Previous reference: Minute 94 (2016/2017)

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 Strategic Director, Health and Wellbeing will submit Document “X” 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 prevention and on asthma and chronic obstructive pulmonary disease (COPD), as these conditions account for a significant amount of the ill health and subsequent costs associated with respiratory disease in the District.

Recommended –

That the Committee note the information provided in the report and support on-going work seeking to address the main challenges going forward.

(Toni Williams – 01274 434071)

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 Strategic Director, Health and Wellbeing submitted Document “X” which provided an overview of respiratory health in the Bradford district and outlined what partners across the NHS and local authority were doing to improve outcomes for people in the district. There was a specific focus on prevention and on asthma and chronic obstructive pulmonary disease (COPD), as these conditions accounted for a significant amount of the ill health and subsequent costs associated with respiratory disease in the district.

The Consultant in Public Health provided an overview of the work being undertaken in Bradford as part of the Bradford Breathing Better Programme, and in Airedale, Wharfedale and Craven (AWC) through the AWC Respiratory Action Plan Group.  It was highlighted that; whilst 13,154 people in the district had been diagnosed with COPD, it was estimated that the actual figure was closer to 19,300 due to an estimated undiagnosed rate; 41,858 people across the district had been diagnosed with asthma and this number was also likely to be an underestimate too; the prevalence of smoking had fallen from 22.2% in 2016 to 18.9% in 2017 but smoking in pregnancy rates (13.8%), although declining, were higher than the national average (10.7%).  Services to support people to stop smoking, and activities to prevent people from smoking, as outlined in Document “X”, were outlined.  It was reported that there was a focus on de-normalising smoking to prevent people from taking up smoking.

A Member stated that he was an asthmatic smoker and his last three asthma check-ups with his GP had been over the telephone.  He considered more could be done to interact with patients to explain what support was available to stop smoking.  In response it was stated that this issue had already been raised by patients and the variations between practices was being reviewed as every patient with a respiratory condition should have an action plan developed, have their inhaler usage monitored and be reviewed regularly.  It was stated that many of the programmes in place were aiming to change the culture of smoking and view it as a long term health condition.

A discussion took place with regard to the uptake of the flu vaccine.  Members were informed that the uptake varied between at risk groups and that it was particularly low for two to three year olds but uptake rates were good for people aged 65 and over.  It was reported that there were many organisations involved in commissioning or providing the vaccine such as schools, GP practices and care homes and, in order to address the uptake rates, a comprehensive flu vaccination plan had been developed.  Members were informed that this had been presented as part of Self Care Week.

The Medical Director, Bradford District Care NHS Foundation Trust, was in attendance at the meeting, and in response to a Member’s question reported that all of the Trust’s sites had been smoke free for over a year.  He also stated that smoking rates were high amongst people with mental health conditions and that the Trust was committed to continually reinforcing messages and offering support to help people to stop smoking.

A Member stated that, whilst the Bradford Royal Infirmary was a smoke-free building, it had a smoking shelter directly adjacent to its main entrance which sent out the wrong messages and needed to be addressed.

It was explained that the Breatheasy Group consisted of patients with respiratory conditions who regularly met up for peer support as well as information and education from guest speakers such as pharmacists or representatives of organisations such as Asthma UK and the British Lung Foundation.  Members were informed that the sessions had previously been spread across the district but had been poorly attended with patients citing access difficulties, therefore a new practice based approach was being piloted in Low Moor. 

A Member provided anecdotal evidence and stated that he wanted to see non-medical self care information being shared with patients that had worked for other patients.  In response it was stated that the clinical advice provided was on an evidence based method, however there were various non-medical support services such as walking groups and support groups that patients were sign posted to by GPs. 

A Member commented on the importance of asthma patients being properly educated on how to use their inhalers and questioned whether there was an alternative flu vaccine available which did not contain porcine gelatine.  In response it was stated that there was no alternative flu vaccine available and that the ingredients of the vaccine were decided on a national level.  Members were also informed that a bid, to support the campaign to increase the uptake of the flu vaccine through nudge theory messaging, had been submitted to the Local Government Association.

Resolved –

That an update be presented to the Committee in two years time.

ACTION: Strategic Director, Health and Wellbeing