To receive a report from the Director of Public Health.

The presentation was brought to the Board by the Director of Public Health, the Public Health Programme Manager, and the Public Health Consultant. The Director of Public Health opened the presentation by informing the Board that they had hoped it could get them thinking about health inequalities. They made the Board aware that Trafford had long been conscious about health inequalities, with substantial work having been done within the borough, but also at Greater Manchester and national level.

The Director of Public Health provided the Board with a definition of what health inequalities meant and classified the health inequalities into four different areas. 

The Public Health Consultant took over the presentation and reminded the Board that the things that made people healthy led to inequalities due to the way they were distributed. The suggestion was that socio-economic conditions, altered someone’s health behaviours, which could impact the likelihood of chronic conditions, which affect life expectancy. The Public Health Consultant made the Board aware health inequalities were about the causes of the causes of the causes.

The Public Health Consultant then provided the Board with some data around life expectancy in Trafford. There had been a plateau of life expectancy in Trafford, but the gap between the most and least deprived was reducing, which was positive. Data was also shared on the immediate causes of death that contributed to the gap in life expectancy in Trafford from 2020-21. For women this was Covid-19 and for men it was circulatory issues, however, both were issues for men and women, with cancer and respiratory issues also being high for men and women. The Board was made aware that conditions and causes of death varied dependent on different factors, such as geography, and different population groups such as those with severe mental illnesses. The Public Health Consultant informed the Board that smoking was still the number one cause of preventable deaths, with overall smoking prevalence in Trafford reduced to 8%, but much higher in certain groups and communities, such as those with mental health issues, or routine / manual workers.

[NOTE: Councillor Karina Carter joined the meeting at 10:51 and the Corporate Director of Children’s Services joined at 10:56]

After providing the data, the Public Health Consultant gave the Board a sense of things that were happening in Trafford on the presentation.

The Public Health Programme Manager provided an example of the work done in Trafford, and how it fitted within the neighbourhood model. The example provided related the aim of the neighbourhood model to tackle health inequalities within different neighbourhoods and the different priorities these areas had. Evidence had been used to develop a health inequalities service and fund. The Public Health Programme Manager explained some of the projects that were in place to support the reduction of health inequalities. The Board were then presented with the process which had been undertaken, which included Initial conversations with the voluntary sector, and discussions with partners, across the Council and externally. A learning event was held, which looked at what was stopping people from changing their behaviour. This was followed by a health needs assessment, with a gap analysis, which looked at what services were already in place, what could be improved, and what was left over to work with. The Public Health Programme Manager was using this information to identify where gaps in service were, and working to support people in these areas who were at the highest risk.

The Director of Public Health asked the Board what approach they think Public Health should take to address health inequalities but did raise some things that should be considered in any suggestions. The Board was then offered some key questions, and a discussion began.

The Chair thanked them all for the presentation and felt that it was important to make sure those at risk of going into hospital were supported before they ended up in hospital.

The Managing Director for Trafford LCO raised a couple of points. The first surrounded Covid-19 as a cause of death, saying that if the population was healthier, we would have had less deaths due to a large amount of the deaths from Covid-19 in the borough coming from those with two or three long-term health conditions. As such they felt that this should be kept in mind this when considering cause of death. Secondly, they said that they were struck by statistics on early death for those with mental health problems. They raised their concern by this, that many will have suffered these problems from childhood experiences, and asked if the Board as providers could look at how they can support these groups to improve the statistics.

The Chair of Healthwatch Trafford mentioned that they have a large group of carers who they have listened to and felt that their concerns will need to be considered in any strategy.

The Independent Chair, Trafford Strategic Safeguarding Partnership (TSSP) first asked if there was a carers strategy and secondly around whether conversations were being had around people with learning disabilities and what this could show about early life. The Chair responded that there was a carers strategy in place. The Public Health Programme Manager responded that the ‘Empower You’ project had looked specifically at those with learning disabilities, which looked at physical inactivity and supporting people to help them to understand the importance of staying healthy.

The Associate Medical Director appreciated the presentation and felt that focused pieces of work would be the way forward. The Associate Medical Director asked what could be done with NHS Health Checks to create opportunities to catch diseases in minority ethnic groups who may have been more likely to get diseases at an earlier point. The Public Health Programme Manager responded that a pilot project had begun with the Pakistani Resource centre that will look at the impact of earlier health checks for those from certain ethnicities.

The Trafford Community Collective representative said that work was ongoing targeting different diverse communities and long-term conditions. They felt that the presentation linked well to the communications strategy and highlighted the need to talk to people to see what works for them.

The Health and Social Care Programme Director felt there needs to be a dedicated focus for the piece of work, as the conversations in the room had shown really good specific examples of the work that was going on, but that it was now time to map out what each partner in the room can do towards the aims in the presentation. They reiterated their belief in the power of the neighbourhood model and how local intelligence came through this to hear about the needs and aspirations of the individual communities within the borough.

The Corporate Director for Childrens Services spoke of the importance of being data intelligent which came through throughout the presentation, but also using this alongside evidence-based work, due to the scarcity of resources. The Corporate Director for Childrens Services welcomed the approach and felt that with a combination of these things it will make it an even stronger approach.

The Corporate Director Adults and Wellbeing spoke of the importance of enforcing the messaging involved with work around behavioural changes for health and wellbeing.

The Director for Public Health suggested working with colleagues at bringing a proposal back to the next Board around a partnership that supports the programme of work and consolidates what was going on with the evidence base and evaluation. They thanked the Public Health Programme Manager for turning the presentations round so quickly and plans to bring the proposal to the next meeting.

RESOLVED:

1)    That the presentation be noted by the Board.

2)    That the Director of Public Health work with colleague to bring a proposal to the next meeting which supports the programme of work.