Agenda item

Purpose: To review the Director of Public Healths Annual Report.

Charlotte Pavitt (Consultant in Public Health) presented the West Berkshire Annual Public Health Report (Agenda Item 8).

During the presentation the following points were highlighted:

·         West Berkshire was a healthy place to live as a whole. However, there were local variations between groups of people and indicators of concern. Nearly one third of Year 6 children and 61.3% of adults were overweight or obese. There was a high rate of self-harm and alcohol related hospital admissions for under 18’s. The three highest recorded long-term conditions locally were depression, hypertension and diabetes.

·         Extensive health improvement programmes of work were noted. These included for children and young people, healthy weight, smoking cessation services, the community wellness outreach service, mental health promotion and the ageing well focus across West Berkshire. The health improvement priorities moving forward were also described.

·         The Public Health approach was highlighted noting collaboration with the BOB ICB and the importance of understanding patterns of health and disease, identifying needs and prescribing effective interventions.

·         Evidence-led interventions, communications and workforce priorities were explained. Embedding the Health in all Polices (HiaP) approach at West Berkshire Council was a key priority.

During the debate the following points were discussed:

·         John Ashton (Director of Public Health) explained that a strong primary and social care focus was needed, with more resources upstream for self-care and community organised responses rather than for secondary care. The local authority was key for that approach. In particular partnership working across and beyond the local authority to mobilise and support the community was needed. This was beyond the services provided by Public Health such as vaccinations and targeting groups that were difficult to reach.

·         The importance of the built environment and housing was noted. John Ashton said that a strategic and integrated approach to housing and health was essential to ensure that people remained living independently for longer. This was particularly critical with the ageing population.

·         It was highlighted that one third of children in Year 6 were overweight or obese and it was queried how public health campaigns could influence that. John Ashton advised that individual behaviours were important, but there were also commercial determinants that needed addressing at a higher level.

·         It was asked what could be done locally. An example was shared by John Ashon on the benefit of providing water fountains in streets. That would enable people to choose not to drink sugary drinks. By-laws could be strengthened to prevent fast food outlets from opening near schools. Parking outside schools could be addressed to encourage walking. It was advised it was important to think laterally and that the Council could influence new developments to ensure cycling, walking and active travel was built in.

·         Health inequalities were noted and the importance of allocating resources to the right areas.

·         The use of technology was discussed. For example, in nutritional information on food shop receipts. While early diagnostics and screening were important, they were not an alternative to primary prevention. For example, three – five million people in the UK had Type Two diabetes which was strongly related to people being overweight. This was at enormous cost to the NHS. Prevention was the real answer.

·         It was highlighted that early detection of cancer was the best option for many cancers. However, some cancers were known to be determined by environmental or behavioural factors. Those environmental and behavioural determinants needed to be addressed.

·         Members expressed concern with specific issues including tooth decay children and adolescent mental health. The wait for neurodiversity assessments, a crisis in adolescent mental health and support in schools were particularly noted. John Ashton noted that children’s mental health had deteriorated particularly since the pandemic and was complicated by social media. It was emphasised that it was essential to get upstream of the issue. John Ashton explained that the concepts of self-esteem, self-directedness, the locust of control and sense of coherence were useful. These were measurable concepts that could provide data to compare between schools, classes and locations. John Ashton advised that he promoted the notion that every child should have a passion by the age of 18. To do that, there needed to be opportunities available for children and these varied hugely between backgrounds and schools. The local authority could facilitate improving this, not just in the classroom but outside it. An asset-based approach of mapping the assets of the community and mobilising them to ensure all children have opportunities to feel mastery of their own personal universe was needed. It was essential to provide a strategic and coordinated approach across West Berkshire.

RESOLVED to note the report.