Agenda item

Review of Health Inequalities - In-depth Task Group Report

Minutes:

Background:

 

This report presented the final report of the Review of Health Inequalities in Medway In-depth Task Group, which had been established by the Health and Adult Social Care Overview and Scrutiny Committee. The focus of this review had been Health Inequalities across Medway wards and how to direct investment where it was most needed.

 

It was noted that the Task Group had met with a cross section of service managers, working for the Council and key stakeholders, to establish standards of working across Medway. A summary of the evidence was set out in Appendix 3 to the review document.

 

The Health and Adult Social Care Overview and Scrutiny Committee had recommended the review document and accompanying recommendations to Cabinet on 8 April 2013. The Health and Wellbeing Board had also commended the recommendations with some suggestions and comments on 22 April 2014. 

 

The main findings of the review were set out under a number of theme headings. These included:

  • Targeted work to minimise the impact of wider determinants on health inequalities
  • An investigation into inequity in access and outcomes at GP practices in Medway
  • The development of alcohol, smoking and workplace health good practice
  • A new strand within the Health and Wellbeing Boards engagement plan relating to barriers to the uptake of services
  • The development of a framework to enable the application of proportionate universalism in a structured way
  • The use of health equality audits in identifying and addressing health inequalities
  • The use of health impact assessments at an early point in the planning of local services and service redesign
  • The adoption of three key principles to assist the Council and partners to direct investment where it is most needed.

 

A Diversity Impact Assessment Screening form had been completed and was attached at Appendix 1 to the review document. This indicated that a full assessment was not necessary.

 

Decision number:

Decision:

83/2014

The Cabinet tasked the Council to continue to work with landlords, developers, partners and residents to aspire to raise housing standards. Where it was apparent that the legal standards were not being met, to seek a resolution to those issues in line with the Council’s Housing Enforcement Policy.

84/2014

The Cabinet tasked the Director of Public Health to engage with the Director of Regeneration, Community and Culture to inform the development of the Medway Local Plan and establish a joint officer project group to ensure that the Local Plan maximises the opportunity to improve the wider determinants of health through the planning system.

85/2014

The Cabinet tasked the Director of Public Health to continue to engage with Licensing Officers to maximise the opportunity to improve the wider determinants of health through licensing, building on the partnership working to date between Public Health, Licensing and other departments and agencies to provide ongoing messages to licensees and the public on public safety and public health issues.

86/2014

The Cabinet agreed to request NHS England (Kent and Medway Local Area Team) to work with NHS Medway Clinical Commissioning Group (CCG) to investigate inequity in access and outcomes at GP practices and report back to the Health and Wellbeing Board with its plan to address the issue.

87/2014

The Cabinet noted that as a large employer Medway Council plays an important leadership role in reducing health inequalities.  As such the implementation of workplace health initiatives are welcomed, and it was agreed that the drug and alcohol policy for the Medway Council workforce would be refreshed covering all types of workers.

88/2014

The Cabinet requested the Director of Regeneration, Community and Culture and the Director of Public Health to expand and build on work with local businesses to support them to implement workplace health initiatives within the framework of the Public Health Department’s ‘A Better Medway’ services.

89/2014

The Cabinet requested the Health and Wellbeing Board engage with members of the public and seek views on barriers to uptake of health and social care services – whether they be Council, NHS or volunteer – in the development and implementation of the Health and Wellbeing Board engagement plan in the next 12 months. The findings of this engagement exercise should be used to programme and target further work to address health inequalities with Council service managers, NHS colleagues and the voluntary sector.

90/2014

The Cabinet noted that one mechanism for providing services to reduce health inequalities, consistent with proportionate universalism, is to provide a universal service with targeted support where appropriate, and requested Public Health to investigate developing a framework to enable the application of proportionate universalism approaches in a structured way in the planning and delivery of all services.

91/2014

The Cabinet requested the Health and Wellbeing Board to identify where health equity audits may help to determine action that would reduce health inequalities across council services and those commissioned by the CCG and NHS England (Kent and Medway Local Area Team). The Public Health department should then provide support or leads on conducting those which are determined to be the highest priority by the Health and Wellbeing Board.

92/2014

The Cabinet tasked the Director of Regeneration, Community and Culture and Director of Public Health to work together to develop a protocol for dealing with any future planning developments in Medway that may have a significant impact on the health and wellbeing of the local populations. (This is to enable the Director of Public Health’s comments to be considered as a material consideration in the determination of those applications).

93/2014

The Cabinet supported the following three principles to assist the Council and partners, where relevant, to direct investment where it is most needed in order to tackle health inequalities:

           Principle 1: Actively seek ways of working in partnership across teams and agencies to tackle health inequalities and direct resources

           Principle 2: Assess the impact of all significant decisions on health inequalities before decisions are made

           Principle 3: Review and evaluate how equitable services are, e.g. through health equity audit, and adjust service delivery to address any inequalities found.

Reasons:

 

The decisions bring forward a comprehensive package in the interests of all Medway’s residents and are designed to direct investment to where it is most needed.

Supporting documents: