Agenda item

Sarah Slater, Advanced Public Health Practitioner, Public Health South Tees

The Advanced Public Health Practitioner for Public Health South Tees presented the South Tees Health Protection Assurance Report 2023/24 to the Live Well Board.

 

Members heard that Local Authorities through their Directors of Public Health, required assurance that appropriate arrangements were in place to protect the public’s health.  The report provided a summary of the assurance functions of the Public Health South Tees Health Assurance Partnership and reviewed performance for the period of 1 April 2023 to 31 March 2024 for the Live Well South Tees Board.

 

The report considered the following key domains of Health Protection.

 

·        Protection from environmental hazards

·        Prevention of communicable diseases and outbreak management

·        Improvement of community resilience around health protection issues

·        Increase equitable uptake of immunisation programmes

·        Increase equitable uptake of screening programmes 

 

The Advanced Public Health Practitioner highlighted the following to the Live Well Board Members:

 

Environmental

 

·        Air Quality - Middlesbrough and Redcar & Cleveland councils produce annual Air Quality Status Reports for DEFRA, showing compliance with national air quality standards and a steady decline in NO₂ levels primarily caused by road vehicles; both councils promote sustainable transport and low-emission vehicle use, supported by a joint Clean Air Strategy (2024) with defined actions to improve and maintain air quality in the South Tees area.

 

·        Noise - The Public Protection Service addressed noise complaints and ensured compliance with licensing laws to prevent public nuisance; in 2023-24, Middlesbrough recorded 983 complaints (down from 1203 in 2022-23) with minimal enforcement action (4 abatement notices), while Redcar & Cleveland recorded 629 complaints (slightly down from 634) with limited use of Community Protection Warnings and Notices, primarily related to barking dogs, loud music, and parties.

 

·        Housing Standards - Good quality housing was essential for health and well-being, with Middlesbrough and Redcar & Cleveland Councils addressing housing standards through statutory powers, Selective Landlord Licensing (SLL) schemes, and responses to tenant complaints; SLL schemes had identified numerous Category 1 and 2 hazards, prompting remedial actions and enforcement where needed, while broader efforts focused on tackling damp, mould, and energy efficiency, alongside national legislative changes to improve housing conditions and tenant protections.

 

·        Houses of Multiple Occupation (HMOs) - HMOs, often housing vulnerable residents, require licensing for properties with 5+ occupants from multiple households. Middlesbrough had 240 licensed HMOs, and Redcar & Cleveland had 32. Inspections ensure compliance with housing standards, including fire and electrical safety, with enforcement actions taken as needed.

 

·        Affordable Warmth - Redcar & Cleveland’s "Warm & Well" service and Middlesbrough’s South Tees Affordable Warmth Partnership provided advice and access to grants for energy efficiency. Initiatives like LAD2 and HUG schemes had improved over 200 homes, while partnerships like "Stay Safe and Warm" assist residents struggling to heat their homes.

 

·        Control of Environmental and Foodborne Infections:
In 2023-24, Middlesbrough inspected 593 food businesses (75% rated 5) and Redcar & Cleveland inspected 648 (91% rated 5). Regulatory actions included business closures for hygiene breaches. Both councils overseen cosmetic treatment premises to ensure public health compliance, with enforcement taken against unregistered operators.

 

·        Emergency Preparedness:
The Cleveland Emergency Planning Unit handled 16 incidents in 2023-24, with training and exercises to enhance resilience. Multi-agency meetings addressed risks like waste fires and extreme weather, while community resilience initiatives, including a grant scheme, were trialled.

 

·        Severe Weather:
The South Tees Adverse Weather Plan consolidated heat and cold weather strategies, ensuring weather alerts were cascaded to councils, care facilities, schools, and health partners to prepare and protect vulnerable populations during extreme weather events.

 

·        Excess Winter Deaths:
In 2021-22, Middlesbrough recorded 20 excess winter deaths (13% higher for ages 85+), while Redcar & Cleveland had zero (1.6%). Compared to 11% for England. Most deaths resulted from circulatory and respiratory diseases, influenced by factors like temperature, and existing circulatory /respiratory diseases rather than hypothermia.

 

Communicable Diseases

 

·        Covid-19, Flu and RSV cases were monitored, with efforts made to reduce local admissions to alleviate winter pressures.

 

·        Scarlet fever and Group A strep returned to normal levels in February 2023 after high levels from September 2022, they remained normal throughout 2023-24.

 

·        HIV rates increased in 2023, there was an increase in Middlesbrough to 23 cases (from 7.4 per 100k to 15.1 per 100k). Redcar & Cleveland had a low rate at 4.3 per 100k.  HIV testing rates had improved from 2020, with a focus on reducing transmission and late diagnosis.

 

·        A Syphilis outbreak in Teesside impacted heterosexual men and women in the 18-34 age group.  Gonorrhoea rates also increased.  A Tees wide campaign was deployed to increase condom use amongst the younger age group.  High chlamydia detection was recognised as a good thing as it prevented onward transmission.

 

·        TB was linked closely to deprivation and health inequalities and was prevalent in those with alcohol/drug misuse, homelessness, prison, mental illness and asylum seekers.  Middlesbrough had the highest rate in the Northeast in 2022 according to the latest data available.  

 

Community Resilience

 

•        Making Every Contact Count trained 506 people in 2023-24 total with a total of 1049 people trained.

•        South Tees NHS Foundation Trust embedded Making Every Contact Count into training, campaigns and communications

•        Health Protection Assurance workshops in 203-24 were well attended, 88 people attended the Children and Young People workshop and 30 attended the adult’s workshop.

•        HealthStart – focused on improving physical health in schools

 

Immunisation

 

Redcar & Cleveland had always performed better in immunisation uptake rates, there are links with levels of deprivation and issues with vaccine records for non-English children.

 

·        Middlesbrough was below 95% target for all 13 indicators, Redcar & Cleveland was below for 8 of 13 indicators.  Atrial was taking place in Middlesbrough and Hartlepool with a wide range of partners – GP, midwifery, registry office, promoting 5 steps to protection, school admissions, nurseries, promoting it’s not too late.

 

·        The seasonal uptake was similar to national trends, Redcar & Cleveland was slightly above England, Middlesbrough slightly below for covid and flu

 

·        Older adults’ uptake was similar to England with PPV (pneumonia) 71% compared to shingles at 48%

 

Screening

 

• One of the most effective public health intervention for protecting against serious illness
• Newborn screening at 97.8% compared to England 99%
• The National Child Measurement Programme indicated growing obesity concerns in Middlesbrough (Reception:30% - Y6:40%) and Redcar & Cleveland (Reception:27% - Y6: 39%) – which leads to implications for NHS.

 

The Live Well Board thanked the Advanced Public Health Practitioner for Public Health South Tees for attending and providing the update to the Board and noted the content of the report.