Agenda item

Members are asked to consider the information presented within the report and note the key issues described.

Dr Bruce Laurence addressed the Select Committee, a summary is set out below.

Improving fitness and health in older people

He explained that Retirement in ACTion (REACT) is funded by the National Institute for Health Research. REACT is a UK study based on a successful US programme called LIFE. It is designed to support older adults to become more active. It is being run by the University of Bath in conjunction with others and Bath will be one of the pilot sites.

He said that a 12 month programme would be delivered in leisure centres and health clubs. Participants will be offered group sessions (15-20 per group) targeting cardiovascular, strength, co-ordination and flexibility. It includes a focus on socialising opportunities and enjoyment and promotes local activities to sustain long term impact.

He added that a pilot REACT study would start in Spring 2016 to test the recruitment and measurement strategies. 180 people (60 in Bristol/Bath) will take part across the three centres. The main trial would begin in Autumn 2016.

Sexual Health Needs Assessment

He shared some of the findings with the Select Committee.

B&NES is a low prevalence area for gonorrhoea with 27 infections per 100,000 population in B&NES in 2013, compared to 55 per 100,000 in England), genital herpes (38 per 100,000 in 2013, compared to 60 per 100,000 in England) and genital warts (123 per 100,000 compared to 137 per 100,000 in England); In 2013, B&NES had a very low incidence of syphilis (5 per 100,000 compared to 6 per 100,000 in England)

Chlamydia detection rates in B&NES are below the recommended rate of 2,300 chlamydia diagnoses per 100,000 15 to 24 year olds

B&NES has a low level of under 18 conceptions, and low level of teenage conceptions when compared to statistical neighbours (18 per 1,000 females aged 15-17 in B&NES in 2013, 21.7 per 1,000 females in statistical neighbours and 28 per 1,000 females in England)

B&NES has a lower rate of abortions than both the regional and national comparators (12.7 per 1,000 women aged 15-44 in 2013, compared to 14 per 1,000 women aged 15-44 in the South of England, and 16.1 per 1,000 women aged 15-44 in England)

He said that five key themes for improvement, with associated actions had been identified as detailed below:

1.  Strengthening intelligence and research: including investigating in greater depth the sexual health needs of and service provision for vulnerable and at risk cohorts; and improving the content of sexual health data;

2.  Strengthening sexual health service provision: including examining ways to increase the numbers of young people attending GUM and CaSH services; increasing the level of chlamydia testing amongst under 25s; increasing the level of LARC provision amongst women; and improving understanding of the strengths and areas for development in school-based relationships and sex education provision

3.  Strengthening prevention and promotion: including developing the SAFE branding scheme; improving website access to information about services; and ensuring all sexual health media and communications campaigns are clearly targeted and evaluated

4.  Working with recent technologies: including reviewing and developing the use of new technologies amongst sexual health service providers

5.  Strengthening training and development: including developing the Sexual Health Training Programme and holding regular networking events for all of those involved in sexual health across B&NES

Alcohol and drug treatment progress

He informed them that PHE have commended B&NES for their rate of successful completions for ‘alcohol only’ clients, for its hospital alcohol liaison service and also for work on blood-borne virus testing and immunisation.

Flu campaign beginning

He explained that this has become a complex campaign, now including 8 groups. Over 65s, pregnant women, various young children’s groups, carers, health and social care workers, those living in residential homes, clinical at risk groups (ie people with heart, lung and other diseases that make them particularly vulnerable to flu at any age)..

Adults will now be able to get vaccinated through pharmacies as well as GPs. Good example of combined efforts of NHSE, PHE providers and the Council. 

He said there was a focus on flu because of the impact on individuals, health and social care system and the economy.

Public Health Budgets

He stated there was still no final confirmation of in year cuts and that they were awaiting the comprehensive spending review as guide to the longer term budget. He added that there was much speculation on whether the public health grant will lose its ring-fence or not, and if it does what will happen in terms of mandation of services.

Councillor Paul May asked how people would be recruited for the REACT study.

Dr Bruce Laurence replied that this would be done via a number of routes and that they were working with partners as part of the recruitment process.

Councillor Paul May said that he was pleased to see the low figures regarding the Sexual Health Needs Assessment. He asked if any specific work had been carried out with the universities.

Dr Bruce Laurence replied that they do have a good dialogue with them and Bath City College and that comprehensive services were available at all sites.

Councillor Tim Ball asked if a future update could expand on how we deal with the trauma of incidents involving alcohol and drugs.

Councillor Eleanor Jackson commented that whilst there had been a national trend that showed a reduction in alcohol consumption in young people there was an increase in the use of Ketamine and other legal highs. She added that there was also an increase in the number of patients aged 55+ reporting to the RUH with alcohol related incidents.

She said that all concerned should be commended for the low teenage pregnancy figures and called for services in this area to not be cut.

Dr Bruce Laurence replied that in terms of legal highs he felt that we still only know a small amount about these drugs. He added that the services related to teenage pregnancy had been well invested in and that he looked to maintain those services.

The Director of Adult Care & Health Commissioning added that the trends relating to legal highs can change quickly. She suggested that the Select Committee receive an update at a future meeting from the Senior Commissioning Manager, Mental Health and Substance Misuse.

The Chair commented that loneliness in older people was also a problem that needed to be considered.

Dr Bruce Laurence replied that this was one of the priorities of the Health & Wellbeing Strategy.

The Chair asked how Shingles was monitored currently.

Dr Bruce Laurence replied that there was a phased project in place that offered vaccination to those aged either 70 or 79.

Councillor Eleanor Jackson commented that she was aware of a number of recent cases of Scarlet Fever.

Dr Bruce Laurence replied that there had been a slight increase over the last few years, but in all cases it had been treatable.

He then addressed the Select Committee regarding a recent case of Legionnaires’ disease in Radstock.

He explained that B&NES has a number of procedures in place to investigate a case of Legionnaires’ disease:

·  Public Health England Health Protection Unit have a 24/7 Acute Response Centre including out of hours provision.

·  B&NES Council also have a 24/7 contact system including an out of hours contact centre, on-call Emergency Planning Officer and Public Protection & Public Health out of hours contact help list.

·  Procedures to investigate a single case or an outbreak of Legionnaires’ disease are included in the Communicable Disease Incident & Outbreak Response Framework - an Avon & Somerset Local Health Resilience Partnership document and the B&NES Health Protection Incident Response Plan (draft) which has consolidated a number of documents/procedures.

·  There are a number of other related guidance documents including the Health & Safety Executives guidance on managing legionella in hot and cold water systems.

He stated that the case in Radstock had been identified towards the end of August 2015 and explained the timeline of events to the Select Committee.

He praised Curo’s approach to the incident with regard to testing a large number of properties nearby.

Councillor Eleanor Jackson wished to also commend Curo for their actions as this incident involved 46 flats being investigated. She asked if there had been a delay between the patient being admitted to hospital and the property being cleaned.

Dr Bruce Laurence replied that the Environmental Health Officer went to the property immediately upon receiving notification and had decided after investigating that there was no further risk to other residents.

The Chair thanked him for his update on behalf of the Select Committee.