Agenda and minutes

Apologies for absence were received from Board Members Councillor Doe, Ian Ayres (Managing Director for Dartford, Gravesham and Swanley, Medway, Swale and West Kent Clinical Commissioning Groups), Ann Domeney (Deputy Director, Children and Adult Services), Ivor Duffy (Director of Assurance and Delivery, NHS England, South East), Dr Peter Green (Vice-Chairman, Health and Wellbeing Board and Clinical Chair, NHS Medway Clinical Commissioning Group) and Ian Sutherland (Director of Children and Adult Services).

Apologies for absence were also received from invited attendees Lesley Dwyer (Chief Executive, Medway NHS Foundation Trust), Helen Greatorex (Chief Executive, Kent and Medway NHS and Social Care Partnership Trust), Martin Riley (Managing Director, Medway Community Healthcare) and Dr Mike Parks (Medical Secretary, Kent Local Medical Committee).

To approve the record of the meeting held on 3 July 2018.

The record of the meeting held on 3 July 2018 was agreed and signed by the Chairman as correct.

There were none.

Members are invited to disclose any Disclosable Pecuniary Interests or Other Significant Interests in accordance with the Member Code of Conduct.  Guidance on this is set out in agenda item 4.

Disclosable pecuniary interests

There were none.

Other significant interests (OSIs)

There were none.

Other interests

There were none.

This report presents the 2018 Medway Infant Feeding Strategy. The Strategy has been developed by a multi-partner Infant Feeding Strategy group which has developed a wide range of interventions and projects to positively influence breastfeeding rates and infant feeding practices within Medway.

Discussion:

The Head of Health and Wellbeing Services presented the refreshed 2018 Infant Feeding Strategy as set out at Appendix 1 of the report which updated the 2011 Strategy. The Board was advised of progress made since this first Strategy was introduced and was presented with a short film which had been created as part of the 2016 ‘Beside You’ campaign, aiming to normalise breastfeeding. The Board’s attention was drawn to the priorities set out within the 2018 Strategy to positively influence infant feeding practices in Medway. Key priorities included increasing breastfeeding rates, supporting responsive formula feeding where appropriate and delaying the introduction of solid food to infants until after they are 6 months old.

A Member expressed concern that even with a number of interventions being undertaken, as set out in paragraph 3.4 of the report, the data presented in paragraph 3.1 of the report represented a decreasing trend in breastfeeding initiation rates. It was explained that breastfeeding rates in Medway had steadily increased from 67.9% in 2010/11 to 70.7% in 2016/17. The rate of increase appeared to have had plateaued at 70%. Given the challenges faced by women living in disadvantaged communities in Medway, maintaining levels at this rate could be viewed as a successful outcome. However, it was recognised that whole system changes were needed to achieve the ambitious target of a 1% uplift per year in breastfeeding initiation and continuation rates.

It was added that there had been some very good interventions since the 2011 Strategy was introduced and that as a result, the United Nation’s Children’s Fund (Unicef) Baby Friendly Initiative (BFI) stage 3 accreditation had recently been awarded to Medway NHS Foundation Trust (MFT). In addition, Medway Community Healthcare CIC had sustained their accreditation to stage 3 and the neonatal unit had achieved stage 1 accreditation for the first time.

A Member also expressed concern regarding Medway’s performance in relation to the rest of the country and noted that, in particular, breastfeeding continuation rates at 6 to 8 weeks had fallen. Recognising that no additional funding was available, he highlighted that there was a risk that the targeted increase in breastfeeding initiation and continuation rates might not be achieved and asked what further action, if any, could be taken. In response, the Board was advised that the Infant Feeding Steering Group was mindful that the target would be challenging but on balance it was considered that an aspirational target should be set. It was added that the Steering Group had been approached by Public Health England to utilise Medway’s Strategy as an example of national best practice. With respect to the target, performance would be monitored and further action would be taken as necessary.

Drawing on her experience and with reference to past examples, a Member sought an assurance that, in practice, health professionals did support breastfeeding initiation and continuation. The Board was assured that this was the case and that this could be demonstrated by the achievement of the Unicef BFI  ...  view the full minutes text for item 357.

This report sets out the results of the initial research and investigation undertaken by the Public Health team into the prevalence and impact of Period Poverty in Medway, following referral of the matter by Council on 26 April 2018.

Discussion:

The Director of Public Health and the Senior Public Health Manager set out the outcome of the initial research and investigation into the prevalence and impact of period poverty in Medway following referral of the matter by Council on 26 April 2018. The Board was advised that within the timeframe of the research, the response was considered to be very good, with over 250 professionals and young people from a broad geographical and age spread participating. Reference was made to published research on period poverty for young people in the UK and the Board was advised that no similar research on period poverty had been undertaken in the South East of England. The Board’s attention was drawn to the methodology of Medway’s research which included both qualitative and quantitative measurement, key themes and conclusions following analysis of the data and suggested next steps. The School Health Team were thanked for their assistance in undertaking the research.

Concerning the conclusions of the research, the Board was advised that the research demonstrated that a number of settings had methods in place to support young women, although it was recognised that there could be greater coordination of support and more awareness of what assistance was available. The Board was also advised that the Public Health Team had proactively contacted a number of organisations including the Red Box Project and Medway Youth Trust with a view to undertaking collaborative work on possible funding streams.

In response to a question asking whether primary schools were engaged in the survey, the Board was advised that year 6 primary school aged pupils had been included within the survey. Referring to experience, a Member suggested that the research should have included year 5 pupils.

A Member commented that timely education of young people, both boys and girls in schools regarding physical and emotional changes during puberty was important to normalise periods and encourage communication. It was added that educational programmes should be created in consultation with parents and be consistent across all schools in Medway. It was considered that this teaching would be the foundation for further education on, for example, having respect for each other. A number of Members recognised the importance of early education in the school setting covering a broader range of topic areas. In addition, a Member noted that parents should also be educated on menstruation and female anatomy to facilitate communication and help dispel myths on what women can do when menstruating and the types of products that can be used.  

The Senior Public Health Manager recognised that there had not been enough time to fully explore the matter with parents as part of this research and that there was a need to better engage parents. With regards to this rounded education, the Board’s attention was drawn to the work that had been undertaken to support schools with Relationship and Sex Education (RSE), as set out in section 3.6 of the report and it was noted that over 70% of primary schools  ...  view the full minutes text for item 358.

The report advises the Health and Wellbeing Board of the forward work programme for discussion in the light of latest priorities, issues and circumstances. It gives the Board an opportunity to shape and direct the Board’s activities.

Discussion

The Democratic Services Officer introduced the work programme report and drew the Board’s attention to the recommended additions to the work programme set out at paragraph 2.2 of the report which had been reflected in the work programme set out at Appendix 1 of the report.

Attention was also drawn to section 4 of the report which provided an update on the work of the Kent and Medway Joint Health and Wellbeing Board. The Board was advised that the meeting scheduled for 19 October 2018 was likely to be brought forward and that the Board would be kept apprised of any change. 

Decision

The Health and Wellbeing Board agreed the work programme attached at Appendix 1 of the report.