Amy's Monthly Briefing - August 2021

After our three anti-racism sessions with brap in the last few months, August’s THT Board focussed on our quarterly finance and performance reports, and future options for the borough partnership within the North East London integrated care system (ICS).

First up, we had an update on the recent SEND inspection. The council thanked partners for their engagement and reported back that inspectors were positive about our self-assessment and our improvement plans, particularly the pace of change in the pandemic. Priority areas of focus are: quality of education, health and care plans; delays in diagnosis for autistic spectrum disorder; gaps in speech and language provision; communications with parents.

Our user voice slot this month focussed on long COVID. We heard from Sally Ramsden of the Yoga for Life project, a community interest company in Bethnal Green that process three weekly sessions online for a diverse group of people with long COVID. As well as yoga, they offer holistic therapy input, occupational health advice and peer support. The ethos is “pacing not pushing” yourself.

Two women who attend the group shared their powerful stories with us. Hayley described feeling “like an 80 year old in a 50 year old’s body”, struggling with fatigue that requires lying down every hour, inner tremors, pins and needles, pain and brain fog. It was deeply upsetting to hear how she was repeatedly not believed and dismissed by health services, until she finally received a diagnosis in September 2020. She now has PTSD from long COVID itself plus the trauma of her symptoms being dismissed. Yoga for Life has been a “life raft” - providing a practical, non-judgemental and welcoming community.

Kardene caught COVID during her work for the ambulance service and faced a rollercoaster of debilitating symptoms. She struggled with her 12 hour shifts due to severe fatigue and had a relapse after her first vaccination. With support from Yoga for Life, her physical and mental health has improved and she’s returned to work on alternative duties. The project’s focus on acceptance has really helped her move forward and she’s now setting up a long COVID support network in the London Ambulance Service.

The Board discussed the need to raise awareness of long COVID and support like Yoga for Life among GPs and Social Prescribers, and using co-production to build on people’s experiences and improve the local service response.

The quarterly finance report outlined that the council faces an overall £11m budget gap and the CCG has a £3.1m overspend, though this is COVID costs and should be reimbursed. Learning disability support is the highest level of council overspend, largely due to transitions between children’s and adults’ services. For the CCG, hospital discharge is driving the overspend. The impact of long COVID on adult social care pressures and rise in demand for children’s social care are still uncertain. The quarterly performance report now shows metrics across the partnership, though Board members highlighted children’s health data and ethnic inequities as vital gaps to fill.

The Local Delivery Board gave a brief report. Most of the 35 projects they oversee are on track and the Board is functioning well, the voluntary sector in particular find the split between exec and operational Boards more helpful to engage with. Multi-disciplinary teams and care co-coordination is being prioritised with the project team currently confirming what’s in scope. Delays to home care recommissioning are due to undertaking more in-depth co-production with users and carers.

Finally, the CCG presented on options for borough partnership accountability within the new ICS arrangements from April 2022. These range from a consultative forum that informs decisions to a joint committee of the ICS NHS body and statutory providers (health and council) or individual directors with delegated authority which could be joint appointments with the local authority and/or across providers. We will be revisiting these options and our ambition as a partnership in the autumn.

I hope everyone has a good summer with some much-needed rest where possible.