Agenda item

(To receive a report by Tony McGinty, Consultant – Public Health, which seeks to provide assurance to the Health and Wellbeing Board that arrangements for protecting the health of local people were safe and effective)

Consideration was given to a report by Tony McGinty, Consultant in Public Health, which provided details of the Health Protection Board Assurance for 2018/19.

(NOTE: Councillor Mrs W Bowkett left the meeting at 3.10pm)

It was reported that the Health and Social Care Act (2012) mandated a role for the Directors for Public Health of upper tier local authorities to provide assurance that arrangements for protecting the health of local people were safe and effective.

Local mechanisms had been put in place to provide this assurance and bring together the various organisations with a role in commissioning or delivering this function.  Two key parts of this assurance mechanism were the Local Health Resilience Partnership (LHRP) and the Health Protection Board (HPB).

The report sought to provide assurance to the Health and Wellbeing Board that these mechanisms were in place and that where there was a need for improvement in performance of the services which protected peoples health, that these were being managed appropriately.

The report provided evidence that both main assurance boards were in place and effectively managing the services and programmes within their remits.  It identified some challenges to delivery to local people for the HWB to note and look for progress on in future assurance reported.  These challenges were summarised for 2018/19 as:

·         The continued challenges with the uptake of immunisation programmes, especially those for children under 5 years;

·         The challenge to cervical screening turnaround times during the preparation for transition to HPV first screening methodology;

·         A range of 'slow burn' outbreaks of communicable diseases;

·         Cyber resilience issues following attacks or accidental disruption of infrastructure within the NHS.

The Board was provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         In terms of the vaccination programme, Lincolnshire was performing averagely, but in terms of the 0-5 age range a steady decline nationally in vaccinations was being seen.  There was an aim to turn this around.

·         Legionnaires disease was becoming more common, and there was no practical reason why this was the case.

·         In relation to the two applications to serve Part 2A Orders highlighted in the report, it was clarified that to carry out these, the district council, on the advice of the Public Health Authority had to go to the Court to apply for the order so the person could be detained in hospital until they were considered to no longer to be a risk to the population.  However, it was noted that this did not compel an individual to comply with treatment, but it did protect the population.

·         A whole range of screening programmes were offered, but breast cancer screening and cervical screening remained problematic due to being subject to national level 'incidents', however a government review into this was now underway

·         It was queried whether there was any significant differences in terms of immunisation take up between the different geographical areas in Lincolnshire.  Members were advised that parts of the east of the county had the worst rates, and the City of Lincoln also had lower take up rates in areas.  Rates did improve in the south of the county, but there were still differences within these areas.  It was noted that there were multiple reasons why particular programmes performed worse than others.  For example, with the 0-5 programme, there was a difficulty in terms of how many visits to the GP were required, as uptake seemed to get worse as the child got older.  It was suggested this may be due to parents finding it harder to get the time off to attend appointments once they had returned to work.

·         It was highlighted that deprivation was also a factor in low take-up and work was underway with health visitors to encourage parents to have their children immunised.  This was important as some illnesses such as measles were now more prevalent than they were 10 years ago.  It was suggested that there was a need to do more work with children's centres to engage parents.

·         Work was taking place with the East Lincolnshire CCG on how to offer immunisations within children's centres. But it was a complicated situation.

·         It was noted that the county had strong and effective partnerships and governance in place to oversee and seek improvement in the health protection offer to the public.  External scrutiny and validation had indicated that generally the county was in a good position.  It was acknowledged that there were some areas that still posed a challenge, but overall Lincolnshire was in a good position, and it was important that that assurance was provided to the Health and Wellbeing Board.

·         The Health and Wellbeing Board had a duty to promote health protection, particularly the 0-5 years programme.

RESOLVED

1.    That the governance and assurance arrangements in place for the protection of the health of the people of Lincolnshire be noted;

2.    That the challenges within the health protection programmes in Lincolnshire, and the plans to address them be noted;

3.    That the plan to report to the Board twice yearly on this area of service be approved.