The Health Scrutiny Committee met to discuss the Director of Public Health's annual report, focusing on the Health and Wellbeing Strategy 2024-2029, particularly progress in smoking/vaping and keeping active; members agreed to receive an update in six months on health inequalities and actions taken by local area partnerships, for public health to continue engaging the voluntary sector, and for future reports to review progress against current themes. The committee also requested a presentation on a diagram for animation encapsulating factors that impact life expectancy.

Here's a breakdown of the key discussion points:

• Director of Public Health Annual Report
• Health Inequalities and Local Area Partnerships
• Community Engagement and the Voluntary Sector
• Smoking and Vaping
• Keeping Active
• Cancer Concerns in Corby
• Future Priorities and Work Plan

Director of Public Health Annual Report

Jane Bethea, Director of Public Health, introduced her annual report, a statutory requirement under the Health and Social Care Act¹. The report focused on the implementation of the council's Health and Wellbeing Strategy, with emphasis on two key areas: smoking and keeping active. Jane Bethea highlighted that smoking accounts for half of the health inequalities between the most and least deprived communities. She noted progress in reducing smoking rates in Corby, but stressed the need to address the normalisation of smoking in some communities.

Councillor Steve Geary raised the point that there is a 50-50 chance if you smoke, there's fatality and asked for a comparison with other risky behaviours like drug and alcohol use. Jane Bethea clarified that smoking is uniquely harmful, with no safe level of consumption, and that many heroin users die from smoking-related diseases.

Councillor Geary also praised the report's inclusion of return on investment figures, noting that a £1 investment in activity can generate £4 for society.

Health Inequalities and Local Area Partnerships

Councillors discussed health inequalities, with Jane Bethea explaining that these are differences in health outcomes that are modifiable or unfair. Data is used to identify inequalities related to deprivation, disability, ethnicity, age and gender. The council aims to target resources accordingly, using a concept called proportionate universalism². Jane Bethea explained that the council is working towards a model of neighbourhoods, using local area partnerships to identify specific community needs. She noted that while data is a challenge, the council works with NHS analysts to replicate data previously available from sovereign councils.

Councillor Mark Pengelly raised concerns about the lack of detail on smoking percentages in Corby and its estates, and asked why previous efforts to combat smoking had not been more successful. Jane Bethea responded that rates in Corby have come down, but not equally across all areas. She said that the council is seeking community input to find new solutions.

Pippa Williams, who is part of the public health team, added that insight gathering work was being done with the Corby local area partnership, including stakeholder interviews, focus groups, and surveys.

Councillor Pengelly also raised concerns about alcohol consumption at home and poor housing conditions, and their impact on health. Jane Bethea acknowledged that alcohol is an insidious drug and that mortality rates have increased since COVID-19. She stressed the need for earlier conversations about alcohol consumption and increased access to treatment. She also agreed that cramped living conditions are detrimental to health and mental health, and that affordable, decent standard housing is essential.

Councillor Harry David Howes asked what the council is doing for people who don't want to stop smoking and those in underserved rural communities. Jane Bethea responded that they cannot force anyone to quit, but they need to have an offer available when people are ready. She added that the council is working with parish and town councils to reach rural communities.

Councillor Julie Lumsden asked about preventing people from starting to vape or smoke. Jane Bethea deferred to Pippa Williams, who explained that national data shows a plateauing of vaping among young people. She added that the new legislation is coming through at a national level, that it will reduce the amount of flavours that are available for vapes for that impact.

Councillor McLean asked whether introducing vapes was just moving people from one addiction to another. Pippa Williams responded that vaping is less harmful than smoking, but the service monitors choices to understand what the level is.

Councillor McLean suggested that flavours in vapes should be removed. Jane Bethea agreed that vaping is aggressively marketed towards young people and that government legislation is looking into reducing the amount of flavours that are available for vapes.

Councillor McLean suggested licensing vape shops to restrict the number of licenses. Jane Bethea agreed that counterfeit cigarettes are already a problem, and that licensing will help.

Community Engagement and the Voluntary Sector

Councillor Lumsden asked how the council is working with the voluntary sector to support resilience and self-care, and how local residents are being involved in co-design and health interventions. Jane Bethea responded that all of the council's big services are recommissioned with the voice of residents and service users at the heart of it. She said that the council commissions organisations with better reach into communities.

Councillor Pengelly raised concerns about vulnerable and isolated people, especially since COVID-19, and asked what can be done to tackle this. Jane Bethea responded that family hubs are a good model, and that old fashioned community development is essential.

Councillor Brooke suggested that Councillor Pengelly should familiarise himself with the Age Well team.

Smoking and Vaping

Councillor Geary proposed a simple diagram or animation encapsulating the factors that can impact upon life expectancy, particularly related to smoking. This was seconded by Councillor McLean and approved by the committee.

Keeping Active

Councillor Geary asked what the council was doing to teach kids about cycling, as they are always going past his house on the back wheel.

Cancer Concerns in Corby

Councillor Pengelly raised concerns about childhood cancer rates in Corby, and reports that poisonous soil was dumped in different parts of the town. Jane Bethea responded that she has been approached by a family and a group in Corby, and that she is doing analysis of that data. She stressed the importance of verifying the data and conducting an objective analysis.

Future Priorities and Work Plan

The committee agreed on the following actions:

• Receive an update in six months on key health inequalities across North Northamptonshire, disaggregated by locality and population group, alongside actions being taken by local area partnerships to address these gaps.
• Public Health to continue expanding its engagement with the voluntary and community sector to deliver targeted preventative programs and report back on reach, uptake, and outcomes.
• The next annual report to include a formal review of progress against the current year's themes and recommendations, with clear outcome measures disaggregated by locality and population group, and public accountability for change.

The committee then noted the contents of the scrutiny work plan for the forthcoming meetings. The next meeting is on 18 November and will cover the Kettering General Hospital annual report, the Northamptonshire Healthcare NHS Foundation Trust annual report, and the winter preparedness plan.