Agenda item

Report attached.

Members received the Health Improvement Report which illustrated how the Council had broadened its preventative approach to tackle the wider determinants of health, and health behaviours and lifestyles.

Living and working conditions, including access to education, employment, decent housing, access to high quality built and natural environment, were major determinants of health and wellbeing. 

The eighteen separate programmes of work summarise in the report, when taken together, responded to the greatest health challenges of today, those of non-communicable diseases such as diabetes, health inequality and increasing health and social care costs.

Public Health and Planning had worked together on a health impact assessment of the Local Plan, and this showed that it is possible to take a very practical approach to health in all policies, and this led to further interest in assessing other strategies and policies for their impact on health

During discussion, members noted that the inclusion of Health and Wellbeing impact statements in key decisions was to be piloted; that the Equality and Health Impact Assessment was being evaluated; and that further training needs in understanding health and wellbeing impacts would be considered. 

The health and wellbeing in schools service had supported schools to achieve Healthy Schools London awards, and had delivered training to school staff on a range of health and wellbeing topics. The service was supporting schools to prepare for new curriculum content on Sex and Relationship education.  Havering was one of six London boroughs to participate in Healthy Early Years London pilot, with eight awards achieved during the pilot phase. A Healthier Catering Committee was planned to be introduced in 2019, focusing on supporting restaurants and cafes to take action to prompt customers to opt for healthier choices.

Air quality was the largest environmental risk to the public’s health and contributed to cardiovascular disease, lung cancer, and respiratory diseases, and increased the chances of hospital admissions and visits to emergency departments.  Although poor air quality affected everyone, it had a disproportionate impact on the young, old, sick and the poor.  The Public Protection service was leading a piece of work on an agreed air quality action plan.

Local authorities were mandated to provide NHS health checks free of charge to local residents aged 40 to 74 who have not already been diagnosed with a Cardio Vascular Condition (CVD).  The check identified those who have CVD, as well as those who were at high risk of CVD, and these residents are given lifestyle advice.  The General Data Protection Regulations had impacted negatively on the flow of information between the CCG and other agencies, and this was a concern as joint working was dependent on information sharing.   

The Health Improvement Plan contained some top line information on sexual health, including strengthened commissioning arrangements; drug and alcohol harm reduction and health visiting and school nursing.  Health visiting and school nursing services, provided by the North East London NHS Foundation Trust (NELFT), had improved and would be re-procured in 2020. 

Since the cessation of the smoking service, which was decommissioned 18 months previously, Havering had contributed to the smoking telephone service which focused on discouraging smoking in the first instance.  Illicit tobacco was making it easier for children and persons from some socio-economic groups to smoke.  A Tobacco Harm workshop focused on how to achieve a reduction in harm from smoking highlighted that vaping caused less harm.  Social marketing and advertising of smoking cessation services were needed on health and GP websites and in the Living Magazine, all of which could be easily accessible by residents. The Local Authority would work with the Havering CCG on an App as a joint initiative. 

Volunteer health champions were committed to health improvement and received accredited training.  It was felt that the system did not utilise volunteers to a full extent and suggested that Patient Group volunteers be targeted and offered the necessary training to become health champions, with the offer to be extended to include coverage in day care centres and libraries.

Employment was a major determinant of achieving good health. The Local Authority had introduced the Health and Wellbeing Workplace initiative and wider health improvement campaigns, and recognised the opportunity to widen the determinants by working across departments, for example the importance of Housing closely liaising with Health in order to establish and tackle root causes.

During discussion, it was suggested that consideration be given to the creation of information resources to be available at GP surgeries, libraries, children’s centres and young providers. 

Members would welcome recognition of GP’s continued training and development in mental health support, in order to provide residents with added confidence in the system.  GP’s agreed their own Continuous Professional Development dependent on their requirements.

During discussion, members requested that consideration be given to engine idling, in particular in areas surrounding educational establishments.  A London wide anti-idling campaign was due to commence in April and a funding application had been submitted to the GLA.  Local schools could be encouraged to promote a cultural change against engine idling, however the policing and enforceability of engine idling would prove difficult. Consideration was being given to banning traffic on certain roads during peak school transport hours and an update on the overall plan would be provided to the Board.

The PDSA improvement model saw ‘fewer referrals than anticipated’.  As a pilot approach, all referrals were supported.  The Early Help team had developed a universal plus offer that built on the localities work, offering a similar approach across the borough. 

RESOLVED:

That the Board considered and commented on the report in the context of the Kings Fund Report.