Presentation from the Director of Public Health, Harrow Borough Council.
The Sub-Committee received a presentation from Harrow Council’s Director of Public Health, which gave an update on the draft Joint Health and Wellbeing Strategy. The following points were raised:
· A refreshed joint health and wellbeing strategy had been developed in order to account for the impact the pandemic had over the last two years. It would enable a collaborative approach that addressed the needs of the population and tackled health inequalities.
· Key areas of focus had been established in this draft strategy that all involved partners needed to consider and incorporate into their planning.
· Achievements were highlighted and this included that Harrow had one of the most successful vaccination rates in NW London during the Pandemic, the development of independent discharge hubs and the work done with communities to tackle health inequalities. However, health inequalities had continued to pose as a challenge, and it was highlighted that more work was needed for continued improvement. In addition, it had been found that young people had raised concerns on feeling anxious and unsafe in Harrow.
· A new approach had been suggested by the Health and Wellbeing Board which had four main objectives, these included: building on the previous strategy and focusing on findings form the Joint Strategic Needs Assessment; for the strategy to be prevention focused; the BBP is the delivery vehicle for the strategy and that it was ensured that partner’s plans aligned with the principles outlined in the strategy.
· Feedback had been received and this covered a wide range of topics from the cost-of-living pressures, issues around housing, school readiness and emotional wellbeing, post dementia diagnosis support services, loneliness, carers, air quality and active travel and access to junk food.
The Chair thanked officers and NHS representatives for their updates. The Sub-Committee asked questions as followed:
· A Member of the Sub-Committee wanted clarification over how support and services for those over 65 would be managed. The Director of Public Health explained that one way in which they were looking to support over 65s was how they could be engaged in community activities as loneliness and isolation had been identified as a big issue. There had been work done to tackle loneliness and this included the development of how younger people and older people could engage with each other so that an intergenerational mix could be established.
The Member went onto ask where funding for these goals would come from, to which the Director of Public Health noted that though additional funding was always sought after it had been intended to make the best use of existing funding available. It was also noted that the use of integration between services was crucial in order for duplication and extra spending to be avoided. However, bids would be made for additional funding where possible. Charities would also be supported where possible; this was because the voluntary sector may have access to funding that where Council does not and this would enhance the voluntary sector.
· A Member of the Sub-Committee asked if being a good neighbour could be promoted, to which, the Director of Public Health agreed and explained the concept of micro volunteering which were small everyday tasks that supported one’s local community.
· The Chair asked if budgets needed to be moved from one area to another for this strategy. The Director of Public Health explained that there were some section 75 funds that could be moved between health and social care. The Managing Director of the Harrow Integrated Care Partnership added that also pooled funds for multiple agencies would also support the reduction of administration, particularly if it was for a single piece of equipment. It was also mentioned, there was a need for Harrow to be levelled up.
The Chair then asked for further information on more complex/long term care packages. The Interim Corporate Director of People Services explained the importance of preventative measures that would mitigate cases becoming complexed, but also the need to have good systems and good practice in place so that complex cases could be supported effectively.
The Chair emphasised the importance of KPIs and reporting, to which the Interim Corporate Director People Services reassured that KPIs would be worked on within the Council but also across the partnership.
· A Member of the Sub-Committee raised the issue of tooth decay in children within Harrow and wanted to know what had been planned to remedy this issue. The Director of Public Health agreed there had been a longstanding problem with tooth decay, missing and filled teeth in children and Harrow’s rate was one of the worst in the country. It was difficult to understand why this had been the case but an early years approach had been taken to help educate parents on tooth health. Supervised toothbrushing at nursery schools had also been carried out and campaigns for teeth health were carried out to young people and adults.
It was also asked by the Member what the major long-term conditions that were most prevalent in Harrow. The Director of Public Health explained that diabetes was one of the biggest issues, Harrow had one of the highest rates of diabetes in the country, with this comes the issue of hypertension which had been noted as a prevalent issue. COPD and asthma were also other conditions which needed to be treated as chronic conditions would mean an improvement in quality of care.
· The Chair asked how communication might could be improved with residents, to which the Director of Public Health explained that communicating with residents was very important and mentioned that a multitude of platforms had been used when residents were engaged by the council. In addition, listening to feedback from residents in order for needs to be understood and that appropriate steps would be taken.
· A Member of the Sub-committee raised the issue of support to Harrow’s unpaid carers, to which the Director of Finance noted that unpaid carers had feedback that they were not satisfied with the support received and that a carers strategy had been planned in order to improve the support unpaid carers received.
· A Member of the Sub-Committee asked of the provision for women with ongoing mental illness and raised concern over those who had never had a smear test or a mammogram. The Director of Public Health agreed that this was a very important topic and would inform the Sub-Committee of how they were supported and ensured that psycho-sexual services would be looked into.
An NHS representative explained that procedures were in place to support women with mental health illnesses in regards to cervical screenings and noted that patients would be invited to in-person meetings with carers to either a GP practice or hospital. In addition, work had been done with charities to support this but explained that uptake had been low and was a challenge.
The NHS representative went on to note the school vaccinations had reduced the incidence of cervical cancer and that regular smear tests might not be required in the future.
RESOLVED: That the report be noted.