A presentation and update from the Health Protection team.

Rob Davies provided an overview of the Re-establishing the Health Protection Assurance Forum report. The principal points included:

1. The forum has a role to assure that a wide range of health protection functions across Herefordshire are working as they should.
2. These functions extend beyond flu and Covid-19 to also include screening and immunisations; environmental health; control of chemical, biological and radiological hazards; risk management and project planning; hospital infectious diseases and hospital acquired infections; and activity in care homes.
3. The breadth of functions thus reflect the range of organisations involved including public health and environmental health in the local authority; UKHSA; NHS partners and others.
4. The forum seeks to understand the risks associated with the range and complexity of the functions across the system and looks to ensure that what is currently in place is robust.
5. The formal meetings of the forum were paused in 2020 during the Covid-19 pandemic. As a result, less was done around the broader health protection work including preventative activity like screening and child immunisation.
6. Since the summer of 2022, there has been work to re-establish the forum and the underline the broader focus on health protection functions. This has required:
   1. Re-establishing relevant terms of reference.
   2. Updating members of key organisations.
   3. Re-establishing data flows and information.
   4. Reviewing performance against range of measures and comparing Herefordshire to other local authorities.  

Rob Davies proposed that an annual report come to the Health and Wellbeing Board to provide a more systematic and rigorous assessment of where the forum is at. This report will help emphasise what key priorities need more attention in addressing.

The Director of Public Health agreed that an annual report would be useful to address system issues to help identify which priorities need particular focus and attention in order to improve performance, particularly as these issues correspond with health inequalities and functions such as the Community Paradigm.

Councillor Diana Toynbee asked why the forum is needed in addition to the other work being done by the HWBB and other agencies including the UKHSA.

The Director of Public Health noted the statutory function that he has as director of public health to ensure that plans are in place to effectively deliver screenings and immunisation. The UKHSA operate at the regional and national levels and are part of the overall forum, however, at the local level there needs to be assurance and coordination that the forum would help to provide. For instance, there have been conversations regarding screenings and immunisation which will be delegated through to the Integrated Care Board from 2024. These conversations with the ICB aim to clarify how screenings and immunisation will be delivered at the local level.

The Chair noted table 2 on page 13 of the report which shows that performance is better in Herefordshire than the national average.

The Managing Director of Wye Valley NHS Trust asked if the health protection function – ‘emergency preparedness, resilience and response’ (EPRR) – was specifically in relation to infection prevention.

Rob Davies said that the list of functions comes from a best practice guide on what functions should be included. It is being interpreted that EPRR does relate to infection prevention, particularly because from a local authority perspective, they have emergency resilience in the team and know their plans.

The recommendations were proposed, seconded, and approved unanimously.

Resolved:

a)    That the Board considers and comments on the report.

b)    That an annual report come to the board on the Health Protection forum’s progress.