The Richmond Health and Wellbeing Board (HWB) convened to discuss key issues impacting the borough, including mental health services for young people, childhood obesity, neurological conditions, and the state of primary care facilities. The board approved the Pharmaceutical Needs Assessment for 2025 and discussed a co-production charter to improve collaboration with residents.

Public Involvement

Wendy Mikkelwright, a member of a community group affiliated with the Hearing Voices Network, addressed the board regarding human rights concerns within the mental health system. She cited a UN report stating that administering electricity to individuals without informed consent constitutes torture, referencing the use of electroconvulsive therapy (ECT). Wendy Mikkelwright also raised concerns about the disproportionate impact of ECT on older women, and called for a citizens' assembly to discuss mental health practices and housing issues.

Councillor Piers Allen, Chair of the Adult Social Services, Health and Housing Services Committee and Chair of the Health and Wellbeing Board, responded by noting that the board relies on guidance from the National Institute for Health and Care Excellence (NICE), and encouraged Wendy Mikkelwright to submit her evidence to NICE for review.

Joint Local Health and Wellbeing Strategy: Start Well Update

The board received an update on the Joint Local Health and Wellbeing Strategy (JLHWS), focusing on the 'Start Well' priorities: preventing self-harm and improving mental health, tackling childhood obesity, and increasing childhood immunisations.

• Self-harm prevention and improving mental health: Ian Dodds, Joint Director of Childrens Services, highlighted investments in digital mental health resources, enhanced mental health support teams in schools, and the transfer of children and young people's mental health services (CAMHS) to South West London, St. George's Mental Health NHS Trust. Councillor Nancy Baldwin, Vice-chair of the Finance, Policy and Resources Committee (Spokesperson for Communities, Equalities & the Voluntary Sector), inquired about the outcomes of a review of communication and support in schools. Ian Dodds clarified that the mental health support offered has become more targeted to address specific issues in each school. The board also discussed support for young carers, with Ian Dodds mentioning the re-commissioning of the young carers contract and a preference for organisations with local knowledge.
• Childhood obesity: Tolle Oloyede, step lead for childhood obesity, presented data indicating that obesity rates among Richmond's reception-age children are better than the England average, but year six obesity rates have increased. Tolle Oloyede highlighted the Healthy School London programme, holiday food activities, and the Bright Box scheme, which supports families with healthy eating. Councillor Nancy Baldwin expressed concern about the rise in year six obesity rates and inquired about the resilience of the FUEL programme, which is partly funded through the Household Support Fund. She also suggested expanding partnerships with voluntary sector organisations like Magic Breakfast and Let's Cook. Shannon Katiyo, Director of Public Health, mentioned efforts to engage schools and offer resources like the NHS food scanner app. Councillor Michael Wilson raised the issue of planning policies impacting access to sports pitches, and Shannon Katiyo responded by highlighting the inclusion of health and wellbeing policies in the council's local plan and conversations with leisure services.
• Childhood immunisation: Melissa Barker, senior public health lead, and Ruth Egan, head of immunisations at South West London Integrated Care Board (ICB), outlined initiatives to improve immunisation access, including integrating pharmacies into vaccine delivery and implementing the Making Every Contact Count (MECC) programme. The discussion covered the challenges of tracking the impact of MEC¹ conversations and addressing vaccine hesitancy. Councillor Nancy Baldwin suggested asking people where they get their news to understand the reasons behind hesitancy. Melissa Barker clarified that the risk of a measles outbreak in Richmond is currently low due to vaccination rates. Councillor Michael Wilson questioned the report's lack of information on what's working and what's not, and Shannon Katiyo acknowledged the challenges of demonstrating progress due to data limitations.

The board recommended noting the progress of the delivery of the Start Well priorities.

Richmond Neurological Conditions Health Needs Assessment 2025

The board reviewed the Richmond Neurological Conditions Health Needs Assessment 2025 (HNA), which highlights rising prevalence, increasing complexity of need, and opportunities for prevention and integrated care for people with neurological conditions.

Nikke Arowobusoye, Consultant in Public Health, presented the assessment's findings, emphasising the importance of the day of diagnosis as a pivotal moment for intervention. The assessment considered a range of conditions, including Parkinson's disease, multiple sclerosis, stroke, migraine, and epilepsy, and examined service provision across health, social care, and the voluntary sector.

Key findings included:

• Higher than average prevalence of Parkinson's disease and multiple sclerosis in Richmond.
• An increasing trend in stroke cases.
• The need for parity in support for physical and non-visible disabilities.

Jeremy DeSouza, Director of Adult Social Care and Public Health, agreed to take the findings back to his senior management team and consider how to address gaps in relation to the needs assessment.

Councillor Nancy Baldwin raised concerns about NHS funding for voluntary sector organisations like Integrated Neurological Services (INS), and Sue Lear suggested addressing this through integrated neighbourhood health work. Councillor Michael Wilson emphasised the need for leadership to translate the report's findings into real-life changes.

Councillor Sara Challice, Carers Representative, shared her personal experience as a carer for her husband who had a brain tumour, and highlighted the impact on carers and the need for support. Nikke Arowobusoye reassured her that the consultation had started and it is out to carers and everything she said the consultation it has started.

The board agreed to ask the place-based partnership committee to address the findings of the report and asked for a qualitative report to be presented in July.

Better Care Fund Quarter 1 2025-26 - Update

Brian Roberts, Head of Health and Care Integration, presented an update on the Better Care Fund (BCF) for quarter one of 2025-26. The report confirmed that national conditions were met and that spending was largely on track.

While the average length of discharge delay was within the target, emergency admissions for those aged 65 and over were not meeting the set ambition. Brian Roberts noted that the expansion of the integrated virtual ward and the work of the frailty collaborative are expected to have a positive impact.

The board noted the year-to-date BCF spend and output activity, as well as the outcomes and impacts of the BCF on independent admission avoidance and hospital discharge.

Report by the Director of Public Health on the Pharmaceutical Needs Assessment 2025

The board received a report on the Pharmaceutical Needs Assessment (PNA) 2025, with Shannon Katiyo introducing the item. Nikke Arowobusoye highlighted that the assessment, which was conducted in line with statutory guidelines and public consultation, identified no gaps in pharmaceutical service provision.

The report noted several themes that emerged from the public consultation, including the desire for more evening and weekend access, concerns about stock issues, and the need for recognition of changing population needs.

Councillor Piers Allen mentioned a possible pharmacy closure in Barnes and inquired about potential changes in pharmacy commissioning. Denise Madden, South West London Integrated Care Board, said she was not aware of any changes but would find out and share an update.

The board signed off the final PNA report for publication and noted the report updates on the previous PNA paper.

Co-production Charter

Bruno Meekings, Community Involvement Manager, Richmond upon Thames Council for Voluntary Service (RCVS), introduced the proposed Co-production Charter (report), which was developed by the Richmond Health and Social Care Co-production Group (HSCCG). The charter aims to provide a simple definition of co-production, set out resident expectations, and increase co-production within statutory services.

Councillor Michael Wilson inquired about how the charter aligns with the existing voluntary and community sector (VCS) compact. Bruno Meekings clarified that the charter focuses on the relationship between residents and the council, while the compact supports good practice within the VCS.

The board noted the work of the co-production group and agreed to consider the charter further at the Adult Social Services, Health and Housing Committee.

Primary Care Estate

Denise Madden provided an overview of the primary care estate in Richmond, highlighting challenges and opportunities for future provision. The report noted that Richmond's primary care estate is below the recommended level of accommodation and that many facilities require updating.

Denise Madden mentioned that the Park Road Surgery in Hampton is a priority area for relocation and expansion. Councillor Piers Allen suggested that the Teddington Police Station could be a potential site, but noted that the Mayor of London's approval would be needed.

The board noted the report and requested a follow-up on the work being done to address primary care estate issues.

Health and Wellbeing Board Work Programme

Shannon Katiyo presented the Health and Wellbeing Board Work Programme, outlining planned meetings and seminars. The next meeting is scheduled for 22 January 2026, with a seminar on whole systems approach to weight management planned for 2 December.

Councillor Piers Allen advised that the vice chair position is vacant and welcomed nominations for the next meeting.