The following disclosures were made in the interest of transparency:

(i)            Councillor A Ahmed disclosed that she was employed by the Yorkshire Ambulance Service NHS Trust and her sister worked in the NHS.

(ii)          Councillor Sharp disclosed that she was employed by an organisation that dealt with mental health issues.

(iii)         Susan Crowe disclosed that she had a contract with Bradford Districts Clinical Commissioning Group and the Council’s Public Health department.

ACTION: City Solicitor

Recommended –

That the minutes of the meeting held on 2 March 2017 be signed as a correct record (previously circulated).

(Palbinder Sandhu – 01274 432269)

Resolved –

That the minutes of the meeting held on 2 March 2017 be signed as a correct record.

There were no appeals submitted by the public to review decisions to restrict documents.

Any referrals that have been made to this Committee up to and including the date of publication of this agenda will be reported at the meeting.

There were no referrals made to the Committee.

The Strategic Director, Health and Wellbeing will submit a report (Document “AK”) which provides an overview of respiratory health in Bradford District and outlines what partners across the NHS and local authority are doing to improve outcomes for people in the District.  There is a specific focus on asthma and chronic obstructive pulmonary disease (COPD) as these conditions account for a significant amount of the poor health and subsequent costs associated with respiratory disease in the District.

Recommended –

That the Committee note the information provided in the paper and support ongoing work seeking to address the main challenges going forward.

(Toni Williams – 01274 437401)

The Consultant in Public Health submitted a report (Document “AK”) which provided an overview of respiratory health in the Bradford District and outlined what was being done to improve outcomes for people.  Members were informed that Bradford was a poor performer and was the second worst District in Yorkshire and Humber.  Respiratory disease was the leading cause of people dying early in the Bradford District and 25% of these deaths were preventable.  The associated health problems had a significant impact on the person’s quality of life and resulted in high attendance at hospitals. 

In relation to chronic obstructive pulmonary disease (COPD), the Consultant in Public Health confirmed that over 13,000 people across the District had been diagnosed as having the disease, however, not all sufferers had been identified and it was believed that the actual number of people with COPD was closer to 19,000.  It was a challenge to proactively seek people with COPD, as the proportion of those undiagnosed varied across the Clinical Commissioning Groups (CCGs) and between GP practices.  The estimated total number had been identified through complicated modelling which looked at similar areas and the makeup of the District’s population.  COPD could not be cured but could be managed, however, it affected older people who had other conditions and were complex cases to cope with.

The Consultant in Public Health reported that over 40,000 people across the District had been diagnosed with asthma, however, it was believed that this was also underestimated and there was a variation in how it was managed in primary care.  The key risk factor was smoking, which was one of the main causes of COPD and according to surveys, one in five people in Bradford smoked.  Air quality was considered in relation to respiratory disease and it was an issue in urban locations.  The Consultant in Public Health stated that the management of the disease needed to continue and a great deal of work had been undertaken regarding the cessation of smoking in workplaces and hospitals.  Smoking in pregnancy had also been a priority for a number of years.    

The representative from NHS Englandexplained that the Bradford Breathing Better programme covered adults and children.  It was noted that the diagnosis of COPD was a key factor and if not diagnosed early it was harder to treat.  A stakeholder workshop had been held in January that approximately 80 people had attended and considered the four work streams of: self care; prescribing and formulary; clinical template; and pathways.  There were also dedicated nurses or GPs in practices across Bradford that were the clinical leads for the programme.

With regard to Airedale, Wharfedale and Craven’s Respiratory Action Plan, Members were informed that they were looking at inhaler techniques and had hospital nurses working in the community.  A trial of a GP practice using Telehealth for COPD cases was being considered along with the early discharge of patients from hospital with support provided in their own home.  It was noted that the next  ...  view the full minutes text for item 94.

The Strategic Director, Health and Wellbeing will present Document “AL” which provides an overview of findings from a recently conducted audit of deaths by suicide in the District 2013-15 and also presents the District’s new multi-agency Suicide Prevention Plan in draft form prior to its anticipated launch in April 2017.

Recommended –

That the Committee note and comment on the audit of deaths by suicide and the District Suicide Prevention Plan 2017-2021.

(Peter Roderick – 01274 437352)

The Speciality Registrar, Public Health presented a report (Document “AL”) which provided an overview of the findings from a recently conducted audit of deaths by suicide in the District 2013-15 and presented the District’s new multi-agency Suicide Prevention Plan, in draft form, prior to its anticipated launch in April 2017.

The Speciality Registrar, Public Health explained that the District had a fairly new Mental Wellbeing Strategy and this included a Suicide Prevention Plan.  In February 2017 access was granted to audit Coroner’s Office files where it was found that 76 cases of suicide had occurred in the Bradford District.  It was identified that the age group most at risk was 50 years old and one of the clear trends was deprivation.  The Speciality Registrar informed Members that the Prevention Plan was a multi agency document and modelled on the National Strategy.  He reported that there was an aspiration to attain a 10% reduction by 2021 and that there were six key areas within the Plan.

Members then raised the following points:

·         Why were 61% of suicide deaths by hanging?

·         Had the number of suicides evened out since the financial crisis?

·         Were the categories relevant in respect of the person’s relationship status at time of death?

·         Could staff who dealt with vulnerable people be trained and could it be built into the Plan?

·         What was the difference between the Coroner’s figures and National figures?

·         How many deaths had there been between people aged between 5 and 19 years?

·         People were being discharged from hospital, referred back to their GP and still having suicidal thoughts.  There were some excellent services available.

·         Would information about suicide attempts by age be available?

·         Some people may feel better if they had decided to end their life and could therefore be missed.  Was this factored into training and plans?

·         A psychological assessment should be undertaken before a person who had self harmed was discharged from hospital.

·         Were most insurance policies invalidated if suicide was a cause of death?

·         How would access to the means of suicide be reduced or prevented?

·         Support was required for those that had to deal with the aftermath of an attempted suicide or suicide.

·         Was there any detailed analysis in relation to those that had committed suicide and were already known to mental health services and those that were not?  

·         Suicide rates in prisons had increased.

·         It would be worthwhile looking at the suicide rates of prison leavers.

In response Members were informed that:

·         Hanging was quick and there was no way back.

·         Three year rolling rates had been compiled and the numbers had increased where expected, however, the rates were reducing slightly now.  It could not be said that there was a trend though.

·         The person’s relationship status had been taken from the information recorded by the police at the time of death and there was very little link, however, a major issue in a person’s life, such as some form of family break up, was a high risk  ...  view the full minutes text for item 95.

The City Solicitor will provide a verbal update on the Committee’s work programme 2016/17.

(Caroline Coombes – 01274 432313)

Members were informed of amendments made to the Work Programme 2016/17.

Resolved –

That the Work Programme 2016/17 be noted.

Action: Overview and Scrutiny Lead