Meeting documents

To consider the report.

The Committee considered the annual report of the Somerset Health Protection Forum. The Somerset Health Protection Forum comprises professional partners across agencies holding health protection responsibilities. The Forum has a collective role to provide assurance on behalf of the Director of Public Health.  To ensure the Health Protection Forum has a focused agenda and forward plan, a Strategic Action Plan is developed annually.  This identifies the priorities and actions to be taken across the system over the coming 12 months, as approved by the Health and Wellbeing Board.  The priorities for 2019 were categorised by the following subjects: Communicable Diseases, Environmental Hazards, Infection Prevention and Control, Resilience, and Screening and Immunisations.  Progress against the agreed actions is summarised as follows:

1. Communicable Diseases

Ensuring that robust communicable disease incident and outbreak response arrangements are in place and embedded across the Somerset system was an important priority for 2019.  Core activity continued throughout 2019, which included:

·         Maintain a system overview of outbreak management processes and response;

·         Ensure robust multi-agency outbreak management plans are in place to support individual organisational arrangements; and

·         Review significant outbreaks, making recommendations where appropriate. During 2019, we had 195 situations/issues/clusters that spanned a broad range of threats to public health ranging from chlorine releases and fumes at a shopping village, to Norovirus/Flu outbreaks in schools and care homes, Shiga Toxin-producing E-coli (STEC) outbreaks, and cases of meningococcal disease and tuberculosis, which requires contact tracing and screening.

In 2019, the UK lost its ‘measles-free’ status due to the increased number of confirmed cases and evidence that there was transmission of a strain of the disease within the country. During 2019, Somerset only had one case of measles, which was linked to a measles outbreak in Devon, despite the increasing prevalence of measles within the UK.  The Somerset Immunisations Group have prioritised work to roll out the measles and mumps elimination strategy within Somerset.  TB remains a concern within Somerset, with 2019 seeing several complex cases of multi-drug-resistant TB.  Even though Somerset has a low incidence of TB, there is still significant pressure on the system when faced with a TB case.  Work is currently taking place to ensure the system has the resources and processes in place to effectively manage TB cases in Somerset.  In 2017, 71% of cases with drug-sensitive TB completed their treatment by 12 months and 11% of TB drug-sensitive patients died.  The Committee were disappointed to hear of the loss of measles-free status but were reassured that there had only been one case in Somerset. The Committee agreed to do all they can in communities to drive up the general immunisation levels for all infectious diseases. The Committee was disappointed that tuberculosis remains a concern within Somerset.

2. Environmental Hazards

The priority of ensuring support for initiatives to reduce or mitigate the impacts of environmental hazards on population health was progressed during 2019. The activity that supports this priority includes:

·         Maintain oversight of environmental hazards posing a threat to population health (health and safety, food hygiene and standards, air, land, and water)

·         Ensure robust multi-agency incident management plans are in place to support individual organisational arrangements; and

·         Review significant incidents, making recommendations where appropriate.

In February 2019, Somerset County Council declared a climate emergency and committed to preparing a strategy by the end of 2019. There is a significant overlap between air quality and climate change, so the work undertaken to date on air quality has been fed into the climate change plan. In the meantime, the recommendations within the Air Quality Strategy are being applied in practice:

·         Major planning applications now frequently include an air quality assessment.

·         Transporting Somerset and SCC Procurement are considering whether changes can be made to make the fleet greener including contracted providers. One change already made is that all pool cars are now petrol rather than diesel.

·         All new contracts now contain air quality as a consideration in the social value element of the contracts.

·         The Air Quality website going live imminently.

3. Infection Prevention and Control

During 2019, it was agreed to ensure that infection prevention and control priorities address local need and reflect national ambition.  A Somerset Strategy for the Prevention and Control of Infection has been produced, for a system-wide approach. The purpose of this document is to set out the CCG’s and Somerset’s system responsibility and objectives for infection prevention and control and the work plan to ensure these are met.

4. Resilience

During 2019, it was a priority to ensure local and regional emergency response arrangements are in place to protect the health of the population. Core activity includes maintaining an overview of local emergency planning, resilience and response workstreams, and review of significant incidents, whilst making recommendations where appropriate.  The Committee asked if this included preparation for a possible Coronavirus outbreak. They were informed that Public Health England are responsible for this and information has already been shared with the appropriate clinicians.  The current advice is to self-isolate and call NHS 111 and take the advice given.

5. Screening and Immunisation

It is a priority of the Forum to ensure screening and immunisation programmes meet national standards and reflect local priorities for increasing uptake. The core activity that continues includes monitoring local performance of all screening and immunisation programmes, working across the Public Health system to reduce inequalities in accessibility of services and to raise local awareness, encouraging uptake of all programmes, reviewing programme performance, and making recommendations for improvement where appropriate.  The Committee asked about the number of entries marked ‘N/A’ and were concerned that these meant the figures were Not Available. The Committee was informed that these figures were not available broken down to a Somerset level. The Committee asked about the upper age limit for some cancer screening and were informed that the programme was a national one and was reviewed on a regular basis.

The Somerset Scrutiny for Policies, Adults and Health Committee:

·         Considered and commented on the report.