The Tower Hamlets Health and Wellbeing Board met on Tuesday 06 April 2021 to discuss a range of critical issues affecting the borough's residents. Key topics included patient experiences at The Royal London Hospital, the SEND improvement plan, and access to primary care. The meeting also addressed the ongoing COVID-19 vaccination programme and the council's Race and Inequalities Commission recommendations.

Patient Experiences at The Royal London Hospital

The board heard powerful testimonies from patients and their families regarding their experiences at The Royal London Hospital. Abdul Doyas and Suroth Miah, representing the newly formed Patients Welfare Association (formerly the Royal London Hospital Patients and Family Group), highlighted several areas for improvement. These included concerns about visit rights for vulnerable patients, the need for patients to be treated with dignity and respect, and issues with the family contact centre, which can cause delays in receiving updates. They also raised concerns about the lack of meaningful Black, Asian, and Minority Ethnic (BAME) representation on hospital boards and within the Health and Wellbeing Board itself.

Lucy Butler, Director of Nursing at The Royal London Hospital, and Simon, a representative from the hospital, responded to these concerns. They confirmed that visiting rights are being reviewed and will be expanded from Monday 12 April, with named visitors being a key element. They acknowledged the need for improved cultural sensitivity and are exploring ways to increase volunteers to provide cultural input at the bedside. The hospital is also reviewing the family contact centre process, with some wards, including critical care, already reintroducing direct bedside calls. They also noted that the hospital board does have BAME representation, including an inclusion champion, and welcomed scrutiny from external bodies like Healthwatch and the Care Quality Commission (CQC).

Abbas, also from the Royal London Hospital, added that they are working with diverse patient and community groups to improve services and welcomed the opportunity to work with the Patients Welfare Association on issues such as visiting and service improvement.

SEND Improvement Plan and Inspection Readiness

Warwick Tomsett presented an update on the Special Educational Needs and Disabilities (SEND) improvement plan, highlighting key strengths such as effective early identification in early years, good attainment and achievement for children and young people with SEND, and strong engagement with parents and carers. However, areas for development include the timeliness and quality of Education, Health and Care Plans (EHCPs), transitions for young people moving into adulthood, and ASD waiting times.

Parents and carers have highlighted the need for a common understanding of the EHCP process across social care, health, and the voluntary sector, and for better joined-up information to avoid families having to repeat their stories. There is also a call for greater clarity on how funding and resources can be used by families, and more opportunities for apprenticeships and supported internships.

The board was informed that SEND inspections are due to recommence in June, and Tower Hamlets is likely to be among the first to be inspected. A SEND progress group is working on inspection readiness, including developing an evidence library and creating one-minute guides for clearer communication. Councillor Denise Jones raised concerns about the lack of specific mention of support for high-functioning autistic young people aged 14-16, particularly regarding resource centres and their mental health, and the cost of sending children out of borough for education. Christabel Shawcross highlighted the importance of advocacy for young people aged 16 and over, transitional safeguarding, and the upcoming changes to the Mental Capacity Act. Amy, another attendee, enquired about the funding and staffing for CAMHS pathways. Warwick confirmed that work is underway to address these issues, with a dedicated plan for transitions being developed.

Access to Primary Care and COVID-19 Vaccination Programme

Dr. Joe Hall, Clinical Lead for St Paul's Way, and Dr. Farah Bede, a Tower Hamlets GP and researcher on health inequality, presented on primary care integration and the impact of COVID-19. They highlighted how the pandemic has exacerbated existing inequalities and underscored the importance of addressing the social determinants of health. Primary care has adapted significantly, with initiatives like the Home Monitoring Service and the establishment of COVID vaccination centres.

Dr. Bede shared research on the disproportionate impact of COVID-19 on Black communities, particularly the Somali population, and the need for meaningful data to inform culturally competent services. She is leading a project to interview Somali patients affected by COVID-19 to gather qualitative data for bespoke service development.

The presentation also discussed the role of Primary Care Networks (PCNs) in coordinating care and the potential for primary care buildings to support social prescribing. The shift towards a total triage approach has improved access times, but concerns remain about potential barriers for older patients, BAME communities, and those with limited digital access. Mitigating strategies include keeping doors and phone lines open, training reception teams, and proactive outreach to vulnerable patients.

Somen Banerjee, Director of Public Health, provided an update on the COVID-19 situation and the vaccination programme. While infection rates have plateaued, they remain high. He highlighted that while disparities in vaccination uptake between White and Asian populations have reduced, the gap for the Black population is increasing, and this is also emerging with second doses. Efforts to increase uptake include multilingual helplines, co-production with community organisations, community clinics, and a vaccine roadshow. The implications of Ramadan for vaccination were also discussed, with a consensus from the British Medical Association and British Islamic Medical Association that vaccination does not invalidate fasting. Randal Smith raised the potential for engaging predominantly Black churches in the vaccination effort, and Chris Banks noted challenges with vaccine supply and negative perceptions of the AstraZeneca vaccine.

Other Updates

Councillor Rachel Blake, Chair of the Health and Wellbeing Board, provided updates on the Health and Wellbeing Strategy consultation, which was due to launch online, and the Better Care Fund, confirming its continuation for 2021-22 with an increased CCG contribution. She also highlighted the recommendations from the Council's Race and Inequalities Commission, emphasizing the need to address health inequalities, commission research, understand barriers to primary care, and campaign for adequate government funding. The commission's recommendations also include addressing digital exclusion, reviewing hostile environment policies, reviewing partnership structures, supporting BAME individuals into health professions, researching causes of health inequalities, and strengthening clinical training. Denise Jones reported on work by the Tower Hamlets Together boards focusing on anti-racist leadership, with further sessions planned.