Agenda item

To provide details regarding the development of the new Health & Wellbeing Strategy for Haringey.

Will Maimaris, Director for Public Health, provided a presentation on the development of a new Health and Wellbeing Strategy for Haringey which would run from 2024 to 2029. The strategy would help to guide the partnership work with the NHS with a broad longer-term view and to engage with residents on this work and the issues that mattered to them.

Cllr Lucia das Neves, Cabinet Member for Health, Social Care and Wellbeing, commented that the strategy was an opportunity to ensure that the Borough vision was connected with health and wellbeing and that it was important to have a structure where issues could be referred.

Will Maimaris then presented slides to the Panel which included the following points:

• The Health and Wellbeing Board was an existing partnership board that oversaw health improvement priorities for Haringey. It was chaired by Cllr das Neves and also included representatives from the ICB, NHS Trusts, Council officers and community leadership. The Board was responsible for the Health and Wellbeing Strategy and understanding the health needs of the population. This work would also be linked to the priorities of the Haringey Borough Partnership. 
• A map of the borough was displayed which illustrated the variations in life expectancy by ward. The borough average was now broadly comparable to London/nationally and had improved since the Covid-19 pandemic.
• Engagement work with residents on health and wellbeing issues had been carried out last year which was carried out through a variety of forums.
• The themes of the new strategy, which had emerged through the data and the engagement work were:

o   Housing & Health

o   Improving Mental Wellbeing

o   Healthy Place Shaping

o   Preventative Health and Care Strategies

• The principles for delivering the strategy were:

o   Co-production and working with people

o   Knowing our communities

o   Stronger partnership working

o   Equity and challenging discrimination and racism

o   Advocating for high-quality local services that are resourced to meet the needs of our residents

o   Taking an all-age approach

• Action plans for the first 18 months of the strategy were being developed for each theme along with an outcomes framework.
• The draft strategy was due to be reviewed and signed off by the Health and Wellbeing Board in September. Updates on progress would then be received after 12-18 months.
• There were links with the rest of the NCL area through the Integrated Care Partnership Council which was a forum that brought together elected leaders and senior officers from each Council to steer the partnership work on population health improvement in NCL.
• The outcomes framework for the strategy that was being developed would track key indicators linked to the four themes of the strategy. Example outcomes were illustrated such as smokefree environments and access to green spaces and it was noted that the data for some indicators involved a time lag of up to 18 months.

Will Maimaris then responded to questions from the Panel:

• Cllr Connor welcomed the themes of the strategy but queried the overlap with other strategic priorities including those of the Haringey Borough Partnership and how these would coherently fit together. Referring to the slide that illustrated the links to the Haringey Borough Partnership, Will Maimaris explained that this flowed into the Health and Wellbeing Board and the aim was that the new strategy would enable other areas of work that were not covered by the partnership (such as housing) to be captured. The Preventative Health & Care Strategies theme and the Improving Mental Wellbeing theme provided a direct link to the Haringey Borough Partnership’s programme of work. The Healthy Place and the Housing & Health themes were wider than the Haringey Borough Partnership and would bring in other parts of the Council. For example, the housing work sat with the Council’s Place-making and Housing Board and so members of that Board would report into the Health and Wellbeing Board. This would therefore reach some of the wider determinants of health and wellbeing. Will Maimaris suggested that this could be mapped out on a chart/table to help illustrate this.
• Cllr Brennan suggested that damp housing should be included as an indicator given the impact that this could have on health. Will Maimaris acknowledged that Housing was an area where they were considering how best to set indicators and that damp was an area that could be measured. However, this would be more difficult to measure in the private rented sector when compared to Council owned housing.
• Helena Kania noted that social isolation was included under the Improving Mental Wellbeing theme but could also be included under Preventative Health theme given the link to dementia and other conditions. Will Maimaris said that this was an issue that had been raised a lot during the engagement on mental health but acknowledged that it was also relevant to other areas. Cllr das Neves also agreed that it could fit into both areas. (ACTION)
• Asked by Helena Kania about the current status of the ageing and frailty project, Sara Sutton, Assistant Director for Place-based Commissioning and Partnerships, reported that this had been through a transition period and that a process was underway to recruit to a number of roles. She could obtain a more detailed update from Tim Miller, Assistant Director of Place, Integration, Transformation & Delivery. (ACTION)
• Helena Kania queried why the indicator on access to green spaces was only about physically active adults and did not seem to include people with disabilities. Will Maimaris said that another part of the Healthy Place Shaping theme was included disabled access both across health and care services and also in terms of local facilities. In the first 18 months of the strategy there was an intention to map out issues with the Joint Partnership Board (JBP) and others to understand what more could be done through the local plan in relation to parks and green spaces. Asked by Cllr Connor about toilet provision in Alexandra Park, Sara Sutton said that this had recently been opened in the past few weeks.
• Cllr Mason raised a number of issues that could be covered by the strategy including support for single parents, obesity, violence reduction and children’s access to health and social care services. Will Maimaris highlighted a programme called ABC Parenting which provided peer support for new mothers and agreed to circulate information about this. (ACTION) He confirmed that obesity was included in the strategy and included a specific healthy weight strategy as a sub-component of this. On violence, the community safety strategy was a plank of this approach so there would need to be indicators linked to that.
• Asked by Cllr Mason how housing and health policy would be effectively brought together, Will Maimaris noted that the Council had a commitment to improving the housing stock and so the aim was to influence this to include health needs such as repairs, damp and mould. There had also been a useful session with health and housing leads about integrating pathways which was a challenging area.
• Asked by Cllr Mason about the geographical allocation of resources and the replication of successful projects in other areas, Will Maimaris referred to the integrated localities work in health and social care as a route to address this.
• Cllr Mason highlighted the importance of picking up on compliments and complaints. Will Maimaris said that this was an interesting point about understanding feedback and that these were typically received by direst service providers. Cllr das Neves noted that the complaints report was submitted annually to the Overview & Scrutiny Committee. Cllr Opoku highlighted the need to engage with residents who didn’t typically provide feedback so that this wasn’t dominated by people who frequently contacted the Council. Cllr das Neves responded that there had been efforts to do this through outreach to community groups, networks and events.
• Referring to the life expectancy ward map, Cllr Opoku queried why life expectancy was lower than other parts of the Borough in the Stroud Green ward. Will Maimaris explained that the numbers per ward could be quite low and so this could be a factor but wasn’t sure about the specific details in this ward. He added that the overall trend for the borough was higher life expectancy rates in the west of the borough. Cllr Connor requested that further detail on this question be provided in writing. (ACTION)
• Cllr Opoku highlighted concerns about insufficient primary care services and too much density in areas of Tottenham with a large number of new homes as this could impact on health. Cllr das Neves referred to the Placemaking Strategy which was intended to address the broader infrastructure issues such as health and community facilities and green spaces. Sara Sutton added that part of the Local Plan was focused on health and the wider social infrastructure.
• Cllr Peacock highlighted her work on the People’s Day event at Tottenham Leisure Centre, which was referred to on page 25 of the agenda pack, and the local pensioners group which had 350 members.
• Cllr O’Donovan referred to the various blocks of support for health and wellbeing as illustrated in the graphic in the report and queried what possible gaps there could be. Will Maimaris suggested that clear governance routes and plans with other parts of the Council was part of this as well as resourcing challenges and progress with understanding the needs of different communities. Cllr das Neves highlighted the importance of a collaborative approach across the different parts of the Council.
• Cllr Iyngkaran highlighted the importance of prevention, most notably in relation to cardiovascular disease and hypertension, as this had a significant potential impact on health, could be targeted and would be measurable. He added that a similar approach on improving screening outcomes for cancer could also have a significant impact. Will Maimaris agreed that cardiovascular disease and cancer screening were fundamental to public health. He added that there was a cancer prevention strategy for NCL and a plan for heart health but there was more that could be done and that would be part of the integrated care partnership strategy. Cllr das Neves highlighted the importance of supporting local community groups and events to help to promote prevention in a practical way including cancer screening.
• Cllr Iyngkaran asked about smoking and the potential adverse outcomes of vaping and whether the strategy would address this. Will Maimaris responded that smoking rates in Haringey were higher than might be expected and that greater understanding about the potential harms of vaping was needed and the national policy approach on this was particularly important. Vaping could be difficult to monitor locally but a question on this would be added to the regular school survey. Cllr das Neves added that the national strategy was on both smoking and vaping and the local strategy in Haringey would follow a similar approach. 
• Cllr Mason spoke about the issues of stress and anxiety and the role of community spaces and community support which were all relevant to helping people to lead healthier lifestyles.
• Cllr O’Donovan suggested that other Scrutiny Panels may wish to consider the Health and Wellbeing Strategy in the context of other policy issues given the cross-Departmental nature of the approach.

Cllr Connor welcomed the development of the new Health and Wellbeing Strategy and summarised the comments and recommendations of the Panel:

• Further clarification was requested on how the outcomes, monitoring and reporting would fit within the governance structure.
• There were some challenges acknowledged in how some outcomes could be realistically monitored, such as people accessing green spaces.
• Further detail would be required on how health policy would be able to link to and influence the Local Plan in relation to housing policy and what realistic outcomes could be achieved given the complexities in this area.
• Further detail would be required on how on the future partnership working and community engagement would work in practice.

Will Maimaris responded that the conversation had been useful as the strategy would be put to the Health and Wellbeing Board in September and the Panel had highlighted the issue of clarity on governance which could be put in place. There would also be a focused outcomes set and there had been input on priorities for this from the Panel. 

Cllr Connor noted that the Strategy would be monitored by the Health and Wellbeing Board but suggested that the Panel may wish to be updated on the governance structure and potentially any specific focused areas of the strategy that could be relevant. Will Maimaris added that there would be a review of the action plan after approximately 12-18 months and so this could be an appropriate point at which the Panel could be updated on progress. (ACTION)