To receive reports on GP Engagement, Screening Services and Antenatal Services from Dr Tha Han, Consultant in Public Health and Allison Duggal, Consultant in Public Health.
· GP Engagement Presentation
· GP Engagement Report
· National Screening Programme Report
· Cancer Screening Report
· Antenatal Services Report
Reports were presented on the following :
Post meeting note – Dr Tha Han has pointed out that his presentation should have stated – Life expectancy gap is : 8.6y (F) and 7.4y (M)
Dr Tha Han presented this report and highlighted
He referred to a plan set out by the public health team to address issues, the aim of which is to reduce illness from preventable conditions and conditions modifiable by healthcare by collaborating with Health and Wellbeing partners.
· To reduce variation in clinical care of long- term conditions among general practices across Enfield by raising awareness of best practice among GP’s
· To improve management of long-term conditions already identified by local GPs, and also to improve identification and management of major diseases and risk factors in primary care
· To improve access to effective community services.
The following questions/ issues were raised:
National Screening Programme Roles and Responsibilities and Cancer Screening Update – Reports presented by Allison Duggal and Jo Murfitt (NHS England)
The first report by Dr Allison Duggal and Lisa Luhman set out the roles and responsibilities of Public Health England, NHS England, Local Government, CCGs and providers in planning, commissioning and delivering the national screening programme.
The following was highlighted:
The second report provided an overview of uptake, coverage and performance of Cervical, Breast and Bowel Screening for Enfield CCG registered patients.
The following was highlighted:
The following questions were raised:
Q: Councillor Abdullahi said he would like to see a breakdown of the data on cancer screening and immunisation, so that we know where to focus our attention and resources
A: The data are not available broken down by ethnicity or geography, but are available by GP practice and this might be used as a proxy for geographic data. It was noted that the data would not be 100% accurate because people are sometimes not registered with a GP.
Q: As public health is now a responsibility for the local authority, since the Health and Social Care Act of 2012 was introduced, do you think the new arrangements work in favour of the local population especially in light of the closure of some of the services at Chase Farm hospital?
Is it possible for public health to support/ work with Local authority to ensure issues are addressed?
A: When the new Act was implemented, the transition was complicated in determining who was responsible for what. In terms of public health influence in the local area, I think it sits well with the Local Authority, as it enables us to address the wider determinants of health. An example of this would be the impact this has had on local Antenatal services.
Q: It appears that the cancer screening data figures look positive and there seems to be improvements relating to immunisation figures.
A: There had been problems with the data recording system for immunisation which appeared to show our immunisation coverage was much worse than was the case. We need to do more work to encourage childhood flu immunisation as often children are ‘super spreaders’ – we are currently looking at 2 -6 year age group and for next year this would be for the 2 – 7 year age group.
Antenatal Services – report presented by Dr Allison Duggal.
This report set out some of the recent work undertaken by Enfield Public ealth to help and advise antenatal service providers in planning and commissioning good quality care to women. Also to address health inequalities in the borough.
The following was highlighted:
· The National Childbirth Trust was supported by Public Health to train breastfeeding peer supporters for different children’s centres.
· A breast feeding App has been launched which provides information on support in Enfield, it shows where breastfeeding friendly premises are located.
· Over last two years the proportion of expectant mothers being seen by 12 weeks 6 days of pregnancy has gradually increased.
· A toolkit and video have been developed with faith groups to help to discuss early access to maternity services. This is targeted at the African community as they often do not wish to access maternity services until later in pregnancy.
· A roadshow was held in Edmonton with DVD to promote early use of antenatal service and breast feeding – the road show was successful and feedback good.
· Some members of the Parent Engagement Panel (PEP) have volunteered to work as community health workers to engage parents and families during pregnancy.
· Obesity in Pregnancy -. Public Health is working with health trainer to provide specialist training in maternity, working with mothers who have a BMI of over 30. Workshops are to be held for affected pregnant women.
· Learning event held for professionals and health workers by Public Health and Safeguarding Children’s Board to raise awareness of child deaths and particularly those related to Sudden Infant Death Syndrome and to promote safe sleeping.
· Joint working arrangements are developing to improve engagement of pregnant women in relation to Enfield’s Hidden Harm Parental Substance Misuse service.
· Ante-natal and new born screening performance data provided – and considered to generally be going well.
· An infant mortality action plan is being prepared and will hopefully be developed into a strategy for the next financial year.
The following issues were raised:
Q: Do we have data giving age evaluation and details of how far into pregnancy women are when they first access maternity services?
A: Yes we do have this information. This is heavily influenced by a woman’s culture. We are trying to move the target time of a first visit from 12 wks. 6 days to an earlier target.
A member of the public thought it would be useful for girls to view a video/ DVD in school to see the consequences of drug/ alcohol misuse in pregnancy and implications of this on their baby. It was also thought this should apply to boys / young men.
Q: Who is responsible for visual defects screening
A: The National Screening Committee has recommended this screening service, but the responsibility for commissioning this service would rest with NHS England. We are not aware of any plans to implement this screening service. There are a number of times when a child would be assessed at school and health visitors do an assessment at 2 years of age.
Q: Who determines that a person has necessary support when a baby is born?
A: A new mother would be seen by a midwife, then a few days later they will be seen by a health visitor who would look at issues such as bonding, baby wellbeing and check for conditions such as neonatal jaundice. If someone was struggling the service would be strengthened. It is the job of the health visitor to take a more holistic view and to signpost additional services should this be required. They would also give advice on immunisation especially on the MMR programme.
Q: Are there an adequate number of Health Visitors?
A: There was a push to train more midwives in 2012. Enfield has a good number of midwives and does very well in retaining them.
Dr Tha Han, Jo Murfitt and Allison Duggal were thanked for their contributions