The Kingston Partnership Board met on Wednesday 20 March 2024 to discuss the Annual Report of the Director of Public Health, 2023, focusing on Ageing Well in Kingston, and to receive an update on the development of a new vision for Adult Social Care and Health. The meeting, however, was not quorate, meaning no formal decisions could be made.

Launch of the Annual Report of the Director of Public Health, 2023: Ageing Well in Kingston

The Board received an introduction to the 2023 Annual Report of the Director of Public Health, which highlights the challenges and opportunities surrounding an ageing population in Kingston upon Thames. The borough currently has approximately 24,900 residents aged 65 and over, a figure projected to rise to 37,000 within two decades. A key concern is the declining healthy life expectancy for both men and women over 65, which has seen a decrease since its peak in 2013-2015. While Kingston's healthy life expectancy for women over 65 is currently ahead of London and national averages, this positive trend is diminishing.

The report identifies significant health inequalities, with residents in more affluent areas experiencing good or very good health for considerably longer than those in deprived areas. For instance, between the ages of 50-54, around 90% of residents in affluent areas report good health, compared to 65% in poorer areas. By age 75, this gap widens, with 70% of residents in affluent areas reporting good health versus 50% in less affluent parts of the borough.

Several factors contribute to poorer health in older age, including smoking, which can lead to a need for care ten years earlier than for non-smokers. Obesity, with 57.2% of Kingston adults being overweight or obese, increases the risk of conditions like diabetes and heart disease. Lack of physical activity also impacts health and social connection, while high alcohol consumption is another concern. The report also notes that a significant proportion of eligible adults, around 25%, do not take up the offer of a flu vaccination, and work is underway to understand the reasons behind this.

The report outlines opportunities to promote longer periods of good health, including addressing key risk factors such as smoking, alcohol, diet, and physical activity, with a focus on areas of greatest need. Encouraging uptake of services like vaccinations and screenings, and supporting reablement and diabetes care to reduce emergency hospital readmissions are also highlighted. The council is working towards becoming an age-friendly borough, guided by recommendations covering eight domains: transportation, housing, social participation, respect and social inclusion, civic participation and employment, communication and information, community support and health services, and outdoor spaces and buildings. A four-year action plan is being developed by the Kingston Council Age Friendly Working Group in collaboration with partners and resident Age Friendly Ambassadors.

The Kingston Arch initiative, developed with the voluntary sector, aims to provide a universal offer of support and guidance. Connected Kingston, established in 2018, continues to help residents and professionals navigate local services and activities, supported by community champions and social prescribers. Hubs in libraries, children's centres, and Guildhall 2 offer advice, though reaching new and hard-to-reach residents remains a challenge. The report also reflects on progress made since the 2013 Annual Public Health Report, which also focused on living well in later life. Data on ethnic disparities is being considered, with a particular focus on supporting South Asian communities, who are at higher risk of diabetes. The Board expressed gratitude for the work on the report and acknowledged the contributions of Iona Lidington, the Director of Public Health, particularly her work during the COVID-19 pandemic and in driving Kingston to become a Marmot borough.

A New Vision for Adults and Health

The Board received an update on the development of a new vision for Adult Social Care and Health, designed to address increasing service demand amidst reducing resources. The vision places residents at its centre, with a focus on emotional wellbeing, prevention, and resilience. It outlines the Council's commitment to understanding residents, building strengths, reducing inequalities, and increasing healthy life expectancy, while also acknowledging the diverse needs of the community. Collaboration with partners is central to creating healthier communities, integrated care, and preventing or delaying the need for care. The vision also aims to embed innovation, learning, and ensure a financially sustainable and resilient health and care system.

The delivery of this vision over the next 2-4 years will inform strategic commissioning, work plans, resident engagement, and joint work with partners. An external Peer Review of Adult Social Care in Kingston has been conducted to identify areas for improvement, the findings of which will inform the vision's delivery and preparation for an upcoming Care Quality Commission (CQC) inspection. The Board suggested that respect for both staff and residents should be explicitly included in the vision, and noted that diversity and inclusion, particularly reaching hard-to-reach communities, is a recognised area for further development. Work will be undertaken with the Adult Safeguarding Board and staff networks to build relationships in this regard.

Update on Statutory Business of the Health and Wellbeing Board 2023/24

The Board was updated on statutory business undertaken by the Health and Wellbeing Board. This included the approval for publication of the Kingston Safeguarding Adults Board Annual Reports for 2020-2021 and 2021-2022, the approval and review of the Draft Kingston Joint Strategic Needs Assessment (JSNA) 2023, and consideration of the Kingston and Richmond Safeguarding Children Partnership Annual Report 2022-23. The Board also approved the Better Care Fund End of Year Report 22/23 and the Better Care Fund (BCF) Q2 and Q3 Reporting Templates. Future statutory business will include the refresh of the Health & Care Plan for Kingston and the refresh of the Pharmaceutical Needs Assessment.

The meeting was attended by Councillor Andreas Kirsch, Leader of the Council, RBK (Chair), Sarah Ireland, Chief Executive, RBK, Sam Morrison, Executive Director, Adult Social Care & Health, RBK, Iona Lidington, Director of Public Health, RBK, Maria Sheridan-Loughrey, Business Manager, RaKAT, CT Grant Henderson, Director, Your Healthcare CIC, Stephen Bitti, Chief Executive Officer, Healthwatch, Sanja Djeric Kane, CEO, Kingston Voluntary Action, Anubha Prasad, Integrated Partnership Manager, South West London and St George's Mental Health NHS Trust, Robin Hutchinson, Director, Community Brain, Joshua Laughton, Superintendent - Kingston Safer Neighbourhoods Lead, Metropolitan Police, and John Azah, CEO, Kingston Race and Equalities Council. Apologies were received from Councillor Rowena Bass, Councillor James Giles, and Councillor Sabah Hamed.