Agenda item

Report attached.

The Board received information which would inform future discussions about a new Joint health and wellbeing strategy.

Members received the King’s Fund paper ‘A vision for population health, towards a healthier future’ which set out the health and wellbeing challenges faced nationally and where efforts were best placed to achieve improvement. The paper provided a useful context and possible framework to help members consider how work at borough level might further the aims of the Board as expressed in any future strategy.

Although there had been great improvements in health over the past decade due to improvements in sanitation, medicines and healthcare, underpinned by economic growth, improved living standards and the establishment of the welfare state, the rate of progress had stalled in England alongside an increasing burden on health services.

Studies into determinants of our health, had identified socio-economic determinants, lifestyle and care as contributors.  The most optimistic estimate suggested that health care could contribute more than 40% of the overall health status of the population, if every effective intervention was provided at the right time to every patient who would benefit.  Other studies put the estimates at under 25%, which lead the authors of the paper to suggest that improving the health of the population and the future sustainability of high quality health and social care was dependent on decisions makers at all levels recognising the importance of other factors.

The Kings Fund report introduced the concept of four pillars of population health and explored the evidence as to how each might affect health, directly or indirectly, alone or in concert with other factors; the strength of that evidence, and the scale and speed of the impact that might be expected on health and health inequalities. 

The Kings Fund report suggested a balanced approach to four underpinning pillars, each of which were a core business of one or more statutory partners:

·         Pillar 1 – Wider determinants of health

·         Pillar 2 – Health behaviours and lifestyles

·         Pillar 3 – The places and communities we live in

·         Pillar 4 – An integrated health and care system

It was suggested that the Board adopt and champion the population health approach, which would be a significant development in the direction of the Board and frame future plans; and would encourage partners to look at the areas of overlap or joint responsibility that might otherwise be overlooked.  The Board sought clarification on the accountabilities between the Local Authority, Clinical Commissioning Groups, the Sustainability and Transformation plan and Integrated Care System.

Members indicated their commitment to achieving a set of explicit time limited goals relevant to the four pillars and the development of a programme of work that was actively managed.   Furthermore, members felt that there should be a more balanced approach and for an increased focus on individuals placing more onus on their own health.

During discussion, concern was raised regarding the number of children in families classified as homeless.  There were issues locally regarding accountability and the importance of engagement Health and Social Care across the three boroughs was paramount.

It was accepted that assistance into work was a crucial element in recovery from illness and mitigated risk of long term unemployment which was risk for further ill health. As the biggest employers, Councils and the NHS had huge buying power and the opportunity to develop skills and income of local residents.  Members noted the importance of involving the community in design and commissioning of services to enabling the community to improve their own health and supported that buy in from local businesses be sought as these were anchor institutions within the community.   

Looking long term, the borough’s ambitious regeneration programme including the improvement of wider determinants such as the improvement of footpaths and created and recreated communities, and the local authority would welcome the Board’s inputs in making sure that Havering localities were fit for purpose.

RESOLVED:

That the Kings Fund report, be noted.