Agenda item

Chris Weiner – Public Health Consultant (Commissioner in Public Health)

Chris Weiner, Commissioner for Public Health, Staffordshire County Council presented the Health and Wellbeing Outcomes and Performance Summary report. A number of points were made including that;

·         The provisional Office of National Statistics data for winter deaths 2014/15 were now available. There had been a substantial peak in national mortality which had had an impact on the acute system and coincided with twelve hour waiting breaches in Accident and Emergency. It was suggested that more could be done to increase flu immunisation rates and that targets were not ambitious enough.

·         People were not dying where they wanted to. Performance on end of life care was going in the wrong direction.

·         Work around delayed transfers of care had been progressing since September 2015. University Hospitals of North Midlands NHS Trust had reclassified the recording of delayed transfers of care but this had not been successfully completed in Burton area where there was a strong belief there was a misclassification.

In the discussion that followed comments were made that;

·         There was a huge amount of work being undertaken to address resilience. The social care teams were actively engaged in Burton. It was suggested that the Public Health team engage with the System Resilience Group on this issue.

·         It was important to communicate effectively with the public. The Board’s messages could be, for example, sent out with Council Tax bills and in the Your Staffordshire magazine.

·         There was no mechanism for the Board to collectively share its message and a communication strategy would be helpful.

·         It would be useful to share with the public the Board’s priorities and gather the public’s views on these.

·         NHS England’s Public Health team were driving immunisation nationally.

·         Board Members could report back individually on how the organisations that they represented were addressing individual issues.

·         Interesting conversations could be held with the public regarding end of life care.

·         There was over medicalisation of end of life care. Thirty percent of the NHS budget was spent on the last year of life.

·         There had been work to engage with the public regarding end of life care in Staffordshire.

·         The treatment of someone at the end of their life was the patient’s choice and the GP would take this into account.

·         Nationally there was not enough planning around death and it was important to have these conversations. A joint Health and Wellbeing Board message around this would be helpful.

·         People had been reluctant to engage in advance care planning in North Staffordshire but it was positive to start conversations with people early. There was an opportunity for GPs to be de-prescribers of medication.

·         Sixty seven percent of people wanted to die at home.

·         Four Staffordshire CCGs looked to procure an end of life service. This had been prompted by poor outcomes. There had been a lot of work undertaken with patients as part of this procurement process, but the process had now been paused. There was more work to do to consider the views of people County wide and not just current patients. Healthwatch Staffordshire would be happy to support this.

·         Many people did not have an advanced plan in place. People may have a lasting power of attorney but health and wellbeing considerations were not included.

·         Many people approaching the end of their life did not have immediate family living nearby.

·         There was an opportunity to debate public attitudes towards death.

·         There had been excellent patient engagement work undertaken by Macmillan.

·         Caution was expressed about the impact of communication plans in changing behaviour. It was emphasised that the Board should not do something if there was not the evidence that it could have an impact.

It was Resolved that;

-       Jan Sensier, Chief Executive, Healthwatch Staffordshire and Richard Harling, Director of Health and Care, Staffordshire County Council present a proposal regarding an end of life focussed workshop session.

The Health and Wellbeing Board note the information contained within the Health and Wellbeing Outcomes and Performance Summary Report for Staffordshire – February 2016.