Agenda item

This report presents Medway’s draft Joint Health and Wellbeing Strategy, which covers the period 2018 to 2023, to the Health and Wellbeing Board for consideration. The Strategy contains a proposed vision and a set of priorities structured around five key themes. The priorities have been chosen after reviewing feedback from community engagement events, evidence from the Joint Strategic Needs Assessment (JSNA) and input from health and social care professionals and wider stakeholders, including the voluntary sector.

Discussion

The Director of Public Health introduced Mr Wiltshire, a local resident and service user who gave an account of his experience using healthcare services in Medway. The Board was advised that Mr Wiltshire’s testimony linked to a range of key themes within the draft Joint Health and Wellbeing Strategy (JHWS), set out at Appendix A of the report.

Mr Wiltshire drew particular attention to the stop smoking service. He explained that the service had given him the tools and support to stop smoking and he expressed his thanks to the Public Health team and the clinical professionals involved.  

It was explained to the Board that the previous Health and Wellbeing Strategy (2010-2015) had been reviewed in light of the Joint Strategic Needs Assessment (JSNA) and additional evidence obtained from partners, key stakeholders and local people during a series of engagement events. As a result of this process, it was considered that the themes within the previous strategy remained important and relevant. The themes of the draft JHWS were: 

1.         giving every child a good start;

2.         enable our older population to live independently and well;

3.         prevent early death and increase years of life;

4.         improve mental physical health and wellbeing; and

5.         reduce Health inequalities.

It was added that three strategic initiatives had also shaped the draft Strategy. These included the Local Plan, the Council Plan and the Kent and Medway Sustainability and Transformation Partnership (STP). The Board was advised that in turn the Strategy would influence these strategic initiatives.

Drawing reference to the Council Plan priority “maximising regeneration and economic growth”, which recognised that employment was an important factor in health and wellbeing, a Member asked a question about employment in Medway. The Board was advised that a Skills Board (Members and Officers Board) had been established which focussed on skills development and access to universities, colleges and training providers. It was also noted that a Skills Plan for Medway had been drafted which encouraged organisations to establish businesses in the Medway area. The Director of Public Health undertook to provide the Board with further information on the Skills Board.

A Member commented that the draft JHWS signified an opportunity to match available resources to Medway’s needs and stated that he would welcome aligning the Council Plan Key Performance Indicators (KPIs) with the JHWS when the Council Plan was next refreshed.

Clarification was sought on the content of and completion date for the Carers Strategy referenced within the draft JHWS. The Board was advised that the Partnership Commissioning team were leading on this area of work and the Consultant in Public Health undertook to update the Member on progress.

With reference to the Local Plan, it was recognised that the design of cities helped shape the health of the population, for example changing parking standards might influence a shift towards healthier modes of transport such as walking or cycling. The Board was advised that the draft Strategy had taken account of the emerging Local Plan and had influenced its development with the inclusion of objectives related to health and wellbeing.

The Director of Public Health also advised the Board that a member of the Public Health team was embedded within the Planning Policy team.

The JHWS was described as a “live” document and it was reiterated that the JHWS was both shaped by and would influence other plans and strategies in an iterative manner.

A Member requested that consideration be given to the inclusion of the following matters within the Strategy:

·         smoking prevention;

·         information and signposts to health and wellbeing services within the criminal justice system and armed forces;

·         a reference to the work of White Ribbon Campaign within domestic abuse support services in Medway; and

·         a reference to potential changes to the future funding of Public Health services (noting that the draft Strategy extends to 2023).

With regards to the theme “preventing early death and increasing years of healthy life” and the associated priorities set out at paragraph 5.2 of Appendix A, a request was made by the STP / Kent and Medway NHS and Social Care Partnership Trust (KMPT) Mental Health Programme Director for consideration to be given to prioritising two particularly vulnerable cohorts. This included individuals with a learning disability and individuals with mental illnesses. It was explained that prioritisation ought to be given to these cohorts because these individuals on average had a significantly lower life expectancy when compared to the general population. In response, the Director of Public Health explained this would typically be addressed when considering health inequalities, nonetheless he undertook to draw this out within the Strategy.

Concerning the theme “improving mental and physical health and wellbeing,” it was requested that consideration be given to including a priority on improving mental wellbeing. Specifically, supporting people with a mostly good mental wellbeing to consciously maintain a good mental health.

Particular support was expressed by the STP / KMPT Mental Health Programme Director for the theme “enabling our older population to live independently and well,” principally the priority to “support work to identify and support those who are socially isolated.” It was explained to the Board that this was because people who were lonely tended to be at greater risk of experiencing cognitive decline and more prone to suffering with depression.

With reference to examples of the experience of local residents, a Member expressed concern that information had not been transferred from hospital Accident and Emergency (A&E) services to General Practitioners (GPs) following treatment of patients. The Elected Clinical Member, NHS Medway Clinical Commissioning Group, recognised that this was an important issue and an experience that she had shared and challenged. She advised the Board that in her experience, GPs had generally received data about attendances to A&E, though often the information was incomplete. The Elected Clinical Member, NHS Medway Clinical Commissioning Group undertook to investigate further.

With reference to the JHWS being a live document, a Member welcomed an opportunity for further information and current data to be accessed through the JHWS if it were to be hosted on an online facility that could support this functionality.

Members stressed the importance of championing the health agenda in wider aspects of Council business. Examples included the work of the Community Safety Partnership (CSP) to reduce the availability of inexpensive alcohol.

Decision

The Health and Wellbeing Board thanked Mr Wilshire for his account and:

a)    considered and commented on the draft Joint Health and Wellbeing Strategy and its priorities as set out in Appendix A to the report; and

b)    agreed that consideration of the final Joint Health and Wellbeing Strategy be scheduled on the Board’s work programme for 6 November 2018.