Agenda item

Ms Shikha Sharma, Public Health Consultant at the Council, advised that the Hillingdon Joint Health and Wellbeing Board Strategy was currently in its second year and that the report provided an interim update on progress.  The Strategy’s three-year cycle would end in 2025 and the report asked that delegated authority be given to the Director of Public Health to develop a new Strategy.  Once the new Strategy had been developed, a consultation and engagement activities would be undertaken which would include professionals, residents and community groups from across the Borough at the different stages of the Strategy development to bring insight and understanding to how the Council would prioritise over the next three years and how these priorities should be tackled. 

It was anticipated that the Year 2 report would be available in January 2025 and would be presented to the Board on 4 March 2025.  Although the data for the current year was not yet available, Ms Sharma was hoping that it would be available soon. 

The report included tables which set out progress against each of the priorities, with a RAG status rating for each based on national benchmarking.  Ms Sharma talked through the progress of some of the priorities including breastfeeding, children’s oral health, children’s obesity and smoking. 

It was noted that there had been a shared ambition for the Borough to be smoke free by 2030.  Funding had been secured for the Swap to Stop and Stop to Start programmes and action had been taken to reduce the instances of vaping amongst young people. 

Ms Sharma advised that progress had been made with regard to the Hillingdon Domestic Abuse Advocacy Service (HDAAS) which had evolved so that it was more robust and had more capacity.  IDVAs (independent domestic violence advocates) had also been funded by the Council for high risk cases.  Huge strides had been made in relation to domestic abuse (DA) but referrals from health partners remained low and needed to be improved and reflected in the report.  It was suggested that primary care needed to participate more in this work so that the impact of DA on health could be determined and changes could be made at a higher level. 

Ms Sharma advised that she had worked on DA training in primary care some time ago, as clinicians often had more contact with victims of DA than other partners

With regard to reducing homelessness, Hillingdon continued to be RAG rated as red.  It was suggested that this was because homelessness rates in the Borough were higher than in London and England and continued to increase from previously published data.  P3 had been working with potentially homeless people in the Borough to try to prevent homelessness and Public Health Management (PHM) approaches had been used to try to reduce the numbers. 

Work on hypertension continued to be rated as amber with the second highest prevalence in North West London.  Action was being taken to scale up the work that had taken place across the Hypertension Prevention Neighbourhood Programme within the local Integrated Neighbourhood Teams.

Concern was expressed in relation to hypertension and the data time lags that existed before outcomes were known.  Although there had been improvements in the detection of hypertension, the health of these patients then needed to be managed to prevent stroke, etc.  The outcome of these interventions would not be known for around 3-5 years.  Detecting hypertension was something that was being done well in Hillingdon which then had a knock-on effect by increasing the demand for services.  Ms Sharma noted that preventative work in relation to hypertension had not been good up until now but that a weight management programme was now in place. 

Board members queried what the two or three biggest areas of concern were in Hillingdon that partners should be focussing on.  Ms Sharma advised that the application of the PHM Programme was key.  There were three posts working on this Programme (two had been appointed and one was currently vacant).  It would be important that these posts identified the areas that partners needed to focus on and determine how improvements should be conveyed.  Work had started by looking at the Integrated Neighbourhood Teams but this had since been widened out. 

It was suggested that Hillingdon needed to improve outcomes for its residents in relation to autism, homelessness and children’s dental health but also childhood obesity and hypertension. 

Although the report was thought to be comprehensive, there needed to be wider reporting on all indicators with primary care so that the information did not stand in isolation (for example, homelessness was not solely a public health responsibility and needed a whole Council and whole system approach).  There had been a lot of work undertaken within primary care which tied into the work that had been set out in the report but which had not been mentioned.  It had been suggested that new reporting and monitoring mechanisms be identified through PHM approaches and introduced from January 2025.  A good Joint Strategic Needs Assessment would provide good data.

RESOLVED:  That:

1)    the reported activities that demonstrate the progress that has been achieved between year 1 and year 2 of the implementation of the Joint Local Health and Wellbeing Strategy (JLHWBS) by lead officers collaborating with HHCP partner organisations, what has been achieved since the strategy was implemented and the plans for year 3 2024/25, be noted.  

2)    planning and implementation progress of the Health Inequalities funded projects be noted.

3)    it be noted that the JLHWBS three-year cycle will end in 2025 and the Board delegates responsibility to the Director of Public Health to develop a new strategy (the timetable of which will be concurrent with the updating of the JSNA) and ensure that there is effective planned and systematic engagement and consultation with Hillingdon professionals, residents, neighbourhood and community groups across the Borough at all stages of the Strategy’s development that brings insight and understanding. 

4)    it be noted that the Year 2 interim report is planned to be presented in January 2025, the combined Year 3 final report that includes strategy closure will be presented with the new Health and Wellbeing Strategy in September 2025.