Agenda item

The Committee received a report of the Corporate Management Team which presented the Joint Local Health and Wellbeing Strategy (JLHWS) 2023-2028 (for copy see file of Minutes).

The JLHWS is a legal requirement under the Health and Social Care Act 2012, to ensure health and social care agencies work together to agree services and initiatives which should be prioritised. The Health and Wellbeing Board has the responsibility to deliver the JLHWS, which is informed by the Joint Strategic Needs and Asset Assessment (JSNAA), as part of Durham Insight, which is an assessment of the current and future health, wellbeing, and social care needs of residents in County Durham.

A Healy, Director of Public Health gave a detailed presentation and explained that the joint strategic needs and assets assessment rooted in intelligence and wider evidence about what drove health and wellbeing across the county. She further explained the vision for the JLHWS ‘County Durham is a healthy place, where people live well for longer’ and noted that the JLHWS focussed on areas that could prevent it from achieving this vision. The four priority areas were:

·      Making smoking history

·      Enabling healthy weight for all

·      Improving mental health, resilience, and wellbeing

·      Reducing alcohol health harms

Councillor Kay asked for further information regarding the strategy’s ability to improve mental health. The Director of Public Health highlighted that this was a priority area. She explained that the mental health strategic partnership had been refreshed to re-emphasise mental health as an important issue and included information on prevention and fair access to services. Councillor Kay expressed concern regarding the challenges experienced by service users in being referred to a specialist mental health team and requested that updates on the JLHWS be brought back to the Committee to keep members well informed on progress. The Director of Public Health advised that the purpose of bringing the JLHWS to the Committee was to allow members the opportunity to consider the strategy in greater depth and she advised that any concerns raised would be feedback.

Councillor Jopling expressed concern with youth vaping, stressing that the long term side effects of vaping were currently unknown and asked what schools were doing to prevent young people from vaping. The Director of Public Health advised that vaping was part of the work that was being done on tobacco. She explained that vaping was a safer option in comparison to cigarettes and was a great alternative for those trying to stop smoking but she stressed that vaping should not be promoted to young people. The Director of Public Health went on to advise that current legislation regarding vaping was challenging. She informed the Committee that a government consultation regarding youth vaping had recently launched and Durham had submitted a robust response seeking the prevention of advertisement to young people. The Principal Overview and Scrutiny Officer advised that youth vaping had been agreed as a topic on the workplan for Children and Young People’s Overview and Scrutiny Committee (CYPOSC) for 2023/24 and assured members of the AWHOSC that they would be invited to meetings when this topic was to be discussed. 

Councillor Brown commented that a study had recently been released which stated that vulnerable women in the North East were 1.7 times more likely to die as a result of suicide, addiction and domestic violence and asked how the JLHWS could improve these figures. The Director of Public Health advised that the strategy tackled inequalities and she informed the Committee that a conference was planned to take place locally which would discuss women’s health and wellbeing. The Director of Public Health offered to share the outcome of the conference with members.

Councillor Hovvels noted the benefits of opening up community assets and stressed that this must be done in partnership, not in isolation. Councillor Hovvels went on to ask if gambling was included in the strategy as this had increased and whether water fluoridisation had been agreed. The Director of Public Health commented that with regards to community assets, local councillors knew their communities the best. In terms of gambling, the Director of Public Health explained that they had recently been successful for a bid which had led to specific posts being appointed by Middlesbrough Borough Council to target those people affected by gambling but stated that the level of need was currently unclear. With regards to water fluoridisation, the Director of Public Health advised that this was included in the oral health strategy and the responsibility for this was now with the Secretary of State for Health. She advised that Durham was in a position to fluoridise water rapidly and agreed to keep the Committee updated on this matter.

Members agreed that gambling was a growing concern. Councillor Currah pointed out that most football teams were sponsored by gambling companies which targeted young males. He further stated that some young people chose to play video games rather than interact socially and drink alcohol and whilst this may decrease the level of alcohol consumption in young people, the impact of this lifestyle could lead to an increase in mental health. The Director of Public Health agreed that advertisements for gambling needed to be addressed and explained that the Local Authority were seeking action on gambling and agreed to provide an update to the Committee and to the CYPOSC. In terms of alcohol consumption, the Director of Public Health advised that there had been a reduction in young people but agreed that mental health in young males was a growing concern and explained that the campaign ‘now you’re talking’ encouraged young males and adults to open up and talk.

R Gott, co-opted member expressed concern regarding mental health services at Tees, Esk and Wear Valley (TEWV) and felt that basic duties such as bloods were being missed by staff and explained that some patients did not have an identified case worker. The Director of Public Health agreed to feedback the concerns to TEWV.

With regards to the obesity strategy, Councillor McKeon explained there was growing evidence that mental health was the biggest factor in cases of obesity and in her opinion, mental health was not discussed enough within the obesity strategy. The Director of Public Health highlighted that mental health underpinned all of the priorities and explained that once the JLHWS was in place, members could challenge it and make improvements.

Councillor McKeon went on to state that it was more difficult for those living in villages to take part in active travel and improving the footpaths between villages would be beneficial. The Director of Public Health noted the Physical Activity Strategy and explained that a consultation on enabling active travel had recently taken place to identify what needed to change to allow active travel more easily.

Councillor Varty expressed her appreciation for being able to attend the meeting of the Adult, Wellbeing and Health Overview and Scrutiny Committee (AWHOSC). She advised that the waiting list for a diagnosis for autism and neurodivergent had increased to four years. She stressed that this was not progress and emphasised that long wait times for a diagnosis impacted on children’s futures and their parent’s mental health. S Burns, Joint Head of Integrated Strategic Commissioning, North East and North Cumbria Integrated Care Board accepted that waiting lists had increased since the COVID-19 pandemic but gave assurance that they were working hard to improve this and to provide the necessary support to patients who were waiting for a diagnosis and post diagnosis. The Principal Scrutiny Officer informed the Committee that neurodivergency was planned to be on the agenda for a special meeting of the Children and Young People’s OSC in October 2023 and members of the AWHOSC would be invited to attend.

Councillor Higgins commented that social workers previously had the power to make referrals to the mental health team directly, and in his opinion, this was a more efficient process than the current arrangement of a GP referral. The Joint Head of Integrated Strategic Commissioning explained that extensive work improving access to community mental health services had commenced to ensure that a broad range of support is available. She acknowledged Councillor Higgins comment regarding referrals by social workers and agreed to feed this back.

Councillor Crute noted the various strategies and asked how they all fit together locally and how the voice of the Local Authority could be heard on a regional and national level. The Director of Public Health explained that JLHWS was overseen by the Health and Wellbeing Board and one of the roles of the Board was to support partners to focus on the wider determinants of health. She advised that recently, the Health and Wellbeing Board had influenced a questionnaire for the Inclusive Economic Strategy and confirmed that they would continue to embed health and wellbeing with partners. The Director of Public Health explained that she worked closely with a group of directors on a regional and national level and these directors had the ability to influence relevant departments. Councillor Crute welcomed the work by the Local Authority but stressed it was vital to continually voice concerns with inequality regionally and nationally and to get services based on need.

Councillor Quinn commented that it was great to see the JLHWS and she welcomed the intervention by local shops with regards to vapes being ceased. Councillor Quinn went on to express concern in relation to energy drinks and highlighted that some of these drinks contained traces of alcohol. She expressed further concern regarding the cost of non alcoholic drinks in food and drink establishments explaining that there was no incentive for those choosing not to drink alcohol. The Director of Public Health advised that they worked with ‘Balance’ and agreed to feedback the concerns raised regarding the cost of non alcoholic drinks. In terms of energy drinks, the Director of Public Health confirmed that a great deal of work had been done on this area and advised that trading standards should be informed of any illegal sales.

Councillor Andrews, the Chair praised the great strategy and expressed her thanks to the Director of Public Health.

Resolved

That the Joint Local Health and Wellbeing Strategy 2023-28 be noted.