Section 1: Looking back
Annual Report of the Director of Public Health
Last year’s report (9) provided an introduction to the public health and wellbeing team and outlined the purpose, vision, values and key objectives for the two years ahead (2015-2017).
To promote and protect the health of the population of South Gloucestershire and to advocate for those whose voice is seldom heard
To improve healthy life expectancy and reduce health inequalities in South Gloucestershire
Source: Annual Report of the Director of Public Health 2015 (9)
Significant progress has been made against our priorities as illustrated in the following brief summary of our performance over the past year.
Mental health and emotional wellbeing
- Specific needs assessments have been undertaken for both adults and children and young people in South Gloucestershire
- A strategy and action plan for adult mental health and wellbeing have been agreed and one for children and young people is in development
- Funding has been secured for five years to further develop and improve local child and adolescent mental health services (CAMHS), with specific investment in prevention
- Development of an adult resilience approach in partnership with the University of the West of England and launch of an anxiety toolkit for use in schools
- A specific needs assessment for child poverty has been completed followed by the development of a strategic implementation plan which will be agreed and overseen by the Children’s Trust Board
Alcohol harm reduction
- Progress continues to be made against the objectives within the Alcohol Harm Reduction Strategy
- The public health and wellbeing division supported Avon and Somerset Constabulary and South Gloucestershire Council licensing officers in undertaking a licence review for Bar Celona in Kingswood where the recommendation to revoke the license for alcohol sales was upheld by the committee
Health in Schools programme
- Public health intelligence from the first South Gloucestershire online pupil survey has been incorporated into the revised JSNA and other needs assessment with funding secured for a follow-up survey in 2016/17
- The Health in Schools programme was officially launched in June 2015 at a well attended and high profile event supported by schools, agencies, charities and other council teams
- A school health and wellbeing audit tool has been developed with the aim of allowing schools to be accredited as being healthy settings – a standard and quality assurance process for the first incremental award (bronze) has been developed and trialled
- Whilst the National Obesity Framework has been significantly delayed, the health and wellbeing division has undertaken a review of potential approaches to dealing with this the complex problem of childhood obesity and has reported their findings
- A research proposal has been submitted to CLAHRC West in partnership with Bristol University: RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to undertake a systematic review to identify locally implementable child obesity prevention programmes
- A specific needs assessment is currently underway to identify, assess and understand the health impacts associated with domestic abuse and violence
Preventing young people starting to smoke
- ASSIST, an evidence-based peer-support programme aimed at preventing smoking amongst school children in Year 8, has been used and the SG Smokefree Alliance are currently reviewing how a similar model will be implemented from 2017
Comprehensive spending review 2015
Since 2013, South Gloucestershire Council, like other local authorities in England, has had a duty to take the steps that they believe are appropriate to improve the health of their populations. The Department of Health funds this activity through a ringfenced public health grant. The Department of Health makes some conditions on how the grant is spent, however the council can decide which issues to prioritise and which programmes and interventions to fund.
Comprehensive spending review is a process carried out by the Treasury to set expenditure limits for government departments and define what improvements that the public can expect to see as a result. In June 2015 the chancellor of the exchequer announced savings to be made across government to reduce public debt. The savings amount to £3 billion and included £200 million from the 2015/16 public health grant. Further details announced during the autumn budget statement included 3.9% annual reductions in the public health grant to local government until 2020/21. This amounts to a total reduction in funding for South Gloucestershire of around £1.8 million, alongside wider reductions in the revenue support grant which funds other council activity. There is clearly a national and local imperative to live within our means, however local authority public health teams must now ensure that reductions in funding do not result in worse health outcomes or widening health inequalities.
Initial savings were made at the end of the 2015/16 financial year in response to the announcement of in-year reduction in funding. However, around £1 million of additional savings must now be made over the next four years to ensure that local public health services and programmes can be sustained.
In order to achieve this level of savings, it has been agreed that the most appropriate way forward is to undertake a comprehensive review across the whole of the public health and wellbeing division to ensure that our priorities, our structure and the services we deliver, both directly and through our commissioning arrangements, continue to be fit for purpose and meet the needs of our population and stakeholders.
We recently consulted with our key partners on our public health priorities and how we should go about achieving these savings. The key outcomes from this were support for our existing public health priorities but with a request for an increased focus on mental health, healthy lifestyles and wider determinants of health. Partners also felt that the review should be based on identified priorities rather than apply savings equally across all areas. The priorities identified through this process are discussed in more detail in Section 4 of this report and an outline of the way forward is included in Section 5.