Agenda item

Members were guided through the performance update and Year End 2019/20 financial update which were attached to the Agenda.

Public Health Performance

Members were reminded that the Public Health Ring Fenced Grant (PHRFG) was used to deliver a number of mandated services and a proportion of the PHRFG was used for discretionary services.

In relation to the national child measurement programme, one third of children were carrying excess weight at Y6 (age 10-11) in 2018/19.  The Director of Public Health reported that it was important to intervene as early as possible by promoting healthy lifestyles, diet and activity levels.  Excess weight in children would also widen the gap in health inequalities with some metrics suggesting areas of concern.  When questioned how accurate the data was, the Public Health Consultant would investigate and report back to the Committee.  Furthermore, clarification was sought on reporting mechanisms when pupils who reside in County are schooled out of County.  The most recent dataset was 2018/19 and it was acknowledged that there would be a gap in data collection as schools had been closed since 20 March.

A new contract to deliver the drugs and alcohol service had been agreed before COVID-19, alongside the new 0-19 service.  Working with District Councils to prevent rough sleeping and working with those most vulnerable in society was vital to improve outcomes.

Some of the sexual health information was recorded in 2018, however, in broad terms, there was less testing in Worcestershire in comparison to other similar Local Authorities and some further interpretation of the data was required.  The Committee noted that sexually transmitted infections (STI) data was showing an improving trend.

In relation to the NHS Healthchecks performance, a national programme of care, the Public Health Consultant suggested that further understanding was required as it could be one method of driving down health inequalities.  First introduced in 2013/14 and delivered through GPs in Worcestershire, it was reported that further publicity would be helpful and that comparisons were difficult as it was commissioned differently in other areas, such as delivered by private companies.

In response to a question as to how HOSC Members could help drive health improvements, it was explained that Member backing for initiatives was key.  Areas of concern for the County were residents maintaining a healthy weight, smoking in pregnancy and manual workers, especially in more deprived communities, and more generally widening health inequalities.  There was a duty in law to reduce health inequalities.  Plans were being prepared for budget setting, which the Committee hoped would target the areas of concern, however, there continued to be uncertainties around the PHRFG beyond 2020/21.

Public Health Finance  

The PHRFG for 2019/20 was £28,360,000, with the PHRFG for 2020/21 confirmed as £30,000,078 (6% increase).  Underspend had been reported in mainly strategic functions and adult prevention services, such as reduced spend in domestic abuse and reduced demand from GPs for NHS Healthchecks. In addition, the Healthwatch Worcestershire contract had reduced.

Overspend had been reported mainly in children’s prevention services, funding the new social mobility project and additional contributions towards prevention activities and positive activities.

The in-year underspend of £208,010 was transferred to the PHRFG Reserve, which was permissible.  When asked what the overall Reserves position was, it was clarified that uncommitted Reserves were around £5m.  When questioned what plans were in place for this sum, the Director of Public Health reported that plans to narrow health inequalities and wider prevention work were being developed and that the plans could be brought back to HOSC when ready.

Whilst constantly reviewing the budget and the need to account for inflation and contract inflation, it was reported that an additional 2.75% of funding was required to deliver the same level of funding in 2020/21.

The Cabinet Member with Responsibility for Health and Wellbeing commented that the PHRFG had to be audited and signed off by NHS England each year.

In response to a Member querying the reduced spend in domestic abuse, it was explained that people needed to come forward in the first instance.  There was an expectation that post COVID-19, these services would be in more demand.

Furthermore, the demand for Mental Health services was expected to increase and extra funding to create resilient communities was being actively considered.

The Director explained that a new Health and Wellbeing Strategy was required by April 2021.

The following information was requested:

·         Clarification on the error band of % excess weight in children figures

·         Clarification on how pupils who lived in the County, yet were schooled out of County, were classified

·         The Director of Public Health was happy to share Public Health plans with HOSC at a future meeting.