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Agenda and minutes

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No. Item




Apologies for absence were received from Councillor Geoffrey Walker, Committee Member and Councillor Naheed Asghar, Portfolio Lead Member for Health and Voluntary Sector Partnerships.


The following substitute member arrangement was in place:


Councillor John Moss for Councillor Geoffrey Walker.



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


Councillor Richard Sweden declared a non-pecuniary interest as he is managed, but not employed, by NELFT.


During discussion of Agenda item 5, Suicide Prevention Strategy, Councillor Richard Sweden declared a non-pecuniary interest in his capacity as a Trustee of Leyton Orient Trust.


Notwithstanding his interest in these items, Councillor Sweden was able to remain in the room and participate in the debate.




To approve the minutes of the meeting held on 22 November 2017.


The minutes of the meeting held on the 22 November 2017 were approved and signed by the Chair as a correct record.




Members of the public are welcome to participate in scrutiny meetings.  You may speak for three minutes on a topic related to the Committee’s work, and fifteen minutes in total is allowed for public speaking, at the discretion of the Chair.  If you would like to speak, please contact Democratic Services (details above) by 12 noon on the day before the meeting.




There were no requests to speak from members of the public.





Russell Carter (Public Health Consultant) presented a report which provided an update on the progress on developing a new suicide prevention strategy for the borough and members were invited to comment on the draft strategy scope, content and actions.  Members were also requested to consider specific stakeholders who might wish to input into the development or delivery of the strategy.


The report provided a local and national picture.  The highest suicide rates were in men aged 40-44 followed by those aged 90+ and 45-49.  In Waltham Forest, 61 deaths were recorded as suicides during the 2015-17 period.  The national picture highlighted that there were more deaths from suicide in men than women, with 50 suicides by men and 11 by women.


The report set out the strategy objectives which as set out below:


·           Implement ‘zero suicide’ approach in Waltham Forest.

·           Provide adequate support for those bereaved or affected by suicide.

·           To re-establish the suicide prevention steering group to develop and oversee evidence based action plans reflecting the needs of the local population.

The Committee discussed the report and asked several questions.


Bereavement - Councillor Sheree Rackham was interested to know what support there was for those who had witnessed a suicide or had been affected by such action and during discussion it was asked what support was provided in terms of bereavement. Currently bereavement services were provided by Barts Heath NHS Trust, but a review of the services was needed to ensure that they were fit for purpose. Members requested that details on the numbers accessing bereavement services be circulated to the Committee. 


Access to mental health services - In addition to the bereavement services, there was a provision for providing mental health first aid training to schools and businesses and Waltham Forest Talking Therapies Service aimed to ensure that as many people as possible receive the treatment and support they need and regularly met their target of people seen and waiting times.  It was noted that CAHMS access was irregular and the Committee requested that a report on the change to CAMHS thresholds be brought to the next meeting.  Bi-annual meetings with the coroner are held to review suicide cases to share learning on what could have been done differently to prevent the suicide or support affected individuals better and to identify any trends in methods or risk spots in the sector.  The Committee requested that officers identify specific hotspots.


Black and minority ethnic groups - it was noted that nationally ethnic groups were more likely to commit suicide, but in general they had a lower self-harm rate.  Statistical data on national suicide figures for age groups and an explanation as to why the statistics for Newham were lower than Waltham Forest, was sought.


Hospital admissions - The number of hospital admissions in Waltham Forest per 100,000 population had decreased significantly from the 2010/11 period, however the trend had not been replicated across London.  The Committee requested that Public Health report back on causes for the drop in self-harm  ...  view the full minutes text for item 16.




Jonathan Cox, (Public Health Consultant) presented a report which outlined the approach being take towards the refresh of the Joint Strategic Needs Assessment Update, the contents of the assessment and the prioritisation of individual chapters for 2018/19. It was explained that the Health and Wellbeing Board had a statutory duty to produce a comprehensive Joint Strategic Needs Assessment of health and social care issues within the Board’s jurisdiction.


The Joint Strategic Needs Assessment refresh process was summarised, as contained within the report.


Mr Shumon Ali-Rahman asked what was meant by the “depth of the assessment in terms of demographics and wards”.  It was explained that, where available, small data was used and the national data had been enhanced with the local data.  The committee requested that they receive an update on progress with the Joint Strategic Needs Assessment every six months, from September 2018.


The Committee accepted the need to change the current assessment, that strategic needs differed and a more responsive process was needed. 


The Chair was interested to know how the assessment interacted with the new Local Plan.  It was explained that the impact would be huge with needs expressed across all aspects of the assessment and engagement from key partners to ensure that consistency of information being used.


Councillor Highfield raised an issue regarding the support that a child with a disability receives during transition into adulthood.  This issue had been discussed by the Steering Group and the Committee themed review would tie into Joint Strategic Needs Assessment chapter on children’s wellbeing and mental health.


Councillor Highfield further raised concern regarding the physical and mental health needs of ex service personnel, upon which it was noted that the Joint Strategic Needs Assessment steering group would consider specific sections on transition and ex or current members of the armed forces.


Three chapters had been completed during 2017, these were: Healthy weight for children, alcohol misuse including licensing and substance misuse.  It was reported that how services were commissioned would be reconsidered as a result of the findings.  Previous predictions had shown that there would be an increase in alcohol related hospital admissions. However data had shown a decrease during 2016-17, bringing the figure in line with the London average.  There had also been a decrease in substance misuse.  The decreases were likely due to an improvement in services, changing demographics and lifestyle changes, despite continuing not to attract a high number of drug and substance users into services and as a result, plans with current treatment providers had been initiated.




The Committee:


(a)   asked that they receive an update on progress with the JSNA every six months; and


(b) recommended that the JSNA steering group considers specific sections on transition and ex or current members of armed forces.





Stella Bailey presented a report which set out the progress made against the eight recommendations made following an in depth review of substance misuse in the borough.  The Committee was requested to review the progress, approve the general direction of travel and make recommendations for further interventions if required. 


In August, a needs assessment into the use and impact of alcohol and drugs in Waltham Forest was commenced.  The results of the need assessment provided information on how to effectively implement these recommendations, using the most up to date available data and the views of service users and residents.  Data showed Leytonstone to have the highest hospital admissions and deaths due to alcohol and substance misuse, highlighting a priority for a hub to be opened in the area and for close working to be carried out with peers and service users to ensure appropriate opening hours. 


The Alcohol Education Trust training package for alcohol awareness had been rolled out to schools in September 2017.  Although there had been a poor uptake by schools, the training would be offered to schools and academies again in early 2018.  During discussion, Public Health were requested to consider what specific training on resilience and risk could be tailored to school leavers in addition to the wider training offer to schools. 


The Council had received a grant from the Home Office to deliver a pilot whole-school approach to address violence against women and

girls in schools.  Evidence indicated that the reduction of violence in all its forms, at a young age is a protective factor against future substance misuse.  The Mayor’s Office for Policing and Crime (MOPAC) had submitted a bid to extend the project for a further two years and extend to a number of schools.  Members requested that an update on the pilot addressing violence against women and girls in schools be circulated in three months.


Recommendation 2, that the Council should continue to work with partners to ensure that the range of services offered by Lifeline is understood by healthcare professionals and wide community was discussed and it was questioned what was being done to rectify the slow take-up of some GPs on offers of services.  It was agreed that councillors would be added to the distribution of the client newsletter.


It was recommended that the Council and Lifeline consider how they can improve treatment readiness for GP and criminal justice referrals.


The alternatives available to secure investment in preventions that would reduce hospital admissions at end of life were sought.  It was explained that a transformation of End of Life Care services was being planned to include substance misuse services.  Training for advance care planning for end of life would include CGL as a service provider. By including CGL in end of life service transformation initiatives, avoidance of end of life hospital admission in patients with substance misuse needs should be reduced. 


An update was requested before the next meeting on Recommendation 8: The Council should use its new VCSE provider,  ...  view the full minutes text for item 18.



Additional documents:


Children’s Mental Health – Concern was expressed that children in Waltham Forest experience poor early social and emotional development, poor behavioural development and poor language development compared to London averages.  It was noted that this would be brought to the attention of the Children and Young People’s Committee. 


Response to questions - Members received a response from Barts Health NHS Trust to the questions the Committee had submitted in November 2017.

Phlebotomy appointment system - With regard to the new online booking system for Phlebotomy appointments, Councillor Highfield raised concern that this may not be accessible for elderly persons or those who were not computer literate.  It was noted that walk-in appointments would continue to be available until further notice for patients who were unable, or did not wish, to pre-book an appointment. It was further notedthat Healthwatch had been questioned and no complaints had been received, confirming that due diligence had taken place.  It was requested that an update from Healthwatch be provide in six months. 

Public Participation - Hydrotherapy Pool - The Chair reported that the Chief Executives of Whipps Cross University Hospital and Barts Health NHS Trust were adamant that the hydrotherapy pool at Whipps Cross Hospital would not be reopened.  However they had offered to fund the travel for the Mile End Pool. It had been agreed that a full review of the options available in the borough would be completed by the end of February 2018.  The Council would also review its leisure centres to ascertain if there were options available.  The Chair would provide feedback to members at the March meeting.


During discussion, Members highlighted that in addition to the Save Our Spines Action Group, other groups would be affected by the closure of the hydrotherapy pool at Whipps Cross University Hospital and should be included in the consultation. 


The Committee requested that further feedback on the hydrotherapy pool review be presented at the next meeting.


Annual Report for the Waltham Forest Children’s Death Overview Panel - The Director of Public Health had confirmed that up to date statistical information on the number of still births in the borough could be provided, upon which Members accepted the offer.


That the Director of Public Health was asked to provide up to date statistical information on the number of still births in the borough.


Statistics for Ambulances Queuing at Hospital A&E Departments in Excess of the 15 Minute Handover Time - A member expressed concern that unfit persons were expected to wait in line in the Accident and Emergency Department at Whipps Cross Hospital and suggested that a ticketed waiting system be introduced.




WORK PROGRAMME - 2017/18 pdf icon PDF 68 KB


A report on the Provision of high quality care during winter was circulated at the meeting.  The purpose of the report was to update the Committee on how the local system was coping with increased demand during winter.

Themed review into pre and post-natal services: children and families centres – (Minute  9 refers): the Committee agreed that the themed review focus on the following items in order of:

1)      Outreach Work

2)      Maternal Mental Health

3)      1 Year and 2/2.5 Year Child Health Reviews

4)      Take Up of Free Nursery Places

5)      On-Line Information and Advice Services for New Parents

6)      Fathers and Co-Parents

7)      Data sharing between services

8)      Pre-natal choice of hospitals and joining post birth services.

It was requested that a draft researched report be presented for discussion at the next meeting and that a further draft be circulated to members for agreement at their meeting in April 2018.


Committee members were reminded that a visit to Neighbourhood Midwifery Team was scheduled for the 12th February 2017, at 2.00pm.

Members thanked Andy Spragg for organising a visit to Walthamstow Children and Family Centre the previous week and Maxine Lafayette for bringing together the professionals.


The Committee noted the forward plan.