Download 5.1 Public Health Annual Report 2014

Highland NHS Board
7 October 2014
Item 5.1
THE PUBLIC HEALTH ANNUAL REPORT
Report by Dr Margaret Somerville, Director of Public Health and Health Policy
The Board is asked to:
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Discuss the report.
Agree the recommendations.
Recommend that both Community Planning Partnerships incorporate the report’s
recommendations into their action plans.
Background and Summary
The Director of Public Health is required to produce an annual report on the health of the
population of NHS Highland. The last three public health annual reports have covered
inequalities in health, the health of older people and the health of children and young people.
Each report has set out recommendations for the NHS and partner agencies to take forward.
Over the last three years, substantial progress has been made on the recommendations from
these reports.
The 2014 annual report covers the health impacts of climate change and actions to adapt to
and mitigate these impacts. Providing sustainable public services for the future is part of
these actions. Recognising and building on the positive aspects of climate change and
adaptive policies that can be beneficial to health is also essential. The report also considers
a range of environmental impacts on health and how these may modify under climate
change.
As the recommendations call for joint action across agencies, the voluntary sector and
communities, they are primarily directed at Community Planning Partnerships for discussion
and implementation.
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The 2014 Public Health Report
Climate change is already affecting the natural environment in Highland, just as it is across
the UK and the rest of the world. Current predictions for Highland suggest that in another
25years, Highland’s climate will resemble that of the south west of England, with warmer
annual average temperatures and more frequent extreme weather events. Even if we were
to stop burning carbon today the climate would continue to warm for some decades.
Adaptation to the likely effects of climate change is therefore essential. Providing
sustainable public services, particularly healthcare, is a key element of both mitigation of and
adaptation to climate change.
Design and planning of the built environment can support health and well-being through
promoting safe active travel, physical activity and access to green space. Warmer
temperatures may provide more opportunities for outdoor activities, making more and better
use of local greenspace and walkable neighbourhoods. These benefits can improve mental
health and well-being and help reduce our current high levels of overweight and obesity.
Despite warming temperatures, fuel poverty is likely to remain a major concern for remote
and rural communities unless specific action is taken to contain fuel costs, improve home
energy efficiency and make best use of local renewable energy sources.
A changing climate also offers significant opportunities to improve health through promoting
enjoyment of the natural environment, more exercise outdoors and a better chance of
obtaining fresh, locally grown produce, even in remote areas. However, climate change has
a downside as it may also lead to more frequent extreme weather events and more illness
from environmentally acquired diseases such as Lyme Disease and food poisoning. In
addition, climate change will contribute to changing patterns of work, land use and
employment.
Private water supplies are more prone to failure than the mains supply, often due to
contamination of the raw water by animal waste, and lack of adequate treatment. Climate
change will increase the likelihood of contamination due to increased levels of runoff as a
result of changed rainfall patterns.
While a warmer climate potentially offers more opportunities for making use of the natural
environment, it may also lead to greater exposure to injury and environmental hazards. The
mountain rescue (MR) teams in the NHS Highland area account for 57% of all MR activity in
Scotland, reflecting over 30,000 hours of volunteer time in responding to incidents. Lyme
disease is also a growing problem in the Scottish Highlands. Unintentional injuries form a
high proportion of the emergency workload of NHS Highland, costing around £1.5 million per
year. While the majority of these injuries arise from accidents in the home, a significant
amount of activity comes from road traffic accidents.
Extreme weather events are a likely consequence of climate change and on several
occasions NHS Highland has experienced multiple incidents due to snow, high winds and
flooding in recent years. While emergency planning to ensure services can respond as
rapidly as possible to restore power, water supplies and access to essential services,
communities increasingly need to be able to support themselves during such episodes.
Health impact assessment is essential for all major developments if health benefits are to be
maximised and adverse effects minimised.
Recommendations for Community Planning Partnerships include (full detail in report)
Monitoring and reporting carbon emissions across agencies
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Supporting communities to develop resilience to extreme weather events
Develop joint infrastructure and services across agencies, particularly in relation to
transport, catering, procurement and use of renewable energy sources
Reducing fuel poverty through reducing fuel costs as well as improving energy efficiency
Raising awareness of the changing natural environment through schools, public
engagement and integrated impact assessment
Promoting physical activity and mental health and well-being through a renewed strategic
approach
Promoting access to and use of the natural environment by all ages and population
groups
Helping to reduce overweight and obesity levels through reviewing and reducing the
obesogenic nature of the local environment and improving access to affordable healthy
food
Reduce unintentional injuries and hazards through promoting outdoor activity and road
safety awareness, awareness of Lyme Disease, testing private water supplies, preventing
falls and home safety
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Contribution to Board Objectives
Designing and delivering services that are sustainable in the long-term is an intrinsic part of
delivering “Better Health, Better Care, Better Value” for every patient every day. Developing
sustainability includes considering and adapting to changes in the external environment and
how these impacts affect health and the need for health care. These impacts may result in
services being delivered in different ways in different settings from current configurations and
include building resilience in local communities to support self-management.
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Governance Implications
Describe impact on all the relevant Governance Standards
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Staff Governance: the report has implications for the ways in which staff deliver
services which require further discussion
Patient and Public Involvement: much of the work described in the report has already
been undertaken in partnership with communities and individuals; other issues still
require further discussion
Clinical Governance: no specific impact identified
Financial Impact: no specific impact identified but recognising and adapting proactively to the impacts of a changing environment is likely to result in more health
benefits and fewer costs in the future
Risk Assessment
No specific risk assessments have been undertaken.
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Planning for Fairness
Formal Planning for Fairness has not been undertaken for this report, but it is noted that the
impacts of climate change affect the poor far more than the rich, at a global, national and
local scale. Ensuring that the organisation recognises the implications of environmental
changes and pro-actively adapts to them to maximise potential benefits will have a beneficial
effect of inequalities.
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Engagement and Communication
Other presentations are planned to the Highland CPP Board and in Argyll and Bute.
Margaret Somerville
Director of Public Health and Health Policy
26 September 2014
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