Health and Wellbeing Forum

Health and Wellbeing Forum

Tower Hamlets Health and Wellbeing Forum 22nd February 2018 10am 12pm Agenda Welcome and Introductions Jennifer Fear Outcomes Focussed Commissioning Michael Keating, THT Obesity & Nutrition Presentations:

Exercise: Applying Outcomes to Obesity & Nutrition Scene Setting & Borough Strategies Abi Gilbert, LBTH H&WBF Updates Food Poverty Strategy Francis Eatwell- Roberts, LBTH THT Vanguard Evaluation - Mirza Lalani Fit for Life Clare Dunne

Communities Driving Change Toyhouse -Julie Morgan Panel discussion Exercise: What is Working Elections for steering group & reps Networking event Networking Welcome & Introductions Chair, Jennifer Fear

Step Forward Obesity and nutrition Presentations and panel discussion What is Tower Hamlets is doing to tackle this issue.. Our aim is to make it easier for children, families and adults to be more physically active and eat more healthily. Working with partners we do this in the following ways:

Improving environments Improving access to healthy food Providing opportunities for children and families to be active Presentations Scene Setting & Borough Strategies Abi Gilbert and Jane Wells LBTH Food Poverty Strategy Francis Eatwell-Roberts, LBTH Fit for Life Claire Dunne, Bromley-By-Bow Centre Toyhouse - Julie Morgan Childrens healthy weight and nutrition Jane Wells, Associate Director of Public Health, LBTH

Policy/ strategy Health & Wellbeing Board key priority around childrens weight and nutrition include working with schools, physical activity, comms and information TH committed to LG Declaration on Sugar Reduction Sugar Smart launch on 4th March Services we commission include Healthy Schools Programme: support schools to work towards Healthy School Awards; includes school policies, healthy eating, physical activity, (eg Daily Mile) Infant feeding and wellbeing service feeding and weaning support Health Visiting advice and support to parents, specialist dietetic expertise School Nursing service National Child Measurement Programme and followup, advice/ support/ workshops

Childrens healthy weight and nutrition Food and nutrition Free school meals for all primary school pupils Reviewing nutritional quality of school meals Healthy Start Vitamins for all infants (and pregnant/ postnatal women) Healthy Start food vouchers Healthy Food Award scheme to encourage food takeaways to provide healthier options Food Poverty Strategy Francis Eatwell Roberts

Tower Hamlets Food Partnership Two possible vision statements Option 1: Working Towards a food system that protects social, physical and emotional wellbeing for all. OR Option 2: A food system that nourishes people and place. Our emerging objectives 1. Healthier food is affordable Holiday Hunger Ended | Healthier Food is Cheaper | Good Food Jobs are Created

2. Healthier food is accessible Healthy Food Economy is Supported | School Food Improved | Procurement made healthy 3. Healthier food is loved Healthy and sustainable food Celebrated | Meals Shared | Skills learnt 4. Food is Sustainable Urban Agriculture Promoted | Food is Redistributed 4. We understand out food system Pooled knowledge | Community Research Next Steps Today: Invite you to join the Partnerships first steering group. Please write to me if you wish to be a member

(Deadline 2nd March) Today : Search for Third Sector Organisation willing to host. Please write to me if you wish your organisation to be considered. We already have options. The steering group will establish a criteria and select in early May. 1st March: Fran prepare and share draft of registration documents. Including Terms of reference. (first draft 2nd March) - Name: Tower Hamlets Food Partnership - List of stakeholders (name of member organisation and public sector department - Vision Statement - Decision making process for appointment of food partnership chair, host organisation, and steering group members

Draft Action plan (First draft 2nd March) - 12 Month Work plan - 36 Month intention 2nd - 19th March: Steering Group members to comment on draft privately or collectively (self-organised) 21nd March: Steering Group members meet and approve final draft of registration docs 21nd March: Confirm our Third Sector Host. 22nd March: Food Partnership Registered with Sustainable Food Cities Early May: Wider Membership Brought together to launch food partnership and attend know your food

system research / work planning event. Mid May: Apply for funding for a Food Partnership Coordinator Fit For Life Claire Dunne Bromley-By-Bow Centre Fit for Life Programme Presented by Claire Dunne Fit for Life Programme The service is designed to support Tower Hamlets residents who would like help

managing their weight and associated long term health conditions. Criteria: 18+ BMI above 30 (27.5 if South Asian) Motivated to change Programme Information Fit for Life is based around four key dimensions:

HEALTHY EATING PHYSICAL ACTIVITY WEIGHT MANAGEMENT MOTIVATIONAL SUPPORT The programme lasts for up to 1 year: Initial Assessment 12 week intensive phase Maintenance phase and support Pathways from 1st March 2018 Fit for Life Centre assessment Specialist Adult Weight Management Specialist Disability Weight Management

Self-management Maintenance Ongoing support Monthly newsletters Monthly drop in sessions Health events Follow up measures The Service so far Now in the third year of delivery 4385 referrals over that period 2285 people assessed so far 75 Self-management 1332 Fit for Life Groups

610 Specialist Adult Weight Management 131 Ability Bow Currently approximately 100 people attending maintenance sessions each month 175 had 6 month follow ups 65 had 12 month data ups A few quotes Learning about healthy food options its pretty manageable when you know how Meeting others and feeling comfortable with the tutors they were great Ive learnt so much about what different foods do to your body and how to make changes to your diet

without going on crash or faddy diets. Feeling more confident about being able to make changes I have been asleep for ages and now I have woken up I lost 5 stone and hit my 5% weight loss target! How to refer GP resource page http://www.towerhamletsccg.nhs.uk/gps/fit4life.htm Email referral form to [email protected]/ Post referral to Fit for Life Centre, Bromley by Bow Centre, Bruce Road, London, E3 3HN

Any Questions? Claire Dunne [email protected] T 020 8709 9705 M 07432 600 614 Toyhouse Julie Morgan What do we do? A Tower Hamlets based family support organisation who for over 39 years Toyhouse has been an active part of local voluntary sector service provision. Our staff & volunteers reflect the diversity of the local community. Facilitating service from pre birth: Toyhouse fosters attachment between

parent & child, encompassing 1001 critical days and beyond Toyhouse works through the medium of play, with the promotion of health & wellbeing underpinning our work Healthy Lives, Healthy People Call to Action on Obesity in England DOH 2011 Focus Points: Exercise AND Diet Children AND Adults Prevention AND Treatment Toyhouse has adopted this holistic approach since we began offering specific obesity related projects in 2008

PROMOTING PHYSICAL ACTIVITY& HEALTHY EATING Active Play & Healthy Eating courses/Workshops Movers & Munchers After School Club Physical Play sessions A whole family approach ACTIVE PLAY

HEALTHY EATING Attachment & Bonding Shared activities, including discussion, cooking & lunch Active Play Healthy Eating is a Tier 2 Parenting Programme for Parents & Children together Supported by emerging research Baby Bonds (Sutton Trust March 2014) Where mothers have weak bonds with their babies, research suggest their children are also more likely to be obese as they entre adolescence Activity Levels in Mothers and Their Preschool Children (CEDAR/Cambridge: March 2014)

MOVERS & MUNCHERS Mondays 3.30-5pm term time Workshops in the school holidays Children & parents explore what makes a healthy diet Making tasty, quick alternatives to unhealthy high fat/sugar snacks

How junk food is advertised Labels & packaging Healthy eating on a tight budget Fun ways to get fit Places to go and things to do Active Physical Play & Early Years Active Play 4 sessions each week in 2 locations Safe fun environment for young children & parents to enjoy Opportunities to explore & risk take developing skills & confidence Encouraging Tummy Time developing core muscle

Supporting 180 mins planned & incidental physical activity Working towards 10,000 daily steps for adults Sally Goddard-Blythe Learning is not all in the mind Movement through free play is the medium through which sensory integrations take place in the early years WATCh? Conference 13th March 2014 Exercise - What is working . In small groups write on post it notes. What is working well What is not working so well What you suggest to change this Place the post it notes the flipchart .

Outcomes focussed commissioning Michael Keating Measuring what matters: the THT outcomes framework Health and Wellbeing Forum 22 February 2018 Michael Keating, THT PMO www.towerhamletstogether.com

#TH2GETHER In 2016 the Tower Hamlets Together Board agreed to develop a framework to articulate partner ambition to improve outcomes, quality and value for local people Why? In health and social care, outcomes should be centred on people, not individual services or specialities In 2016 review of what people have said in the past plus additional engagement led to the development of a set of I statements In 2017 the New Economics Foundation validated them, concluding: the majority of outcomes identified by THT have been reflected in some shape and form with the residents of Tower Hamlets most of the assets people valued in Tower Hamlets are linked to how they impact on their health and well-being

The future: after using Tower Hamlets Together services we want residents to be able to say Around me My doctors, nurses, social workers and other staff I feel safe from harm in my community I play an active part in my community I am able to breathe cleaner air in the place where I live I am able to support myself and my family financially I am supported to make healthy choices

I am satisfied with my home and where I live My children get the best possible start in life I am confident that those providing my care are competent, happy and kind I am able to access safe and high quality services (when I need them) I want to see money is being spent in the best way to deliver local services I feel like services work together to provide me with good care Me I understand the ways to live a healthy life I have a good level of happiness and wellbeing Regardless of who I am, I am able to access care services for my physical and mental health I have a positive experience of the services I use, overall I am supported to live the life I want

I believe the trust, confidence and relationships are in place to work together with services to decide the right next steps for us as a whole community Tower Hamlets Together Next steps Work with the new THT lifecourse workstreams Born Well and Growing Well, Living Well, Ageing Well - to decide which outcomes they should be responsible for and decide on a list of metrics to help measure them Desire to be less bureaucratic and more easily understood Changing roles for commissioners, providers and other partners More open relationships with local people

How would it apply to obesity and nutrition? www.towerhamletstogether.com #TH2GETHER Participants Updates All Other updates. Vanguard evaluation - Mirza

Lalani H&WBF Steering Group Elections Networking Event 14th March Communities Driving Change programme Electing new Steering Group Currently recruiting new chair & vice chair, steering group members & representatives, to sit on boards to represent the sector For more information about role descriptions, look on the THCVS website H&WBF pages - or contact: [email protected]

Networking Event 14th March 2018 The Centre, Community Hall, 32 Merchant Street, E3 4LX 10 - 12pm THCVS invite you to our March Networking Event. We want to facilitate new partnerships and consortiums who are equipped to take advantage of both borough and external commissioning opportunities, as well as other funding opportunities. The event will bring commissioners and voluntary sector organisations together to learn about: - The Joint Strategic Needs Assessment (JSNA) that underpins the commissioning approaches - The commissioning framework and timescale - Outcomes Focussed Commissioning - Tower Hamlets Together work streams - Network to find new partners with which to strengthen your commissioning offer There will be opportunities to showcase the work of the voluntary and community sector directly to

commissioners, highlighting and demonstrating how you add value - not just to residents, but to the health and social care sector. If you would like to attend please register below if you would like to showcase your work please contact [email protected] Tower Hamlets Health and Wellbeing Strategy 2017-2020 5 Priorities:

Communities Driving Change Creating a Healthier Place Employment and Health Childrens Weight and Nutrition Developing an Integrated System Communities Driving Change Programme changes led by community involvement What have we commissioned? Outcomes based programme Short medium long term outcomes

4 x locality-based lots (200k each) Each locality working on 2-3 areas of focus Support and evaluation contract( c.50K) Co-production approach Phased approach Consistency of approach required Providers Area North East Locality Lead Partner Bromley By Bow Centre

South East Locality Poplar and Limehouse Network CiC MyTime Active Young Foundation South West Locality North West Locality Support and Evaluation contract for all localities UEL

Their Partners SAfH Training PATH- Families Healthy Island Partnership Uscreates Uscreates REAL C3 Training Evaluation Phased programme Phase 1

Phase 2 Phase 3 Oct Jan 18 Feb April 18 May-April 19 Scoping Community Engagement

and Development Delivery, Reflection and Review Report on selection of Areas of focus Co produced delivery plan for each area locally determined outcomes Activities in outline

Mobilisation Very different providers with different approaches. Issue for consistency of approach but still maintaining uniqueness of what each provider brings Realising that there are some bottom lines Selecting the areas of focus - workshop deriving a set of criteria. Branding work with providers Identifying what is fixed and what is flexible ( set of fidelity factors) Evaluation lead for each area Proposed criteria for selecting areas of focus

1. Data: JSNA, locality and ward profiles; look at several indicators including deprivation/disadvantage (eg Index of multiple deprivation (IMD)) and other social determinants such as education, work, place 2. Community infrastructure and assets that can be mobilised; eg local champions, buildings, community organisations etc 3. Lack of community infrastructure and assets; areas that have not previously been engaged with and/or where not much community development or other interventions have happened 4. Stability in the population; not an area of high turnover where large numbers of residents are moving out; eg. an established community or new neighbourhood/housing estate 5. Bridging official and local data: Stakeholder insights into needs and priorities Resident insights; needs from the communitys perspective/voice

Resources Public Health Locality Manager for each programme supporting process Dedicated coordinator for each area of focus Networks Volunteers with in the areas of focus Community connectors and builders Funded plan - projects Training for teams and local residents Process & deliverables Phase 1 Oct Jan 2018 Mobilisation and Scoping Recruitment and Training

Areas of Focus Phase 2 Community engagement Feb April 2018 Development of Outcomes Framework Local Delivery Plan KPIs Phase 3 Delivery and Review May 18-April 19 Reflection on Delivery KPIs and process outcome Interim evaluation Apr Jun 2019 Future Jul Sep 2020 Governance Structure in progress

Health & Wellbeing Board Communities driving change Programme Board Programme Management Group Ass Dir PH Quarterly Meetings Support Contract (includes evaluation) Quarterly Monitoring with PHPL &

team Lot 1 Lead Contractor Monthly meetings with Support providers PH Programme Lead PH Programme Manager Area 1 Area 2 Area 3 Lot 2 Lead Contractor Monthly meetings with Support providers PH Programme Lead

PH Programme Manager Area 1 Area 2 Area 3 Lot 3 Lead Contractor Monthly meetings with Support providers PH Programme Lead PH Programme Manager Lot 4 Lead Contractor Monthly meetings with Support providers PH Programme Lead PH Programme Manager

Area 1 Area 2 Area 3 Area 1 Area 2 Area 3 How does it differ? Local people defining outcomes Local people developing action plans Working across the life course Bringing people from all backgrounds together

Working with the whole community rather than at risk groups or individuals Working with statutory service providers Delivering change rather than services Theoryof changefor theWell CommunitiesFrameworkapproach Priorities and programme of community action Priorities and agenda for improvement,

refocusing and/or redesign of local services Interventions to build individual and community capacity Interventions improving, refocusing and/or

redesigning local services Health related behaviour Change Employment; income; financial resilience Community effects - in: Participation Formal and informal networks

Social support/connectedness Sense of ownership/control Perceptions of place Perceptions of safety Cohesion Resilience Demand for appropriate services Improved quality of life Improved access to/uptake of

more effective and efficient, community focussed services IMPROVEDCOMMUNITYHEALTHOUTCOMES,WELLBEING&RESILIENCE COMMUNITYENGAGEMENT, DEVELOPMENT& COPRODUCTION --------------------------------Street/Doorstep interviews; Community world cafes; Profiling, Asset Mapping , Service audit; Appreciative

inquiry; Community and stakeholder co-production and action workshops Local volunteers delivery team; Training & skills development; Participatory budgeting Participatory design and delivery Community perceived needs, priorities,

motivations and aspirations; key success factors for each community Interventions on health and wellbeing, including local social, economic and environmental determinants of health Individual effects- in: Self esteem

Self efficacy Confidence Formal and informal networks Skills and knowledge Sense of control Control over health Resilience Effective use of services Employability and employment Physiological , psychological

and psychosocial improvements Networking ALL Next Health and Wellbeing Forum 10am to 12pm on 24 May 2018 at PDC, Bethnal Green Road

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