Agenda item

The Director of Public Health, Dr Heather Grimbaldeston, to present the Annual Public Health Report.

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.