Dagmar Zeuner, Director of Public Health, and Julia Groom, Consultant in Public Health introduced the item, highlighting successes and challenges in the delivery of the Health and Wellbeing Strategy theme 1: Best start in life:

·         Access to child mental health services: the single point of access approach has seen an improvement; access to a tier three Child and Adolescent Mental Health Service assessment has shortened by three weeks since 2013/14.  Referrals for  Autism Spectrum Disorder diagnosis takes longer but an Autism strategy for all is being developed;

·         School readiness: the gap in school readiness is reducing although data for 2015/16 is awaited.  Work is on-going through Children’s Centres and other settings to support school readiness;

·         Immunisation: this remains a challenging area.  The Public Health team and Merton Clinical Commissioning Group are working with NHS England to improve the quality of data, parental awareness, visit the least well performing GPs in the borough and promote immunisation through all available channels (including MyMerton and health visitors).  In 2017, the focus will include  working with Children’s Centres to promote immunisation; and

·         Childhood obesity: whilst the childhood obesity target has been achieved, there are still 4,500 overweight and obese children in the borough.  The healthy weight action plan focuses on work with partners to achieve a wider preventative approach including developing a better food environment (ie: getting a catering commitment from local food suppliers, influencing school catering contracts, work on holiday hunger and promoting healthy school programmes) and supporting access to parks etc. 

In response to member questions, officers clarified:

·         There is a continual need to challenge and cleanse child immunisation data received from GPs.  This is an on-going process.  It was also noted that a new childhood information system is being developed;

·         A full report on childhood immunisations will be given to the Commission at its meeting on 7 March 2017.  This will cover progress against the recommendations of child immunisation task group;

·         Promotion to parents to encourage healthy eating is being achieved using national and local resources (ie: Change for Life and the Health Matters website) being distributed through schools and Children’s Centres.  The team is continuing to work on how to target families with healthy eating and weight management messages;

·         The team agreed to contact school governors and make them aware of the support available for parents to tackle and prevent childhood obesity;

·         It was highlighted that parents cannot be blamed for increasing childhood obesity.  Rather the focus is on giving practical help and suggestions such as encouraging schools to get children participating in the Daily Mile initiative; and

·         It was noted that only 10% of all funding for mental health goes towards the children’s service and that currently it takes 18 weeks to achieve an Autism Spectrum Disorder diagnosis.

Janet Lewis (Director – Children’s Services) and Shelly Heffernan (Clinical Business Unit Manager), of the Central London Community Healthcare NHS Trust (CLCH) addressed the Panel (a slide presentation was laid round and is provided for the minutes).  CLCH has been the provider of Merton’s children’s public health service since April 2016 and has challenging  targets that have been jointly set by the Council and the local Clinical Commissioning Group (CCG).  These include that every baby born in the borough receives a visit from a health visitor in its first 14 days and has a one year review with the aim to provide the same at two years.

In response to member questions, CLCH’s representatives clarified:

·         It is in a strong position.  It is getting support from the Children’s Trust Board, it has been provided with a clear strategic direction and it was engaged through a joint commissioning process with the Council and the CCG working together.  This was based on a robust procurement process, following a review of services and identification of gaps;

·         It is fortunate to be working through Children’s Centres which allows for better integration into the local community; CLCH now has 70 staff based in Children’s Centres in Merton; and

·         There is more work to be done to integrate GPs and hospital trusts into its joint working.  Working with three local hospitals does make this more complex.

RESOLVED: The Panel resolved to receive a further, more detailed update on the childhood obesity strategy the timing for which is to be agreed.