Agenda item

Public Health England - Nicky Saynor (Health & Wellbeing Programme Manager) & Terry Blair-Stevens (Public Health Consultant in Health & Wellbeing)


1.            The Chairman welcomed Nicky Saynor, Health and Wellbeing Programme Manager and Terry Blair-Stevens, Public Health Consultant in Health and Wellbeing, both from Public Health England (PHE).  Both guests were invited to introduce themselves and gave a background to their work. 


2.            Terry explained the differences between the role of PHE and Government Ministers (the Select Committee had previously heard from Andy Staniford, Senior Policy Advisor, Department for Digital, Culture, Media and Sport).  He explained that the Government was responsible for setting policy and PHE provided evidence to inform the Government’s strategy and policy making.  PHE accessed evidence available through existing public sources and international databases.  There was a need to be clear about the questions being asked and the measures being looked at.    The officers were trained to critically appraise the evidence.


3.            Terry gave Members a presentation which is available online here and via this link:


4.            Terry explained that there was a difference between loneliness and isolation and the relationship between the two was complex and varied between individuals.  Referring to impact on health and wellbeing there were links between loneliness and social isolation and dementia.  Terry described a study which had looked at nuns, living long and healthy lives with high cognitive abilities.  The nuns donated their brains to science and the scientists found that their brains had the same level of aging brain disease as those who were not nuns, therefore it was thought that the social connections of nuns living together was keeping their brains active. 


5.            Terry referred, briefly, to the “Men’s Sheds” programme in Kent specifically designed to prevent suicide and loneliness in men.


6.            Terry explained that research suggested that those aged 16-24 were significantly more likely to feel lonely often/always than the other age groups, it was considered that the key to reducing this was to build personal resilience.  A Member asked if there was any correlation with the use of social media in that age group?  Terry stated that there was evidence around how it affected their self esteem and how well liked they were.  Nicky commented on the pressure and pervasiveness of social media.  There had been limited research on social relationships and the ways in which people interact online as opposed to on social media.  A Member asked if research had been done on different cohorts of young people, such as those in boarding school which was another environment which was 24/7 as it was considered social media was?


7.            In response to a query about whether studies had been undertaken on children under the age of 16 years Terry explained that there were studies available, however these were affected by the way in which questions were asked.  The term ‘loneliness’ could be stigmatising for all age groups.  It was recommended that alternative language was used that enabled people to feel more open and confident about discussing their experience of loneliness. 


8.            Evidence suggested that there was a significant correlation between low socioeconomic status and social isolation.  Terry explained that there was strong evidence that people from disadvantaged backgrounds experience more social isolation and loneliness.  However, it should be remembered that that experience could happen to anyone. 


9.            Referring to physical disconnection Terry explained that there had been a study in Belfast with older people in a community who were offered an area of green space, but they did not want it because of the fear that young people would congregate in it.   Members discussed the benefits of locating cafes in local parks which then could become community hubs for example. 


10.         Nicky stated that it was important to recognise that more was needed than the bricks and mortar of cafés; they were important to facilitate intergenerational cohesion.  Terry also pointed out that often there was no additional cost to the local authority of because the cafes could be rented out.  It was important to look at how space was managed for the benefit of the community.  There were also opportunities for schools and other groups to be involved.


11.         Terry explained that male care givers were likely to be more isolated because females tended to have more contacts. 


12.         It was considered that there had not been enough research on the oldest old (85+).  There were numerous factors to consider such as being in residential care settings, in which residents reported that they didn’t feel sufficiently close to family and that they felt disconnected from communities.  There was strong evidence that focussing Public Health intervention on those most at risk had the greatest impact.  Efforts were concentrated on those who lived alone, had poorer health, and were recently bereaved or were carers, rather than all older people.  There was a focus on positive mental health promotion this was more likely to reduce feelings of social isolation and loneliness and included helping people to realise their mobilities and feel a sense of belonging and worth. 

13.         A Member questioned the statistic set out in the presentation which stated that “57% of 85-year olds reported ‘never’ feeling lonely” and whether it was a surprise.


14.         A Member asked if there was a correlation between those who were clinically depressed and those who were lonely.  Terry explained that there most definitely was.  If you were depressed you might not have the confidence or energy to connect with your partner and children let alone with the wider population. 


15.         Terry and Nicky explained that group interventions were much more beneficial than one to one (with the exception of the recently bereaved or those who were recently discharged from hospital).  Work was targeted in particular circumstances.  Nicky stated that there was evidence that with certain groups 1 to 1 intervention worked well in specific situations.  Targeted 1 to 1 was good but the general approach to befriending was worth questioning. 


16.         The Select Committee discussed social isolation across the life course.  It was considered that being in work was a positive health outcome and related to better health.  In relation to retirement and later life it was important to promote good quality work. 


17.         In relation to wider public health interventions; there were issues around supporting older people such as ensuring there were accessible public toilets and seats. 


18.         Terry also raised the promotion of physical activity for the over 50s and tackling drugs and alcohol.  It was important to look out for signs and symptoms and there were opportunities to identify lonely people through health screening.


19.         In conclusion there were cross cutting opportunities between public services and with the private sector and community and voluntary sectors.  There were clear opportunities for the local authority to work with the NHS. 


20.         A Member asked whether there was any research linking eating disorders to social isolation and loneliness and with the ex-forces and their needs?  Terry explained that some groups did experience more social isolation and loneliness than other groups.   


21.         One Member commented that the act of volunteering was perhaps one of the best ways of preventing social isolation and loneliness.  At certain points in life society could pick a person up and encourage them to spend two days a week volunteering with meals on wheels for example.  Terry and Nicky agreed and thought that this could be more ambitious.  Information would be shared through KCC’s public health team as this was the most direct link.


22.         Referring to social prescribing Nicky stated that by 2020 it was expected that there would be social prescribing in every GP practice.  There was a need for specialists, who have an idea of what the community needs, to advise people who visit their GP with concerns around loneliness.  The Chairman concurred with this view, that trained people were needed to ensure that GPs felt confident that the residents would be helped and sent to the right place.   


23.         The Chairman thanked the guests for attending the Select Committee hearing and for answering Members’ questions. 

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