Agenda item

The Director of Public Health submits an overview of the Long Term Conditions (LTC) programme currently being delivered through Public Health and its proposed future direction.

The Programme Manager in Public Health presented the report, and it was noted that:

·       The strategic justification for the Long-Term Conditions programme came from the Leicester Health, Care and Wellbeing Strategy 2022-2027, the Prevention and Health Inequalities Steering Group, Primary Care Networks City Priorities and the Core20Plus5 national framework.

·       The principles were to prevent as far as possible; reduce health inequalities; ensure well-meaning work hadn’t compounded health inequalities; that it was data driven and evidence based whilst also being innovative; and that it addressed gaps and prevented duplication.

·       Hypertension is persistent high blood pressure and was often referred to as the silent killer as it was symptomless.

o   The high levels of cardiovascular disease in Leicester had contributed to the higher than average under 75’s mortality rate. In order to improve the health outcomes, those who had not been diagnosed needed to be found.

o   Interventions had included the NHS Health Check, Community Pharmacy and Primary Care Network case finding. It had been proposed to engage with those being missed through a community pharmacy outreach model, a roving health unit, targeted NHS health checks, PCN case finding and optimisation and working with GP practises where there was high prevalence.

·       An increasing number of people had been living with multiple long-term conditions.

o   Engagement work was done with GP’s who had higher than average prevalence of cases of multiple long-term conditions to conduct focus groups and development sessions which considered the barriers and challenges faced. 

·       The Health and Wellbeing Board had scheduled a development day in April to consider long-term conditions.

·       Lots of other work had occurred across the city addressing long term conditions including cardiovascular disease, respiratory disease, cancer, obesity and mental health.

·       There was an ongoing partnership with the PCN’s.

·       Part of the prevention strategy was the ‘Make Every Contact Count’ initiative. This was a national approach to behaviour change which focused on the numerous contacts that occur with members of the public to help them make healthy behaviour changes. This initiative considered broader determinants of health as well, such as poor housing and debt alongside more obvious ones.

·       Next steps of the programme were to consider what had been learnt from the hypertension programme and allow this to influence the direction of future programmes, to consider where public health intervention had best been used, to continue the roll out of ‘Make Every Contact Count’ and to further identify areas of need.

In response to questions and comments from Members, it was noted that:

·       A prevention team was working on a whole systems approach to obesity and all the factors that influence this.

·       This was a big partnership for the whole systems approach and the NHS had been asked to sign up.

·       Many factors influenced healthy weight, including environment, access to healthy food and education. The structures and environment can make it more difficult to live a healthy life. This included the big companies, and work was needed in advertising and planning to address their influence.

·       To assess how approaches worked, they would be piloted in a small area initially, such as working with take aways or access to green spaces. More input was required on both a national and international level though.

·       A report was requested by members on the whole systems approach to healthy weight.

·       Communities had been engaged through the Community Wellbeing Network which was coordinated by Public Health. They worked in partnership with over 500 VCSE groups on common problems. Information was sought, but mainly Public Health wanted to listen to what they have to say and to what is important to them.

·       Community pharmacies appeared to be working well on hypertension.

·       Training was provided to help those working with the public to have the confidence to participate in conversations on mental health. Healthy Conversations training was available to everyone, and it was suggested that anyone who had customers who sit in a chair for a length of time should be encouraged to participate in this training.

·       More vendors of fruit and vegetables in certain areas that lack accessibility to these products was suggested. It was encouraging to see these types of vendors appearing outside of places such as hospitals.

AGREED:

1.     The Commission noted the report.

2.     Whole systems approach to healthy weight to be added to the work programme.