Agenda and minutes

There were no declarations of interest received at this point in the meeting.

The minutes of the Health Scrutiny Panel meeting held on 20 November 2023 were submitted and approved as a correct record.

 

ORDERED: That in accordance with section 4.57 of the Council Procedure Rules, the scrutiny panel agreed to vary the order of business to consider Agenda Item 5 as the next item of business.

The Scrutiny Panel will be asked to approve the content of the draft final report and agree recommendations, for submission to the Executive.

The Democratic Services Officer presented a brief overview of the draft final report on the topic of Dental Health and the Impact of Covid-19. The following information was provided:

 

·        The aim of the scrutiny review was to examine the oral health of Middlesbrough’s population and the accessibility of local NHS dentistry services.

 

·        The Terms of Reference, for the review, were detailed at paragraph 2 of the report.

 

·        Background information, included at paragraphs 3 to 14 of the report, provided a definition of oral health, NHS dentistry and details on access to NHS dental services.

 

·        Evidence in respect of Term of Reference A was included at paragraphs 15 to 24 of the report and covered the Local Authority’s responsibilities in respect of oral health and NHS England’s responsibilities in respect of dentistry.

 

·        Evidence in respect of Term of Reference B was included at paragraphs 25 to 35 and covered oral health data in respect of Middlesbrough’s children and adults, information on oral health promotion and the future work of the Local Authority to improve oral health.

 

·        Evidence in respect of Term of Reference C was included at paragraphs 36 to 61 and covered information on Covid-19, dental workforce recruitment and retention, NHS dental contract and dental system reform and work being undertaken to improve access to dental care.

 

·        Evidence in respect of Term of Reference D was included at paragraphs 62 to 79 and covered information reported by Healthwatch, detailing the views and experiences of the local population during the period March 2020 to October 2023. It also included information on the future work of Healthwatch and the North East and North Cumbria Integrated Care Board (ICB).

 

·        Evidence in respect of Term of Reference E was included at paragraphs 80 to 110 and covered programmes to reduce oral health inequalities, such as targeted supervised tooth brushing in childhood settings, the provision of toothbrushes and paste by post, targeted community fluoride varnish programmes, water fluoridation programmes, the development of an oral health strategy and improving access to Teesside University’s Student Dental Facility.

 

·        Additional Information was included at paragraphs 111 to 119 and covered advice for patients with an urgent dental treatment need and safeguarding. Whilst those areas were not directly covered by the terms of reference, they were relevant to the work of the scrutiny panel.

 

·        The conclusions were detailed at paragraph 120 of the report and they summarised the main findings of the review and identified key areas for further consideration, in terms of Middlesbrough’s oral health and access to dental care services.

 

Following the publication of the agenda, two comments had been received from the North East and North Cumbria Integrated Care Board (ICB) and NHS England.

 

·        In terms of paragraph 49 - The ICB had requested that the sentence, which referenced  ‘For example, a dentist is paid the same fee, regardless of whether they perform one filling on a patient or 10.’ was replaced with ‘Recent national dental contract reforms introduced in November 2022 have gone  ...  view the full minutes text for item 23/26

Representatives from the North East and North Cumbria Integrated Care Board (ICB) will be in attendance to provide:

 

·        details of the services available to meet the reproductive health and general health needs of women throughout their life course; and

·        an update on the development of women’s health hubs and how the local hub model will be tailored to meet local population needs.

 

The Director of Place Based Delivery and the Commissioning Delivery Manager from the North East and North Cumbria Integrated Care Board (ICB) were in attendance to provide information on the women’s health programme.

 

The Commissioning Delivery Manager advised that the Department of Health and Social Care (DHSC) had recently published the Women’s Health Strategy for England, which set out 10-year ambitions for boosting the health and wellbeing of women and girls, and for improving how the health and care system listened to women. The strategy encouraged the expansion of women’s health hubs across the country to improve access to services and health outcomes.  The DHSC had recently announced a £25 million investment, nationally, to create new women’s health hubs, as part of the Women’s Health Strategy for England. It was explained that North East and North Cumbria ICB had been allocated £595,000.

 

The scrutiny panel heard that:

 

·        51% of the population were women;

·        59% of women were unpaid carers;

·        78% of the NHS workforce were women; and

·        82% of the social care workforce were women.

 

In terms of national health challenges, the following areas were outlined:

 

·        Although women lived longer than men, women’s heathy life expectancy was less than men.

·        Contraception was difficult to access.

·        45% of pregnancies were unplanned or ambivalent.

·        Abortion rates were rising in women over 22 years old, often because they were unable to access long-acting reversible contraception (LARC), such as the implant or the coil.

·        Maternal mortality was 4x higher in black women and 2x higher in Asian women.

·        Suicide was the leading cause of direct maternal death in the first postnatal year (UK and IE).

·        35% of women who were eligible for screening had not been tested in over three years, which could have saved approximately 1400 lives in England per year.

·        Women from more deprived areas were less likely to take up breast screening.

·        Menopause symptoms lasted for an average duration of 7 years and around a quarter of women suffered severe symptoms.

·        Since 2018:

o   in the most affluent areas of England, there had been a 4-fold increase in the number of women accessing Hormone Replacement Therapy (HRT); and

o   in the most deprived areas of England, there had been a 2.5-fold increase in the number of women accessing HRT.

·        1 in 3 women over 60 years old experienced urinary incontinence. 

·        The symptoms for cardiovascular disease varied for women, and women often received their diagnosis later than men.

·        Osteoporosis and frailty were major causes of morbidity and mortality for women.

 

The priority areas of the Government’s Women’s Health Strategy included:

 

·        Menstrual health and gynaecological conditions;

·        Fertility, pregnancy, pregnancy loss and post-natal support;

·        Menopause;

·        Mental health and wellbeing;

·        Cancers;

·        The health impacts of violence against women and girls; and

·        Healthy aging and long-term conditions.

 

In terms of the regional context, for the area of the North East and North Cumbria, the following information was outlined:

 

·        The gap in life expectancy between the most and least deprived neighbourhoods had increased for both males and  ...  view the full minutes text for item 23/27

The Chair will present a verbal update on the matters that were considered at the meeting of the Overview and Scrutiny Board held on 15 November 2023.

The Chair explained that at the meeting of the Overview and Scrutiny Board, which was held on 15 November 2023, the Board had considered:

 

·        an update from the Executive Member for Finance and Governance;

·        the Executive Forward Work Programme; and

·        updates from the Scrutiny Chairs.

 

NOTED