To consider a report on Building Heart Healthy Communities in Torbay.

(Note: presented by Sam Trethewey, Registrar, Public Health; Julia Chisnell, Consultant in Public Health, Torbay Council and Dr John McGuiness, GP.

Dr Samuel Trethewey Public Health Registrar and Dr John McGuinness GP provided an update on the implementation of the actions arising from the 2023 Director of Public Health’s Annual report which focussed on cardiovascular disease (CVD) as set out in the submitted report and presentation which was circulated after the meeting.  The overall goal was ‘we want everyone to have an equal chance to thrive physically, mentally, socially and economically’.  Prior to the meeting Members of the Sub-Board had their blood pressure taken as part of the ‘know your numbers’ week.

The Director of Public Health thanked the Trainee Registrar and GPs who had been working with the Public Health Team to address Cardiovascular Disease and help provide professional insight into the work of the Team.

Members asked questions in relation to what preventative action was being undertaken in deprived areas such as Watcombe; were employers encouraged to support employees in accessing services and identifying illness sooner; health checks for 40 to 74 year olds and why this stopped at 74; what happens when the funding for cardiovascular disease runs out; the lack of adequate information and advice to the public when they were identified as being at risk of high blood pressure or high cholesterol and the lifestyle and diet changes recommended; the cost of the Cycling and Walking Infrastructure Plan and what cheaper alternatives could be explored; how many people were told they should go to the GP with high blood pressure but refused to go as they believe they would just be told to loose weight etc; and what was being done to tackle childhood obesity which could lead to longer term health issues including CVD.

Pat Harris, Chief Executive of Healthwatch thanked the Public Health Team for their support with the Community Hub which demonstrated the opportunities to work together with key partners in the community.  Previously people were trained as Covid Champions to support people in the community and there was an opportunity to train people to become health champions.  Healthwatch was also working with the Torbay and South Devon NHS Foundation Trust to support people waiting for surgery through the Community Hub.

In response to questions Members were advised that there were often barriers to accessing services which were often economic or social, based on affordability and availability of transport to appointments and the impact on working people and those who had caring responsibilities.  The work carried out at the Community Hub was a good pilot and would help provide evidence of the impact of providing support in the community to enable this to be rolled out wider, looking at libraries and other community settings.  The Public Health Team had been working with our anchor organisations to try to encourage more support to their employees’ health and wellbeing, there had been a mixed response and it was important to get the right message.  Focus was on organisations where staff were likely to be higher risk e.g. smoking and overweight.  It was suggested that an organisation that helps people with their health and wellbeing could be seen as more attractive and it was questioned if there could be a charter mark or similar standard for this. 

The NHS health check was a nationally funded initiative and pilots were being undertaken in work places to try to encourage take up.  However, it was noted that communication to patients about the health checks was varied across each GP practice although Torbay had higher take up than some areas.  More work was required to ensure a more consistent approach was taken across the whole of Torbay with individuals being invited for a health check at least once every five years.  The cut off age of 74 was set nationally but this did not mean that people over 74 should not receive any health screening and can access as needed by their GPs depending on their individual circumstances and risk.

Members were informed that there were issues around sustainability of support for cardiovascular disease initiatives such as the library loan scheme for blood pressure machines with stop and start funding but there were other options to upskill people in the community and investing the funding where it would have the most benefit.

The Director of Public Health advised that whilst the Cycling and Walking Infrastructure Plan was being developed the Council and community need to think differently about how to improve access to walking and cycling making the most of existing paths and what action would need to be taken to make routes accessible to everyone.

It was noted that monitoring information had been sought from community pharmacists, GPs, libraries and other areas as well as the BP monitor pilot questionnaire to ask what category people were in with their blood pressure and if they shared the results with a healthcare professional and did they make any changes as a result.  However, the key factor to improve outcomes for people at risk of cardiovascular disease was behaviour change this would take time to implement.  It was important to look at the person and family/friends as a whole as behaviour was not just an individual issue and many health related issues were linked.

Members were advised that initiatives such as ‘Torbay on the Move’ and the national child measurement programme were carried out in schools and when children were identified as being overweight a letter was sent out to the parents.  However, the Public Health Team would like to see more done in the community with both children and adults to support change for the whole family which will help improve health outcomes in the future.

The Sub-Board acknowledged the relative lack of engagement in the community of professional health services when it came to sustaining behaviour change and that people were more likely to engage through community groups, local sports and social groups.  More could be done to provide facilities such as blood pressure monitors out in the community to reach more people, as well as better sign posting and sharing of fact sheets with actual numbers rather than percentages as they were more meaningful.

Resolved (unanimously):

That the Director of Public Health be recommended to work with Your Health Torbay and GP Practices to review signposting information to patients once they have been identified as having or being at risk from cardiovascular disease or high cholesterol etc. to provide better signposting to relevant support and options for improved wellbeing and not assume that people know what actions they should be taking and to develop relevant factsheets for Councillors and members of the community to use to encourage people to identify issues and follow up with relevant behaviour changes or seek necessary support.