Issue - meetings

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) to provide an overview of the key prevention and Health Inequality activities taking place in West Berkshire.

Steve GoldenSmith (Asssociate Director of Prevention and Health Inequalities, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) gave an overview of the report on Health Inequalities for West Berkshire.

During the debate the following points were discussed:

·         There were four ways the NHS could reducing health inequalities:

1.    Influencing / supporting multiagency action to address the social determinants of health.

2.    The NHS as an anchor organisation – as commissioner, employer, partner and purchaser.

3.    Tackling existing inequalities in healthcare.

4.    Focus on ill health prevention and influencing healthy lifestyle behaviours. This needed to be collaborative to encourage and embed people to manage lifestyles in a more positive way.

·         It was advised these were not In order of priority and the solution was in working in partnership to address the wider determinants of health.

·         West Berkshire data was shared which showed that there were a number of areas of concern. These included above national average rates of asthma, cancer, dementia and hypertension.   Many of these could be driven by wider determinants of health and health inequalities. It was noted that Reading and Oxford had more areas of deprivation to West Berkshire, but West Berkshire had higher rates of these health conditions. It was not known why this was as a full evaluation by the BOB ICB had not taken place yet.

·         It was explained that the NHS focus on reducing health inequalities through the Core20Plus5 approach which enabled Integrated Care Sytem’s (ICS) to target action for the most deprived 20% of the population. Key clinical areas were maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case-finding.

·         Data was shared on the index of multiple deprivation that highlighted Eastfield House surgery, Falkland Surgery and Strawberry Hill Medical centre by in large provided most of the primary care services to these populations.

·         An overview of the data insights methods was shared which highlighted how the BOB ICB could drill down the data to enable focussed work on targeted areas of the population and for targeted clinical priorities.

·         For children, the BOB ICB had a different set of clinical areas that they focussed on to address health inequalities. These were asthma, diabetes, epilepsy, oral health and mental health. They used data insights to target cohorts with particular needs.

·         It was advised that inequalities were found in access to healthcare, peoples experience of healthcare and the outcomes of healthcare. Access to services could be influenced by a variety of factors including trust and knowledge. Experiences and outcomes of services could also vary hugely.

·         The BOB ICB were carrying out community engagement through Healthwatch to understand the challenges to access to NHS dental services and specifically for children who were neurodivergent.

·         The BOB ICB were also starting to utilise improved data to understand if there was any unwarranted variation in access, experience and outcomes of children’s mental health services. There was also some targeted work being undertaken through getting help level teams, such as Mental Health Support Teams.  ...  view the full minutes text for item 5

Purpose: To review the System approach to oral health and dentistry including the preventative approach and commissioned services.

Steven Bow (Consultant in Public Health, West Berkshire Council) gave an overview of the report on Oral Public Health. Steven Bow highlighted the role of local authorities in oral health, noting oral health surveys and prevention. Data on local population oral health was shared and it was highlighted that one in six children in West Berkshire had tooth decay. A number of initiatives including brushing for life in early years, as well as work in family hubs and in schools had been implemented. A national review of the oral health of people living in residential and nursing care homes found that untreated tooth decay was higher among older people than the general adult population. It was advised that the next steps for public health included a local oral health survey focused on adults over 65 living in a care setting. Once completed the Public Health Consultant would work with the BOB ICB to provide support on an approach to build preventative care into treatment pathways.

It was advised that future work on oral health in West Berkshire could include an oral health needs assessment, a review of evidence and guidance and to develop partnership working.

During the debate the following points were discussed:

·       There was a general downward trend for tooth decay among five-year-olds in West Berkshire. Fluctuations in the graph (Figure 1 in the Oral Public Health report) may have been explained by the smaller numbers locally being compared to larger national figures. It was noted that there was a slight increase in the graph between 2018 and 2022.

·       It was noted that the number of tooth extractions in five- to nine-year-olds in West Berkshire were worse than the national average. It was asked if supervised brushing schemes in early years had helped. It was advised that there were limitations with up-to-date data.

Action: Steven Bow to provide up to date data on tooth decay and tooth extractions in children when available.

·       The results of the national oral health survey in older people in residential and nursing care homes was noted and it was asked how this was being addressed in West Berkshire. Matt Pearce, Director of Public Health, advised the Committee that the local oral health survey planned would help to identify issues. Hugh O’Keeffe, Head of Pharmacy, Optometry and Dentistry BOB ICB, advised that there was a pilot underway in Oxfordshire with care homes that they would review the outcome of. It was a very complicated area that was a multiagency issue. There was a community dental service available, but it had limited capacity.

·       It was noted that the data in the report was not up to date and made it more difficult for Public Health to respond to. A Public Health Analyst had been recruited recently and would work more closely with the BOB ICB to get data that would assist in informing a direction of travel in a timelier manner. Matt Pearce advised that the oral health survey sample size could be increased, however there  ...  view the full minutes text for item 5