Agenda item

4.1

The Committee received a report of the Director of Public Health (Greg Fell) on the development of a Public Health Strategy for the City Council.  The report indicated that it was the ambition to achieve a strategy that sets the direction of travel for public health, and which did not override existing plans, but enhanced them.  The ambition was also to engage a wider set of stakeholders into public health, and the Strategy had been developed following a review of the public health function in 2015, as well as linked external work undertaken by the Kings Fund.  The report also set out information in terms of the structure of the draft Strategy, which was attached to the report, and what the Strategy would mean for the people of Sheffield. 

4.2

Councillor Cate McDonald (Cabinet Member for Health and Social Care), who was also in attendance for this item, stated that the draft Strategy needed to be considered alongside the Director of Public Health’s Annual Report, and that she and the Director of Public Health would welcome the Committee’s views on its contents. 

4.3

Mr Fell stated that one of the aims of the Strategy was to ensure, as far as possible, that the deployment of resources met the aims of the Strategy.  The Strategy had been designed to be a statement of intent, and had been kept deliberately brief, with ‘easy to read’ text.  The principal aim of the Strategy was to increase healthy life expectancy by one year over the next 10 years, explicitly focusing on improving fastest in those with lowest healthy life expectancy, and it was hoped that this aim could be achieved not by one specific intervention, but by a collection of a number of different pieces of work.  The draft Strategy, which was intended to be more an enabling document, set out four main objectives, in that the Council would use existing skills, expertise and resources to enable such outcomes to be delivered, and which were as follows:-

1 - Refresh and revise our approach to health inequalities.

2 - Optimise health outcomes as an output of public service reform, integrate health and wellbeing as a core consideration in all City Council policies and processes, and upgrading our approach to prevention across the totality of the City Council.

3 - Maintain and develop a robust system to protect the population from preventable infections and environmental hazards.

4 - Develop ambitious policy and service-based approaches to healthy lifestyles to support people to be as healthy as they can.

4.4

Members of the Committee raised questions and the following responses were provided:-

·                Whilst there had been improvements in terms of dental health, particularly regarding children, this was viewed as a very important issue, and steps would be taken to make it more explicit within the Strategy.

·                Staff within Public Health would be more than happy to speak to representatives of Healthwatch Sheffield in order to discuss the issue of the nature of the language used in the Strategy.   

·                Consideration would be given to public health issues in connection with the determination of licensing and planning applications.

·                There were a number of proposed changes set out in the Sheffield Alcohol Strategy 2016-2020, which was to be considered by the Cabinet at its meeting to be held on 21st September 2016.  Discussions had also been held with the Co-Chairs of the Licensing Committee in connection with the determination of applications dealing with Premises Licences.

·                Whilst it was acknowledged that decisions made with regard to health issues were generally made based on evidence provided, as was usually the case in other areas of policy-making, there was a belief that there needed to be other considerations as part of the decision-making process.

·                Whilst the decision in terms of some GP Practices not being able to carry out certain sexual health treatments was a public health decision, current data indicates that sexual health services were performing adequately at the present time.

·                Whilst the average life expectancy for Sheffield was rising, the City’s healthy life expectancy was not.  There was more information on healthy life expectancy in the Director of Public Health Report for Sheffield 2016.  It was appreciated that the reference in the section on risks to the delivery of the intentions in this Strategy, relating to the potential loss of the ring-fence on the public health grant presenting significantly more opportunities than threats, may be optimistic.  However, it provided an opportunity to put health in a different context, such as highlighting the fact that it was a good investment to improve the economy.  For this reason, it was viewed as more of an opportunity rather than a threat.

·                It was not totally clear as to what action the Council would take in terms of resolving conflict in connection with improving public health.  One example in terms of proposed action would be the need to factor in the adverse consequences of the effects of poor air quality. 

·                Public Health staff were working with schools and the Planning Service in connection with providing advice and guidance on the benefits of improved public health in these areas.  Progress in terms of working with schools was more advanced, with most schools wanting to engage in the health agenda.  It was considered that it was in the schools’ interest to work with Public Health staff as statistics showed that healthier children perform better at school.  Staff, however, were only able to provide advice and give ideas to the two services, and not able to provide any funding.

·                Efforts were being made to ensure that funding could be secured in terms of health trainers and other initiatives, in connection with a social model of health.  Recent budget cuts in the Health Service had resulted in a serious adverse effect on community health work. 

·                The City was developing a model of social prescribing, the aim of which was to add to the range of options available to GPs, and others, beyond traditional medical interventions.

·                As the effects on health did not form part of the criteria in connection with licensing and planning applications, the public should be encouraged to lobby their local Members of Parliament in terms of seeking changes to the law in this regard.  There was a need to consider the Accumulative Impact Policy in terms of the number of licensed premises in a given area, and it was hoped that this could be explored through the Council’s Alcohol Strategy.

·                The comments received in terms of the layout of, and language used in, the draft Strategy were acknowledged, and consideration would be given to including a contents list at the front, and a glossary at the end of the draft Strategy, as well as including a short description of other plans and strategies.  The Director of Public Health would be more than happy with the principle of adopting a more ambitious approach in terms of the draft Strategy, particularly with regard to targets relating to child poverty.  It was, however, considered that there was a need to focus on stopping the worse causes of child poverty, rather than stopping it all together.

4.5

The following comments were also made:-

·                The fact that the aim of the Strategy was explicitly highlighted was welcomed.

·                There should be more detail in terms of the links between public health and housing.

·                An action plan, with clear targets which could be monitored and reviewed, would be welcomed.

·                There was a need to balance the two approaches to improving health and wellbeing, in terms of the medical and social models of health, recognising that both models were important.

·                It would be helpful if reference could be made to public health implications on the front sheets of reports being submitted to Council meetings.

·                Consideration should be given to some of the wording and terminology in the draft Strategy.

4.6

RESOLVED: That the Committee:-

(a)       notes the contents of the report and the draft Public Health Strategy, now submitted, and the comments now made and questions raised; and

(b)       requests the Director of Public Health to submit a report to a meeting to be held at the end of the 2016/17 Municipal Year, providing a full and detailed account of how the Public Health Strategy was progressing and highlighting any areas that needed addressing.