Issue - items at meetings - Joint Health & Wellbeing Strategy (JHWS)

Report of Strategic Director, People (copy attached).

17.1    The Board considered a report of the Strategic Director, People which stated that from April 2013 each local Health & Wellbeing Board would have a statutory duty to publish a Joint Health and Wellbeing Strategy (JHWS).  At the last meeting, the Board agreed that the local JHWS should focus on five high priority areas: Smoking; dementia; cancer and access to cancer screening; healthy weight and good nutrition; and emotional wellbeing (including mental health).   An action plan for each priority had been produced by officers and was attached as appendix 1 to the report.

17.2    Robert Brown asked the following questions.

            a) Has life expectancy in all wards across the city improved over the last 5 years, and if not why?  Could we have this information for every ward as it is known that life expectancy varied by almost a decade across the city? 

            b) How many responses did you receive on just the strategy through the consultation portal?

            c) If this is a draft strategy, will there be time to share it with Community & Voluntary Sector organisations and members of the public for comments and input before the final version is signed off in April. 

            d) What is the process for translating these priorities into commissioning intentions?  Will members of the public be involved in all tendering around these priorities?

            e) How will commissioners be supported to undertake Equality Impact Assessments in the priority areas if the strategy is not covering this, and how will the board receive this information?

            f) What work is being done to ensure that health services have the staff and resources they need to handle increased demand in cancer screening caused by public health campaigns, and will be caused by it being a priority area for this strategy?  The LINk newsletter could be used to raise awareness of public health messages, cancer prevention and screening. 

17.3    The Deputy Director of Public Health referred to question (a).  He confirmed that life expectancy had improved overall but he could not say with certainty at that time if it had increased in all wards.  Robert Brown referred to page 34 of the agenda which stated that life expectancy in Brighton and Hove was 77.7 years for males.   However, there was a large difference in the figures for Queen’s park and Patcham. The Deputy Director agreed that there was a gap in life expectancy between wards which needed to be addressed, but stressed that the overall trend for the city was increasing.

17.4    The Shadow Health & Wellbeing Board Business Manager referred to question b).  He stated that less than 10 responses had been received on the strategy through the consultation portal.  Most of the consultation had been carried out through the Community & Voluntary Sector. 

17.5    The Shadow Health & Wellbeing Board Business Manager referred to question c).  He stated that officers were planning to engage with the CVS and the LINk. 

17.6    The Deputy Director of Public Health referred to question (d).  He confirmed that the strategy would be turned into an action plan.  Where they already exist, the relevant steering groups will take forward the actions.  New groups may need to be established to progress this work and officers would be also be consulting groups that were already in existence.

17.7    The Shadow Health & Wellbeing Board Business Manager referred to question e).  He stated that the JSNA process had a great deal of support from the Council’s equalities team.  There was not a full EIA on the draft strategy.  Most of the equalities work would be in the detailed commissioning plans. 

17.8    The Deputy Director of Public Health referred to question (f).  He confirmed that plans were in place to manage the increased demand in cancer screening. 

17.9    Dr Tom Scanlon acknowledged the work that had been carried out on the JHWS and thanked the authors.  In terms of outcomes, he found it helpful that the number of priorities had been reduced.  The Deputy Director of Public Health stated that in terms of outcomes there was a need to identify short-term, intermediate and long term outcomes. 

17.10  Councillor Meadows referred to the campaign that prevented breast cancer screening services being moved from Brighton to Haywards Heath.  She asked how that campaign had affected the document and whether the strategy would achieve similar campaigns.  The Deputy Director of Public Health replied that it would be for the Board to decide how it wished to amend the strategy in response to such campaigns.   The Chair commented that the Board could make observations regarding the accessibility and location of services.   The Shadow Health & Wellbeing Board Business Manager stated that if there were major changes to services it would be a matter for the Health & Wellbeing Board to consider.  

17.11  Geraldine Hoban informed the Board that there were wider determinations of health and wellbeing and there was a proposal to weave these through the various sections.  Employment and housing was a key element in all the sections.  There needed to be a more joined up approach.   The Shadow Health & Wellbeing Board Business Manager replied that he wanted to get the view of the Strategic Housing Partnership and other partnerships.   The Chair suggested communicating with the relevant council committees and asking them for their view on the JHWS. 

17.12  Councillor Duncan informed the Board that he had attended a meeting of Brighton Action for Wellbeing where there had been a talk on mental health and happiness.   Councillor Duncan also referred to smoking and made the point that many people had given up without any contact with the NHS.  How would that be measured?  He also asked if there was any data on tobacco products that were sold.  The Deputy Director of Public Health replied that the government had developed a happiness index to measure happiness.  With regard to smoking, the NHS currently had an outcome of the number of people successfully quitting at four weeks, but that from 2013 the outcome measured will be population smoking prevalence.  He hoped that local data would be gathered on a more regular basis.   Local supermarkets were wary of releasing information about sales of tobacco products.

17.13  Dr Tom Scanlon stressed that there was a need to have information on the contribution of partnerships.  He suggested that there should be a paper on that issue.  The Chair suggested that the partnerships should be approached to ask them how they could be involved and what they thought of the board’s priorities.  There needed to be an agreement with each partnership.  It was agreed that the Chair & the Shadow Health & Wellbeing Board Business Manager would make an informal approach to partnerships before a more formal approach was agreed.

17.14  Hayyan Asif referred to the action plan for healthy weight and good nutrition.  He asked what measures were in place to ensure that the academies would follow the plan.  Councillor Shanks stated that the Healthy Schools Partnership did some work in academies.  A great deal of youth work was carried out with youths outside mainstream schools. 

17.15  The Chair asked if there had been any consideration of working with children outside the state system.  Was there a remit or intention to engage with public schools?  Councillor Shanks replied that she did not think the Healthy Schools Partnership worked with private schools.  The Chair considered that there needed to be further thought about this issue as these young people would become adults who would be included in the council’s figures.

17.16  The Chair stated that he was concerned that HIV was not a priority.  He felt that there might be specific problems in Brighton and Hove that could not be left purely to the NHS to deal with.  The Deputy Director of Public Health explained that there was a recently established Sussexwide HIV Network and a local sexual health CRG. A great deal of work is carried out on prevention and early diagnosis.  Dr Tom Scanlon stated that he considered that it was important to continue to support the five high priority areas agreed at the previous meeting. 

17.17  Councillor Shanks referred to paragraph 7.6 of the previous minutes relating to breast cancer screening and asked if there was clarification about this issue.  The Deputy Director of Public Health replied that there was a national review of breast cancer screening and it was best to wait for the outcome of the review before having a further discussion on this issue. The report would be available before April 2013.

17.18  Councillor Cobb pointed out that some pages of the Joint Health and Wellbeing Strategy quoted percentages and other pages quoted numbers.  She asked for a consistent approach.  The Shadow Health & Wellbeing Board Business Manager agreed that there was a need for a consistent method of reporting data.

17.19  RESOLVED – (1)     That the draft Joint Health & Wellbeing Strategy (Appendix 1 to the report) be endorsed.