The Health and Wellbeing Board met on Thursday 7th October 2021 to discuss the Staying Well This Winter plan, an update on the Integrated Care Partnership (ICP), and the Afghan resettlement effort. Key decisions included noting the progress of the ICP and the Better Care Fund, and discussing the ongoing response to Afghan resettlement.

Staying Well This Winter Plan

The Board received an update on the Bi-borough Integrated Care Partnership's (ICP) plan to address the challenges of the upcoming winter months. The plan focuses on three key priorities: a community-led approach to public health messaging and preventive interventions, enhancing system resilience to manage demand on health and care services, and supporting the health and care workforce. The plan aims to be proactive by encouraging residents to stay well, manage demand pressures by supporting people in the community or at home, and ensuring the workforce is supported through the winter.

During the discussion, concerns were raised about the accessibility of healthcare for residents who are not fluent in English. It was highlighted that telephone triage appointments can be difficult for those with limited English proficiency, potentially leading them to use urgent treatment centres or A&E instead of primary care. The Board was assured that face-to-face appointments are increasing and that interpreting services are available, though their consistent use was questioned. Councillor Nafsika Butler-Thalassis, Deputy Leader and Cabinet Member for Adult Social Care, Public Health and Voluntary Sector, emphasised the importance of using interpreting services for all appointments, whether telephone or in-person. A commitment was made to provide an email update on the local authority's efforts to ensure residents can stay warm during winter, particularly in light of rising fuel prices.

Integrated Care Partnership (ICP) Update

An update was provided on the progress of the Bi-Borough Integrated Care Partnership (ICP), which aims to address system-wide challenges that individual partners cannot resolve alone, such as obesity, mental health, and homelessness. The ICP is moving towards a community-led approach, with care and support models tailored to local needs and Primary Care Networks (PCNs). The report highlighted the COVID-19 vaccination programme as a key driver in accelerating ICP relationships and ways of working.

The priorities for the ICP were outlined as: obesity, care homes, discharge, children and young people, mental health, population health management, PCN development, integrated care teams, diabetes strategy, and the COVID response, including vaccinations. These priorities are expected to continue into the next financial year. Councillor Tim Mitchell, Chair of the Health and Wellbeing Board, expressed a need for clarity on how the ICP and its priorities will be informed by the Health and Wellbeing Board's policies and discussions. James Benson, Chief Operating Officer for the bi-borough area, explained that the ICP will serve as the vehicle for delivering on objectives set by the Health and Wellbeing Board, allowing for public scrutiny of the work being done to improve population health. He also noted that the ICP will inform the Integrated Care System (ICS) of local priorities, and vice versa, with examples like diabetes management and homelessness being discussed. Olivia Clymer from Healthwatch Westminster welcomed the pragmatic approach to drawing on existing consultation material but flagged patient transport as an ongoing issue. James Benson acknowledged the challenge of balancing strategic objectives with immediate needs and confirmed that the scope of work would be extended to include support for neurodiverse individuals. The effectiveness of the ICP will be tracked through key performance metrics, which are being developed.

Afghan Resettlement

The Board received an update on the ongoing work to support Afghan residents who have arrived in the boroughs. Janet Cree, from North West London CCG, described the collaborative effort between multiple agencies, including health, local authorities, and the voluntary sector, to provide a health response. This includes initial health needs assessments, registration with local GP practices, and support for mental health and wellbeing. Approximately 1,300 to 1,400 individuals are being supported across four sites in the bi-borough area. The West London GP Federation is coordinating immediate responses and facilitating registrations, with a target to complete all triaging by October 22nd. Challenges include the availability of GPs due to existing workloads, including the booster vaccination and flu campaigns.

Etienne, from Children's Services, provided figures on the number of children and young people arriving, with a focus on enrolling primary and secondary school-aged children. He noted that over 85% of the evacuees speak little to no English, with Pashto being the predominant language. Lena Choudary-Salter from the Mosaic Community Trust highlighted the importance of community-based organisations in supporting the mental health and wellbeing of Afghan refugees through social interaction and integration with local communities. She suggested greater partnership between health providers and local community organisations. The term evacuees was questioned, with a preference for hotel residents or Afghan refugees being suggested. Anna Bokobza, from Imperial College Healthcare NHS Trust, provided a public health update, detailing risk assessments conducted at hotels, COVID-19 testing, and the provision of translated health information. Efforts are also underway to address risks related to TB and measles, and to support COVID-19 vaccination clinics, including on-site options and transport to community sites.

Better Care Fund (BCF) Update

Grant Aitken, Head of Health Partnerships, provided an update on the delivery of the Kensington and Westminster Better Care Fund (BCF) for the 2021/22 financial year. The report noted that national guidance for the BCF had been received, with a revised submission deadline of November 16th. The financial assumptions for the year include an anticipated 5% uplift in funding. The BCF plan will be reviewed to align with local ICP priorities, focusing on principles such as putting local people at the centre, adapting to the impacts of COVID-19, valuing preventative and reablement services, maintaining a resilient local care market, and supporting local carers. The report also outlined national performance metrics for the BCF, including non-elective admissions, residential admissions for older people, and reablement success rates. The Board was asked to note the report.