Agenda item

(To receive a report from Dr Tony Hill (Director of Public Health – Lincolnshire County Council) which provides an independent statutory report to Lincolnshire County Council on the health of the people of Lincolnshire to raise the issues of importance to the health population of Lincolnshire.  Dr Tony Hill (Director of Public Health – Lincolnshire County Council) will be in attendance for this item.  Please note:  Appendix A to the report has been circulated electronically)

The Committee gave consideration to a report from the Dr Tony Hill, Executive Director of Community Wellbeing and Public Health, which provided the Annual Report on the Health of the People of Lincolnshire for 2015.

It was reported that it was a statutory duty of the Director of Public Health to produce an annual report on the health of the people of the area for which they are responsible.  The report was an independent view of the state of the health of the people of Lincolnshire, with a series of recommendations on the action needed to be taken by a range of organisations and partnerships.  The Committee noted that the previous year's annual report had focused on the major causes of premature mortality, which was when people died under the age of 75 years.  That report had highlighted three major findings, one of which was that the levels of mortality arising from liver disease were deteriorating.  As a result of the increase in preventable liver disease, it was highlighted that the current report concentrated solely on this issue.

The annual report described what liver disease was, what the causes and stages were, and the patterns, facts and figures relating to liver disease.  The Executive Director of Community Wellbeing and Public Health reported that the three main causes of liver disease were obesity, alcohol and hepatitis.  The report highlighted that there was a need for some sustainable investment in liver disease prevention and treatment and the development of effective pathways of care for people with liver disease and its causes.  The Committee were advised that in each chapter there were a series of recommendations on the action needed to be taken by a range of organisations and partnerships.  It was noted that it was hoped that the next year's commissioning plans would address the needs highlighted in the annual report.

During discussion, the following issues were raised:-

·         Budgetary constraints – The Committee noted that the Autumn Statement had reduced the amount of grant relating to public health and that this amount would continue to reduce year on year.  Some preventative services had been de-commissioned, or reduced, however, it was hoped that by working in partnership with other organisations that some of the services would be maintained.  Unfortunately, this information could not be shared with the Committee at this moment in time.  The Committee noted that not all services de-commissioned by the County Council would therefore cease.  The Committee were also advised that the NHS Five Year Forward view emphasised the need for prevention. 

·         The Committee were advised that the smoking cessation contract had been re-commissioned at considerable savings; significant improvement and better value for money.  It was noted further that the weight management contract had been de-commissioned, as its role was for CCGs and NHS England;

·         Page 10 of the Annual report document –Figure 1.1 provided the Committee with data relating to trends in United Kingdom (UK) deaths rate since 1970.  It was noted that during the forty year period, all other major causes of premature deaths in the UK had fallen, but the death rates from liver disease had seen a continuous rise (figure 1.1 provided that data).  It was reported that the death rate from liver disease was across all age groups had risen more than 400% since 1970.  However, under the age of 65 years, this had increased by 500%.  Concern was expressed that generally the general public were not taking liver disease seriously.  Some members felt that it would have been useful to had some data relating to the effect on admissions to hospitals; and relative incidents;

·         Page 12 – That the average age of death from liver disease was 59 years, compared with 82-84 for those with heart disease, lung disease or a stroke.  The Committee noted that alcohol and obesity were significant contributory factors to liver disease.  The Committee noted further that better clinical pathways needed to be developed for the treatment of liver disease;

·         Reference was also made to the previous work carried out in 2011, by the Committee's Reducing Alcohol Harm in Lincolnshire Task and Finish Group.  The Committee considered whether it would be useful to review the content of that report, in light of the Director of Public Health's Annual Report;

·         The Committee discussed the issues surrounding obesity, and the fact that the low fat diet had made matters worse, as the fat content was reduced, but, the sugar content in products was increased.  The Committee were advised that a lot of work was being done by Public Health England to try and change the emphasis.  To make a difference people needed to change their lifestyle;

·         An update was received from two Councillors who had recently attended the Public Health Conference who had been advised that the reductions were not about savings but were as a result of priorities;

·         Some discussion was had regarding whether anything could be done locally to publicise to young people the issues surrounding obesity and alcohol.  Particular reference was made to the need for working with supermarkets.  The Committee was advised that there was a national voluntary partnership working with retailers to try and change things.  It was felt that trying to do work at a local level would have little effect and there were no resources available to do that type of work.  It was felt that health in the workplace was a starting point.  Some reference was made to binge drinking and the fact that in some countries the purchase of alcohol was not made from supermarkets, but from strictly controlled shops;

·         Members expressed their thanks to the Executive Director of Community Wellbeing and Public Health for his annual report; and

·         One member enquired whether there was a correlation in increased alcohol related issues and the relaxation of licensing laws.  The Committee was advised that there was a correlation, as the amount of drinking had increased over the decade since licensing laws had been relaxed.

The Chairman, on behalf of the Committee extended her thanks to the Executive Director of Community Wellbeing and Public Health.

RESOLVED

1.    That the Annual Report on the Health of the People of Lincolnshire, from the Director of Public health be noted.

2.    That further consideration be given to the outcomes of the report of the Committee on Reducing Alcohol Harm in Lincolnshire.