Agenda item

Mark Adams, Director of Public Health for South Tees

The Director of Public Health for South Tees delivered a presentation to the Live Well South Tees Board on a Whole System Approach to Prevention and Inequalities.

 

The Director of Public Health provided context to the Board on the levels of deprivation and inequalities in both Middlesbrough and Redcar and Cleveland.

 

·        Middlesbrough is ranked number 3 out of all English Unitary Authorities (out of 59) in the Index of Multiple Deprivation (IMD) and number 5 out of all 317 authorities in England

·        In Middlesbrough 48.840 per cent of lower super output areas are among the 10 per cent most deprived

·        Middlesbrough has the highest percentage of children living in poverty at 40% and Redcar is also in the top 10

·        Life expectancy gap between the most and least deprived quintiles for Middlesbrough gap for males is 11.3 years and females 8.8 years. Redcar for males 12.1 years and females 7.4 years

 

Social Detriments

 

·        Insecure employment

·        Economically inactive

·        Appropriate housing

·        Homelessness

·        Public spaces and green areas

·        Life expectancy

·        Deaths of despair

 

ICB Approach

 

The Core20Plus5 approach is designed to support Integrated Care Systems to drive targeted action in healthcare inequalities improvement.

 

The key clinical areas of inequalities in adults:

 

·        Maternity

·        Severe mental illness

·        Chronic respiratory disease

·        Early cancer diagnosis

·        Hypertension case finding

 

The key clinical areas of inequalities in children:

 

·        Asthma

·        Diabetes

·        Epilepsy

·        Oral health

·        Mental health

 

Prevention

 

Primary Prevention, population level universal action

 

·        Aim: reduce the incidence of diseases and risk factors

·        Can also include targeting high risk groups

·        Largely a political choice (legislation, vaccination programmes

 

Secondary Prevention, systematic early detection

 

·        Aim: shorten duration and severity of disease

·        Systematically detecting the early stages of disease and intervening early

·        Screening for early diagnosis (cancer screening, primary care case finding, Healthy heart checks reducing cholesterol, reducing high blood pressure)

 

Tertiary Prevention, mitigating the long-term impact of disease and supporting

 

·        Aim: restore functioning within limits of disease

·        Supporting self-management

·        Rehabilitation and reablement

 

Information was provided to the Board regarding the effects of:

 

·        Smoking

·        Alcohol

·        Obesity

·        Screening

 

Recommendations

 

The following recommendations are from “Health and Wealth – Closing the Gap in the North East” Report of the North East Commission for Health and Social Care Integration

 

·        Establish an ambition to radically increase preventative spending across the health and care system and wider determinants of health and wellbeing

·        Partners across South Tees should integrate preventative action and action to tackle inequalities in all decisions.

·        Increased preventive spend should be assigned to a dedicated Preventive Investment Fund managed on a cross-system basis and bringing together contributions from all partners who stand to benefit from the expected savings, including central government.

 

Proposal: South Tees Prevention Board

 

·        Sub-committee of the statutory Health and Wellbeing Board – connecting work in the ground with policy – making recommendations to the HWB

·        Provide a link between the Health and Wellbeing Board and partner organisations with roles in the delivery of ill health prevention plans and support the broadening of the scope of the PH IHP programme.

·        Provide a setting for the exchange of information, scrutiny of plans and analysis of data with all partners with a role in the delivery of ill health prevention across South Tees, ensuring that they are acting jointly and effectively to improve the population’s health

 

 

 

 

 

Objectives

 

·        Provide assurance to the Health and Wellbeing Board that plans are in place to improve the population’s health addressing some of the main challenges experienced locally

·        Provide assurance on the Care Act Prevention Duty of Councils

·        Provide governance and accountability framework for those with an ill health prevention remit – a mechanism to discharge prevention duties across the system

·        Regularly review; progress against milestones, issues, risks, actions, data and learning through ill health prevention programme updates

 

The Live Well South Tees Board were asked to agree to the following recommendations:

 

·        Establish a Prevention Board as a sub-committee of the Live Well South Tees Board

·        Approve sign up to the Healthy Weight Declaration as a tool to gain leadership support and promote the Local Authority’s commitment to addressing obesity.

 

ORDERED:  The Live Well South Tees Board agreed to the proposed recommendations