The Health & Wellbeing Board met on Thursday 23 November 2023, noting reports on the Autism Strategy, Serious Violence Duty, and End-of-Life/Community Palliative Care. The Board also discussed the implementation of the Health and Wellbeing Strategy through Integrated Neighbourhood Teams and addressed a public question regarding non-smoking clauses in council housing tenancies.

Autism Strategy

The Board noted a report on the all-age Autism Strategy, published in 2020, and the Adults Autism Strategy, launched in November 2022. The aim of these strategies is to increase awareness and support to improve the lives of autistic people. Currently, there is an 11-month wait for autism assessments and diagnoses for adults, with waiting times for children to be provided separately. The report highlighted increased flexibility for adult assessments, including online options, and the introduction of a specialist peer-to-peer service for adults post-diagnosis, with exploration into expanding this for children and young people. A key issue identified was the transition from children's to adults' services, with a dedicated officer recruited to ensure better collaboration between clinical and social services. The report also noted that universal services already have good diversity of participants, with a high representation of young people with Special Educational Needs and Disabilities (SEND) attending youth clubs. Schools are being supported to build confidence in supporting autistic young people, even those without an Education, Health and Care Plan (EHCP).

Serious Violence Duty

The Board noted a report concerning the Serious Violence Duty, a new requirement under the Police, Crime, Sentencing and Courts Act 2021, which needs to be agreed by January 2024. Both Westminster and Kensington and Chelsea Councils use the London-wide definition of serious violence, which includes violent and sexual offences and domestic violence, but excludes terrorism. In Westminster, serious violence is concentrated in the West End and St James's wards, largely due to the night-time economy and high visitor numbers. Kensington and Chelsea experiences less geographical concentration. The report indicated that a low proportion of crime reports result in a criminal justice outcome and that crime may be under-reported due to residents' anxiety about reporting and a belief that action will not be taken. Officers confirmed that crime data is used to understand the impact on residents and target interventions. The report also mentioned that adopting an intersectional approach to Serious Youth Violence (SYV) is a recommendation, and acknowledged that fear of reporting is understandable, particularly in cases of SYV, with options for anonymous reporting available.

End-of-Life and Community Palliative Care

The Board noted an update on End-of-Life and Community Palliative Care services from NHS North West London ICB. The COVID-19 pandemic and service changes, such as the closure of Pembridge Hospice, have impacted palliative care delivery. The report indicated that many individuals in hospices do not require acute medical care but benefit from the support provided in such environments. A review of the service has been undertaken, and options will be presented, followed by a business case once an option is selected. Engagement and consultation will be ongoing. The review will include support for carers, with existing measures such as a 24-hour helpline already in place.

Health and Wellbeing Strategy Outcomes Framework and Integrated Neighbourhood Teams

The Board noted a report outlining the implementation of the Health and Wellbeing Strategy over the next two years, focusing on linking healthcare and communities to address health inequality. Integrated Neighbourhood Teams are intended to facilitate co-production across departments, organisations, and with residents, covering wider geographical areas to achieve economies of scale. Key considerations for the Board included defining ownership of the Strategy, managing the transition from engagement to co-delivery, and ensuring effective community engagement. Further work is required on how the Place Based Partnership will function in practice. While it is a bi-borough Strategy, interventions will be tailored to each locality. The Chair requested that the Framework return to the Board as plans develop.

Public Notice Question: Non-Smoking Clause in Council Housing

A Public Notice Question was raised requesting the inclusion of a non-smoking clause in council housing tenancies. The questioner highlighted smoking as a major health risk factor, contributing to cancer deaths and impacting the NHS, with the most disadvantaged being most affected. It was noted that public areas of social housing are typically non-smoking, and private landlords often include such clauses. Officers responded that a full written response would be provided, and that both councils would be responding to the national smoking consultation.