Decision Session – Executive Member for Health and Adult Social Care	13 July 2022
Report of the Director of Public Health

Allocation of underspend from Public Health Grant

Summary

1. The report will give an overview of how an underspend against the Public Health Grant will be allocated in order to address public health priorities in the City.

Recommendations

2. The Executive member is asked to:

1) Approve the recommended allocation of budget.

Reason:  The recommended areas of funding are based on current public health priorities according to the JSNA and the public health work programme, and are aimed at addressing inequalities in the City.

Background

3. The Secretary of State for Health and Social Care, in exercise of the powers conferred by section 31 of the Local Government Act 2003, determines each year the allocation of a ring fenced Public Health Grant.  The Grant is paid to Local Authorities on an annual basis and is ring fenced for use as set out in the Act.

4. During the financial year 2021/22 an underspend accrued.  This was largely due to the Covid-19 pandemic and some business as usual activities not taking place as well as some staff vacancies. 

Priorities for Investment

5. With reference to the Joint Strategic Needs Assessment and Health and Wellbeing Strategy, it is proposed that £250,000 of underspend be allocated to work within the public health team as set out below.  The proposed areas of work meet the conditions laid out in the Public Health Grant.

6. Changing Habits

Continuation of 2 x Changing Habits Practitioners / Liaison Workers and their management, training and supervision.  Based in GP practices and other venues across the city as part of an outreach-based model, the Changing Habits service offers tailored support for people who are drinking to hazardous or harmful levels, and have often experienced a range of issues related to their alcohol use. Initially known as the GP Liaison Service, this service has been given its own branding: ‘Changing Habits’ and is open to self-referrals and referrals from partners across the system alongside primary care, including York Hospital’s hepatology department and the local IAPT service.

7. Addressing the needs of children and young people

The public health team recently undertook a school survey of primary and secondary school pupils in the York.  The survey highlighted a number of areas of concern, where additional funding could be used to support schools to address issues within their curriculum, or where external agencies could deliver support within schools.  The four most pressing areas that interventions will be developed around are diet and nutrition, sleep, children that have no one to talk to about their worries, and healthy relationships.

8. Suicide Prevention Training

Provision of evidence based training to professionals in priority workforce groups in York who would otherwise not have access to this training. The training is aimed to support professionals to recognise when person may be at risk of suicidal thoughts and provides skills to ask about suicide and refer to appropriate support.

9. Oral Health

Work with the Community Dental Service to roll out training and supervised toothbrushing programmes across those settings with the most need to re address oral health inequalities and improve outcomes.  Other areas to be targeted as part of this campaign is work with Gypsy, Roma, Traveller communities and foodbanks. A universal campaign on oral health is also planned for the other early years settings not included in the targeted work, as well as settings such as pharmacies and GP surgeries.

10. Maternal Health

Pregnancy and early parenthood is known to bring about many social factors that can precipitate poor mental wellbeing (relationship strain, reduced finances, life change). Good support for mental wellbeing also encourages good physical health habits (excess weight, smoking, stress management) that contribute to healthy pregnancy, as well as supporting good attachment which underpins many of the outcomes of the first 1001 days.

Despite universal screening through midwifery and health visiting, there is no bespoke support available for mental wellbeing of pregnant or new mothers in York.

Additional funding will allow the establishment of a new pathway for support for mental wellbeing for pregnant women directly from midwifery and health visiting into an existing women’s support charity in York.

11. Early Communication skills

The Early Talk for York Programme of work has developed a screening tool to identify children with speech, communication and language issues as well as a toolkit of evidenced based interventions.  The area that is missing is how parents can also be supported to recognise speech, language and communication difficulties in their own children and to also be skilled to deliver interventions at home.  Additional funding would enable this element of the programme to be rolled out this year.

12. Physical Activity

The City of York Council has recently launched a 10 year Physical Activity Strategy for the City.  Additional funding would support the implementation of this strategy.

13. Tobacco Control

The tobacco control plan is aiming to reduce smoking prevalence in York to 5% or below by 2025. There are serval actions on the plan that would benefit from financial investment, including, supporting vulnerable people (e.g. homeless) to quit, and training.

Additional funding to extend by 4 months a 1 year post at the hospital to implement the commitments around smoking in hospitals in the NHS Long term plan. The extension will ensure project support until the work is implemented.

Additionally, following the NEMS illicit tobacco survey, additional funding to support the recommendations from this work and enable greater enforcement around sellers of illicit tobacco.   

14. Joint Strategic Needs Assessment

Work to update the layout, style and accessibility of the JSNA website to bring it in line with the latest accessibility requirements.

15. Infection Prevention and Control

The current contract for Infection Prevention and Control that City of York Council contributes to with wider partners across York and North Yorkshire does not have any provision for support to schools or settings other than care homes.  In the past any TB directly observed therapy requirement has been difficult for the team to respond to.  An additional contribution to this contract will enable support to other settings, which is a priority post covid, as well as providing sustainability to the TB elements.

Work area	Amount
Changing Habits	£70K (over 2 years)
Addressing the needs of children and young people	£62
Suicide prevention training	£8k (over 3 years)
Oral health	£10k
Maternal health	£20k
Early communication skills	£10k
Physical activity	£5k
Tobacco control	£43K
Joint strategic needs assessment	£2k
Infection prevention and control	£20k
TOTAL	£250k

Consultation

16. The plan has been discussed with Public Health Managers and at Public Health DMT.  It has also been discussed with finance colleagues at our budget meetings.  The investment areas are based on evidence from the Joint Strategic Needs Assessment.

Council Plan

17. The investment proposals set out here contribute to the Council Plan’s priority for Good Health & Wellbeing.

Implications

18. The report has considered the following implications:

· Financial

The cost of the proposals are met by underspend from the allocated annual public health grant.

· Human Resources (HR)

No HR implications

· Equalities

Equalities Impact Assessment completed – none identified

· Legal

No direct implications

· Crime and Disorder

Overall aim of the National plan is to assist with decreasing crime and disorder      

· Information Technology (IT)

No IT implications

· Property

No Property implications

· Other

None

Risk Management

19. No known risks

Contact Details

	Chief Officer Responsible for the report:
Fiona Phillips Assistant Director of Public Health Public Health Tel No. 01904 565114	Sharon Stoltz Director of Public Health
	Report Approved	ü	Date	30/06/2022
Specialist Implications Officer(s) Financial:                                       Name Steve Tait                              Title  Finance Manager                  Tel No. 01904 554065
Wards Affected:					All	ü
For further information please contact the author of the report

Annex A    Equalities Impact Assessment

Abbreviations

JSNA          Joint Strategic Needs Assessment

IAPT           Improving Access to Psychological Therapies

NEMS        NEMS Market Research Company

TB              Tuberculosis

DMT           Directorate Management Team