Decision details

Dr Sakthi Karunanithi, Director of Public Health, presented a report which explained that the public health and wellbeing service within Lancashire County Council was undergoing significant transformation. With year on year reductions forecast in the financial resources, including the public health grant, the service continued to maximise the value of its investment through commissioning, partnership working and direct delivery.

The Committee had previously scrutinised the public health function in its meetings held during 2015, including an update on the Health and Wellbeing Board in November 2015. A copy of the presentation is appended to these minutes.

Sakthi provided an overview of the background to the Public Health and Wellbeing Service Transformation and confirmed that there was an in year reduction of £4m in the Public Health grant with further predicted reductions of £1.5m each year for the next three years.

Members were informed that two funding streams (NHS and Public Health grant) formed the funding for Lancashire and despite the increase of £3.8 billion from Central Government into the national sustainability and transformation fund, Lancashire had not been identified to receive any of this additional funding.

Sakthi advised members that there was an overall gap between financial resources and the pattern of demand in Lancashire.

The Wellbeing, Prevention and Early Help services were reported to be mainly commissioned through the NHS and included services such as children's centres, Young Peoples Service, NHS Health Check, alcohol and substance misuse.

Sakthi responded to a question on the strategy to address the fragmentation that currently existed across these service areas, and confirmed to members that a consultation was being undertaken around the joining up of services for 0-19 years within children's centres, health and other partners to wrap around services.  It was noted that there was a need to ensure that focus was not lost on early years and that the overarching strategy would be monitored by the Lancashire Health and Wellbeing Board.

It was reported that the NHS Health Checks continued to be a mandatory service with widening access online and through workplaces to improve take up and to assist with the prevention of current risk factors to reduce NHS demand.

The Committee was advised that substance misuse continued to be a significant area of spend although there had been a shift in focus to a recovery orientated approach.  Initial information suggested this was proving successful.

Sakthi updated the Committee on the current review of contracts which was near completion with the new services contracted to commence from April.  In addition, preparations had been undertaken to understand the further reductions and how this would look in relation to services.  Sakthi confirmed that contracts could be stopped at short notice as a response to this.

Members were invited to raise questions and a summary from the discussions is set out below:

The subject of infant mortality (particularly smoking in pregnancy) was highlighted where it was shown that through the successful implementation of all resources and systems there had only been a 0.1% reduction.  Sakthi acknowledged that there was a need to look at tobacco control as a whole to influence the necessary culture change required in these areas. Peer support and education (which had been successful in substance misuse and alcohol) was an area identified to be looked at in greater detail.  In addition, Sakthi discussed that there would be the possibility of utilising incentives.

Further detail was requested concerning the healthy new towns pilot and the current situation in Burnley where it had been agreed to change the pedestrianised town centre to a shared space.  This seemed to be a contradiction to the pilot and further information was requested on the consultation with health and the potential health impacts relating to this change.  Members were assured that the implementation of shared spaces had not yet resulted in an increase in road safety issues but it was acknowledged that pollution was an emerging issue.  Sakthi also confirmed that the planning staff worked with other councils and used the Health Impact Assessment as a way to identify potential issues in any planning requests.

A query was raised regarding the future of the smoking cessation service and the domestic abuse services.  Sakthi reported that there were no plans to stop the smoking cessation service as it was seen to be one of the best intervention services currently available.  In addition, domestic abuse continued to be a priority for Lancashire County Council and across partners.  The Community Safety Agreement (for the delivery of shared outcomes across partners in Lancashire) included this as a priority and services had been made available for both victims and perpetrators.

Resolved:

1. That the report be noted.
2. Sakthi to provide further information to CC Brindle on the query raised in relation to healthy new towns pilot in Burnley.

  iii.  Sakthi be asked to draft a letter to the Minister in response to the reduction in funding and the challenges faced for the Chair to send on behalf of the Committee.