Councillor Alex Sanderson, Deputy Leader, chaired the Health and Wellbeing Board meeting, which ratified the Better Care Fund quarter four report, heard highlights from the People's Department, and received the North West London Child Death Overview Panel annual report. The board also noted progress on the Pharmaceutical Needs Assessment.

Child Death Overview Panel, North West London, 2023-24 Annual Report

Chris Miller, Independent Chair of the North West London Child Death Overview Panel, presented the panel's annual report. The Child Death Overview Panel is a statutory body run by child death partners, including the local authority and the integrated care board, and reviews the death of every child normally resident in North West London¹.

Miller explained that the panel looks for cases that should be notified as a serious incident², cases affecting the safety and welfare of children, and ways to improve holistic care for children and their families. The panel seeks to clarify the cause of death, determine contributory factors, identify learning that may prevent future deaths, and make recommendations to relevant organisations.

The panel has moved to a thematic approach, with regular neonatal panels, and panels on trauma, sudden and unexplained deaths, and medical and palliative care. Miller noted that there are about 140 child deaths a year in North West London.

The report highlighted several issues:

• Ethnicity data: The ethnicity data within the Child Death Review (CDR) process is not always reliable.
• Deprivation: There is not a straight line between deprivation and child deaths.
• Modifiable factors: A modifiable factor is an issue that, if it hadn't happened or could have been changed, might have made a difference to the death or vulnerability of the child.
• Interpreting: Access to reliable interpreting services is an ongoing challenge.
• Consanguinity: Consanguinity is a big issue across North West London.
• Gestational diabetes and race/ethnicity: Black and Asian mothers-to-be are not always assessed accurately in relation to gestational diabetes.
• Group B Streptococcus (GBS): There is a trial underway to determine whether routine screening of mothers for GBS makes a difference to death and other conditions.
• Emergency services: Parents sometimes take their children to the wrong place instead of calling the emergency services.

Miller also presented a map mapping deprivation against the number of deaths in lower super output areas³, and said that the panel is starting to build up a picture that these little communities do not have the same numbers or the same rate of child death across the piece.

Councillor Helen Rowbottom, Chair of the Children and Education PAC and H&F Industrial Strategy Ambassador, asked how the commonalities on modifiable aspects link through to commissioning and research and development. Miller said that the commissioning discussion through the ICB is around the disparity in commissioning of community nursing for palliative cases. He also noted that there are some very simple things, like the aspirin pathway for mothers who are assessed as being overweight or obese, that come up far too often.

Councillor Natalia Perez, Chair of Health and Adult Social Care PAC, asked if the recommendations made to other organisations are followed through. Miller said that it is a tricky issue, but that the ambulance service is working on it, the police have been working on their end of it, and the hospital trusts all know that it is an issue and they work at their commissioning of interpreting services and their language line.

Sue Spiller, Chief Executive Officer, SOBUS, asked if there is any data on the cause of death by ethnicity. Miller said that they have that data, but the problem is that the ethnicity data is not always specific enough.

Anna Carpenter noted that themes identified through the child death review process are fed into the local safeguarding children partnership, and that they have done lots of promotional work around safe sleeping.

Pharmaceutical Needs Assessment 2025-28

Dr Nicola Lang, Director of Public Health, presented an update on the Pharmaceutical Needs Assessment (PNA) 2025-28. A PNA is a statutory duty of the Director of Public Health to produce one every three years. The PNA maps current services against local health needs, looks at gaps in service provision, informs commissioning decisions and market entry, and supports service development.

The analysis and picture of the borough will be done by the business intelligence team and in public health, and a specialist provider will be tendered to do the technical details of provision.

Councillor Natalia Perez asked if the recommendations from the 2022-25 needs assessment fit into this process. Lang said that the main part of this is to look at how many pharmacies there are and what they are doing. Some pharmacies are now offering childhood vaccinations and doing more, but some pharmacies have also closed.

In relation to the north part of the borough, College Park and Old Oak, Lang said that the specialist provider will advise on whether there are gaps.

Councillor Helen Rowbottom asked about the timeline and scrutiny for how a specialist provider would be selected. Lang said that sometimes large multinationals take over a pharmacy chain, but then you'll find a small provider providing a really good service. She added that the council has a local pharmaceutical committee, and that they tend to say when they're worried about something.

Sue Roaston, Borough Director for North West London ICB, added that the NHS has commissioned quite a lot of additional services from community pharmacy, showing what their worth is in the local community.

Councillor Natalia Perez asked about the membership of the PNA steering group, and whether the patient's voice is incorporated as part of that process. Lang said that the PNA will go out to consultation for a long period, and that they try to oversample clients who use pharmacies who might not always be asked their opinions, like homeless people, drug and alcohol clients, and sexual health clients using emergency hormonal contraception.

Sue Spiller asked if there are any standard questions that have to be asked in the consultation, and how much flexibility there is in tailoring questions for the local community. Lang said that there is lots of flexibility.

Carleen Duffy, Healthwatch, said that she worked on the 2022 one, and that Healthwatch gathered 93 responses from people face-to-face from people that don't ordinarily use the online one.

Lang said that if there was a closure in a place that had very sparse provision, that does create a bit of an emergency.

Lang added that the PNA should consider emerging trends in pharmaceutical innovation.

Highlights from the People's Department

Jackie McShann, Executive Director of People, presented some of the activities that the department has been up to.

Peggy Coles was instrumental in organising a dementia afternoon tea party for over 180 residents, carers, and families, in partnership with Fulham Football Foundation, Hurlingham Charities, and Peggy's Dementia Action Alliance. The event was opened by Councillor Sharon Holder, Mayor, and included a speech from Catherine Wilmot, Director of Adult Social Care.

Parents Active celebrated their 25th anniversary in May.

Foster Care Fortnight was celebrated with lots of events, and Councillor Alex Sanderson led on the weekly briefing, celebrating foster carers and those who support them. Minister Davey joined for a Foster with West London event. Hammersmith and Fulham host a recruitment hub for foster carers across the eight West London authorities.

A community organisation has supported Jack Tizzard School to put solar panels on the roof. Ed Miliband, Secretary of State for Energy and Climate Change, visited the school, along with Councillor Alex Sanderson and MP Andy Slaughter.

Nikki Lang said that there was a session of a roundtable on men's mental health at Nourish Hub last week, and that they are doing lots of digital analysis and mapping so that the footprint of people using the council website can then be followed to provider services like the Listening Place, Men Who Talk, James's Place, and Andy's Man Club.

Councillor Alex Sanderson congratulated Parents Active for their 25th birthday, and said that if anyone would like to foster, it is a wonderfully rewarding experience and there is a huge package of support available.

Councillor Natalia Perez asked if the council is meeting the needs that they have for foster carers, and if there is a recruitment process. McShann said that there is absolutely a need, and that there is a national shortage of foster carers.

A member of the public said that they used to foster for Hammersmith and Fulham and the support that came along was brilliant, but that the support for post-adoption hasn't been as great in the last few years. McShann said that they absolutely do provide support, and that if they have feedback they want to share it with the operational director, that would be really helpful.

Better Care Fund Quarter 4 Report 2024-2025

The board ratified the Better Care Fund (BCF) quarter four report for 2024-2025. The BCF supports community health and social care resources to reduce the number of people who need to be admitted to hospital, and supports residents that do require admission to get home as soon as they are well.

The report detailed planned and actual expenditure to date, and planned and actual outputs delivered to date. Two of the four BCF metrics are not on track to meet target:

• Avoidable admissions: Data is currently unavailable to assess progress due to suspected issues with the National BCF Data.
• Residential admissions: The aim of this measure is to support residents to achieve optimal independence and thus avoid residential care where possible. The aim is to remain below the predicted target of 72 residential placements by the end of the year, but the council was at 79 placements by the end of quarter four.

The overall outturn spend was £45,275,046, resulting in a net underspend of £385,993.