Venue: Conference Room A - Civic Offices. View directions
Welcome and Apologies for Absence
Apologies for absence had been received from Councillor Gwen Blackett, Councillor Mike Read and Councillor David Keast.
Declarations of Members' Interests
Councillor Peter Edgar declared a personal interest as he is on the council of governors at Portsmouth Hospitals' NHS Trust.
RESOLVED that the minutes of the meeting held on 3 February 2015 be confirmed as a correct record.
Keith Percival, Honorary Secretary, Hampshire and Isle of Wight Local Dentists Committee, Dr Janet Maxwell, Director of Public Health and Dr Jeyanthi John, Consultant in Dental Public Health, will answer questions on his report which is to follow.
Dr Janet Maxwell, Director of Public Health and Keith Percival, Honorary Secretary introduced their reports. In response to questions from the panel they clarified the following points:
With regard to the figures in paragraph 2.3 it was clarified that
it was 25% of the total of 12 year olds who had untreated
A dentist did not visit all schools routinely. Public Health were
focussing on targeting pre-school children, making sure they are
registered with a dental practitioner and that parents are able to
educate their children on how to brush their teeth. The team are working with schools to provide
dietary advice, targeting those in the more deprived areas of the
The 'Brush Up' fluoride varnish programme targets children in year
The issue of fewer NHS dentists may have had a knock effect on the
low figures of adults who had attended the dentist in the last 12
months. Mr Percival was not convinced that there were fewer
dentists providing NHS dental services and added that there were 28
NHS dental contacts in Portsmouth with a value of just over
£9 million. Money from underperforming dentists was clawed
back. Due to the 2006 regulations however dental practitioners
cannot exceed their contracted value by more than 2% and take on
more patients even if they have workforce and appointment capacity,
which was a flaw with the 2006 contract. The Local Dental Committee
does not commission dental services and this is the responsibility
of NHS England.
The current system is not flexible and Mr Percival advised that
under the forthcoming contract reform process he would like to see
equitable activity flexing between practices to allow patients to
attend a different practice to capitalise on the funding available
in the city areas and beyond.
Dental health is the responsibility of the top tier authority so in
a two tier system it is the county's responsibility.
If a patient is suffering from severe dental problem (out of hours)
for example if this was affecting the patients breathing or it
could life threatening they should telephone the 111 service who
would advise the patient to attend A&E. There should be no
reason why A&E should not treat the infection and provide
medication with possible hospitalisation. There are also emergency dentists throughout the
area and the 111 staff can advise on the nearest
Councillors felt that Portsmouth dental academy was an excellent
facility and a great resource for the city. The dental students and staff provide thorough
work and are very patient.
Before the fluoride varnish can be applied, teeth need to be clean
and ideally healthy. The issue with the
fluoride varnish outreach programme has been obtaining consent from
parents, with the average consent rate for all schools at 80% which
is lower than for tooth brushing. This
relates to the adverse publicity surrounding water fluoridation;
however in areas such as Birmingham the results of fluoridated
drinking water had proved to be excellent.
· The Wessex Area Team has robust ... view the full minutes text for item 4.
Janet Maxwell, Director of Public Health will give a presentation on the work of the Public Health Team.
Dr Maxwell gave a presentation to the panel on the work of the public health team, which would be published on the council's website shortly after the meeting.
Dr Maxwell clarified the following points:
The national prevalence of smoking is reducing
nationally however in Portsmouth this is slower. There are less young people taking up smoking,
however up to 40% of young girls who are pregnant are still smoking
in some of the city's most deprived wards.
Drug use, in particular Cannabis use, continues to
be a big issue in the city. Dr Maxwell
advised she is working with the smoking and wellbeing teams on
schemes to raise awareness of the effects of using this drug. The
same applies to legal highs and e-cigarettes and Dr Maxwell felt
that young people needed to be made aware of the harmful effects of
these to change their mind-set.
With regard to making the population less reliant on
cars, councillors pointed out that buses are often not used due to
the cost or limited services particularly during the evening or
weekends, she said that it might be possible to bring in more
buses. In addition some cities are using car clubs where a small
car is available in communities which can be hired out, similar to
the bicycle hire scheme. Other cities
have found success with this and it was important that Portsmouth
was not left behind. Strong cross party
agreement was needed to find a sensible way forward to improve
transport in the city and reduced car usage.
Currently it has been agreed to distribute
£1.47 million to invest in the wider determinants
from the PH grant in 2015/16. Public Health
England is proving the Council's public health team with
Plain packaging for cigarettes should help reduce
the number of young people taking up smoking. More work is now needed in terms of food and
alcohol packaging. The traffic light
system on packets was good and helps people identify how much salt,
fat, sugar is in their food but further work is also needed to
promote healthy fruit and vegetables rather than processed foods
that have high sugar contents.
Portsmouth is leading the way with removing high alcohol content
drinks from shops but stronger legislation is needed to support the
public health campaigns.
The council is in partnership with a number of
groups to promote healthy eating and growing your own
In addition to excessive alcohol consumption,
causing liver problems people who are overweight can be at risk
from non-alcoholic liver disease. The
mind-set of people needs to change so that they change from the
high sugar content foods to healthier alternatives.
RESOLVED that the update from the Director of Public Health report be noted.
Susan Davies, Interim Director of Commisioning (Wessex) NHS England will present the attached report.
Nikki Osborne, Head of Public Health, presented her report that had been circulated with the agenda and in response to questions from the panel, clarified the following points:
The new service would start at the beginning of May
and women will experience no difference in service.
There had been a lot of work done nationally to
promote cervical screening and also breast screening. There is a perception by many women that it is
difficult to make the time and attend the appointment and it is the
younger women where there has been the biggest reduction in
A lot of work with GP practices
to make sure the right messages are given to women and
working with the Public Health team to get screening programmes up
The age range of women that are screened is
25-64. Science does not support
screening of women who are younger than 25 as the results show more
false positives as their bodies are still developing.
The HPV vaccination programme for young girls was
introduced to stop girls developing cervical cancer. The first cohort was vaccinated in 2007 and they
will be due to be screened in another 7-8 years. There were some
objections initially from parents about their child receiving this
vaccination but take-up is now at 90%.
· The details of cervical screening patients are held by the primary care agency using the Open Exeter database. They will notify patients when they reach the age of 25 that they are due to be screened and will send a reminder letter every three years to advise that an appointment is needed, however depending on the results the patient may be required to attend more frequently than this.
Angela O'Brien, Locality General Manager will attend and present the attached report.
Angela O'Brien, Locality General Manager presented his report that had been circulated with the agenda and in response to questions from the panel, clarified the following points:
The community hospitals where Southern Health have provided
increased support through social care included Gosport War Memorial
Hospital and Petersfield Community Hospital locally and Chase
Community Hospital in Bordon.
Action plans have been agreed and a rolling program of peer reviews
is taking place following the CQC inspection. Southern Health was required to agree deadlines
for implementing improvements with the CQC.
RESOLVED that the Southern Health update report be noted.
Mark Paine, Senior Project Manager, Integrated Commissioning Unit will answer questions on the attached report.
Mark Paine, Senior Project Manager (Dementia Lead) and Kerry Pearson, Senior Programme Manager, (OPMH lead) presented the report that had been circulated with the agenda and in response to questions from the panel, clarified the following points:
The dementia team are looking at pathway once a patient has been
diagnosed with dementia. Once a patient
is diagnosed they are referred to a dementia adviser. It may be that at that time they do not require
any support/assistance but the advisor will make contact on a
regular basis and it is up to the patient or carer whether they
engage and take the offer of help. It
is important to know that they are there when they feel they need
The dementia team support dementia patients with their quality of
life and help to improve their wellbeing. There are many activities that people can
participate in such as the memory café which helps to
stimulate people with dementia and provide support for them and
In addition to the specialist elements, there are things that
everybody can do to become more dementia friendly. Highbury College
recently approached the team to work towards becoming a dementia
friendly college and officers put them in touch with the
Alzheimer's Society. Southsea Fire
Station has also become dementia friendly and all staff
have been trained on how to deal with
people with dementia.
There are currently 2,500 dementia friends in the city who have
received training and 102 dementia champions who can train the
The 'This is me' document is for people who are receiving
professional care for dementia. It
information that people with dementia can use to tell staff about
their needs, preferences, likes, dislikes and
With regard to the recommendations arising from the dementia
pathway review, additional funding for pilots has been
agreed. It is proposed that the money
will be used to procure new service.
Final figures are currently unavailable need to make sure final
elements in play.
Dr Maxwell added that dementia is largely preventable and further
recognition that this trend can be stopped and money needs to be
shifted into prevention focusing on the main risk factors of
tobacco use, alcohol, physical activity and poor diet.
The Dementia Action Group has a representative from the Learning
and Development Team at the Council and are looking at whether the Council could become
dementia friendly. The PHE campaign on dementia and the internal
communications team are promoting this and there have been
advertisements in the Chamber of Commerce magazine and Flagship to
filter the message into different parts of the community.
Solent offer mental health screening and there was also an
opportunity to include this in the health checks available to the
· Mr Paine said he was awaiting a response from the Alzheimer's Society on how it is determined whether a city is classified as a dementia friendly city.
RESOLVED that the Dementia update report be noted.
Andrea Wright, Health Development Manager and Janet Maxwell, Director of Public Health will answer questions on the attached report.
Dr Janet Maxwell, Director of Public Health, presented the report that had been circulated with the agenda and in response to questions from the panel clarified the following points:
Obesity is measured using the Body Mass Index (BMI). A healthy BMI is between 19 and 25. Waist circumference for women should be below 31.5
inches and below 37 inches for men, to reduce the risk of
developing health problems. The NHS Choices website provides a
useful guide where you can enter your age, weight and height and it
provides you with your BMI.
· Physical activity needs to be built into daily lives. A lot of work is being done but this needs to be embedded more strongly. The Public Health Team are working with the Sports Council to provide more sport activities in schools. Ben Ainslie Racing was keen to raise aspirations with encouraging young people to try sailing.
Councillor Horne advised that King Richard School had removed all fizzy drink vending machines from the school and replaced them with water dispensers and this had made a huge difference to children's behaviour. The panel felt that the figures included in table 3.2 were shocking and felt that a future meeting could perhaps focus more on this issue, in particular looking at what physical activities are being provided at after school clubs at the city's schools.
RESOLVED that the obesity and healthy weight strategy report be noted.