Agenda item

Ansaf Azhar, Director of Public Health and Communities (Oxfordshire County Council), has been invited to present the Director of Public Health Annual Report.

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

Ansaf Azhar, Director of Public Health and Communities (Oxfordshire County Council), Kate Austin (Public Health Principal), and Fiona Ruck (Health Improvement Practitioner), were invited to present the Director of Public Health Annual Report.

The Committee received a presentation on the Director of Public Health’s Annual Report, which took the form of an interactive web?based publication designed to make health information more engaging and accessible. The Public Health Principal and Health Improvement Practitioner demonstrated the platform’s features, noting its use of bold visual design, clear navigation tiles and intentionally concise text to help users explore themes such as local data, lived experience, health inequalities and community voice. Offices highlighted that the new format builds on the direction set by the 2020 report, “Some Are More Equal Than Others”, by showing progress in several areas of deprivation and showcasing community?led initiatives that have developed despite significant financial pressures across the system.

The Committee heard that the digital report incorporates videos, case studies, blogs and toolkits, including contributions from Professor Sir Michael Marmot and local community health workers. These materials aimed to demonstrate the real?life impacts of health inequalities and highlight the positive outcomes achieved by communities themselves. Officers explained that the toolkit had been designed to help local groups access and interpret data at the most appropriate geographic level, and where possible at parish level, to support targeted action in both urban and rural contexts. They highlighted how the toolkit could provide granular detail at parish level, supporting tailored action in both rural and urban communities.

Officers discussed how the report and associated tools address the specific challenges faced by residents in affluent rural areas, where isolation, poor transport links and hidden deprivation can hinder access to services. They emphasised the importance of integrating local insight with the NHS ten?year plan to ensure that community experience influences future commissioning. The wide geography of the Thames Valley ICB was acknowledged as a further challenge, reinforcing the need for strong partnership working and a consistent focus on inequalities. The overarching intention of the new digital format is to foster dialogue, empower isolated individuals and enable community narratives to shape future public health priorities and service development. Importantly, they underlined the report’s aim to foster dialogue, empower isolated individuals, and ensure community voices influence future health services and tangible health improvements.

Members sought clarity on the level of granularity available in the forthcoming toolkit and digital data platform. Officers explained that while users can already explore detailed data for the ten priority wards, equivalent parish?level information was not yet available county?wide due to national data limitations. Some indicators could be broken down more locally than others, and qualitative community insight was currently published for the fourteen areas where Community Insight Profiles had been completed. The long?term ambition was to extend this model across Oxfordshire, but data gaps, particularly in rural settings where small populations can mask need, prevented a fully consistent approach. Officers stressed that the new toolkit would support communities to undertake their own profiling, and demonstrations could be provided to any area wishing to use it.

Officers described how the initial focus on the ten most deprived wards had expanded as evidence of rural inequalities grew. Newer insight profiles already included areas outside the original list, such as Bicester?area communities and parts of West Oxfordshire. Rural deprivation, they noted, was complex to measure and often concealed within overall affluence, making mixed?method approaches essential. Work had therefore begun on a rural inequality dashboard that combined indicators such as transport access, housing and availability of services. This would support more precise identification of localised issues and guide tailored recommendations for market towns, villages and isolated communities. The long?term ambition was to extend the community insight model countywide, allowing tailored recommendations for market towns, villages and isolated communities.

The Committee explored how lived experience could be incorporated into the public health dashboard. Officers confirmed that including stories, videos and examples of community?led work was both feasible and desirable. Qualitative insight had always been central to the Community Insight Profiles, and Officers expect community?generated material to become increasingly important, particularly where quantitative data remain inconsistent. The forthcoming toolkit was intended to support community groups in collecting, structuring and sharing their insights.

Discussion then turned to rural access to GP services. Officers acknowledged that limited transport, dispersed populations and reliance on voluntary schemes left many residents effectively cut off from primary care. The community insight work had already highlighted these barriers, and the rural inequality framework aimed to map them more systematically. Officers emphasised the importance of using public health evidence to shape broader decisions about housing, transport and place?shaping so that access to GPs becomes a proactive consideration rather than a reactive one. Innovation in rural areas, they said, would require stronger collaboration between councils, the NHS and local community groups.

Members asked how the Community Insight Profiles aligned with the NHS ten?year plan. Officers explained that the profiles were designed as a shared system resource rather than a standalone public health exercise. They already fed into neighbourhood?level planning and commissioning decisions led by the ICB, supporting a preventative approach that complemented clinical priorities. By embedding insight on wider determinants, the profiles helped to guide decisions about service locations, resource deployment and targeted interventions. Strong collaboration across the system was essential to retain this alignment.

Concerns were raised about whether the newly expanded Thames Valley ICB might dilute the focus on local inequalities. The BOB ICB Chief Delivery Officer outlined that senior leadership appointments had been confirmed and that staff consultation on organisational structures would begin in February, after which clearer operating models would be defined. He emphasised that the ICB remained committed to prevention and reducing inequalities, and highlighted successful joint programmes already under way, including Well Together and learning disability initiatives. Officers reiterated the importance of ensuring that the needs of rural and vulnerable communities continued to shape decision?making despite the larger geographic footprint.

Members also discussed how the community voice would continue to shape public health and wider system commissioning. Officers emphasised that community insight informed not only public health work but programmes such as school readiness and joint NHS–council evaluation projects. Stories, feedback and co?produced recommendations were expected to play a growing role in shaping prevention work and wider determinants of health across the system.

Officers noted that epilepsy, which affects about a quarter of people with learning disabilities, had been raised through recent LEADER findings. Further detailed information had been sought from health partners and fed through the Health and Wellbeing subgroup to inform ongoing planning.

Members sought reassurance on the accessibility of the new interactive website, particularly for people with visual impairments, limited digital literacy or unreliable internet connectivity. Officers confirmed that accessibility considerations would be built into the next development phase and that feedback would be passed to the communications team. Features such as text?to?speech and clearer navigation were being explored, and the team was considering the publication of a technical report or alternative formats alongside the online version.

Finally, the Committee asked about monitoring progress against the report’s recommendations. Officers explained that impacts would continue to be overseen through existing governance structures, primarily the Health and Wellbeing Board, with relevant issues returning to HOSC as appropriate. They emphasised that the report aims to shape long?term system priorities, so monitoring will focus on broader prevention and inequality outcomes rather than short?term activity measures.

The Committee AGREED to issue the following recommendations subject to minor amendments offline:

1. To embed Community Insight Profiles (CIP) into routine commissioning and service design, ensuring decisions explicitly reference CIP findings and community led priorities.

2. To ensure that neighbourhood working includes public health leadership and community voice structures. It is recommended that there is a systemwide roadmap for neighbourhood maturity, resourcing, and integration with the existing voluntary and community sector and council assets.

3. For the Prevention and Health Inequalities Forum to publish annual system wide progress on prevention programmes, including Well Together and physical activity pathways.

4. To move Community Health Development Officer, Well Together roles and community led programmes onto multiyear funding cycles, given that short funding cycles undermine sustainability. It is recommended that there is a best value review and prioritisation of funding continuity to avoid regression of gains in areas with improving Index of Multiple Deprivation deciles.

5. To prioritise Oxfordshire-wide rural areas that are experiencing a regression on the Multiple Deprivation deciles of inequalities. It is recommended that the capability of rural communities is explored by the development of the Neighbourhood offer to Towns and parishes; and to give consideration for a contextualised offer to support an independent voice, local members, and to enhance community capabilities.

City Cllr Upton left the meeting at this stage.