Agenda and minutes

The Chairman welcomed everyone to the meeting. Apologies were received from Councillor Tom Wells.

None.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager in writing or by email indicating the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 12 January 2023). Enquiries can be made through the telephone number/email listed in this agenda and on the website.

None.

Previously circulated

The Minutes of the Meeting held on 1 December 2022 were agreed as a correct record and signed by the Chairman

The Cabinet Member with Responsibility (CMR) for Health and Well-being introduced the report on the public health ring-fenced grant and reminded everyone that the allocated funds were very much predicated on outcomes with great emphasis on prevention.

The Interim Director of Public Health (the Director) provided a summary of the Agenda report, including public health statutory duties, the purpose of the PHRFG allocation and the related mandatory public health functions.  The confirmed PHRFG allocation for 2023/24 was awaited, however the report included a financial update as at period 6, with the main explanations for budget variations. The fairly large sum of reserves was in part due to Covid-19, since the Plan already drawn to utilise reserves which had been gradually accumulating, had been stalled during the pandemic – this would now be implemented and was targeted towards health and well-being, reducing inequalities and the impact of the pandemic.

Attention was also drawn to the additional sheet with further detail on expenditure of the PHRFG which had been circulated in advance of the meeting (attached to Minutes).

The Chairman invited discussion and the following main points were made:

·         A HOSC member asked about expectations for the level of PHRFG allocation, referring to the fact that in real terms, grants had been gradually decreasing over recent years. The CMR and Deputy Chief Finance Officer pointed out that Worcestershire did very well compared to other areas, although it was acknowledged that while the grant had not been decreased, recent increases in the PHRFG of 1-2% did not match inflation increases.

·         The reason for the £0.8m underspend of the PHRFG in 2022/23  was questioned. The CMR explained that this underspend was partly due to services needing to stall during Covid rather than any withdrawal of public health service.

·         HOSC members were keen to see the PHRFG fully made use of and were therefore pleased that the 3 year plan in place for the use of the reserves which had been paused during the COVID pandemic, was now underway.

·         A Committee member questioned whether there was any monitoring in place to ensure that the NHS Health Checks Programme for everyone aged between 40-74 were offered to everyone who was eligible, once every five years (funded by Public Health).  Some members of the Committee stated that they had never been offered a health check despite being eligible. It was explained that such checks would not be extended to anyone already being treated for a long-term condition, but that Public Health managed the programme and monitored GP practices’ related work. The CMR added that the main concern was around people who did not see a GP especially those who were not registered with a GP.

·         A HOSC member also pointed out that not everyone who would benefit from a health check would have any symptoms and the importance of health checks in tackling issues such as rising levels of obesity was agreed, as well as learning from the pandemic about how to identify pockets of people  ...  view the full minutes text for item 1109.

The Public Health Consultant summarised the main points of the Agenda report on health inequalities resulting from the Covid-19 pandemic, which highlighted the fact that the impacts had not been felt equally across the population, therefore increasing existing health inequalities.  For example, the risk of death had been raised across ethnicities and there had been an association between the risk of death and deprivation.

Long Covid was affecting sizeable numbers of people, estimated to be 20,000 across Worcestershire based on national levels.

The report also set out indirect impacts of Covid-19, including education, alcohol consumption, physical activity and mental health. Those in deprived areas had suffered more and experiences had drawn into focus knowledge around the need to focus on the least affluent.

The Cabinet Member with Responsibility (CMR) for Health and Health and Well-being highlighted the importance of addressing the long-term impacts of Covid-19.

The Chairman invited discussion and the following main points were made:

·         HOSC members agreed the report was very interesting in highlighting the themes which were emerging from the pandemic.

·         Regarding linking actions to outcomes on the work of Public Health in tackling health inequalities resulting from the pandemic, the CMR advised that this was being considered, along with how to inspire and enable people to make better decisions to improve their health outcomes – which could be reported back to the HOSC in future.

·         The Interim Director of Public Health highlighted the fact that every single line of the Plan for use of reserves accumulated during the pandemic, was focused on those most affected by Covid-19 – an example being extra health checks for young children, who may have missed standard checks.

·         The Officers explained that the impacts of the pandemic meant new ways of working were needed, for example working with the NHS on different structures in order to reach people.

·         The Officers acknowledged that some symptoms of Long Covid were very similar to other health conditions including Myalgic Encephalomyelitis (ME), however were confident there was awareness of this within the local health system and Public Health worked with the local Integrated Care Board (ICB) and Integrated Care System (ICS) to boost GP awareness. Specific services such as Long Covid clinics had been set up.

·         The Officers were not aware of specific data on the impact of Covid-19 on period poverty, however were working with schools and Worcestershire Children First (WCF) on sanitary products.

·         A HOSC member asked whether the push for people to get vaccinated (against COVID) had ceased, however was reassured that vaccination continued to be very important and that the offer remained very much open.

·         Language barriers were considered as part of public health work, with access to translators for most of the major languages spoken in the UK.

·         Regarding the mortality data presented, the Officers did not have data to hand regarding the various mutations of the Covid virus, although research continued internationally.

·         It was explained that the slower increase in mortality now was because it was more beneficial to  ...  view the full minutes text for item 1110.

Regarding the Work Programme, an update on the NHS Health Checks Programme would be added.

The following items would be scheduled in:

·         Workforce

·         Community Pharmacies