Agenda item

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.

2. 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 with The Kent Association of Local Councils on 17 July 2023 which would explore similar themes with Parish Councils. Work was also ongoing with KCC directorates and Health and Care Partnerships to inform and develop the strategy.

Public Health Service Transformation Programme – Dr Ghosh said this was a significant programme with work due to begin. It was noted that 80-90% of Public Health contracts were with two major NHS providers, and both provider contracts were due to expire in March 2025. There had also been a change in the commissioning landscape with the new Integrated Care Board (ICB) and Health and Care Partnerships which provided new opportunities for alignment. Dr Ghosh informed the committee that The Public Health grant had a 3.3% increase this year and a 1.3% increase in 2024/2025, due to inflationary and cost pressures this was in effect a real terms cut, which was a further driver of the service transformation programme. It was noted that a change to procurement regulation was anticipated later in the year in the Provider Selection Regime. An ongoing review would be monitored. The process was about to start and would be a yearlong review programme with three phases, the first of which, planning and scoping, was complete. Between July and December, the main body of the review would take place, an update on which would be provided at the September meeting of the committee.

Public Health Update – Dr Ghosh provided an update on the work being undertaken by the Public Health team, including:

• Health protection including work with refugees and asylum seekers ongoing with a concern about infectious diseases being monitored.
• Work was ongoing on the wider determinants of health.
• 18 July 2023 an event would take place at the Turner Contemporary in Margate on suicide prevention. This would showcase 11 projects, 8 funded by a £1,000 grant and 3 with a £5,000 grant, which would highlight the issue of hope in suicide prevention.
• Work was ongoing with prevention under the NHS framework Core20PLUS5, Public Health were in the process of identifying the plus group, outside the 20% most deprived. It was noted that Gypsy, Roman and Traveller (GRT) was a priority being considered as part of the plus group.
• The three sub-committees of the ICB, Prevention chaired by Dr Ghosh, Health Inequalities chaired by James Williams and Population Health Management chaired by Vincent Badu, were at the final stage of developing work plans.
• The Joint Commissioning Manging Group had agreed to create a joint ageing well strategy to build on the World Health Organisation (WHO) model of creating an age-friendly community. Work had not yet started but was being scoped.
• It was noted that Public Health had not been successful in its bid to become a Health Determinants Research Centre this year due to very strong competition but would try again next year. It was noted that brick-by-brick development was ongoing with some funding secured for at least 5 projects totalling £300,000 and a small team was in place to see how this work would proceed.
• An update was provided on Public Health as a teaching base, with work experience offered.
• The whole system obesity work was ongoing, the Public Health team had rolled out an approach for a Healthy Weight Management Programme in all four Health and Care Partnerships, a cultural shift to partnership working utilising place-based strategies that promoted healthy weight amongst the population. Primary care providers and their network had been given physical activity and healthy eating resources and GPs and practice nurses were given training on child weight management. It was also noted that an agreement had been reached to restrict advertising of high fat, salt and sugar products in Greenhithe, Gravesend and Dartford bus shelters and was expected to be enacted county-wide at the end of 2023 or the beginning of 2024. Work was ongoing with rail stations to redistribute abandoned bicycles back into the community at targeted groups.
• Work was ongoing with the Active Kent Team to provide bicycle training to black, Asian and minority ethnic groups. Also, to promote physical activity among those with mental health challenges. It was noted that Active Kent had released their Move Together Strategy for 2023-27.
• Public Health was working proactively with trading standards officers and the KCC communications team to address the rise of young people taking up vaping and to reduce sales of vapes and e-cigarettes to young people and children.

3. In response to questions from Members, it was said:

(a)   The Chair asked if the Kent-wide bus shelter advertising code was legally enforceable or voluntary. Dr Ghosh said he would come back to the committee on this.

(b)   The Chair asked for an update on the number of cases of Monkey Pox and Covid-19. Dr Ghosh said Kent's rate was at 2.4 per 100,000, the lowest rate recorded for Covid-19. It was noted that there was no cause for concern regarding Monkey Pox cases at this time but would be monitored going forward.

(c)    A Member asked about cycling training and why it was only being provided to black, Asian and minority ethnic groups and not wider. Dr Ghosh said it was being targeted at specific groups, this was a starting point and would expand further going forward.

(d)   Asked by a Member if local children’s partnerships groups came up during the District Council workshops. Dr Ghosh said they did come up and the critical role they had was recognised.

(e)   Asked how the evidence of wider determinants of health was being collected. Dr Ghosh explained that a literature review had been done to understand what evidence was available. Overall, the evidence was patchy due to the use of national data not applying directly to the local challenges found in Kent and it was difficult to link prevention measures with outcomes, but work was ongoing. A range of other tools were available to Public Health, including cohort modelling and system dynamics modelling, to collect richer data. This was a novel approach not believed to be happening elsewhere in the country.

(f)     In response to a question on where medical school students were placed, it was said that they come under the Kent and Sussex deanery and they would decide on placements.

(g)   A Member asked how closely they were able to monitor emerging global threats and their potential impact on Kent. Dr Ghosh and the UK Health Security Agency (UKHSA) had a national and international surveillance team. The UKHSA had local branches, including one in Kent, that work closely with Kent Public Health and would share information if any threats became likely to reach the UK or Kent.

(h)   A Member praised the communications campaign on vaping and underage use and requested further details on the plan going forward. Clarification was sought on the Public Health position of using vapes and e-cigarettes as part of the strategy to get adults to quit smoking. Dr Ghosh responded that vapes were still part of the strategy to get adults to quit smoking but the fear that vapes could be a gateway to a tobacco habit was recognised but overall vaping was seen as a less harmful alternative to smoking. There was a concern that vaping was being pushed by the tobacco industry onto young people and children and actions were being taken to proactively mitigate this. Jo Allen gave a further update on the advertising and communications campaigns going forward. Further materials were expected to be provided in time for school summer holidays and a national campaign was expected to follow, a Kent-based campaign was ongoing to be targeted at young people, schools, parents and carers expected to go live in autumn and winter 2023/24.

(i)     Asked if alternative campaigns on social media and utilising influencers were being looked at as this was what most engaged children. Jo Allen responded that currently most channels were focussed on older people, but work was being done to understand exactly how best to reach out to young people.