Agenda item

This paper highlights to the Board the Kirklees Director of Public Health (DPH) Annual Report 2023/24, entitled ‘Inequalities in the experience of death and dying: What are the assets and opportunities within Kirklees communities?’

The Board will receive a presentation outlining the DPH Annual Report.

Contact:  Rachel Spencer-Henshall, Strategic Director, Corporate Strategy, Commissioning and Public Health, Lucy Wearmouth, Head of Improving Population Health and Owen Richardson, Data and Insight Enablement Lead for Public Health

Rachel Spencer-Henshall, Strategic Director Corporate Strategy, Commissioning and Public Health, introduced the item, advising the Board that this work has been undertaken alongside Kirkwood Hospice, who have been a great ally with this project.

The Board was informed that Public Health annual reports are brought every year to the Board, and it is an opportunity, to consider as a system how to use the information to inform the work going forward. It would be useful to receive feedback on how to take the report further. It is important to thank everyone who has been involved in this because it is an excellent piece of work.

Lucy Wearmouth, Head of Improving Population Health, informed the Board that the Director of Public Health (DPH), chooses what the annual report should focus on, and the 2023/24 annual report focused on death and dying. The aim is to use the report as a vehicle to identify important key issues and gaps and flag up problems and report progress. Last year’s annual report which focused on poverty, has facilitated taking conversations about poverty into areas and organisations where previously this would not have happened. The report is a key resource to inform stakeholders of priorities and recommend actions to improve and protect the health of the communities they serve.

Another important factor regarding the report, is for it to be as accessible as possible, for people to be able to read and access. It will be hosted on the Kirklees Council website, and it is in chapters, enabling people to easily find the information they require.

The focus for the 2023/24 annual report is ‘Inequalities in the experience of death and dying, taking an assets based approach looking at what are the assets and opportunities in Kirklees communities, recognising there are differences between population groups. It was recognised when undertaking this work, that there is already work happening within this space, for example, members will be aware of the Dying Well Board that is in place and there has been recent insight gathered by Kirklees and West Yorkshire Healthwatch teams. The intention was to add value to what has already happened, rather than repeating work, therefore the focus was on understanding inequalities.

The Board was informed that there are many things that can be undertaken universally to support a good death, whilst recognising there are significant inequalities across different population groups, which has been explored within the report. In relation to this, the following was undertaken:

What we did

-      Looked at national evidence, to understand which population groups are most at risk of experiencing inequalities in death and dying

-      Facilitated discussions with a wide range of Kirklees organisations who work with the following population groups, including, people who identify as LGBTQ+, people experiencing homelessness, people with learning disabilities, people with non-malignant (non-cancerous) health conditions, people with serious mental illness or addiction issues, people living in poverty or deprivation, diverse experiences by race, ethnicity or faith and unpaid carers 

What we asked

A series of questions were asked to a range of groups and organisations across the district, focusing on four main areas:

-          The experience of end-of-life planning or care in Kirklees (with particular emphasis on inequalities)

-          Gaps and challenges

-          Examples of local strengths

-          What would help to improve experience

The Board was shown an animation which outlined the work undertaken and the findings, in a way that is accessible to a broad range of people to digest in an easy way.

Owen Richardson, Data and Insight Enablement Lead, informed the Board that the animation summarises the key points from the annual report and there is a lot of insight that is gathered as part of the process. An important aspect of the report, is the case studies that have been gathered, which highlight some of the good work that is being undertaken in Kirklees. By sharing these examples, the aim is to demonstrate best practice and encourage others to adopt those methods. There are case studies from the Mission in Huddersfield, a few cases from Kirkwood Hospice, and from the library.

Alongside local recommendations, it is important to consider the impact of national issues,  policy and decision making. In April 2024, hospice funding was debated in the House of Commons, with a recommendation for a national review of funding. The Marmot Review 10 Years On (2020) made several national policy recommendations, including how to ensure a healthy standard of living for all. These should be considered through a lens of death and dying. NICE guidance provides recommendations on service delivery for end-of-life care and care in the last days of life.

The Board was informed that in addition to system recommendations, the aim has been to also incorporate things that individuals could possibly do for themselves. While being aware that not everyone will be able to do these, there is a list of potential things that people could consider in advance of end of life, for example, making a will, getting their financial affairs in order, plan for future care, and organ donation.

The Board was advised that in terms of next steps, the report will be published shortly, and there will be a dedicated session to present and discuss with the Dying Well Board, and there is also a project team who will be disseminating the report across broad range of local organisations, partnerships and boards.

      A couple of questions were posed to the Board as follows:

-      How can the Health and Wellbeing Board disseminate and support the findings of this report?

-      What are the opportunities for joint working across the system?

Michael Crowther Kirkwood Hospice, informed the Board that as an organisation, Kirkwood Hospice was delighted to have been involved in the development of the report and to help steer some of the work. The organisation is supportive of the recommendations particularly around keeping this at the front and centre, and encouraging the right conversations.

RESOLVED:

That:

i)     the officers be thanked for presenting the Director of Public Health Annual Report 2023/24 focusing on inequalities in the experience of death and dying.

ii)   the questions to the Board be considered.