Agenda item

The Director of Public Health will brief Members on the use of the Public Health Grant in Havering in 2016/17 (report attached).

The Interim Director of Public Health explained that when responsibility for public health transferred to the Council in April 2013, Havering had received one of the smallest grants in the UK. This had been based on the previous low expenditure on public health by the then Primary Care Trust. The Interim Director was required to account for how the Public Health Grant was spent and cuts to funding meant some services had been lost or reduced.

The total grant for public health services in Havering was £9.7 million but this had received a significant in-year cut of £688,000. A further cut of around £1 million was required in 2016/17 and an additional £300,000 in 2017/18. A paper had therefore been taken to Cabinet in February 2016 suggesting disinvestment in some public health services worth a total of £850,000. These cuts did not impact on the Council’s mandatory public health services nor on certain non-mandatory services such as school nursing, the drug and alcohol service and health champions.

Services that may be decommissioned included some sexual health and physical activity services as well as the stop smoking service. The final decision on whether to decommission these services was a matter for the relevant Cabinet Member.

The Council’s public health team had been cut by one third and offered a corporate support service to other Council departments and partner organisations such as the Clinical Commissioning Group. Services which received the most funding were health visiting, sexual health and drug & alcohol services.

The Interim Director accepted that the most controversial proposal was to decommission the stop smoking service. Some negative feedback on the proposal had been received but it was felt this constituted the ‘least worst’ option in order to make the required savings. Smoking cessation services for pregnant women would be retained and it was noted that people were making more use of electronic support and obtaining nicotine replacement products from their GP.

The prevalence of smoking had fallen and this had made the stop smoking service less cost effective. Other boroughs were also considering decommissioning of smoking cessation servicers and it was possible that a pan-London digital platform could be commissioned for this. It was emphasised that non-smoking was the norm in Havering although prevalence of smoking was higher in certain sub-groups that could be targeted via services such as the Healthy Schools programme.

The Interim Director wished to identify the added value provided by the service and there were therefore public health business partners for each area of the Council. The service was able to comment on section business plans and was looking to integrate an assessment of public health into decisions. There was also a target to raise the profile of the Healthy Workplace programme.

The current sexual health service operated on an open access basis whereby people referred themselves to clinics for e.g. sexually transmitted infections. The Council had to pay for all Havering residents who received these services (other than HIV services) even if they were treated in other areas.

The Council was also obliged to commission open access to the family planning service which was managed by GPs from Queen’s Hospital and four other sites within Havering. These services would not be changed although a remodelling of the sexual health service was being consulted upon.

It was noted that women tended to go to other sexual health services rather than their GP and could go to the family planning service to obtain the contraceptive pill although this was a more expensive method for public health to fund. 

The Sub-Committee NOTED the position.