Agenda item

The Director of Public Health introduced the report on the current Public Health Integrated Services Contracts.

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

•           Universal 0-19 Healthy Child Programme

•           Integrated Sexual and Reproductive Health

•           Integrated Community Substance Misuse (Drugs and Alcohol)

•           Stop Smoking

In respect of the four contracts, the Committee heard about current public health funding, what each service was commissioned to deliver, contract performance, improvements, future plans for 2022/23 and post covid changes.

Although attendance data for substance misuse services and support groups was unavailable to hand, it was explained that attendance level varied due to a number of individual circumstances and challenges. There was often differences in service attendance monthly as some individuals who used these services may choose to attend on an irregular bases.

In terms of integrated sexual health, questions were raised regarding the low return rate of  68.2% for sexual health kits that were ordered through the online service and whether improvements were being considered.  It was explained that this was not a poor return rate generally when compared with other online testing services such as bowel cancer screening however improvements could always be made. Context on why the integrated sexual health and contraception service for residents of all ages from 13 – 90 years of ages and was not offered beyond 90 would be investigated and reported to the Committee. Repeat abortion rates was another area that needed to be explored further to identify any underlying issues and consequently how to reduce the rate.

During Member questions around prediction rates in each of the services when looking at commissioning activity. It was explained that trends and patterns needed to be explored to identify activity baseline needs and project this forward to anticipate a change in service use. As part of that process use in other areas can be used as a measure to help inform, and better use of data from statistical neighbours (areas with similar populations to the borough) needed to be identified, data needed to be analysed and collaborative working needed to be explored. Wider examples of how this is used to measure performance was discussed, for example, cancer screening and health checks, priority areas for the Health Protection Board, and targeting communities where uptake of services is lower – this approach was important in the context of the pandemic to support action in tackling areas that had been marginalised and at greater risk as a result of the pandemic.

In response to Member questions around areas of ward deprivation and improvements being considered, it was reported that overall, some indicators were improving however there needed to a refocus on the areas where improvement progress had plateaued.   It was explained that comprehensive planning based on informed information was needed to target intervention and to tackle health inequality and there was a focus on this through all our work and will be the basis of improvement plans for commissioned services.  In addition to commissioning and providing services, improving the publics health was also about the infrastructure in which people live, and these ‘wider health determinants’ such as access to good employment, education and housing, services provided by the Council as a whole play a more significant role in improving public health than health service provision.

Discussion on the stop smoking service - it was noted questioned about the role of  vaping as a harm reduction alternative to smoking. Services in the borough do not actively encourage the take up of vaping, rather to cease smoking without using vaping as a ‘step down’. It was also noted that pharmacies were being used to encourage services such as the Chlamydia Screening programme and that use of pharmacies for public health services allowed for increased accessibility.

In terms of targeting the more vulnerable and those we used to define as ‘hard to reach’, were in reality ‘hardly reached’ residents, and that our objective is to try harder to do this. It was explained that the Health and Wellbeing Strategy aimed to increase access to services, improve people’s experience of services and the health benefit and outcomes they achieve from them – to do this we must create more options for those residents who are ‘hardly reached’. 

The Committee thanked the Director of Public Health for the good report and positive presentation. Members were pleased to see inclusive language throughout the report and comparative data particularly around health checks.

RESOLVED: That the Committee noted the report.