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Health and Wellbeing Board |
22 November 2023 |
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Report of the Director of Public Health |
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Health Protection Annual Report 2023
Summary
1. The purpose of the report is to provide members of the Health and Wellbeing Board with an update on the health protection assurance arrangements in York and health protection activities over the past year.
2. A copy of the Health Protection Annual Report is attached at Annex A
Background
3. The protection of the health of the population is one of the mandated responsibilities given to local authorities as part of the Health and Social Care Act 2012. The Director of Public Health (DPH) for City of York Council is responsible under legislation for the discharge of the local authority’s public health functions.
4. The health protection element of these statutory responsibilities, and the responsibilities of the DPH are set out below:
a) The Secretary of State’s public health functions
b) Exercising the local authority’s functions in planning for, and responding to, emergencies that present a risk to the public’s health
c) Such other public health functions as the Secretary of State specifies in regulations
d) Responsible for the local authority’s public health response as a responsible authority under the Licensing Act 2023, such as making representations about licensing applications
e) A duty to ensure plans are in place to protect their population including through screening and immunisation.
5. Within City of York Council, the remit for health protection is delivered by the DPH in partnership with the Public Protection and Emergency Planning teams.
6. The Humber and North Yorkshire Health and Care Partnership (Integrated Care Board or ICB) has responsibilities for health protection including, for example, arrangements for delivery of Infection Prevention and Control services in York through a joint agreement with York and North Yorkshire Public Health Teams.
7. The UK Health Security Agency (UKHSA) core functions include protecting the public from infectious diseases, chemicals, radiation and environmental hazards and supporting emergency preparedness and response. The team responsible for delivering these functions sit at regional level and facilitate access to national experts in this field. In addition, a new Centre for Climate and Health Security has been launched within UKHSA to lead efforts to protect health in the context of a changing climate and provides a focus for partnerships and collaborations with academia, local authorities and other public sector organisations.
8. NHS England is responsible for commissioning and quality assuring population screening and immunisation programmes.
9. The Humber and North Yorkshire ICB is now a statutory NHS organisation and has a new role as a Category One responder for Emergency Planning, Preparedness and Response. A Humber and North Yorkshire Local Health Resilience Partnership (LHRP) has been established which brings together NHS provider organisations, the Local Resilience Forum’s, UKHSA and local authority Public Health to ensure protocols and procedures are in place providing consistency of approach across the Humber and North Yorkshire footprint. The Humber and North Yorkshire LHRP is chaired by the Deputy Chief Executive and Chief Operating Officer for the ICB. The City of York Council DPH is the vice-chair.
Health Protection Arrangements in York
10. One of the lessons learnt from the COVID-19 pandemic is that maintaining a focus on high quality and responsive health protection services is vitally important to protect and improve the health of people living in York. Local health and care organisations and leaders are operating in an increasingly complex national policy and commissioning environment and are required to maintain their effectiveness to protect and improve health in the face of multiple challenges.
11. The DPH in York has established a York Health Protection Committee which brings together the key partners across the health protection system to work collaboratively on actions to protect the health of the local population. This Committee is chaired by the DPH and the Terms of Reference and Membership can be found as an Annex to this report.
12. The work of the Health Protection Committee is driven by the health needs of local residents and includes:
a. National programmes for vaccination and immunisation;
b. National screening programmes for antenatal and newborn, cancer (bowel, breast and cervical), diabetic eye careening and screening for abdominal aortic aneurysm;
c. Management of environmental health hazards, including those related to air pollution and food;
d. Health emergency preparedness and response, including management of disease outbreaks and chemical, biological, radiological and nuclear hazards;
e. Infection prevention and control in health and social care community settings;
f. Other measures for the prevention, treatment, and control of communicable disease and in response to specific incidents.
Main/Key Issues to be Considered
13. The Health Protection Annual Report 2023 provides an overview of health protection activities over the past year and identifies a number of for the coming year which are summarised below:
Screening
a. Continue the work with the breast screening unit to identify those eligible who have not attended for screening, understand the reasons why and remove barriers to access.
b. Identify missed opportunities for younger women to attend cervical screening. For some marginalised groups this may involve looking at alternatives to GP practice for screening including the sexual health service.
c. Identify what is working well in other local authority areas with higher uptake of abdominal aorta aneurysm screening and apply this learning to York.
d. There will be a focus on targeting persistent non-attenders and those experiencing health inequalities in access.
Vaccination and Immunisation
a. Increase the uptake of seasonal flu and covid vaccination in all eligible groups.
Sexual Health
a. New contractual agreements for sexual health and contraception services to be put in place.
b. Development of a service delivery model which reduces inequalities and improves access to services ensuring a ‘no wrong door’ approach is delivered.
c. Introduce call and recall to improve uptake of annual HIV testing in men who have sex with men.
d. Relaunch the condom distribution scheme.
Oral Health
a. Continue the roll out of the supervised toothbrushing programme in more early years settings, dependent on continued funding.
b. Continue the development of the workforce training offer and development of support resources for those who are not part of the targeted supervised toothbrushing programme but whish to be involved, dependent on continued funding.
Winter Resilience
A key priority for 2024/25 is the ongoing work of the Winter Planning Group. The group was formed in March 2023 and meets fortnightly with the aim of developing a collaborative approach to tackling the challenges that winter brings to the health and care system. The group shares expertise and resources to achieve better outcomes for the population across the region. For example, a suite of communications is currently being developed to share consistent health messages as required in weather events, commencing with specific winter health messaging. Members of the group include representatives from the Integrated Care Board (ICB), NHS England (NHSE), York and Scarborough Teaching Hospitals Trust, regional Local Authorities and Pharmacy services.
Air Quality
a. Progress consultation with stakeholders and residents on a draft Local Transport Strategy. We will also consult on a revised Air Quality Action Plan (AQAP4) that will outline the action we will take to further improve air quality in York over the next 5 years to meet health-based National Air Quality Objectives in all areas and to work towards meeting stricter World Health Organisation (WHO) Air Quality Guidelines in the longer term, to improve public health outcomes. AQAP4 is fully aligned to the Council Plan and reflects ambitions contained within our 10-Year Strategies covering climate, health and wellbeing and the economy.
b. Continue feasibility work to address first/last mile delivery of light goods in York and will work with partners to evaluate low emission delivery modes.
c. Progress further upgrades to bus services (including further electrification of the urban fleet).
d. Consider the feasibility of extending the Clean Air Zone (CAZ) to other areas and vehicle types.
e. Continue to address idling emissions and raise awareness of the links between idling emissions and health in line with CYC’s existing ‘Kick the Habit’ anti-idling campaign.
f. Progress upgrades to CYC’s fleet vehicles as part of an EV upgrade programme.
g. Continue to reduce emissions from taxis and undertake further consultation with the trade in relation to updates to our Taxi Licensing Policy.
h. Continue to work with developers to ensure development related emissions are appropriately mitigated and exposure to poor air quality is reduced. We will also continue to facilitate and encourage walking, cycling and low emission public transport use, which have co-benefits for health and wellbeing.
i. Progress a DEFRA funded project to improve public awareness of the links between domestic solid fuel burning, particulate emissions and health impacts. This project will highlight the links between solid fuel burning at home and links to both indoor and outdoor air pollution.
Environmental Permits
a. To continue working with the metal coating sites to reduce the volatile organic compound usage using water-based products or alternative coating methods. To consider the potential use of abatement to further reduce emission to the environment.
b. To support one of the readymade concrete batching sites to expand whilst maintaining compliance with the environmental permit.
c. To update the permit held by the vegetable dryer to cover the new processing plant installed following major investment in the site.
d. The A2 site requires a full review of the permit to take account of the new guidance documents, the compliance deadline for this is 9 December 2024. E have been working with the new operators at this site and progress towards meeting this deadline is going well.
Land Contamination
a. Update the council’s Contaminated Land Strategy to incorporate recent changes in legalisation/guidance and provide an update on progress made to date. This includes consultation with various stakeholders and residents.
b. Continue to assess all land contamination investigation, risk assessment and remediation work undertaken through the planning regime to ensure that new developments are safe and do not pose unacceptable risks to people, property or the environment.
c. Continue to inspect any site as a matter of urgency if we suspect that there is a serious risk to human health or the environment.
Migrant Health
a. To continue the focused work to achieve full vaccination for asylum seeking and refugee children and adults.
b. To improve the information sharing between partners to ensure that progress is jointly monitored.
The UK Health Security Agency regional health protection team
a. As we progress through 23/24, we aim to move away from the proportion of work spent on reactive pieces and look more to proactive strategic work. We have undertaken quite a lot of work over the past year in York. We have worked together looking at migrant health plans and measles plans and had a collective meeting discuss ways of working between UKHSA and York City Council Public Health Team.
b. Going forward a priority of the coming year will be to confirm the infection prevention control contract that is up for renewal. They are partners we work with very closely especially in terms of care home outbreaks and supporting infection control in care homes.
c. Continue to build on the strong working relationships with different agencies across York.
Options
14. There are no options to consider. The production of a health protection report to provide the Health and Wellbeing Board with assurance is a statutory requirement.
Strategic/Operational Plans
15. There is a general link across to the York Joint Health and Wellbeing Strategy 2022-2032 and the City of York Council Plan 2023-2027 because of the health inequalities impacts of health protection and the need to protect the health of the local population.
Implications
16. There are no specialist implications in this report.
Risk Management
17. There are no risks associated with this report.
Recommendations
The Health and Wellbeing Board are asked to:
i. Receive the report.
Reason: To be assured of the health protection arrangements to protect the local population.
Contact Details
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Author: |
Chief Officer responsible for the report: |
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Philippa Press Public Health Specialist Practitioner Advanced
Anita Dobson
With contributions from members of the council’s Public Health Protection Team and the York Health Protection Committee
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Sharon Stoltz Director of Public Health
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Report Approved |
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Date |
14 November 2023 |
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Wards Affected: All
Annexes:
Annex A – Health Protection Annual Report 2023
Annex B – York Health Protection Committee Terms of Reference