Apologies for Absence were received from Jane McSherry (Director Children Schools and Families) Dr Aditi Shah.

There were no declarations of interest.

RESOLVED: That the minutes of the meeting held on 22 March 2022 were agreed as a correct record.

The Director of Public Health gave an overview of living with COVID.

Instead of an acute response, COVID is currently being treated as other respiratory infections. She advised that the Board has an ongoing role in the oversight of COVID preparedness: supporting with ongoing vaccination, looking after those with Long COVID and ensuring the vulnerable have good access to therapies. If a more serious variant emerged, the acute response would be led nationally by the UK Health Security Agency. She reminded the Board of its Community Subgroup which kept an active dialogue with the community through the pandemic and is ready to stand up, if needed, in future. In terms of legacy, Infection Prevention Control is now better embedded in care homes and adult social care settings and active engagement is ongoing with Community Champions and the voluntary sector

Heather Begg (Commissioning Officer, Adult Social Care) Sally Burns (Parent and Carer) and Tracy Weight (CEO Carer Support) presented a summary of Merton Carer’s Strategy.

The slides from his presentation are attached to the minutes.

Sally Burns said she had been involved in the Strategy since 2019 and last spoken at the HWBB in 2020. She emphasised the impact of caring on both physical and mental health. She explained that COVID had exacerbated loneliness with less support services available and delays to health treatments. It is important that we make progress, both for carers and to avoid even more future demand. A joint approach is needed and, she felt that, whilst there is effort on all sides, lack of resources is impacting progress, for example, delivery of Carers’ Cards.

The Chief Executive of Carer Support said the Carers Strategy is one of the best co-produced pieces of work she has been involved with. The current focus is on young carers who have been disproportionately affected by COVID and they are working with schools and GP practices on identification. Also working with parent carers looking at pathway to assessment to help get support in place and avoid crisis point. This work is due to be completed in August.

The Locality Director Merton and Wandsworth welcomed the Carers Strategy and congratulated partners. It was good to see GP identification included and suggested an area to consider is discharge from hospital, referencing the Healthwatch survey.

The Director of Public Health asked partners see how resources could be identified to help mobilise action. It was agreed that the Interim Director of Community and Housing will meet with the Director of Children, Schools and Families and the Locality Director for Merton and Wandsworth to review resources. The Chair asked that they report back on this as he recognises the value of carers and wishes to support them.

RESOLVED:

A.    That the Board acknowledge the progress of Merton’s Carers Strategy 2021-2026

B.    That The Board review the priority outcomes and determine whether there are other priorities to be included for year 2

C.   That The Board commit the necessary resources to supporting the work to deliver the priority outcomes for carers

D.   That The Board seek the views of more carers including young carers and parent carers to help shape the changes.

Dr Yannish Naik summarised his report which set out the collaborative approach of Health in All Policies, focusing on the wider determinants of health as a key way of addressing health inequalities. The proposal suggests that the impact on health and wellbeing should be considered in all policy making. He referenced the progress made to date and outlined a two part approach: ways of working together with partners, and, exemplar trailblazers potentially including Merton as a ‘borough of sport’, supporting healthy weight and combatting frailty. The role of the Public Health team in this will be to hold the action plan and to support networks in the embedding of Health in All Policies.

The Locality Director for Merton and Wandsworth welcomed the report as exactly what we should be partnering on. The Chair asked how we can get embedded into different depts. The Director of Public Health said that Health in All Policies could be included in staff induction, appraisal and review. A trailblazer of ‘borough of sport’ would lend perfectly to be inclusive, linking to ‘Active(ly) Merton’. Councillor Gould referenced the link to the Climate Action Plan and the Locality Director will take Health in All Policies to the Merton Health and Care Together Committee. Walk and Talk opportunities were referenced as was green social prescribing, Merton Can and Try 22 in Merton 2022. The Chair asked that a report on Health in All Policies be brought to a future Cabinet meeting.

RESOLVED:

That the Health and Wellbeing Board commented on the revised Health in All Policies Action Plan

Better Care Fund Plan

The Assistant Head of Transformation presented the Better Care Fund Plan for 2021/22 for the agreement of the Board. She advised that guidance for the Plan for 2022/23 is due, so she could bring to the September Board. The Chair asked how the Better Care Fund helps tackle health inequalities and the Assistant Head of Transformation outlined the funding of proactive care including: social prescribing for those most vulnerable; maintaining the community response hub post-pandemic to help people access services; the Living Well service run by Age UK; and, the Tuned-In project reducing isolation among men. The Chair suggested a written report on how the Better Care Fund is taking health inequalities be brought to the next Board as part of proposals for the 2022/23 Plan. Dr Vasa Gnanapragasam outlined some of the valuable work supported by the Better Care Fund and offered to help with this report.

RESOLVED: The Better Care Fund Plan 2021/22 was agreed.

Health and Care Plan

Gemma Dawson gave an overview of the Health and Care Plan and its approach of start well, live well and age well in a healthy place. The presentation included reference to Core 20+5 data and it was agreed that a further report will come to the Board in September, aligned with the Joint Strategic Needs Assessment, to help inform a common understanding of health and wellbeing needs, as well as assets. The Chair requested that this include a clear description of the meaning of Core 20+5. Councillor Gould said that she would like to have access to Core 20 information. The Director of Public Health explained that understanding population need is an ongoing piece of work, including ward profiles and now developing understanding of Core 20. Dr Vasa Gnanapragasam explained that data will not be current, but can be used to help inform how we invest in the wider determinants of health and prevention, and that this is a key part of tackling health inequalities.

Epsom and St. Helier

The Locality Director for Merton and Wandsworth gave an update. He referenced that the Health Scrutiny Panel will be taking a fuller report in September in order to scrutinise latest proposals. It was suggested that the September Health and Wellbeing Board could consider health inequalities in relation to this, specifically the recommendations of, and response to, the Kings Fund report. The Chair referenced a recent Health Service Journal article reporting a cut in funding that could result in further delays. He said that residents deserve better and referenced a ‘blight’ on investment. The Locality Director said that the national programme is yet to confirm levels and dates of funding and that these are currently being lobbied for. Members commented and raised particular concerns on the impact on health equalities.

East Merton Health and Wellbeing Hub

The Locality Director for Merton and Wandsworth acknowledged that the project has been many years in gestation. He reported that the most recent consultation and engagement programme identified the Wilson as  ...  view the full minutes text for item 7.

8 

Pharmaceutical Needs Assessment (Agenda Item 8)

The Director of Public Health gave a brief outline of the Pharmaceutical Needs Assessment report circulated to members. In 2015 it became a statutory duty that Health and Wellbeing Boards publish a Pharmaceutical Needs Assessment, refreshed every three years, as a tool to assess market entry. She stressed that community pharmacies are an important part of healthcare and the Board was asked to comment, be active in the consultation, and share with their networks.

RESOLVED:

A.         That The Board note the process to produce a revised Pharmaceutical Needs Assessment by 1st October 2022 has commenced and is being managed by the Merton PNA Steering Group.

B.         That The Board agreed to share the draft Pharmaceutical Needs Assessment with their networks and to respond formally to the consultation, which will inform the final Pharmaceutical Needs Assessment in Merton.

C.        That The Board delegate the sign-off of the final Pharmaceutical Needs Assessment to the Director of Public Health in order to meet the statutory deadline of 1st October 2022

Dr Mohan Sekeram outlined ‘The Biggest Issue’ of healthy weight, which has been a key priority of the Board and links to its earlier work on the Diabetes Truth Programme and Child Healthy Weight. He asked Board members to support the survey on the Biggest Issue and it was agreed that the findings of the survey will be reported back to a future Health and Wellbeing Board. The Chair asked that the Council’s Communications Team help promote the survey and both the CCG and voluntary sector partners also agreed to share the link with their networks.

As this was Dr Vasa Gnanapragasam’s final Health and Wellbeing Board meeting, the Chair thanked him for his huge and valuable contribution as Vice Chair.