The Health and Adult Social Care Scrutiny were scheduled to meet to discuss the first year of the council's response to the Marmot report, a health protection, vaccination and screening update, and the scrutiny report.

One Year of the Marmot Response

The committee was scheduled to discuss the first year of Waltham Forest Council's response to the 2022 report, 'A Fairer and Healthier Waltham Forest: Equity and the Social Determinants in Waltham Forest', which was produced by the UCL Institute of Health Equity. The council's response, 'Building a Fairer and Healthier Waltham Forest: Our response to the Marmot recommendations', was finalised in January 2024 and published in March 2024.

The council's response centred on three priority areas for accelerated action:

• Good Work, Better Health
• Healthier Homes
• Greener and Healthier Places

Each priority area had two Marmot Accelerators identified:

1. Good work for residents with disabilities and long-term health conditions
2. Good work for South Asian women
3. Healthier homes for private renters
4. Healthier homes for older residents
5. Greener and healthier places for communities in the south of the borough
6. Greener and healthier places for residents most at risk of food poverty

The report highlighted progress against the Marmot commitments, and set out how the council will continue to develop its work around Marmot in 2025/26 and beyond. It was noted that the findings of the Marmot research and cross-council work to develop the response helped catalyse a strategic shift within the council towards a focus on prevention.

The Equality Impact Assessment (EqIA) screener template determined that there was no impact on the council's equality duty.

Good Work, Better Health

The report noted that there had been significant progress on providing targeted coaching, training, and in-work support to adults with long term conditions and disabilities, including through IPS (individual placement and support schemes) in primary care and substance misuse services, which supported 76 people with long term health conditions into employment during 2024/25.

It was also noted that Waltham Forest became the first council in London to sign the National Disability Employment Charter, and has started a programme of work to make the council a more inclusive employer of those with disabilities.

Ongoing work is taking place to provide language, learning and employment opportunities to South Asian women, addressing the key barrier of language capacity and capability. A council-wide Inclusion Action Plan has been launched, including specific actions to make Waltham Forest a 'radically fairer' place to work. Work is underway to support businesses to become accredited as London Living Wage (LLW) employers, which will benefit South Asian women already in the workforce. The number of Living Wage employers in WF increased from 56 to 66 in 2024-25.

Healthier Homes

All the actions committed to in the Marmot response have been included in the new Private Rented Sector (PRS) strategy approved by Cabinet in November. Over 171 residents at risk of losing their homes due to issues with their tenancies have received support from the pilot housing sustainment team, including with negotiations around repairs and income maximisation.

HEET (a local charity) were commissioned to deliver community outreach and home visits, and have supported 100 residents in making an application to retrofitting or energy support offers. A specialist damp and mould team was established, focusing on completing urgent inspections in council-owned and managed homes. It has now been integrated into a general repairs taskforce. The Supported Housing Strategy is in development it will help deliver new homes targeted at older people and other key groups, working with them to co-design, implement and pilot approaches to inform future developments.

Greener and Healthier Places

A cross-council Green Spaces working group has been established to deliver a mission-based approach to Green Spaces work across the council. The SANGS (Suitable Alternative Natural Green Spaces) implementation process has led to enhancements of key local green spaces, and includes procurement of a new service for measuring access to green spaces. A programme of greening housing estates, in collaboration with residents and the voluntary sector, has begun, with improvements made to the Grange.

A food innovation fund has been launched, and a total of 7 projects have been funded, including projects focussing on food co-operatives, meal distribution services, improving youth employment and community resilience, and providing education on food growing, cooking and meal planning. The Waltham Forest Food Partnership launched in October 2024, initially connecting council teams, food growers and food resilience projects to share knowledge and explore collective responses to food insecurity challenges, with a preventative ethos embedded into the partnership structure. A new more sustainable model of emergency food distribution, with food banks receiving food directly from the Felix Project, rather than via a council-run food hub has been implemented for 2025-26.

Health Protection, Vaccination and Screening Update

The committee was scheduled to receive an update on health protection, vaccination and screening programmes in Waltham Forest.

The Vaccination, Immunisation and Screening Strategic Oversight Group (VIS) priority areas for 2025 are:

• Under 5 immunisations, with a particular focus on MMR
• School-aged vaccination programmes
• Inequalities in uptake of seasonal vaccinations (Covid-19 and flu) by ethnicity
• Bowel cancer screening

It was noted that there are a number of routine vaccinations for children in the UK, and that over the past decade, there has been a slow national decline in the number of parents and carers getting their children vaccinated with the MMR and other childhood vaccines. Measles is highly contagious so even a small decline in MMR uptake can lead to a rise in cases. Locally, regionally and nationally there has been an increased focus on improving MMR uptake since 2024, when numbers of cases rose significantly and there were widespread outbreaks in several parts of the country, including London.

Several changes to the routine childhood immunisation schedule in the UK will be taking place on 1 July 2025 and on 1 January 2026.

There are four school-aged vaccination programmes: seasonal influenza, Human Papilloma Virus (HPV), Meningitis ACWY (MenACWY), and tetanus, diphtheria and polio vaccination (Td/IPV).

Inequalities in uptake of Covid-19 vaccination have been a persistent issue, with particularly low uptake amongst Pakistani, Black African, Black Caribbean and Black Other ethnic groups. Inequalities in flu vaccination uptake tend to be less pronounced, although some differences in uptake still exist across the borough. These largely follow the same pattern as inequalities in Covid-19 vaccination uptake, however the lowest uptake is amongst the Black and Other White ethnic groups.

Bowel cancer screening has been a priority for VIS for the last two years because of lower coverage in the borough compared to London and England, and inequalities in coverage between different groups. Bowel cancer screening is offered to men and women who are registered with a GP practice when they turn 50 years old.

In addition to bowel cancer screening, there are another four adult screening programmes offered in England: breast cancer, cervical cancer, diabetic eye screening (DES) and abdominal aortic aneurysm (AAA) screening. There is also a maternal and newborn screening programme.

From 1 April 2026, the commissioning of the significant majority of vaccination and screening services will be delegated from NHS England to Integrated Care Boards (ICBs).

The Scrutiny Report

The committee was scheduled to review the draft Forward Plan for the 2025/26 municipal year and make recommendations as necessary, as well as review and comment on the Action Tracker and Recommendation Tracker from the previous meetings.

The key decisions listed in the report were:

• One Year of the Marmot Response, decision due date 15th July 2025
• Adoption of new Mental Health S75 agreement with NELFT, decision due date 4th November 2025

The prospective items for consideration were:

• Commissioning Framework Paper
• ASC Provider go into the 25/26 proposals and prepare a report to be included in the general CQC readiness (waiting lists included)
• Dentistry Access
• GP access and triage services
• Hospital discharge
• Women's Health (Public Health and ICB) What is being done locally and how does WF compare to other NEL boroughs.
• Child Mortality Rates
• Tobacco and Vaping Strategy
• Integrated neighbourhood model

The action log included updates on the following actions:

• Officers to provide an update on how many Life Line volunteers have experience befriending elderly people
• Officers to update members once the eligibility criteria for residents to receive the Hardship Fund has been determined
• Officers to provide further information about the support for unpaid carers
• Officers to share the coroners response with the Committee once it is completed
• Officers to bring a future item on the business plans for the Safeguarding Adults Board

The recommendation log included updates on the following recommendations:

• Service to keep Scrutiny informed (for 12 months) regarding plans for the site if the decision is to close the Markhouse Centre
• The Committee recommend services to explore continuing the Kooth offer and identify a source of funding where possible
• The Committee endorses the decision for services to begin the consultation