Agenda item

To receive an update in relation to a peer review undertaken in respect of Public Health.

The Chair invited Councillor Baker-Rogers, Cabinet Member for Adult Care and Health to introduce the presentation.

Councillor Baker-Rogers set out the background to the Council’s participation in the peer review.  They advised the focus of the review was determined following an internal self-assessment process which generated leadership and governance, culture and challenge and making a difference as the three domains. Councillor Baker-Rogers advised that feedback was predominantly positive and had identified a number of key strengths, alongside key recommendations which focussed on the refresh of the Health and Wellbeing Strategy.

The Director of Public Health, Ben Anderson explained the contents of the agenda pack as they related to the peer review.  They described that this had included an overview paper, the storyboard that had supported the peer review process, an overview of the LGA strengths and risks tool and the slide pack. The peer review undertaken was described as smaller scale and less resourced than some other LGA peer reviews that may have been seen in other areas of scrutiny, and the slide pack provided was the feedback received.

The Director of Public Health described the sector led improvement approach of the peer review, and outlined that lots of preparatory work was undertaken including reviews of around 60 documents such as strategies and minutes to allow the peer review team to form a picture of Rotherham. There was a large evidence base, and the work undertaken equated to 159 hours of public health consultancy, which was a significant investment.

The Director of Public Health reiterated the key lines of enquiry, where added value was sought and highlighted the positive affirmations and quotes included in the slide pack from interactions during the peer review which had acknowledged strong governance, strong partnerships and effective use of the JSNA (Joint Strategic Needs Assessment).  The peer review was approached with honesty and openness by staff who participated, and reported that the Public Health team was well respected, knew itself, was effectively embedded in the partnership and was adding value to the system. The children’s capital of culture next year was also highlighted as a meaningful opportunity to engage young people and seek feedback on health and wellbeing matters.

The Director of Public Health noted the strengths and areas for further consideration identified which included, clear and consistent partnership working hard-wired into governance arrangements but not led by them alongside strong and stable leadership across the partnership.    

In terms of areas for further consideration, the refresh of health and wellbeing strategy was a large piece of work which would be reported into the Health and Wellbeing Board in Spring 2025.  This represented an opportunity to build upon existing practice and maximise focus on delivery and outcomes. There was also the opportunity to go further with the health in all policies approach and to consider how to make space for looking ahead in the context of anticipated financial challenges. As there were 2-3 years left on most Public Health contracts, as it was anticipated that inflation during the intervening period would create significant pressures around re-commissioning of services.

With regards to culture and challenge, the clear ‘golden thread’ of performance reporting across the partnership was highlighted as a strength which included the development of the prevention of health inequalities framework had helped to look at performance differently and focus on specific high-risk groups which represented an engagement challenge. Health and Wellbeing Board leadership was considered a strength, citing members ability to challenge and hold each other to account across the partnership. The JSNA and intelligence function was seen as a real strength, but how community data fed into the JSNA and reflected public voice into the work of Public Heath could be strengthened further.  There were also strong examples of co-production, particularly with respect to commissioning work, however it was acknowledged that there was the need to close the loop and feed back to communities in respect of what the influence of local voice had achieved.

With regards to the making a difference strand, the role of the JSNA in shaping priorities, service development and delivery and the role of RODA (the Rotherham Office of Data Analytics), which was a partnership between the Council and the NHS Trusts, were highlighted as strengths in terms of their use and influence across the Council including service integration.

The Director of Public Health summarised the recommendations and added that they were largely encapsulated in work related to the refresh of the Health and Wellbeing strategy, focus on outcomes, ensuring that intelligence and engagement informed priorities, whilst recognising and addressing the needs of geographically diverse specific groups across the borough.

The Chair thanked the Cabinet Member for Adult Care and Health and the Director of Public Health for the presentation and invited questions from members.

Councillor Havard sought clarity regarding what was meant by a health in all policies approach and how this benefitted Rotherham residents. 

The Director of Public Health explained that this related to recognition that almost everything the council did had an impact on health and wellbeing and encouraged thinking holistically about how decisions being made were impacting on peoples’ health and wellbeing, how to reference and promote that in policies and working practices across all Council services and functions to maximise the reach, influence and impact of the small team. Work was ongoing across the Council exploring how the Public Health team could support this approach.

Councillor Duncan noted the reports in the peer review regarding the need to improve engagement with seldom heard voices and hard to reach communities. They questioned whether it was understood why this continued to be an issue, and sought reassurance as to how progress in this area would be measured.

The Director of Public Health explained that they expected this would always represent an issue due to the inherent complexities of the communities for whom services were commissioned, and the need to engage with different groups at different time dependent upon the work that was undertaken.

Co-production with communities not accessing services, and the barriers to access was always a consideration.  There was the clear intention to move the JSNA from data based graphical representations to a richer picture of what the needs of service users are based on feedback, meaningful engagement and hearing the voice of specific groups and communities regarding, when and how they accessed services with a view to informing service design, commissioning and delivery.  There was the desire for the Health and Wellbeing strategy refresh to reflect what was important to Rotherham people, rather than solely reflecting what data indicated was an issue. For example, to reflect that better access to green spaces was needed to promote increased physical activity as a driver for the reduction of cardiovascular disease rather than solely highlighting its statistical prominence as a health concern for the borough. Engagement work through public events and community groups was ongoing to develop this further.

Councillor Yasseen expressed the opinion that the Public Health team was a gem within the Council, but acknowledged its need for wider influence on the offer.  They expressed the view that whilst the report rightly acknowledged effective partnership working on a corporate basis, it equally suggested that the same level of partnership working was not embedded with communities.  They advocated radical approaches, and cited the need to fully understand why the Council were not reaching seldom heard voices and hard to reach communities to ensure that their voices were reflected in commissioning and associated decision making, and sought reassurance regarding what would be done differently to achieve this.

Councillor Baker-Rogers commented that it was widely acknowledged that progress on population health was a slow process, and highlighted the need to measure progress over extended timescales.  They also encouraged all Health Select Commission Members to attend the ‘Prevention Matters’ workshop in January 2025 as this would be relevant to the issues raised by Councillor Yasseen.

The Director of Public Health advised that some partnership and tenant engagement groups were community led, and gave examples of ways in which he believed the Council worked in partnership with communities already.  They expressed the view that the potential gap was harnessing the voice of those communities with which the Council frequently engaged with the specific goal of ensuring those interactions resulted in feedback which informed policy design, service planning, commissioning and delivery.

Councillor Thorp explained that as a relatively new Councillor their knowledge and understanding of social prescribing, open arms, warm welcome, was limited and they were concerned about how information was shared, both with Councillors and with communities.  They advised that they had not seen information about those services shared in either capacity, and therefore queried how the Council could address the marketing and communications strategies to raise awareness amongst those who needed to know.

The Director of Public Health was appreciative of the feedback, and advised they would have further discussions with Councillor Baker-Rogers and would work with the communications team to ensure that social media algorithms and other means of communication were being appropriately channelled for maximum impact with the target demographic.

Resolved:-

That the Health Select Commission:

1. Noted the findings of the Peer Review of Public Health.