Agenda and minutes

Virtual Meeting, Health and Wellbeing Board - Thursday 11 February 2021 1.30 pm

Contact: Jo Partridge  020 8461 7694

No. Item




Apologies for absence were received from Dr Nada Lemic.


Apologies for lateness were received from Dr Andrew Parson.


The Chairman welcomed Teresa Bell, Independent Chair of the Bromley Safeguarding Adults Board; Jonathan Lofthouse, Site Chief Executive – PRUH and South Sites, King’s College NHS Foundation Trust; Jacqui Scott, Chief Executive Officer – Bromley Healthcare; and Matthew Trainer, Chief Executive – Oxleas NHS Foundation Trust, to the meeting. The Chairman also welcomed back Dr Angela Bhan – Borough Based Director, South East London CCG following a period of absence.




There were no declarations of interest.



In accordance with the Council’s Constitution, questions that are not specific to reports on the agenda must have been received in writing 10 working days before the date of the meeting. 


Questions specifically relating to reports on the agenda should be received within two working days of the normal publication date of the agenda. Please ensure that questions specifically on reports on the agenda are received by the Democratic Services Team by 5pm on Friday 5th February 2021.


Please note that all public questions will be answered by written reply.


No questions had been received.




In respect of Minute 38, a Member noted the presentation received regarding the ‘Don’t Wait to Lose Weight’ campaign, which had emphasised the important link between obesity and COVID-19, and asked for a further update.


The Portfolio Holder for Adult Care and Health highlighted that communications relating to the campaign had been posted on both the Council’s website and Twitter feed, and would run throughout the year. The Consultant in Public Health advised that some further work had been undertaken relating to the campaign, which would also be revisited as part of the ongoing Better Health Campaign.


The Chairman noted that an Obesity Task and Finish Group had been established back in the summer, and suggested that a further meeting could be arranged to consider the next steps. Members agreed that the Obesity Task and Finish Group should reconvene within the couple of weeks.


RESOLVED that the minutes of the meeting held on 3rd December 2020 be agreed.




Report ACH21-023


The Board considered a report providing an overview of the work undertaken by the Housing department and health partners to support homeless households in response to the COVID-19 pandemic.


The Assistant Director for Housing advised that staff in Housing, Planning and Regeneration had responded swiftly to the onset of the COVID-19 pandemic, ensuring that all frontline emergency services remained operational and that resources were diverted to those most in need of critical assistance. Whilst a small number of officers had continued to provide in-person assistance at the Civic Centre in order to assist those presenting in an emergency, the majority of staff had been working at home since March 2020. Services had adapted quickly, and a significant amount of work had been undertaken in order to maintain contact with clients and provide the necessary support and essential services.


The department worked jointly with colleagues providing supported accommodation, and received support from Public Health, to ensure that schemes were able to operate in a “COVID Safe” manner, and that additional practical and financial support was made available to both organisations and residents. A particular challenge for the service had been the additional assistance given to support those effected by rough sleeping as part of the government’s ‘Everyone In’ initiative, and the subsequent work that had arisen. In excess of 90 clients who were identified as sleeping rough, or at risk of rough sleeping, were accommodated into emergency accommodation and work to support this cohort was ongoing. Across London more than 5,000 households have been assisted under ‘Everyone In’.


Working jointly with colleagues from Public Health, MHCLG and Thamesreach, the department had formed a Rough Sleepers Response group to provide critical oversite and additional support to those they were assisting. This has allowed for a clear referral and rehousing pathway to ensure any person or agency who had knowledge of a rough sleeper could refer them through to services for assistance, and for enhanced services to be allocated to those clients with the most complex needs. Colleagues had worked together to ensure that timely, joint interventions were put in place. When officers had carried out the rough sleeper headcount in November, an annual exercise which saw staff from housing, the police, charity workers and volunteers go out in the early hours of the morning to visit common bedding down sites and areas where there had been reports of rough sleepers, thankfully only one rough sleeper had been identified. Unfortunately, they were well known to the service and had not accepted repeated offers of assistance, but they continued to try to help.


Working closely with the MHCLG, officers applied for Next Steps Accommodation and Rough Sleeper Initiative Funding, and received a combined grant award of £494,904. This had enabled them to meet the increased demands for accommodation, as well as allowing access to more support and a wider variety of essential items to help those most in need. They were working closely with partner agencies to ensure that the grant  ...  view the full minutes text for item 55.




Independent Chair of the Bromley Safeguarding Adults Board


The Independent Chair of the Bromley Safeguarding Adults Board (BSAB) thanked the Chairman for providing an opportunity to give a brief summary of the work which was going on in terms of prevention, service provision and assurance for people’s safety during the current phase of the pandemic.


The Independent Chair – BSAB informed Board Members that since taking up the post at the beginning of the year, she had received a very helpful induction to understand more about local context. The BSAB was participating in a national project (Insight Project), co-sponsored by the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS), which had been established at the beginning of the pandemic to share data and provide a comparative baseline to understand the impact of the pandemic. The concerns seen in Bromley were much the same as elsewhere across the country, and included:

-  Care homes (support for homes and their staff);

-  Closed institutions (and the need to ensure good quality assurance);

-  Impact on carers (including informal, unpaid carers with more people being cared for at home, and some services being less accessible);

-  Self-neglect – hidden harm (increase in self-neglect referrals);

-  Impact on the workforce (staffing levels, and increased pressures, particularly in care homes); and

-  Domestic Abuse.


A meeting had recently taken place with the BSAB’s statutory partners to seek assurance from them, particularly in relation to the current phase of the pandemic, and responses to these areas of concern.


One of the areas which the Independent Chair – BSAB considered to be particularly impressive was the Care Home Operational Group. The group met on a daily basis, chaired by either the Director of Adult Social Care or Director of Public Health, with a membership that included representatives from across the local health and social care sector. At each meeting, members looked at the number of COVID-19 cases in care homes, which allowed them to make contact with providers and offer support as required. There was a clear escalation process in place, and the system was an example of very good practice.


With regards to Domestic Abuse, Board Members were advised that less referrals had been received during the initial phase of the pandemic than expected. However, it was noted that since the beginning of this year, referrals had started to increase. This increase was considered to be a breakthrough, and was being attributed to the large amount of work which had been undertaken to raise awareness in, for example, vaccine hubs and with front line staff across the partnership.


The Independent Chair – BSAB advised that there had been an enhancement of community outreach programmes to the most vulnerable groups – this was positive to hear as a number of the centres used by residents had closed as a result of the pandemic. There was also a multi-agency complex case pathway and guidance agreed for referrals  ...  view the full minutes text for item 56.



To include:

- situation report from all partners

- immunisation roll out for Bromley


The Borough Based Director – SEL CCG (“Borough Based Director”) advised Board Members that a large amount of work had been undertaken over the last couple of months to deliver, increase, and try to manage any inequalities in the uptake of the COVID-19 vaccination. Bromley had been doing very well in terms of uptake – over 89% of the over 80’s age group, a similar percentage for the 75-79 year old cohort; and 88% of 70-75 year olds had received their vaccinations. Work was also taking place to vaccinate health and social care staff, and residents classed as clinically extremely vulnerable. It was noted that the denominator of who was considered to be clinically extremely vulnerable kept changing, however it was thought that over 70% of this cohort had been vaccinated, largely due to the PRUH’s ‘Hospital Hub’ contacting in-patients that they were aware fell into that category.


GPs had been vaccinating residents through their Primary Care Network (PCN) vaccination sites, which the GP Federation in Bromley had been instrumental in helping to deliver. It was highlighted that pharmacists were not delivering the vaccinations in Bromley. Satellite services had been established, so some GPs could deliver vaccinations where they needed to, and over 100 residents had received their vaccinations at the mosque in Keston the previous weekend. There were plans to have a mass vaccination centre and the Civic Centre, and they were extremely grateful to partners for making this available.


With regards to residents and staff in care homes, vaccinations had been administered through the GP Practice for Care Homes. So far, 91% of people had been vaccinated, and this figure continued to increase – there had been delays going into some care homes due to outbreaks of COVID-19, so vaccinations would continue to be offered. It was noted that in Bromley, as across the country, there was a lower uptake from care home and hospital staff than had been anticipated. Commitment had been made to vaccinating 75% of the top four cohorts by the 14th February 2021 – this had already been achieved, however it was emphasised that the programme would not stop, and they would be continuing to offer the vaccine to the most vulnerable residents. There were a number of people within these groups that were housebound, or reluctant to go out, and as a result they were looking to adapt their services. Work was also being undertaken with partners to encourage social care and care home staff to receive their vaccine.


In response to questions, the Borough Based Director advised that in relation to care homes for older adults and those with Learning Disabilities, around 60% of care home staff had been vaccinated. It was noted that the vaccination programme for this cohort was still underway, and they would continue to offer them the opportunity to receive the vaccination on numerous occasions. The Director of Public Health and Director of Adult Social Care had also been working to set up webinars, however there was  ...  view the full minutes text for item 57.




Report ACH21-020


The Consultant in Public Health advised that it had been agreed, as part of the JSNA process, that a chapter relating to the health and wellbeing needs of veterans be developed and published. Some preliminary scoping work in terms of data availability was undertaken in 2019, and highlighted a small amount of data specific to Bromley available from the Census. However, data for Bromley was not routinely available, which presented a problem in identification of all veterans in the Borough.


It had therefore been decided to explore the possibility of conducting a GP Survey to assess the situation in Bromley, in terms of health needs and medical care for veterans. This information could then be used together with the information currently available for a section on veterans in the JSNA. NHS England had recently asked GPs to sign up to become “veteran friendly” practices, and it was hoped that some GPs in the Borough would be interested in doing so.


The question to be included in a survey to all GP practices in Bromley had been developed, and these were agreed by the Board in late November of 2019. The GP Practice Survey was then promoted to GP Practice colleagues with an ask that they all complete the survey by the end of March 2020. However due to the pressures of the COVID-19 pandemic, the survey was paused. The GP Practice Survey was then promoted again in November 2020, with 11 (out of 47) GP Practices responding. Due to the increasing work for GP Practices in relation to the COVID-19 pandemic, and the low response rate received so far, it was proposed that this work be paused again – with the survey re-visited with GP Practices in Bromley at a later point in 2021.


A Member enquired as to the definition of a ‘veteran’. The Consultant in Public Health said that her understanding was that a veteran was someone, of any age, who had worked within the Armed Forces and then left the service. There was still a responsibility on society to look after these individuals as they had served their country. Another Member highlighted that the report stated that a veteran was ‘any one of any agewho has formally served for at least one day in the Armed Forces’.


Councillor Botting advised Board Members that he had been working with Councillor Fortune, Armed Forces Champion on the Armed Forces Covenant. This focussed on helping members of the Armed Forces community to have the same access to government and commercial services and products as any other citizen – such as housing, education,and health services. Historically, work undertaken had not identified many veterans living within the Borough, as there were no military establishments. However, it was noted that there were a number of Cadet groups, who had veterans helping out that had worked in the Armed Forces. It was suggested that most would not consider themselves as ‘veterans of need’, as they knew where to access services  ...  view the full minutes text for item 58.


JSNA UPDATE pdf icon PDF 119 KB


Report ACH21-019


The Board considered a report providing an overview of plans for further chapter updates and development of needs assessments.


The Consultant in Public Health advised that the following JSNA chapters had been completed:

-  An older people JSNA chapter to support the Ageing Well Strategy (2019);

-  A Learning Disabilities JSNA chapter to support the Joint Learning Disabilities Strategy (2019);

-  A sexual health needs assessment was completed in 2019 and this supported the completion of the Annual Public Health Report for Sexual Health in 2020; and

-  GP practice profiles, PCN profiles and School profiles were produced in 2019 and the early part of 2020.


Work planned for 2020 had been put on hold due to the COVID-19 pandemic and the Public Health Intelligence Team were unable to produce any updates to the JSNA during that period. Therefore, it was planned that the Team would produce the following JSNA chapters during 2021:

1. Demography – refresh to bring the chapter up to date, providing a live dashboard;

2. Mental Health – to support the commissioning of Mental Health Services across the Local Authority and CCG; and

3. Impact of COVID-19 on the Bromley population – looking at health inequalities and the wider determinants of health.




1)  The update on progress towards the JSNA chapter updates be noted; and


2)  The work being undertaken on further needs assessments be noted.




The Consultant in Public Health informed Board Members that the majority of the Health and Wellbeing Strategy: JSNA Priority Areas had been on hold as a result of the pandemic. However, it was important to note that they were in the process of “picking up” some of this work.


The Cancer group were looking at a campaign to promote breast screening, due to the reluctance of residents to attend during the pandemic. Screening rates were now up to around 60%, but there was still work to be undertaken to achieve the figure of 85% which had been seen prior to the pandemic.


The Diabetes group would be meeting at the end of February 2021, after which they would continue to meet on a regular basis; the Obesity group would be continuing with the ‘Don’t Wait to Lose Weight’ campaign; and the Mental Health Strategic Board would be meeting towards the end of the month.


RESOLVED that the update on the Health and Wellbeing Strategy: JSNA Priority Areas be noted.




Report CSD21025


The Board considered its work programme for 2020/21 and matters outstanding from previous meetings.


The Chairman noted that the Mental Health Resilience presentation from Oxleas NHS Foundation Trust had been deferred to the meeting of the Health and Wellbeing Board on the 29th April 2021.


RESOLVED that the work programme and matters arising from previous meetings be noted.



The briefing comprises:


  • Better Care Fund (BCF) and Improved Better Care Fund (iBCF) 20-21 Quarter 3 Performance Report


Members of the Health and Wellbeing Board have been provided with advance copies of the briefing via email. The briefing is also available on the Council’s website at the following link:



The Health and Wellbeing Board Information Briefing comprised one report:


  Better Care Fund (BCF) and Improved Better Care Fund (iBCF)

2020-21 Quarter 3 Performance Report.


RESOLVED that the Information Briefing be noted.





There was no other business.



1.30pm, Thursday 29th April 2021


The next meeting of the Health and Wellbeing Board would be held at 1.30pm on Thursday 29th April 2021.



The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.


The Chairman to move that the Press and public be excluded during consideration of the items of business listed below as it is likely in view of the nature of the business to be transacted or the nature of the proceedings that if members of the Press and public were present there would be disclosure to them of exempt information.



To follow


The Board noted the Part 2 information within the report.