Meeting documents

Presenter:

Dr Jane O’Grady, Director of Public Health

Dr J O’Grady, Director of Public Health presented her report and the following points were made during the presentation:

• The Director of Public Health produced an annual report as per statutory requirement. Each year the report highlighted an area of particular interest and this years had focused on pregnancy and the early years of life.
• Healthy weight, eating well and good mental health along with the avoidance of maternal smoking, alcohol and drug use were all of vital importance to the outcomes for babies and young children.
• Pregnancy would impact on every aspect of life including development, social skills, levels of happiness, education and adulthood health.
• The general health of mothers in Buckinghamshire had been shown to be good however 7.6% of babies were born prematurely (before 37 weeks) and 2% of babies born after 37 weeks had shown low birthweight which had the potential to impact on their lifelong health. Births prior to 34 weeks accounted for half of all long term neurological disabilities in children and three quarters of neonatal deaths.
• There were modifiable risk factors including maternal smoking, drug or alcohol misuse, domestic violence and maternal stress that were known factors contributing to prematurity or low birth rate.
• The ability for parents to give a child the best start in life depended on their social context. Mothers needed to be healthy before, during and after pregnancy. A third of pregnancies in this country were shown to be unplanned.

• Approximately 6,000 babies were born every year in Buckinghamshire, 25% of mothers were born outside UK (Pakistan, Poland, India, S Africa), 23% of mothers identified their babies as of non-white ethnicity. The birth rate had shown as higher in more deprived areas reflecting population profile.
• 14% of women booked late into antenatal care in 2013 which could be a potential indicator of worse outcomes for both mother and baby.

• Health of other household members would be equally important and fathers can experience difficulties during pregnancy that can impact on the child’s health.
• Access to high quality services including contraception would be important for the health of the baby.
• Teenage conceptions had fallen dramatically in Buckinghamshire and were lower than both the South East and national average. The maternal age had risen and the average age of first time mothers was  between 30 and 34 years.
• Those in deprived areas and ethnic groups had worse outcomes.
• Low birth rates had shown as more prevalent in certain groups and Buckinghamshire shown as performing worse in these areas compared to the national average. Buckinghamshire had the second highest birth rates alongside the county’s CIPFA peers.
• Smoking in pregnancy had shown to effect the brain growth of babies. Passive smoking also harmed mothers, babies and families. 432 women had been reported as smokers at the time of booking in Buckinghamshire, with 252 of these referred to smoking cessation. Out of the 252 women, 42% had quit smoking.
• There had not been any routine data collection regarding expectant mothers that were overweight or obese but Buckinghamshire Healthcare Trust had collected some statistics across Buckinghamshire and found that 27% of pregnant women had been overweight or obese at 12 weeks. Only 68 referrals had been made to the Weight Referral Programme.
• 9% of babies born every year are the child of a lone parent. Of non-white ethnic groups, about 17% of babies born to Asian parents had an increased risk of low birth weight.
• Those that live in poverty could still have positive outcomes if they received high quality parenting.
• Good PSHE in schools would increase the opportunity for a child’s negotiation skills and understanding of sexual health to develop.
• Dr J Sutton noted that the results were shocking. Much of the targeted work which had been locality based had still shown on the graph as unchanged. The Premature Clinic at the hospital as well as the Health and Wellbeing Board needed to focus on the bigger picture and what could be done to help the highest areas of deprivation. 
• Ms R Shimmin stated it would be important to think about defined localities and undertake some targeted work in the areas where the issues were known and use collective intervention. Ms Shimmin suspected that some of those children on the Child Protection Register would be from those areas of deprivation and support needed to be provided in a more holistic way.
• Ms J Baker stated that Healthwatch Bucks had produced a report on fathers and the maternity process. Buckinghamshire Healthcare Trust had taken on board the recommendations and put an action plan in place.
• Ms I Darby stated that the District had undertaken a lot of work on homelessness and it was important that these be linked with health and the Health and Wellbeing Board. .

The following actions were agreed from the presentation:

• Dr J O’Grady would look at life expectancy figures for specific ward areas.
• Dr J O’Grady would  bring a proposal back to the next Health and Wellbeing Board following the Maternity Workshop on what could be done in specific localities to tackle some of health inequalities raised in the report. 

ACTION: Dr O’Grady

• Ms K Mcdonald to add housing needs to the Health and Wellbeing dashboard.
• Ms K Mcdonald to inquire whether  a representative from the Police and Crime Commissioners Officer available to attend a future meeting item related to domestic violence.

ACTION: Ms K Mcdonald

RESOLVED

Board members CONSIDERED and ENDORSED the Director of Public Health’s Annual Report.

Board members DISCUSSED how their constituent organisations would support the recommendations set out in the report to improve outcomes for babies, mothers and families in Buckinghamshire.

Board members AGREED to disseminate the Director of Public Health’s Annual Report through their organisations.

Board members ENDORSED the partnership workshop planned for October to improve outcomes for families, mothers and babies in Buckinghamshire.

Board members AGRERED to bring a proposal back to the next meeting on taking forward the recommendations from the DPHAR and local approaches.