Agenda item

An annual review of the outcomes indicators which contribute to the Joint Health and Wellbeing Strategy (JHWS) and a review of updates to the Joint Strategic Needs Assessment (JSNA) is required to inform annual partnership commissioning plans. This is to ensure that there is an appropriate commissioning response to any new information which has been received prior to the commissioning cycle 2017-18. This report sets out the conclusions of a joint review of the appropriate indicators by Medway Council and Medway CCG and highlights any changes that commissioning partners may need to consider in setting their own priorities for the next year.

Discussion:

The Interim Director of Public Health, Dr Andrew Burnett, introduced an update on the Review of the Joint Strategic Needs Assessmentand Joint Health and Wellbeing Strategy Indicators for Commissioning Cycle 2017-2018.

An annual review of the outcomes indicators which contributed to the Joint Health and Wellbeing Strategy (JHWS) and a review of updates to the Joint Strategic Needs Assessment (JSNA) was required to inform annual partnership commissioning plans.

The key points in relation to future service commissioning were highlighted as follows:

·         More needed to be done to make the prevention of avoidable diseases a key element of service commissioning and to empower those providing frontline services to effectively promote prevention.

·         The number of people affected by a single disease or condition e.g. heart disease was relatively small. Service provision needed to reflect that people tended to be afflicted by multiple physical and / or mental conditions.

·         Medway continued to experience relatively high cancer death rates. This was particularly the case for cancer deaths amongst those aged under 75. One year survival rates tended to reflect how early the disease was detected, while five year survival rates depended upon the effectiveness of treatment.

Members of the Board raised a number of issues which were responded to as follows:

·         Smoking rates: Encouraging people to give up smoking would always be a particular challenge due to it being an addiction, with the majority of smokers starting smoking during childhood. A variety of services were already available to help people to quit. Smoking during pregnancy was a particular concern due to the impact that this could have on an unborn baby. An update on work undertaken to support people to give up smoking would be included in future JSNA updates provided to the Board. It was noted that a working group had been established to support this work.

·         Asthma rates: Concerns were raised that the increase in the rates of asthma in Medway had been significantly above the England average for the past two years. It was not known what the precise reasons were behind the increase in the rates of asthma in Medway or nationally, although it was believed that an element of the increase was due to there being greater awareness of the condition. Although the rise in Medway was a concern, it was not considered that there was any particular issue affecting the numbers locally.

·         Support for health conditions: Medway was in the bottom 25% nationally in terms of how supported people felt to be able to look after themselves effectively. There was a need to give people confidence to live as normally as possible

·         Vehicle contracts: A Member advised that a contract for the provision of refuse vehicles was coming up for renewal. It was requested that Public Health be given the opportunity to comment on the health impacts of the vehicles being proposed.

·         Infant mortality: Medway was above the English average for infant mortality. This was partly attributed to Medway having a number of relatively deprived areas and the prevalence of smoking during pregnancy. It was acknowledged that work was required in this area. The promotion of breastfeeding was also important as this could have a positive impact on the health of a baby.

·         Housing: The quality of housing had an impact on health and there was a need for Housing services and Public Health to work together to minimise the resulting health impacts.

·         Emotional wellbeing of looked after children: The emotional wellbeing of looked after children in Medway was well below the national average. It was anticipated that an Emotional Wellbeing Strategy for children and young people would help to address this. Children’s Services would be asked to comment further in relation to this.

·         Early diagnosis: Public Health encouraged routine screening for certain illnesses. One example of this was a bowel cancer screening programme for those aged over 50. However, encouraging those eligible to participate was a challenge, with uptake in the region of 50%. Those experiencing symptoms associated with particular illnesses were encouraged to visit their GP to seek an early diagnosis, although it was acknowledged that further work was required in this area.

·         Physical and mental health issues: Those with mental health issues tended to die sooner than the rest of the population, although this was not generally as a direct result of the mental health issue. Work was being undertaken with health providers to improve services for persons with multiple health issues.

The Chairman thanked all those involved in the work highlighted by the Interim Director of Public Health.

Decision:

The Board agreed the report presented and agreed to ensure that relevant partner organisations use the information and recommendations in it to inform the next commissioning cycle.