The Health and Wellbeing Board of Hackney Council met on Thursday 25 January 2024 to discuss updated terms of reference, the City & Hackney Safeguarding Children Partnership Annual Report, the Annual Director of Public Health Report, and the Sexual and Reproductive Health Strategy. The Board also reviewed findings from the NEL Big Conversation and the NEL Joint Forward Plan.

Updated Terms of Reference

The Board discussed proposed updates to its terms of reference. Dr Stephanie Coughlin, ICP Clinical Lead and Co-Chair, highlighted that the updated terms would include a commitment to receive regular Community Voice presentations and add the Sexual and Reproductive Health Strategy to the list of strategies the Board would oversee. Dr Sandra Husbands, Director of Public Health for City & Hackney, suggested that instead of naming specific strategies, the terms of reference should refer to oversight of public health strategies and be regularly updated by the Board. The appropriate governance approach for the Combating Drugs Partnership (CDP) was also discussed by Dr Husbands and Councillor Christopher Kennedy, Cabinet Member for Health, Adult Social Care, Voluntary Sector and Culture.

City & Hackney Safeguarding Children Partnership Annual Report 2022/23, including Child Q Update

Rory McCallum, Senior Professional Advisor for Children's Social Care, presented the annual report, which detailed the safeguarding partnership's governance, progress against priorities, and lessons learned. The report also included an update on the Child Q case, which is feeding into the Council's work on active anti-racism. While overall data indicated positive trajectories, including a reduction in Child Protection Plans and Looked After Children, likely due to earlier interventions, Frances Haste and Councillor Anntoinette Bramble, Deputy Mayor and Cabinet Member for Children’s Services and Young People, raised concerns about the absence of school exclusions in the report and their disproportionate impact. They highlighted the work of the Hackney Reducing Exclusions Partnership and discussed the health and wellbeing implications of policing and safeguarding issues. Mr McCallum and Jacquie Burke, Group Director of Children and Education, confirmed that school exclusion is recognised as a safeguarding issue and a significant area of work for the partnership. They noted that the Council is developing work around school exclusions, viewing it as a systems-wide issue, and that a specific priority exists around safeguarding adolescents, which includes keeping children in school.

Annual Director of Public Health Report 2023/24, including Confirmation of Themes for 2024/25

Danny Turton, Public Health Specialty Registrar, presented the annual report, which focused on sexual and reproductive health (SRH), particularly for the under-30 population. The report highlighted that Hackney has the fourth-highest rate of sexually transmitted infection (STI) diagnoses in England, and STI testing rates have not yet returned to pre-pandemic levels. Five recommendations were made: a recommitment to co-production with increased community involvement; making services more accessible, especially for younger people; improving awareness of available services; enhancing collaboration between stakeholders; and continuing to focus on inequalities.

Anthony Blissett, Public Health Specialty Registrar, announced that the theme for the next two years will be 'social capital', based on evidence linking it to improved health outcomes. This will involve reviewing the evidence base in 2024 and developing a practical action plan with local communities in 2025. A supporting social capital advisory group with diverse membership is also proposed. Frances Haste, Councillor Kennedy, and Dr Husbands raised questions, welcoming the focus on social capital and requesting the inclusion of the voluntary sector. A specific and shared definition of 'social capital' was sought, and the importance of community involvement as an overarching recommendation was noted. The inclusion of local organisations formed during the pandemic was also suggested. In response, it was confirmed that Tony Wong, Hackney CVS Chief Executive, had been contacted for voluntary sector representation, and efforts were being made to include other groups. The proposed advisory group will help define 'social capital' in a local context.

Community Voice: NEL Big Conversation - Hackney Findings

Sally Beaven, Healthwatch Hackney Chief Executive, presented findings from the NEL Big Conversation, which gathered views from Hackney's communities on service accessibility, competence, and person-centred delivery. Specific examples included members of the Turkish and Kurdish community facing challenges with language support, a wheelchair user encountering access issues due to a dropped curb, and positive feedback on the responsiveness of the Long Covid service. The report also emphasised the impact of wider determinants of health, such as anti-social behaviour, and the importance of feeling accepted and free from stigma when accessing services. Councillor Kennedy and the Chair questioned the number of local people consulted and whether the findings were representative. Ms Beaven clarified that 57 individuals were engaged through workshops, in addition to survey respondents, and committed to providing further clarity on the data sources.

Sexual and Reproductive Health Strategy

The Board considered the Sexual and Reproductive Health Strategy. The Deputy Director of Public Health explained that while the strategy itself was ready for approval, the detailed action plan had not been circulated due to a paper error. It was agreed that the action plan would be circulated after the meeting, with members having seven days to provide comments before it is approved by Chair's Action. Froeks Kamminga, Senior Public Health Specialist, outlined the consultation process, highlighting strong agreement for the proposed themes and priorities. Key findings included the importance of involving target audiences in campaign development, barriers such as lack of knowledge and access, stigma surrounding sexual health, and fragmented commissioning of services. The action plan proposes a central online resource for information and signposting, and a joint sub-group of the City and Hackney HWBs to oversee implementation. Councillor Kennedy, Basarit Sadiq (Deputy Chief Executive, Homerton Healthcare NHS Foundation Trust), and Deputy Mayor Bramble raised questions about responsibility for the online resource, the impact of digital poverty, and the reasons for lower STI testing figures. Responses indicated that while a NEL-wide approach to the online resource would be preferred, ensuring accessibility for all communities was crucial. The pandemic's impact on younger people accessing STI testing was noted, with figures returning to pre-pandemic levels. Concerns about service affordability and the need for increased investment were also raised.

Combating Drugs Partnership and Substance Use Support Update

This item was considered alongside the Sexual and Reproductive Health Strategy. Simon Young, Principal Public Health Specialist & Substance Misuse Partnership Lead, provided an update on the Hackney Combating Drugs Partnership (CDP). The report detailed the national context, the CDP's structure and partners, operational outcomes including improved continuity of care for those leaving prison, and a modest increase in service access. An additional £2.9 million in funding is anticipated, which will be used to increase access to in-patient detox and rehab services and invest in local organisations for better community engagement. Frances Haste, Councillor Susan Fajana-Thomas (Cabinet Member for Community Safety and Regulatory Services), and Deputy Mayor Bramble raised questions about the commissioning of voluntary sector groups, representation of Community Safety on the CDP, and whether specific population groups had been identified for targeted services. Responses confirmed that voluntary sector organisations are commissioned to work with groups facing barriers to access, and that the CDP is meeting quarterly with representatives from Community Safety and the Metropolitan Police Service invited. A needs assessment is underway to improve understanding of underrepresentation and inform service targeting.

NEL Joint Forward Plan

Amy Wilkinson, Integrated Commissioning Workstream Director, introduced an updated version of the North East London (NEL) Integrated Care Board (ICB) Joint Forward Plan (JFP). The five-year JFP is refreshed annually, with this year's draft including slides focused on each constituent Place. The Chair and Ms Wilkinson discussed the City & Hackney Place slide, which summarises strategic priorities, delivery plan highlights, and interdependencies. Councillor Bramble, Frances Haste, the Deputy Director of Public Health, Councillor Kennedy, and the Chair raised questions regarding the connection between key programmes and the summary, particularly in relation to Black and Global Majority residents, the proportion of funding for prevention, and whether feedback from previous discussions on community engagement had been incorporated. They also inquired about the better reflection of SRH as a priority and the inclusion of specific City & Hackney priorities such as improving the mental health of Black and Global Majority young people, tackling high STI rates, and addressing low vaccination rates. Ms Wilkinson confirmed that the ICB is still being formed and that further work is needed to improve connections between Place and cross-cutting programmes. She stated that there is freedom to provide greater clarity in the City & Hackney slide and that feedback on language would be shared. Prevention and early intervention remain priorities, and work is underway to define the City & Hackney Place-based element of the ICB budget. The Place slide was seen as an opportunity to share and confirm City & Hackney's priorities.