This Integrated Meeting of Waltham Forest Health & Wellbeing and Health & Care Partnership Boards considered four joint items, one item solely for the Health and Wellbeing Board, and one item for the Health and Care Partnership Board.

Business planning for Integrated Health Boards

This item included a discussion on the functions and statutory duties of the boards, the history of priority setting in the partnership, and existing priorities and workstreams, with a view to defining the boards' partnership priorities, and distinguishing these from business as usual. The report noted previous priority setting included a 2023-25 set of priorities set during a cross-cutting partnership event and a set of priorities agreed by the Health and Care Partnership Board in 2024/25.

The report then describes the work of a workshop that was held by The King’s Fund Charity in May 2024, that sought to determine priorities for health equity partnership working:

Decisions were made based on data around inequality and need (as per Joint Strategic Needs Assessment {JSNA}; stakeholder feedback; and the potential to create system change.

The report pack also includes the three priorities that the workshop settled on:

• The mental health and wellbeing of Black boys and young men
• Childhood obesity and the path to diabetes¹, especially among children from the global majority²
• Long-term conditions and the early onset of complexity and frailty

Diabetes is a long-term condition that causes a person’s blood sugar level to become too high. Global majority is a term that is increasingly used to refer to non-white people.

The report pack included the following recommendations for the boards to consider:

• Noting the activity undertaken by the Boards so far, to identify partnership priority areas
• Endorsing the recommendation to adopt the priorities determined in the workshop supported by The King’s Fund.
• Agreeing an indicative forward plan for the coming year.

Promoting Wellbeing workstream - update

This report pack item summarises the progress of the Promoting Wellbeing workstream, focussing on updates to the five priority areas within the workstream:

• Strengthening the partnership with the voluntary and community sector and faith groups, to promote health
• Mental health promotion
• Locality Hub³ and Primary Care Spaces
• Maximising employment support
• Housing and health

Locality hubs bring together in one place a range of services, such as healthcare, social care, community services, and the voluntary sector.

The report describes some of the key achievements and challenges in the workstream:

• The voluntary sector ambitions are difficult to quantify using metrics as they relate more to the system at large than the specific services provided.
• There is a lack of dedicated programme management resource, with the workstream instead being supported by Strategic Partnerships.

• There were significant gaps identified in adherence to Safe Surgeries principles:

  The Mystery Shopper report undertaken for the Borough of Sanctuary workstream identified significant gaps in adherence to Safe Surgery principles, which have prompted targeted improvements. However, risks such as capacity constraints, limited awareness of Safe Surgery principles, and access barriers for migrants and refugees remain, and may hinder the effective implementation of the action plan.

• Risks remain around the Locality Hub programme:

  Although a new Locality Hubs Executive Board has been created, input is required from a number of stakeholders and progress is taking more time than initially expected.

The report pack includes recommendations for the boards to review the updates, progress, and risks, assess the transition to the delivery phase, and to indicate any areas for future deep dives. The report pack also asks that the boards endorse the following proposed allocations for the Health Inequalities Fund for 2025/26:

Implementing the Marmot recommendations

This item provided a summary of progress on six commitments set out by Professor Sir Michael Marmot in his review, “A Fairer and Healthier Waltham Forest: Equity and the Social Determinants of Health”, and Waltham Forest Council’s response to it, “Building a Fairer and Healthier Waltham Forest: Our response to the Marmot recommendations”:

• Good work, better health
  • Good work for residents with disabilities and long-term health conditions
  • Good work for South Asian women
• Healthier homes
  • Healthier homes for private renters
  • Healthier homes for older residents
• Greener and healthier places
  • Greener and healthier places for communities in the south of the borough
  • Greener and healthier places for residents most at risk of food poverty

The report pack included a summary of progress against the six commitments, a discussion of some key opportunities and challenges, and a proposed plan for the future. It noted the links between the Marmot Review and the Council’s Mission Waltham Forest Strategy, and the Council’s Stronger Communities programme.

Response to Marmot recommendations - workshop

This report pack item describes a workshop held with the objective of reviewing the Council’s response to the Marmot Review. It lists the following questions and topics scheduled for discussion:

• What are the biggest successes?
• Where have the biggest challenges been encountered?
• What are the biggest missed opportunities?
• What are the biggest priorities for future work?
• What should the focus be for the 1-year report in March 2025?
• What should our approach be for beyond the 1-year point?
• What areas are missing, and how can they be integrated?
• How can we work differently to achieve a greater impact?
• How can we strengthen our engagement with residents?
• How can we better measure impact?
• What is the King’s Fund’s role in the future of the work?

Better Care Fund - quarterly report

This report pack item contains the Better Care Fund Quarter 2 report, seeking approval for it. The report highlighted the following points:

• A Deed of Variation to the existing Section 75 agreement was being sought.
• The report pack included actual performance data on four metrics:
  • Avoidable admissions: On track to meet target.
  • Discharge to normal place of residence: On track to meet target.
  • Falls: On track to meet target.
  • Residential admissions: On track to meet target.

• There has been a decrease in new clients for the short-term domiciliary care pathway:

  This shift is generally positive for our clients, as it better aligns with their needs and the approach to ensuring increased reabling support as a preventative measure.

• There has been an increase in demand for the social support and urgent community response teams:

  The system has monthly meetings that monitor demand in a proactive way.

The report pack included the recommendation for the Health and Wellbeing Board to approve the Better Care Fund Quarter 2 report and delegate to the Integrated WF Finance Oversight Group the authority to take the Deed of Variation through governance.

Resident engagement

This item focussed on the role of residents in shaping the work of the Health and Care Partnership Board. It identified a distinction between resident insight, resident stories, and resident voice, with a view to developing a plan for incorporating all three into the Board’s work.

The report pack contains recommendations for discussion around the following questions:

• How do we effectively bring a range of resident insight into board meetings?
• How do we develop a schedule of resident stories to be heard at meetings?
• How can we formally incorporate resident voice into meetings?