10:35
The Director of Public Health, Dr Jonathan McWilliam, will give an oral report on the priorities for his next Public Health Annual Report (JHO6).
Minutes:
The Director of Public Health asked for the Committee’s views on his early thoughts for the topics to be included in his forthcoming sixth independent Annual Report. The proposed topics were:
· A better start in life – with particular focus on maintaining the pressure for high levels for breast feeding and immunisation services within the county. Also to continue to maintain the current downward trend in childhood obesity levels.
· Improving the quality of life for all –with particular focus on reviewing and thereafter keeping a watching brief on the status of people suffering with mental health problems in Oxfordshire. In the past this had often been highlighted by organisations as a difficult aspect to measure, thus placing it in danger of being overlooked. Other themes to this topic would include adult levels of obesity; a close watch on issues associated with drug and alcohol use; to keep a watch on smoking status and the health conditions which can ensue such as heart disease and cancer etc; and Ageing Well – keeping good physical functioning;
· Reducing inequalities and disadvantages - to look at the increasing diversity of the county with regard to ethnic mix ensuring that Oxfordshire’s services meet demands; to keep a close watch on the levels of thriving families and ensure that troubled families continue to get the help they need; to ensure that vulnerable groups are kept high on the agenda, to include the homeless, people who are hard of hearing, carers needs and people living in rural isolation;
· Protecting and maintaining current levels of good health in the county – to include the traditional topics on infectious diseases such as Tuberculosis and to keep an eye on sexual health such as the levels of syphilis; to ensure that health checks in the county are as good as they can be in light of such diseases becoming more resistant to current medicines; and finally to report on what is the role of health prevention in an acute hospital.
Members congratulated Dr McWilliam on an excellent list of ideas and added their thoughts during the ensuing discussion. These included :
- As part of the role of health prevention in acute hospitals to look at the length of time between the first and second outpatient appointment;
- To look at the wider issues of homelessness such as poor accommodation and insecure housing, living in damp environments, bad landlords and air pollution;
- More stress on earlier interventions at school, for example school nurses do not give a service until the child is 3 years old. Also to give some thought to how parenting classes could be provided from birth and earlier identification of those families who are struggling the most;
- The possibility of doing some work on how having a child in local authority care affects their families and some work around help for young carers.
With regard to the comment on earlier intervention, Dr McWilliam reported that the Health Visitor service was to transferred over the local authorities in September 2015 which would afford a major opportunity to address this. Also in relation to earlier work needed before families get to the troubled families stage, this county was doing some work with Public Health England looking at indicators on the possibilties for prevention before families get to that stage.
In response to a question about the lack of data for the mental health service, Dr McWilliam reported that his department were working with MIND on how to quantify this via comparative data. He added that there was good data available on hospital admissions and GP prescribing, but less of an opportunity to build up data on the less serious levels of mental health such as self- harm. He added that perhaps Healthwatch Oxfordshire could help with this.
Dr McWilliam pointed out that in the last 5 years much sharper tools had arisen with which to measure outcomes in the form of the Health & Wellbeing Board , in particular its sub - Board, the Health Improvement Board, which was, for example, looking specifically at the effect of bad housing on health than previously. There was also much better access to sharper contracts.