Agenda and minutes

Dr Michelle Northrop

Dr Mehboobali Alimohamed

Dr Jeanelle de Gruchy

Dr Fiona Wright

The Chair will consider the admission of any late items of urgent business.  (Late items will be considered under the agenda item which they appear.  New items will be dealt with at item 10 below).

None

A member with a personal interest in a matter who attends a meeting of the authority at which the matter is being considered must disclose to that meeting the existence and nature of that interest at the commencement of that consideration, or when the interest becomes apparent.

A member with a personal interest in a matter also has a prejudicial interest in that matter if the interest is one which a member of the public with knowledge of the relevant facts would reasonably regard as so significant that it is likely to prejudice the member’s judgement of the public interest and i9if this interest affects their financial position or the financial of a person or body as described in paragraph 8 of the Code of Conduct and/or it is related to the determining of any approval, consent, license, permission or registration in relation to them or any person or body described in paragraph 8 of the Code of Conduct.

Dr Rebecca Viney – Member of the Health and Wellbeing Board Executive and Clinical Commissioning Group.

To take the panel through the Scrutiny Engagement wheel.

Laura Murphy, CfPS Adviser.

To hear from Dr Michelle Northrop on a GP perspective of engaging with men to improve their health.

The Panel was taken through the attached presentation by Dr Rebecca Viney.

Key points noted:

• One bad experience with a surgery can prevent people from going back in future.
• Ad hoc health promotion is done where possible e.g. checking the patients blood pressure.
• Q-Risk online system is used to calculate the risk of a heart attack or stroke within the next ten years. (http://qrisk.org/).
• Ad-hoc as this can only be done if there is time within the consultation.
• Information is recorded on the Quality Outcomes Framework data.
• Not every patient is seen on an annual basis, there is also a turnover factor whereby people may not longer live in the same area.
• Where possible, when women attend they are asked whether their husband is registered to try and encourage male registration.
• Men may be more likely to attend A&E than a GP surgery.
• Not always possible to open at weekends due to financial and resource capacity issues.  It is not just about GP capacity – there also needs to be practice staff.
• Discussion around opening hours in relation to men’s health.  Noted that those in the target group are not necessarily employed and therefore in this case there may be no need to have extended opening hours.
• You can’t see a GP on the same day that you register – discussion around whether this means that men may register but not go back for their registration consultation.
• Discussion around the link between pharmacists and GPs.
  • Noted that Pharmacists can and do call GP surgeries when they are concerned about patients.  However this will depend on relationships.
• Possible barriers may include reception staff.  Discussion as to whether some training could be beneficial to assist them in ensuring men follow through on registration.
• Budget for training of nurses has been taken away from practices.  In Haringey this budget has now gone to Whittington Health.
• Noted that unless it is a matter of urgency appointments are often given for two weeks down the line – does this then put men off from returning?
• Getting men into health services is like ‘gold dust’ – how to we keep them once they are there?
• Discussion around the suggestion of a targeted ‘health week/day/month’/’road show’
  • This could take place at a venue like the Tottenham Green Leisure centre.
  • All professions to be involved, including GPs, Health trainers, pharmacists etc.  In addition to the suggested list Optometrists and Mental Health workers should be involved.
  • Person receives a ‘stamp’ from everyone they are seen by.  This then equates to free swims/discount at shops/healthy meal etc.
  • Noted that the Local Pharmaceutical Committee supports this idea.
• Community kitchen idea also discussed where local men could be taught simple meals.
  • Noted that Dr Viney knows of some men who may be interested in helping with this.
• Noted that having childcare provision is an attractor at events.
• Discussion around the advantage of local GPs getting out and about and making their faces knows to help break down barriers perceived  ...  view the full minutes text for item 5.

Deferred from last meeting.

To hear from Public Health a strategic overview of the Life Expectancy gap in Haringey.

Cllr Anne Waters (as Chair of the Cross Party Working Group on Health Inequalities) presented a brief overview of the Life Expectancy Paper.

Key priorities for action include:

• Smoking
• Physical Activity
• Obesity and nutrition (particularly in children)
• Alcohol

World Health Organisation has stated that smoking cessation would have a huge impact on life expectancy.  Aim is to de-normalise smoking e.g. considering ways to make parks and bus stops smoke free.

Noted the educational aspect of smoking shishas as there is a perception that they are not harmful when they are.

If a child is obese at 5 years of age they are then likely to be obese as an adult.

The Life Expectancy gap won’t be solved overnight  - will take a sustained effort.

There are transience issues in Haringey – 25-30% turnover and lots of small communities which has an impact on targeting messages.

Chair of Panel asked that everyone have a look at the recommendations within the paper and consider ways which we can adapt them to make them specific to men over 40 years of age in the target group.

Comments to Melanie.Ponomarenko@Haringey.gov.uk

To receive input from the Local Involvement Network representatives.

The Panel was taken through a presentation by Ricardo Johnson

Noted that Ricardo’s report was anecdotal from the perspective of someone who had lived in Tottenham all of his life.

Reasons for not accessing health:

• Female health professionals
  • Noted that 70% of those in medical school are women.
• Cultural issues, including that some people have come from countries where there is either no recognisable public health care system or a system like the one in the UK. Also that some males may be culturally uncomfortable taking advice from women.
• Men are not necessarily use to speaking to women about personal issues.
• Recommends a ‘buffer layer’ between GPs and men e.g. nurses and health trainers.  These staff may still be female but they are not in such a ‘high’ position so as to be daunting.
• There is a need to normalise going to see a GP for men from an early age.
• Need to break down gender barriers to get men to go to see female GPs and to listen to their advice.
• Discussion around the need to do a thorough analysis of target group to consider cultural issues within country of origin, language and religion to fully understand gender issues.  Then consider who is most appropriate to up-skill as this would need to be more than GPs.
• Noted than NHS choices states when there are female GPs at surgeries.
• Discussion around the need for sports leaders within communities to actively get people involved in activities.
• Need to build activities into everyday living e.g. how do we make walking enjoyable and the norm?

To approve the minutes of the last meeting.

Approved

TBC

To consider any items submitted under Item 2 above.

None