Agenda item

Report by the Corporate Director of Public Health and Wellbeing.

The purpose of this briefing (POSC6) is to provide the People Overview and Scrutiny Committee with requested information on health inequalities in Oxfordshire to provide an opportunity to review current approach to tackling inequalities, the context for future agenda items and inform the development of the scrutiny work programme.

The Committee is RECOMMENDED to

a)            note the background information provided on health inequality in Oxfordshire;

b)           note activity currently underway and consider implications for the Committee’s future programme of work.

The Committee received a briefing which provided background information on health inequality as context for future agenda items and to inform the development of the scrutiny work programme.

Councillor Mark Lygo, Cabinet Member for Public Health and Equality introduced the report.  He drew attention to the definition of health inequalities in paragraph 5 as “unfair and avoidable differences in health across the population, and between different groups within society”.

Councillor Lygo emphasised the importance of partnership working across the local system which was particularly evident during the pandemic.  This included the city and district councils as well as the voluntary and community sector.

Ansaf Azhar, Director for Public Health, added that, while there were many partners involved in the wide range of activities, tackling underlying causes – primary prevention – lay very much within the local authority remit.  He went on to outline the governance element.  He co-chaired the Health Inequalities Forum on BOB-ICS (Bucks, Oxon, Berkshire West – Integrated Care System).  They were in the process of setting up an Oxfordshire Forum across the health and care system and this will develop a local policy which will include tackling underlying causes, ensuring all partners are working together and avoiding duplication, and will tie in to the Council’s Corporate Plan.  The Oxfordshire Health and Wellbeing Board will also be involved and that is where Members will have input.

Members expressed concern that the creation of these multi-agency fora can have the effect of taking discussion further away from Members.  There was also a concern that inequalities in rural areas were often overlooked because the numbers were smaller.  Councillor Lygo responded that they would be working with district councils on any outreach work they can do.  Ansaf Azhar added that Members would have an important role in identifying inequalities in their areas.

The Chair noted that one of the ten most-deprived wards had been profiled and that the other nine had been delayed due to Covid.  Ansaf Azhar responded there was now funding to progress the other wards.  They had also gained useful insights during the pandemic.  However, the ward approach was not the only one.  For example, the FAST Programme (Families Active Sporting Together) was going to be expanded out across the County to counter physical inactivity.  This will be paid for through a health inequality fund.

Robin Rogers, Programme Director Covid Response, added that the County Council’s joint working with Cherwell District Council had supported a lot of work on health and wellbeing which was now being applied across the county with the other district councils who in turn have close links with Parish Councils and local communities.

Members noted that six of the ten wards were in Oxford East.  There had been long-term problems with educational achievement, linked to deprivation in that area.  It was suggested that the committee – perhaps through a deep dive – could take a close look at education data in that area to see how schools were coping.

Members asked about cuts to funding for swimming lessons which were an important encouragement in terms of physical activity.  Councillor Lygo described some partnership working with individual schools and colleges to provide access to facilities.  The target was to ensure all schools across the county achieve a 100% target with swimming lessons.

Members asked about gender inequality in health.  The UK had reportedly the largest gender gap in the G20 and various screening programmes were at a low point in terms of uptake.  Officers responded that screening had been particularly hit by the pandemic but the Council was working closely with the national campaigns on screening to improve uptake.  The Health Overview and Scrutiny Committee had gender health inequality on their work programme and Members might like to refer some points to that Committee.

Officers also added that the figures in Oxfordshire did not show a general gender health gap although some teenage girls had lower physical activity levels and sometimes that was linked to particular ethnic minority groups.  The FAST programme, for example, had worked with the Mosque in Banbury to come up with specific proposals.

Members suggested supporting initiatives in clubs such as providing equipment to those who cannot afford to buy it.  Also, providing less structured opportunities such as community walks.  The importance of volunteers in all of this was recognised as paramount.  These programmes not only encourage physical activity but also help mental wellbeing and community integration.

The Chair asked if all directorates were buying into this approach or how that could be achieved.  Officers responded that it was hoped that this would be achieved through the Oxfordshire Health Inequalities Board where all directorates and partners could bring together everything they are doing to promote wellbeing.  It was recognised that the solutions will not be the same for every area and that it does not always have to be the County Council providing programmes but the Council can coordinate with community and voluntary groups.

The Integrated Care System will be very relevant to this topic.  There was likely to be funding coming forth and it was hoped that having the Board in place will put Oxfordshire in a good position to avail of those funds when the time comes.

Councillor Jenny Hannaby, Cabinet Member for Adult Social Care, added that voluntary groups had really shone during the pandemic.  Communications with the elderly were particularly key as they had lost confidence during the lockdowns and there was a lot of good work being done on digital inclusion.

Members suggested that a flow chart or map of all the partner involvement would be very helpful.

The Chair proposed recommendations that were agreed by the Committee.

Councillor Lygo thanked all of the officers involved in this work and offered to come back in a year to update on progress.  The Chair agreed that the Council was fortunate in having such a strong team.

RESOLVED:

·         That policy ‘hooks’ for this work be defined and refined swiftly across the directorates.

·         That health inequality be embedded across the system with measures to assess performance.

·         To consider when discussing the Work Programme whether to have a deep dive on educational data in the ten identified areas of deprivation.

·         To support roll-out of the FAST model across the county.

·         To contribute to the HOSC discussion on women’s health.

·         To ensure that Members are properly included in the governance structures for the multi-agency work.

·         To endorse developing a strategy around the voluntary sector given its importance in delivering the ambitions of the initiative.