Agenda item

The Chair of the Integrated Commissioning Board to submit a report providing an update on the implementation of the Joint Health and Wellbeing Strategy.

The Chair of the Integrated Commissioning Board submitted a report providing an update on the implementation of the Joint Health and Wellbeing Strategy.  This was the second bi-annual progress report to the Board and it aimed to provide an assurance that actions identified in the strategy were either being delivered and/or were flagged up as potential risks to delivery.  In addition the report also aimed to report on the performance indicators used to monitor the progress of the strategy.  The report monitored the strategy at a high level and was underpinned by separate monitoring and reporting through governance arrangements of partner organisations.

It was noted that there were no areas of the strategy where serious concerns were expressed or where action had not taken place.  There were 6 areas where progress was slower than expected but it was considered that progress could be recovered.  There were 10 areas where good progress was being made, particularly in relation to the initiatives relating to teenage pregnancy, alcohol, NHS checks, dementia, carers and mental health.  Substantial improvements had been made in relation to initiatives for sustaining breastfeeding, bowel cancer screening uptake, reducing the number of persons aged 65+ years being admitted permanently to residential or nursing care and the success of reablement (older people supported to live at home following discharged from hospital). 

Three indicators had worsened either since the strategy was published or since the last report.  These were smoking cessation which was showing lower achievements of people quitting than in previous years, which was thought to be largely attributable to people using e-cigarettes and reflected a nationwide trend.  There was also a slight deterioration in the number of women smoking in pregnancy, but there were relatively small numbers involved which exaggerated the fluctuations in percentage changes in this indicator.  This was not felt to be a specific cause of concern or trend but there were actions being taken to strengthen performance.  The third area related to indicators in relation to carers number of actions had been taken to improve the experience of carers and how they felt they were supported. 

In response to a question about outcomes, it was noted that the agreed indicators contained in Appendix 2 of the report were broadly used as a monitoring process to indicate whether the contents of the strategy were delivering the changes that were being sought. Specific outcomes beneath these indicators would be monitored by the various stakeholders involved in implementing the various actions.  In addition, the CCG Operational Plan had a range of outcomes, including one relating to potential years of life lost to healthcare amenable conditions, and as part of this the CGG had to commit to series of reduction trajectories relating to these areas.

It was also noted that in relation to young carers, work was in progress to enhance the current joint carer strategies between Adult Social Care, Children’s Services and the CCG.

Following questions about whether there was a further breakdown of figures for ethnicity etc in relation to the indicators for health checks concerning heart disease, high blood pressure, cholesterol and diabetes as well as mental health; it was noted that the CCG had information which indicated that there was a consistent level of take up for health checks from all groups in differing parts of the City.   It was also noted that the health economy was currently struggling with regard to mental health bed capacity and that the three CCGs have recently begun a review of pathways for mental health across the City and the County to improve care and outcomes for patients and in particular review capacity, and this review will report later in the year.   

The Chair commented that the report indicated that the direction of travel was making progress but it did not fully recognise that there was a lot of work going on to improve and secure improvements in relation to mental health outcomes.    A number of mental health summits had been held in the City and the Council’s Health and Wellbeing Scrutiny Commission were currently undertaking a review of mental health services for young black British men.     

RESOLVED:

1)    that the progress on the delivery of the Joint Health and Wellbeing Strategy be noted.

2)    that the Board noted with concern that 20% of the indicators had slipped from the baseline but also noted that remedial actions were being taken to address these.

3)    that future reports include both percentage changes and actual numbers involved in the performance indicators.