'm quite surprised that there's no mention of school exclusions in it I mean because we know that school in exclusions are more common amongst vulnerable children for a variety of reasons and that once excluded they become more vulnerable to exploitation and gangs Etc we also know that school.

Exclusions are high in Hackney and disproportionately affect the same groups that you mention on page 103 as being vulnerable to various forms of exploitation I.E young black males and it raises the question why School exclusions are so high for certain groups are I.E those with supported educational needs fre School.

Meals and of a Caribbean background and also why are they that were the exclusion process and prus so hostile and punitive which often which results often in in poor mental health of all of already disadvantaged young people I think this is a real issue for the health and well-being board and for safeguarding indeed one might argue that.

School exclusion is a safeguarding issue in its self so it sort of seems as a little bit of Disconnect between services and strategies that are dealing with vulnerable children and young people I'd like to mention here the work of Hackney um reducing exclusions partnership where various voluntary groups who are supporting excluded.

Children and their families have come together to work in a partnership towards looking for Solutions and also to mention that there's a there's a meeting of of the hack rep on Monday at the Tom Linton Center at at 3:32 discuss these issue and and look towards finding Solutions great thank you very much.

Francis I can't see any oh I've got one other question do you want to come I question and and now a comment and thank you uh uh it was just I welcome what you said and it it's nice that it's not often just me and councelor Kennedy in the room talking about exclusions and the importance of it and talking about disproportionate outcomes for young.

Black men so it's it's nice to know that someone else holds that mantle and holds it very strongly um two things really we talked we often talk about child CU in the context of the relationship with police and safeguarding do you think we are at the place now where we start talking about the context of health and well-being um because often when people.

Have a traumatic experience with the police it's their mental health and wellbeing and the impact that happens after I'm not sure we talk about that and consider that enough in the context or indeed when these initial um interfaces happen thinking about at that point when an incident happens the point at the point of contact what the impact.

Of someone's health and wellbeing is on and actually Echo the points around disproportionate outcomes for young black men and exclusions and the impact on their mental health and wellbe and then they are unrepresentative in talk therapy and early intervention and only end up often in cute care when it's quite critical so how do we how do we.

Plug that Gap it would be interesting to see and also the safeguarding risk if they are not in school they are more at risk to the things that actually in school we're saying we don't want to see that behavior we then put them more at risk to the very things that we say we don't want to see um in the school environment that was a lot there but I.

Hope it wasn't too muddled for you um Rory and and chair hope that was okay thank you right I can't see any other hands up at the moment so perhaps Rory and Jackie um you know as as appropriate perap you want to respond to those two okay uh I'll I'll go first um so thank you um for the questions and Francis you make a really good point about.

Exclusions and I I don't disagree with you I mean as a partnership uh we've done a lot of work um uh on this issue not least through the reviews that we have under taken on child C to sha Ed child ey our consideration of the national panels view into uh exploitation the first one that they did which highlighted quite clearly at that.

Point about the correlation between exclusions and escalating risk um for exploitation so the the recognition of that as being a safeguarding uh theme a safeguarding uh issue both locally regionally and nationally that needs uh addressing has been well recognized uh certainly by senior leaders around the table at the executive uh and and I'm.

Aware that the council was already developing work around exclusions I think the child to sha Ed's case I think acted as a really good Catalyst uh to help kind of concentrate minds and efforts in in in that particular area and there's uh been some really good responses since so some practical things that we've been able to track through.

The partnership around efforts to try and reduce that by no means am I sitting here saying you know that that's been cracked Jackie will know more of the detail behind that um but certainly the connection around exclusions and the correlation with risk is well understood and well recognized by senior leaders around the table at the the executive.

Group uh Jackie may you want to come in at that point um if I may chair um thank you that was a really helpful point about exclusions um as the group director for children education I can give you absolute assurance that we're not looking at this in a silo and um I chaired myself a Summit um on exclusions.

In the summer term last year which brought together children's social care young Hackney School leaders and voluntary groups to look at um to look at the issue of exclusions in the round because they're all our children they're not they're not just don't just belong to a school it's just it's not just a school's issue so um tactically and.

Strategically we are looking at this is a systemwide issue and of course you've got our whams and our cams colleagues who are very much part of our inter ventions to keep children in school and to keep children safe in school I think your point about it not being in um explicit in this annual report as well made um we do have a specific um a.

Priority around the Safeguard in adolescence and within that keeping children in school where we know they are safer is is a huge priority our colleagues in education are working tirelessly with school leaders um to look at how we can be better and the disproportionality is a burning issue for us about who who is who's been.

Excluded um so this is just an ongoing piece of work it's a huge priority for us in um children education and uh I'm really grateful to you for continuing to to raise that and I think it's a point well made about its profile in the safeguarding um annual report so yeah come back back in Lor I was I was going to move on to um Council.

Bramall's point but yeah yeah thank you is that okay so again um good questions and you know no no kind of disagreement from my perspective I mean I think broadening the understanding about the impact um the trauma that young people can experience when they um are engaged by our colleagues in the criminal justice system but not only by.

Them by kind of other a agencies that are from the state so to speak speak we we've always got to consider uh the impact of what that professional intervention might mean for their health and well-being um I think specifically thinking about the child Q uh incident itself we know that there um were local plans that were developed around uh um.

Strengthening a kind of trauma informed response to children who might be stopped uh and uh subjected to an to an mtip or Mor search with referral going through to the mash automatically uh children in custody who might be subject to searching again uh locally there was an exploration around Pilots for for referrals to the mash uh.

For those young people as well recognizing um that actually that provides an opportunity to engage children about their experiences and what they've seen and whether they need any support or services in that context um I I met with the uh home office last week with Jim uh uh around some uh draft proposals that they're pulling together.

Around reforms to the PACE codes uh and there uh is certainly a an interest uh in that space around strengthening uh how the focus on trauma is built into the legislation uh so sitting here now I I don't know the precise detail of what that will look like uh but to me that sounds a good thing uh if we're kind of mandating that.

There needs to be uh focus and a wider focus on how uh the trauma that can be experienced by children young people uh who are engaged by the police and by others but having that built into legislation as part of the pace codes it's a specific issue but to me seems to be a a sensible Way Forward there's other aspects around that that I I.

Probably wouldn't agree with um uh not necessarily that that particular issue itself but um yeah it's a point well made and I think there is a wider debate to be had about how we uh kind of move uh beyond the incident of child q and thinking kind of more systemically about other issues where health and well-being is kind of.

Impacted um uh on children young people great thank you very much um I can't see any other hands up either in the room or online I'm going to suggest we move on to the next agenda item I think we're now cor we are we are so um if I can take everyone back to the start of the agenda and the updated terms of reference um there are there is an.

Addition of the community voice commitment in the terms of reference and uh we have added Sr strategy as a named that's a sexual and reproductive Health strategy as a named commitment in the terms of reference as well and we're just I'm asking that the health and well-being board accepts those changes to the terms of.

Reference Sandra thank you chair I've got a couple of comments although I've lost the page but one of them is about um naming both the the sexual health strategy well more than the sexual health strategy tobacco strategy and various um public health strategies um separately um kind of suggest that every time we have a new.

Strategy we'll need to update the terms of reference and I'm wondering whether we just say public health strategies and don't necessarily have to name those specific ones there are some sorry I've completely lost the page but there's a number that are named that it makes sense to name separately like the joint health and well-being strategy and some.

Other partnership strategies um but it doesn't but we don't NE need to name every specific Public Health one um and the there was other another just a correction really which sorry because I can't find the page I can't tell you where it says um it's the first time it refers to pool's budgets it says pool budgets and it should say pulled p.

P l d i don't we're building a smon pool um although that would be I'm sure that be very nice for residents um okay uh councelor KY um thank you given that we have got that list there um I just wondered should the we've just undertaken a duty um about um the community drugs partnership haven't we Sandra is that what it's called the.

Combating drugs partnership um should that be there as well um so the combating drugs partnership really reports to the um Community safety partnership rather than here specifically but um we could make reference to it because obviously there there are health and well-being P um implications and not just Community.

Safety implications of that work okay so the suggestion from Sandra is that instead of naming each of the public health strategies individually that we change the terms of reference to include reference to public health strategies um which would make it simpler from a governance perspective and because we wouldn't have to bring.

Have to make a change every time which um is a sort of pragma pragmatic approach would seem quite sensible so I guess that is what I'm double-checking with everyone and people are happy to approve that yeah spefic yeah yeah people happy um and then there's a specific question around the combating drug.

Partnership and just the reference to that health and well beings in in words that uh are acceptable to our director of Public Health okay um and we are happy with the addition around Community voice voice commitment y okay great so I think we can um approve all of those yes thank you great so I'm going to keep us going through the agenda now and we on.

Now on to the annual director of Public Health report for 2324 including confirmation of the themes for 2425 so welcoming Chris Danny and Tony I don't know which of you it's a good question I don't know if Chris wants to ch so only really to to just offer profound.

Thanks to Dany um who's produced the latest director of Public Health Report um it's great to see I think he's at the end of the the the table but I think Danny's going to give us a a brief synopsis and then um Tony's going to uh talk about the the theme for the next director of Public Health Report okay great thanks very much okay.

Danny so you seen in the pack and maybe on the web um the uh annual report uh focuses on sexual and reproductive Health it's quite lengthy so we produced a summary document uh to accompany it um the sort of key message uh a key message is sexual reproductive health is a Cornerstone of good population Health generally but having said that we chose.

To focus on uh the young those under 30 because they are those that that currently make most use of uh sexual and reproductive Health Services um furthermore while sex transmitted infections is is only a small part of the general field of sexual and reproductive Health it is striking and this is highlighted in the summary.

Document that hacky is the fourth highest rate of new STI diagnoses in England um and the top Place uh goes to city of London which is Tiny so to an actual fact we we're very much uh dealing with the wealth the high burden of new STI diagnosis um and one of the the liking things that came out of the um the.

Research and interviews for the report is that testing for sexually transmitted infections reduced dramatically as a result of the covid pandemic and has still not at least at the time of writing report managed to get back to the pre pandemic metals and this is sort of an urgent area where where we feel that.

That work needs be done the report makes five uh recommendations the first is the need for um Community involvement uh to be doubled down upon and uh the council and other stakeholders commitment to co-production should should be really looked at again and that is the anchor by which or the the lens to which all.

The other recommendations should be viewed um the second recommendation is that um we need to make Services easier to access to particular particularly to younger people um the third recommendation which is linked to that is that um people need to be more aware of what services are available um there's some uh confusion and some.

Difficulty uh in getting information in some areas uh and there's more detail in the full report the fourth recommendation is the need to focus on improving collaboration between the various stakeholders both NHS and um civil society and uh Council um particularly in the context of uh relatively uh tight Financial restraints.

Bed with increasing need and the final recommendation is is simply a a call for of ongoing research but particularly with a focus on trying to address those inequalities that that may be identified um there is more detail about in the B report about particular areas where you might want to Focus attention on within those.

Recommendations um but that's the the the general overview of the and and the desire to really um uh raise the profile of this issue in general um I think that's that's enough in terms of the summ from me right so do we want to before we take questions about the whole agenda item do we want to now move on to also talking around the confirmation of.

The themes Chris you mentioned that Tony was going to cover those yeah yeah I think it probably take take it as just one item soy yeah thanks Chris hi everyone um so moving on to the plan going forward for the dph reports for 2024 and 2025 we decided to focus the topic and the themes for the next two years on Social.

Capital so the rationale for doing so is a growing body of evidence that showing a correlation between the increase in Social Capital and improving outcomes on a a variety of metrics not least of all Health outcomes so that was particularly evident during the pandemic as we saw the communities coming together and we saw them supporting each other in ways.

That had quite a profound positive impact on health and well-being and we we want to work off the back of that and and see what what more is is available to us there so given the complexity of the the topic we've opted to break it up into a two part approach and spread that over those two years of the report so in 2024 the plan would be to focus on.

Reviewing the evidence base that there is for social capital and health and seek to answer some fundamental questions about utilizing Social Capital at the community level so questions such as how exactly do we Define social capital for public health um can we build it and if so how do we build it how would we then measure it and what.

Does success in measuring it look like um and ultimately what is the role of local Authority and public health teams in doing this and then the plan would be in 2025 to take the knowledge and learning from that first year out into our communities and aim to work collaboratively with them to create a essentially a practical and useful.

Action plan that can have measurable benefits for the residents of Hai and for the city of London so throughout those two years run along alongside those two report outputs we're planning to run a supporting Social Capital Advisory Group so that group would consist of members drawn from across sectors so including VCS the council NHS.

Academia independent consultants and a a variety of others and the purpose of that group would be to help support and guide the overarching project and also provide insights and expertise from the various members backgrounds on on the board and essentially to ensure that we're capturing a very complete picture of what social capital looks like at the.

Community level and how it would impact our residents in in Hackney so with that in mind we're actively seeking for interested partners for the group and we would certainly welcome participation from any of the members on the board at the moment and we're also very open to any suggestion of partners that the board may have that.

They think may have particular Insight or expertise that they could lend in the area so so I I think that summarizes it nicely I think I'll stop at that point and um I'll open it up to the board to say if you have any follow-up questions any comments for either myself or for the other members of the public health team that are present such as Chris and.

Sandra right okay thank you very much uh for those two presentations so we'll take um questions and comments about both the Public Health Report and also the confirmation of the themes um and so I've got one hand up so far in the chat Francis thank you um I'm I was very interested to see you focusing on Co Social Capital I think that's I think.

That's a really interesting idea and a really important idea it's it's my I just wanted to have a plea really to work very closely with the voluntary sector which is very strong in Hackney and it's a major a major sort of um column of social capital in the Barra and an awful lot of people do an awful lot of good.

Stuff working with communities and as as being an both an interface a supporting the supporting groups and a range of other things I think that that that came out really strongly in the in co under covid as well in terms of the work that was being done by a whole host of different Community groups so it's a plea to involve them really.

Strongly um just to come back on that your ple has heard we we already have um contacted Tony Wong on the Hackney CVS side and we'll have a representative from Hackney CVS we also have a few other members from the VCS Community including for Orthodox Jewish and other voluntary units within Hackney so your players heard can I can I also mention.

That not everybody knows what the term Social Capital means so if you're asking for people to be involved in a social capital group they might say well what the hell is that so you might need to be just a little bit more specific thanks Francis I think you rais an important point just in terms of terminology and understanding um it's.

Actually simplify making that as simple and as easy to understand so that you get the right engagements key okay so I've got councelor Kennedy in the room uh yeah thank you um uh uh thanks thanks for this year's report I absolutely love the layout and the stick theme um it it makes it so much easier and more pleasant to read.

And look at a report but when it is presented that that beautifully um and uh long long may that continue um uh I'm really really glad that that first recommendation about Community involvement is seen as an overarching one and and one as you said that absolutely all Partners need to double down on um because that will be a theme.

Going forward um it will link in some ways actually into what I agree is a wonderful theme for the next report um uh soal Capital um all sorts of um Partners but I'm thinking particularly about um local authorities and NHS Partners talk about how important it is to encourage those groups those organizations that are.

Absolutely closest to Residents um um so those locally born ones that flowered flourished grew up during the pandemic um many of them out of the necessity of the pandemic but um many of which have carried on in in Altered forms um and everyone is beginning to recognize that the only way you can do what everyone always wants to do which is prevention.

Or what the NHS now calls proactive care is by involving those those organizations and where people um are closest to um other in their Community who are helping them so um I think that you could do an extraordinary piece of work there about what is going on in in city and Hackney and perhaps in a way that could help inform other places um.

About how they can best use soal Capital so I will um support that in every way that I can thank you okay Sandra um thanks I just want to start by putting on the record my thanks to Tony Delany who couldn't be here today and Danny for the incredible work they've been doing Danny's Danny on last year's.

Um report and um Tony and Delaney on the the ones that are to come and and also just to give credit to Danny for the um design of the Sexual Health Report which it was his idea and um he worked with the designers and got permission from the artist um to execute in that way so well done and thank you and I'm glad it's having impact but I wanted to just.

Come back on the point about the definition of social capital you're absolutely right I think the reason that we didn't go into that in detail because we didn't want to write a whole pce about all the different definitions of social capital for this board report but that will be one of the things that um through the work of The Advisory Group.

We'll be teasing out in terms of what does it mean for us locally and in a practical sense about how we can use it as an both as an idea but also as something that we can build um in partnership in order to improve health and reduce Health in inequalities so so when we come back with the annual report there'll be a much clearer definition of.

What we mean but for now what we're really just talking about are those connections between people that um improve their lives and in particular improve their health both an individual and also a community level great thank you Sandra and have just echo my comments around the summary document it was really nice to read um.

And uh as simple as as simple as you can make the topic um with good good photos which definitely P Drew you in so thank you very much for that um okay any other questions or comments on this if not um I will move us um on but lots of interest in the social capital theme for 2425 so it's back um when the time comes okay moving us on now to the next agenda.

Item we have the community voice Northeast London big conversations and the hacky findings and welcoming s thank you and and I'm really delighted to bring this in today this been a huge piece of that's gone across the whole of northeastland and it's been fantastic just before you carry on tell I just want to check can everyone hear Sally on.

The on the chat okay good just double check thank you um it's been been fantastic to feel that there's been some real partnership working that's gone on between all the watches across Northeast Landon and with the NH on this um in Hackman we we we undertook a series of surveys um Workshop events in smaller focus groups for T.

Communities in particular on the health webs side we Linked In with for instance turkey speaking Community um black African and black Caribbean Community we work long-term conditions we work with service uses using the long Co service to get a real local perspective on this bigger piece of work Northeast London what's come out it this is a matrix and.

I hope this I won't go into too much detail because there's too much in here to go through and hopefully people all had a chance to have a look at reports this is a mat to really look at whether you're delivering a service whether you're commissioning a service a step back and think is this service accessible are what we is is what we.

Deliver in competence really thinking about that first and centered in that trustworthy aspect which is this is what the residents on the ground are telling us that they want and need from services that they access and it's that what that means is broken down throughout this report I wanted to give I think you can read the.

Report for yourself but just some real local examples of things that we heard when we talking to people think about accessibility it can be the real big meaty issue so language is something that particularly comes up locally in Hackney we give a lot about the need for um interpreting services so one of the things heard speaking to the Turkish.

Speaking group for instance was some of the ladies that we spoke to in that group told us we do have AIT of English which means that we're able to walk into the service say hello say who were here to see and we're then met with the assumption that fine you can speak English there's no need so so no interpreting is offered actually when.

We're then speaking of a clinician we've got no idea what's what's being said because you've gone beyond the level un standing by so there's bigger issues down to things which and this is why we want people to use this Matrix to stop and take a step back and look at the whole of their service I'm not going to name the service because we haven't had.

A chance to have conversation with them yet but an example with this is there's a newer service um a service service and told us that she was pred by her GP to go to this this service and was l in a wheelchair she said service itself it was well sign posted it completely accessible but the approach to get there there was a curve it wasn't dropped down.

And as a result of that she really really struggled her to ask people fine to help her and so sometimes take a step back we think we've done everything we can let's look at the bigger picture and make sure we've captured everything um things that we've heard locally in terms of really some good news but um the Hy we spoke with service users of the long.

Covid service to understand their experience thinking about long-term conditions we spoke about person centered and we heard so much about how responsive the service was they listened to their service users when they told them this is what's working for us this isn't this isn't working we'd like to.

See more of this we'd like to see change which is made what we heard from that grou was service listens they involved us they allowed us a SP space to share they went to back got to change his work and that group in particular talking to me and saying we would like rest ofice London we believe that we've.

Got something special here in happy and we believe that that doesn't happen enough other for us we so I think that be interesting and throughout the rest of the report you can read through it it's it's it's not just looking at I had to sense people think you know this is all about just real the health care services actually.

There's a lot in here about those wider determinance of health so we've heard a lot from people about what makes us feel happy and healthy in the space that we live so people spoke to us about an social behavior fear people spoke about the importance of spes and feeling that those spaces are there but then we heard.

A lot about people wanting to be free which I think we've heard about it this for to be themselves to feel accepted without stigma they're accessing Services whoever they are um I think I'll leave it there because there's too much to really go through and open up for questions but our hope and our Fe is that people will take this away use it.

As a tool to look at the services they deliver and what I would say to people is if you feel Hang on we're coming up short in an area with my health Co have on the answer is engagement talk to your talk to people that use your service find out how to make that change in a way that's meaningful them and if you need any support to do that have to help.

Which be very happy to help you with that process ESS for we great thank you very much s so opening now to questions comments I've got councelor Kennedy in the room yet um can I just check how many it looks am I right from slide three you spoke to 57.

People uh yes that's that's the people that we spoke to locally and then that fit into the bigger this bigger piece of work ISR P land which I'm sure what the what um so uh I'm worried that that's too small a number of people and and I'd love I was expecting it to be more and and I I'll tell you exactly why it was.

Because when I went to the N integrated care partnership for the whole region I think Charlotte said the big conversation had spoken to 2,000 people I can answer to that a big convers I I believe that charte was including the survey respondents in that figure right as opposed to the people that we've engaged and this isn't this.

Figure is the people who've engaged through workshops and events face to face conversations I have to I can check you the number of the survey respondents Bo Lally but I believe that that is the case that bigger of 2000 I don't think that's 2,000 people that be supposed to to face to face in workshops or focus groups I think I see.

So all the the data in your slides is that based on the survey respondents and the people you spoke to face to face or is it just the 57 people you spoke to face to face the demographics in this this slide would be based on people that we spoke to face face however the the overall findings most most of these slides the.

Overall findings these are the same slides that be presented at health and wellbeing boards across the patch so these pillars in this Matrix isn't specific to Hackney but the work that demographic shows you the work that had done to feed into this if that makes I see.

Okay yeah oh I see and then where you've got data further down you're talking about so it's integrated from across the board okay so I think that's giving me more yeah that's giving me more comfort so further down your presentation pack you're talking about the whole survey that includes the the uh but is that.

Then City and hatney aggregated or or are those then n which P which page one well I guess the thing that's a little bit confusing is that I think this is a pack that's been produced for a wide audience and there are some specific references on some of the slides which say what does this mean to you know recommendations.

For babies children and young people in Hackney I guess the question is are those recommendations essentially does the pack sort of insert the different places depending on where it's been discussed or are the the slides which have which specifically re re um reference Hackney are they specific for here or is that.

Sort of commed assumptions from a nail wide perspective is that what you mean it it is and let me give an example so um uh slide 14 we're doing a Hackney and Northeast London comparison so actually it's not quite what I mean chair what I mean is.

On slide 14 a week and is that about 300 hatney respondents their response compared to the 200000 at Northeast London level so is that based on survey data or your 57 face- tof face data I think I need to go away and check that where I'm looking at the slides um I'll give you an examp example um that's.

My slides I'm looking at a slide about competent care which says 27 mentions from 23 respondents that's based on our local responses not across the whole the whole of Northeast London and then so here I'm reading compared to Northeast London in total have responsible more.

Likly find that they're looked after by FR professionals who understand their specific needs so the slides within this arey specific the figures I think some and some of the slides because you can see references in small type to some of the differences where it Compares Hackney to nail wide are from surveys so this is a Hackney lens on it so they've.

Extrapolated what was the survey results for Hackney residents versus the nail wide um but I guess I think it's just understanding where that the sort of key what's really good in your presentation is you pulled out some of the key um Hackney themes um that were relevant it's just sort of identifying those being able to immediately pull.

Those out from the pat yeah it is I mean I guess the thing that's that's coming to my mind today is if there were elements in this that particularly useful and interesting with a happy lens we we can take this is we I mean we heal for just planning our our work plan for 2425 now so we can take some of these elements and say this was.

Interesting build on and develop that work any sphere of this they're more interested in it's great timing actually as we thinking about work plan for 24 to 25 to think which elements we really dive into a bit more thank you any um any other questions comments suggestions on this so I guess it's an Ask of the group.

Here if there are specific things from the pack that has been shared that healthwatch can take forwards as they start to plan their 2425 um workstream it's really sort of flagging that to you okay yeah FL flagging that to you directly um so that those you can build that into the discussions but I appreciate it's.

Difficult when um when there's multiple different sources of information that are coming through and how that's been Amalgamated in terms of a pack it's um yeah the way it just the way it's been produced okay so I think we finished on that agenda item now so moving as now so we've got two um two different.

Presentations we have the sexual and reproductive Health strategy and then we have substance misuse as well and I think the suggestion was that we take hear both of the presentations and then we'll take questions uh from both afterwards questions and comments from both afterwards is that okay with everybody Chris Chris yes so apologies.

Sandra had to leave um but just in terms of the sexual reproductive Health strategy that there's a slight um error that occurred in the papers so we were hoping to seek the board's approval for the strategy but also to sign off the action plan unfortunately the action plan wasn't circulated um with the papers it is quite a detailed action.

Plan which has gone to Partners um for pre-approval but we were actually asking for the board to note the action plan and then it becomes part of the strategy and be updated with an annual base so I think the suggestion was um we can either um uh delay the decision on the action plan um or potentially by chair's action um give you the opportunity for.

People for seven days to comment formally on the action plan and circulate it to to members of the board and then unless there's any objections by chair's action it could be approved to to move forward or delaying it to our next meeting would cause a little bit of difficulties because we are so Keen to get on with the action plan it's uh with.

The action plan as well as the strategy but I think um uh I can see partners um on the call but you know the key Partners have already seen the action plan and have essentially nodded that they're content with it but we would obviously just give seven days as a a kind of for any last minute um uh comments so a proposed to either delay.

It which we wouldn't be particularly supportive of but would understand in terms of governance or by chair's action seven days to comment and then approval chair's actually yep people happy to do that in ter terms of um given that many people um in the group have already seen it but appreciate that doesn't apply to everybody so we we'll.

Hear the presentations and then we'll circulate the action plan and then we can do that by a chair's action I guess Chris just asking if there are some specific headlines on the action plan that you think are important to weave in um as part of the presentation i' just ask that you just incorporate any key headlines from the action plan just to.

Give a bit of a FL so that when people come to read the document after the meeting they know you know where where are key places to be looking I think that would be quite helpful thank you and and I was going to hand over to fooks to to give the presentation and fooks I think we will give you that assurance that you you've seen the.

Action you've seen the the strategy and draft version already it has been out to full consultation and the action plan has been developed as part of that so it's not something that's just been dreamed up by fs and myself in a darkened room so FS I guess if you could just um pull out any you know key things from the action plan highlights just as.

Past the end of the presentation that would be really helpful yeah okay thank you very much um yeah so uh to be honest it is a bit of a moment as this has been quite a long process um from last year June to now um and I'd like to just talk you to through some of the key phases and how the overall process shaped the strategy and the action plan and of.

Course a lot of this is covered in the papers that were attached so I will be can I just interrup for one second can you just move the microphone on your headset slightly closer okay is this better is this better yeah it's a bit better if you just speak speak loudly that was probably probably thanks well I I.

Normally have no problems reaching a room because I tend to be loud but um yeah it's um it's a well yeah D's um smiling in the room um so uh uh yes please just I think it's something just do we're turning up the speakers here just so that we can hear a bit better so sorry for interrupting but yeah please carry on okay all right thank you well.

I'll try I'll I'll be loud better great um so yes uh as you know the initial draft strategy was presented to yourselves in June 2023 as well as to uh the city uh health and well-being board and you both agreed on the consultation process we then had an online survey open uh from the 1st of July closing in.

September and this gathered 102 responses from City and Hackney we also developed an easy read survey uh uh for people who were not comfortable with u reading an online survey and for people who with learning disabilities and that had an additional 13 responses we we had a number of online and imperson consultation sessions uh some of them.

Were theme based some were audience-based and that way we were able to engage with another uh 94 people in total and another 20 through workshops with uh key partners and stakeholders and um yeah to promote the survey Etc we use the number of methods and those are all listed in the in the presentation uh and those kind of.

Engagement events ran into October November to ensure we had sufficient engagement with different groups now all the consultation uh findings notes recordings written feedback Etc uh found itself its way into the redrafting of the strategy and the formation of the action plan and it was also very beneficial to have the the.

Views and the feedback from the the hne young people scrutiny committee who reviewed the draft strategy in September uh especially in relation to the provision of relationship and sex education in school and Sexual Health provision for young people what to me really stood out from the consultation and the overall.

Feedback was that people who engaged were very invested in it either from a personal perspective or personal experience or on behalf of their children and young people or their communities and to just summarize a little bit uh the consultation showed us strong agreement on the themes and priorities priorities identified uh for.

For example very strong affirmation of the importance of relationship and sex education in schools and also for example that all residents should be able to recognize whether a relationship is abusive or unhealthy another key finding and that has also very much been mentioned by by Denny the importance of involving the people you want to reach.

In the development of your materials and your campaigns Etc so co-production the the key the key barriers that were named were lack of knowledge of and lack of access to Services again what Danny also also found in in his report and I think uh it's important to mention that stigma and shame attached to sex and STI and.

HIV persist and uh as one uh participant noted people don't know what they don't know and that kind of applies to all of it whether it's lack of knowledge lack of access um how to be able to to make healthy decisions for yourself if you don't know what you don't know how will you make an informed decision uh another key finding was that Services remain.

Fragmented Across The Wider sexually and sexual and reproductive Health pathway often due to the fragmented commissioning responsibilities so as a result of the overall consultation process uh we did re revisit and hopefully strengthen the strategy uh by for example being a bit more inclusive around reproductive.

Health uh by including fertility and assisted conception we also made better mention of the sexual assault referral centers um we rewarded and strengthened the the the theme five around inclusion communities and complex needs uh Stronger focus on co-production and also for example uh include living well with HIV in addition to talking about.

Prevention and treatment um so in terms of the action plan what people brought to the table really made it clear that um we need a central online resource for sexual and reproductive Health to provide information advice and signposting to all relevant Sexual reprodu Health reproductive Health Services in city and Hackney with for.

Example booking links where possible links with you Communications and engagement uh strategy and uh an awareness campaign around sexual health and but in doing that with a stronger Focus again on co-production of materials resources campaigns with specific population groups or service users uh in relation to you know whether.

It's SDI testing or contraception or any of the other subjects uh a key element of the action plan is also joint working and where possible um you know maybe joint commissioning or um having an alter trying to be less fragmented with our commissioning for example in the areas of young people and education substance.

Misuse uh communication and health literacy more broadly and inclusion groups so for example with regards to uh relationship and sex education in schools we would definitely advocate for closer collaboration between Public Health young Hackney education and the schools for example and uh overall partnership working will be key to the.

Success of the strategy and the action plan so that's where we are at now um revised strategy and a fairly elaborate action plan as Chris already said um and of course the the added issue that unfortunately the action plan as such was not included in the paper um but of course any plan is only as good as its implementation which is.

Why we are also suggesting that a joint subgroup of both health and well-being boards would be set up uh providing a partnership and Reporting process to ensure oversight of the implementation of the action plan and its continuous alignment with the strategy and this would obviously involve regular meetings to assess progam against outcomes as.

Well as at least one annual planning exercise to agree the next year's action plan for submission to the boards uh in terms of next steps it will go to the City Health we health and well-being board next week Friday and within hacky uh the strategy and action plan or this will be considered as a key decision to be taken in cabinet which is planned for.

February 20 uh 2024 thank you for your time and also for every partner and every stakeholder and every resident who engaged and and gave their time and their views and their insights uh it is greatly appreciate it thank you great thanks very much Brook so please just hold your questions or comments and we'll just.

Take the substance missuse presentation next and I think that's Andrew oh yeah I can see you on the screen Andrew welcome and uh and Simon as well yeah Simon hear in the room okay so um we'll take that presentation and then we'll take questions and comments over the two so I don't know between Andrew and Simon who Andrew are you kicking it.

Off um yeah we just uh paper speaks for itself for the most part uh I'll just hand over to Simon for a very brief introduction but then happy to move straight into questions thank you thanks Andrew thank you chair uh so it's a brief uh for information paper uh just covering what we've been developing as part of the combating drugs partnership.

Locally in Hackney uh the paper starts with some general National context so a brief discussion of the national strategy some of the key aims which national government has outline for all local authorities to deliver against alongside the directive to start new Partnerships called combating drugs Partnerships uh the paper goes on to.

Then talk about the exact structure of our combating drugs partnership and the number of partners that we have involved the various different working groups who are overseeing different aspects of our strategic AG we want to achieve paper then moves on to discuss a little bit in terms of operational outcome two key highlights so really.

Good improvements in relation to our continuity of care for people who are leaving prison coming back into Community Services as well as a modest Improvement in the number of people accessing Services uh which in light of the local context around us so with neighboring borers where there is a significant decline in the number of.

People accessing Services is actually really positive Improvement uh the paper then go on to detail the fact that Ohad uh sorry the office of Health Improvement and disparities are really happy with our performance and really happy Happ with the governance structures that we've created this is leading them to continue enhance levels.

Of uh substance funding for us as part of the supplementary subst achievement and Recovery Grant next year we stand to be able to access around about 2.9 million pounds worth of additional funding to help further improve our services and our system uh finally the paper then goes on to talk about what we want to try and utilize that money for.

So looking at increases in access to impatient detox and Rehab as well as further investment in local organizations to help ensure that we're always engaging with the Grassroots Community understanding in relation to drugs and what can help um support people through in their treatment Journeys I think that covers it for me.

So happy to opens the floor for any questions okay great thank you okay so if we take um questions and comments on the first at the first of the two presentations if that's okay so on the sexual and reproductive Health strategy so um I think Han went up and H went down but I will'll take that first and then we'll take substance misuse C.

Pened um yes so the sexual and reproductive Health strategy thank you fuxs I think that's in um a really really great shape um lovely feedback um and actually um Deputy Mayor Bramble and I um have had a series of questions that have come through to us from the children and young people's scrutiny commission that um Chris is helpfully.

Working up our response to and I'm really Keen that uh we weave in reference to the strategy um and how we're actually going to uh take forward uh the recommendations um and and the work of that um uh into our answers to that commission um at the same time as far as possible Chris referencing the um uh the annual report um that we looked.

At earlier um so that we weave the two into together and and the children and young people's scrutiny commission um uh see how much good work is going on there the uh the one question I have is that Central online resource that I agree is absolutely key to making sure that the strategy can succeed and deliver for uh residents where's the where's that going.

To sit who's who's going to hold that what does the action plan say about that okay thanks very much I've got one hand up online so if we bring in baz now and then we can see if there's any other questions or comments and go back to F and Chris B thanks F I was just pondering on that issue of people not knowing what.

Services are available so the lack of knowledge and just wondered whether it relates to a particular group or whether there's something else perhaps it's digital poverty or something like that so I thought it was interesting I just typed on my phone Sexual Health young people and the first link I get is the happen the young people of a list of all.

Of the clinics you can go to the opening times good advice actually on them that was like in 10 seconds but yet we've still got people who in your survey say they don't know which services are available so I just wondered whether given this age of young people have had access to Internet and they they might have got there quicker than I did in 10.

Seconds what whether um there's something else about those group who say they can't access it because the link that I've just seen in 5 seconds is brilliant so yeah I just be thought it' be helpful to think about how we how we resolve that okay FKS are you okay to take those two.

Questions and comments yeah Chris do you want to come in oh I'll take the first one and then FRS the second one okay thanks Chris okay so so um I mean the aspirations that we've been working on we've been trying to share as broadly as possible because with sexual health services they're quite unique in that people do.

Choose to go out of area and people choose to come into area as well so we have been um working with our Northeast London local authorities and also advocating loudly nationally as well as um across London because I think a lot of the issues that we're raising we we're very very certain they're specific to city and Hackney but there's almost.

Certainly evidence that it's not unique to city and Hackney and the issue of a central resource um is a really important one so there is NHS choices um and there is also um the local authorities uh websites and also the homan's websites but I think what we do have is is quite a complicated area where some people can access some.

Services and some people will choose to access others so that Central resource is really important uh we are looking to update our making every contact count approach and also the council's um uh uh repository of information but I think at the moment especially in terms of the online services so there is more and more services such as access to.

Contraception and and STI testing which is available online but actually having that single portal as well as all of the social media such as Tik Tok and Instagram and everything that young people um use is important with our hered community what we've heard um and it's not unique to sexual health is that don't just put everything online because.

People won't be able to access it and so it is important that Primary Care both Community pharmacies and GPS are also able to help navigate people as well into the services um so I think on the central resource the simple answer at the moment is that we're looking at options we'd very much like to have a Northeast London approach because we.

Think we do get benefits of of scale and it would be if there's capacity at the r London Hospital if there's capacity at newm or capacity at homon it does seem to make sense to Residents when we talk to them that we give them the choice of where to go um obviously the homon is a very very well respected service and we would hope that they would go there but.

For some people's speed is quite important of wanting to get their need their need met so I think that's probably it's still under consideration um we will if if we can't make progress at a Northeast London or London level we will definitely do it ourselves locally to get that Central resource okay thanks Chris FS yeah um.

It's actually it wasn't just young people who who said like oh we don't know what is where yes they can they can access things online but for instance a lot of young people don't know that they can access uh testing condoms um and um EHC at at pharmacies for example um there's some people don't still know know about shl about going.

Online but also uh some of the the the service users who use the the easy read survey for example were were like oh well for instance talking about STI testing um well if people know where to go they they should be they could find it if they knew how to look for it so it's it's and and the other element of it is is the confidence in accessing the.

Services and that I think especially for the young people um is something that also came up in in the conversation uh with young people like first of all you have to know what there is and then feeling confident and and comfortable going there and so um yeah there's kind of two two aspects to it but it was not just young people who who had were not.

Always sure what services were available and where access them also for instance for for long acting reversable contraception yeah any other questions or comments yes I've got two in the room thank you chair just on that point and linking back to what you was saying earlier about uh post pandemic and people accessing the.

Service hasn't gone up uh to the numbers that we saw before I was curious to understand if that was young people not uptaking the service or older people uptake the service and was there in Trends in terms of people that were accessing the services that are not now and if they and in that way we can then think about how we target those groups.

In terms of speciality I don't know coms engagements that was what came to mind chair when I heard all the different officers commenting on this we work do you want to respond now and then we'll take the last I think there were issues as a result of the pandemic with certainly Clinic times changing and things like.

That did have a particular impact on young people accessing I think most of that has has been reverted and put back into place during the pandemic there was a changes in the way people were getting appointments and I think that frustration is sort of ongoing okay um but improving um and in terms of the impact because young people are those.

That are using Services the most any change impacts in most chair can I just said that's really helpful to hear because it sounds like the challenges quite easily rectified in my view just the case of changing when the service is accessible that sounds like something that's straightforward and not as biger challeng.

Capac probably yeah one one would hope that it was a straightforward you as you've outlined well I guess the hope is that um people have previously known how to access services so actually there's something about reigniting that um the internal to psychology around actually yes you do need to continue to do what you were.

Doing before and then that passes on to uh younger people coming up into that sort of age group rather than people who have never engaged um with with testing so different challenges hopefully lesser challenges and Chris yeah so I don't think yet um we have a duty of caner but at the same time I think it is important to be um honest about the challenges as.

As well as um some of the opportunities I think we we have seen a um a resurgent of people uh coming forward for STI testing as well as STI and things like effective partner notification are really really important we think we can almost certainly get more people who have been at risk because a partner has actually been diagnosed with an SDI.

Tested and treated one one of the issues that is definitely uh for all the local authorities and you may have seen it on the BBC News over the weekend is the issue of the affordability of the services our providers have all been working extremely hard to actually get the most effective way of delivering these services and moving some of the.

Services online the STI testing is part of it but at the moment we haven't seen inflationary linked pay increases or or a grant increases for the service providers and I think it is really really important just to highlight that the moment we have got a very significant funding challenge in order to actually meet the aspirations of our.

Sexual and reproductive Health strategy I can see baz is is nodding profusely um and I think is going to come uh even more to the four we're obviously entering into a year of where there will be um almost certainly a general election and it is one of the areas that there is a lot of advocacy by um local government associations and the.

Directors of Public Health to highlight the fact that Sexual Health Services in particular already make up a very large part of the public health Grant if we are to meet some of our aspirations then we almost certainly will need to invest additional resources into this to to make good on our aspirations I think there are things that we can do.

Differently in the action plan does talk about that and having a less disjointed service and also looking at some of the areas for opportunities to do um better service provision around what's Cally called chemsec so people who are using uh illicit substances but also for the purpose of enhancing their sexual experience so there is a link between.

The work that um the combating drugs partnership and the sexual health strategy but I think it would be a disservice for us not to say that the big elephant in the room really is how we actually um try and become even more efficient I think there are limits but also then be advocating very strongly that this is an area where you need.

Investment from national government in forms of an increased Public Health grow okay thanks Chris that's really um really helpful to just give a bit of a reality check as well on sort of where we are in terms of kind of service provision going forward okay so I'm going to move us on now to questions or comments around the substance use um.

Agenda item Francis thank you uh I've got two uh related questions first one is are you commissioning any volunt sector groups in order to access those people who are reluctant to engage with mainstream services and if so um are those Ser are those Services commissioned over a reasonable time.

Frame let me give you an example a while back I did a focus group with with with a group that had been commissioned for a year to provide services and just as they were starting to be really effective um the the the financing stopped and I have to say there were a number of pretty distraught people in the room about it so it's really.

Important that commissioning does take the does take that sort of time frame into account okay thanks we just got one question in the room as well I'll take oh I've got two you want to go first yeah thanks very much and apologies again for joining late I'm sure my colleagues P my apologies I was.

Attending a community event down the road it is not a question it is a comment around the combating drugs partnership can I just say thank you to Simon and Andrew for the update but just want to say would be good for us to get the combating drugs partnership meetings uh of the ground where we have Community safety and the police can feed.

In as you should be aware we do have uh in the burrow we do have the uh combating uh substance misuse pre 2022 when there was that statutory requirement from the home office to set up the this board and since then the other board was deleted and nothing has really happened here where strategic partners are able.

To feed in it would be good to together that not too sure is he was mag started before she left and nothing has happened since okay and we got one more in the room yes it's in relation to I think 2.9 um in the report so it was talking about the fitting hne combating drug partnership and I was really I really welcome the different layers that you're.

Looking at around um looking at adult social care children social care but you're also looking at people's mental health and well-being physical well-being if they've been in contact with the criminal justice system I just wondered over time if the partnership was going to look at any any data set and if so if that data set um highlights.

A particular either uh gender or ethnicity what what that group is who is that gender and how that could be targeted and if that could come back here because I have my hypothesis chair but it's some of the it's the outcomes and groups of the same groups that we were mentioning before but that's my hypothesis but it's important that we.

Have the data to strengthen that or actually dispel that hypothesis of who I think those outcomes May lie um so yeah just your Reflections on that but I really welcome uh this approach it's really really good to see thank you great thanks uh I can't see anyone else um so I guess over to Andrew and Simon to pick that thank you chair uh I will.

Try and take them in order apologies if I got your questions uh wrong uh so the first question counselor yes we do currently commission some voluntary services to work with folks who are the furthest away from treatment so those who may have a number of additional barriers to to certainly working with our core.

Substance use service um we work with swim who work with older black men to try and ensure that we've got good levels of impacts there we work with St Charles who are providing enhanced levels of support for folks to enter the employment field where they have more kind of complex support needs in their presentation we are hoping to use the.

Additional funding next year uh to work with a number of uh other groups to help ensure that we are bringing more people through into substance use treatment uh there is a young lero so a lived experience recovery organization that we're hoping to fund to make sure that we've got the idea of peer Le initiatives integrated into everything.

We're doing with the the system we are also currently working with an organization called the London joint working group for the elimination of hepatitis C uh which is a mle so I will say ljw from here on out but they're looking at how we can provide needle and syringe provision to those who have rejected working with traditional.

Services and they're currently developing a paretic model and a model which integrates some other local Services who we don't currently commission but we are in conversation about work that we might be able to do moving forwards particularly thinking about members of the LG LGBT community uh in terms of the length.

Of time that we are commissioning those services for unfortunately it's much like any other authority because a number of those um services are commissioned as part of the money we're receiving on a year-by-year grant basis at each contract that we have tends to be a year our core service which is currently delivered by turning point.

Point was a 5-year contract with the option of extending we are looking at what we can do to work more thoroughly with turning point to make sure we can have longevity with some of our other community based organizations but that's something that we have to talk about on an ongoing basis uh in terms of the next comment from councelor fan Thomas as the.

CDP meetings are in operation the strategy group has been meeting quarterly um Community safety are invited to that um the local BCU are also invited to that so Shan Lions who is heading up and the adow work which has now gone met wide has been a regular attendee of that I can't remember some of the other officers that we have in in.

That meeting space too but there're certainly in attendance as well one of the thing that we really want to do is start bringing some of the conversations that we're having in that SG further into the space where there are uh yourselves from the members invited but that's the kind of thing that I think we need to look at as this year goes on uh.

In terms of the next comment and question hopefully I've answered some of it in terms of underrepresented groups in treatment in talking uh to some of the organizations that we're working with on um a shorter term basis in terms of data sets data is not particularly good in this in this field we are beholden to a national monitoring system.

At the moment uh which is quite archaic in terms of how it looks at ethnicity how it looks at gender how it looks at sexuality uh we did have uh one of the meetings of the CDP working groups focused on equalities today where data was one of the key conversations we are talking to all of our partners all of our commission Partners about how we can.

Improve local data so we can have a better level of insight into who's accessing Services where under representations might lie but it's also an ongoing conversation that we're having with ohid centrally to look at ways of trying to influence what's happening with the national monitoring system I hope that covers all the.

Questions points sorry chair can i p back and I have Simon to check your mailing list I can confirm to you that board partner ship board both celor Kennedy and myself are me to the part of and we've not been attending and I pck this up with my head of service just last week Community safety has not been invited to any meeting I'll double check.

The invite list but so we have the next meeting of the SG is actually next week if uh no member of community safety is on that I'll make sure that they are on that but they certainly have been involved when aled was here he was involved in in meetings and discussion in terms of an interface with yourselves um as elected members we're looking at.

How we can instigate that obviously part of that was coming here to make sure the update is being put put forward to you all and we want to make sure that we're going to the CSP I'm not sure if something's lined up with regards to that but but absolutely hear your comments and we'll make sure I'm going away and double checking everybody's.

Invited okay um sorry Andrew yeah thanks Simon for very comprehensive update and answering of the questions just one final comment on the data uh we are undertaking a needs analysis at the moment sorry needs assessment um so we'll be working on that probably the next six months okay thank you everyone and for.

The presentation and the really helpful questions Chris uh sorry um Steph just to to uh we are looking for a steer as to whether how the sexual and reproductive Health um action plan should be best steered oh yeah so I think we we agreed so we'll do the um so just to recap with the group we are in agreement in signing up to the sexual.

And reproductive Health strategy and we are also in agreement that the action plan will be circulated after this meeting with a week's um 7-Day turnaround time for comments or questions or which should go directly to you Chris or uh FS would be Greatful and then then after that we'll take a chair action to approve it thank.

You and then the subgroup of health and wellbeing board as a way of um holding to account encouraging people to make good on the action plan I think was in the yeah I think in agreement with that as well definitely confirming that on the group now yes thank you good um okay right anything else on those two agenda presentations that I've missed anything.

Else just before we move on no okay good right so moving on now to the last substantive agenda item which is the nil joint forward plan which is being presented by Amy Wilkinson just in case you haven't checked your emails um a an updated version of the plan has been sent round to the mailing list on email during this meeting um and I guess.

Amy just if you could highlight any of any key differences from what was circulated earlier as well that that would be um helpful um but that is also there uh for reference after the meeting um is that okay Amy yeah great okay to you sure okay um so many thanks um for taking this item I I realized there um it's a very lengthy.

Paper um and um so hopefully the item will be relatively brief though so um last year Northeast London um moving to become an ICB um articulated a 5year forward plan um it's being refreshed every year so this paper sets out the process to do that um and Northeast London I Keen that it's socialized through all of the place help.

And wellbeing boards uh for noting um so the the big change um this year is that we are going to include a slide for each place um and this is not in the paper that was published but it is in the pack that has come around to you so our city and Hackney slide is on page 52 and just to uh clarify that this is a draft um and I don't expect you to.

Have looked at it so similarly to Chris really happy for you to look outside and send comments um and let me know if you're happy with what is in the city in Hackney slide it's one slide it's very straightforward it just articulates the plans uh that are or the priorities that are in our integrated delivery plan around the best start in life um.

Improving mental health and reducing mental ill health and supporting those with long-term Health and Care needs so the process from here over the next few weeks and up to March is further development of the draft and of the plan and then we can bring a a final agreed plan um later toward the end of Feb or middle of March if that suits so.

Happy for for questions Amy I guess in terms of the updated pack that was sent which has the slide on City and on City and HCK me on page 52 of the um slides that were sent around during this meeting I guess it would be fair to say that actually the contents of this slide is a summary of the Strategic priorities that we have already brought through the.

Health and well-being board as well as some of the key highlights around the delivery plan is that a fair sort of yes absolutely yeah it um it's it's very overarching it sets out some some interdependencies with other ICB programs um and a summary of the benefits and impacts that Northeast London local people will hopefully.

Achieve through this um so yes very straight one so actually the the I guess just because people didn't have chance to read this before the meeting so actually but actually the core contents of this we have seen through the health and well-being board and through other papers but this is a a summary slide and as you say it's in draft and so we'll be.

Further worked on over the coming weeks um okay opening out to question and comments let's take um in the room first thank you chair I just wanting to understand the connection between the Key Programs the vision and Mission opposed to the summary because the summary talks about particular for people of ethnic minorities I think you.

Know Glo black and Global majority I think is the language that we're using as a local Authority uh people with learning difficulties uh autism homelessness uh living in poverty and carers so those are all important groups and those are pieces those are pieces of work that we are holding as a local Authority that's in the summary not in.

The key program of work so I'm just wondering where the connection is and where we're holding this as a system to ensure the framework of having that dialogue um happens at a strategic level and in a strategic Forum because we've spoken a lot this today actually in this meeting about health inequalities um outcomes and disproportionate outcomes.

For particular groups and my concern would be that we're talking about it but where does that strategic piece sit I know councelor Kennedy and I for example are leading a piece of work on this and working closely with Andrew but if it's not anchored in a document like this where is it anchored it would be my question thank you um Amy I'm going to.

Take the other hands up that are online at the moment as well and then perhaps if you could come back and together okay so we've got Francis then Chris thank you um the report talks a lot about prevention um I I'm sorry this is quite a difficult question but can you tell me what proportion of the total funding.

Available is is to be spent on prevention and supporting services and on groups that are providing preventive services and support thanks and I guess just um setting expectations around some of the questions it's really helpful to have these questions but some of the questions may be also quite difficult to.

Get specific um answers to Chris uh so two points really um I think the um legislation holds the role of the health and well-being board in actually approving the forward plan and commenting on it as a really important part of of the role of the board I think the last time we had this about a year ago there was comments and some.

Reflections about how better to try and engage both the board and the broader communities I'm not sure if we've been able to fully reflect those in how we're now receiving a forward plan and being able to comment on it so just any Reflections on is there any way that we can improve and do more of our co-production that we have all signed up.

To and then the second issue that I think we again raised last time both at the city and at the Hackney health and wellbeing board is that section reproductive Health was an area that we were very keen to see reflected and we were very keen to work with the ICB having just done a very quick search I can see I think five references to HIV.

But no references to sexual health and this is something that we have been trying very very hard to get the ICB to engage with because reflecting on the last item we recognize it's a fragmented system that in order to improve we need to work differently so it just would be really encouraging to see a little bit more reflection of that in the forward.

Plan of the ICB thank you thanks very much and um Chris uh thank you um Amy I realized uh this is um draft and still being worked on but I think building on what um Deputy Mayor Bramble said and and Chris has just said where there are things that we absolutely know that we're working on in city in hatney um like.

Improving uh the mental health of our black young people uh like our concerns about the high rates of sexually transmitted infections like our concerns I would add about our low rates of uh vaccination um among especially among certain areas of our population um is the idea that that the city and hatney specific.

Slide gets populated with those those bits of work um and and is that you're sort of like ask to us go away have a look at it make sure what is important for you and your area of work and the reason why you're on this board and and tell you and then you'll get it in there so that when I'm sat at the ICB at the Northeast London level I can look at the.

City and hatney thing and go ah I can see all our our priorities I can see all the things that that keep people in Hackney awake at night are in there okay thanks um any do you want to take um take each of those uh questions and comments and then if anyone else has any others please do po your hand up yeah absolutely um thank you that this.

Is really really helpful conversation and um and we're really Keen to take this back to to the conversations to those who are creating and developing the plan um so to the first question um from Deputy Mayor Bramble so around um where's the join up between the the summary and the programs and I think the this is part of the development of the.

ICB and um the ICB has been forming for for quite some time um and is still it is moving um but there are still elements of it that are to be worked out and some of those things as you've rightly pointed out uh what is the connection between place and place priorities and uh the collaboratives and the crosscutting programs so that I.

Think that needs more work and um but for our city slide and now sitting happy bit of it I think we we have the freedom to make that a little bit clearer um and we can do that locally so we'll try and reflect that in our slide where where our join up is so thank you for that and also um thank you for the point on the language as well I will Fe that back to.

The central team and we'll make sure that it is in line with with what we're saying um the um Francis your question around um summaries oh sorry on financial envelopes and uh prevention that's really helpful um we at the moment we are going through a process of understanding exactly what our city and hecky place uh NHS budget might look.

Like um this is being extracted from the wider ICB budget there's currently just one budget Al together um we have a better idea about what this used to be and as City in hackme um always really prioritize prevention and early intervention and that was the reason that we got a lot of the good outcomes that we did so we are still championing.

That and we are are pushing really hard to get a clear idea of what our new budget will be um and we will definitely still be prioritizing those areas but I will need to come back to you with confirmation about uh what the figures actually look like once we clear about that but thank you for raing it's really helpful um there so um and Chris's Point.

Around um how how we make this I guess a bit more exciting and bring it to light a little bit more and that's um that's a bit linked to councelor Kennedy's Point as well um and it it does look like the the big slide set of NHS blue slides that they are so good at doing um or we are so good at doing so I think it would be really helpful to be able to I think.

Just pull out the city and happy bit of it and maybe to to get that around to you and to and have actual conversations about this and boards and out there and things in the next few weeks before we finally submit this and make sure that it looks like uh it reflects City in Hackney and what we really want to prioritize so we can take that away um.

And take away the key bits and highlight those and and bring that back and we definitely can incorporate um what we've heard today around section reproductive health and um run a substance misuse work and all of those other important things um and yes absolutely thank you councelor Kennedy for summarizing that's um that is what we need to do to to this.

One slide I guess to celebrate the chance to have a place slide in there we didn't have Place slides in in the first R last year so it's an opportunity and um if we can all put in as much as we can or or just passionate thoughts that would be really helpful thank very much Amy and I would Echo other people's um comments around.

The slide I think first of all it's progression from last year to have the uh Place based slides as part of the forward plan so I think it's just acknowledging the progression there um but also just perhaps a bit of a rethink on that slide so that it absolutely sort of brings to life exactly what what is a sort of ethos and.

At the heart of what we need what we're wanting to do and Achieve perhaps rather than a duplication of information that is probably else you know that will be elsewhere in the pack um and probably perhaps more of a focus on you know some of the summary and the Key Programs um rather than necessarily having to list every collaborative that that it.

Interfaces with I guess for me is probably something more about that richness how can we use that slide in richness recognizing there may be a template but how can we actually Flex this so that it is something that we could use or something that we could show somebody and say actually if you want to know what we're doing you know.

In one thing this is what you're doing whereas I think probably just this doesn't quite doesn't quite do that um and all I've got in my mind is images of the stick people I don't know what I don't know what um what they're what they're called but you know just thinking about what we've seen sort of Elsewhere and how might you know in some.

Of the pack to dat and how might we be able to just sort of capture some of the number of that and probably less information but a bit more um tailored towards us if that makes sense but recognize it's difficult to do all of that just on one slide so yeah not an easy task but I think that probably sums up what the feedback that people are.

Giving yeah yeah thank you okay um I can't see any other hands up online or in the room so I think that brings us to the end of our substantive items and now just anything from Matter's Rising so okay good well thank you very much um everyone for coming today and really for the very helpful detailed and.

And thoughtful presentations that we've had across um the board and this afternoon just as a reminder the next the date of the next meeting will be the 21st of March at 3:00 um and if you do have anything that you want to add to the forward plan please do email Emanuel and we'll get just reminded to get the the action plan for the sexual.

Reproductive Health strategy forwarded and then we'll set some clear parameters around deadline to respond and and thank you very much and have a lovely evening and a good rest of week and we will see you in a in two months time thank you thank you thank you

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