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Agenda and minutes

Venue: Committee Room 3 - Waltham Forest Town Hall. View directions

Contact: Holly Brogden-Knight, Democratic Services Officer  020 8496 4211 | Email:

No. Item




Apologies for absence were received from Linzi Roberts-Egan (LBWF, Deputy Chief Executive), Joe McDonnell (LBWF, Director of Public Health), Dr Anwar Khan (WFCCG), Helen Davenport (WFCCG), Detective Superintendent Richard Tucker (Metropolitan Police Service, Borough Commander) and Ceri Jacobs (NHS England).

Heather Flinders (LBWF, Divisional Director Children and Families) was present as substitute for Linzi Roberts-Egan.

Joe McDonnell was represented by Jonathan Cox (LBWF, Public Health Consultant).         





Members are required to declare any pecuniary or non-pecuniary interests they or their spouse/partner may have in any matter which is to be considered at this meeting. Interests are defined on the inside cover of this agenda.


Councillor Naheed Asghar made a declaration of interest regarding her status as a landlord.





Joe McDonnell, Director of Public Health, had requested it be asked when the item regarding hospital beds as a resource, discussed at the previous meeting, could be brought to the board again.


It was noted that an update on the Pharmaceutical Needs Assessment report was to come to the board at a later date also.


The minutes of the meeting held on 11 April 2018 were approved and signed as a correct record.



SCORECARD INDICATORS UPDATE - Review & plan pdf icon PDF 443 KB

Including a discussion paper about indicators – about what is and is not possible.

Additional documents:


Jonathan Cox, Public Health Consultant, introduced the paper and explained that it focuses on red RAG (Red, Amber, and Green) rated indicators and further discussed a proposal to change some of the indicators. Some of the indicators that were red status, such as SEN (Special Educational Needs) timelines and flu vaccine uptake, were improving, but many were not, such as uptake of second MMR and emergency readmissions within 30 days. Smoking quitters was also not improving, but a change in budget had led to this expectation.


Councillor Asghar highlighted that there was no description of cancer early stage diagnosis in the report, and that there was no data from CCG analysts. It was also pointed out that there was a lack of data on emergency readmissions. The board requested further updates.


During discussion on SEN figures, when asked why they were not benchmarked against annual figures from London and England, Andy Beckett, Director, Disability Enablement Service, explained that it is not a like-for-like comparison - the LBWF figures were less than annual figures because of differences in periods between LBWF and other areas, but this could still be picked up in the annual scorecard.


Councillor Grace Williams noted that MMR uptake rate was still 15% off target. The board had previously discussed how different agencies were involved and how sharing local data could impact uptake. Councillor Asghar agreed that there was a need to look at where the problem really lies with MMR uptake. Mr Cox responded that the borough has an Immunisation Board and explained that Vaccinations UK, the immunisation provider in schools, understands local context and that MMR uptake is a London-wide issue. It was suggested that immunisations be picked up as a topic for the September meeting of the board.


Ken Aswani, Waltham Forest CCG, made the point, regarding areas that are improving, that it is important to keep an eye on the overall strategic picture. For example, with regards to improvements seen in the child obesity indicator, whilst improvements have been seen in the last quarter, the real issue is over the longer period.


Mr Cox then outlined suggested changes to the scorecard to reflect actual reporting of indicators – some indicators are only measured annually but are still reported on each quarterly scorecard.




The board:


(a)  noted the scorecard incorporating suggested versions;

(b)  asked that they be provided with updates on data for performance in some indicators, such as emergency readmissions and cancer early stage diagnosis.




(a) Children’s Healthy Weight (Russell Carter)

(b) End of Life Care (Jonathon Cox)

(c) Drug & Alcohol (Alastair Macorkindale) &

(d) Mental Health (Nick Davies)

RAG-rating and narrative on progress (challenges, barriers and next steps)

5 minutes updates and Q&A


Additional documents:


Children’s Healthy Weight


Russell Carter, Public Health Consultant, introduced the item and updated the Board on recent work.


There was discussion regarding collecting data on Under 5’s Swim for Free sessions. It was pointed out that it is difficult to obtain this data as there is no membership requirement and no guarantee that those attending are actually Waltham Forest residents. Numbers of how many children attend the sessions is known, but not the breakdown of where from and how often. Concern was raised that additional administration to obtain such data, such as through membership cards, might actually be a barrier to attendance.


Dr Tonia Myers, Clinical Director, Waltham Forest CCG, suggested that instead of focusing on Under 5’s Swim for Free sessions, perhaps a more suitable measure would be looking at attendance of children aged 6 and above and then follow this up to year 6 children. This would reflect the need to monitor the obesity trend between reception and year 6.


Mr Carter asked the board if they wanted to look more closely at food and diet because this was not currently being looked at. Dr Myers suggested that the board pick up food and diet for discussion in November.


Mr Carter explained that one of the main results to come out of the last quarter was the training for GPs around raising healthy weight issues with families. This was a key objective in the strategy and so far the training had been evaluated positively by attending GPs. How this can now continue needs close consideration.


Mr Carter also explained that food poverty workshops had been held and the feedback from these had fed into an action plan to be published in September. This will be sent to board members for comment.


End of Life Care


Jonathan Cox, Public Health Consultant, introduced the item. Mr Cox explained that the End of Life Care Task and Finish group had been looking at key objectives, at what the group will look at going forward and what the End of Life transition board should pick up.


A competency framework around End of Life skills had been used to identify workforce training and development requirements. Furthermore, there was a specific piece of work ongoing around progressing needs assessments, the importance of engaging stakeholders to identify community development aspects around End of Life Care and ensuring people understand what support and advice is available.


Mr Aswani stated that there were some key questions around what happens on the front line with carers and in the home, as a sense of progress in those areas is important. He also suggested it may be useful to look to other boroughs that are further along in the process, such as Tower Hamlets, for information.


Brenda Pratt, Associate Director, Health and Social Care Integration, explained that there are only six practices in Waltham Forest that are not signed up to the End of Life local incentive scheme. Part of that scheme is to use Co-ordinate My Care as  ...  view the full minutes text for item 5.



Verbal update.


Councillor Asghar reminded members of the schedule for future reports.



HOUSING & HEALTH - Plan, review & decision pdf icon PDF 156 KB

A presentation based on the Housing Strategy linked to health and wellbeing.

What do you see as the main areas that you want to work with partners on?


John Coker, Head of Housing Improvement, showed a presentation to the board and gave an update about progress with the Housing Strategy and sought input on some health links to the strategy. Mr Coker further explained that the LBWF Housing strategy expires this year and will have to work with the Mayor of London’s housing strategy which was published in May 2018 and has four main objectives:


·         Increasing housing supply across all tenures

·         Ensuring decent, safe and healthy homes

·         Tackling and preventing homelessness

·         Creating inclusive and sustainable neighbourhoods

Mr Coker then explained that currently over half of temporary accommodations are outside of the borough because of pressures on London markets and summarised other key housing statistics that illustrate the housing demand in the borough. He also explained how LBWF Housing was working with colleagues in public health to develop a Joint Strategic Needs Assessment which currently defines a healthy home as:


·         Affordable

·         Warm and dry

·         Appropriate size

·         Safe and secure

·         With good air quality

In addition a healthy home should be health promoting, connect people with neighbours, meet the needs of those with disabilities and additional needs, and should be led by responsible landlords and supported residents.


Mr Coker explained that current initiatives in place to work towards the above aims include, among other things:


·         Aiming for 50% affordable housing

·         An investment programme of £70 million in Council homes over the next five years

·         Loft conversions and extensions to relieve overcrowding

·         Focus on energy efficiency and gas safety

·         Regeneration of the Marlowe Road estate

·         Council led scheme to deliver 1000 Council affordable homes over five years.

Other work described included working with the CCG to try to develop new healthcare facilities, working to improve standards of private sector licensing, tackling Anti-Social Behaviour and building a database to help engagement with landlords.


It was explained that the new Housing Strategy should be going to Cabinet in November but there was consultation ongoing.


There was discussion around homelessness and temporary accommodation with a strong message on working with Whipps Cross Hospital regarding hospital discharge. The Council has strong links with health colleagues and there is lots of work ongoing determining client need.


Sue Boon, NELFT, described how many mental health patients coming out of hospital do not qualify as homeless even though they may be without stable accommodation due to their own vulnerabilities. Ms Boon explained that there was a focus group looking at improving pathways for those people and suggested that its findings could be useful for the strategy.


Althea Bart, Healthwatch Waltham Forest, stated that the healthy homes initiative had been well received by the Health and Wellbeing forum but there were queries around accessibility, adaptability and integrated support for those homes. Ms Bart also said that while resident engagement had been mentioned, Healthwatch currently don’t have an understanding of what that engagement was and how meaningful it was. Mr Coker explained that lifetime homes standards mean that new properties should be much easier to adapt. He also explained that  ...  view the full minutes text for item 7.


PRIVATE SECTOR LANDLORD LICENSING SCHEME - Plan, review & decision pdf icon PDF 177 KB

How does the Scheme support improved health and wellbeing outcomes for residents? What could Board partners do to support the scheme?


Consideration was given to a report by David Beach, Head of Selective Licensing and Regulation. Mr Beach discussed how the sector had doubled in size over the last 15 years and how the Scheme was introduced in 2015 to drive up standards. It was estimated at that time that 26,000 addresses would fall under the Scheme but there are now more than that and most properties need a licence to operate, although temporary accommodations fall outside the scope of the license. The licensing generates income for enforcement.


Mr Beach further described that the work Private Sector Housing and Licensing Team aligns with the Council Policy for Healthy Homes and that officers in the team work closely with other members of Council staff, such as the Neighbourhoods team, Planning Enforcement and Children and Adult Social Care. He also explained that the Scheme had helped provide a lot of intelligence about properties and who is in control of them and that audit inspections are targeted off the back of bad inspections looking at the portfolio of a landlord.


Mr Beach stated the Schemes importance and said that if something is a housing issue it’s also a health issue.


Ms Bart commented that the Scheme had been discussed at the Health and Wellbeing forum.




The Board noted the report.




Verbal update


·         One Panel

·         Learning and Improving Practice Forum, including multi-agency audits on Alcohol and Drugs, and Mental Wellbeing

·         Safe and Well month

·         Strategic Partnerships Induction



Suzanne Elwick, Head of Strategic Partnerships, gave the Board a brief update. Ms Elwick explained that there is a current investigation into a safeguarding adult review in relation to drug and alcohol issues and other complex needs that result in them not accessing services. This will be reported to the Board in September.


Ms Elwick also explained that there are four multi-agency audits being undertaken this year, which will be reported to the Board at future meetings.



SECTION 106 ITEMS - Information only pdf icon PDF 310 KB

·      Lloyd Park Section 106: Russell Carter (Public Health Consultant, LBWF)

·      Kings Head Medical Practice: Aklasur Ahmed (Strategic Commissioning Project Manager, Waltham Forest CCG)

Additional documents:


Councillor Asghar asked that all queries be sent directly to the report author.



PHYSICAL ACTIVITY & SPORTS STRATEGY (2017-2021) UPDATE - Information only pdf icon PDF 147 KB


Councillor Asghar asked that all queries be sent directly to the report author.



SUBSTANCE MISUSE STRATEGY 2018-2021 - Information only pdf icon PDF 115 KB


Councillor Asghar asked that all queries be sent directly to the report author.



MENTAL WELLBEING STRATEGY - Information only pdf icon PDF 157 KB

Additional documents:


Councillor Asghar asked that all queries be sent directly to the report authors.





Suggestions put forward for the next meeting included the Ultra Low Emission Zone (ULEZ) and smoking and its impact on health and costs.


Ms Bart stated that while it is good that housing will be coming back at the next meeting, there was a need to look at the integrated offer that sits with housing to address gaps that haven’t been considered. Mr Simon concurred and requested the board look at what happens to current housing stock that is not covered by new home requirements as both the social and health impacts for those can be huge.


Mr Beach, suggested that it could be worthwhile having air quality as a future focus for the board. Mr Beach will report to the board at its next meeting.

Councillor Asghar stated that there was a greater position of responsibility the Board could take, and that she, as Chair, would like to shift towards what the Boards duties are and also what the focus of the Board should be outside of health, into subjects that affect health.


Ms Pratt explained that there is now a policy requirement to develop truly integrated offers that are person based which is a very different way of working and central to the business of this board.




What has the Board done today that makes a difference to Waltham Forest residents?