Agenda and minutes

1.1  Cllr Christopher Kennedy, as Co-Chair, confirmed that following Raj Radia stepping down from the Health and Wellbeing Board (HWB), the representatives from the City and Hackney Local Pharmaceutical Committee would now be Shilpa Shah, Chief Officer, and Dalveer Johal, Pharmacy Support Manager.

2.1  Apologies for absence were received from Cllr Anntoinette Bramble, Jacquie Burke, Mary Clarke, Dr Adi Cooper, Jim Gamble, Nina Griffith, Stephen Haynes, Dr Sandra Husbands, Dalveer Johal, Jessica Lubin, Shilpa Shah, Paul Senior, Dr Kathleen Wenaden, and Helen Woodland.

2.2  In addition, apologies for absence were also received from Det Chief Superintendent James Conway, who was represented by Det Chief Inspector Yasmin Lalani, and it was confirmed that Dr Stephanie Coughlin would join late.

3.1  There were no declarations of interest.

RESOLVED: That the minutes of the meeting held on 21 September 2023 be agreed as a true and accurate record of proceedings.

5.1    The tracker was noted.

6.1  There were no questions from members of the public, but Cllr Kennedy confirmed that he had taken receipt of postcards from the ‘Keep our NHS Public’ campaign before the start of the meeting, and would reply, treating them as a petition.

7.1  Shohel Ahmed, Safeguarding Adults Board Manager, introduced the report and highlighted the achievements of the City & Hackney Safeguarding Adults Board (CHSAB), which included the publishing of two Safeguarding Adults Reviews (SAR) and the commissioning of one further SAR; the ongoing action plan which identified learning from SARs; work on raising awareness and engagement, and learning and development; and, the distribution of grant monies allowing community organisations to hold Safeguarding Adults Awareness events throughout Hackney.

7.2  The report also highlighted priorities for 2023/2024, which included the inclusion of new aims related to self-neglect, and continuing to raise SAR awareness.  The report also provided a breakdown of the data sets that had helped to drive the work of the CHSAB and their priorities.

7.3  Questions and comments relating to the report were raised by Frances Haste, Cllr Fajana-Thomas, Chris Lovitt, and Rosemary Jawara who asked;

·  about the consultation planned on the findings of the report, particularly amongst partners providing services to vulnerable adults;

·  about the housing repairs issues highlighted by case study 1;

·  what trends were being seen in relation to domestic abuse;

·  was there further opportunity to include safeguarding clauses in non-public health contracts;

·  and, what links there might be between increased instances of domestic abuse and the cost of living crisis.

7.4   In response Cllr Kennedy, the Safeguarding Adults Board Manager, Georgina Diba, Director Adult Social Care Operations, and DCI Yasmin Lalani, Metropolitan Police Service, confirmed that;

·  CHSAB partners, including HCVS, had been consulted with during preparation of the annual report, but further feedback would be gratefully received;

·  the case studies omitted some detail to preserve anonymity, but in case study 1 the referral to Safeguarding came from the Council’s Housing department;

·  representatives of the Council’s Housing department attended safeguarding learning events;

·  the increase in domestic abuse was likely due to changes in recording of abuse instances, but a possible increase in adult children on parents cases was noted;

·  the Police were reassured that reporting of domestic abuse had improved, in part because confidence amongst victims had increased;

·  the Citizens Advice Bureau reported positive interactions and support from Safeguarding partners, when reporting instances of domestic abuse;

·  the suggestion relating to contract clauses would be raised with CHSAB;

·  and, the cost of living crisis was not an excuse for domestic abuse, but CHSAB and partners had taken an interest in this issue, and the wider support available was discussed.

Action:  1. CHSAB to consider inclusion of safeguarding considerations and concerns in future contracts

8.1  After discussion, Mark Watson, Programme Lead, and Chris Lovitt, Deputy Director of Public Health, confirmed that the request to the HWB was to agree that the report should still be presented to the Board annually, but that the HWB delegate approval of the Better Care Fund plans to the relevant Group Director and Cabinet Member.

8.2  Following a question from Cllr Williams, Cllr Kennedy, as the relevant Cabinet Member, advised that he would want the HWB to see an annual report for information, but was happy to take the decision on the plans with relevant Senior Officers on behalf of the Board.

RESOLVED: The HWB agreed to delegate approval of the Better Care Fund plans, and receive an annual report for information.

9.1  Sally Bevan, Healthwatch Hackney Chief Executive, introduced the report and highlighted that every year the Local Authority encouraged community pharmacies to enter into a contract to deliver free emergency hormonal contraception, and Healthwatch Hackney wanted to see how that contract was being delivered by the 38 pharmacies who had agreed to provide that service.

9.2  Via a telephone mystery shop in 2022, 23 pharmacies offered the service for free and 15 charged.  This was then followed by an in-person mystery shop of 16 pharmacies, which discovered that 9 had charged for the service,  at c£25.  As a result, recommendations were made to both Public Health and City and Hackney Local Pharmaceutical Committee, along with a commitment to continue to monitor the situation. 

9.3  In 2023, when following up, 7 of the 9 pharmacies were still charging and some of the reasons given for charging included a pharmacy needing to refurbish consultation rooms and staff being on leave or having a lack of knowledge.  This raised concerns for Healthwatch Hackney that other contracts might have been prepared without due consideration given to how they can be practically delivered.  The HWB were invited to consider how they commissioned and managed services.  Kanariya Yuseinov, Enter and View and Volunteer Manager, who led the mystery shop programme, also highlighted issues related to poor sign posting to accessing what is a free service. 

9.4  In response, Cllr Kennedy provided confirmation from Dalveer Johal, Pharmacy Support Manager, that they would consider all the feedback from the report and the discussion.  In addition the Deputy Director of Public Health welcomed the report, confirming that it accurately diagnosed the problem and also provided an opportunity to look at solutions, and also confirmed that the updated strategy was in the consultation phase and access to good sexual health would be a key aspect.  The Deputy Director of Public Health also highlighted some of the services that were available at the local level and being proposed at the national level.  A detailed action plan would be presented to the HWB at a future meeting.

9.5  Questions and comments relating to the report were raised by Frances Haste, Rosemary Jawara, and Cllr Williams, who;

·  asked why this was not a case of fraud;

·  were concerned about the extent that Public Health should be encouraging people to take more responsibility for their sexual health, and increases in gonorrhoea rates;

·  highlighted the competing demands on community pharmacies, which were also small businesses.

9.6  In response, the Deputy Director of Public Health confirmed that;

·  an analysis of the contract had shown that none of the pharmacies that had charged had submitted invoices, indicating a lack of full awareness of the scheme and the processes required to deliver the programme;

·  we do benefit from the number of community pharmacies in Hackney, as they are often a resident’s most local NHS representative;

·  at the Neighbourhood level Public Health is investigating the needs of local communities in relation to what community pharmacies can  ...  view the full minutes text for item 9.

10.1  The Healthwatch Hackney Chief Executive and the Enter and View and Volunteer Manager provided the background to the accessibility audit, which included visiting every community pharmacy in-person to examine physical access to the premises, the accessibility services within the premises, and signage and communications materials.

10.2  Key findings from the audit included;

·  26 pharmacies were recommended to build or repair the concrete ramp outside the premises;

·  two pharmacies were recommended to repair the pavement outside the premises, and four were recommended to repair the potholes in front of their entrance;

·  36 pharmacies were recommended to install an accessible bell or entry phone system outside the premises;

·  feedback from the investigation indicated that pharmacies had issues with landlords and the Council’s Planning department;

·  and, that pharmacies were businesses and a significant number had cash flow concerns, meaning no spare money to invest in necessary improvement works.

10.3  The Deputy Director of Public Health responded by thanking Healthwatch Hackney for their work and confirmed that Officers would liaise with relevant Council departments to address issues with pavements and potholes; in relation to bills and invoicing, whilst there was an important requirement to validate services, Public Health was mandated to pay as quickly as possible; and, the financial sustainability of community pharmacies is an issue that is being raised in a number of places.  Cllr Williams recognised the importance of access, and highlighted the findings from dementia training, which should also be considered.

Action:  3. Public Health Programme and Projects Officer to discuss the streetscene issues raised with the Council’s Highways department.

4. The City and Hackney Local Pharmaceutical Committee Chief Executive to report back to HWB on progress.

11.1  Joia De Sa, Consultant in Public Health Population Health, and Anna Garner, Head of Performance and Population Health, spoke to the published presentation, providing details on the Population Health Hub (PHH), which would be a shared system resource, that aimed to support the City & Hackney Place Based Partnership, and wilder system partners, to reduce health inequalities and improve the health of the population.  The six main focus areas were confirmed as;

·  Capacity building

·  Prevention and equity

·  Evaluation of impact

·  Codesign and partnerships

·  Intelligence

·  Evidence

11.2  After the presentation, questions and comments were raised by France Haste, Chris Lovitt, who;

·  asked about the timeframe for partners to engage with issues relating to health inequalities;

·  highlighted the findings of the Health in Hackney Scrutiny Commission’s investigation into issues impacting Hackney’s Trans community, that also focused on the need for better ways of collecting and reporting data;

·  and, who asked for an update in relation to the LGBTQIA+ work around equalities.

11.3  In response, the Head of Performance and Population Health, Cllr Kennedy, and the Consultant in Public Health Population Health, confirmed that;

·  partners had as long as they required to provide feedback and data as it was expected that the need for data and feedback would be an ongoing one, and that the PHH would always be grateful to receive what could be provided;

·  an equalities data strategy was being scoped and some of the work would be around supporting those collecting data and explaining why it was being collected, as there was a recognition that there have previously been issues related to trust in this area;

·  in relation to the use of data, there is an ambition to improve the collection of information about experiences and outcomes and the embedding of the data that is already collected;

·  a needs assessment of the Youth Justice System had recently concluded and was hindered by the lack of access to data;

·  and, Public Health Intelligence team leaders were providing a lot of training around data literacy to explain the importance of collecting data.

12.1  Cllr Kennedy noted that 11 days before this meeting of the HWB had been World Suicide Prevention Day and, as per guidance from The Samaritans, we shouldn’t report the locations or methods of suicide.

12.2  Jennifer Millmore, Senior Public Health Specialist, added that in relation to language, “commit” was a word not to employ,  as it can imply a crime, nor should the words “successful” or “unsuccessful” be employed.  It was noted that the data being provided in the report was numerical and summarising,  but that it had not been forgotten that behind the information were real people and tragic circumstances. 

12.3  Suicide prevention rests with Public Health and this would be the first in a series of annual reports.  This first report indicated that suicide rates are not high in comparison to national rates and the data has provided some insights to help develop proposals to increase prevention.

12.4  Andrew Trathen, Consultant in Public Health, discussed the differences between incidents in Hackney and incidents in the City of London, which require a diverse set of responses; summarised the newly updated national strategy, including the aim to reduce the suicide rate over the next 5 years, as the rate had remained static since 2012; and, highlighted the work of the Zero Suicide Alliance.

12.5  Cllr Kennedy welcomed the report, thanked Officers for their work, and agreed that updates should return to the HWB annually.

Action:  5. Suicide Prevention Update to come back to the HWB annually.

13.1  There were no matters arising for consideration.

14.1  The next meeting of the Health and Wellbeing Board would be 25 January 2024 at 3.00pm.