The Committee had commissioned an update from the Policy and Partnerships Team Manager on the progress made against the recommendations made by the Committee in March 2017.

Cllr Tidball spoke to the report drawing attention to Appendix 1 and the 60 recommendations of the Oxfordshire Health Inequalities Commission, responsibility for which was shared with partner organisations. The recommendations had originally been presented to the Health and Wellbeing Board in 2016. She encouraged members of the Committee to get in touch if there were matters in relation to those recommendations where they thought more should be done.

She drew attention to two particular matters of concern. First was the absence of a clear pathway for those leaving prison and other institutions. Secondly was the issue of homelessness and rough sleeping in the City and the associated influx of people from neighbouring districts and the parallel need for those Districts to contribute to the associated costs. She also noted the importance of addressing the issue of fuel poverty, support for which had been provided by the City Council in the form of a helpline.

Appendix 3 of the report noted progress with the Committee’s 10 previous recommendations made to the City Executive Board made in March 2017. A great deal of innovative work had been undertaken with the help of £100k from the City Council and £100k matched funding from the Clinical Commissioning Group.  Cllr Tidball said there were important pieces of work which needed some additional dedicated officer resource to accomplish, drilling down into the data more thoroughly and pulling together related areas of work in, for example, housing and adult social care.

The data provided in the report were, in places, quite dense. On the one hand it would be helpful for high level messages to be drawn from them for a wider audience but, also, there a was a need for a more detailed analysis which would, among other things, allow resources to be more closely matched to need. There might be merit in seeking to secure the services of an academic from one of the City’s two universities or a health partner to ensure that no opportunities are lost from linking with any work already underway in this area.

Some data already gleaned from the City’s customer service team had  illustrated that there were ‘hot spots’ of deprivation lying within areas otherwise not considered to be of particular concern. It was suggested that there might be merit in looking at the correlation between air quality indicators and life expectancy.

Cllr Tidball noted with concern the loss of some Early Years provision previously provided by the County Council but was optimistic about the development of community led children’s centres based in the City and supported by the City Council. The loss of provision for older children (via youth clubs etc) was, also, a source of great regret and the potential consequences of that, drawing parallels with a recent increase in youth violence in London, were noted.

While the development of the community led children’s centres was to be commended, there was some concern that they might be in areas were the local communities were empowered and not necessarily where the need was greatest; it was important that they should offer open access, be sustainable and serve areas of deprivation .

Cllr Taylor, as a Councillor who had previously been involved in the original scrutiny of the Oxfordshire Health Inequalities Commission’s recommendations, was disappointed that little discernible progress had been made in altering the fundamental inequalities that had been identified but was pleased that Cllr Tidball was taking every opportunity to hold the County Council and other key partners to account as necessary.

In working with partners, while it was possible to exert influence about some matters, it was important to  be clear about those matters in relation to which the City Council was in a position to make a direct difference itself and then to be able to measure that difference. Given the multi-agency element of many of these issues, a joint approach to communications would be desirable, not least to maximise public awareness.

Cllr Tidball was able to provide strategic leadership in relation to these matters in her position as a member of the Health and Wellbeing Board and the Children’s Trust and took every opportunity to raise matters of concern as appropriate. Similarly the Corporate Policy, Partnerships and Community Manager and the Policy

and Partnerships Team Manager represented the Council on the relevant partnership groups. Collectively they were clear about what the City Council needed to do to address the matters of concern and, “had the ear” of key partners but their capacity to engage in the necessary cross cutting work was limited.

The Committee had recently scrutinised the City Council’s Children and Young People’s Strategy, one of the objectives of which was that young people should be “healthy and safe” and the use of leisure centres and parks would contribute to that objective. It was noted that the County Council would be consulting on its own Children and Young People’s plan in June and it would be important for the City Council to take that opportunity to  make representations about these matters as they affect children and young people noting, for example, concern about the lack of youth service provision.

There was a shared recognition of the increasing incidence of mental health issues amongst young people and the lack of sufficient capacity in the Child and Adolescent Mental Health Service and the Primary Child and Adolescent Mental Health Service to cope with demand. It was important that those who needed help from these services were able to access it without delay.  This was another matter which should be raised in the response to the County’s draft Children and Young Peoples’ Plan.

Cllr Tidball reminded the Committee about the introduction of a “Youth Impact Zone” which would focus on a geographic area and encouraged Members to engage with it.

The promotion of physical activity of all kinds, whether at community and leisure centres or elsewhere,  was important and  opportunities for it needed to be local and, if charged for, affordable. Some courses only ran for limited periods of time when continuity would be preferable. A host of low cost, high value activities such as exercise, nature walks etc were not dependent on gym membership. A “Green Spaces” conference, involving key partners, was to be held the following month which would include promotion of physical activities. While activities as a means of prevention were important, sight should not be lost of those who need support now which included, for example, those at the end of life.

Social prescribing was recognised as something which had the capacity to make a valuable contribution but, at the same time, it was noted that there were not always suitable organisations to prescribe to; they needed to be local and available in areas of deprivation.

It was noted that the Barton Healthy New Town (the aim of which was that all residents should have an equal opportunity to good physical and mental health and good health outcomes) was explicit in its promotion of social prescribing.  A review of the provision in Community Centres was looking at how to attract other groups which could be part of the social prescribing network.

The Barton Healthy New Town also promoted the “Make Every Contact Count” initiative  which sought to enable general members of the community “through opportunistic conversations in everyday life” to have “positive conversations” with others about health matters. While it was good to empower lay people with the skills to help others, it was also important to ensure that where there was a need for more specialist support, it was available and from those who had the necessary professional training.

In conclusion the Committee resolved that the Council should:

1.    Prioritise strengthening its policy development and research capacity in order to better understand and address health and other inequalities in the City, with a focus on providing tangible outcomes and improvements for local services; and

2.    Engage with local universities and health partners to explore opportunities for pooling local data and expertise to better understand and address health and other inequalities in the City.