Agenda and minutes

Health Reform and Public Health Cabinet Committee - Tuesday, 11th July, 2023 10.00 am

Venue: Council Chamber, Sessions House, County Hall, Maidstone. View directions

Contact: Dominic Westhoff  03000 412188


No. Item


Apologies and Substitutes

To receive apologies for absence and notification of any substitutes present

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Ms K Constantine and Kelly Grehan were in attendance virtually.



Declarations of Interest by Members in items on the agenda

To receive any declarations of interest made by Members in relation to any matter on the agenda.  Members are reminded to specify the agenda item number to which their interest refers and the nature of the interest being declared

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Mr Jeffrey declared an interest in item 7 on the agenda and noted that he received remuneration from the Roman Catholic Arch Diocese of Southwark and fundraises for the Society for The Protection of Unborn Children.



Minutes of the meeting held on 18 May 2023 pdf icon PDF 240 KB

To consider and approve the minutes as a correct record.

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RESOLVED that the minutes of the meeting held on 18 May 2023 were correctly recorded and that a paper copy be signed by the Chair.



Verbal updates by Cabinet Member and Director

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  1. Mrs Bell provided an update on the following:

National Awareness Weeks Update – Mrs Bell noted that in June: Carers Week, Learning Disability Week and Shared Lives Week had taken place with support from Kent County Council (KCC). The 2-9 July 2023 was Alcohol Awareness Week and to mark this KCC and partners were encouraging residents to take the ‘Know Your Score’ test, an online quiz which would help show how drinking was affecting yourself and others, depending on the score it would offer appropriate advice on where to find help. Specialist help was available for dependent drinkers. Mrs Bell said that last year KCC support services provided help to over 5000 people to cut down their drinking or break the cycle of alcoholism. These services were discussed at the bi-monthly Kent Substance Misuse Alliance meeting, which Mrs Bell chaired. More advice and support can be found on the KCC website: Alcohol and drug support - Kent County Council

Kent and Medway Integrated Care Strategy Focus Group - Mrs Bell thanked Members of the committee, Dr Anjan Ghosh and the Public Health Team for their attendance at the focus group on 13 June 2023 and welcomed any further feedback on the 6 priorities of the interim strategy. The feedback would be reported back and contribute to the engagement activities that would take place across the summer and the results from a survey that was open to the public, which could be found on the Lets Talk Page of the KCC website and here: Kent and Medway Integrated Care Strategy | Have Your Say In Kent and Medway.

Deputy Chief Medical Officer Visit to Kent – Mrs Bell said that on 26 May 2023 one of the three deputy Chief Medical Officers for England, Dr Jeanelle de Gruchy, visited Kent to see first-hand Public Health funded initiatives across the county. Mrs Bell, Public Health officers, local Members and KCC Leader Mr Roger Gough accompanied Dr Jeanelle de Gruchy to services in Gravesend, Sheerness and Maidstone. Services visited included: Hypertension Heroes, a voluntary organisation that goes into the community to get those at risk to get blood pressure readings, Sheppey Matters, a healthy living centre and Change, Grow Live Maidstone, a community substance misuse treatment and recovery services and an inpatient centre for those with alcohol addiction issues. Mrs Bell noted that Dr de Gruchy was very interested in the facilities visited and they spoke on health inequality and wider determinants of health challenges.

  1. Dr Anjan Ghosh provided an update on the following:

Integrated Care Strategy Update – It was said that workshops were taking place with all district Councils across Kent, 5 had taken place and the rest were expected to be completed by early August 2023. These workshops would be similar in format to the one which had taken place for Kent County Council Members. The workshops aimed to identify local priorities to shift the dial on prevention and inequalities. There was also an upcoming Health and Well-being conference  ...  view the full minutes text for item 263.


23/00032 - Kent Drug and Alcohol Contract Commissioning pdf icon PDF 205 KB

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Matthew Wellard, Interim Senior Commissioner - Public Health, was in attendance for this item.

  1. Matthew Wellard introduced and provided an overview of the report. 10-month extension for 3 contracts, East Kent, West Kent and Young Persons, which would extend the contracts from April 2024 to January 2025. And an endorsement was sought for a re-procurement of recovery housing due to changes in the service specification.
  2. In response to questions from Members, it was said.

(a)   Asked by the Chair if there could be earlier notice to discuss extensions on re-procurement rather than at the end of the contract so that other options could be considered.

(b)   A Member asked that it is ensured in this instance, and with all other service re-procurements, that the users be protected during the cross-over phase.

  1. RESOLVED recommendations agreed as outlined in the report.



23/00062 - Long-Acting Reversible Contraception in Primary Care Service pdf icon PDF 298 KB

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Laura Bush, Senior Commissioner - Public Health, was in attendance for this item.

  1. Laura Bush introduced and gave an overview of the report. It was noted that Local Authorities were mandated to provide sexual health services, and Long-Acting Reversible Contraception in Primary Care (LARC) commissioning was part of supporting population health. The committee was asked to approve commissioning arrangements and award new contracts for delivering LARC in primary care.
  2. In response to questions from Members, it was said.

(a)   Asked by a Member if the costs of meeting demand were reimbursed through the public health grant down the line or if the money would have to be found elsewhere. Ms Bush said that the average cost was calculated and there would be a return on investment. Mrs Tovey noted that very high demand would be a cost pressure.

(b)   Asked about the 1-year contract with the two 1-year extensions and if this was the most appropriate way to award the service contract rather than a fixed longer-term contract. Ms Bush said the reason for the extension was due to the potential impact of the Service Transformation Programme and the role of the ICB which could affect how the service could be commissioned. Mrs Tovey said that providers were used to 1-year contracts as that had been the norm previously, however after the completion of the Transformation Review they would be looking at a longer-term plan.

  1. RESOLVED that the recommendations be agreed as outlined in the report.



Performance of Public Health Commissioned Services (Quarter 4 2022/2023) pdf icon PDF 132 KB

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Victoria Tovey, Head of Strategic Commissioning – Public Health, was in attendance for this item.

  1. Victoria Tovey said that the overall position was positive, with 11 green and 4 amber Key Performance Indicators (KPIs). Mrs Tovey highlighted the One You Kent deprivation metric, and that due to a refresh there had been some data improvement moving the target from amber to green. The position had stabilised post-Covid-19 and would be looking at stretching the targets going forward.
  2. In response to questions from Members, it was said.

(a)   Asked about what pressure points had been identified going forward. Mrs Tovey said that reviews were ongoing, and some targets would be increased in the following year. Health Checks were being looked at as they had been green for some time. But others would be reviewed and stretched as part of a continuous review process.

(b)   Asked by a Member about the Mental Health and Wellbeing Services metric and that the satisfaction rates reported did not correspond with her experience or with the reports from residents. It was noted that younger people were struggling to access these services. Mrs Tovey responded that the metric only focussed on adults and those who used the service not all those with a mental health or wellbeing need. Mrs Tovey noted that there was a range of services available for young people, but some areas were a challenge with long waits. More information would be provided outside the meeting and the Member was invited to discuss any specifics they had. Jessica Mookherjee said that it was recognised the challenges faced in Thanet with a higher suicide rate seen in the east of the county. It was said that improvements were needed in the provision of mental health support and the service was aware of this and active work was ongoing.

  1. RESOLVED The Performance of Public Health Commissioned Services (Quarter 4 2022/2023) was noted.



Public Health Communications and Campaigns Update pdf icon PDF 320 KB

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Jo Allen, Marketing and Resident Experience Partner was in attendance for this item.

  1. Jo Allen introduced the update. Ms Allen gave an overview of the paper and highlighted some key areas, including new colour-coded weather alerts, adult obesity campaign, drug and alcohol support services and vaping campaign.
  2. In response to questions from Members, it was said.

(a)   Asked about the immunisation campaigns and the plans going forward. Ms Allen said work was taking place with Public Health colleagues about the next stage and more information would be provided later in the meeting.

(b)   Asked by a Member about internet bullying and campaigns related to this. Ms Allen said the point would be taken away and reported back.

  1. RESOLVED the Public Health Communications and Campaigns Update was noted.



Update on the Start for Life Programme including Infant feeding pdf icon PDF 418 KB

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Wendy Jeffreys, Consultant in Public Health, was in attendance for this item.

  1. Wendy Jeffreys introduced the update. In an update since the report was published, it was said that two centres would open on 13 July 2023 as test sites. The sites had been identified as areas with greater needs, in Millmead Margate, which would focus on children 0-5 and their families, and the other in Seashells Sheerness, which would focus on the wider 0-25 provision. An update was also provided to Members on the public consultation on Family Hubs Start for Life Programme due to begin on 19 July 2023 for 8 weeks. As Kent was a trailblazer authority it would have to demonstrate how it was going further than other Local Authorities.
  2. Dr Ghosh wanted it to be noted that Start to Life was a part of the overall Family Hubs model, the governance of which sits with the Children and Young People directorate. However, infant feeding, prenatal mental health and parent-infant relationship were all widely recognised as Public Health issues so there would be a separate governance pathway under a Start for Life board that would be chaired by Dr Ghosh, while the Family Hub board would be chaired by the director for Children and Integrated Services. Both would report formally to the Children’s Transformation Board, within the ICB, which was chaired by Sarah Hammond. The executive decision-making route would take place within the Health Reform and Public Health Cabinet Committee to be taken by the Cabinet Member for Adult Social Care and Public Health.


  1. In response to questions from Members, it was said.

(a)   Asked by a Member to ensure that the approach be cohesive going forward given the cross-over between Public Health and Children’s, Young People and Education (CYPE). Ms Jeffreys confirmed that close working with CYPE was ongoing.

(b)   Asked by a Member about the divergent breast-feeding figures found across the county and if a further breakdown of each hospital could be provided so that the methods used in higher-performing hospitals could be studied and replicated. Ms Jeffreys said there can be many reasons why there was a difference in the rate of those babies receiving the first feed of breast milk, including health needs and personal choices. It was noted that differences between the trusts were longstanding and may reflect generational decisions.

  1. RESOLVED that the recommendations be agreed as outlined in the report.



Update on the Immunisation Coverage in Kent with a Focus on Children pdf icon PDF 1 MB

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Dr Ellen Schwartz, Deputy Director of Public Health, was in attendance for this item.

  1. Dr Ellen Schwartz introduced the update and highlighted some key points. It was noted that immunisation rates had stabilised following a dip witnessed during the Covid-19 pandemic.
  2. In response to questions from Members, it was said.

(a)   Asked by a Member about the geographical data and why the lowest uptake areas were not uniform across the different vaccine types, was there any reason to explain this. Dr Schwartz said this was difficult to answer. It was noted there had been disruption with the MMR vaccine due to now discredited links with autism. Uptake rates were usually associated with deprivation level and family and community attitudes and values.

(b)   A Member asked what strategy was needed to overcome the spread of disinformation and conspiracy theories found on the internet. Dr Schwartz noted that the Council did not provide or commission the immunisation services but there were options available by working across the ICB and the Prevention sub-committee. There was a need to ensure that all system partners were clear on the importance of immunisation and to utilise a communications campaign which would target specific concerns.

(c)    A Member expressed concerns that Thanet was consistently at the lower end of the immunisation take-up rate and without intervention, the gap between those areas with lower and those with higher rates of take-up would continue to grow. Dr Schwartz said that the effectiveness of core childhood immunisations was overwhelmingly beneficial, and this should be expressed to residents. It was noted that they were not aware of any areas where the trend was indicating that the position was worsening but areas with low take-up should be supported and targeted.

  1. RESOLVED the update was noted.



Work Programme pdf icon PDF 109 KB

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RESOLVED that the Work Programme 2023/24 be noted.