Agenda and minutes

To receive apologies for absence and notification of any substitutes present

Apologies were received from Mr Cole, Ms Grehan and Jenni Hawkins. 

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

There were no declarations of interest.

To consider and approve the minutes as a correct record.

RESOLVED the minutes of the meeting held on 5 September 2023 were correctly recorded and that a paper be signed by the Chair. 

Zena Cooke, Corporate Director Finance, and Jane Blenkinsop, Finance Business Partner Public Health, were in attendance for this item. 

1. Mr Oakford, Deputy Leader and Cabinet Member for Finance, Corporate and Traded Services, noted that the current financial position of the Council was challenging but that the impact on Public Health was limited due to the grant being ringfenced. Mr Oakford said that £46 million of savings had been identified for the next financial year but a £50 million as yet unidentified savings gap remained which would need to be found before the budget was finalised in February 2024 as the budget must be balanced. It was said that the Council cannot be reliant on reserves this financial year or the next one.

2. Mr Watkins said there would be a modest increase in the core revenue grant 

from central Government. It was noted that there would be increased cost pressures from inflation and salary increases, but plans were in place to offset the impact of these pressures. Mr Watkins said Public Health would be able to maintain its core programme alongside some efficiency projects. The Public Health Transformation programme was underway and would be central to the ongoing sustainability of the directorate.

3.    Dr Ghosh said that the budget was mainly ringfenced but recognised the financial struggles that the Council, as a whole, was facing. Dr Ghosh noted that there were measures, including the preventative agenda, that Public Health were developing, that would support the Council’s position going forward.

4.    A Member raised a concern that Members had not been given sufficient information, with limited context provided on the wider impact of the proposals. The Member noted that they would like to know what else Public Health would be able to do with the budget available and the extent of the issues facing Kent. Mr Oakford said that the grant was ringfenced for specific reasons and that the budget was balanced around what was required. The Public Health team could look at where the money is spent within government guidelines. Dr Ghosh noted that the grant was £74 million, which was in the middle to low range for Southeast England per capita. Many parts of the programme were prescribed by the government, so they were not flexible. It was said more could be achieved through integration with partners. Mr Watkins provided details on how the budget was modest but would support the work of the Integrated Care Strategy (ICS), as this was the best way to bring about systemic change going forward. It was noted that preventive and proactive action was being driven forward over maintaining reactive services.

5.    A Member said that Members needed to know the impact of the budget lines on the delivery of Public Health services, as there was no rating on how impactful the changes would be. Ms Cooke said that there were two elements to the Public Health budget, firstly, the element of the Public Health budget that funds eligible Council services, about 10%  ...  view the full minutes text for item 286.

1. The Cabinet Member for Adult Social Care and Public Health, Mr Dan Watkins, provided a verbal update on the following. 

Update on Vaping – Mr Watkins updated the committee on the follow-up actions since the recent discussions on vaping at the committee and full council. Leader of the Council Roger Gough’s letter had been responded to by the Department for Health and Social Care and shared with the committee. It was noted that the Department for Environment, Food and Rural Affairs (DEFRA) had published the result of its consultation on the environmental impact of disposable vapes. The Prime Minister had made the statement at the Conservative Party Conference and launched a consultation focussed on restricting the flavours and appearance of vapes, restricting the sale of disposable vapes and looking at giving Councils more powers to hand out on the spot fines to those selling vapes to underage people. Mr Watkins said that this was in the direction of travel that the Council had advocated for. 

World Mental Health Day – Mr Watkins noted that 10 October 2023 was World Mental Health Day, the theme for this year was mental health as a universal human right. It was said that Kent and Medway Suicide Prevention Team announced 11 new projects dedicated to preventing suicide, saving lives and reducing self-harm. The team had given out grants of between £500 and £1,500 to community initiatives. On 10 October 2023, Mr Watkins attended a roadshow in Herne Bay with Samaritans and other mental health community groups who were raising awareness for mental health. A representative from the Suicide Prevention Team was also in attendance to promote Release the Pressure. Mr Wakins said that Deputy Cabinet Member, Mr Kennedy, spoke at the Kent Mental Wellbeing Awards, on 20 October 2023. 

Healthy Start Card – Mr Watkins said that this new initiative would help parents buy healthy food, milk and vitamins. The initiative was the Council supporting the NHS’s Healthy Start Scheme, by supporting low-income parents purchasing essentials. Those eligible, more than 10 weeks pregnant or have a child under 4 or under 18 and pregnant even if not in receipt of benefits, would be sent a Healthy Start Card pre-loaded with money that could be used in many UK shops. The would-be worth £1,230 per child, with the money loaded onto the card every 4 weeks. Mr Watkins urged those eligible to apply and to the Committee Members to raise awareness in their communities. More information could be found through the NHS, GPs, health visitors and midwives, and on the following websites:

Kent County Council: Help to buy food, milk and vitamins - Kent County Council

NHS: Get help to buy food and milk (Healthy Start)

Kent and Medway Health and Care Symposium – Mr Wakins said that he had attended, alongside Dr Ghosh and other Public Health officers, the event at Canterbury Cricket Ground, on 20 October 2023. It was an opportunity for partners in Health and Social Care from across the county to  ...  view the full minutes text for item 287.

Jenny Dixon-Sherreard, Policy Officer, was in attendance for this item. 

1. Dr Ghosh introduced the report and referenced how it was different from the interim strategy that was last brought to the committee. It was noted that the document was a top-line strategy to outline the six shared objectives for the whole Integrated Care System. Dr Ghosh said that extensive engagement with the public, all 12 district councils, parish councils, Health and Care Partnerships, the Police as well as with Kent County Council (KCC) colleagues and workshops with Members had informed the refreshed version. Dr Ghosh said that the next stage was to turn the strategy into action, including through local plans which were in development based on three or four locally identified priorities identified by each District. More work on delivery was expected, and county-wide plans were being developed within KCC and with partners. A named Public Health specialist would be linked with each District to provide Public Health support.  

2.    Jenny Dixon-Sherreard provided some further details. Ms Dixon-Sherreard said that the document had been guided by developing shared outcomes to be delivered by work across all partners. It was noted that the document set out the ambition with work on the details and delivery ongoing with the relevant partners that provided the expertise in their area. It was said that the prevention and the wider determinants of health were central guiding principles of the document. Ms Dixon-Sherreard provided some further detail on the specific outcomes outlined in the document. It was noted on governance that the strategy was owned by the Integrated Care Partnership (ICP). The ICP would recommend the document for approval by the three statutory bodies, KCC, NHS Kent and Medway and Medway Council. It was expected that the ICP would recommend the strategy in December 2023, to be followed by approval from the KCC Cabinet in early January 2024. 

3.    Dr Ghosh said that the ICS was also the Joint Health and Wellbeing Strategy for Kent, a statutory requirement of each Health and Wellbeing Board.

4.    In response to comments and questions, it was said. 

(a) A Member raised a concern about the fragmentation of services, as this creates a complex situation for residents to access the services they require. There is a large range of voluntary organisations that is hard to keep across and may leave some residents falling through gaps in the system. Dr Ghosh said that the ICS was about addressing this system challenge. It was noted there were around 3500 of these organisations in operation across the county and the District Council workshops repeatedly raised the need for a directory. Work was ongoing to find a solution to this issue. 

(b) A Member said that the metrics and graphics in the document were very helpful and will be useful to follow in the years ahead to ensure that targets are met. It was asked if more absolute figures could be used in the future. Ms Dixon-Sherreard said that the indicators were currently  ...  view the full minutes text for item 288.

Dr Ellen Schwartz, Deputy Director of Public Health and Laura Bush, Senior Commissioner, were in attendance for this item. 

1. Dr Ellen Schwartz introduced the report and provided a brief overview. It was noted that a Public Health Quality Committee had been set up which was working through the recommendations. Dr Schwartz said that it would work closely with the Public Health Transformation Programme on how quality processes and best practices could be implemented across all commissioned services. 

2. In response to comments and questions, it was said.  

(a) A Member asked if there was scope for the coroner's reports on preventable deaths to be included in the Annual Quality Report going forward. Dr Schwartz said that there was scope to include and consider such evidence. Dr Ghosh said that the idea was a good one but there were issues with accessing the coroner's reports for data protection reasons. The Member said this was the public notice of preventable deaths. 

(b) It was noted that there were few complaints and compliments in the report as most would go directly to the provider of the service who would then analyse the data. 

(c) In response to a question about whistleblowing and internal information from the staff on the services. Dr Schwartz said that it was included in the report at an assurance level as it would be embedded in all contracts. 

(d) A Member asked if there was an obligation for the service providers to share complaints data with the Council. Ms Bush said that there were regular contract monitoring meetings with all commissioned providers which included a standard agenda item on complaints and compliments. Any comments or learning that could be implemented system-wide would be taken away and reviewed. 

3. RESOLVED the Health Reform and Public Health Cabinet Committee considered and commented on the content of the report.  

Laura Bush, Senior Commissioner, and Wendy Jeffrey, Consultant in Public Health, were in attendance for this item. 

1. Ms Bush introduced the update.  

2. In response to comments and questions, it was said.

(a) Mr Watkins said that this was an area where demand was growing and asked what the drivers of this were. Ms Bush said demand growth had been seen in the online Sexually Transmitted Infections (STI) testing service. It was noted that during the COVID-19 pandemic, this service was opened to asymptomatic people and demand growth has occurred since and more testing was a good sign. How this demand would be managed would be reviewed as part of the Public Health Transformation programme. 

(b) A Member raised a concern that coastal areas of the county were neglected by services such as these, it was asked if this service was actively working to ensure it was accessible in these areas. Ms Jeffreys noted that Sexual Health Services had outreach workers and the services were provided through community pharmacies. It was also said that many services could be accessed online or over the phone.

3.    RESOLVED the Health Reform and Public Health Cabinet Committee noted the report.  

RESOLVED that the Work Programme 2023-2024 was noted.