Agenda item

Abraham George, Consultant in Public Health was in attendance for this item

1.    Mr George introduced the 2025 Kent Joint Strategic Needs Assessment (JSNA) exception report which highlighted the health needs assessments, reports and analyses completed in 2024, as well as key population health figures. The JSNA allowed both the Board and the Kent and Medway Integrated Care Partnership to be aware of the relevant issues and trends which needed to be addressed and reflected in the key priorities and outcomes of the Integrated Care Strategy and district local plans. Mr George highlighted that there had been a total of 12 needs assessments completed over the last year (highlighted throughout the report) by the KCC Public Health team and other partners organisations . Where available, final reports were published on the Kent Health Observatory (KPHO) website . Mr George highlighted the key findings from the report and welcomed questions.

2.    In response to comments and questions from Members of the Board, it was noted:

(a)  In response to members interest regarding the Kent and Medway Care Record (KMCR) and its promising application, Mr George explained that the KMCR which had been developed over several years as part of the NHS's national digital and data infrastructure program, was a shared care record contracted to GraphNet. Initially intended for direct care planning, its use expanded during COVID to include population health intelligence, aiding JSNI-related work. Despite its benefits, Mr George highlighted the need for a strategy to incorporate non-social care NHS datasets to better understand the broader at-risk population. Efforts were underway, particularly in West Kent Health and Care Partnerships (HCP), to explore data integration from local councils and voluntary organisations. The record's risk stratification tools had been useful for profiling high-risk patients

(b)  Members expressed appreciation for the data available and noted its usefulness in addressing inequalities, with specific reference made to  Tunbridge Wells. A request was made that the maps from the KPHO were better labelled to help focus on communities with problems. Mr George agreed to further discuss the suggested improvements offline.

(c)  With regard to A&E admissions for children and whether there was any assessment of other influencing factors, such as primary care availability or temporary housing conditions, which identified commonality of need; Mr George explained that the current public health data sets were high-level and did not allow for detailed analysis. However, with the Kent care record, there was potential to link multiple data sets to better understand these risk factors. He emphasised the need to collaborate with NHS healthcare partnership colleagues to ensure accurate interpretation of the analysis.

(d)  In response to the healthy weight statistics for children and whether local efforts had made an impact on trends becoming more static as opposed to worse, Dr Ghosh emphasised the importance of looking beyond Kent and comparing its data with similar areas like Hampshire or Surrey, but with caution. He acknowledged that maintaining current obesity levels ("standing still") might have seemed counterintuitive, but it was a debated and agreed-upon target in the log frame. The goal was to prevent obesity rates from increasing and eventually reduce them. Achieving a stable state was still seen as progress, though its duration was uncertain due to various influencing factors. Dr Ghosh noted that if they could maintain the current level of stability and begin to see a decline by next year, it would be an achievement.

(e)  In response to the recommendation regarding “Online parenting courses should be available and promoted, with a focus on “understanding your child” and developing personal, social, and emotional skills in families”, a point was raised that parenting courses were a significant factor in the delivery of Family Hubs, delivered both in-person and online, and this would help to address one of the selected recommendations from the needs assessment.

(f)   Members commented on the stakeholder insight, specifically in relation to transgender men and non-binary patients with a cervix invited for cervical screening and inquired whether any discussions had taken place, given that these programs were nationally commissioned and delivered. It was suggested that the recommendation might be better phrased to ensure that anyone with a cervix is offered screening. Furthermore, a better understanding was needed of the National Screening Commission's role, as the cervical screening program was commissioned nationally and it was therefore important to assess the feasibility of the recommendation and determine whether it should be directed to GPs or the national commissioners. Dr Ghosh advised that it was currently an aspiration to implement the recommendation, however, further liaison was needed with the relevant leadership groups to determine if the recommendation could be actioned as the findings were specific to analysis in East Kent practices.

(g)  Ms Varshney offered support from the NHS perspective, referencing section 3.3.4 of the report in relation to health characteristics of Kent residents in receipt of social care services.

(h)  A suggestion was made to revise the statement in section 2.6.1 on page 20 to indicate there are 1,310 serving UK Armed Forces personnel, including 900 Gurkhas, to avoid upsetting the Nepalese community by not considering Gurkhas as UK serving personnel.

(i)    Members queried the high rate of dementia  in Folkestone and Hythe and whether this correlated with the higher age profile in the area, or whether it was becoming more prevalent in younger people. Dr Ghosh Advised that it was common practice in public health to standardise for age when examining prevalence rates of long-term conditions like dementia across different sub-geographical areas. This meant that the data was adjusted to account for age distribution in those areas

3.    RESOLVED that the Kent Health and Wellbeing Board approve the actions to be undertaken in relation to the specific recommendations outlined in the JSNA exceptions report, specifically:

Health needs assessment for 5-11 year olds in Kent

• Online parenting courses should be available and promoted, with a focus on “understanding your child” and developing personal, social, and emotional skills in families.

• Trauma informed approaches should be used more widely, and all professionals working with children should be trained.

• Activities which address wider determinants of health should be undertaken, for example addressing damp and mould in housing and reducing excess weight in children.

Sexual Health Needs Assessment

• Increasing monitoring and methods to prevent human immunodeficiency virus (HIV) transmission by increasing collaboration with wider partners to help identify at risk individuals and refer them for testing, for example drug and alcohol services, adult social care, domestic abuse.

• Raise awareness to increase visibility of sexual health services through

marketing and campaigns.

Armed Forces and Veteran Community in Kent Needs Assessment

• Service providers in Kent should be “veteran aware” to accommodate their

treatment needs.

Kent & Medway Housing Strategy Evidence

• Kent County Council (KCC) and partners should commit to activities which

prevent, reduce and delay the need for Adult Social Care including, monitoring and evaluating the impact of interventions on falls in the elderly.

Dartford, Gravesham and Swanley HCP Needs Assessment

• Local survey data should be collected to explore the efficiency of service

utilisation for children aged 0-4 in Dartford, Gravesham and Swanley Health

Care Partnership (HCP), such as GP, pharmacy and urgent care.

East Kent HCP Needs Assessment

• A dedicated mental health needs assessment should be carried out to review services for mental health and evaluate the increase in the burden of depression in East Kent.

Stakeholder insight

• GP surgeries should also invite transgender men and non-binary patients with a cervix for their cervical screening, if they are not registered as female and keep an updated register.

Kent JSNA Evaluation

• KCC Public Health will coordinate with the Kent JSNA Steering Group to put in place a regular online process for disseminating reports, updates or any new data to the public.