Agenda item

For the Board to focus on it's medium term objective to 'reduce premature mortality by helping people live healthier lives', which is the subject of the Annual Report from the Director for Public Health.

The Board considered a report (Agenda Item 9) which presented the Annual Report from the Director of Public Health. Judith Wright advised that Dr Lise Llewellyn was on long term sick leave and she would be the Interim Strategic Director of Public Health for the Berkshire Shared Team. The subject of the report was avoidable and preventable mortality and had been written by Dr Lise Llewellyn.

The report outlined that nearly a quarter of all deaths could be deemed to have been preventable. The rate of preventable deaths was lower than the national average, and reducing, in both men and women in West Berkshire, however men were still four times more likely to suffer preventable mortality than women. The reason for this inequality might be because men are more likely to get heart disease and historically have smoked at higher rates than women. Dr Bal Bahia noted that men were also less likely to visit a GP than women.

There was a strong correlation between deprivation and preventable deaths and this was likely to be linked with the prevalence of unhealthy behaviours among people living with deprivation. There were eight commonly agreed risk factors that if addressed would reduce preventable deaths; alcohol use, tobacco use, high blood pressure, high body mass index, high cholesterol, high blood glucose, low fruit and vegetable intake and physical inactivity. Judith Wright explained the impacts and possible interventions for those risk factors.

Garry Poulson asked whether the impact was known of vaping on smoking rates, noting the visibility of vaping retail outlets. Judith Wright advised that there had not yet been a longitudinal study to assess the long term impact on overall rates and it was difficult to examine the short term impact as individuals often made independent decisions to take up vaping rather than going through NHS services.  

Tandra Forster asked if the Board should be concerned regarding the numbers of young people smoking (9255 people aged 16-34); Judith Wright advised that the rate was a concern and the best method to reduce the number of people smoking would be to stop people from starting. Paul Jones enquired whether data was collected regarding the number of children aged 11 and older, noting that Royal Berkshire Fire and Rescue Service delivered anti-smoking education to children from the age of 11 as behaviours might be embedded by the age of 15. Judith Wright advised that the data came from school health surveys which were conducted with 15 year olds.

Judith Wright concluded that in West Berkshire smoking cessation services saw people at rates which exceeded the national average but there were further opportunities for the system to reduce the levels of smoking. Councillor James Fredrickson enquired what about West Berkshire’s interventions were supporting so many people. Dr Anees Pari advised that there were a number of interventions, including a popular play targeted at school children called ‘Meet the Stinkers’. He also advised that the long term trend was that smoking rates were reducing. Councillor Fredrickson requested a breakdown of the age and gender split of smoking cessation service users so that more information on the reasons for West Berkshire’s good performance for smoking cessation rates could be known.

Judith Wright advised that there were similar correlations between smoking and alcohol in regard to the link with deprivation. There were a variety of community and cultural factors which lead to people drinking at harmful levels. Judith Wright recommended that identification and brief advice would be useful to the wider population and the Board might also want to focus on people who had several hospital admissions. Councillor Graham Jones asked about brief advice in non-clinical settings, Judith Wright advised that many professionals were reluctant to talk to their clients about their alcohol consumption as there was a wide cultural acceptance of drinking. Nationally, there would be benefit to considering the accessibility to alcohol including pricing and licensing laws.

Andrew Sharp noted that at a recent meeting of the Alcohol Harm Reduction Partnership, Dr Anees Pari had provided information regarding the saturation of licensed premises among areas of deprivation and expressed the view that there should be a more proactive approach to planning, licensing and public health.

Regarding obesity and physical activity, Judith Wright reported that West Berkshire was below the national average for the number of children classified as obese, however it was higher than national average for the number of children who were overweight; a quarter of West Berkshire’s children were overweight or obese. Weight reduction interventions had the most impact when the referral was made by a GP.

Councillor Fredrickson asked how West Berkshire compared overall to national averages. Dr Anees Pari advised that for many indicators such as physical activity West Berkshire was performing better than the national average, although he noted that the Council’s website could be amended to raise the profile of the available interventions. There were some indicators which West Berkshire had performance lower than the national average and these would be considered further at a meeting of the Locality Integration Board in June; preventable mortality of people with a serious mental illness and children admitted to hospital as a result of self-injury. Judith Wright commented that while West Berkshire was outperforming the national average on many indicators, in an area of general affluence one might expect even better performance. Dr Pari further noted that inequalities were stark on each indicator, including where performance was better than the national average. Councillor Fredrickson advised that he would look into the profile of available information on the Council’s website.

Tandra Forster enquired why West Berkshire was completing fewer NHS Healthchecks than the national average. Dr Bahia advised that in West Berkshire, GPs had been encourage to provide these checks and due to the pressure on primary care they had not been prioritised but that did not stop GPS having conversations with their patients about risk factors. Judith Wright advised that Public Health England were seeking a national review of NHS Healthchecks to examine their success and identify good practice.

RESOLVED that

·         The report be noted.

·         Information on the breakdown of the age and gender split of smoking cessation service users to be gathered.