Agenda item

A report was included in the agenda pack at page 21. Jeanelle de Gruchy, the Director of Public Health introduced the report to the Board. There was also a presentation which was included in the agenda pack at page 27. The report and presentation provided an update to the Board on progress in delivering Haringey’s Health and Wellbeing Strategy 2015-18 and also set out the challenges in delivering the ambitions, as well as areas for focus for the next 18 months. Following the presentation the Board discussed the findings.

The Board was reminded that nine ambitions were identified for the Health and Wellbeing Strategy with three priority areas for sustainable improvements: Reducing obesity, increasing health life expectancy and improving mental health and wellbeing. In the first 18 months of delivering the Health and Wellbeing Strategy significant progress was reported in the following areas: Establishing strategic frameworks for delivery, establishing partnerships and governance to deliver improvements at population level and initiating key interventions. The Board noted successful improvements made through stroke prevention initiatives in Primary Care; with a 7 % increase in the number of people diagnosed with hypertension from 2014/15 – 2015/16, and a 13% increase in the number of people diagnosed with atrial fibrillation from 2014/15 – 2015/16.

The Director of Public Health updated the Board on current performance levels against the 9 nine ambitions set out in the Health & Wellbeing Strategy. The Board’s attention was drawn to significant underperformance on Ambition 4, around achieving a reduction in the rate of early death by stroke by 25%. Haringey’s stroke rate stood at 22.3 per 100k compared to 16.3 for similar boroughs and placed Haringey as the worst performing London Borough for early deaths from stroke. The Director of Public Health also drew the Board’s attention to the key areas of focus over the next 18 months. The Board previously agreed to the prevention pyramid approach which focused on getting health into all policies at a population level.  The Director of Public Health outlined examples of clear priorities that Haringey wanted to take forward at population, community and personal health levels, as well as the opportunities that existed through the Haringey and Islington Wellbeing Partnership.

The Director of Children’s Services advised that in relation to Ambition 7, he undertook a piece of work with a group of 60 young people during the summer and it was clear from the discussion that those young people had a very good awareness of mental health in and amongst each other. The Director of Children’s Services also advised that the Bridge Renewal Trust were coordinating a piece of work on young people’s mental health in Tottenham called Young Minds, and that this would provide a key opportunity for awareness raising around young people and mental health. 

The Deputy Chief Executive commented that the organisations represented at the Board, as well as the services that were commissioned through them, employed a significant number of people in the borough and advocated that if the Board was able to successfully encourage health improvements through work based health policies then this could make a significant impact on overall heath levels in the borough. The Deputy Chief Executive suggested that this might be something that the Board wanted to consider in greater detail going forward.

The Cabinet Member for Health and Finance commended the ambitious targets that had been set through the Health & Wellbeing Strategy but questioned whether, given that the first 18 months had been spent developing the frameworks and partnerships necessary for implementation, whether there was enough time to deliver activities and meet those targets. The Cabinet Member questioned whether the Board might want to review the targets going forward. The Director of Public Health advised that significant activities had been undertaken in the first 18 months as demonstrated by the pyramid diagram that was included in the slides in the agenda pack. The Director of Public Health suggested that the targets were seen in terms of aspirations and were therefore quite set at an optimistic level, but acknowledged that there would only be a certain amount of progress that was achievable in a 3 year period.

The Deputy Chief Executive commented that the Board did spend a significant period of time previously setting out exactly where to set that level of ambition and that it was decided at the time to preference setting a high level of ambition and fail to reach that level in certain areas, given how challenging some of the ambitions were. The Leader suggested that during earlier discussions it was felt that these targets could roll into the following three year period, and in doing so would give a greater sense of strategic continuity from one planning period to the next. It was suggested that it would take a significant period of time to turn around some of the issues involved in a meaningful and lasting way.

In response to concerns about the strategic level of the outcomes and targets agreed, the Director of Public Health acknowledged that there was a suite of 4 or 5 sub-indicators and agreed to compile these for the board, to give a more comprehensive overview of performance and show where improvements were being made. The Director of Public Health cautioned that the data would need to show the link between the activity and its impact on a potentially complex range of outcomes. 

The Director of Children’s Services highlighted that there was a disconnect between having an investment period of 5 or 10 years through the STP and a three year health and wellbeing strategy. The Director of Children’s Services further highlighted the work that had been done through the Board and the HWB Partnership with Islington to promote the health and wellbeing of children and young people such as the healthy schools programme, given some of the significant health issues involved; such as smoking, diabetes and childhood obesity. 

RESOLVED:

I). That the Board note the progress implementing the health and wellbeing strategy over the last 18 months and agree the key areas of focus for the next 18 months.