Agenda item

The Committee considered a joint report of the Director of Public Health and the Director of Corporate Resources which provided information on the proposed 2021/22 to 2024/25 Medium Term Financial Strategy (MTFS) as it related to the Public Health Department. A copy of the report marked ‘Agenda Item ‘9’ is filed with these minutes. 

 

The Chairman welcomed Mr. L. Breckon JP CC, Cabinet Lead Member Health, Wellbeing and Sport, to the meeting for this item.

 

In introducing the report the Director informed the Committee that for 2021/22 the Public Health Grant was to be maintained at the same level as the previous year on a ‘flat cash’ basis. Funding for the following years was uncertain. The Department sought to bring as many services as possible in-house in order to benefit from efficiencies and more joined up working with other services provided by Public Health, whilst recognising that some specialist services needed to be commissioned.

 

The Cabinet Lead Member highlighted the additional work that the Public Health Department had been carrying out in relation to the Covid-19 pandemic and stated that the general public were now better aware and more appreciative of the work of the Department. He stated that the pandemic had brought to the fore issues such as mental health and the need for the public to exercise regularly and he expected that these areas would receive greater attention in future.

 

Arising from discussion, the following points were noted:-

 

Service Transformation, Proposed Revenue Budget and Budget Changes and Adjustments

 

(i)          It was very difficult to estimate the impact residual issues from the Covid-19 pandemic would have on the budget therefore the budget had been based on demand being at normal levels.

 

(ii)         Approximately two thirds of the net budget for 2021/2022 was proposed to be spent on Sexual Health, Children’s Public Health 0-19 and substance misuse.

 

(iii)       Previously the Health Protection Response was the responsibility of Public Health England but during the 2020/21 year it had become part of the local Public Health workstream due to the Covid-19 pandemic. During 2020/21, the Department received a grant of £2.3m for local authority test and trace support services. The Health Protection Response Team had been created within the Public Health Department and members of that team had been heavily involved with care homes during the pandemic. The Infection Control Team had also been invested in using the additional Covid-19 funding.

 

Growth

 

(iv)       The only growth expected related to the retro-viral drug PrEP. There had been a legal case regarding who should pay for the drug itself which had concluded that Public Health England should provide the funding. However, as a result of the drug being used there were expected to be additional referrals into the sexual health service which was funded by the County Council’s Public Health Department. Consequently the Department had been awarded £20,000 to enable it to manage the additional referrals.

 

Savings

 

(v)         A review was taking place of the GP Health Check service to ascertain whether any further savings and efficiencies could be made. No indications could be given yet as to the results of this review but alternative ways of delivering the service were being explored such as the alternative provider model and using other public sector organisations such as the fire service. There was no timeline for when the review had to be completed though the savings had to be delivered by 2024/25.

 

(vi)       The First Contact Plus service was delivered via telephone and online and was aimed at service users rather than professionals. A member of the public could self-refer to this service and receive advice on healthy lifestyles, debt and other matters. External funding of £159,000 per annum was received from Better Care Together to help support First Contact Plus. A considerable amount of money had been taken out of the service in previous years therefore it would be difficult to produce further efficiencies from First Contact Plus.

 

External Influences

 

(vii)      There had previously been discussions initiated by Government regarding whether Sexual Health commissioning should remain with Public Health Departments or become part of the NHS remit. There had been no recent update from Government regarding this.

 

(viii)    In the future there could be other structural changes to Public Health and the wider health system but the nature of these was not yet known.

 

The Director of Public Health and members expressed their thanks to the Public Health staff for their work during the Covid-19 pandemic and it was noted that many staff had carried out duties in relation to Covid-19 in addition to their normal workload.

 

RESOLVED:

 

(a)  That the report and information now provided be noted;

(b)  That the comments now made be forwarded to the Scrutiny Commission for consideration at its meeting on 25 January 2021.