Agenda item

30 minutes maximum for this item.  Questions may be submitted to be answered by the Scrutiny Committee or Council officers who are attending the meeting as witnesses, on any item that is within the scope of the Committee. Please see the procedure (below) for the submission of questions.

Question from Mr David Ingham:

“I recently attended and observed a meeting of the Health and Wellbeing Board on 13-07-23.  During the meeting there was a highly informative presentation which highlighted the highest areas of deprivation within Derbyshire - which appeared in the majority to extend down the eastern boundary of the County. It highlighted a stark picture but the level of data and the transparency of such is to be applauded and key to effective decision making. 

I note with interest the report of the ICB relating to the Derby and Derbyshire 5 year plan. I also consider this really informative. At 2.4.3.3. key actions will include: Reallocating primary and community care resource between localities – so that people with the poorest health outcomes have greater access to services and 2.4.5.2. Promoting health literacy - particularly amongst people living in some of the most disadvantaged communities in Derby and Derbyshire, as a way of improving self-management of conditions.

I don’t underestimate for one moment the extensive challenges presented within the 5 year plan but having a regard for the concentrations of deprivation within Derbyshire how will this be specifically factored for and considered when progressing actions such as 2.4.3.3 and 2.4.5.2?”

Response from the Integrated Care Board:

“Many thanks to Mr Ingham for asking the question which asks about how we will ensure that socio-economic deprivation is factored into our work  - particularly from the perspective of improving health literacy and building the multi-disciplinary service model at 'PLACE':

Health literacy

The recently publish 5-year plan sets out to put people much more control over their healthcare.

A core component of this is the focus to achieve greater 'health literacy', particularly within those individuals and communities which are subject to high levels of socio-economic deprivation, given that:

·        it is the strongest correlation to ill health – stronger than education level, deprivation, age, or ethnicity.

·        and there is a close link between socio-economic deprivation and low health literacy.

The challenge for the Health and Care Partnership over the next period, is to turn around a situation where only a third of the working age population routinely understand health and wellbeing information they are given.

As a key member of the Partnership, the NHS holds the issue of health literacy intersected socio-economic deprivation in high regard and is taking the following action.

1.    Technology has an important role to play. There are a variety of different digital platforms that are coming into play and increasingly being used by citizens to interface with the NHS. The most prominent initiative in this regard is the "NHS App" which is developing functionality at a rapid pace – allowing citizens to book appointments, access their personal health information and check symptoms. Whilst there is much more for us to do to achieve greater uptake of this application, it is positive to see that a greater proportion of people living in the most deprived communities across Derby and Derbyshire are using the functionality compared to those people living in the least deprived.

2.    The role of the voluntary sector is key. Over the next five-year period, the NHS will strengthen its support to the voluntary sector which plays an instrumental role in connecting health and wellbeing services to Derbyshire Communities, particularly the most marginalised. This will come in the form of infrastructure support and financial settlements which will allow the sector to plan in the medium to long term. 

3.    Training and Development. The NHS in Derby and Derbyshire has a comprehensive training and development programme in play to ensure that staff 'make every contact count' with citizens. More detail of this programme can be found at the following link for further information https://www.mecclink.co.uk/east-midlands/

Give the teams working in our localities, the authority to determine the best ways to deliver improvements in health and care delivery for local people

Over the next five-year period we intend to 'back' multi-disciplinary teams of professionals, working in and with local communities, with the resources they need to improve 'up stream' intervention. This is one of the most important aspects to our reform agenda and is the only viable course of action. This operating model - a new form of 'organisation of professionals' - offers significant opportunities for greater innovation and flexibility, quickly adapting to errors, fixing problems and targeting their time to those communities in the greatest need.

We start in a good position across Derby and Derbyshire to achieve this and will build on the work that we have already started via our 'Team-Up' approach (that is focused on improving the health and care offer to some of the most vulnerable older people in the community) and we will enhance the scale to which this operates. However, we fully recognise that scaling this approach will involve having to redistribute resource at various levels given the resource constraints that we have - between different parts of the health system but also across different geographical locations. This will involve difficult decisions that the Partnership will work through in a considered way.”

Mr Ingham thanked the ICB for their in-depth response.  There was no supplementary question.