To approve as a correct record the minutes of the meeting held on 8 September 2021.

A Member stated that, whilst the minutes of the meeting of 8 September 2021 were accurate, the section that related to the item HSC/21/35 ‘Provision and access to NHS Dentistry’ did not fully capture the strength of feeling and frustration expressed by the Committee during the discussion.

Decision

To approve the minutes of the meeting held on 8 September 2021 as a correct record, noting the above comment.

The Committee will hear from Professor Sir Michael Marmot, author of ‘Fair Society Healthy Lives’ (The Marmot Review) published in February 2010 and ‘Health Equity in England: The Marmot Review 10 Years On’, published February 2020.

Professor Marmot will discuss the key issues relating to health inequalities and what he believes are the measures to be taken to address these in Manchester.

The Committee heard from Professor Sir Michael Marmot, University College London and author of ‘Fair Society Healthy Lives’ (The Marmot Review) published in February 2010 and ‘Health Equity in England: The Marmot Review 10 Years On’, published February 2020. Professor Marmot had been invited to discuss with Members the key issues relating to health inequalities and what he believed were the measures to be taken to address these in Manchester.

Professor Marmot spoke of the positive measures taken following the publication of his review, stating that cities such as Coventry and Gateshead had declared themselves as Marmot Cities and sought to implement the Marmot recommendations to address health inequalities. He stated that he had welcomed the decision taken by Greater Manchester to also become a Marmot City region.

The Professor described that the onset of COVID-19 had drastically revealed and amplified the existence of health inequalities, and he further highlighted the stark figures in relation to life expectancy in Manchester and across the North West. He stated that the understanding of inequalities and deprivation, across a range of metrics was essential to tackle and address adverse health outcomes for residents of the city.

The Committee noted that recently published data on life expectancy at birth over time in Manchester compared with England showed that life expectancy had fallen (i.e. got worse) for both males and females in Manchester in the 3-year period 2018-20 compared with the previous period of 2017-19. However, data for the 3-year period 2018-20 combined did not fully reflect the impact of the pandemic on life expectancy. Local calculations showed that life expectancy at birth for Manchester residents had fallen by 3.1 years for men and 1.9 years for women in 2020 compared with 2019. In absolute terms, 568 more men and 295 more women died in 2020 compared with 2019.

In response to questions from Members, the Professor advised that it was undeniable that the Government’s policy of austerity and continued reductions in public sector budgets had an adverse effect on health outcomes and exacerbated inequalities, adding that austerity had not ended and the Government needed to address the regressive funding cuts that had been imposed. He stated that if the Government was committed to Building Back Fairer for regions such as the North West, they needed to provide adequate funding settlements to support activities across a person’s life course. He further commented that it was important that Government investment should be prioritised in social infrastructure, not physical infrastructure projects.

In response to a specific question regarding the decision to abolish Public Health England to be replaced by the UK Health Security Agency and Office for Health Improvement and Disparities, Professor Marmot stated that whilst he always remained optimistic the use of the term Disparities was not adequate and a more appropriate title would have been Office for Health Improvement and Inequalities.

In reply to a question regarding his opinion of the Health and Social Care Bill, published 6 July 2021 that set out  ...  view the full minutes text for item 39.

Report of the Director of Public Health

This report gives an overview of some of the current population health inequalities in Manchester and provides examples of how partners across our population health and wellbeing system work collaboratively to address them. The examples include a particular focus on social prescribing as requested by the committee. The report also covers the work of COVID-19 Health Equity Manchester (CHEM) and the important lessons learned for ongoing work to promote health equity in the City. Finally, it summarises the next steps for Population Health Recovery within the context of the pandemic, and how Manchester would be responding to “Building Back Fairer in Greater Manchester” - the post-pandemic recommendations made for Greater Manchester as a Marmot City region.

The Committee considered the report of the Director of Public Health that gave an overview of some of the current population health inequalities in Manchester and provided examples of how partners across our population health and wellbeing system worked collaboratively to address them. The examples included a particular focus on social prescribing as requested by the Committee. The report also covered the work of COVID-19 Health Equity Manchester (CHEM) and the important lessons learned for ongoing work to promote health equity in the City. Finally, it summarised the next steps for Population Health Recovery within the context of the pandemic, and how Manchester would be responding to “Building Back Fairer in Greater Manchester” - the post-pandemic recommendations made for Greater Manchester as a Marmot City region.

Key points and themes in the report included:

·         An overview of the Manchester’s Population Health Plan (2018-2027), the city’s overarching plan for reducing health inequalities and improving health outcomes for Manchester residents;

·         What health inequalities looked like for Manchester’s population;

·         Population Health Recovery Framework;

·         Health equity and the impact of the COVID-19 Pandemic;

·         Delivering the Population Health Plan – Examples of collaborative working;

·         Whole system approach to population health and wellbeing;

·         Taking action on preventable early deaths;

·         COVID-19 Health Equity Manchester and its objectives and activities;

·         Manchester Health and Care Commissioning (MHCC) – addressing health inequalities in health and care; and

·         Next steps, including the Marmot Task Group and refresh of Manchester’s Population Health Plan and delivery of Manchester’s Population Health Recovery framework and associated flagship programmes.

The Committee heard from Valérie Touchet, citizen of Manchester, who spoke of her experience of engaging with her Employment Coach at One Manchester. She spoke of her circumstances that led to her engagement with this service and the positive outcomes that she had experienced. The Committee expressed their appreciation to Ms Touchet for attending and speaking to the Committee. Members expressed the importance of continuing to appropriately engage with people to keep enquiring if they were okay and to be there when assistance was required.

The Chief Medical Officer, MLCO, stated that all partners across the MLCO embraced the Our Manchester approach and were committed to delivering better outcomes for residents, noting that that the question that was asked by practitioners was ‘what matters to you?’ rather than ‘what is the matter with you?’ which was indicative of the approach taken.

The Committee then heard from Hendrix Lancaster, Coffee4Craig who described a case study that he had circulated to Members of the Committee in advance of the meeting. In response to this example the Executive Director of Adult Social Services stated that she remained committed to reviewing the services provided for homeless people, adding that a Health and Homelessness Group had been established that included key partners and stakeholders. She said that a report to the Committee on this work could be provided at an appropriate time. In reply to the issue raised in the case study regarding the lack of identification, the Director of Public Health  ...  view the full minutes text for item 40.

Presentations from the Director of Public Health, Manchester City Council and the Medical Director, Manchester Health and Care Commissioning

The Committee considered the joint presentation of the Director of Public Health and the Executive Clinical Director, Manchester Health and Care Commissioning, that had been circulated to all Members in advance of the meeting. The presentations provided an update on COVID-19 activity that included the latest available information on data and intelligence.

In response to a question from the Chair regarding COVID-19 rates and school age children, the Director of Public Health stated that the situation was being closely monitored. He informed the Members that the Public Health Team continued to support and advise Education colleagues and support Head Teachers. He further commented that it was anticipated that the October school holiday would act as a natural circuit break, however he reassured the Committee that this situation would continue to be closely monitored, with the appropriate advice and support offered to local schools.  

Decision

To note the presentation that had been circulated to all Members in advance of the meeting.

Report of the Governance and Scrutiny Support Unit

The monthly report includes the recommendations monitor, relevant key decisions, the Committee’s work programme and items for information. The report also contains additional information including details of those organisations that have been inspected by the Care Quality Commission.

The report of the Governance and Scrutiny Support Unit which contained key decisions within the Committee’s remit and responses to previous recommendations was submitted for comment. Members were also invited to agree the Committee’s future work programme.

The Chair informed the Committee that the ‘Suicide Prevention Local Plan’ and the ‘The Our Manchester Carers Strategy’ would be considered at the December meeting. The Chair further advised that an item relating to Climate Change and Health would be considered at a future meeting, with the date to be determined following discussions with relevant officers to agree the scope of the report.

Decision

The Committee notes the report and agrees the work programme, subject to the above comments.