Agenda item

To receive an update with regard to the emerging Cambridgeshire and Peterborough Health and Wellbeing strategy and consider local priorities for the refreshed Fenland Health and Wellbeing strategy.

Members considered the Health and Wellbeing Strategic priorities report presented by Councillor Mrs Wallwork.

She introduced members to Liz Robin (Director of Public Health) and welcomed her to today’s meeting.

Members asked questions, made comments and received responses as follows;

1.    Councillor Purser highlighted the varying types of mental health issues with some being of a very complex nature. He stated that many parents do not have the professional knowledge to detect these issues and early detection is paramount to the appropriate treatment. He asked what provisions and services are available to detect mental health problems and resolve them. Councillor Mrs Wallwork stated that in her professional opinion, family involvement is key to young people’s mental health as usually parents are the first point of delivery of children’s needs. She stated that the services are out there and whilst detection is important, the wider issue is the availability and suitability of these services. She highlighted that currently there is a minimum of 6-8 months waiting time for most mental health services.

2.    Councillor Mrs Wallwork reminded members that whilst the Council do not deliver these services, there are various mental health services and referral routes available for residents including one which works alongside the whole family. She stated that the help is there however the need of these services outweigh their availability due to the growing number of patients.

3.    Councillor Purser asked what assistance is given to individuals whose issues start at home. Councillor Mrs Wallwork confirmed that other services feed into one another. For example, in domestic violence cases the Police automatically feed into the relevant education provider. She stated that further work needs to be taken to engage with individuals that are not flagged up by services, in particular young adult men who have suicidal thoughts do not always engage with the necessary support and further focus needs to be given to this.

4.    Councillor Mason stated that the report contains lots of figures highlighting the health inequalities across Fenland. He asked what progress is being made on improving these figures and what new ideas are being pursued in actions that have not been successful to date. Carol Pilson explained that the Council’s Health & Wellbeing strategy has been developed to support other service partners in tackling these problems. She explained that the report captures the large number of health systems and structures available including the Clinical Commissioning Group (CCG) and the new Primary Care Networks (PCNs) and the Council’s role is focused more on prevention work. She stated that the Council can assist via their environmental health, leisure and planning services to contribute support to other health partners to improve these statistics. She added that some of the Council’s most impactful work has been in relation to the ‘Active Fenland’ project as this engages with individuals that face health problems such as obesity and provides an accessible service to them as well as educating them on longer-term solutions.

5.    Councillor Mason stated that neighbouring authorities, such as South Cambs District Council, have much lower deprivation than Fenland and asked what can be learnt from them. Councillor Mrs Wallwork explained that the Council need to be realistic in its expectations on tackling deprivation and focus needs to be given on educating the younger generation to avoid long term issues continuing for generations to come.

6.    Liz Robin explained that South Cambs District Council have made a long standing commitment to health and wellbeing and perform well against similar authorities. She stated that the Council needs to consider and compare against areas with similar social demographics rather than neighbouring authorities. She explained that Fenland does have a high health need and all partners within Cambridgeshire and Peterborough are committed to ensuring that this need is factored into the distribution of resource. The district’s needs are included in the Cambridgeshire and Peterborough Health and Wellbeing Strategy with Wisbech being highlighted as an area with a high level of heart disease. She hopes that this targeted approach will enable practical measures to be implemented which will eventually improve these statistics.

7.    Councillor Cornwell stated that there are many tiers of organisations and structures within the region including the newly formed PCNs. He asked where these will be located and are they delivering currently. Carol Pilson explained that the PCN initiative is being rolled out over the next 3 years with Wisbech being used as a trial area. Work will be undertaken to establish priorities in order to formulate a focused action plan for GP surgeries. She agreed to circulate to members the proposed PCN boundary maps.

8.    Councillor Cornwell stated that whilst the Council are not a health authority, are they engaging with and influencing delivery partners. Carol Pilson confirmed that the Council work hard to establish strong working relationships with partners and ultimately educate the health system on the support district councils can offer.

9.    Annabel Tighe confirmed that she and Councillor Mrs Wallwork are working hard to establish connections with senior members of these organisations to see if they will commission the Council to undertake some of their preventative work.

10.Councillor Miscandlon asked if the Council can align with other local authorities in relation to this. Councillor Mrs Wallwork reiterated that the health system is not ‘one-team’ and therefore whilst the Council can try and establish relationships with members of other organisations, there cannot always be a cohesive approach.

11.Councillor Mrs Wallwork explained that whilst the Council have established links within the health service, as new schemes are set up it is not as easy to get involved in these new services. She welcomed suggestions from members on how this can be improved.

12.Carol Pilson agreed and highlighted that the Cambridgeshire and Peterborough CCG recently attended an All-Members seminar. She confirmed that the Council are actively involved in the PCN work and both she, Councillor Mrs Wallwork and Annabel Tighe are committed to making connections with the relevant partners and building on existing relationships.

13.Councillor Wicks explained that the Whittlesey PCN links with South Peterborough which is not a cohesive approach as these are two very different environments with one being a rural area and the other urban. Carol Pilson confirmed that the Council had lobbied at the time for a cohesive approach to PCNs to ensure all communities were correctly represented and stated that at the recent All Member Seminar with the CCG, the geographical boundaries of the PCNs had been discussed.

14.Councillor Miscandlon stated that the CCG had confirmed that they would be reconsidering the structure of PCNs.

15.Councillor Cornwell asked if the PCNs are based on the location of GP Practices. Carol Pilson confirmed this.

16.Councillor Cornwell stated that there has previously been a reluctance to understand the work undertaken by local authorities in relation to health and wellbeing and how the systems work surrounding local government. Liz Robin responded that the Health and Wellbeing Strategy aims to lay out how local authorities and the health service can work together in a practical way to tackle issues. She highlighted that the CCG had undertaken a health assessment on rough sleepers and worked with the Council’s Trailblazer project in relation to tackling homelessness through local authority work. She added that the Health and Wellbeing Board are keen to support and endorse the work of district councils to ensure a cohesive approach is taken with practical outcomes.

17.Councillor Hay asked if the GP Practices in Chatteris would be part of a PCN. Carol Pilson confirmed that all GP surgeries will be included.

18.Councillor Hay praised the local ‘Mental Health Crisis Concordat’ and asked if this is working successfully. Liz Robin explained that the service allows access to the mental health crisis team via the 111 emergency services phone line. She stated that the service is available in Wisbech and there has been a reduction in the number of patients experiencing mental health crises visiting A&E. She stated that suicide rates can be difficult to monitor as they are statistically lower than deaths by other causes and whilst it is difficult to assess a significant change in these numbers, the number of cases is not rising as it has in recent years. She confirmed that the NHS is working alongside the media, coroner and Public Health in relation to this.

19.Councillor Mrs Bligh highlighted that social media can cause a number of mental health issues and asked what work is being undertaken to tackle this. Councillor Mrs Wallwork confirmed that all social media platforms have reporting methods in place however young people do not always engage with the services available. She reiterated that both schools and parents are key in flagging up mental health issues in young people and whilst mental health services are not within the Council’s remit, support can also be offered by members to their wider community.

20.Councillor Booth recommended that whilst the Council cannot deliver on many health services, they can directly influence the responsible authorities.

21.Councillor Booth stated that he had heard reports that Cambridgeshire County Council are considering increasing the rates charged to pre-schools operating from their premises and this will have a wider effect on the early learning educational needs of the district’s children. Councillor Mrs Wallwork stated that she was not aware of this report.

22.Carol Pilson highlighted that 4.1 of the report shows the direct impact of the Council’s work on health and wellbeing including the Active Fenland project. She stated that the Council must continue to align with the appropriate authorities to impact this further. Liz Robin agreed and highlighted that members can influence the health and wellbeing of their district via policy setting in relation to services such as licensing and housing. She reiterated that council policies are very important in improving the health and wellbeing of an area.

23.Councillor Mason stated that the Council must ensure it has adequate signposting for users to the services available. Councillor Miscandlon agreed.

24.Councillor Cornwell agreed that the Council have an important role in the health and wellbeing of the district and stated that the Council’s leisure service should operate alongside the Health and Wellbeing Strategy as this can greatly influence the wellbeing of residents. Councillor Mrs Wallwork agreed.

25.Councillor Wicks stated that the district has locations within both the Cambridgeshire and Peterborough CCG and West Norfolk CCG and asked if the Council engage with both of these entities. Carol Pilson confirmed that both CCGs are considered as part of the service planning process and agreed to focus on strengthening the relationship between the Council and both CCGs.

26.Councillor Booth asked if media reports stating that the smoking rate in Fenland has reduced were correct and if so, why has this not been reflected in the report. Liz Robin explained that a sample survey in 2017 had shown that Fenland had a lower smoking rate than Cambridge City however a survey carried out in 2018 showed Fenland as having a higher rate however both surveys had not shown a statistically significant difference from the national average. She confirmed that data received from GP surgeries in Wisbech show a high rate of smoking in the town and a draft smoke-free strategy is being formulated and focus will be given to this as part of the Wisbech 2020 initiative. She added that Public Health is also focused on reducing the smoking rate across the district.

27.Councillor Booth asked when the draft smoke-free strategy will be completed. Liz Robin confirmed that counselling services, campaigns and support are all available currently within Fenland. A campaign has recently been developed to target the diverse population of Fenland and further work will be undertaken with GP’s as part of the PCN work.

28.Annabel Tighe explained that work has been ongoing for some time and members will be updated on the progress of this. She explained that the Council have undertaken work with local businesses as well as Trading Standards in relation to the sale of illicit tobacco. She confirmed that the Council’s environmental health team have undergone training in relation to detecting illicit tobacco and will continue to build the profile of this. She reflected that this is an area in which partnership work has been very successful.

29.Councillor Mrs Bligh highlighted the statistic in the report which states that 25% of women in Wisbech smoke during pregnancy and asked if literature was available for non-English speaking women. Councillor Mrs Wallwork confirmed this and added that translators are used to promote this message too.

Members thanked Liz Robin for her attendance at today’s meeting.

The Overview and Scrutiny Panel received and commented on the draft Cambridgeshire and Peterborough Health and Wellbeing Strategy and commented on the proposed key priorities for the Fenland Health and Wellbeing Strategy 2020-23.