Agenda item

Jonathan O’Sullivan, Director of Public Health, invited questions on his written report on Public Health performance for quarter 2 in 2023/24.

Questions/responses were as follows:

Could the Committee have a picture of measles in the capital at the moment?  The response given was that there had definitely been an increase in measles cases month on month, across London as a whole.  There was also a similar pattern in the west Midlands. There was concern about the level of measles, mumps and rubella vaccination uptake, both for the first and second doses.  Together with the NHS, the Council was working on a range of activities to improve measles, mumps and rubella vaccination uptake. As was apparent in the report, there was currently no data available through the local health system, so authorities had worked carefully on a triangulation of the other vaccinations given at the same time and the Director of Public Health had said that he was very confident that it was just a data coding issue which was not being picked up in the local system.  He noted that in national data, an increase in MMR 2 vaccination was evident, again supporting the sense of a local coding issue.  Key messages had been shared with councillors about the importance of the MMR vaccine, including sharing some of the information in community languages. NHS colleagues were doing more in terms of promotion and roll-out to the community to encourage more people to attend for their vaccinations.

The Chair reported that he had met the Bangladeshi Association last year  and had met with Islington Public Health staff and offered to attend the mosques with information on vaccinations.  He had suggested to the imam that it would be helpful if he could attend a Friday prayers session to talk about the issue.  The Director of Public Health said that it would be helpful for councillors, who were trusted in the community, to do anything they could to spread the message about vaccinations.

On substance misuse, it was noted that services were delivered by the organisations “Inroads” and by “Via”, the latter including outreach work for various people. Confirmation was requested on whether the carrying of Naloxone was carried by the outreach workers only?  There was reference in the report to “services collaborate closely with criminal justice partners to ensure effective pathways into treatment from prison, probation and police, which includes co-locating of services and in reach support” and how exactly this was working in Islington?  There was also a reference to “strong service focus for the coming quarter to help increase people with opiate addiction coming into treatment services.” and whether there were problems with nitazenes and higher risks of overdose?  The Director of Public Health replied that naloxone was carried by outreach workers to promote supplies for people using opiates as it was considered important.  Harm reduction was most important. The kits previously were injectables but were now nasally administered.  There was an initiative with community pharmacies who were in contact with people using opiates in order to address that. Naloxone was a treatment which reversed the affect of an overdose and therefore dramatically reduced the risk of mortality. The concern for drug supply around opiates and other drugs in the UK was that it might follow the pattern of drug use in the US and other parts of the world, with synthetic opiates being far more potent and far more dangerous, with a risk of overdose. Part of the reason to proactively reach out to people, was about sharing harm reduction messages and there was a local plan for action if there were reports of overdoses.  Over December to January, there had been some deaths due to opiates, which could have been linked to  synthetic opiates or metazene, which made it even more important to share the messages about Naloxone and wider harm reduction. On collaboration, Public Health was working hard on relationships with the Criminal Justice System, with a good model in place in Probation and staff working in the custody suite (latter point to be confirmed).  The very limiting factor was that the Police had much pressure in terms of vetting procedures as to who could work in those settings.  Islington was not the only borough experiencing these difficulties and the matter had been escalated to London level to increase the pace of vetting. Positive work engagement had continued, including with the Prison Service. The Director of Public Health was pleased to note support to black African and black Caribbean men in the criminal justice system. The outreach service was receiving positive feedback from Police colleagues, particularly around the level of knowledge of outreach workers, helping to get people into treatment.  Collaborative work was being carried out by the outreach workers, the Police and the Council’s Community Safety Team on tackling these issues.

It was noted that there was no reference in the “Smoking” paragraph of the report to the detrimental affects of smoking on pregnant women.  The Director of Public Health concurred with the concerns expressed about pregnancy and smoking. He reported that, in the most recent quarter, the quit rate for pregnant women was 84%. This compared to the London average of 56% and the England average of 50%. One of the reasons for maintaining the Start Well programme maternity and neonatal  at the Whittington Hospital was because excellent public health services were inputted into that Hospital. Breast feeding initiatives were also high.  It was suggested that these points be included in the current consultation on the future of maternity and neonatal services.