Grenfell Recovery Strategy

Population Monitoring in North Kensington

The Council, local NHS, and Public Health England (now the UK Health Security Agency (UKHSA)) made a commitment to closely monitor and support the health and wellbeing needs of those directly affected by the Grenfell tragedy as well as the wider North Kensington community. 

In 2018 a Joint Strategic Needs Assessment (JSNA): The Journey of Recovery was completed. It was an initial assessment of the needs of the community in the wake of the tragedy, drawing on disaster recovery literature, available health and wellbeing data and some community insights. Recommendations from this work included regular joint data monitoring, responding to community concerns as well as carrying out a wellbeing survey over five years to understand the ongoing health and wellbeing needs of the community and shape future services.

Since 2018, a wide range of support has been put in place by the Council and the NHS to respond to the recommendations of the JSNA. The Council put in place a targeted Grenfell Recovery programme in 2019 to provide dedicated support to bereaved and survivors and a wide range of community‐based support to people living in North Kensington. The latest information about the delivery, reach and impact of the programme is summarised in the Grenfell Recovery Programme Annual Report. 

This includes details on what is being delivered through the programme, who it is reaching and what difference people feel it is making.

UKHSA have been carrying out environmental monitoring and air quality reports which are available online. The NHS offer a range of services as part of their Health Monitoring for survivors, including enhanced health checks, community respiratory checks, annual lung function test and annual general developmental and physical health check with a paediatrician for children and young people. See all the NHS Grenfell services and how they can be accessed.

As part of the longer-term monitoring arrangements, Kensington and Chelsea Council’s Public Health team has put in place a monitoring programme which includes:

1. Population Health Monitoring: The aim is to track the health and wellbeing of the population in North Kensington over a long period of time using NHS data. The focus is on health conditions, medication that has been prescribed and the use of services. Patients cannot be identified from this data.
2. A five-year health and wellbeing survey: the aim is to understand the community’s experience of the ongoing impact of the Grenfell tragedy. The survey focusses on perceptions around health, wellbeing, and recovery and to help shape services accordingly to local need.

The update on the North Kensington Joint Strategic Needs Assessment

The Grenfell Joint Strategic Needs Assessment is in the process of being updated and a draft outline has been developed. Read the Summary of plans to update the Grenfell Joint Strategic Needs Assessment.

This draft document outlines plans to update the 2018 Journey of Recovery JSNA to build a better understanding of the ongoing impact of the Grenfell tragedy on bereaved and survivors and local residents. An updated JSNA is needed to help us plan collectively with the community for the next phase of support, ensuring the right support is in place for those most affected by the tragedy, now and in the future.

Led by the Council and supported by the NHS, this document summarises some of the evidence gathered since 2018 about the ongoing impact of the tragedy on survivors, bereaved family members and people living in the immediate local community. It sets out an initial view of what this evidence means for the longer-term needs of these specific groups, focusing particularly on the challenges ahead in the next phase (2024-28).

This is a draft outline document. The focus of the next phase of the work on the JSNA (June to September 2023) will be to work with bereaved, survivors and residents to gather additional evidence to inform the final document to be published in Autumn 2023. We hope that the evidence presented here and the initial conclusions drawn will be discussed, debated and challenged over the next six months.

If you would like more information about this work or would like to provide feedback, please email: [email protected].

Contacts

Health and Wellbeing Support 

The NHS provide extra health services in the local area to help support the health and wellbeing of those affected by tragedy. If you need a Dedicated Health Worker, call 020 8637 6279 from 8am to 8pm, Monday to Thursday, and 8am to 5pm on Fridays.

Alternatively, please email [email protected]. For more information visit www.grenfell.nhs.uk.

Air quality reports

The UK Health Security Agency has been carrying out air quality monitoring. For general enquiries to the UKHSA, email [email protected]. 

---

Notting Dale Residents Health Checks Group Meeting - Wednesday 3 May 2023

At the request of the Notting Dale Residents Health Checks group, the Council facilitated a discussion with the UK Health Security Agency (UKHSA) and National Health Service (NHS) to talk to residents about the scope of the health and environmental monitoring in the area.

Agencies present

1. Anna Raleigh - Facilitator, Director of Public Health for the Royal Borough of Kensington and Chelsea.
2. Liz Brutus - Deputy Director of Public Health for the Royal Borough of Kensington and Chelsea.
3. Rebecca Brown - Pollution Regulatory Team Manager, Environmental Health, Royal Borough of Kensington and Chelsea.
4. Janice Lo - Consultant in Health Protection, North West London Health Protection Team, UK Health Security Agency.
5. Mary Mullix - Director, North Kensington Recovery Team NHS.
6. Andrew Steeden - Medical Director West London Clinical Commissioning Group NHS.

Air Quality monitoring, UK Health Security Agency (UKHSA)

Feedback from residents

• Residents are reporting feeling unwell and being concerned; Grenfell cough, coughing up blood, motor neurone disease, skin conditions, stomach problems, cancers, welfare of pets. 

Questions raised by residents

• What were UKHSA asked to test for and when did monitoring start?
• Need for clarity on what is being monitored – what chemicals, toxins, biomonitoring? What else could be monitored?
• Is there air quality data from 2017? What was being monitored between 2017-2023, specifically in the first two weeks and before the tower was wrapped. In this period, what was identified as high?
• What protection will be given to residents during tower deconstruction – what monitoring will be undertaken?
• Need for clarity on the support available ‘what can you do for us? And what will you do?’
• How can residents be involved in and shape the discussion? How can they feed in their concerns?

Health Monitoring, NHS North Kensington

Feedback from residents

• Many concerns about residents’ mental health as well as physical health (people coughing blood, breathing getting worse).
• Been fighting for six years, more could be done.
• Concerns about trust and responses from GPs; health concerns being dismissed.
• What trauma-informed care and cultural awareness training is available for primary care practices and is it being taken up?
• It would be helpful to have health services consultants, e.g. toxicology consultants, respiratory consultants and paediatric consultants to attend sessions with residents. 
• Need a system to be introduced to enable residents to raise concerns about medics/GPs (Patient Advice and Liaison Service (PALS) not deemed appropriate).
• Request for one stop shop that residents can go to and talk to someone about their health concerns/symptoms and any other Grenfell related worries.
• Several residents requested their blood is taken for research purposes.
• Community-led research/data collection is underway, and residents would welcome further discussion around the results. 

Questions raised by residents

• What exactly are you monitoring?
• Much reference to the firefighters and the health effects that they are now experiencing – recognising their intense exposure for a short duration as opposed to residents’ general exposure over a longer period. ‘Can we get the tests that the fire fighters are getting?’
• What is being done to highlight the Grenfell NHS ‘offer’ including annual health? How will these services benefit residents and what are the mechanisms for residents understanding what’s available for them? Is annual spirometry too blunt an instrument to use?
• What is the Toxicology Service from Guys and St Thomas’? Is there any value in extending it to the wider community/people around the tower vs those who were survivors? What size of cohort has been tested – what have they tested for?
• A private school in close proximity to the Tower has air monitoring/interventions in place – what is the monitoring offer to local state schools in close proximity to the tower?
• What was the learning from other international tragedies such as 9/11?  Please can this be shared with us.

Actions and next steps

1. UKHSA to respond to the specific environmental questions raised:
   1. What were UKHSA asked to test for and when did monitoring start? 
   2. Need for clarity on what is being monitored and what else could you monitor.
   3. Is there air quality data between 2017 and 2023 and in this period what was identified as high?
   4. What protection will be given to residents during tower deconstruction? Department for Levelling Up, Housing and Communities (DLUHC) have not announced a decision yet to deconstruct, further advice will be sought once decisions are made.
      
      The response to this question is in a separate document
      Document

      

      Grenfell Notting Dale resident meeting: UKHSA response PDF, 123.29 KB, 5 pages
2. NHS to communicate the support offer to survivors and bereaved and the wider community.
   
   The NW London NHS team has provided the following response: The North Kensington Recovery programme support offer is accessible via the NHS North Kensington Health and Wellbeing website. The programme has worked with a number of local Community groups to develop targeted communications to promote services. There will be a leaflet drop in 33,000 households during June and July 2023.
    
3. NHS to outline the training offer available to GP practices to help them to support residents impacted by Grenfell.
   
   The NW London NHS team has provided the following response: An accredited Cultural Competency training package is currently being rolled out to GP practices. The training will help GPs and practice staff to support patients in a culturally appropriate manner. NW London NHS colleagues will be working with primary care to understand what further training is required and how this can be delivered to ensure its effectiveness for patients and staff.
    
4. NHS to clarify the process for escalating any concerns by residents about their care (either health concern or quality of care).
    

   The NW London NHS team has provided the following response: All forms of feedback are encouraged to improve services. Sharing views and experiences, positive or negative, can done by speaking with a member of service staff or by completing a service feedback form. Raising these issues should not impact on your care by that service and may help improve services for everyone.

   If a patient has a complaint about their care, they should speak with a member of service staff. However, if this is not possible, a comprehensive guide to how to complain to the NHS can be found on the NHS website.

5. NHS is currently seeking advice from Scientific Advisory Group (SAG) on additional blood testing and will share the outcome of this when available.
   
   The NW London NHS team has provided the following response: The NW London NHS has been advised that the Chief Scientific Officer will be advising on the services and considering how to address additional blood testing requested.
    
6. NHS to confirm the mechanisms for collating patients and clinicians concerns regarding ‘Grenfell-related symptoms’.
   
   The NW London NHS team has provided the following response: There is no mechanism in place for collating patients and clinicians’ concerns regarding ‘Grenfell-related symptoms’. However, services are in place to identify, treat and monitor health issues caused by the Grenfell Tower fire. Services have not raised any issues regarding themes or trends in ‘Grenfell-related symptoms’ with NW London NHS.
    
7. Joint Strategic Needs Assessment (JSNA) to bring together how learning from other tragedies has shaped the local approach to recovery.
    

   The 2018 Journey to Recovery report brought together evidence from a range of sources. This included evidence from other disasters in the UK and across the world, such as the Hillsborough disaster, Aberfan disaster, the Lockerbie bombing, Hurricane Katrina, the Christchurch earthquake in New Zealand, and the September 11 attacks, among others. 

   The 2023 Joint Strategic Needs Assessment (JSNA) will include other learning from the International literature on disaster recovery. In the meantime, a draft has been published here. We are aiming to have the final version of this document available autumn 2023. If anyone wants to provide insight for this document, they can contact the Public Health team at [email protected].

8. Education services to confirm if private school in close proximity to the Tower has air monitoring/interventions in place and if there is a similar offer to local state schools in close proximity to the tower.
   
   The council’s Education team has provided the following response: We have reached out to the private school in close proximity to the Tower to find out if they have air quality monitoring in pace and will provide an update as soon as we have more information. With regards to local state schools, air quality monitoring or any similar interventions would need to be carried out at a national level, as such, Education colleagues have reached out to the Department for Levelling Up, Housing and Communities and are awaiting a response. An update on this will be provided once a response has been received.
    
9. Environmental Health, in conjunction with UKHSA to respond to a request from a resident to have the debris in their garage tested. The Multi Agency Partnership, which oversaw the Environmental Checks Programme, will be consulted.
    

   The council’s Environmental Health Team in conjunction with UKHSA have provided the following response: The subject of testing debris that had fallen outside Grenfell Tower was previously raised with the Multi Agency Partnership (MAP) in 2021.*  At the time, it was agreed that the Environmental Checks programme and the soil testing was following a rigorous process and there was a high degree of confidence that all appropriate chemicals were being tested for. It was understood that the testing of debris would not show what someone in the local community has been exposed to, and any debris found now would have been exposed to various other environmental elements since the fire. MAP was further consulted following your query to see if there was any change to this advice, and their assessment has not changed.

   * The Multi-Agency Partnership (MAP) was established to provide the relevant expertise to design and deliver the environmental checks, assess risks to public health and advise health partners on any additional health monitoring and treatment options for residents, should these be required. MAP is currently comprised of the Royal Borough of Kensington and Chelsea, the Environment Agency, UK Health Security Agency (previously known as Public Health England), the Food Standards Agency and representatives of the Department for Levelling Up, Housing and Communities (previously known as Ministry of Housing, Communities and Local Government).

10. Public Health to contact residents who wanted to discuss the results of the Community-led survey.
    
    We have reached out to residents that specifically requested to discuss results of a community-led survey. Public Health welcomes further comments to shape the JSNA in addition to the community insights programme which is being carried out over the course of June and July 2023. If anyone wants to provide insight, they can contact the Public Health team at [email protected].