Agenda item

[The receive a report on an overview of Public Health performance for the year 2018-2019.  The report details some key areas of work undertaken during 2018-2019, notes some of the challenges and successes throughout the year and seeks discussion and feedback from the Panel].

The Director for Public Health presented a performance report on Public Health for the year 2018-2019.  To achieve the ambitious targets detailed in the vision, Public Health had focussed on different approaches to issues where traditional approaches had been unsuccessful in achieving change.  He outlined some of the priorities in the Public Health Vision, as detailed within the report.  Critical to achieving overall success was ensuring a good start to life, having a good education, obtaining skills and good employment, living in quality housing, and living within a good community.  If all of these elements could be achieved for a person, the probability was that health campaigns on matters such as obesity and smoking would not be required as people would be educated and comfortable enough to make the right decisions.

The Director for Public Health remarked that NHS health checks performance had significantly improved in the last year.  NHS checks were now solely provided through primary care.  Through closer collaborative working with Wolverhampton Clinical Commissioning Group (CCG), Primary Care Group Managers and GP Practice Staff across the City and a complete review of the system there had been an unprecedented rise in the access and uptake of NHS health checks.  Wolverhampton had gone from the bottom 8% in the country to the top quartile in the past year.  This meant health problems could be identified earlier with ultimately better health outcomes achieved.

The Director for Public Health commented that they had been working more in partnership rather than the usual commissioner provider relationship, they previously had with the Royal Wolverhampton NHS Trust.  They were working on getting the basics right on health visitor checks and school nursing.  Performance in this area was at its best since Public Health had moved back into the Local Authority in 2013.  On the matter of rough sleeping he commented there had been 33 people sleeping rough as of last May.  Bucking the national trend, the number had been driven down to 16 people as of the present day.  Rough sleepers would be provided accommodation if they sought help.   

The Director for Public Health stated that they had achieved the best coverage in flu vaccinations in schools since Public Health had moved back to the local authority in 2013.  There was also more coverage within social care settings than before and the lowest number of outbreaks of flu in social care settings had been achieved in the last year.  Public Health had helped to shape the ICS (Integrated Care System), working with the CCG and NHS Trust.  Partnership working was critical to addressing the health problems faced by the City.  Earlier in the month they had solidified a joint intelligence unit for the City to help all partners make better decisions through the flow of information on the health of the population of the City.

The Director for Public Health remarked that they had undertaken considerable more work with the Police on Community Safety.  They had obtained some pump prime funding for intervention work to help tackle the problem and perceived problem with youth violence and knife crime.   They were trying to increase the number of people receiving chlamydia tests, some people who had the condition were unaware, as they were not necessarily symptomatic.  Wolverhampton in the last twelve months had moved from bottom in their comparative region to second to top for chlamydia testing in the region.  A congratulatory note had been sent from Public Health England for the innovative work that the Public Health team in Wolverhampton had undertaken in collaboration with the Royal Wolverhampton NHS Trust. 

The Director for Public Health stated that one of the challenges they faced was the continued decrease in funding received year on year in Public Health.  This emphasised the need to work better in partnership.  A spending review was about to be announced, which the team awaited in anticipation. 

The Chair, Vice-Chair and several Members of the Panel complimented the Director for Public Health on the refreshing approach that had been taken by the department and for their considerable achievements in the past twelve months.

A Panel Member asked for some feedback from the conference on child obesity which the Director for Public Health and a Consultant in Public Health attended on 31 May 2019.  He also asked if Public Health were looking at any new innovative ways of combating childhood obesity.  The Director for Public Health responded that there was a real issue with childhood obesity in the City.  The evidence suggested that you could not “treat” your way out of the problem.  It was therefore not about providing additional services.  The conference on child obesity had been a coming together of stakeholders across the City which had been hosted by Eleanor Smith MP.  There had been a concentration at the conference on service provision.  He had spoken about the importance of creating a good environment for people to make better choices, which would help tackle the obesity problem.  The conference had discussed some of the forthcoming NHS policies.  There had been two papers recently published, “Prevention is Better than a Cure” in November and the NHS Long-Term Plan which had been published in January. 

The Consultant in Public Health added that childhood obesity rates were measured by school nurses in reception year and again in year 6.  There was a high prevalence of overweight and obese children in reception year and an even greater amount in year 6.  In the past letters had been sent to parents informing them of a concern about a child’s weight, but these letters had not been received very well.  She wanted to make sure more work was completed before the children were even measured in reception year.  It was then, important to work effectively with the children who were at risk of not being a healthy weight.  There was a place element to their strategy to tackle childhood obesity, if there was an attractive environment for people to be active, it was hoped obesity rates would fall.  As party of the policy work stream it was clear that supermarkets had a vital role to play and it was important for the Public Health Team to work closely with the WMCA, Public Health England and the Department for Health on the issue.  There was also a people’s workstream where Public Health wanted maternity services to work with pregnant women on how to have a healthy pregnancy and to advise on healthy child development.  They wanted the healthy development and growth message to be consistently reinforced by health visitors, early year settings and in primary and secondary care.  A systematic partnership approach she saw as the way forward. 

The Consultant in Public Health remarked that a partnership with the working title, “the Healthy Growth Partnership” was about to be launched, with their inaugural meeting in July and a second meeting planned in the Autumn.  The Children and Families Together Board had asked for an update on the new partnership’s work, at their meeting scheduled for December.

A Panel Member asked about the percentage of children who received a health check at 2 - 2.5 years old in Wolverhampton.  The Director for Public Health responded that it had been historically poor in Wolverhampton.  It had been as low as 50% in May 2018, but they had managed to improve the figure to 62% as at November 2018.  More improvement was still required, which he very much wanted to achieve.  The checks were ultimately aimed at ensuring that the child was ready for school, to ensure the best start to life. 

A Member of the Panel asked if the GP extended opening hours in the City were making a difference.  The Director of Strategy and Transformation at the CCG responded that he could provide the figures on the effect of the GP extended opening hours on A&E admissions after the meeting.  He believed it was having a positive effect on reducing A&E admissions.

There was a discussion about the activities being undertaken to help combat begging in the City, this included information on the charity which had been setup called “Alternative Giving”. 

A Member of the Panel asked about the use of the nasal flu vaccine for children which had an ingredient derived from a pork product.  She said that for some people in certain communities this was considered a prohibitive reason to give their children the flu vaccine.  She asked about the alternative arrangements available and any future plans.  The Consultant in Public Health confirmed that it was true the nasal flu vaccine did contain an ingredient that was derived from a pork product.  Regionally NHS England were in control of how vaccines were provided across the West Midlands.  It was Public Health’s role to try and ensure the population had the best protection available.  He had recently been in discussions with a local Imam about the matter.  There was a national debate about whether there was now an equality issue, which was prohibiting certain sections of the community from accessing the vaccine.  Public Health were doing various consultations with different groups. The animal-based stabiliser was better than plant-based stabilisers, with the Pork one being the best.  There were two vaccines, however the jab was not commissioned by NHS England and therefore could not be offered from a Local Authority perspective.  There were also many tablets which contained a pork product. 

The Chair of the Panel asked what definition was used for “rough sleeper” for compiling the statistical analysis in the Public Health performance report.  The Director for Public Health stated that he would circulate the current definition that was used.   

The Chair asked if the good practice from the Public Health team had been shared with other Local Authorities.  The Director responded that they probably hadn’t celebrated and shared their good work enough, but they could do more in the future.  The Chair commented that he wanted to increase the publicity of the good work taking place.