Agenda item

At the 2 March 2023 meeting it was proposed and agreed that as a result of work undertaken in partnership with the Local Government Association the Committee adopt a hybrid model moving forward.

This would be based on the assumption that meetings will last no more than three hours, with two hours focused on the theme and the remaining time on general matters that need to be reviewed by the Committee as existing ongoing business. 

Following consultation with the Director of People, Children and Adults’ Services it was agreed that this meeting would be Public Health Themed with a presentation on Public Health Child Health and reports on Family Hubs and Start for Life Programme, and Childhood Obesity Five Year Plan.

Discussion:

Members received a presentation on Public Health - Children’s Health and considered reports on the Family Hubs and Start for Life Programme and the Childhood Obesity Five Year Plan.

Members commended the team for all the work that was being carried out across Medway, and raised several comments and questions which included:

Hospital attendance – clarification was sought on hospital attendance by Ward, and the Committee learned that the data presented was a snapshot of hospital attendances for children under 5 years old. The data showed the wards that statistically had significantly higher than average attendances, and these were wards that were in close proximity to the hospital. The increased instances of attendance could have been as a result of difficulties in the ability of families in getting GP appointments. Work continued to be undertaken across the Council on addressing issues with GP access.

Asthma - it was asked what the drivers were for under 19 year olds emergency admissions for asthma. The Committee was informed that there were a range of issues associated with emergency admission, and the Medway and Swale Health Care Partnership continued to work on interventions. Across the (HCP), it had been identified that the management of asthma plans needed to improve, due to a culmination of understanding of the condition by parents, GP reviews, as well as appropriate use of medication. The HCP now had a dedicated Asthma Nurse working to address the issues presented and ensuring that asthma plans were appropriate for the individual. Across Medway, 34 schools had signed up for the asthma friendly programme which focused on training and education as well as engagement with school nurses. The school nurses supported the asthma programme as part of their work in school function. It had been identified that historically there had been limited training for GPs on asthma and that not all patients had a well-crafted asthma plan in place. Additionally, annual reviews were not always robust. The work of the asthma nurse was to upskill GP Practices, in particular those practices where their patients had high instances of hospital attendance.

A breakdown of hospital attendance by Ward was requested to determine a link between air quality and the impact on asthma. It was advised that data was available, and the Committee was informed that a Task and Finish Group Review was being conducted, which included strands of work on air quality and asthma. Discussions took place on what could be done to improve air quality, in particular, near schools where vehicles were often idling, and it was suggested that schools continue to engage through the use of other parents and children in the community and that information could be disseminated through the headteachers newsletter on what additional action could be taken to improve air quality around schools.

Family hubs - it was asked if Medway had lost out on a year of delivery due to receiving the funding late to start the project.  The Committee was informed that Medway was not unique in that situation as this was the same for many authorities across the country. It had been challenging to ensure investment over a two year period instead of three as it took time to commission services, however, they had succeeded in accomplishing what was planned and ensured that there was a comprehensive programme and offer in place. The Finance Business Partner added that Medway was bound by the terms of the grant and worked hard to utilise the funds in order to prevent having to return any grant funding back to Central Government.

Funding - in response to a question on what the plan was at the end of 2025 when the grant funding ceased, it was explained that this had been a concern from serious consideration was given as to whether to apply. It was decided, universally, to apply for the funding as it would be instrumental in increasing investment and improving the infrastructure for young people in Medway. The funding had been used to invest in future sustainability of some of the programmes that were already in place as well as training and delivery of other programmes. All investments had been risk assessed in order to understand the impact to date. The SEND team were now moving into the family hubs, however, there were improvements and investment to be made to the satellite spaces to make them more viable.

The Family Hubs enabled a more generic offer of support for the community that was not just limited to social care and all families would be able to engage with and access various activities through the hubs. Early Help Co-ordinators were in place to identify families with emerging needs and support staff on how to engage with families.

Medway Champions - it was asked how many people had been through the Better Medway Champion programme and how was the impact they were having in the community measured. The Committee learned that there had been over 500 people trained. It was made clear at the beginning of the programme that the aim was to have community champions that were confident to engage in conversations about health and signpost appropriately and not about them having to return data on the number of conversations they had with people. Members were reminded that they were all welcome to attend training and become champions.

Obesity – in response to a question on what the Local Authority was doing to tackle healthy eating in schools, it was acknowledged that healthy school food was a vital aspect to addressing obesity. The team had identified a funding pot and commissioned the Food for Life Programme, and two years into the programme, 41 schools had signed up and were working through the objectives. Members were urged to reach out to schools in their Wards to encourage them to sign up to the programme which had one more year to run.

A Member added that whilst the Food for Life Programme was beneficial, further conversations needed to take place with schools about the companies they contracted for their catering services. It was confirmed that the Public Health Team did engage in challenging conversations and encouraged schools to be strict about their guidelines when awarding catering contracts.

Improving food choices – it was commented that it was disappointing to see young people making poor food choices out in the community and schools needed to ensure that there were better healthy food choices on the schools’ catering menu. It was explained that there was a comprehensive Personal Health Social Economic programme across schools in Medway which provided a wide range of information and support on healthy eating and exercises which had been developed to provide children and young people with the knowledge to make informed choices. It was also important to note that addressing poor eating was rooted in behaviour change by equipping the community with the resources, opportunity, and motivation to make better choices by reinforcing the messages at every opportunity through partnership with all services, businesses, and institutions across Medway.

It was added that it was vital that schools and parents work together in partnership to address issues and provide support for children. There was also a need to make access to sports and means of exercise available to all children in Medway.

Dad space – in response to a query on the progression of the programme, the Committee was advised that the first course was scheduled to commence on 12 October, and they were currently working with the community on where the session would be held. It was important to have a robust maternal parenting programme but just as important to focus on dads. Work was being undertaken with the Dads’ Institute on a universal programme that would cover all important paternal milestones.

Drinking in pregnancy - it was commented that there was a lack of data on activities to address drinking in pregnancy. It was explained that there had been some work undertaken in the last 18 months, with comprehensive training in place for social care staff and front line professionals. The Family Hubs/Start for Life was a universal programme which targeted the areas of most need, and this included those at risk of drinking during pregnancy. The Public Health Team delivered a healthy pregnancy programme that addressed all risks and worked extensively to ensure that midwives consistently reported concerns as part of the foetal alcohol syndrome programme.

Health checks - it was commented that young people over the age of 14 with SEND were eligible for a health check, which was offered by some GPs but not all. Additionally, many parents were not aware of this entitlement, and it was asked what could be done to ensure consistency of practice. The Head of Children’s Commissioning said that at present, Medway exceeded the national average of checks, achieving over the 75% target. Historically the number of checks completed had been low and a lot of work had been undertaken to increase the offer as well as take up. The next step was to ensure that the outcomes and pathways from the health checks were progressed.

Walk to school programme – it was asked what more could be done to encourage parents and carers to participate, as not all children were attending their nearest primary schools which put pressure on families to drive. It was acknowledged by officers that there were challenges and more needed to be done to support families to walk to school. The active travel group supported the programme and continued to explore various ways to encourage families. There were various programmes and groups taking place across Medway which all had a positive impact, and Members were encouraged to lend their support promoting the programmes within their Wards.

Food partnerships – in response to a question on what was being done to ensure children were at the heart of strategies, it was explained that officers had been working on the Medway Food Strategy which was due to be presented to Cabinet. This focused on all aspects of food, healthy eating, growing, and buying food as well as food waste.

Decision:

a)    The Committee noted the Family Hubs and Start for Life Programme.

b)    The Committee noted the Childhood Obesity Five Year Plan.