Agenda item

To receive a presentation from North Central London Integrated Care Board.

Received the report of Ruth Donaldson, Director of Communities, North Central London Integrated Care System and Dudu Sher-Arami, Director of Public Health, London Borough of Enfield, highlighting the following:

1.    The introduction by Dudu Sher-Arami, Director of Public Health (LBE)

2.    In 2020, a Communities Team was established to ensure that the Integrated Care Board (ICB) is addressing inequalities and improving access, outcomes, and experience for its most underserved communities.

3.    COVID shone a light on the differential outcomes for Enfield’s most deprived residents who experience three times more hospital emergency admissions and five times longer length of stay. Within Enfield we see a difference in life expectancy of 7.4 years (male) and 7.2 years (female) between our most and least wealthy wards.

4.    The North Central London (NCL) ICB established an Inequalities Fund of £8.75m, with funding weighted across NCL towards the 20% most deprived wards. The team also lead on Inclusion Health (homeless health and asylum seeker/migrant health), the Sustainability Plan, Blood Borne Viruses, Serious Youth Violence, and the Anchors Programme.

5.    Further information was provided on the work of the Communities Team, the Inequalities Delivery Group, the Inequalities Fund, and the impact of some of the projects that had been implemented.

6.    The next steps had been identified and were discussed in detail as part of the presentation. Positive progress is being made but it was acknowledged that there is still a lot to do.

7.    In response to a question raised by Cllr Pratt, clarification was provided on the Enfield’s life expectancy figures and how these compared nationally and to other London boroughs.

8.    Pastor Nick Chanda praised the work of Dudu and her team for the amazing engagement work they undertake with the minority community groups, especially during COVID, which included educating the black community on how to access vaccinations and all other aspects of health care. He encouraged other community groups to liaise closely with Dudu and her team as the practical work they provide is central to bridging the gap in health inequality.

9.    Dudu thanked Pastor Nick for his support. She said that some key learning has originated from the work that took place over the COVID period and this can now be used to address lots of other health issues moving forward and her team will continue to work hand in hand with communities and residents to do this. These ongoing relationships will help provide the team with a better understanding of its residents and an insight into what is and isn’t going to work, and it is only really people within certain communities who can provide that feedback as people with lived experience is another dimension that is crucial to everything.

10. Ruth echoed Dudu’s comments and added that she is also keen to ensure that there are clear routes and processes in place to enable people to feedback effectively.

11. Cllr Rye said that the key to good health, good education and good life outcomes is having good quality housing and in Enfield there are too many properties both within the Council’s control and the private sector that do not reach the appropriate standard, and this is something that collectively the Council, Government and all bodies have not got control of and, until this is tackled, this will continue to be a challenge.

12. Officers agreed that there are many factors which contribute to the inequality gap, and therefore it is key to implement the Inequalities Fund as this is designed to look at the wider determinates including housing standards.

13. Concerns were raised regarding the number of residents not registered with GPs as well as the continued poor access to GP services. However, work has taken place via the Inequalities Delivery Fund and various other channels to promote and support residents to register with a GP, this has included pop up registration events and working closely with PCNs to promote registration within their community groups in their practice areas. It was agreed however that a lot more needed to be done but through the work and projects within the Inequalities Fund this provides opportunities to better address this issue by working with community groups to share information about the benefits of registering with a GP. Officers agreed to feedback Members’ concerns to their Primary Care colleagues.

Action: Dudu Sher-Arami/Ruth Donaldson

14. Cllr Erbil referred to the Early Years local NHS services in Enfield and how these differed greatly to other boroughs, such as Islington, where the amount of funding received was significantly more. Ruth agreed that the differences do boil down to funding. However, one of the reasons for the Inequalities Fund is to try and show that if you put resource into areas with the greatest need then you can make an impact. One of the first things the ICB did when it was formed was a community services and mental health review into the outcomes of spending across the five boroughs. There is a whole programme around how this will be addressed but over time changes will be made to funding in these services.

15.  In conclusion Members said they would like to see the evaluations of the Inequalities Fund once this becomes available, and Officers agreed to bring this to a future meeting of the Equalities Board.

Action: Dudu Sher-Arami