The Health and Wellbeing Board met on Monday 24 April 2023 to discuss updates on public health, adult social care, and local NHS services, as well as the NEL Joint Forward Plan and the Redbridge Babies, Children and Young People Programme. The Board noted the public health update, which included information on COVID-19, vaccination campaigns, and other infectious diseases. They also noted updates on adult social care and community health, highlighting recruitment challenges.

Public Health Update

Gladys Xavier, Director of Public Health at the London Borough of Redbridge (LBR), provided an update on public health matters. COVID-19 testing is now primarily for high-risk individuals, though isolation advice for those with symptoms remains. COVID-19 deaths have decreased, and the focus is shifting to guidance on living with the virus, with the COVID-19 detection app set to be discontinued. A new, highly transmissible Omicron variant has been identified, primarily in other countries, with a small number of cases and deaths recorded in the UK, mostly among older age groups.

The spring booster campaign is underway, with care home residents vaccinated and the focus now on individuals over 75 and those who are immunosuppressed, as well as clinically vulnerable children aged 6 months to 4 years. A catch-up programme for polio and MMR vaccinations is scheduled for the summer in London, employing a mixed model for younger and school-aged children. Resident engagement is ongoing to keep the public informed. Maternal whooping cough is being monitored, with liaison between the Council, maternity units, and pregnant women. Travel-related infections such as hepatitis A and typhoid are also a concern, with travel health messages being promoted. A case of encephalitis due to a tick bite in the UK has prompted messaging about tick awareness. A UK-wide alert was tested, intended to be part of the surveillance programme. A key point raised during the discussion was whether messaging for healthy adults, who continue to contract the virus, is sufficient, given the current focus on at-risk groups. The Board resolved to note this public health update.

Adult Social Care and Community Health Update

Bob Edwards, Integrated Care Director for NELFT and LBR Adult Social Care, reported that referrals for Adult Social Care and Community Health remain steady. The primary challenge is staff recruitment and ensuring sufficient staffing levels to meet service demands. Strategies to address this include organising a recruitment fair and benefiting from NELFT's international recruitment efforts, which have brought 266 nurses from Botswana, Zambia, and South Africa to the Trusts locally.

Industrial action has had an impact, particularly concerning pay, although local nurses did not meet the threshold for striking. The doctors' strike necessitated collective planning across health and social care, which was managed successfully without serious concerns. The discussion highlighted staff recruitment as a key area, with a focus on local staff development. The Health & Wellbeing Board noted this update.

NEL ICS, BHRUT & Whipps Cross Update

Tracy Rubery, Director of Partnership, Impact and Delivery at Redbridge NHS NEL, provided an update on the Integrated Care Board (ICB). The Hewitt review report has been released, with recommendations relevant to the ICB. A consultation has begun, which is expected to result in a 20% to 30% staff reduction across the ICB. However, for Redbridge, this is viewed positively due to a commitment to level up when the NEL ICB was formed. If the current consultation structure remains, there will be 20 staff members organised across start well, live well and age well functions. The consultation concludes on 2 June, with an outcome report in late June and subsequent implementation. The local team will operate at a reduced capacity until the end of the year, but the overall outlook for Redbridge is favourable. Currently, four staff members are primarily based at the Redbridge level, with wider responsibilities as needed.

Louise Dark, Managing Director of King George Hospital (KGH), reported on BHRUT's achievements. The KGH Surgical hub is the only one in London accredited and has eliminated the 78-week wait, with the next target being the elimination of the 52-week wait. Work is progressing on two new theatres at KGH. For emergency and urgent care, the Trust is collaborating with an external provider on a streaming pathway and improving same-day emergency care processes. All executive annual goals have been renewed, and efforts are underway to understand and address staff survey results. The Chair congratulated BHRUT on eliminating the 78-week wait and sought clarification on current waiting times. The Health & Wellbeing Board noted this update.

NEL Joint Forward Plan

The NEL Joint Forward Plan (NEL JFP) is a draft five-year plan outlining how the system will deliver the Integrated Care Partnership Strategy and core NHS services. A supporting document provides further detail on transformation programmes. The partnership acknowledges that more work is needed to develop a cohesive action plan to address challenges, with ongoing engagement planned with local people, partners, and stakeholders for plan iteration and improvement, including annual refreshes.

In Redbridge, four key accelerator priorities have been identified through the Place-based Partnership, informed by local needs and insights: Housing and Overcrowding, Children and Young People, Mental Health, and Improving Multidisciplinary Team Working. Additionally, Redbridge partners have local priorities including Health Inequalities and the development of the Iford Exchange. The NEL JFP provides an opportunity for Redbridge partners to ensure their locally agreed priorities are reflected.

Hilary Ross, Director of Strategic Development at NHS NEL, presented the report, explaining that the Joint Forward Plan is a draft system delivery plan. It is a work in progress, with further development planned over the summer. The Board was asked for feedback on the plan's alignment with local priorities and any potential gaps. Discussions included whether the plan covered all relevant areas, how to engage disadvantaged communities such as refugees and asylum seekers, the balance between wider NEL working and local focus, accessibility of the plan (including an easy-read version), and the involvement of the voluntary sector. The Health & Wellbeing Board resolved to note the comments on the NEL JFP's alignment with Redbridge's local priorities and any potential gaps.

Redbridge Babies, Children and Young People Programme - Update Report

This report provided an update on the Redbridge Babies, Children and Young People (BCYP) Programme. Redbridge NHS NEL is transitioning from the BHR BCYP Transformation Programme to a Place-Based approach, with Dr Sarah Heyes, the Pathway Lead for the Redbridge Place-Based Partnership, having recently taken up her post. She is tasked with understanding the Partnership over the next six weeks to propose BCYP priorities by early June, aligning with the development of a Redbridge Partnership Plan.

The existing BCYP team continues to support the establishment of system priorities and manage current operational and strategic workstreams, including Special Educational Needs & Disabilities (SEND), Integrated Community and Complex Care pathways, Child Health General Practice Hubs, Looked after Children (LAC), and Autism Diagnosis and Integrated Support.

Tracy Rubery provided an update on the BHR Transformation Board's relation to this programme, noting that the Children and Young People Transformation Board is moving to the new structure with Dr Heyes as the Pathway Lead for Redbridge. The Redbridge Children and Young People programme is still being developed, with the aim of bringing all partnership areas together by June. Key discussion points included whether the voluntary sector was included in Dr Heyes's initial engagement, the number and location of Child Health GP hubs funded by £150,000, improving access to information on support for children and young people, integrating education, health, and care plans for SEND, and the need for increased investment in Child and Adolescent Mental Health Services (CAMHS). The Health & Wellbeing Board resolved to note the progress and priorities of the BCYP programme, agreeing to receive regular updates, and also agreed to receive a report on the Redbridge-specific BCYP work plan at a future meeting.

Redbridge Safeguarding Children Partnership Annual Report

Adrian Loades, Corporate Director for People at the London Borough of Redbridge, presented the Redbridge Safeguarding Children Partnership (RSCP) Annual Scrutiny Report for 2021-2022. This report offered an independent review of multi-agency safeguarding effectiveness in Redbridge between October 2021 and September 2022. The RSCP comprises members from partner agencies, led by the statutory safeguarding partners (Local Authority, Police, and Integrated Care Board (ICB)), who are committed to protecting children and young people from abuse and neglect. The report was authored by the Independent Chair and Scrutineer appointed in April 2022.

The work undertaken focused on three priorities carried over from 2020-2021: safeguarding vulnerable adolescents, monitoring and supporting the multi-agency safeguarding response to the COVID-19 pandemic, and child sexual abuse within the family environment. Strategic priorities for 2023-2024 include transitional safeguarding, contextual safeguarding, response to national safeguarding reviews and reports, children and young people's mental health, and Child Friendly Redbridge. The scrutiny of key measures indicated that most areas were rated green, signifying that overall safeguarding arrangements for children and young people in Redbridge are effective.

During the discussion, actions to improve amber rated areas to green were raised, along with how the programme's work would be managed given a deficit of approximately £30,000, and efforts to engage young people whose voices are not being heard. The Health & Wellbeing Board resolved to note the RSCP Annual Scrutiny Report 2021-2022.

Forward Plan

The Forward Plan was included as item 9 on the agenda. An additional item, a report on the Redbridge-specific Babies, Children and Young People work plan, was to be added. The Health & Wellbeing Board resolved to note the Forward Plan and the additional item for inclusion.

Dates of Future Meetings

The Health & Wellbeing Board noted the dates for future meetings for the new municipal year: 19 June 2023, 18 September 2023, 27 November 2023, 26 February 2024, and 22 April 2024.