Agenda item

Ansaf Azhar (Director of Public Health, Oxfordshire County Council); David Munday (Deputy Director of Public Health); Dan Leveson (BOB Integrated Care Board Director of Places and Communities) have been invited to present a report with an update on the Health and Wellbeing Strategy Outcomes Framework.

There are FOUR documents attached to this item:

1.    A main report with an implementation update on the Health and Wellbeing Strategy.

2.    Annex 1- Oxfordshire Joint Health and Wellbeing Strategy 2024-2030 Outcomes Framework- Shared Outcomes, Key Outcome Indicators, & Supporting Indicators.

3.    Annex 2- Age Well Performance Report (Sept 2024).

4.    Annex 3- Thriving Communities Performance Report (Dec 2024).

The Committee is invited to consider the report, raise any questions and AGREE any recommendations arising it may wish to make.

Cllr Liz Leffman (Leader of Oxfordshire County Council); Ansaf Ashar (Oxfordshire County Council Director of Public Health); David Munday (Oxfordshire County Council Deputy Director of Public Health); and Dan Leveson (BOB Integrated Care Board Director of Places and Communities); were invited to present a report with an update on the Health and Wellbeing Strategy Outcomes Framework.

The Leader of the Council explained that the strategy emphasised health prevention and highlighted the importance of collaboration with district councils and health partners for better outcomes. By March 2023, the outcomes framework was approved, and ongoing progress reviews were initiated. At each Health and Wellbeing Board meeting, specific priorities were reviewed to ensure effective changes.

The Deputy Director of Public Health explained that the strategy represented a system-wide effort involving multiple partnerships and detailed the outcomes framework, including shared outcomes, key activities, and indicators. The Deputy Director of Public Health reported that three priorities had been reviewed thus far, with additional priorities to be addressed in future meetings. The 10 Health and Wellbeing Strategy priorities, derived from the Joint Strategic Needs Assessment, reflected Oxfordshire’s population needs and were collaboratively agreed upon, focusing on short- to medium-term progress indicators to achieve long-term goals.

A question arose regarding the absence of end-of-life care in the Health and Wellbeing Strategy. The Deputy Director of Public Health explained that, while end-of-life care was important, the strategy focused on key building blocks and health drivers. It was noted that end-of-life care was included in service-specific planning, such as the Joint Forward Plan held by the ICB, and its principles, like maintaining independence and providing care close to home, were reflected in the strategy's age well priorities.

The Committee questioned Officers on the potential ways to enhance engagement with schools, improve relationships with GPs, and better implement social prescribing. Both schools and GPs had been acknowledged as essential but challenging to engage effectively. A healthy schools advisor, funded by Public Health, collaborated with schools to promote physical activity, healthy food, and smoke-free environments. The reformed Children's Trust Board was seen as an opportunity to improve health outcomes for children and young people.

The vice-chair of the Health and Wellbeing Board was a GP, and there was strong representation from GPs on the board. Efforts were underway to improve relationships and engagement through primary care networks. Various social prescribers, including local area coordinators and community health development officers, collaborated with different stakeholders, especially in areas of need. Ongoing efforts aimed to map out social prescribers and maximise their impact.

The Committee raised concerns about children starting school unprepared, lacking social skills, and not being toilet trained, particularly due to insufficient family services in rural areas. In response, the Leader of the Council explained that, if passed at Council, next year's budget had allocated over £1,000,000 to support early years, with a focus on identifying and assisting children who needed help early on.

Public health funding ensured that children were systematically assessed at ages 2 1/2 and 4 for school readiness. An early years strategy and a new board were developed to provide necessary services and support. The Marmot work prioritised giving every child the best start in life by addressing inequalities in deprived areas and understanding holistic needs across the county.

The Committee probed Officers about communications among stakeholders and the community, the strategy’s goals for promoting active lifestyles, and on workplace wellbeing initiatives. Officers explained that the strategy had been launched via social media, community organisations, and focus groups, with ongoing projects including the Oxfordshire Way prevention strategy and tobacco control.

Officers described how the Move Together programme promoted physical activity, particularly for those with long-term conditions or housebound, ensuring accessibility. Additionally, a wellbeing lead worked with businesses to enhance workplace health by collaborating with HR and occupational health teams to implement initiatives supporting employee health and return from long-term sickness.

The Committee examined system partners' mutual accountability and the public accessibility of forums. It focused on how these aspects were managed within various boards. The Officers explained that mutual accountability was ensured by the health and well-being board, along with subgroups like the Health Improvement Board and Children's Trust Board, through strategic discussions. Publicly minuted forums, such as the Health Improvement Board and Children's Trust Board, discussed strategy details. Although the Place-Based Partnership Board was not public, similar discussions occurred in the Health and Wellbeing Board.

The Committee inquired about the extent of collaborative efforts within the strategy to address dementia, considering its significance at both national and local levels. They sought clarity on how the strategy's preventative focus aimed to mitigate the risk of vascular dementia by promoting physical activity, maintaining healthy weight, and reducing the harms associated with tobacco and alcohol consumption.

In response, it was emphasised that the strategy prioritised ageing well, stressing the importance of independence and strong social relationships for individuals with dementia and their families. Collaborative work across BOB regions on memory clinics and access to services supported the principles of the strategy, addressing the needs of those with dementia. Additionally, the carers strategy included actions such as implementing a carers identification card to aid carers, especially when the primary carer was unwell.

The Committee addressed various issues, including KPIs for reducing smoking in Oxfordshire, concerns about vaping, and monitoring mobile phone use amongst young people. The Director of Public Health noted that smoking prevalence in Oxfordshire had decreased to around 10.5%, with a particular focus on reducing smoking among routine and manual workers, mental health outpatients, and pregnant women. This reduction was partly attributed to the use of vaping as a harm reduction measure.

Concerns about vaping were discussed, noting its role as a harm reduction tool for smokers unable to quit tobacco, while efforts aimed to discourage young non-smokers from starting to vape. Both national legislation and local actions, such as enforcing age-related sales and curbing illicit tobacco, formed part of the strategy. Success was measured through smoking prevalence data, particularly focusing on high-risk groups, and by monitoring the impact of these actions.

The impact of mobile phone and social media use on young peoples’ mental health, was recognised by Officers, with ongoing efforts to balance digital device use among children. School nurses and health advisors played a role in educating young people on appropriate digital device usage. Additionally, Officers awaited national legislation on smoke-free school gates while engaging with schools to enforce local smoke-free policies, aiming to de-normalise smoking for children through initiatives like smoke-free parks and sports event sidelines.

The Committee addressed employment prospects for poor and disabled individuals, and protection from Department for Work and Pensions (DWP) interrogations. Officers mentioned the new advisory service in Oxfordshire that provided financial advice and support for accessing services. Additionally, the community wealth building initiative aimed to benefit all residents, including those with disabilities.

Officers also explained how the Oxfordshire Inclusive Economy Partnership worked with the DWP to support those out of work for six months or more, many of whom faced health or disability challenges. This initiative demonstrated a commitment to improving employment opportunities for disadvantaged groups through collaboration with relevant organisations.

Concerns were raised about the treatment of disabled individuals during DWP interrogations, with the Committee highlighting a distressing example involving a young family. It was noted that better training and understanding among DWP staff were needed. The Director of Adult Social Care mentioned that feedback had been relayed to the relevant organisations to address these issues.

The Committee queried the progress of efforts with anchor institutions to create opportunities for young people, particularly aligning with the health and well-being strategy's priorities concerning healthy economies and homes. The Director of Public Health noted that ongoing collaboration with institutions such as the County Council and NHS partners provided opportunities for young individuals, including those with diverse needs. The Director of Public Health report for the upcoming year aimed to emphasise economic inactivity among young people and workplace well-being, generating more opportunities through apprenticeships and internships.

Furthermore, the Oxfordshire Inclusive Economy Partnership led efforts to leverage the economic capabilities of anchor institutions for the benefit of all residents, including young people. The relationship with universities, including the University of Oxford and Oxford Brookes University, had been fortified by the Marmot Place initiative, enhancing their roles as anchor institutions. Initiatives included Level 3 and 4 apprenticeships and the Connect to Work programme in collaboration with the DWP, targeting young people with disabilities or poor mental health.

The Committee AGREED to issue the following recommendations:

1. To ensure that rural geographies in Oxfordshire were also at the heart of implementing the priorities and actions of the Health & Wellbeing Strategy.

2. To support sustainable funding in the Oxfordshire County Council budget for early years readiness for school.