Agenda and minutes

To receive apologies for absence and notification of any substitutes present

Apologies for absence had been received from Mrs Cole, Mr Cole, Mr Daley and Mr Lewis. Mr Dendor was present as substitute for Mrs Cole.

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 that the minutes of the meeting of the Health Reform and Public Health Cabinet Committee held on 23 November 2022 were correctly recorded and that they be signed by the Chair.

1.    The Cabinet Member for Adult Social Care and Public Health, Mrs Clair Bell, gave a verbal update on the following:

Level Three Cold Weather warning – As part of the warn-and-inform responsibilities, Public Health were urging residents to follow simple steps to keep warm, and to help vulnerable families, friends and neighbours stay safe during the forecasted severe cold weather and icy conditions in Kent. It was said cold weather increased the risk of range of illnesses including heart attacks, strokes and flu.  Those with underlying health problems, the elderly and frail were particularly vulnerable.

Public Health Services – Members and the public were reminded of the public health services available including: the Release the Pressure helpline and text services for mental health; the One You Kent healthy weight services; and the One You Kent support for cutting down alcohol consumption.

Scarlet Fever – It was said that the Council was working with NHS to raise awareness of the symptoms of scarlet fever following a national alert by the United Kingdom Health Security Agency. It was said that Dr Ghosh, Director of Public Health, had written to Head teachers, nurseries, childcare centres and parents across the county to raise awareness.

Kent Substance Misuse Alliance – Mrs Bell had recently chaired a meeting of the Kent Substance Misuse Alliance. This was a partnership of key organisations including councils, Kent Police, emergency services and health providers, recent strategy developed to tackle drug and alcohol misuse through prevention, treatment and recovery, and community safety. The quarterly meetings provide a useful forum for the organisations. The most recent meeting focused on the work being undertaken by KCC to deliver drug and alcohol support services.

2.    Dr Ellen Schwartz, Deputy Director of Public Health, gave a verbal update on the following:

Public Health Staffing – It was said that the Public Health team was being developed to ensure that staff were in the best position to provide advice on health and wellbeing across Kent. It was necessary to have an appropriate level of expertise to deliver these services.

COVID-19 and Flu – Levels of COVID-19 and flu were said to show a marked reduction in both incidence and hospital bed occupancy levels. Dr Schwartz encouraged Members and the public to get the flu vaccine and the COVID-19 booster, particularly those at higher risk, to avoid getting seriously ill.

Refugees and Asylum Seekers – Public Health Team had made a fourth visit to the sites to ensure that these individuals were looked after in care.

In response to questions from Members it was said:

a)    Figures detailing the fourth COVID-19 vaccination uptake, the r rate and hospitalisation data would be shared with the Committee.

b)    Dr Schwartz would provide further information regarding the monkey pox vaccination, including take up rate, outside of the meeting.

3.    RESOLVED to note the verbal updates.

Ms Zena Cooke (Corporate Director Finance), Mr Peter Oakford (Deputy Leader and Cabinet Member for Finance, Corporate and Traded Services) and Ms Jane Blenkinskop (Capital Projects Manager & Acting Business Partner for Public Health) were in attendance for this item.

1.    Mr Peter Oakford, Deputy Leader and Cabinet Member for Finance, Corporate and Traded Services, introduced the Draft Ten Year Capital Programme, Revenue Budget 2023-24 and medium-term financial plan 2023-26. Mr Oakford highlighted the financial and operating pressures facing the council including inflation and the increased demand for Adult Social Care services. It was said that gross additional proposed spending growth was £216.8m.

Despite additional income generation, there was an anticipated drawdown on reserves. This arose from the need to divert insecure income, such as dividends received from a holding company, to the base budget rather than into reserves. Additionally, in order to achieve a balanced one-year budget, £39.1m of savings would need to be delivered.  Given the scale of the savings, enhanced monitoring arrangements would be put in place. There was, however, a small risk reserve to offset any savings that were not achieved.

2.    Mrs Bell said that Public Health was funded from a ringfenced grant from the Government. This grant for 2023-24 had not been announced at the time of the Cabinet Committee meeting. Consequently, there was a high level of uncertainty in the Public Health Draft Budget for 2023-24. Therefore, assumptions had been made, including a conservative estimation of a £2m (2.8%) increase in the grant. A settlement of more than 2.8% would enable Public Health to revisit the savings that have been identified.

It was said that the pressures for the Public Health budget included: NHS pay increases; increased cost of service providers; increased demand in certain services; the ending of COVID-19 grant funding; uncertainty around some external funding; additional staffing costs; and additional requirements as a result of updated national guidance.

Public Health reserves remained relatively high and had increased as a result of underspends returned to the council by the Kent Community Health Foundation Trust (KCHFT). The underspend had been primarily due to staffing vacancies, reduced service levels and/or demand post COVID-19. It was anticipated that the ringfencing of the KCHFT reserve would be relaxed, enabling the reserve to be used more widely to achieve public health outcomes.

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

a)    Recruitment into permanent senior positions had not had a high success rate and, therefore, interim positions had been introduced. The intention was to replace the interim positions with permanent staff. 

b)    The Business Partner would provide further information regarding the sources of minor growth for public health outside of the meeting.

c)    It was highlighted that the proposed Council Tax increase was in line with the government’s expectation of a 3% referendum limit and 2% adult social care precept.

4.    RESOLVED to:

a.    Comment on the draft capital and revenue budgets relevant to this committee including responses to consultation

b.    Propose any changes to  ...  view the full minutes text for item 235.

1.    Jo Allen, Marketing and Resident Experience Partner, introduced the paper which reported on the campaigns and communications activity delivered through the KCC Public Health team in 2022 and outlined plans for the remainder of the financial year. The statutory warn-and-inform responsibilities, as lead for the Kent Resilience Forum Outbreak Control Management Plan, had seen the Director of Public Health and the KCC communications team at the forefront of public attention during the winter months. It was also said that severe weather communications had been a focus area in 2022, including reactive communications in response to the government’s Level 4 heatwave alert in July 2022.

2.    It was highlighted that planned engagement with residents in 2023 aimed to increase understanding about how current factors are affecting residents’ wellbeing. The engagement included a digital survey, focus groups and targeted group conversations. It was anticipated that this feedback would help KCC to shape future Public Health priorities and inform communication strategies.

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

a)    Campaigns and communications were delivered in a variety of formats. Commissioned services and providers helped to identify key target groups and the Campaigns and Marketing Team advised on how to deliver to these groups. The success of the campaigns, including the reach and engagement levels, was tracked.

b)    The Marketing and Resident Experience Partner would provide further information regarding the campaigns to specifically target young people, including evaluation figures and the specific details of the reach.

c)    The Committee raised concerns regarding the targeted audience of the smoking cessation campaign. It was suggested that further engagement was required with younger audiences, particularly given the rising use of electronic cigarettes. The Marketing and Resident Experience Partner would raise this concern with the relevant consultants.

4.    RESOLVED to COMMENT on and ENDORSE the progress and impact of public health communications and campaigns in 2022 and the need to continue to deliver throughout 2022/23.

1.    Victoria Tovey, Lead Commissioner (Public Health), introduced the paper which provided an overview of the Key Performance Indicators (KPIs) for Public Health commissioned services. In the latest available quarter, July to September 2022, eight of 15 KPIs were RAG rated Green, five Amber, and two Red. It was highlighted that some of the indicators in the Amber category were still subject to the impact of COVID-19, for example the NHS Health Check Programme.

2.    In response to questions from Members it was said that:

a)    The Lead Commissioner would feedback to providers the concern from Members that the discontinuation of sexual health walk-in services could discourage younger residents from engaging with these services, particularly due to the loss of anonymity.

b)    The amount of young people exiting treatment in a planned way had decreased to 57% from 78% in the previous quarter. It was said that the numbers in the service were low so any change would have a large impact to the percentage. Furthermore, some disengagement had been linked to staff turnover. This was being monitored, however, staffing levels had become more stable since Quarter 2. The Committee were also reassured that the provider did have robust dropout procedures in place.

c)    It was suggested that there was insufficient collaborative work between agencies to engage with younger people. The Lead Commissioner would provide further information regarding how this work was being carried out.

3.    RESOLVED to NOTE the performance of Public Health commissioned services in Q2 2022/23.

1.    Dr Ellen Schwartz, Deputy Director of Public Health, introduced the Kent and Medway Interim Integrated Care Strategy which had been approved by KCC’s Cabinet on 1 December 2022 and discussed at County Council on 15 December 2022. It was said that the aim of the Strategy was to join up planning and delivery for health and social care across Kent and Medway. The Strategy focused on key approaches including prevention and early intervention. Action plans at a district level were in development.

2.    In response to questions from Members it was said that the Strategy would take into account levels of activity, need and demand in planning the delivery for health and social care across Kent and Medway.

3.    RESOLVED to NOTE the Kent and Medway Interim Integrated Care Strategy.

This agenda item was deferred to a future Health Reform and Public Health Cabinet Committee meeting.

1.    The Clerk highlighted that, since the publication of the agenda, the May meeting of the Committee had been moved from the 10^th to 18^th of May 2023 at 14:00.

2.    RESOLVED to consider and agree the Health Reform and Public Health Cabinet Committee Work Programme for 2023 subject to the deferral of the ‘Update Report on Gambling Addiction Interventions in Kent’ item to the 16 March 2023 meeting.