Respiratory disease is an important cause of ill health and early death in Bradford District.  The District performs relatively poorly compared to other areas in England. Recognising this, partners across the District, including the local authority and NHS, have prioritised respiratory health with the aim of improving health outcomes and reducing inequalities.

The report of the Director of Public Health (Document “W”) provides an overview of respiratory health in Bradford District and outlines what partners are doing to improve outcomes for people in the District. This is an update of a previous paper presented to this committee on 22nd November 2018.

Recommended –

That the committee to note and comment on the information provided in the report and to support ongoing work seeking to address the main challenges outlined. Support from senior stakeholders, decision makers and politicians will be necessary to address the issues related to the impact of air pollution and climate change in the health of Bradford population.

(Jorge Zepeda – 07816 082224)

Respiratory disease as an important cause of ill health and early death in Bradford District. The District performs relatively poorly compared to other areas in England. Recognising this, partners across the District, including the local authority and NHS, have prioritised respiratory health with the aim of improving health outcomes and reducing inequalities.

The report of the Director of Public Health (Document “W”) provided an overview of respiratory health in Bradford District and outlined what partners were doing to improve outcomes for people in the District. This was an update of a previous paper presented to this committee on 22nd November 2018.

The Senior Health Protection Manager was in attendance and with the invitation of the Chair, gave a synopsis of the report. He explained that respiratory disease is a leading cause of dying early in Bradford district. Over 500 people die each year from respiratory disease and 25% of these deaths are preventable. The rates of asthma and chronic obstructive pulmonary disease (COPD) in the district are higher than the national average. Outcomes are linked to deprivation and the wider determinants of health with higher rates of hospital admissions from those living in most economically deprived wards.

Respiratory health is an NHS priority – it is one of the priority areas of the Core20PLUS5 approach to support the reduction of health inequalities which is implemented locally by Bradford District & Craven Health and Care Partnership. Bradford Council has implemented public health measures targeting determinants of respiratory health like the Clean Air Zone and the Tobacco Control Alliance.

Proceeding the presentation, a question and answer (Q&A) session ensued:

·         What strategy was being considered to tackle inequality?

o   Regionally, the WY Integrated Care Partnership was committed to implementing the NHS CORE20PLUS5 approach to reduce health inequalities. This approach defined a target population (the 20% most deprived as defined by the national Index of Multiple Deprivation) and five clinical areas that required accelerated improvement. Chronic respiratory diseases were one of the key clinical areas, and the focus was on increasing uptake of COVID-19, flu, and pneumonia vaccines to reduce COPD exacerbations and hospital admissions in adults.

·         What was the major concern for poor respiratory health in deprived communities?

o   Indicator of quality of care for patients with asthma was the assessment of second-hand smoking status. Exposure to tobacco smoke as linked to poor control of symptoms and more asthma attacks and this assessment could trigger actions to support family members to stop smoking. There was an increase from 63% in 2020/21 to 73% in 2021/22 in the proportion of patients where such assessment was recorded in Bradford – still, these rates were higher than the national average; and,

·         Did other factors impact on poor health?

o   Factors that impact on people’s ability to adapt to the cold may also impact their ability to reduce exposure to respiratory infections, for example through reduced ability to maintain good respiratory and hand hygiene. Particular groups at risk included severe mental illness, dementia and other causes of cognitive impairment, disabilities, being bed-bound, being very young and including drug and alcohol dependencies.

Resolved:-

(1)  That the report be noted and that a further update, to include information on Covid-19, be presented in 12 months’ time; and,

(2)  That officers be thanked for the informative report.

Action: Director of Public Health