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 11 December 2023 were submitted and approved as a correct record.

The Director of Public Health and the Mayor and Executive Member for Adult Social Care and Public Health will be in attendance to present the budget in respect of Public Health.

The Director of Public Health and the Mayor and Executive Member for Adult Social Care and Public Health were in attendance to present the budget in respect of Public Health.

The Director of Public Health explained that, in terms of the Council’s overall budget:

·        Feasible savings had been identified, however, there was a remaining budget gap of £6.279m in relation to 2024/25.

·        A Local Government Finance Settlement had been announced on 18 December 2023 and an analysis of impact would be completed in January 2024.

·        The Council’s initial assessment was that the settlement was in line with officer expectations and did not close the 2024/25 budget gap.

·        If the combined effect of the Local Government Finance Settlement and any further identified and assured budget proposals were insufficient to close the remaining budget gap for 2024/25, then it would not be possible for the Council to achieve a legally balanced budget for 2024/25.

·        Chartered Institute of Public Finance and Accountancy (CIPFA) guidance to Section 151 Officers, who were considering issuing a Section 114 Notice, was to engage with Department of Levelling Up, Housing and Communities (DLUHC) and make an application for Exceptional Financial Support (EFS) in order to agree a financial recovery plan that would avoid the requirement for a Section 114 Notice.

·        EFS would provide a temporary funding solution that planned to buy time for the Council to achieve financial sustainability and avoid a Section 114 Notice.

·        Prior to issuing a Section 114 Notice, the Section 151 Officer and Chief Executive (with the support of the Mayor and the Executive) would make an application for EFS.

·        A response from DLUHC in respect of the application, would be received prior to the Council meeting on 28 February 2024.

In terms of Public Health’s budget, it was explained that:

·        To provide assurance, there had been a need to:

o   ensure public health grant spend was compliant with the public health grant conditions;

o   establish clarity of priority public health outcomes through the development of the Public Health Strategy; and

o   develop whole Council action, through clear Service Level Agreements and public health grant allocation.

·        Without robust arrangements in place, there would have been a significant risk to non-compliant use of the public health grant. Failure to comply with the grant conditions or provision of the requisite level of assurance to the Secretary of State could have resulted in the grant payments being reduced, suspended, or withheld. Repayment of whole or part of the grant monies paid may also have been required, which would have had a significant impact on the overall financial position and reputation of the Council.

·        On 20 December 2023, the Executive had approved the Public Health Strategy and the approach for the allocation of the public health grant to the wider Council to ensure spend was in line with the grant conditions.

·        Work had been undertaken across three phases:

o   Phase 1 involved establishing the scale of risk regarding the current allocation of £4.858m.

o   Phase 2 involved the  ...  view the full minutes text for item 23/31

The Consultant in Public Health will provide a general overview/introduction of the topic, including:

·        information on the role of Public Health South Tees in preventing ill-health, specifically:

o   reducing inequalities through the prevention and early detection of disease and supporting the management of long-term conditions; and

·        key data and information on Middlesbrough’s rates of preventable and avoidable mortality and how these compare regionally and nationally.

The Consultant in Public Health was in attendance to provide a general overview/introduction of the topic of Avoidable Deaths and Preventable Mortality, including:

·        information on the role of Public Health South Tees in preventing ill-health, specifically:

o   reducing inequalities through the prevention and early detection of disease and supporting the management of long-term conditions; and

·        key data and information on Middlesbrough’s rates of preventable and avoidable mortality and how those compared regionally and nationally.

The information below was outlined to the scrutiny panel:

·        Life expectancy at birth, for the area of South Tees, was significantly lower than the England average. Members heard that life expectancy for Middlesbrough males was 75.4, which was 4 years below the England value of 79.4 and 9.3 years below the highest local authority area in England. It was commented that gap between South Tees and the England average was continuing to widen.

·        In terms of male life expectancy at birth, there was significant inequalities across the wards in South Tees. Members heard that there was a 14.9 year gap between the lowest life expectancy ward of Central (located in Middlesbrough) at 69.4 years to the highest life expectancy ward of Hutton (located in Redcar & Cleveland) at 84.3 years.

·        In Middlesbrough in 2022 the smoking prevalence rate was 16.5%, which was higher than the England rate of 12.7%. In England, there had been a steady decline in smoking prevalence in the adult population, with a reduction from 19.8% in 2011 to 12.7% in 2022. It was explained that in Middlesbrough, although the rates did tend to fluctuate at times, they had reduced.

·        Middlesbrough’s rates of alcohol-related mortality, alcohol-specific mortality and admission to hospital for both alcohol-specific conditions and alcohol-related conditions were significantly higher than the England average. It was also highlighted that, in Middlesbrough, the number of premises licensed to sell alcohol per square kilometre was also significantly higher than the national average.

·        All local authorities located in the North East region, apart from Northumberland, had a higher rate of those classified as overweight or obese compared to the England average. Middlesbrough's rate was 70.7%, which was similar to the North East rate.

·        In terms of premature mortality during 2019-2021, for all ages, Cancer was the most common cause of death, accounting for 25.6% in Middlesbrough, followed by Dementia and Alzheimer disease and then heart disease. For those under 75, Cancer was yet again the most common cause of death and was even higher at 32%, followed by heart disease and respiratory diseases. Locally, there were higher rates of chronic lower respiratory diseases, accidents and accidental poisoning, when compared to the England average.

·        In terms of cancer screening uptake, there was a clear correlation between the most deprived GP practices and low cancer screening uptake rates with regards to breast, bowel and cervical screening.

·        In terms of causes of death, the scrutiny panel was shown a table that identified all those conditions that were considered treatable/preventable.

A mission of the Joint Strategic Needs Assessment (JSNA) was  ...  view the full minutes text for item 23/32

The Chair will present a verbal update on the matters that were considered at the meeting of the Overview and Scrutiny Board held on 20 December 2023.

The Chair explained that at the meeting of the Overview and Scrutiny Board, which was held on 20 December 2023, the Board had considered:

·        Executive Forward Work Programme;

·        Council Plan 2024 Onwards;

·        2024/2025 Budget and MTFP Refresh;

·        Final Report of the Health Scrutiny Panel - Dental Health and the Impact of Covid-19; and

·        Updates from the Scrutiny Chairs.

NOTED