Agenda item

Sarah Perman, Director of Public Health, HCC presented an overview of the current public health landscape, highlighting the newly launched business plan and the impact of local government reforms. The speaker emphasised the use of data from the Herts’ Evidence website to identify key priorities such as addressing health inequalities, life expectancy gaps due to circulatory diseases and COVID-19, and tackling obesity across all age groups. The presentation outlined the mandated public health functions now sitting within local government, the range of services provided, including NHS health checks, sexual health, smoking cessation, weight management, and drug and alcohol recovery. The speaker also described the integration of strategic partnerships, focusing on homelessness and domestic abuse, and the collaboration with district councils on initiatives like the Health Hub. Furthermore, the speaker detailed the organisational structure, reporting to the Chief Fire Officer, and the team’s composition of approximately 130 staff. The funding model was explained as a ring fenced grant from the Department of Health and Social Care, totalling around £54 million annually, largely contracted to NHS providers. Current priorities include developing drugs and alcohol delivery plan, transforming health visiting and school nursing services with a focus on family support, and adopting national health protection changes such as the introduction of a new gonorrhoea vaccine. Throughout the presentation the emphasis was on maintaining prevention duties despite financial challenges and fostering partnerships to improve public health outcomes.

Responding to a question the speaker talked about a three-year funding programme called Prevention and Health Inequalities Programme (PHIP), funded by public health grant reserves aimed at supporting local organisations to focus on early help, prevention and reducing health inequalities. The programme targets three main themes; aging well, health weight and economic inactivity due to ill health. The first phase has concluded with impressive proposals from various organisations, some advancing to the next stage. The speaker also highlighted ongoing uncertainties regarding local government reorganisation and devolution but confirmed that public health responsibilities and mandated services will remain with unitary local authorities under current legislation. The speaker emphasised potential opportunities for public health to support broader functions such as skills, employment, transport, housing and strategic planning, aiming for more integrated health considerations at the mayoral and strategic authority levels.

A further question was raised on mental health, whether it featured in the priority. The Director of Public Health explained that HCC has a dedicated team addressing mental health across all age groups, with key initiatives including a multi-agency suicide prevention board and a Real Time Suicide Surveillance System that tracks suicides and attempts to identify emerging patters for timely intervention. They collaborate with community organisations such as Hector’s House and the OLLIE Foundation (One Life Lost is Enough) to deliver targeted programmes and provide long-term suicide bereavement support for affected families and friends. Beyond suicide prevention, there is a strategic shift towards enhancing public mental health by fostering community resilience and supporting children and young people, especially within schools. Initiatives include a pastoral network of teachers focused on mental health needs and exploring the role of school nurses through health service procurement to better support youth mental health.

The discussion also focused on the importance of the third sector in addressing health inequalities and delivering public health services. The critical role of local voluntary organisations was highlighted in reaching diverse communities that broader county-wide initiatives may not effectively engage. The conversation highlighted existing partnerships with voluntary groups across Hertfordshire, including their involvement in programme development, co-production efforts in areas such as domestic abuse, homelessness and substance abuse, and the inclusion of individuals with lived experience to inform public health strategies. There is a clear intent to increase financial support for the voluntary sector by shifting funding from public health grants to these organisations through multi-year contracts like the Prevention and Investment Fund.

Bob Jones from Watford and Three Rivers Trust raised concerns about preserving the voluntary sector, especially as many voluntary groups are structured around existing district and boroughs. The proposed move to fewer unitary authorities could require significant restructuring of voluntary organisations, potentially disrupting both formal and informal community groups. The speaker highlighted ongoing discussions and collaborations with local groups and charities, encouraging voluntary sector members to engage with forums such as the Herts Community Leaders Forum and attend upcoming meetings. There is particular worry about the informal voluntary sector at the neighbourhood level, which may face challenges in maintaining connections with statutory bodies under the new structure.

The importance of considering the voluntary sector in the reorganisation process is emphasised, with assurance that it remains a priority for local government planning.