The Chair welcomed Vusi Edeki and Russell Styles to the board.

Apologies were given by Jane McSherry with Elizabeth Fitzpatrick in attendance as substitute and Dan Jones with David Gentles in attendance as substitute.

The chair extended his thanks to Dr Laura Jarvie and agreed to write a letter of thanks on behalf of the board.

There were no declarations of interest.

RESOLVED: That the minutes of the meeting held on 27 June 2023 were agreed as an accurate record.

Barry Causer (Public Health Lead for Adults, Health Improvement and Health Protection) and David Gentles (Head of Sports and Leisure) introduced the item.

Barry informed the committee that the focus on physical health was because it was also good for mental health, to connect socially and could be fun.

Merton performed well when compared to London and national averages but as detailed in 2.2 of the report, 31,000 Merton residents were physically inactive and these were the residents that they wanted to engage in the program.

Merton also performed well compared to national averages when they looked at physically active young people but there were still 16,000 children and young people not active enough to benefit their health. The partnership approach from the Health and Wellbeing Board and Merton Health and Care together was welcomed and positive.

The Borough of Sport and Actively Merton teams worked closely over the last 8-9 months and would continue to do so.

Over the pass 12 months, Actively Merton was able to identify funding and delivered Beat the Street. 14 grants to local voluntary sector organisations valued at a total of £15,000 were also awarded. The grants had the dual purpose of gaining more physical activity over the summer and to further understand the barriers of participation so that this could be addressed. The continued insight would be crucial and shared with the board.

Active Merton worked with the Borough of Sport team on Park Play as detailed in the report under section 3.5. Play was the fundamental building block of an active lifestyle. Funding had been identified and programs were put in place for 2hrs of free community play in Cannons Mitcham, with the view of extending this further.

Evidence from Park Play showed that it helped individuals overcome the barrier to participation. Over 57% of the Park Play players were women and girls, 78% of which were inactive or barely active and over 3 quarters said their family activity increased.

In June 2023 they held a workshop to discuss the assets within Merton and the barriers which needed to be addressed. Section 3.8 of the report detailed some of the barriers such as supporting older people to be more active, toilet provisions, opportunities to work with organisations across the borough, ways to encourage residents as they aged to maintain activity levels and support for careers and residents with dementia. For women and girls, some of the barriers mentioned were personal safety and a lack of women only opportunities. Some suggestions put forward were intergenerational classes, childcare provisions and social elements to the activities. Residents with a disability mentioned barriers such as a lack of leisure provisions and awareness. Having assessed the evidence, they now looked at putting together an action plan to further promote physical and social activity alongside communications and awareness.

Evaluation of Actively Merton remained an important focus and they planed to put in an application to the first program of public health intervention responsiveness studies which would look at  ...  view the full minutes text for item 4.

Mark Creelman (Local Executive Director) and Graham Terry (Assistant Director Adult Social Care Community and Housing) introduced the item.

Mark informed the board that each year they were given guidance around health and social care, particular on how to manage resilience throughout the winter months.

£3.26 million was allocated towards health, which was the same amount allocated the previous year. With escalated winter pressures it was important that funds were allocated as wisely as possible. Some of the initiatives in place was placing a London Ambulance Worker in the Emergency Department which allowed people to get into the emergency department quicker. Space within the emergency department was increased to allow for more people to be seen and reduce the time people had to wait in an ambulance. A Transfer Care Hub was also being developed. This was a joint development across all partners with the aim to have an integrated team to discharge patients as efficiently as possible. There was now a frailty zone within the emergency department in St Georges Hospital to ensure patients received the right care as quickly as possible. Escalation beds were also now open in St Georges Hospital. Alongside local authority partners, they looked at intermediate care to support those who were discharges but needed further support.

Primary care was presented to OSC (Overview and Scrutiny Commission) which highlighted some improvements they could make, but it was important to highlight that across the 21 practises in Merton, there were 6 PCN’s (Primary Care Networks). Primary care appointments were available 7 days per week between 8.00am – 8.00pm which included a mixture of practices, primary care networks and boroughwide enhanced GP Hubs. Over the last couple of years, they recruited 70 new staff into Merton Primary Care to enable residents to be seen by the right person, at the right time and as quickly as possible. This would also help to take some of the pressure off of GP’s.

A range of digital solutions were coming online, such as the NHS App, but they recognised that the digital approach did not suit everyone and would ensure that non digital solutions remained. Investment in a cloud base telephony service was being rolled out across all practices and would help to avoid residents from having to call at 8.00am and wait in queues to get an appointment.

Graham informed the board that a letter from the Ministry of State was received which set out the expectations of adult social care over the winter months.

Adult Social Care introduced key services such as the reablement service which, at any one time, would enable up to 50 people to be discharged safely from hospital. During winter and where possible, they would increase capacity.

The Mascot Telecare Service provided a free 4 week telecare service for those who were discharged, this was currently being rolled out within the community and they estimated that approximately 30 people per month would benefit from the service. The free 4 weeks offered was a trial  ...  view the full minutes text for item 5.

Gemma Dawson (Deputy Director – Merton Health and Care Together) introduced the report.

Gemma highlighted that they had a broad, joint and integrated contract between the local authority and NHS which covered a broad remit of community services such as children’s services, core physical health services, district nursing and specialist nursing in the community. The contract was due to expire at the end of March 2025 and presented an opportunity to strategically work together and development services to achieve some of the long term ambitions around integrated care.

A recent project was launched locally which included all directorates from the local authority, voluntary and community sector leads, primary care and the NHS. Lived experience and carer representatives were also to be included in the task and finish group.

They worked collaboratively to develop the vision for community services with a focus on outcomes. The aim was to develop a blueprint on how this could be delivered and become a reality by 2025.

There was a fantastic history of integrated work within Merton with continued examples of partnership and integrated work such as virtual wards, COVID and emerging growing integrated locality teams within primary care.

The aim was to promote some of the holistic principles and develop more integrated services by being person centred and coordinated to move away from episodic or transactional approaches.

In response to questions, the following was stated:

•         The team welcomed the idea of linking with Councillors and officers to share dates and ways they could support.

•         They aimed to work as one and if not as one to be as aligned as possible, but the work needed to start now.

RESOLVED: That the Board agreed the recommendation.

A verbal update to be provided at the meeting.

Barry Causer introduced the report.

In June, the board was given two options and the board requested that both options were implemented.

The four themes were now confirmed and were Holistic Support, Individual and Community Prevention, Healthy Place and Workforce and Awareness, Learning and Collaboration.

Holistic Support would imbed air quality alerts into health and care pathways. This would be done via text message, for example, if a person had asthma, they would get a text message in the morning to inform them that the air quality was poor and explain what they needed to do. They were in discussion with colleagues from primary care to help promote their resources. Another consideration was to switch asthmas inhalers to versions that were greener, healthier to the environment, cheaper and still as effective as previous versions.

Individual and Community Prevention looked to increase awareness of the smoking services available and how they could best support frontline workers who go into people’s homes.

Healthy Place and Workforce looked at staff travel planning, with a draft plan currently in place. A School Air Quality Pilot was to be implemented which gave some young people in the borough a personal air quality monitor. This would allow the team to better understand air quality whilst at home, whilst they travelled to school and whilst at school.

Awareness, Learning and Collaboration looked at aligned communication and engagement around vaccinations. Resources and teams were in place to promote the messages and evidence based interventions.

Continued learning remained important and they planned to implement actions to set up a community of practice.

In response to questions, the following was stated:

•         The Childrens Trust Board met to look at the matters which were of concern to young people and there was a good strand in the children’s and young people plan around My Merton.

•         Anna Huk (Young Inspector) informed the committee of a new project within the public health team call The Stop Vaping in Merton which explored why some people chose to vape, why they returned to vaping and further understanding on how, as a community and local authority, to encourage young people to stop vaping whilst also looking at the behavioural element. Conversations continued to take place with providers to ensure as many young people were represented such as those from SEND backgrounds and those home schooled.

•         A further update on the air quality pilot rollout would be provided to members.

•         The association of Public Health sent representations to central government to address concerns of young people vaping. It was illegal to sell vapes to those under 18 years old and they still did not know the long term impact of vaping, but short term impacts included nausea, headaches and dizziness. For adults who smoked for a long time, vaping was still recommended as harm minimisation.

•         Work with trading standards continued to take place to help to prevent the sale of vapes to under 18 year olds but more was needed.

•         Work  ...  view the full minutes text for item 7.

By Virtue of paragraph(s) 3 of Part 1 of Schedule 12A of the Local Government Act 1972, this item was closed to the public..