Agenda item

This report presents the Joint Board with six indicators forming a subset of the Prevention Dashboard. The report also sets out context and progress for each indicator.

Discussion

Medway Council’s Director of Public Health presented the Joint Board with a subset of six high-level indicators which had informed and been drawn from the priority areas within the Kent and Medway STP Prevention Action Plan. The indicators, as set out in Appendix 1 of the report were:

·         Smoking prevalence 18+ (%)

·         Smoking at time of delivery (%)

·         Physically active adults (%)

·         Adults overweight or obese (%)

·         Obesity in children aged 10-11 (%)

·         NHS Health Checks invitations offered.

The Director of Public Health highlighted the financial impact of addressing these challenging areas, noting for example that the cost in Kent and Medway to treat adult obesity was £151 million per annum. He stressed the importance of prevention to reduce morbidity and mortality and the need to be efficient with available resources.

The Joint Board’s attention was drawn to particular focus areas where the data indicated that further intervention was needed; one example given was the need to increase physical activity among adults in Gravesham (the rate of physically active adults in Gravesham in 2016/17 was 61.4% compared to a target rate of 70%). The Joint Board was advised that the actions to improve outcomes in these six focus areas were set out in section 3 of the report and it was explained that detailed work programmes accompanied each area.

With respect to the indicator ‘NHS Heath Checks invitations offered’, a Member requested that data be included on Learning Disability (LD) Health Checks. It was explained that this would give the Joint Board a fuller understanding of the position across the whole population of Kent and Medway. In response, the Joint Board was advised that other health partners, namely GPs, rather than Local Authority Public Health Teams tracked LD Health Checks and that it may be difficult to obtain this data. However, the Director of Public Health undertook to review whether data on LD Health Checks could be incorporated. Concerning the likelihood for individuals with LD to have more adverse health outcomes, the KCCs consultant in Public Health explained that this was currently under review and could be presented to the Joint Board at a future meeting.

In response to a question asking whether the comparative data provided for each indicator could reflect similar demographic areas at borough and district level rather than England, the Director of Public Health advised the Joint Board that other comparators could be incorporated and that this would be reviewed.

A view was expressed that more detailed data was required in respect of the indicators and should include, narrative on what the data showed, whether the required outcomes were being achieved, lessons learnt from interventions that had worked and those which had not and information on expenditure. With reference to an example in Manchester, where the careful consideration of data helped target interventions to improve outcomes for men in the most deprived areas, it was explained that the Joint Board should use this more comprehensive data to focus preventative interventions and target commissioning in the right areas and to set broad new targets which could be tracked by the Joint Board on an ongoing basis. Support was expressed by Members in relation to analysing data at a lower super output area level, with a view to focussing interventions where need was considered greatest and to learn from what had worked well elsewhere.

The Board was advised that the Public Health Team held comprehensive data at individual conurbation level and at Lower Super Output Areas (LSOA), in addition to detailed financial information on, for example, costs associated with treating individuals as a result of a specific health condition. It was explained that analysis of this suite of information had enabled the Team to highlight key areas of focus to the Joint Board, whose role was considered to be as an enabler. The Joint Board was reminded that the dashboard presented was a synopsis of data in the context of the Kent and Medway STP Action Plan rather than the Joint Strategic Needs Assessment (JSNA). However, it was suggested that more detail could be provided as part of the ‘deep dives’ into the priority areas.

In response to a question regarding measuring substance misuse and the impact substance misuse has had on prevention aims, the Joint Board was advised that in Medway a new drug and alcohol service had recently been commissioned which was based on a recovery model. As well as addressing the addiction, this model aimed to assist individuals with maintaining work and/ or education. In Kent, it was noted that a move towards a psychosocial model had been made which looked at services around an individual as well addressing addiction. It was added that one of the Joint Board’s future ‘deep dive’ topics would be reducing alcohol consumption.

With regards to a question concerning take up of Health Checks, the Joint Board was advised that Medway was one of the best areas in delivering Health Checks, with double the rate compared to the rest of the South East region. It was added that within Medway, the Public Health Team was working with NHS colleagues to target areas where take up of Health Checks was considered low. These tended to be areas of higher deprivation, such as Chatham. It was noted that specialist Health Advisers were based at the Smokefree Advice Centre in Chatham to offer easily accessible Health Checks to this demographic.

With regards to the position in Kent, the Joint Board was advised that there had been problems with the IT systems which had meant that some invitations had not been sent to individuals. However, it was explained that the Public Health Team in Kent were in constant contact with the Health Check provider and that specific areas had been targeted to improve rates.

Owing to the importance of Health Checks as the first step in the preventative agenda, Members requested that at the next meeting of the Joint Board a ‘deep dive’ into this topic be undertaken, taking account of the comments made at this meeting regarding the detail of information provided. It was noted that the Joint Board would need to consider two to three ‘deep dives’ per meeting so that within six months, the Joint Board would be in a position to draw conclusions on where these areas of work and outcomes should to be in 5 -10 years’ time.

Decision:

The Kent and Medway Joint Health and Wellbeing Board:

a)    noted the progress on the included outcomes;

b)    continued to support the prevention workstream to achieve the prevention plan priorities;

c)    agreed that a ‘deep dive’ on Health Checks be scheduled for the next meeting of the Joint Board on 14 December 2018; and

d)    requested that further detail be provided in future reports providing an analysis of data at a lower super output level, lessons learnt and information on expenditure.