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Amy Gibbs - Chair of Tower Hamlets Together December Briefing

Posted on: 15 December 2020

In November, I attended the Health & Wellbeing Board to do the Independent Chair's progress report on Tower Hamlets Together. I shared the fantastic examples of partnership working we have seen during the pandemic, the lessons learned and governance changes made as a result, our current priorities and programmes, and a flavour of our public and patient engagement work. You can read the slides here -there is so much good practice to celebrate, even in what has been such a heart breaking and challenging year.

I also presented at December's Born Well Growing Well life course workstream and the voluntary sector Health and Wellbeing Forum. It was great to connect with staff from across the partnership and take questions on particular areas of concern -including how we embed inclusive and diverse citizen voice at senior decision-making levels; the need to strengthen focus and capacity on children's needs and services; and the shocking death rates for working age disabled adults from COVID-19 which are receiving less public or political focus.

At December's Executive Board, we heard from Keith, one of our 300+ COVID champions, which were created by the council to establish better connection to and information-sharing with residents. The Board were impressed by the use of WhatsApp to get clear, accurate and evidence-based information out quickly and at scale, with significant onward reach via social media and personal networks. Keith shared the benefits of this voluntary role -such as building community cohesion and helping people who may be out of work due to COVID redundancies. Champions also have to navigate challenges such as sharing sufficient info while not bombarding people, and encouraging kindness in online debates when people express anxieties e.g. about vaccines. We reflected on the huge potential of this model for other topics while needing to be clear who we are not reaching via this route, such as people with learning disabilities.

This month's performance report showed that local COVID-19 cases are above the London and England averages, reflecting a broader concern across North East London and potential risk of moving into tier three. Adult social care and children's health and care data are now better reflected in the report, with some refinements needed e.g. additional metrics for children's healthy weight and oral health -two THT priorities. We heard how critical care beds at the Royal London have been increased but are nearly full -a third are COVID patients, as trauma and elective care is still happening compared to lockdown one. The Board asked for more interrogation of why paediatric care rates have not recovered to the same degree as adults, especially given children's unplanned admissions are almost back to normal levels.

We had a positive update from the Local Delivery Board which is operating well, with the right reps in the room, and is focussed on monitoring business cases, priority projects and risks. There was concern the children's agenda is still not visible enough here, so the Board asked for a future focus on children's services across WEL, local hospitals and the council, to improve oversight and momentum.

The rest of the meeting was dedicated to our quarterly system finance report. Both the council and clinical commissioning group face significant financial pressures and uncertainty moving into 2021. On the NHS side, COVID funding is helping some partners to break even. For the council, the in-year pressures build on years of austerity and insufficient funding to meet local demand, particularly in adult social care where we have major pressure in the costs, volume and complexity of care packages for older people. The Board noted that we are not sighted on the financial health of GP practices or voluntary sector organisations. The CVS will identify which charities are commissioned by THT so we can build a better financial picture and understand issues. The Board agreed to hold a further discussion on savings and how proposed changes will impact through the system. We also plan to review investments made under the Better Care Fund to see how they align with THT priorities and what further opportunities there are to pool budgets.

I wanted to wish you all a safe Christmas period, with hopefully a tiny bit of rest, and here's hoping for a more positive 2021.