Agenda item

The Consultant in Public Health/Deputy Director of Public Health introduced the report on the Public Health Integrated Services Contracts.

An update was provided on the following commissioned Public Health contracts:

·         NHS Health Checks

·         Adult and Children’s Weight Management Services

·         Integrated Sexual and Reproductive Health Services

·         Integrated Specialist Community Substance Misuse Services

·         Smoking Cessation Services

·         Healthy Start Scheme

The Committee was updated on the cost of the different services and how they had developed over the years. It was reported that services had been tailored to meet the needs of residents and this was continuously reviewed in light of changing circumstances. Since 2013, some services such as Integrated Sexual and Reproductive Health (ISRH) Services and Integrated Specialist Community Substance Misuse Services which each had been made up originally of a range of service providers had, following going out to tender, been transformed into a prime provider delivery model in order to provide more integrated services for residents and  increased efficiency.

It was noted that services were always being developed to meet changing demands.  The example of mystery shopping exercises, which were conducted periodically to identify possible gaps in provision and to provide service user feedback regarding  aspects of the commissioned that could be improved.  There was also an increased focus on raising the profile of the different services available to residents. This was evident in for example the Healthy Start Scheme where raising the profile and awareness of the service among care and health professionals had led to an increase in uptake of the service from residents.

In terms of baseline information about performance, the Committee noted that it would welcome pre-COVID-19 data as well as comparison of performance against our statistical neighbours in future reporting.  It was felt that this would provide a clearer understanding of the performance of services. 

The cost pressures around NHS Health Checks were acknowledged however the Committee raised concerns about the 13.3% of the eligible population that was not being reached. Although this figure may have improved it was difficult to compare this figure in the absence of comparative data.  It was noted that although the pandemic had impacted the number of health checks undertaken, this was gradually beginning to improve.

It was noted that preventative work was being done with GPs to raise the profiles of the different services (ie. the Emerald Pathway, the Healthy Start Scheme, Smoking Cessation Services, Adult Weight Management) available to residents. The services offered residents support to avoid health issues such as heart disease and strokes.

The Committee considered that equity of provision was important and stated that it would welcome maps of areas showing deprivation in future reporting and how this is used to inform the future planning of services. It was confirmed that many of the figures in the report were obtained from The Public Health Outcomes Framework (PHOF).  It was noted that the PHOF is updated every quarter, however, due to COVID-19 some of the indicators had not been updated since 2019. PHOF reported  performance against outcome indicators for benchmarking purposes using a  a ‘traffic light’ approach. An update of the PHOF is  expected in March 2022.  It was noted that  the Joint Strategic Needs Assessment (JSNA) was used to inform service planning and identify areas for improvement.

In terms of the structure of contracts, it was reported that surveys had been used with residents in relation to  the provision of Sexual and Reproductive Health services in order to obtain  feedback on proposals to transform the service and adopt  new ways of working. This survey identified that younger residents preferred online services, whereas other residents preferred human contact. The service was therefore transformed in a way which took these differing views and preferences into account through the provision of both an on-line and face to face service for residents. 

The example of the ‘Emerald Pathway’ was mentioned.  It was noted that this service, for those aged 60+ years, had been developed by ARCH (CNWL) - the substance misuse service provider in response to a steady flow of referrals coming through the hospital of older people who had had drink-related falls leading to fractures, or self-referrals.

Officers provided details of outcome indicators from the Public Health Outcomes Framework for commissioned public health services.  Members stated that they would welcome more information on performance against these indicators in future reporting to the committee.

Members noted that take up was low in various areas and questioned how awareness could be raised. It was reported that a communication plan had been put in place and work was being developed in the new year. The Public Health team was working closely with the Council’s Communications team.

Members also welcomed the identification of areas of challenge and would like to hear more about how these challenges would be managed.

With specific reference to the provision of substance misuse services, the Committee welcomed information about the provision of services for those addicted to medicated drugs in future reporting.

The Committee was pleased to see that the commissioned Substance Misuse services made reference to sex workers and recognised this cohort as a vulnerable group. It was clarified that the Rough Sleeping Drug and Alcohol Treatment Grant 2020/21 work had commenced and was doing well.

It was noted that discussions were being held with primary care networks to consider the delivery of NHS Health Checks.

The Committee thanked officers for the good and interesting report. The challenges were recognised and the impacts of the pandemic were noted. It was agreed that it would be useful to receive follow up report in the Spring 2022.

The Consultant in Public Health/Deputy Director of Public Health was thanked for their work and wished well for the future.

RESOLVED: That the Committee noted the contents of the report.