Across all life stages
You asked for an overarching plan for improving services as well as the focus on life stages.
Our Health and Care Plan identifies health areas which systems have agreed to deliver collaboratively to achieve positive outcomes for residents. This, for some health areas include improving services, for example through the use of digital technology.
You wanted more detail about how out Health and Care Plan will be resourced (staffing and finance), delivered (with timescales), measured and evaluated.
The Health and Care Plan Summary 2022 to 2024 is a high level strategy summary. Development of an Implementation Plan will identify actions and deliverables. The Place Based Leaders Partnership Committee will confirm the project management function of the Health and Care Plan delivery. The services identified in the plan are existing services which are resourced.
You asked what processes will be in place to capture people’s feedback on the priorities, quality of care and improvement.
The creation of the Health and Care Plan refresh process embedded an engagement process inviting residents to provide their feedback. The content on this page captures the feedback and responses.
You said the Covid-19 pandemic and its impact on health inequalities needs a stronger presence.
Health inequalities is featured as an overarching theme across each life course in our Health and Care Plan.
You said we need to take a more integrated approach across health and care e.g. people with long term disability are impacted by both health and care
The Live Well life course includes the objective ‘Implement a model of care for long term conditions to include prevention, detection, management, and optimisation. This will promote a standardised approach to care and identify and address areas of inequality of access and health outcomes across the borough.’
You said the needs of people with a neuro disability, though identified as a significant proportion of hospital patients, are missing from the live well and age well life stages.
Neuro disability services was discussed at a Richmond Health and Wellbeing Board meeting, the action was to facilitate connection between the local lead contact and South West London Integrated Care System Neurodiversity lead officer. A specific neuro development objective has been added to the Start Well Plan On A Page.
You said that healthy active lifestyles should be included in all life stages, not just for Start Well.
There are initiatives outside of the Health and Care Plan that encourage residents to lead an active lifestyle. It is included in Start Well due to the specific issues identified for children and young people.
You said that the topics in our summary document are not fully reflected in the life stage documents.
Each life course has a ‘Plan on a Page’ which provides further detail of the priorities, objectives and outcomes associated with the life course.
You asked for more references to the role played by unpaid carers, including young carers, with specific carer focused objectives in each life stage.
Carers is featured as an overarching theme in our plan and therefore is addressed in each life course theme.
You asked for more partnership working with the voluntary sector, with earmarked funding to support this, and greater involvement in the delivery of services.
There are a number of projects across the life course which commission the voluntary sector to deliver services. The voluntary sector is embedded in the work of our Health and Care Plan.
You wanted greater focus on the role of technology and occupational therapy to support people in their own homes and in care homes.
Our Health and Care Plan acknowledges the increasing role of digital technology to improve health and care of residents.
You said the plan needs to address digital inclusion or exclusion.
Our Health and Care Plan acknowledges the increasing role of digital technology to improve health and care of residents. This is a growing area with some services
likely to embrace change through the introduction of the NHS White paper.
You wanted more emphasis on active travel, safe walking and cycling infrastructure for all ages for health and climate reasons. The Council’s choices about transport infrastructure could improve people’s quality of life.
The Health and Care Plan features joint priorities from across health, care, and wider determinant systems. The full version of the Health and Care Plan 2022-24 will feature individual organisation’s strategies acknowledging there are many contributors to good health and wellbeing.
This feedback influenced the development of our Start Well plan on a page.
You want us to use the family centred approach to achieve our plan’s objectives.
Although not specifically mentioned, this is an approach prevalent among many of the services involved.
You asked us to increase services for children and young people’s mental health that are able to be more flexible in delivery.
The plan includes services across a range of delivery methods including schools, peer to peer, a drop-in centre, and digital.
You said there’s a need for better provision of support for young families in conjunction with the NHS, and more facilities for families with under 5s.
Our Start Well Plan On A Page includes “Improve the early identification of Special Educational Needs (SEND) through improved multi-agency working” and the
borough’s SEND Futures Plan includes the “First 1001 days” initiative.
You said there’s a need for early diagnosis of the neuro
diverse, including dyslexia. Also ADHD and autism to get support earlier for the child and parents
Our Start Well Plan on a Page includes “Improve the early identification of
SEND” and “Develop the neuro-developmental service to improve timeliness of assessments and pre and post-diagnostic support.”
You wanted greater emphasis on the role of schools in developing healthy lifestyles.
Our Start Well Plan on a Page includes “Work with all schools implementing initiatives that actively promote healthy weight through healthy eating, regular physical activity; maximising opportunities for children to safely walk or cycle to
You wanted greater emphasis on support for parents in the first 1,001 days, to promote babies’ development and parents’ mental health and wellbeing.
Our Start Well Plan on a Page includes “Promote breastfeeding and safe infant feeding practises to improve nutrition of babies and infants in their first 1,001 days” and “Improve the early identification of Special Educational Needs (SEND) through improved multi-agency working”. The borough’s SEND Futures Plan includes the ‘First 1001 days’ initiative.
Our Health and Care Plan includes an overarching theme of ‘mental health’ across all life courses.
You asked for greater access to early professional support to help mothers continue breastfeeding beyond 6 weeks.
The Start Well Plan on a Page includes “Promote breastfeeding and safe infant feeding practises to improve nutrition of babies and infants in their first 1,001 days.”
You said we should improve and offer equal access (free) to exercise and fun activities for young people.
Our Start Well Plan on a Page includes “Create more opportunities for children and young people to participate in active play, sport, and adventurous activities, including targeted programmes……”
You asked us to replace the term ‘obesity’ with ‘healthy weight’ as there is a need to acknowledge and act on the reality of low weight as a growing problem. This needs to be considered as much as high weight.
Agreed – this has been changed.
This feedback influenced our Live Well plan on a page.
You asked for stronger focus on aftercare support when addressing obesity, to address potential unhealthy eating behaviours.
We are developing a system wide approach around healthy weight management and will incorporate the support for aftercare in our plans.
You asked for greater focus on healthy living, rather than dealing with just the sickness.
The work we are doing around the early identification of risk factors for the development of long-term conditions aims to engage with those at risk to make healthy choices and to provide them with the support to maintain a healthy lifestyle through targeted interventions.
You asked to make exercise and activities in the borough available and free to everyone e.g. Ham tennis courts.
Tennis courts like the one in King George’s field in Ham is a public tennis court and we appreciate that there is a charge for playing tennis on such public courts
across the borough.
The Council uses this money to reinvest in the tennis courts. For example, King George’s was refurbished about three years ago. There are two types of membership: Family – £55 per year and then all courts are free to be booked; Junior – FREE for under 16’s; and then they can also book courts free of charge and can play with an adult (for example, a family member). It is also possible to pay and play but the cost is £4.50 for half an hour and as such membership offers better value.
Ruils’ Healthy Lifestyle resources are for anyone who would like to improve their
health and wellness – whether they are looking for an exercise app, a weight loss programme or an exercise activity or want to engage in local offers (free or paid).
This links to a range of activities across the borough. These include information on the Council’s website about how the Council is helping people to move more.
This feedback influenced our Age Well plan on a page.
You said there was a need for greater focus on prevention at this life stage
There are a range of preventative projects and programmes of work under the objective ‘Encourage active, resilient and inclusive communities that promote
health ageing and reduce loneliness and isolation’.
You said we should include client feedback as part of assessment for paid carers.
We do consider client feedback – both positive and negative – when monitoring care providers.
You said the plan does not address the support needed by people with high dependency needs or address the increase in people living over the age of 80 and the increasing demand this population will have on services. There was little reference to care homes except to make them “more digitally integrated” and extra care housing wasn’t mentioned.
There are a range of initiatives that support people with higher levels of needs against the objective ‘Support people to live at home independently and for as long as possible, including people with dementia’
You said we need to maintain access to services for older people via telephone and face to face.
All services will continue to offer telephone and face to face options.
You said we should improve communication between services and with the patient/user.
We always strive to improve communication between the service provider and the person receiving the service and are keen to receive feedback from service users to know when communication is poor – and also when it is good.
About GP services, you had concerns around an increase in non- clinical roles, such as social prescribers, and had difficulties getting an appointment or services from GP practices. You also thought GPs were not as accessible to patients since practices moved to
online systems and that they lack skills in mental health.
We will share this feedback with primary care leads to inform future discussions around primary care developments.
You said there was a lack of health and care provision in Ham, with Ham clinic being underutilised.
Hounslow and Richmond Community Healthcare are delivering a range of community services from Ham clinic including community paediatric medical team,
looked after children’s health team, paediatric speech and language therapy services, paediatric occupational therapy services, paediatric physiotherapy service and adult podiatry.
Currently the building does not have spare capacity for other services. However if the local health and care plan priorities require a change to the
services being delivered then this will be looked at
You said the text service at Kingston Hospital is not working
This feedback has been shared with Kingston Hospital so they can review the provision of the text service
You said we should improve commissioning and contract terms for school nursing to enable follow up support for children (and
parents) identified as obese or morbidly obese, via the National Child Measurement Programme (NCMP)
In Richmond there is a follow-up process to access further support from school health for young people identified through NCMP. School nurses provide additional support to families where identified.
This may include nutritional advice, advice on managing weight and exercise.