Agenda item

To receive an update on the Public Health grant.

Darrell Gale, Consultant in Public Health updated Members on the Public Health Grant.

During the discussion of this item the following points were made:

·         Darrell Gale outlined the mandated services that Public Health offered.

·         Public Health had set a fully committed budget for 2015/16, including investment across council services supporting public health outcomes of £751,200, and commitment to commissioned services including the recommissioning of stop smoking services.

·         In July 2015 an in-year cut to the national public health grant of £200million had been announced.  A cross-cutting 6.2% reduction to each council’s public health grant was made, with this being taken as a reduction in the Quarter 4 grant.  For Wokingham this had equated to a saving of £319,000 needing to be found. 

Ø  £57,000 – within Public Health – staffing, training, projects and marketing;

Ø  £15,000 – within Sport’s Department – projects and casual staff;

Ø  £67,000 – other Council departments (including Beat the Streets);

Ø  £56,000 – decommissioned services – small legacy projects;

Ø  £64,000 – Drugs and Alcohol Services – based on previous underspend;

Ø  £60,000 – Local Enhanced Services (GP and Pharmacy) – based on in year estimates.

·         Corporate savings for 2015/16 had totalled £202,000:

Ø  Cancellation of planned stop smoking service expansion;

Ø  Reprocurement of GUM and sexual health services;

Ø  Physical activity and prevention services provided by Sports Development;

Ø  Internal efficiencies and recruitment freeze.

·         Members were informed of the challenges for 2016/17.  The budget was not yet completely confirmed.  It was noted that the 6.2% cut had been made permanent.  In addition the Autumn statement had made a further 2.5% cuts.  In total the 2016/17 Public Health grant to Wokingham Borough Council had been cut by £419,000 from the expected position, to £5,634,000.  The Council’s ongoing financial position remained difficult whilst there was an ongoing challenge across local government and the NHS to increase preventative activities.

·         The Health Improvement Officer post had been removed.  It was anticipated that £82,000 would be saved from the joint agreement, including the decommissioning of some services.  £70,500 would be saved from legacy services.  It was noted that funding for chlamydia screening and oral health promotion had reduced.

·         The Council had one of the lowest spends on public health per head of population in England at £32.  Darrell Gale explained how this figure was calculated.  The Committee asked how Wokingham compared with other Berkshire authorities and were informed that it had one of the lowest spends on public health per head of population.

·         Members were notified that any further cuts would require major change.  Consideration would have to be given to decommissioning services and there would be potential for Public Health not to be able to provide or commission mandated services.  This would have an effect on Public Health outcomes.

·         Councillor Richards asked how there had previously been an underspend in the Drugs and Alcohol Services.  Darrell Gale indicated that options for services included residential treatment.  However, this element had not been taken up by service users.

·         The Committee discussed smoking cessation.  It was noted that those who solely vaped were not counted as smokers.  Councillor Shepherd-DuBey questioned whether information on smoking could be sought from GPs and was informed that not all GPs would have a complete picture of smoking prevalence amongst their patients.

·         Councillor Shepherd-DuBey also asked about how more information could be collated regarding alcoholism.  Darrell Gale indicated that there was a low rate of problem drinking within the Borough.  Information could be gathered informally via routes such as GPs and social workers.

·         With regards to the nationally set chlamydia testing target, Darrell Gale commented that it was based on national and not local prevalence.  There was not the level of chlamydia within the local population. 

·         In response to a question from Nicola Strudley regarding an increase in suicides and a number of these cases having links to substance abuse, Darrell Gale emphasised that a Dual Diagnosis Worker was funded with Berkshire Healthcare NHS Foundation Trust.

·         With regards to the removal of the sexual health information service from schools, the Sexual Health Needs Assessment had shown that many young people wanted to access services online. 

·         There was little discretionary funding available.  Nevertheless, some anxiety workshops for children and parents were being funded.

·         In response to a question from Councillor Blumenthal regarding the use of consultants, Darrell Gale responded that they had been used for work regarding GP provision in the Strategic Development Locations and nutrition work.  A locum consultant had also undertaken work on liver services and long term conditions.  There was no forthcoming work where a skills or knowledge gap would require the use of consultants.  Specialist Registrars, Interns and GP trainees on attachments could also be used for specific pieces of work if required.

RESOLVED:  That the contents of the paper be considered and support to the public health department to make the best use of the ring-fenced public health grant within the context of the corporate financial position, and the reductions in public health grant to 2020, be continued.