Agenda item

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.

The report was introduced by the Director of Public Health and presented by The Specialist Public Health Practitioner.

The Director of Public Health summarised that this annual report provided assurance that York has a response to such threats as Mpox, measles, whooping cough, and a new influenza variant; he advised that the report detailed York’s sexual health services, due to a recent rise in STIs; he advised that the report detailed the reduction to one central air quality plan for York as only one street now exceeded the World Health Organisation recommended amount of pollution; finally he advised that the report covered an uptake in vaccination in York’s migrant asylum seeker communities.

The Specialist Public Health Practitioner focused on the discussion of immunisation and health screening; she advised that statistics for men’s bowel cancer screening were improving, as were statistics for women’s breast cancer screening. She stated that cervical screening figures were less impressive, largely due to the younger age cohort not attending, and as a consequence there had been quite a lot of work around that. She noted that the Abdominal Aorta Aneurysm data looked dreadful in the report, due to significant capacity issues in that programme, but it was in fact getting better. She summarised that generally things were going well with screening and unfortunately some (not always accurate) data let things down.

Regarding immunisation she noted that those particularly susceptible to winter viruses were becoming unwell quickly. She stated that the school aged uptake was well ahead of where we were last year and the authority was making good progress, particularly in secondary schools. She stated that they had also made progress with MMR catchups, including among home schoolers where there had previously been consent issues. With over 65s flu injections the authority was nearly where they were this time last year when they had started a month earlier. MMR2 is lower than target of 95% but this is possibly due to data cleansing issue - uptake went up by 12% last year without the extra vaccination.

The Director of Public Health added that there had been high levels of Covid in September of this year but this had gone down again in the past week. Flu levels were starting to rise and anticipated to peak in January.

The board asked about oral health in children raised in the report – if there is a 5 year old or 10 year old with oral health concerns, what is the impact regarding this individual going forwards?

The Director of Public Health answered that poor oral health is programmed in at an early age and can be hugely linked to poor cardiac health in later life due to a bacteria that exists in the mouth and can exacerbate symptoms. He stated that this was wrapped up with poverty and disadvantage. Supervised toothbrushing from health visitors or social care can encourage better habits from an early age in vulnerable individuals.

The Chief Executive, York CVS noted recent work from the Travellers Trust and others around vaccine hesitancy, and those not wishing to attend screenings in hard to reach groups, suggesting that social prescribers could be utilised to improve relationships and dispell fears and misunderstandings. She suggested that support like this can be put in to establish the reason for hesitancy and to encourage dialogue.

The Specialist Public Health Practitioner responded saying she would be delighted to work with these groups/volunteers to reach people.

The Manager, Healthwatch York noted a recent report by Healthwatch England which indicated that cervical screenings could be undertaken at home and there was enthusiasm for this among women, which would greatly increase participation if enacted nationally.

The chair asked for clarification whether or not we actually are below 95% for MMR vaccination and whether this was a safe level for herd immunity.

The Specialist Public Health Practitioner answered that the 95% figure was a World Health Organisation statistic. She clarified that there are two MMR vaccines, MMR1 and MMR2, and that within the authority a certain group of people are coded on NHS systems as having received the MMR1 vaccine twice, consequently it is unclear whether this is the literal truth, or whether they are fully vaccinated with both MMR jabs and this is simply a data entry error.

The Director of Public Health note that that this data is from age 5, when the second MMR vaccine is supposed to be administered, so if a second jab is taken after the recommended age they would not be counted in these statistics.

The board asked whether report would benefit from having data that went back further, in terms of establishing whether public health messaging and early help was working. The Director of public Health agreed to take this on board.