Agenda item

[John Denley, Director of Public, to give presentation on the role of local authorities in public health, current and future challenges and proposals for developing a new service model.]

John Denley, Director of Public, gave a presentation which outlined a new approach to role of public health.  The approach is based on the view that improving public health and meeting statutory priorities is the responsibility of the whole organisation and not the small specialist public health service. The Director of Public Health listed the factors that influenced the health of a population and stated that health service provision only makes a small contribution – lifestyle factors e.g. smoking, diet and socio-economic factors, e.g. employment, income had much greater impact on the health of a population.

The Director of Public Health commented on the slow progress in reducing differences in life expectancy at a ward level and argued that the role of the service must be to support all three council directorates to deliver the statutory public health responsibilities of the authority.  

The Director of Public Health commented on evidence which challenged the effectiveness of services typically offered by public health service such as smoking cessation where the focus was not on addressing the causes of the behaviour but on designing services to meet the need.  The Director of Public Health added that the new approach will mean reducing the delivery of services and focus on making changes at the population level.

The Director of Public Health commented on proposed changes to the commissioning of services and create services that people can user to use and build community resilience and move away from the delivery of services. The role of public health in the future will be to influence the work of other agencies such as hospital and Wolverhampton CCG in achieving the priorities detailed in the corporate plan.

The panel discussed the issue of drugs and alcohol preventative services and the implications for other agencies such as GPs if public health service reduces its provision. The was concern expressed that the proposals need to be discussed with other partners as the changes are likely to affect areas differently if funding for stop-smoking services is stopped. The panel discussed the high number of fast food outlets concentrated in certain parts of the city and the challenge for the Council in wanting to reduce the number empty shops and the impact of such premises on health. The panel discussed the important role of planning control on the public realm.

The panel queried the risks of the approach in reducing the provision of support services at a time of high demand. The Director of Public Health responded that the issue of fast food outlets and there is a need for the Council to consider the balance between creating a business environment and promoting better health. The Director of Public Health discussed the evidence about the factors that support behaviour change and the importance of raising aspirations to persuade people reduce levels of smoking and drinking. The Director of Public Health commented on the importance of raising the aspiration of young people in order improve future life chances.

The panel accepted the need for change to reduce the gaps in life expectancy  but there was concern about the loss of public health skills if the plan were introduced – the panel added that it would want to lose the experience and skills  and would like to see more details about the plans. The Director of Public Health agreed to bring a further report on the proposals to a future meeting of the panel.

The Director of Public Health agreed to provide current Public Health Outcomes Framework for Wolverhampton with an update on performance against key indicators.

The panel welcomed the report.

Resolved:

1.    The Director of Public Health to present report detailing Public Health Outcomes Framework for Wolverhampton and an update on performance to a future meeting.

2.    The Director of Public Health to present report on proposed changes to public health service to a future meeting of the panel.