Siobhan Farmer, Director of Public Health, to present an overview of the work undertaken by the Public Health Team, (and within the remit of the committee), including anticipated issues and activities that may require consideration during the forthcoming year.
Members will be invited to ask questions.
Siobhan Farmer, Director of Public Health, gave a detailed overview of the work of the Public Health Team, (within the scope of the committee terms of reference), including anticipated issues and activities that might require scrutiny during 2023-24.
To view the report published with the agenda for the meeting, please refer to the link here
The slide show presentation presented at the meeting is attached to the minutes for information.
Members recalled that under the Health and Social Care Act 2012, responsibility for public health had transferred from the NHS to upper tier and unitary local authorities in April 2013. Under the Care Act, the County Council has a statutory duty to take appropriate steps to improve the health of the local population, including appointing a Director of Public Health, and delivering a number of mandated public health services.
Outlining the statutory role of the Director of Public Health, including that of principal adviser on health matters, it was explained that not all public health work was the responsibility of the public health team. A large proportion of work was fulfilled in partnership with others, including extensive collaboration with the Gloucestershire Fire and Rescue Service. The role of the public health team was to provide a leadership role and to influence and offer guidance on public health.
Inequalities and inconsistences evident between different groups of people/people living in different areas of Gloucestershire is a key area of work. At the request of members, it was agreed to provide data on some of the disparities that exist between male and females and between people living in non-deprived and deprived areas of the county. Action by – Public Health Team
Reporting on the Public Health Budget, it was confirmed that the total budget was approximately £37.6million, (excluding Covid and Homes for Ukraine funding). The majority of funding came from the ring-fenced public health grant, awarded at £26,075,974 in 2023/24, (a 3.2% increase on 2022/23).
It was confirmed that between 60% and 70% of the public health grant was attributed to providing treatment services, the remaining balance of which was invested in deterrence and prevention. Other ‘additional’ funding was sometimes made available to the council during the year. Reporting a comfortable financial position, members were advised that it may be necessary to absorb some of the public health reserves accrued in recent years.
Members noted the work of the public health team to support delivery of the three ‘Exemplar Themes’ identified as priority areas by the One Gloucestershire Integrated Care Strategy. The themes included: i) reducing smoking, ii) prevention of high blood pressure, and iii) creation of employment and skills opportunities. The team was also working with partners to develop a new Prevention and Health Inequalities toolkit.
Responding to questions, the following points were raised at the meeting: -
Questioning the level of work undertaken in association with district partners, it was explained that, post Covid, this had reduced slightly, and acknowledged that now might be an opportune time to consider reconvening joint discussions between the county council and the 6 district councils. Members were reminded that each district had their own Health and Wellbeing Plan, for which the scrutiny of the plan was the individual responsibility of the relevant authority. The Director of Public Health agreed to circulate information on the council’s work with the district councils after the meeting. Action by – Director of Public Health
Referring to the additional grant funding awarded annually by the Department of Levelling Up, Housing and Communities (DLUHC) to meet the council’s statutory duties introduced by the Domestic Abuse Act in 2021, it was suggested that details of the bidding processes involved and list of projects for which funding had been awarded be circulated after the meeting. Action by – Public Health Team
A specific area of focus for the members of both the Adult Social Care and Communities Scrutiny Committee and the Gloucestershire Health Overview and Scrutiny Committee was child and adult obesity. In response to consideration of Motion 881: Tackling Poverty and Deprivation at the Full Council meeting on 8 September 2021, and the request for ‘regular progress reports on the Health and Wellbeing Boards 7 Strategic Priorities to HOSC, (Health and Overview and Scrutiny Committee)’, it has recently been agreed that the ASCC committee work plan items relating to Obesity and ACES, (Adverse Childhood Experiences), should be included in a Health and Wellbeing Board Strategy update at a joint meeting of both committees on the planned HOSC meeting date of 11 January 2024. The date of the ASCC meeting planned for 16 January 2024 is no longer required and should be removed from members calendars. Action by – ASCC members/officers
Responding to questions on the investment in prevention initiatives for the county, including tackling knife crime, members attention was drawn to publication of the Serious Violence Duty in December 2022, and the requirement for councils and local services to work together to share information and target interventions to prevent and reduce serious violence. The duty to be reviewed by the end of December 2023.
It was confirmed that the County Council had a shared responsibility with the 6 district authorities, Gloucestershire Police, Gloucestershire Fire and Rescue, and Gloucestershire Health and Care NHS Foundation Trust, to look at serious violence in the county. Several initial meetings had been held, culminating in a number of positive outcomes and endorsement of several priority areas. It was requested that, when available, information on the country’s response to the Serious Violence Duty be circulated as a briefing note to the committee. Action by – Public Health Team
The update was noted, with several messages of appreciation and support for the work of the Public Health Team, and as encouragement for the team to invest in more prevention. It was agreed that further investment would only add value to the wellbeing of county in the long term.