Agenda item

Report of the Director of Health and Wellbeing, London Borough of Camden; Director of Integrated Care, North Central London Integrated Care Board; Director of Equalities and Disproportionality, Camden Council.

An update report was requested at the Health and Adult Social Care Scrutiny Committee in December 2023 on the work of the Scrutiny Panel set up to address health and wellbeing inequalities experienced by Camden’s Bangladeshi community.  The Committee asked that the update report identify if there are any outstanding recommendations not sufficiently progressed yet and consider further opportunities for collective action.

The Panel was set up by this Committee in 2015, working with Healthwatch Camden.  There have been several published updates, with the most recent received by this Committee in 2017.  This report focuses on progress against actions identified within four key workstreams for this work:

·       Healthy weight and healthy lives – obesity and physical activity;

·       Adult community learning, training, and routes into employment;

·       Accessibility and quality of primary care;

·       Building resilience and mental wellbeing

This report updates the Committee on the status of actions identified in 2016, describes inequalities in the Bangladeshi community from the 2021 Census, and summarises current activities tackling inequalities in the Bangladeshi community.

This review found that there were no outstanding recommendations that have not been sufficiently progressed, however both the issues contributing to inequalities and the Council’s and partners’ response have evolved considerably in recent years.

A combination of the Covid-19 pandemic and the subsequent Cost of Living crisis have impacted on the inequalities experienced by the Bangladeshi community as well as other ethnic communities.  This review identified a range of activity building on that underway in 2017 and incorporating a focus on tackling further inequalities identified during Covid and the Cost of Living crisis, from key overarching strategies such as We Make Camden and Building Equal Foundations to individual services.

Conversations with voluntary and community sector organisations supporting the Bangladeshi community show that inequalities are persistent and enduring and that a focus on tackling inequalities needs to be maintained.

Consideration was given to the report of the Director of Health and Wellbeing (London Borough of Camden), Director of Integrated Care (North Central London Integrated Care Board) and Director of Equalities and Disproportionality (Camden Council), as presented by Piers Simey (Assistant Director for Public Health).

In response to questions about whether similar work could be conducted to address the health and wellbeing needs of other ethnic minority groups, the Assistant Director for Public Health agreed that there was a need to address inequalities across all communities but in particular for larger populations such as the Bangladeshi and Somalis communities in Camden. There was an opportunity to revive the work for the Bangladeshi community and to launch a piece of work for the Somali community. Ian Sandford, Public Health Strategist, addressed queries about whether any recommendations had not been met. It was clarified that the recommendations were action-based and had been either time-limited with learnings identified, were still in place, or had evolved over the previous seven years.

It was confirmed that Camden did have a community champion model, which was resident-led and sought to improve lives on estates on broad basis. There were also champions that were more specifically health-focused.

In response to questions about how success could be quantitatively and qualitatively measured for activities, such as the smoking cessation service, the Director of Health and Wellbeing commented that attrition was an issue due to the timescale, with Covid-19 preventing an earlier report to committee. The Assistant Director for Public Health highlighted the two-thirds success rate for the smoking cessation service, although it was not known how far the service reached into the community. One element to consider would be what would have happened without the programme being in place. Further objective information for the reporting period would be useful for analysis. Census data did indicate that there were greater needs in this population. The Director of Health and Wellbeing noted that desired quantitative outcomes would be considered for future programmes, alongside the development of participation and evaluative frameworks from the outset. The involvement of participants and their perception of the process was equally as important as the outcomes.

The Assistant Director for Public Health highlighted the initial findings of the physical activity needs assessment in paragraph 8.6 of the report, which helped to increase understanding of barriers and opportunities for being physically active more broadly among Asian/British Asian residents. More work was required with particular communities. There were particular themes such as the need for women to exercise in environments where they feel safe, comfortable and not overlooked. There were already specific opportunities such as at three leisure centres, swimming pools could be made private for women to swim in female-only sessions.

With regard to campaigns to support less active residents over 60, it was noted that there were differences in participation based on age, disability, ethnicity, and deprivation. There was a particular need for older residents to become more active and the campaign would draw on behavioural science, with voluntary and community sector (VCS) organisations conducting outreach.

It was recognised that there was an over-representation of Bangladeshi learners in the adult community learning in 2022/23, which was considered a success. This had been achieved through working with community groups.

In response to questions about learning on community strategies and how that could be applied to other groups, the Director of Health and Wellbeing commented on the gap in organisational memory following the Scrutiny Panel recommendations in 2016 but highlighted other learnings from Covid-19 around communicating health risk, increase health literacy and the need to build trust. A multi-faceted approach was needed, with cross-London approaches taken for very small communities dispersed widely.

The Chair noted the need to support deaf residents within the Bangladeshi community.

The Assistant Director for Public Health explained that social value requirements in contracts were a broad area in addition to quality requirements. They included wider benefits such as the recruitment of apprentices.

Mathurini Visakan, Head of Equalities and Social Purpose, commented that the council communicated key messages through working closely with the VCS, via WhatsApp groups for certain communities, and information was provided in different languages or formats. The Building Equal Foundations programme had been developed into the Equalities service and was able to support on health inequalities issues.

RESOLVED –

(i)             THAT the key findings relating to the focus of the Scrutiny Panel on meeting the needs of the Bangladeshi Community, and key progress that was made, be noted;

(ii)            THAT the range of initiatives currently in place that help meet the health and wellbeing needs of the Bangladeshi Community in Camden be considered;

(iii)          THAT an ongoing focus on addressing health and wellbeing inequalities within this community through tailored initiatives by the Council and a range of local organisations responding to key local intel/information on the needs of the Bangladeshi Community, and by ensuring that initiatives supporting all communities are fully accessible and well promoted, be endorsed.