Somali Task Force: Health & Wellbeing Meeting Minutes
October 14th 2015
6:00pm
Members present:
Cllr Sirajul Islam (SL) / Co-ChairCllr Amina Ali (AA) / Co-Chair
Louise Russell (LR) / Service Head, Corporate Strategy & Equality, LBTH
Abukar Essa (AE) / Task Force Member
Zahra Jama (ZJ) / Task Force Member
Abdi Hassan(AH) / Task Force Member
Sulaiman Hashi (SH) / Task Force Member
M.Ali (MA) / Task Force Member
Sahra Digaleh (SD) / Task Force Member
Awo Ali (AA) / Task Force Member
Ibrahim (IB) / Task Force Member
Abdi Hassan (AB) / Task Force Member
Jama Muse (JM) / Task Force Member
Muna Mohamed (MH) / Task Force Member
Khadra Sarman (KS) / Task Force Member
Safia Jama (SJ) / Task Force Member
Yonis (YO) / Task Force Member
Jama Omar (JO) / Task Force Member
Shanara Matin (SM) / Service Manager, Corporate Research Unit, LBTH
Leo Nicholas (LN) / Senior SPP Officer, Corporate Strategy &Equality, LBTH
Juanita Haynes (JH) / Senor Research Officer, Corporate Strategy & Equality, LBTH
Barbara Disney (BD) / Strategic Commissioning Manager, LBTH
Abigail Knight (AK) / Acting Associate Director in Public Health, LBTH
Daniel Kerr (DK) / SPP Officer, Corporate Strategy & Equality, LBTH
Ellie Hobart (EH) / Deputy Director of OD and Engagement, CCG
Safa Moghul (SM) / Engagement Support Manager, CCG
Sharon Hanooman (SH) / Women’s Health and Family Services
1. Welcome & Introduction
Councillor Islam and Councillor Ali welcomed members to the meeting, outlined the format, and detailed some of the key objectives of the meetings. These included:
· an overview of the data captured on the Somali community and an understanding of what the council is undertaking to address the gaps.
· an overview over social care provision, to gain community insight on areas that may require co-production / community views within social care.
· an overview of health provision, to draw out community insight on areas for co-production / community views within health e.g. MMR campaign, Mental Health service pilot.
2. Declaration of interests
SI asked the members of the reference group to declare any conflicting interests. There were none to be noted.
3. Overview presentation covering the Somali population in TH
The task force received a briefing on current budget consultation activity. SM provided a presentation detailing the financial challenges impacting the council including £63million required in savings. The presentation included details of the Councils approach to achieving savings whilst aiming to protect the vulnerable and services residents rely on, reduce the cost of living for residents, create growth and regeneration, and be a lean, flexible and citizen centred council.
JH provided a presentation detailing analysis of Census data to identify what we know about the Somali community in Tower Hamlets. JH stated that it is difficult to build an accurate profile of the Somali population due to the limitations of the Census only measuring country of birth data and not capturing Somali data in other areas. Estimates from local research suggest that the Somali population could be between 2 – 3 %, 5,500 to 8,000 people. Migration levels from Somalia seem to be declining which follows a London wide trend , with the number of Somali nationals registering for national insurance numbers declining from 144 in 2002/03 to 17 in 2014/15. There is a higher than average proportion of 25 – 49 year olds and pensioners in the Somali born population: possibly a feature related to migration and the age profile not known for wider Somali community. Somali-born residents mostly living in the east of the borough (historically East India and Lansbury, and Bromley by Bow).
Research about the Somali community in Tower Hamlets and Camden highlighted a number of housing issues for the community – overcrowding, affordability and homelessness. Local research in 2012 showed that almost half of Somali families locally are living in the social housing and the 2011 Census confirmed that there are higher levels of overcrowding amongst the community. Currently around 3.2% of those on the council’s housing waiting list are Somali.
Attainment levels for the community are very positive. There has been improvement in attainment levels for Somali pupils achieving 5 A* - C including English and Maths, 64.2% in 2014 compared to the borough average of 59.4%. At KS2 attainment levels are above the borough average for Grammar, Punctuation and Spelling 83.7% compared to 81.8%. At KS1 attainment levels are above average for reading writing and science.
Data on employment of Somalis shows that this is a key area of inequality in outcomes. Somali-born Londoners had the lowest economic activity rates, and highest unemployment rates, of all migrant groups compared. Moreover when looking at the type of work Somalis are undertaking data from the 2011 Census about the occupations of Somali-born residents and their year of arrival in the UK shows that the majority (26 per cent) were in elementary occupations.
The corporate research team has commissioned more data from 2011 Census in order to develop a picture of the Somali community locally in terms of: population numbers and household characteristics, labour market participation, attainment and qualifications and health.
4. Social Care
Barbara Disney, Strategic Commissioning Manager, provided a presentation to the Task Force focusing on the Care Act and the impact it will have on the work of the council and members of the Task Force.
The Task Force reviewed an information video about the Act.
The Act is built around people and the principle that the person is the best judge of their own well-being and needs and people must be genuinely involved and influential throughout the planning process.
Meeting needs is an important concept under the Act and moves away from the previous terminology of providing services.
This provides a greater variety of approach of how needs can be met, developed through care and support planning. There might still be more traditional services including care in the home, but there are also other more flexible options such as assistive technology (e.g. friend and dad)
The act will improve advice, information and advocacy, and establish new assessment criteria that are clear and fair. It will be easier to get information about what is available locally through things like the e-market place and it will introduce personalised support plans and personal budgets ensuring a range of high quality services that meet peoples identified needs. Finally it will put carers on the same footing as those they care for.
BD stated that she has looked at the issues that have been previously raised with this group and notes the issue around language barriers as being important. It is clear that there is a need to improve access to services for all our communities rather than commission new services, particularly given the budgetary pressures that local authorities are facing.
BD then asked for feedback from Task Force members on what they felt the key issues were in the area of social care and received the following feedback from the group.
Access to Information and Advice and areas for improvement
The feedback suggests issues with awareness about where residents can access and get appropriate advice and in terms of the broader changes and implications of the Care Act on service users.
The list of sources of advice were:
· Tower Hamlets Council
· Schools
· GPs
· Mosques
· Family &Friends
· East End Life
· Some participants worked within settings that also provide advice e.g. OSCAR.
· People are not aware of what the Care Act is about.
Digital access and trust in services were significant barriers to accessing information and services, including key services such as GPs and Schools
· Mind, Praxis, Oscar (places that include Somali speaking staff)
· Language barrier is a significant factor restricting access – especially for the older generation.
· Digital inclusion for older people
· Going to the GP is problematic
· Community not aware of where they can get information. Need to develop better understanding in community of where to receive information and advice.
· Not sure if all Somali community can use the internet.
· Somali senior citizen club – 99% no English & literacy. Role of established organisations to support them. Community network of activists can deliver this information to the older generation, the council needs to engage with them. Need a bottom up, not top down approach.
· Need branding for information and advice services, it needs to be accessible and recognisable
The reference group highlighted the importance of better representation of the Somali community in roles and jobs within public and third sector services as a key way of overcoming barriers to access for the Somali community.
· Mobilising Somali community activists as the community relies on word of mouth
· More Somali people working as frontline staff
· Somali development officer working to support services in working with the Somali Community.
· Need a Somali development officer who can help the council understand how they can access the community to provide the information
· Need Somali workers/speakers in frontline staff- GPs, surgeries
· Schools should also be a source but families find it difficult to communicate
· Significant demand for Third Sector organisations to provide advice and guidance
Current ways in which people participate and access community networks
The reference group detailed services that focus on the Somali community including befriending services and sheltered accommodation.
Range of council provided services listed as ways that people prevent isolation or access community networks.
· Lunch Clubs
· Somali coffee shops
· Day centre
· Mosque
· Mayfield House
· Granby Hall
· Need women’s health project
· Need Somali specific befriending services
· Phoenix Court
In terms of participation, the group raised issues faced by Somali women particularly around isolation and mental health issues.
· Need for having a social network (especially women)
· Some don’t know where to go/who to see. Some know where to go but have mobility and transport issues preventing them from getting there.
· Need for sheltered accommodation which is similar to Sonali Gardens where attendees can come together and develop own community.
· The situation is more difficult for women who cannot use Somali coffee shops and do not see children centres as a place for mothers to meet.
· Older Somali women in particular have no facilities to go to.
· Concerns about Mayfield House and need to continue to have provision for Somali elders.
· More of an issue because there are no extended families
· Clubs could be more creative in terms of the offer by providing Somali dancing and physical activities.
· Women do not have the same opportunities to socialise, suggestion of women only centre for women and young children.
· Important to find Islamic culturally sensitive provision, e.g. swimming.
· Women have raised the concerns about cameras/CCTV whilst swimming.
· Raising awareness about options - an assessment doesn’t lead to either home care or day care – could include using direct payments to employ a personal assistant and use that to go to a mainstream service. Need to focus on post natal depression
· Integrated health, mental health and care
· Choice and personalised care
· Correct assessment and getting what they need.
Language and communication barriers identified as key issues in accessing services.
· Language issues – most important thing is ability to communicate, can’t utilise a service you can’t understand
· Want more advice and advocacy. People don’t know about existing advocacy services and they don’t know basic information of how to access the system. There is a need to improve communication and publicise services wider and more effectively.
· Understanding of literature and translation of documents
· Want to know when they need to go to a GP.
· Transport to access services
· Literacy problem – use Somali TV not leaflets to communicate.
· Professionals that understand Somali/speak the language
Problems with access to services were defined in terms of a lack of understanding of cultural issues on the part of service providers and a lack of trust and confidence in services.
· Cultural sensitivity e.g. provision of halal food etc.
· Limited choice, there are only 2 Somali led care agencies that support families and who understand the needs of families
· Only people from the community can deliver this information because of level of exclusion
· There is a need for Somali social workers.
· The community does not have trust in the service that had been offered because they are underrepresented.
5. Health
Ellie Hobart, Deputy Director of OD and Engagement CCG, provided an overview of the CCG’s provision to support the needs of the Somali community and an update on the recent engagement work they have done with the Somali community. In 2013-14 a bursary scheme led to research projects working with elderly Somali men, and Age Concern was contracted to raise awareness of mental health and specifically dementia in the community. In 2014-15 projects included a targeted self-management service, an FGM awareness raising project, and a community health services review. A focus for 2015-16 is on commissioning work to support the voluntary organisations supporting the Somali community. In April 2015 the CCG ran an event which focused on Somali women and looked at issues such as mental health, advocacy, integrated care, maternity services and long term conditions. A key concern expressed at the event was around representation of the workforce, advocacy and interpreting restricting access to care, ensuring both Somali men and women have equal access to services, a need for integrated care, and ensuring the community is engaged in a meaningful way. All information from the event will feed into commissioning intentions for this year. The CCG are currently refreshing their public consultation involvement strategy to ensure it has diverse input and work streams. Mulberry Girls School is setting up a university technical college and will train local people to become involved in health and social care and is being supported by the CCG. A key finding from the refresh of the Equality and Diversity strategy is the need to improve representation on their Maternity Service Liaison Committee.