Agenda item

This report seeks to give the board an overview of the position of the Medway and Swale Health and Care Partnerships Population Health Management Programme and integration with the wider system. The report seeks to highlight key issues arising from the Health and Care Partnership surrounding funding and fair share allocation.

Discussion:

The Director of Health and Care Integration and Improvement, Medway & Swale Health and Care Partnership introduced report and informed the Board that the programme had been in place since 2021. The outcomes achieved by the programme was due to the partnership with other services, in particular Healthwatch and the voluntary sector. All the work completed to date was evidence based, supported by data provided by the public health intelligence team. The information provided by other services was used as evidence to support appropriate means of intervention and most of the work completed did not require financial investments but was more reliant on realignment of work currently taking place.

Members then made the comments and raised questions which included the following:

The recommendation from the report asks the Board to challenge the ICB in terms of funding for intervention. The Health and Wellbeing Board was clear that challenge must be done in a positive way. Addressing health and inequalities, should be evidence based and funding should follow the evidence. There were health inequalities in Medway, and it was clear that the ICB would take note of concerns raised by the Health and Wellbeing Board and ensure that resources were directed accordingly. It was recognised that all services were financially challenged and management of resources was crucial to impactful change and achieving outcomes. The wider determinants of health must be tackled on a shared responsibility basis.

The approach of moving from a population based allocation to that of targeted services of areas most in need was welcomed.

The improved partnership and collaboration of organisations and sectors was commended. The relationship between the voluntary sector and Medway and Swale had taken some time in developing but was now a good one. The voluntary sector felt they had, in the past been let down by various services and as a result, a culture of being sceptical of new initiatives developed. However, this was not the case with this initiative and a vast majority of voluntary organisations were in support of the population health programme. There had been a real achievement by the Health and Care Partnership (HaCP) in ensuring the partnership worked well and reinforcing the common aim of improving outcomes of the communities work with.

There was a distinct disparity in access to health services and outcomes in the most and least deprived areas of Medway and it was important to prioritise work to ensure the while population had the same level of access to services and improvement on health outcomes,

The team was congratulated on their award for their programme of work on childhood asthma. This remained an issue in Medway, and it was encouraging to note that there were a few asthma friendly schools. The numbers signed up to the scheme were small and it was suggested that schemes to increase numbers could be targeted to schools whose catchment were in the most deprived areas of Medway. The officer said that with the population health programmes, they started with the highest area of need and not just with the highest deprivation areas. There was a plan to roll out so that all school by the end of this financial year would be asthma friendly schools. Youth clubs, sports clubs and all establishments accessed by children and young people were bring targeted to raise awareness and ensure that the information was being transmitted to both adults and children. This work was also linked to green doctors to pass on information on high pollution areas.

In response to a question on how outcomes on the various programmes of work would be measured, the officer said information on outcomes had already begun to be gathered as there were various external agencies involved in evaluations.

It was suggested that the social regeneration conference outputs could be embedded into how regeneration initiatives could be better improved in Medway.

The Director of Strategic Change and Population Health, Kent and Medway ICB added that in order to understand population need and who would benefit most, the information gathered formed the basis of targeted health and inequalities programmes. The persistent health inequalities in Medway were recognised and the ICB continued to be committed to addressing the inequalities and recognised the importance of core and social determinants of health outcomes. The financial and resourcing challenges across the health sector in general must also be recognised. Therefore, the focus was to devise ways to utilise available resources across transformation programmes through collaborative working and for different organisations to provide a solution based approach to addressing health inequalities.

Decision:

1. The Health and Well Being Board agreed to note the report.

2. The Health and Wellbeing Board agreed that challenging funding allocation was a work in progress and fair share allocation continued to be seen as desirable aspiration by the HaCP.