Agenda item

The Director for Public Health and Health Partners submit a presentation to provide the Commission with an overview of services and systems.

The Director of Public Health provided the Commission with an overview and it was noted that:

·       Public Health is considered as both the science and art of preventing disease, prolonging life and promoting physical health through organised community efforts.

·       The understanding of ‘health’ has changed over time and encompasses mental health and wellbeing as well as physical health.

·       One of the key features of Public Health has been tackling the health inequalities and differing outcomes between communities and areas to address the stark differences in life expectancy, healthy life expectancy and disease rates etc. that are preventable and unjust.

·       There is a strong link between poverty and health outcomes. 10% of the world’s population lives in poverty. The population of an area impacts the demands and priorities of Public Health.

·       Leicester’s population is characterised by:

o   Younger population than national average.

o   Large increase of population in last few decades.

o   Ethnicity change – huge diversity and census shows that for the first time, the white population is now the minority.

o   Significant deprivation in Leicester wards compared to England. There are large disparities between different areas of the city.

·       Deprivation in the city impacts life expectancy and healthy life expectancy. This has meant people die younger and get ill earlier in Leicester which consequently has implications for health and social care and service demands.

·       Life expectancy was improving in Leicester until 10 years ago when it plateaued. Leicester’s life expectancy has been consistently below the national life expectancy. 

·       A further dip in life expectancy during the pandemic but this was sharper in Leicester than the national average due to deprivation across the city meaning people often live in crowded conditions and more likely to have underlying health conditions.

·       Public Health is based within the City Council and has followed their values, with the premise of working with partner organisations to benefit residents. The overall vision of Public Health is a fairer society where we can live with health and happiness.

·       The aim has been to prevent ill health, rather than treat. Working with partners has allowed a more targeted, cost-effective approach but required hard conversations around priorities.

·       Core 20 is an NHS initiative focused on 20% of most deprived neighbourhoods in the country. In Leicester, Leicestershire and Rutland over 90% of those in the 20% are in the city.

·       The priorities of Public Health for the next year are to be focused on primary and secondary prevention. An upcoming workshop in August will enable discussion of key priorities.

·       Wider determinants of health are influenced by the Council such as leisure centres, economic development, housing etc. all impact on health and wellbeing.

The Chief Operating Officer at the Integrated Care Board provided the Commission with an overview of health services in which it was noted that:

·       The NHS developed new organisations to replace former Clinical Commissioning Groups. The Integrated Care System (ICS) aims to bring together public sector organisations to do what is right for local people supporting social and economic determinants.

·       The Integrated Care Board (ICB) commissions services and convene professionals to work collaboratively and identify solutions to achieve outcomes. The Integrated Care Partnership has worked with the Local Authority to promote an alliance of partners including the fire service, police and VCSE who promote the health and wellbeing of the local population.

·       The ICB 5 Year Forward Plan is a statutory requirement which has been developed through partner and community engagement to identify 13 pledges. It aims to improve outcomes for the population, tackle inequalities and improve access.

·       Key programmes of work include elective care, urgent care, mental health and addressing inequities for individuals with learning disabilities. A different approach to working has been developed with a focus on collaborative models and partnerships whereby organisations are provided a mandate to lead with the ICB as a partner.

·       The ICB operates across Leicester, Leicestershire and Rutland – each are identified as places and in partnership with Local Authorities Place Based Plans have been developed to identify what is needed for their communities.

·       Lots of work is ongoing with partners and working with organisations who know their communities to address concerns and improve health services for local people. Examples of recent improvements include elective care waiting lists, 62day cancer backlog, cervical screening and health checks for individuals with a learning disability and/or autism.

·       Primary care continues to experience issues with the 8am rush to book GP appointments but multiple other ways have been implemented, including the NHS app and SystmOnline.  These options are most popular in the under 50 population. There is a current recruitment drive for increasing GP numbers as it is recognised there are not enough but will take time and will need to be routed into areas that need it most.

·       Ongoing issues are evident in with emergency care and residents are waiting too long across all areas. A revised governance programme has been established and led by the Chief Executive at UHL. It is hoped measures being taken will help improve performance, particularly during winter.

The Chair requested that the Commission receive the presentation on the ICB 5 year forward plan pledges and would then allow discussion, questions and comments from Members in relation to both items which was agreed.

AGREED:

·       The Commission noted the report.