Agenda item

Resolved: that the report be noted.

8.1      Danny Ruta (Director of Public Health) introduced the report; the following key points were noted:

• The Health and Wellbeing Board was responsible for the delivery of the Health and Wellbeing Strategy.
• The Board had identified nine priorities for focus – which formed the basis of the Strategy.
• It monitored progress against these themes in two ways. Firstly, it had a delivery plan, which included SMART (specific, measurable, assignable, realistic and time related) objectives. These were regularly RAG (red, amber, green) ratings.
• To monitor progress in the longer term, a group of indicators had been chosen from a national set to assess progress.
• Most actions on the delivery plan were currently rated as green – and it was expected that by the next time the plan was reviewed, all actions would be rated green.
• Translating the delivery of the action plan into measurement of outcomes was difficult.
• The successful outcome of some actions might take 30 years or more to have an impact; for example, it took 25 years for the lung cancer risk of smokers to reach normal levels once they had given up smoking.
• It was also very difficult to demonstrate a causal link.
• One indicator of the impact of public health interventions was the change in the numbers of ‘potential years of life lost’.
• Potential years of life lost for the whole population was calculated by measuring the difference between average life expectancy and premature deaths.
• HPV (Human Papilloma Virus) vaccination had decreased. This was problematic, because evidence demonstrated that the vaccination was one of the most important ways to prevent cervical cancer.
• Officers from Public Health would visit all schools in the borough to encourage uptake.
• Alcohol related admissions in the borough had increased.
• The smoking quit rate had decreased.
• The rate of admission to long term care was decreasing.

8.2      Danny Ruta (Director of Public Health) responded to questions from the Committee; the following key points were noted:

• Officers were developing risk stratification (identifying individuals most at risk for proactive treatment) techniques as part of the adult social care and health integration programme.
• Primary care services were not set up and organised in a way to deal effectively with cross cutting issues.
• There were a high number of small practices, which could not deliver on the broader aspects of quality required from coordinated primary care.
• Fundamental changes were taking place in the delivery of primary care.
• Groups of GP practices would work to care for groups of up to 50,000 patients rather than very small groups, which would be positive for public health.
• It was difficult to know what factors influenced the numbers of potential years of life lost; it could be that as people moved in and out of the borough the figures changed.
• Immunisation rates in London were poor.
• The primary cause of low rates of immunisation was the poor level of coordination and organisation of primary care.
• Tower Hamlets had provided a good example of how coordinated primary care immunisations could work. The population of Tower Hamlets had achieved ‘herd immunity’. This meant that because of the high level of uptake of immunisations, the small numbers of people who were not immunised were also protected against infection.
• Officers in Public Health had done almost everything possible to increase numbers of immunisations; the impetus now lay with GP practices and primary care to increase levels coordination and uptake.
• Rates of termination of pregnancy were very variable across the borough – as rates reduced in one area, they often increased in other areas.

Resolved: that the report be noted.