The Health and Wellbeing Board met on Thursday 12 September 2024 to discuss a range of public health initiatives and service updates. Key discussions included progress on the Harrow Borough Based Partnership, an upcoming inspection of children's services, and strategies for tobacco control and health behaviour change.

Harrow Borough Based Partnership: Update Report

Lisa Henschen, Managing Director of the Harrow Borough Based Partnership, presented an update on the partnership's activities during June and July. The Integrated Intermediate Care Team for Harrow is now operational, aiming to improve post-discharge support and has already shown a reduction in rehabilitation bed delays. An Early Supported Discharge and Community-Based Rehabilitation model for stroke patients is also set to launch. Positive signs were noted regarding child tooth decay rates, with a decrease in hospital admissions for young children. The Winter Wellness Program is transitioning into community hubs, and all integrated neighbourhood teams are now operational, focusing on health inequalities. The board's winter plan has been finalised, though a funding gap in community health services was highlighted. Significant concern was raised about the 100% increase in demand for children's occupational therapy since 2018, with 440 children currently on the waiting list. Discussions are ongoing about potentially narrowing eligibility criteria for the service. The Board agreed to continue monitoring key issues, including the impact of Integrated Care Board (ICB) changes, winter admission prevention, and GP service performance. A detailed report on GP performance and an investigation into the Occupational Therapy Service's organisation and communication will be presented at the next meeting.

Inspection of Local Authority Children's Services (ILACS) Briefing

The Board received a briefing on the upcoming Inspection of Local Authority Children's Services (ILACS) by Ofsted, expected in the next quarter. Harrow was last inspected in 2020 and received a Good rating. The inspection process, focus areas, and post-inspection procedures were outlined. Councillor Hitesh Karia, Portfolio Holder for Children’s Services, thanked the Children's Services team for their efforts in improving training and performance management, acknowledging the challenges of resource and staff retention pressures. The Board confirmed their readiness to support the inspection and discussed the importance of multi-agency working and safeguarding. The Children's Services team confirmed that they have been extensively reviewing their services and are well-prepared, though acknowledged that Ofsted inspections can present unpredictable elements.

Tobacco Control Strategy

Carole Furlong, Director of Public Health, presented the draft Tobacco Control Strategy, highlighting that smoking remains a leading cause of premature death in the UK and Harrow. The strategy aims for Harrow to be smoke-free by 2030, with priorities including preventing smoking in younger generations, promoting smoke-free pregnancies, reducing inequalities, and improving cessation services. New funding of £192,000 will be used to recruit additional staff and explore alternative cessation methods. The Board discussed concerns about the rising use of e-cigarettes among young people and the need for consistent messaging. They also raised issues regarding vaping advertisements, the prevalence of chewing tobacco, and the sale of illicit tobacco. The Board agreed on the importance of forming a working group to enhance enforcement efforts against underage sales of vapes and illicit tobacco. The strategy will be finalised after further consultation.

MECC (Making Every Contact Count) Update, Strategy and Programme Evaluation

The Deputy Director of Public Health presented an update on the Making Every Contact Count (MECC) programme. The programme equips frontline staff with skills to initiate conversations promoting health behaviour changes. An evaluation indicated positive outcomes in increasing staff confidence, with 380 staff trained against a target of 350. Voluntary Action Harrow has been re-commissioned to continue delivering the programme until July 2025, with a strategic target to train 750 frontline staff by 2027. The Board discussed the programme's effectiveness, diversity outreach, and how it could be further developed. They suggested incorporating chewing tobacco awareness into training and exploring the use of social media and podcasts to reach younger audiences. The MECC programme will be aligned with the upcoming winter health campaign. Actions agreed include closer work with diverse communities, tailoring training for disabilities, incorporating chewing tobacco awareness, involving volunteers, and utilising social media and podcasts. The Board agreed to promote MECC to frontline workers and volunteers.