Rachel Flowers (RF) provided a verbal update on the Public Health Report by outlining that a Human Resources concordat had now been agreed. Public Health England will shortly agree funding details but no additional information on this issue had been released to date. Further information on the role of Health and Wellbeing Boards had been now made available and on the transitional arrangements.

GB tabled a paper on “Improving the Health of the Public”. GB introduced the paper by outlining that there was no new information in it but the paper pulls together the issues and challenges the status quo. The first step of the work would be for Newham to create a Public Health paper and then share with colleagues in other boroughs. Subsequently a joint paper will be produced by the director of public health.

Key issues and opportunities of the “Improving the Health of the Public” paper were:

• Traditionally, Public Health has not been transformational in nature and this needed to change to capture resilience, skills and capability and how the economy / employment (work) affects health.
• Role of the Health & Wellbeing Board needing to influence broader public sector and use new ways of working and the Board will be challenged to lead on commissioning agendas. By having the responsibility for the JSNA and Health and Wellbeing Strategy there is any opportunity to set strategic direction.
• Public Health within local government is an opportunity to influence and shape the key functions of local government that include planning and transportation
• Opportunity for the potential to share services in new innovative ways and the Local Health Plan will give an evidence base for this.

Cllr Furness asked that members provide comments on each section of the “Improving the Health of the Public” paper.

Introduction

JL asked that the introduction section provides more detail on general changes and about doing things differently. Notably, influence on issues such as highways and leisure centres could be given.

MG commented that the penultimate paragraph of the introduction includes mention people being able to “shape” the decisions that affect them.

Cllr Laguda asked that an increased statement about the importance of education was added and highlighted the issue of unwanted pregnancy. Cllr Laguda added that taking ownership meant being resilient. RF added that people don’t often talk about health and the term needed to be defined.

New Ways of Working

MG stated that shared resources would mean that all are signed-up to the new ways of working.

Dr Shah added that there were many issues that could be added including late presentation of pregnant women.

RF explained that the concept of social impact bonds was very new and it was just one possible model that could be considered. However, it was agreed that the direction of travel from government was that changes like social impact bonds were necessary because they could leaver new funding. It was agreed that any scheme such as a social impact bond had to be right for the borough. Work would continue with the CCG and a broader set of partners to agree what was right for the borough.

JL explained that the focus of paragraph two was not the payment associated with social impact bonds but the “effort” that should be focused on.

Health and well-being boards at the heart of the transformation

RF outlined that even though the Board will have a role in overseeing and approving the JSNA, the Director of Public Health has the responsibility of producing this document. Cllr Furness added that the JSNA and the Health & Wellbeing Strategy would need the approval of the Board. JL added that the Board would need to have an intellectual role in providing the overseeing role. MG asked that this section references more than one plan in paragraph four.

Structural Changes

JL outlined that extra structural relationships could be added to this section. Notably the key role that the CCG has in dealing with the determinates of health. 

It was agreed that significant improvement of health services had reduced inequalities and the challenge moving forward was how local authorities were going to use the public health “tag” to continue this work.

Sharing Services

CH asked that this section provided more emphasis on the CCG working with the Local Authority and this it was suggested could be articulated in ways such as community forums. CH added that the synergy of the clustering that has and will take place would require high-level decision making. GB agreed to add information of how the structural changes would develop.

Local Control

MG asked that information on HealthWatch was added to this section. MG also asked that the range of terminology such as clusters, forums and hubs was made clearer to avoid confusion.

Dr Shah asked that the Voluntary Community Sector was given greater emphasis to provide a supporting role.

Cllr Furness thanked all for the comments on the paper and asked GB to consider them. GB agreed to develop a second draft of the Improving the Health of the Public (009).

Action

Further development of the “Improving the Health of the Public Paper” (009)