Agenda item

The Panel received the annual report on health protection assurance in Doncaster covering the financial year 2017/18.  Areas that were considered as part of the discussion included the following:

Members were assured that there would be an investigation as to why some practice areas demonstrated a low take-up.  Members were informed that there was an Immunisation Working Group that could tailor the immunisation programme to encourage engagement with certain groups.  It was added that Public Health was working closely with NHS England around recommendations set for 2018/19.

Members raised concern around areas which were experiencing diminishing resources.  It was explained that results were possibly impacted by cultural issues and poor quality of information (passed on by parents).  It was recognised that attitudes needed to be changed although good resources existed to support young people within the Councils youth provision.  Members were informed that provision such as Children Centres could be used to direct services at parents, children and communities.

It was explained that innovative work was being undertaken within GP practices as part of health inequalities work.  This included areas such as having a focus on those children who were less likely to attend an appointment.  Potential solutions to address this included practices being more flexible to accommodate patients as there may be issues such as transport for some family that are affecting their attendance.  It was explained that the intention is to target a small number of patients and find ways of increasing the numbers that need to be vaccinated.  Members were advised that there was a need to expand signposting to certain groups such as 0-5 years through existing avenues including children’s centres, health visitor’s initiative as well as members of the travellers and gypsy community who may not be registered (therefore by encouraging wider registration). 

It was explained that Public Health is working closely and supporting NHS England’s Immunisation and Screening Coordinator to improve the uptake of MMR vaccination through.  It was further added that this fits with national model of working closely with GP practices, communities and Health Visitors to focus on how to identify those kids who were not vaccinated.

It was recognised that pupils and staff within schools were at high risk of flu.  It was shared that the Council would like to see schools working towards developing more effective partnerships.  Members spoke about the impact of parental choice and the extent to which relevant information can influence uptake rates of immunisation.

It was explained that staff within Care Homes and carers who live at home were vaccinated for free.  It was explained that publicity work would commence from September/October 2018 and that it will be marketed through pharmacies and GPs who had direct contact with anyone over 65 and those with long term illnesses.

In respect of stocks of flu vaccines not supplying demand, it was explained that GPs ordered the stock in advance based on the number of the current register and the number presented last year.  It was clarified that shortage of vaccines stock was not an issue.

In terms of those groups at risk, Members were informed that the NHS produced a list of all those groups that should be provided with flu vaccinations.  It was indicated that the Council identified staff it targeted for flu vaccination as those who had direct contact with customers, on the frontline and those individuals critical for business continuity (e.g. Directors).

It was explained that there was no connectivity between schools, Public Health and parents around vaccinations as information held with GPs was historical and well established.  It was outlined that in the United States, they have sight of the immunisation status prior to the child being allocated a place at the school, something that was not applied within the United Kingdom.  It was clarified that parental consent for vaccination of their children was an important factor. 

It was clarified that the onus was on the GP practice and whole system to ensure the uptake of flu vaccinations as well as the importance of the ‘red book’ (personal child health record).  Members were informed that the target of 95% was there to ensure that the majority of children were vaccinated then the remaining 5% should also be protected.  It was shared that it was a challenge to increase the uptake although it had improved. It was explained that information was a good leaver for influencing practice.

Concern was raised that smoking rates were quite high at 19% who smoke (equivalent to 50,000 people) however, it was reported that prevalence was coming down.  Members were pleased to hear that smoking was reducing although not fast enough.  It was acknowledged that there were more challenges with adults/older people stopping.

Concern was raised around passive smoking; Members were informed that this was considered as an important issue and that actions had been taken such as not allowing DMBC staff to smoke around the entrances/pillars outside.  It was clarified that the declaration to reduce smoking in Doncaster had been signed more recently by the NHS CCG.  It was felt that there were good intentions in this area but that it was more difficult to enforce.

Members raised concern about the lag in data and statistics that had been reported on as part of the item.  It was explained that information had been reported on for those years so that there could be direct comparisons with other areas indicating trends/variations and whether interventions were working to enable Public Health to target effectively.  Members were informed that more recent information for Doncaster was available.

RESOLVED that the Panel;

a.     Note the progress made from 2016/17 to 2017/18 on addressing health protection matters in Doncaster.

b.     Support recommendation to continue work with local partners and to monitor immunisation update, in particular flu vaccinations and MMR.

c.     Support the work of Doncaster Active Travel Alliance, acknowledging the importance of encouraging residents to cycle and walk short journeys plays in addressing not only Doncaster’s Health and Wellbeing key challenges but the wider benefits to the economy, communities and environment; and addressing air quality.

d.     Support work on tackling the reduction of smoking in Doncaster.

e.     Support continued work in monitoring and reporting on progress on broader health protection functions in the borough.