Issue - items at meetings - Proposal for the Development of the Joint Health & Wellbeing Strategy

Report of the Director of Public Health (copy attached).

7.1       The Board considered a report of the Director of Public Health and a presentation from the Lead Commissioner, Children, Youth & Families and the Consultant in Public Health.  The report and presentation set out the recommendations for the Board and explained the aims and underpinning principles of the Joint Health and Wellbeing Strategy (JSNW) and how it was proposed to develop and structure the strategy locally and the process for identifying the local priority outcome areas.  Members were informed of the consultation process and the recommended prioritisation of the high impact social issues for the JHWS.

7.2       The recommended high impact social issues for the JHWS were: Healthy weight and good nutrition, Emotional health & wellbeing, including mental health, Smoking, Cancer & access to cancer screening, Flu immunisation and dementia. The issues not recommended to be included were alcohol, domestic and sexual violence, disability, HIV & AIDS, Diabetes, and Coronary Heart Disease. 

7.3             The Chair supported the inclusion of smoking in the prioritisation and recognised that a great deal of work was already being carried out in relation to disability.  He shared the desire to keep focused and not have too many targets.

7.4             Terry Parkin considered the report to be an excellent paper.  However, he wondered why diabetes was not included as a priority.  There were an increasing number of children with diabetes.  Having a focus on diabetes might have a profound impact on outcomes. 

7.5       The Consultant in Public Health considered diabetes to be a commissioning issue for the CCG.   Geraldine Hoban (CCG) explained that the CCG wanted to ensure that the pathways for children with diabetes were working.  Dr Xavier Nalletamby explained that there was a huge amount of work already going on in this area.  Diabetes was a failure of healthcare.  In addition, the priority for healthy weight and good nutrition relates directly to Type 2 diabetes.

7.6       Councillor Shanks referred to cancer screening and mentioned that there had been a debate about whether breast cancer screening was effective.  She wanted to be assured that breast screening was clinically effective and a good use of money.  The Consultant in Public Health explained that there is an ongoing national review of the breast screening programme. Locally the cervical cancer screening programme coverage is improving but is still below the national target.  As part of the national programme there is a local bowel cancer screening programme. The Chair asked for clarification at a future meeting on the position relating to breast cancer screening.

7.7       Geraldine Hoban stated that the CCG welcomed the inclusion of emotional health and wellbeing including mental health, healthy weight and nutrition and cancer and access to screening.  She noted that substance misuse and suicide were not included.   The Consultant in Public Health explained that these areas had not been identified as stand alone high impact issues from the JSNA. 

7.8       Dr Tom Scanlon considered that the six priority areas would entail a great deal of work.  He suggested that flu immunisation should be dropped from the list of priorities.  He considered that it was too narrow an area for the Board to provide any additional benefit to the work already being carried out.

7.9       Robert Brown mentioned that Albion in the Community was involved in work to provide information about bowel and other cancers.  He asked if these people were qualified NHS staff.  He asked how people who received information could feed back on the effectiveness of the campaign.  The Consultant in Public Health explained that there was a national campaign, as well as a local campaign, aimed at raising awareness about the early signs and symptoms of certain cancers.  The CCG had commissioned the Albion to carry out work to provide information and advice to people in Brighton & Hove.  The people involved in this work were properly trained.   

7.10    Denise D’Souza was pleased to see dementia included in the list of priorities.  She noted the wider determinants such as employment and unemployment which would link in with emotional health & wellbeing, including mental health.  

7.11    Councillor Norman supported Dr Tom Scanlon regarding his view that flu immunisation should be dropped from the list of priorities.  He considered that focusing on healthy weight and good nutrition would have a greater impact.

7.12         Hayyan Asif considered emotional health and wellbeing and mental health to be most important.  Domestic and sexual violence and suicide were all linked to emotional health and wellbeing.   

7.13    Alan Bedford, Chair of the Local Safeguarding Children Board expressed the view that with a focus on five areas, there was a risk of having a negative impact elsewhere.  He asked when there would be a process by which matters not included on the list of priorities were tackled.  The Chair replied that if a subject was excluded from the initial focus, it needed to be made clear that work was being carried out and that the matter should be reviewed and reports prepared on these items.

7.14    Denise D’Souza reported that there was an in depth commissioning plan for recommended and non recommended priorities.  

7.15    Terry Parkin stated that child poverty work was underway.  A report on this matter could be brought to a future meeting.  

7.16    RESOLVED – (1) That the outline structure of the Joint Health and Wellbeing Strategy be agreed.

(2)       That the top priorities for inclusion in the Joint Health & Wellbeing Strategy and which will be led by the Shadow Health & Wellbeing Board are: Healthy weight and good nutrition; Emotional health & wellbeing – including mental health; Smoking; Cancer & access to cancer screening; and Dementia.  

(3)       That the following areas (led from elsewhere) be recommended to officers, where further Shadow Health & Wellbeing Board monitoring input might add value – Child Poverty; Education; Employment & Unemployment and housing.    

(4)       That a further report should be brought to the Shadow Health & Wellbeing Board in September 2012 setting out detailed plans for improving outcomes in each of the draft priority areas.