The Health and Wellbeing Board met on 21 November 2024 to discuss safeguarding adults, the joint local health and wellbeing strategy, and the Better Care Fund. Key decisions included noting the Richmond and Wandsworth Safeguarding Adults Board's annual report and approving recommendations for its future work, as well as noting the update on the Better Care Fund for Quarter 1 2024-25.

Richmond and Wandsworth Safeguarding Adults Board Annual Report 2023/24

The Board received the annual report from the Richmond and Wandsworth Safeguarding Adults Board (RWSAB) Richmond Wandsworth Safeguarding Adults Board Annual Report. Christabel Shawcross, Chair of the RWSAB, presented the report, highlighting the board's statutory responsibilities, strategic priorities, and achievements over the past year. The report detailed an increase in reported concerns and enquiries, which was viewed positively as an indicator of increased awareness and reporting.

Key areas of discussion included:

• Making Safeguarding Personal: The report emphasised a focus on person-centred approaches and ensuring individuals' desired outcomes were met.
• Learning from Reviews: The RWSAB is working to share learning from Safeguarding Adult Reviews (SARs), Domestic Homicide Reviews (DHRs), and Coroner's Prevention of Future Deaths reports.
• Partnership Working: The report highlighted the establishment of a strategic safeguarding partnership for Wandsworth, aiming for a more local focus. There was also discussion about developing a criminal justice framework for safeguarding, involving partners such as probation and the prison service.
• Specific Issues: The report touched upon issues such as homelessness, the needs of younger populations, and the overrepresentation of certain ethnic groups in mental health services. Engagement with Wandsworth Prison was also discussed, with a new governor keen to collaborate.
• Provider Quality: Information on the quality of care homes and homecare services was presented, with an overall assessment of good quality across the borough.
• Health Inequalities: The RWSAB is aiming to map locations of abuse and compare them with areas of health inequalities to identify potential links and address disparities.

During the discussion, members raised questions about the sources of referrals, engagement with GPs, and the lack of a dedicated GP lead for adult safeguarding in Wandsworth. It was noted that a review of these roles was underway across South West London. The Board also discussed the importance of culturally competent organisations and improvements in mental health services.

The Board approved the recommendations to note the information in the report, acknowledge the assurance that safeguarding practice is monitored, and to consider further links and joint working between the Health and Wellbeing Board and the Safeguarding Adults Board.

Joint Local Health and Wellbeing Strategy - Start Well Delivery Update

The Board received an update on the Start Well theme of the Joint Local Health and Wellbeing Strategy Start Well, which covers the early years of life. The update focused on four key steps:

• Self-harm and Mental Health: Mr Graeme Markwell, Senior Public Health Lead, reported on efforts to improve children's mental health and resilience through whole-school approaches, increased Mental Health Support Team (MHST) coverage, and the PATHS programme in primary schools. The Portus toolkit for self-harm and suicide prevention is also being developed.
• Childhood Obesity: Ms Tolu Oloyede, Public Health Lead, highlighted national increases in childhood obesity and outlined local strategies including promoting breastfeeding, a family weight management programme, and work with leisure partners. Data showed an increasing prevalence of obesity in Year 6 children.
• Childhood Immunisations: Ms Hollie Stone, Senior Public Health Lead, presented an update on childhood immunisation coverage, noting that while routine immunisations were generally higher than regional averages, they were lower than the England average. A comprehensive MMR vaccination campaign had led to an additional 389 children being vaccinated. Efforts are also underway to improve uptake for whooping cough and flu vaccinations.
• A&E Attendances and Hospital Admissions: This section of the report focused on reducing preventable A&E attendances and hospital admissions for unintentional and deliberate injuries in children under five. Key activities included maintaining the Healthy Child Programme and strengthening links between safeguarding teams.

The Board noted the delivery outputs as set out in the report.

Healthwatch Annual Report

Sarah Cook, Healthwatch Manager, presented the Healthwatch Wandsworth Annual Report Healthwatch Annual Report, detailing their work in championing the views of local people using health and social care services. The report highlighted key achievements in engaging with communities, influencing service improvements, and providing advice and information.

Key areas of focus for Healthwatch included:

• GP Communication and Health Needs: Work to improve how GP practices meet communication and health information needs, particularly concerning the Accessible Information Standard.
• Perinatal Mental Health: Efforts to improve mental health support for new parents, with recommendations for more supportive conversations, accessible information, and greater involvement of partners and the community.
• Community Diagnostic Centres: Feedback gathered on patient experiences in Community Diagnostic Centres, leading to commitments for improvement from St George's Hospital.
• Carer Support: Work to improve how carers are identified and supported during hospital discharges, with St George's Hospital taking steps to enhance these processes.
• Homelessness and Mental Health: Highlighting the needs of people experiencing homelessness and the impact of mental health, advocating for joined-up and strategic support.
• Cost of Living Crisis: A survey highlighted the impact of the crisis on health and wellbeing, informing the Council's Cost of Living strategy.

Healthwatch also outlined its priorities for the coming year, including access to primary care, autism and mental health for children and young people, experiences of Community Mental Health Service changes, and experiences of the Acute Stroke Unit at St George's Hospital.

The Board approved the recommendation to note the annual report and provide feedback on progress and future priorities.

Better Care Fund Quarter 1 2024-25 Update

Brian Roberts, Head of Health and Care Integration, presented the update on the Better Care Fund (BCF) for Quarter 1 2024-25 BCF BCF-Appendix 1. The report detailed the spend and activity for schemes within the Discharge Fund. All schemes to support discharge were reported as being operational and having an impact.

The Board noted that £2.72 million had been spent in Quarter 1, representing 35.82% of the total BCF discharge fund for the year. Discussions touched upon the front-loading of spending, increasing demand for services, and the allocation of monies between the ICB and the local authority. The importance of enabling smooth and safe discharges from hospital was emphasised, with ongoing work between partners to achieve this.

The Board approved the recommendation to note the Better Care Fund spend and outputs/activity for the period April – June 2024.

Work Programme

Lynn Wild, Assistant Director of Health and Care Integration, presented the Health and Wellbeing Board's Work Programme for 2024 Work Programme. The programme outlined planned meetings and seminars, with a focus on evolving requirements and partner input. The Board was encouraged to suggest topics for future consideration.

A seminar was scheduled for January or February 2025, led by the LGA, to discuss how the Board could improve its partnership working and connection with residents. Abi Carter, Voluntary Sector Representative, offered to lead a seminar on health inequalities and learning disabilities.

The Board approved the recommendation to note the Work Programme.

Date of Next Meeting

The Board noted that the next meeting would be held on 27 February 2025.

The meeting concluded with thanks to the officers for their presentations and to all attendees for their contributions. Councillor Graeme Henderson wished everyone a Merry Christmas and a Happy New Year.