Agenda item

[To scrutinise and comment on the draft Public Health Annual Report 2020 -2021]. 

The Director of Public Health presented the Public Health Annual Report 2020-2021.  A copy of the presentation slides are attached to the signed minutes.  He thanked the Portfolio Holder for Public Health and Wellbeing and the two members of staff who had led on the production of the report, Neeraj Malhorta (Consultant in Public Health) and Emily Hackett (Senior Public Health Specialist). 

A Panel Member praised the Public Health Annual report and in particular the individual Ward profiles at the end of the report.  She acknowledged the exemplary corporate response to the pandemic.  She however highlighted that the UK was one of the most unequal countries in Europe.  There was still a great deal of work to do, Covid-19 had amplified the inequality within the country.  With reference to domestic violence, she stated that she was the Councillor observer on the Haven Board and confirmed that demand for the service had exceeded the supply over the period of lockdown.  They were exceeding the numbers for which they had been contracted to do and suggested this was an area which could be looked at by Officers in the future.  She noted that cancer screening had declined as would have been expected.  She added that this would mean poorer outcomes for people in the future, when cancer was finally discovered.  She remarked that she wanted to see safe cycle routes into the City Centre.  She did not believe there was a safe route from Bilston into the City Centre at the current time.

The Director of Public Health on the matter of domestic abuse promoted the importance of partnership working to help people that were vulnerable to domestic abuse.  He preferred to think of it in this way rather than from a purely contractual perspective.  Creating stability to be able to respond and growing the service in relation to the need was key.  He saw cancer screening as part of the “Relight our City” agenda.  Responding to try and improve the situation was key.  With reference to cycling there were key elements, ownership of a bike, ability to ride a bike and being able to ride a bike in a safe environment.  The third part was a challenge, safe routes and helmets were important. 

The Chief Executive of the Royal Wolverhampton NHS Trust commented that safety for cycling also included personal security.  A number of his staff used to cycle on the Canal tow path into the City Centre.  They had now stopped doing this as a Member of his staff was pushed into the canal with his bike after his wallet had been taken.  He commented that people were presenting with cancers at a higher stage than would have been preferable.  This was clearly a concern going forward.  They were doing everything they could to ramp up the cancer services as rapidly as possible.

A Panel Member asked about the percentage of houses with one or more category one hazards.   He asked for more information about the seriousness of the situation and a better idea as to what these hazards were.  He also referred to an anomaly on the Heath Town Ward profile in the annual report where there were some crosses rather than a number. 

The Consultant in Public Health (Neeraj Malhorta) responded that category one hazards were a nationally defined framework.  It included hazards where it was deemed the tenant or residents would be put into serious harm.  If a hazard was category one, the Local Authority had powers to act.  The data they had been given for the report was based on a report from the Builders Research Establishment and it was from 2017.  They took a sample of houses and using an expert methodology then estimated the prevalence of those hazards across the housing stock.  It was a reliable methodology but it was based on a sample from 2017.  There was now a Better Homes Board in Place and this Board had oversight of the Housing Strategy.  The Housing Strategy had three major work streams. The first being about improving the supply of housing stock, the second about the quality of housing stock and the third was about making sure the housing offer was accessible to vulnerable groups such as those experiencing domestic abuse.  Work to improve the quality of the housing stock was therefore a key element of the housing strategy.  She offered to circulate in conjunction with her housing colleagues more information on the types of category one hazards and the remedial action that took place.   The Director confirmed that it was a design error as to why there were some crosses on the Heath Town Ward rather than a number. 

The Chair commented that considerable work had taken place since 2017 with reference to housing and therefore the accuracy of the data in reference to category one hazards was in question.  The Director of Public Health commented that over the next year he thought there would be significant updates in relation to category one hazard housing data.  During Covid-19 a lot of survey work and data collection had not taken place across the county for the last 18 months.  The Ward Profiles meant they were able to better work at place level.  

The Chair stated that the Public Health Annual Report aimed to set out how to learn to live with Covid-19 and ensure no one was left behind.  She asked what steps health partners were taking to help people with long Covid-19.  The Managing Director of the Wolverhampton area of the CCG responded that there were now some long Covid-19 clinics.  To access the service, you had to be referred to the clinic by your GP.  Around 1 in 5 Covid patients suffered from long Covid syndrome.

The Chair commented that the report provided some useful statistics on obesity, physical inactivity, smoking, deprivation and housing.  These were all factors in how well someone recovered from Covid-19.  She asked what new initiatives there were to help improve these areas for Wolverhampton citizens.  The Director of Public Health responded that in spite of Covid-19, the Public Health team were continuing to direct resources to help improving these areas, which were all the more important. 

The Chair remarked that the annual report quoted that 0.6% of the population was recorded on GP systems as having a learning disability.  But it also stated, that they thought this was an underestimate of the picture.  She asked what could be done to make this more accurate and why they thought it was an underestimate? She commented that to help people with learning disabilities, accurate data was needed.  The Director of Public Health responded that he was in agreement that accurate data was needed in order to be able to improve services and this was something which they would work on in the future in partnership with other organisations. 

The Chair commented that the report referred to Public Health leading and coordinating responses to promote healthy growth and emotional wellbeing within Schools.  He asked for some examples where Public Health were leading.  The Consultant in Public Health responded alongside the physical activity work that was planned for school age children they were working with the Wolverhampton Wanderers Foundation to prevent obesity in children, working with pre school children and families.  In terms of emotional wellbeing there were 5 or 6 youth suicides in the Black Country and neighbouring areas between October and March.  As a consequence they had led briefing sessions to all secondary schools on suicide prevention.  They were also organising training with an external provider to prevent suicides in young people.  This would take place from September on a Black Country footprint.  The Public Health team also worked extensively across teams in the Council to help improve the physical and emotional wellbeing of children in the City.

The Vice Chair asked whether Public Health, to improve physical activity and help reduce obesity, would introduce a FitBit pilot in some of the school classes in areas of the City with the worst statistics.  He added that he was aware of at least 3 Wolverhampton residents who would be competing in the Olympic Games.  He thought some publicity for them would be good for the City as they would be placing the City on the world stage.  The Director of Public Health responded that he was thrilled that Wolverhampton residents would be competing in the Olympic Games and encouraging physical activity in as many different ways as possible was important.  There was currently open a grant scheme, which enabled sports clubs in the City the opportunity of up to £1,000 for them to open up again safely, review their membership and build upon it.  In terms of FitBit and other brands, technology was getting a lot cheaper.  If fitness trackers could be used to make a difference in certain populations, then he saw this as part of physical promotion and was certainly happy to investigate and embrace moving forward. 

The Chair stated that the Annual report referred to the future of Test and Trace being allocated locally.  She asked if the Public Health Team were ready and if they agreed with this approach.  The Director of Public Health responded that because people who were double jabbed would not be required to isolate in the future, the work of the Test and Trace team should in principle decrease.  As a Service they were certainly ready if needed.  The change in rules was another reason for people and their families to have themselves vaccinated. 

The Chair remarked that the report referred to a 190 Community Champions.  She asked if this was the ideal figure, or did they want more.  She asked how the number of 190 had been reached.  The Director of Public Health responded that the Community Champions was an initiative which had been set nationally and devolved to Public Health teams locally to implement.  He praised the work of the Community Champions to date.  He spoke highly of the model and how this model could be used in the future as part of a place based approach. 

The Vice Chair commented that the report stated they had pro-actively contacted people who were yet to take up the vaccination.  He asked if everyone had been pro-actively contacted who was eligible for the vaccination and what methods of contact were they using.  The Director of Public Health responded that working in partnership alongside data sharing protocols there were three principles in place.  The first being, everyone received a text message, the second being a personal call to as many people as possible, the third intervention was a knock on the door of their home address, if the first two had not been successful for whatever reason.  It was a combination of a systematic and targeted approach.