The Director of Public Health, Dr Heather Grimbaldeston, to present the Annual Public Health Report.
Minutes:
Heather Grimbaldeston, Director of Public Health, did a presentation to the Committee on the main points of the Annual Public Health Report.
The report was in chapters focusing on different areas:
Chapter 1 – this chapter concerned healthy lifestyle choices,
healthy behaviours and reducing health inequalities. It referred to national and local actions that had
improved health and prevented illness caused by lifestyle choices
and behaviours. The Chapter introduced
Public Health Outcomes Framework and Indicators for each lifestyle
area. There were 2 high level outcomes
– increased healthy life expectancy; and reduced differences
in life expectancy and healthy life expectancy between communities
through greater improvements in more disadvantaged
communities. These outcomes were
supported by a set of 66 public health indicators split over four
domains covering - improving the wider determinants of health;
health improvement; health protection; and public health and
preventing premature mortality.
Dr Grimbaldeston referred to initiatives around stopping smoking
which had seen the Stop Smoking Service exceed its target of 2425
by supporting 3205 smokers to stop. There was still work to be done to try to
reduce smoking in pregnancy rates.
There were a number of areas where health improvement or lifestyle
services had been commissioned by the PCT or work had occurred in
partnership to target areas of need and reduce health inequalities
– breastfeeding Project Group; immunisation uptake rates had
improved overall; and a Hospital Alcohol Liaison Team had been
established at Leighton Hospital to identify and treat those
admitted to hospital as a result of drinking or whose alcohol
misuse compromised their care.
Chapter Two – provided a commentary on opportunities to
improve the public’s health through making every contact
count; taking an asset approach – eg looking to co-design
service with communities; the Localism Act and the role NHS
Commissioners played in improving public health.
Chapter Three – this chapter focused on public health support
to NHS Commissioning, through support to the Clinical Commissioning
Groups’ Commissioning Plans, priority setting systems and
policy making and review. Public health
could contribute in a number of areas including addressing excess
winter deaths through recommending an increase in flu vaccines in
certain areas, addressing emergency admissions by children into
hospital where it was felt over half could be avoided through
measures such as reducing exposure to tobacco smoke and improving
living environments.
Dr Grimbaldeston further outlined the purpose of the Public Health
Outcomes Framework (PHOF). The public
health system was to be refocused around achieving positive health
outcomes and reducing health inequalities rather than being focused
on process targets. The vision of the
PHOF was “To improve and protect the nation’s health
and wellbeing and improve the health of the poorest
fastest”.
In discussing the presentation, Members raised the following points:
Whether smoking awareness was part of the school curriculum as it
was suggested that there was a lack of teaching about the dangers
of smoking? In response, Dr
Grimbaldeston agreed that there was a risk that success in smoking
cessation initiatives could lead to complacency, however, the
Public Health Outcomes Framework did make reference to smoking
prevalence among 15 year olds;
There was an important role for public health to address premature
mortality rates, try to keep people in their own homes for as long
as possible and keep well during winter. Reference was made to whether family carers should
be given advice around avoiding smoking in close proximity to their
loved one. Members were informed that
there was a Sub Group that reported into the Health and Wellbeing
Board about keeping older people well and that it was recognised
that this was an important issue in Cheshire East with an ageing
population;
Reference was made to whether figures and targets were included in
the report in relation to life expectancy rates. In response, the Committee was advised that
previous reports were data driven and complex with a lot of
statistical information included. The
data would still be relevant. There was
also statistical information in the Joint Strategic Needs
Assessment. There were no national
targets in relation to life expectancy therefore no local target to
reduce the gap, however, it was a priority;
The importance of screening was
discussed and it was noted that a 40% reduction in mortality rates
could arise due to screening and early detection. Currently screening was commissioned both locally
and nationally but in the future it would be the responsibility of
the National Commissioning Board. There
were some good examples of successful screening
programmes. It was noted that, although
prevention and detection were important, some people had a fear of
attending screening checks and this needed to be taken into account
;
Reference was made to differences in life expectancy between men
and women. It was noted that targeted
work had been undertaken in conjunction with GPs in the Vale Royal
Area to address some men’s health issues through encouraging
men to undertake blood pressure checks etc; this had been a
successful approach. It was noted that
although life expectancy was important, the main thing was to live
well for as long as possible and ensure people had good quality of
life;
The need to address the social determinants of health was raised
along the lines of the Marmot report.
It was suggested that future reports could be based on the 6 themes
within the Marmot report. There was an
important role to focus on improving wellbeing and lifestyle;
Whether obesity among teenagers was increasing? It was noted that children were weighed in the
first year of primary school and then again in year 6 by which time
weight had disproportionately increased in many cases. It was noted that obesity and alcohol were
emerging health challenges in Cheshire East although the area was
not the worst nationally for either issue.
RESOLVED: that the presentation be noted and paper copies of the Annual Public Health Report be distributed to Committee Members.
Supporting documents: