Previous reference: Minute 72 (2014/2015) and Minute 19 (2016/17)

The Strategic Director, Health and Wellbeing will submit a report (Document “D”) that provides an overview of local performance based on the Public Health Outcomes Framework, giving particular emphasis to:

a)    indicators which show Bradford compares unfavourably, or has had a recent history of comparing unfavourably, with the Yorkshire and Humber region, and/or England as whole; and

b)    indicators which have been the subject of other Public Health reports presented to the Health and Social Care Overview and Scrutiny Committee.

The report is a follow up to the document presented at Health and Social Care Overview and Scrutiny Committee on 28 July 2016. 

Recommended -

That the Committee acknowledges the content of the report and seeks a further performance report on Public Health Outcomes Framework indicators in 2018.

(Jonnie Dance – 01274 432333)

Previous reference: Minute 72 (2014/2015) and Minute 19 (2016/17)

The Strategic Director, Health and Wellbeing submitted a report (Document “D”) that provided an overview of local performance based on the Public Health Outcomes Framework (PHOF), giving particular emphasis to:

a)    indicators which show Bradford compares unfavourably, or has had a recent history of comparing unfavourably, with the Yorkshire and Humber region, and/or England as a whole; and

b)    indicators which have been the subject of other Public Health reports presented to the Health and Social Care Overview and Scrutiny Committee.

The report was a follow up to a report presented to the Committee on 28 July 2016.  At that meeting, the Committee resolved “that a further performance report on Public Health Outcomes Framework indicators be submitted in 12 months’ time.”

The Public Health Information Analyst provided an overview of the report, which also contained further information on Infant Mortality, Tuberculosis, HIV diagnosis and Screening and Vaccination rates as they were areas that the Committee had previously asked for more details on in terms of their PHOF indicators:

He stated that there were areas in which Bradford was doing well, such as the provision of accommodation to adults with mental health needs and fewer complaints received about noise disturbances.  These were not covered in the report. 

He indicated four areas of concern:

·         Indicator 1.01i – Children in low income families.

o   The proportion of children who live in poverty had increased.

·         Indicator 2.20ii – Cancer screening coverage – cervical cancer

o   The percentage of women screened for cervical cancer had decreased.

·         Indicator 2.06ii – Excess weight in 4-5 and 10-11 year olds.

o   The proportion of children aged 10-11 classified as overweight or obese had increased.

·         Indicator 2.15i – Successful completion of drug treatment – opiate users.

o   Bradford’s rate of the number of adults that successfully complete treatment for opiates in a year and who did not re-present to treatment within 6 months had worsened at a faster rate than regional and national rates.

He also stated that TB treatment was becoming more successful, HIV late diagnosis was improving and although cancer screening for women was a concern, vaccination rates were improving.

With regard to infant mortality, rates had reduced considerably over the last few years but had increased slightly within the last three year rolling period.  Overall, numbers of infant deaths had reduced from an average of 68 per annum in 2008-10 to 47 per annum in 2013-15.  This equated to 5.9 deaths per 1,000 live births in Bradford compared to 4.3 deaths per live births in Yorkshire and Humber.  Further details were provided in Appendix 3 of the report.

In response to Members’ questions, it was reported that:

·         In order to improve the dissemination of health messages, Health Champions were being considered.  Learning was being taken from Wigan Council where this had worked well, particularly in connecting with hard to reach communities.

·         Every infant death in the District was reviewed by the Child Death Overview Panel and if it found any trends, messages were put out to the public.

·         Genetics awareness training was delivered sensitively to increase community understanding of the role of genetically inherited congenital anomalies as a cause of infant death.

·         Consideration was given to who was best placed to give messages within a community.  E.g. in some cases mothers and grandmothers of expectant young mothers were better placed to give messages rather than professionals and work was done to ensure the right messages were disseminated.

·         A service review into substance misuse had taken place in 2016.

·         In Public Health there was a push to consider issues holistically in terms of lifestyle approaches to avoid issues being reviewed in isolation.

·         Reviews were undertaken where improvements were made to ascertain what was working well.

·         Sometimes the mechanism by which calculations were made in relation to reporting on indicators varied.

·         As there were many indicators reported on; a steer from Members on which to report on would be welcome for future reports.

·         Reports would be taken to Area Committees with specific information relating to constituencies.

The Chair commented on the stark differences in infant mortality rates across different wards in the District and emphasised the impact of domestic violence, poor diet, lifestyle, smoking and alcohol on the rates.  She also affirmed that the indicators to report on would be discussed in her briefing prior to any future reports being submitted to the Committee.

A Member commented that complacency should not set in if slight improvements in indicators were reported.

A Member referred PHOF indicator 2.15i in the report which stated that 108 of the 2492 adult opiate users in treatment successfully completed treatment and did not re-present to treatment within 6 months.  He stated that there were many other unknown drug users in addition to the 2494 cited in the report and that as funding for drug and alcohol treatment services had been cut back, there was likely to be an increase in the drug-addicted population.

Resolved –

That the Committee acknowledges the content of the report and seeks a further performance report on Public Health Outcomes Framework indicators in 2018.

ACTION: Strategic Director of Health and Wellbeing