Agenda item

14:00

The Director of Public Health will present his Annual Report to the Committee (JHO9). The Committee will be asked to consider the key issues which it would like to take forward in the year ahead.

The Committee had before them the Director of Public Health’s Annual Report (JHO9). Members were asked to consider the key issues which they would like to take forward in the year ahead.

Dr McWilliam was congratulated on a very interesting, easy to read and comprehensive report.

In relation to alcohol related hospital admissions and illness, Dr McWilliam was asked what was in place to educate the public in relation to the dangers of alcohol. He responded that Public Health Officers addressed it to the best of their ability, it was also part of the schools’ curriculum and part of the school nurses remit. He added however that drinking rates among young people were falling, along with teenage pregnancy numbers, but both needed to be kept under surveillance. Public Health advocated a growth in referrals, but also a good and timely service. The key element of the new service which had been put in place was that of outreach for people in psychological distress. School health nurses also dealt with mental health problems and help was on hand for children suffering from stress. However, it was his view that services were still not dealing with this aspect quickly enough and there was a need for him to keep a watching brief.

Dr McWilliam was asked to expand on what services were in place for children aged 15 – 19, in light of the recent surge in mental health issues experienced by this age group. He reported that the Care Quality Commission had highlighted the matter of increases in waiting list times and assessment at first appointment. The Chief Medical Officer had highlighted a more stressful lifestyle as the cause for this and had advised young people to come forward earlier in life if they were experiencing problems. He added that the Child & Adolescent Mental Health Service (CAMHS) provided access to school counsellors and school nurses had been invited to attend a conference on alcoholism which was held every two years. He also added that he had been very pleased with the outcomes of the alcohol prevention project when Oxfordshire Fire Service had been involved.

At the request of the Committee, Dr McWilliam gave a flavour of the areas in which Public Health had been involved over the last year. This included:

·         A breast feeding project in Brighton with an aim to increase support in areas where there was a low uptake.

·         A person had been employed to telephone primary care patients with the aim of encouraging them to take up their health check.

·         School nurses were keen to know what outcomes they should meet and were thinking of a way to use these to target help where it was needed most.

·         Pegasus Theatre had staged some excellent plays on Health issues.

A Committee member asked about Health services and transport (in the face of reduced bus subsidies) for older people in villages in light of the closure of some GP practices. Dr McWilliam agreed that there big issues for Public Health if the proposal to concentrate medical services in Oxford was to come to fruition. He reminded the Committee that practices were independent businesses and people were starting to shop around for services more frequently. He added that the advent of evening surgeries would attract more people in the future.

A member asked whether ‘shimmies’ (wired in equipment in new homes giving advice on local services) would come at a cost, or would they be free of charge. Dr McWilliam was unsure of whether there would be a cost. He commented that there was a need to raise this initiative in planning committees or as part of the Healthy Town initiative.

A member asked how it was ensured that pockets of deprived areas were included within Public Health initiatives. Dr McWilliam responded that Public Health initiatives were available across the board. However, the bigger issue was more about how the NHS met the needs of the population. There was discussion in the report about whether there is sufficient differentiation in how services were delivered in these areas. This would be included in the Health Inequalities Commission report later in the year.

A member of the Committee wondered if the TP and STP were intending to deliver a link with local planning to deal with prevention and Health inequality issues and with low target groups. He referred to the distribution of indicators contained within the report for disadvantaged groups, and in particular, those for children with mental health and behavioural issues and the inherent difficulties with data collection. He applauded the Director and his Team for trying to get into these areas. Dr McWilliam responded that it was down to all parties to ensure that the Plan was differentiated down to all groups in the population and how they would be served. He added that Health Inequalities was another focus. He pointed out that it was disadvantageous that the data was only available at the top levels and there was a need to drill down to a local level, for example, on relation to mental health.

A member asked if the Public Health status had grown and was more visible now that it was situated in the ambit of Local Government. Dr McWilliam responded that at the moment it still had a ring-fenced grant worth £32m, with a guarantee that this would remain until the end of 2017/18, after which it was not known whether it would be ring-fenced.

In response to a question about whether Public Health would be underspent again this year, Val Messenger, Deputy Director of Public Health, came up to the table to report that there was a possibility that there would be an underspend of £125k this year, but the level of a grant would be reduced next year. Public Health was trying to make the budget more sustainable so that it would not have to make any further service changes next year.

The Committee was pleased to see more actions taken during the year documented in the report, and that they were undertaking some good campaigns. Even more information on these, together with a view on what the Team had achieved would be welcomed in the future. The Director responded that the Team were trying to gain an overview of the health of the whole ‘body politic’ of Oxfordshire and trying to make Public Health the ‘soul’ of Oxfordshire.

The Committee also complimented him on the interesting section on Health Checks. Dr McWilliam responded that it had been noted by the OCCG that this was a good programme and would be delivered in the future using OCCG money, though this was unconfirmed as yet.

The Committee AGREED to inform Cabinet that the Director and his Team were to be congratulated on the report for the above reasons.