Report of the Director of Public Health.
The Sub-Committee received a report of the Director of Public Health, which set out her Department’s plans for 2019-20 and provided an overview of the budgets and the priority areas of work for the team.
Members were informed that prior to April 2018 (not 2019 as indicated in the report), public health in Harrow was a shared service with Barnet Council. This changed in April 2018 when the team became two separate teams, with a restructure of the Harrow team also occurring at that time. With a re?focused Harrow team, the plans and priorities for the coming year were before the Sub-Committee for their information.
The Consultant in Public Health introduced the report and outlined the work areas and priorities, encompassing some strategic work in the following areas: Joint Strategic Needs Assessment (JSNA), Joint Health and Wellbeing Strategy (JHWS) and Annual Public Health Report (APHR), details of which were set out in the report. The Consultant reported on other priorities such as public health commissioning, health improvement, wider determinants of health and health care public health. She referred to table 1 in the report, which set out the use of the public health budget for 2019/20 and referred to the grant which was currently confirmed until 2020.
Q - If from April 2020, the public health national ring-fencing of the budget was lifted, what would that mean in Harrow?
A - The Consultant in Public Health reported that the public health ring fence was due to finish in April 2020 and, thereafter, the government expected public health services to be funded from the retention of business rates. Councils were lobbying for the ring fence to remain and, if they were unsuccessful, money would have to come from other sources, such as business rates, if the work was to continue.
Q - Given the Sub-Committee’s work on dementia, what progress had been made, such as in the provision of a Dementia Hub?
A - The Consultant in Public Health reported that a new Dementia Hub had been launched in May 2019 and its impact would be monitored. Robust monitoring practices would be put in place and analysed. Details and data on the parameters set would be provided separately to the Sub-Committee.
The Sub-Committee requested that a report be submitted to its next meeting setting out which recommendations set out in the Scrutiny report on Dementia had been carried forward.
The Consultant added that dementia was a priority area of focus for integrated care and that the CCG were leading on the Dementia Strategy.
Q - Engagement plans for the Joint Heath and Wellbeing Strategy for 2020-23 and the Obesity Strategy were expected to be refreshed this year. What would be scrutiny’s input?
A - The Consultant in Public Health reported that the Health and Wellbeing Strategy workshops would be held in July 2019 and members serving on scrutiny bodies would be invited. Members of the Health and Wellbeing Board would also be invited to help shape the Strategy and decide on how best to engage with the community. Plans for engagement in the Obesity Strategy had not yet been fully developed.
Q - What actions were being considered around mental health, especially given that it was the focus of the Annual Public Health Report this year.
A - The Consultant in Public Health reported that cohesive thinking was required in this area with a view to bringing together various initiatives and to help identify gaps. A new Children’s Mental Health Board had been set up.
Q - The London Assembly Health Committee’s report ‘Keeping the Tooth Fairy Away’, as reported in the Evening Standard 5 June 2019, underlined massive inequalities between London boroughs in children suffering tooth decay by the age of 5. On average, a quarter of children in the capital were suffering from tooth decay. However there were huge differences between boroughs, as quoted in the report – 14% of 5 year olds suffered tooth decay in Bexley compared to 40% in Harrow. Was Harrow the worst in London? Why would this be? What actions were being taken to improve the situation – was it a priority? What was the uptake of free dental care in the borough? What work was ongoing with schools?
A - The Consultant in Public Health acknowledged the problem and considered Harrow’s situation a high priority. Money from the Migration Fund was being used to educate people on the importance of oral health and outreach work with affected sections of the community was underway such as supervised brushing of teeth. The importance of weaning and oral health were being addressed. An oral health strategic group had been established to provide an oversight.
Q - Please identify local actions in public health that linked to the NHS 10-year Plan.
A - A Health Protection Board had been established and would meet quarterly with its first meeting scheduled in September 2019. The Board’s remit would include oversight of outbreaks, infections and immunisation.
In conclusion, the Consultant in Public Health responded to questions on social prescribing and the need to set up a network which would involve the Third Sector. An adviser was of the view that prescribers should be at grass root levels – locally based.
RESOLVED: That the Public Health Forward Plan be noted.