Agenda item

Meradin Peachey (Director of Public Health) and Dr John Allingham (Medical Secretary, Kent Local Medical Committee) were in attendance for this item.

(1)       The Chairman introduced the item by explaining that he had attended the public health briefing for KCC Members on 24 February and that had been very informative and welcomed the opportunity the Committee had to receive an update.

(2)       In providing an overview, the Director of Public Health explained that it was a timely opportunity because there had been a series of useful documents produced by the Department of Health on public health and the transition to the new system. Within KCC there was a business manager and support staff to assist with the transition as well as to assist in the assessment of recent spending estimates for future public health functions from the Department of Health. These were based on spend in 2010/11 and the Cabinet was currently considering the findings. The Director of Public Health commented that whatever the detail of findings, it had been a useful exercise as the public health spend within the NHS had never been separated out and quantified in this detail.

(3)       Members raised the issue of the different levels of identified spend in Kent compared to other areas. The response was given that the figures related to what was spent on the public health service responsibilities which are transferring to local authorities. The responsibility therefore had rested with Primary Care Trusts and across the South East. The levels of spend had been low, but in London they were higher. This was connected to levels of deprivation and health inequalities. On the subject of spend, the Committee were informed that the PCT cluster had reduced spending on management costs to the £25/head level which was to be allocated to Clinical Commissioning Groups (CCG) in the future.

(4)       Connected with this was work on identifying public health contracts held by the NHS which may need to be transferred to the NHS. Similarly, there was the question of staff. Across the South East there was a low ratio of public health consultants to population, but consultants were the most expensive staff group and the staff mix required would depend on what the authority wanted to do in the area of public health. There were some functions, such as health protection, carried out across the whole Kent and Medway PCT cluster together which did require specific skills. Kent was a pilot area relating to plans for a revalidation scheme for non-medical public health consultants. In terms of wider capacity, KCC had a public health champions scheme to widen understanding. Other ideas were also being looked at.

(5)       Although it was conceded the documents on public health did not discuss borough/city/district councils at length and that the formal public health commissioning responsibilities would remain with the County Council and NHS commissioners, the important role of this tier of Government was acknowledged. The Director of Public Health and Cabinet Member for Adult Social Care and Public Health had met with all the leaders of Borough/City/District Councils to discuss joint commissioning of public health. Several Members provided examples of good practice in this area carried out by Locality Boards, such as that being undertaken in Dover and Shepway.

(6)       The work being done in Dover by the District Council and Clinical Commissioning Board with KCC was also mentioned by the Director of Public Health. This was connected with the work of the Health and Wellbeing Board, which had a key role to play.

(7)       One role of the health and Wellbeing Board will be to produce the Joint Strategic Needs Assessment (JSNA) which will be used to inform commissioning. More broadly, with the move of public health intelligence into KCC, there was to be an offer to GPs to provide public health support for commissioning decisions.

(8)       This provided an opportunity for KCC to develop its own vision. This would look at issues such as inequalities and would be linked to Bold Steps for Kent. There had been a good turnout at the Members briefing on 24 February which showed there was good Member engagement as well.

(9)       Dr Allingham took the opportunity provided by this item to update the Committee on CCG developments. There had been a reduction in the overall number and some others already shared back office functions, so may merge in the future. The emerging CCGs were tied into PCT commissioning structures now and while it was still too early to definitely say, the final number may be 1 or 2 in East Kent, 1 in West Kent, with another CCG possibly joining up the ones in Swale and Medway and the one covering Dartford and Gravesham.

(10)     RESOLVED that the Committee note the report and thank the Director of Public Health for her timely and informative update.