Agenda item

In attendance for this item were:

Dr Kathryn Cobain, Director for Public Health

Maria Idoine, Senior Finance Business Partner

Cllr John Smith, Cabinet Member with Responsibility for Health and Wellbeing

The Chairman queried whether a quarterly update was needed, the Director of Public Health was aware that all of the scrutiny bodies had a performance and budget monitoring role, but agreed that reporting patterns for public health needed to be reconsidered since the relevant performance data was not updated quarterly and use of the public health ring-fenced grant was subject to specific conditions. It was agreed that the scrutiny officers would liaise with the Director regarding performance information reporting patterns.

Performance Monitoring – Quarter 1 (April to June 2020) – there was no update at this time.

Budget Monitoring – Quarter 1 (April to June 2020/21)

Maria Idoine, Senior Finance Business Partner referred to the presentation included in the Agenda.

From this year’s public health allocation of £30 million, spend was forecast to break even, with a small underspend on staffing. Due to funding uplift this year, there was currently an unallocated grant of £1.1m and plans for its use were likely to include additional support to the alcohol care team, smoking cessation, substance misuse, quality assurance, as well as the Agenda for Change staffing inflation.

The forecast position excluded the impact of COVID-19 as the following specific costs were assumed to be funded from the following external sources:

·       COVID-19 grant £29m         

·       Test and Trace - £2.75m

·       Infection Control - £7.45m

·       Transport - £1.3m

·       Community Hardship - £0.6m

·       Support for loss in sales, fees and charges

·       Use of PHRFG reserve- £0.4m

·       CCG grant relating to hospital discharges and avoiding admission to hospital.

Areas where COVID-related spend had occurred relevant to the Committee included additional costs of personal protective equipment, test and trace activity, support for the community and additional payments to providers.

·       The Chairman asked whether public health reserves were being spent to address COVID-19, since during previous updates, the Committee had noted that reserves were relatively high and were being saved for appropriate future need, which COVID-19 surely must be, and it was confirmed that this was the case.

·       Several members highlighted the growing critical problem of obesity in Worcestershire, including child obesity, and the risk factor of obesity for COVID, and would welcome use of public health funds to tackle this area. The Director reassured the Committee that the problem of obesity was absolutely relevant, although it was a very complex area which linked to various public health issues and social factors, therefore funds would be directed to work with communities on the wider perspective.

·       Regarding numbers of mothers smoking during pregnancy, the Chairman sought reassurance that people in maternity wards were not allowed to smoke, which the Director confirmed, although the overall hospital site was not completely smoke free. Public Health commissioned a service from the Acute Trust to address smoking during pregnancy, which was important as it affected the whole household, however it would take some time to see the impact.

·       In response to a concern raised about a potential major surge in mental health problems which would require additional planning and funding, the Director emphasised the Team’s ongoing commitment to mental health and wellbeing across the spectrum. Pre-COVID, additional funds had been granted for suicide prevention work thanks to a successful bid with the local CCG to address raised suicide levels amongst young males. Mental Health and Wellbeing was one of the objectives of the Health and Wellbeing Strategy, which was currently being reviewed, and the Public Health Team had been working very closely with Worcestershire Health and Care Trust on early intervention.

·       The CMR reassured the Committee that whilst COVID-19 was the top priority at the moment, this did not mean that other areas were not being addressed.

Summing up, the Chairman suggested a further update on the areas being given extra focus from the use of reserves and how Public Health was responding in comparison with other councils in early 2021, which the Director would be happy to address, along with an update on the Health and Wellbeing Board Strategy.

On behalf of the Committee, the Chairman thanked the Director of Public Health for all the work completed and the CMR also placed on record his appreciation to the Public Health team who had been working extremely hard.