Issue - meetings

Andrew Scott-Clark led the discussion on the item with a power-point presentation. He emphasised the need for using more positive data in order to convey a positive message to the public. Mr Scott-Clark requested Board members to agree on the best approach to present statistical data, whether through percentages or the ‘thermometer.’ He said that life expectancy data showed significant inequalities between Thanet and other areas in the county. There was therefore a need to provide support that was proportionate to the significance of the problem in Thanet.

Aspirations for Children

Mr Scott-Clark said that with regards to the Aspirations for Children, officers were still working on coming up with some of the Key Performance Indicators (KPIs). As regards the Universal Child Programme, not all the mandatory performance indicators were currently being delivered in Thanet and other areas of the county.

Women Not Smoking

Evidence based approach was being used to support an early referral approach for pregnant mothers and first time mothers under 18. The aspiration was to have 95% of women not smoking when pregnant in 4 years’ time. CO² monitoring has helped identify early on a number of issues/problems not necessarily related to smoking, like a leaking boiler in one of the households. Midwives were engaging expecting mothers and talking to them about smoking up to the point they gave birth.

The Board agreed to aspire to achieve the following target; that 95% of women not smoking when pregnant in 4 years’ time.

Women Initiating Breastfeeding

Mr Scott-Clark said that there were challenges regarding the information system. Peer support programmes for midwives to work with individual mothers had been started county wide. He was going to find out the age profile of breastfeeding women in Thanet.

The Board agreed to aspire the following, that 75% of new mothers would be breastfeeding in 5 years’ time and maintain at least 50% breastfeeding over six to eight weeks.

Reduce Alcohol Specific Stay in Hospitals

Mr Scott-Clark said that Thanet has the highest admission rates in the county. Madeline Homer said that TDC had previously directly funded pastoral street persons in Thanet. Mr Scott-Clark advised the meeting that work was in progress on some initiatives that would increase children resilience to say no to peer pressure in relation to alcohol use.

The aim to reduce alcohol related stays in hospitals from 58.3% per 100,000 to 40% in 5 years’ time. Board members suggested that more discussions be conducted that would look at approaches that the Licensing function of Council could play to the health and wellbeing of the local residents.

Reduce Teenage Pregnancy

Thanet‘s aspiration was to reduce the rate to below 30% in the next 5 years.

Reduce Prevalence of Adult Smokers/Adults Not Smoking

Members were concerned that currently the advertisements that were being put out by companies selling cigarettes were sending the wrong messages to the public. Mr Scott-Clark said that discussions were on-going about the national policy on e-cigarettes.

The Board agreed to aim for a  ...  view the full minutes text for item 4

Andrew Scott-Clark reported that the only direct comment that he had received since the last meeting had been from Esme Chilton.  In accordance with her request, safeguarding of children had been added as an aspiration.

In answer to a query from Councillor Gibbens, Andrew Scott-Clark stated that he believed that the aspiration to achieve a 5% reduction in smoking in pregnancy over the next five years was realistic and deliverable.  He referred to the success of the “Baby Clear” initiative at the QEQM hospital, aligned with the cessation of smoking service.

It was RESOLVED:

1.  THAT the aspirations, as set out at Annex 1 to the report, be APPROVED;

2.  THAT the Board be provided with periodic dashboard reports setting out milestones in relation to each of the aspirations and progress achieved.

Andrew Scott-Clark stated that plans (similar to that for Alcohol on the agenda for this meeting) would be brought to the Board meeting in November 2014 and that detailed work would be carried out in relation to the aspirations for long term conditions.

NOTED.

Andrew Scott-Clark to give a presentation

Andrew Scott-Clark gave a presentation on the key aspirations for health and wellbeing in Thanet over the next five years (slides now published on the website as part of the details for this meeting).

In addition to the information on the slides, Andrew Scott-Clark made the following points:

A.  Smoking in Pregnancy:

Statistics provided were based on self-reported evidence. 

There were now initiatives in place whereby midwives monitored carbon monoxide levels, but these were likely to result in the rate of smoking in pregnancy going up before it came down.  Carbon monoxide readings had recently resulted in three lives being saved; in those cases, however, the source of carbon monoxide had been from a boiler rather than from smoking.

B.  Breast feeding initiations:

It was important to have more joined-up working across the district.  For example, shops could be encouraged to offer protected areas for breast feeding.

C.  Reduce alcohol specific stays in hospital:

Kent County Council had recently reviewed a new alcohol strategy, and it was proposed to bring this to the next meeting of the Board.

D.  Reduce teenage conceptions:

The roles of the Health and Education Services in combatting this problem were very much complementary.

Although some schools, particularly Marlow & Hartsdown, provided excellent sexual education, it was felt that Education’s approach needed to be more universal and systematic. 

E.  Deliver universal child health programmes:

A report would be brought to a future meeting of the Board on commissioning intentions relating to school nursing.

At this point, the meeting was left open for members’ participation.  Comments included:

  i.  In relation to Breast feeding initiations:

(Councillor Johnston)  More breast feeding friendly signs/stickers should be displayed in public places. 

(Esme Chilton)  In Deal, the Breast Feeding Support Group had been very successful in promoting breast feeding in public premises.  Methods used included the display of stickers and provision of support for staff.

  ii.  In relation to reducing teenage conceptions:

(Councillor Johnston)  It should be noted that not all conceptions resulted in deliveries.  There was a “generational cycle” of teenage conceptions which needed to be broken.

(Councillor Hart)  Dover had reportedly implemented some successful initiatives to reduce teenage conceptions.

(Esme Chilton)  The Children’s Board was in a good position to support the education side of things.  Working alongside young people, the Board could make a real impact in preventing teenage pregnancies.

  iii.  In relation to reducing smoking in pregnancy:

(Councillor Johnston)  Hard-hitting campaigns, featuring the use of posters, could be used to help combat this problem.

Councillor Gibbens expressed concern that the Board had not yet agreed on specific targets to focus on, commit to and regularly review.

A debate ensued on which philosophy to adopt in relation to the Board’s objectives:

  EITHER

a.  Have realistic, achievable targets; 

OR

b.  Have aspirations.

It was noted that there was a danger of the Board becoming frustrated if aspirations were so ambitious that they could not be achieved.  On the other hand, aspirations encouraged “stretch” and the best, rather than merely the  ...  view the full minutes text for item 48