Report of Director of Public Health attached

The Board considered the report of the Director of Public Health that provided background information about the refresh of the Operational Local Health Economy Management Plan for Manchester and includes the draft plan for approval. It also provided a detailed focus on current epidemiology and issues relating to tuberculosis (TB).

The Board was informed that the Health Protection Board had focussed on covid during the covid pandemic, however other diseases such as TB remain a serious public health concern and present a challenge to public health funding. Reference was also made the Outbreak Management Plan (appendix 1, of the report), concerning the operational arrangements in place specific to Manchester. The operational arrangements in place address several diseases specific to the complexity and diversity of city. It was reported that the covid pandemic had highlighted the lack of public health protection capacity and work had been ongoing to address this. The report also addressed the incidence of TB in Manchester which had risen in the latest reporting period. It was reported that there are current funding and capacity challenges regarding levels of latent TB and screening.

The Assistant Director of Public Health reported on the good working relationship with health service partners to help identify and treat TB cases through MFT. It was reported that current funding levels have limited preventative screening work to identify latent TB and this has been highlighted from outbreaks of TB across the city in different settings such as care homes and schools. Health partners were requested to consider the provision of services to ensure health equity for all the city’s population.

The Chair thanked officers for their ongoing important work in tackling TB within the city and noted that current funding allows screening for 26% for latent TB, and highlighted the necessity for anyone newly arriving in Manchester to be provided with health screening checks to identify illnesses at the earliest stage.

Members welcomed the report and noted the difficulties of detecting and treating latent TB across communities. The importance of developing a joined-up communications strategy to raise public awareness and provide information to a range of communities on recognising TB symptoms must continue as well as encouraging attendance for screening appointments. The approach taken to engage with communities, in particular migrants, is important to ensure health screening and the take up of vaccination at the earliest opportunity before individuals were resettled to other areas.

The Board was informed that a business plan is in place to address funding issues for services across the city and the help of the Health and Wellbeing Board is welcomed in progressing that work.

Reference was made to those individuals with no recourse to funds, in particular homeless people leaving hospital and requiring accommodation to help sustain their recovery. A recovery pathway has been produced to help homeless people recovering from TB, where accommodation will be provided and located close to hospital to ensure treatment is continued. The system has been recognised nationally as unique to Manchester and will be shared with other public health providers. Funding for the service has not yet been determined and is currently provided via the Public Health team until NHS funds are available. 

The Director of Public Health reported that the NHS GM Migrant Health Group had met on 18 September 2023, and would be the appropriate forum to escalate the matters raised concerning TB. The Group can provide a lobbying role on the subject which is a national issue, and this may provide access to funding to increase TB screening. 

Decisions

The Health and Wellbeing Board;

1.  Approve the Operational Local Health Economy Outbreak Management Plan for Manchester, as detailed in appendix 1, of the report submitted.

2.  Are informed of the current issues around TB and recommend that the Director of Public Health a) escalates migrant health related issues to the newly established NHS GM Migrant Health Group; b) advocates through professional networks for more latent TB testing to be available for all residents with higher risk of TB, not just new entrants and not just adults.