Apologies for absence were received from Councillor Andrew Howard and Councillor James Holmes attended as a substitute .

Councillor Sally Kenny also gave apologies  and Councillor John Dehaney attended as a substitute.

There were no declarations of pecuniary interest

Minutes of the previous meeting were agreed as a true and accurate record

The Chair announced that the Cabinet Member had to attend an important engagement and this item would be deferred until the next meeting.

The Commissioning Manager from Merton Clinical Commissioning Group (MCCG) gave an overview of the report stating there are three podiatry clinics in Merton as well as a  home visiting service, they are all accessed by referral from a GP or health professional. The proposed changes will limit access criteria to those with the highest need.  This criteria has already been implemented in other boroughs across London.

In response to questions from the Panel it was reported that:

·         The funding for the service has not been reduced changes will ensure it can meet the rising demand over the longer term.

·         A person deemed to have low need could still access the service if they are assessed as being vulnerable. Those who have high needs should see a reduction in the waiting time for the service.

·         These proposals have been prepared and will be implemented upon the comment and agreement from this Panel.

The Director of Commissioning, MCCG reported that this will make the service more resilient with improvements for those with high need.

The Director of Public Health said she is in support of the proposals as it will result in the right care for the right patients. There will still be support for those with low needs who do not need specialist services.

A panel member said they are a satisfied  recipient of the podiatry service,  they highlighted the importance of the assessment being based on individual need. The Commissioning Manager agreed a blanket approach would be unhelpful and although the criteria is structured, individual need will be taken into consideration. GPs and the Service have looked at the criteria and will work in a consistent way.

A panel member asked if training was available for carers. The Service Team Lead said training could be made available as they had provided it in the past and found it was successful.

The Director of Commissioning said they recognise that they can do more work with partners to provide information for people with low needs.

A Panel member said they were concerned because the podiatry service can play an important role in identifying early complications with diabetes. The Service Lead said people with diabetes should have a full check up every year, there are a variety of ways of monitoring their health.

A panel member asked if leaflets will be available in other languages. The Director of Commissioning said leaflets were translated for other services and they will also do if for podiatry.

RESOLVED

The Panel gave its approval to the proposals for changes to podiatry services subject to the following recommendations:

To translate information on this service into other languages

To provide more information for people with low podiatry needs

To promote the availability of training for carers organisations on basic foot management.

The Director of Public Health gave an overview of the report highlighting how immunisation services are provided and commissioned. It was pointed out that public health Merton has an oversight role. 

The Principal Advisor for Commissioning  reported there are 18 immunisations programmes from birth to death. London has trailed behind other regions in uptake rates for a number of reasons including the impact of a transient population.

The Immunisation Commissioning Manager reported that NHS England is working closely with partners to tackle these issues. Immunisations are reviewed and discussed with practices at a quarterly meeting, targeting those with the lowest uptake.

A panel member who had participated in a previous childhood task group in 2014, asked what role the council can play in championing vaccination uptake. The Principal Advisor for Commissioning  said we need to think of different ways to tackle this issue, councils can help by highlighting the importance of immunisations.

A panel member asked if there are plans to incentivise GPs to increase immunisations uptake.  The Principal Advisor for Commissioning   reported that discussions are taking place with primary care who hold the contracts.

A panel member asked if community champions are used within settings such as pharmacies and gyms. The Principal Advisor for Commissioning  said they are keen to do more work like that in this area as a pilot on lay immunisation champions in a deprived London area had proved to be very successful.

The Director of Public Health said resources for promotion sit with Public Health England. Therefore the council is using Public Health England material within our infrastructure.

RESOLVED

The Chair thanked officers for their report and noted the limited resources available to our public health team for the promotion of immunisation uptake.

The Director of Public Health gave an overview of the report and highlighted that there is a sincere effort to bridge the gap in health inequalities in Merton. This is a complex issue as the data changes  in different scenarios. The gap in life expectancy is closing for women but not for men. Self-reported wellbeing and mental health is worsening in more affluent areas.  If interventions had not been put in place it is likely that the gap would be significantly worse.

A panel member asked if the successes achieved can be applied to other areas. The Director of Public Health said they have looked at learning from elsewhere to understand the evidence to reduce inequalities. We need services to address the issue as well as tackle the wider determinants of health. It needs a combination of factors over the long term.

RESOLVED

The Chair thanked the Director of Public Health for the report.

The Panel noted the Work programme.