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                           DEPARTMENT OF HEALTH


        Regional Director of Public Health (RDPH) Annual Visit 2003/04

        Notes of the Wyre Forest PCT/Wyre Forest District Council Visit
                        on Wednesday 24 March 2004


Wyre Forest PCT

Ray Duffell                      Director of Public Health
Peter Forrester                  Chief Executive
Karen Wright                     Specialist in Public Health

Wyre Forest MBC

Walter Delin                     Chief Executive
Andrew Dickens                   Head of Cultural, Leisure and Commercial Services
Lynette Jones                    Senior Health & Sustainability Officer
Mike Parker                      Head of Planning, Health & Environment

West Midlands South SHA

Andrew Richardson                Acting Head of Public Health

West Midlands Public Health Group

Rod Griffiths (RKG)              Regional Director of Public Health
Julie Davis                      Support Officer/Note Taker


      RKG outlined the history of the visiting process, which had been undertaken
      principally with health organisations but with visits to Local Authorities (LAs)
      on more of a random sample basis in the past. The overall purpose of the
      visits was developmental, focusing on important current issues with the aim of
      adding value to processes that are undertaken across the region. The notes
      of the meeting would also form part of the succession plan for when RKG left
      his role in May.

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      The County-wide emergency planning arrangements had been covered during
      a separate visit to Worcestershire County Council (CC). It was noted that the
      CC takes responsibility for civil contingencies planning but under the new Civil
      Contingencies legislation Wyre Forest District Council would assume statutory
      responsibility for the area.

      Within Wyre Forest, the Chief Executive, Walter Delin, is the Emergency
      Planning Officer. The Head of Cultural, Leisure & Commercial Services,
      Andrew Dickens, leads the Emergency Response Team. The PCT and DC
      are happy they have appropriate systems in place and feel they have coped
      very well with the Fuel Crisis, Flooding and Foot & Mouth major incidents
      which have occurred over the past few years. There is also a DC “Business
      as Usual” plan.

      Both Walter Delin and Andrew Dickens have received emergency planning
      training at Easingwold. An emergency response exercise and an exercise for
      the Rest Centre teams have been undertaken in Wyre Forest (and it was
      noted that this latter plan has actually been activated). Wyre Forest has
      sustained flood levels of 5.8 metres in recent years, which have affected up to
      300 properties. Ray Duffell confirmed that such high floods do affect GPs’
      ability to travel around the area.

      The CC and DC have a joint emergency telephone line which can be staffed
      from six separate organisations on a 24 hours per day, 7 days per week basis.
      From September 2004, this service will be extended to operate from seven
      organisations with ten telephone lines.

      The PCT would link into the DC’s emergency planning arrangements,
      depending on the nature of the incident. RKG stressed that experience has
      shown that only one telephone line should be set up to deal with multi-agency
      incidents, in order to ensure that consistent messages are given to the public,
      media and Ministers. He said many NHS organisations now use NHS Direct
      telephone lines for Health incidents. Across Wyre Forest there is an
      arrangement that the Police media team are responsible for the issue of all
      multi-agency press releases and Walter Delin is responsible (with the DC
      Communications Manager in his absence) for briefing MPs at both DC and CC

      The PCT also has its own Major Incident Plan and Planning Group.
      Developing a Kidderminster Hospital site plan is underway and involves all
      NHS and partner organisations.

      The DC are fully aware of the PCT and Acute Trust’s site emergency plans.

      CC staff are very supportive of the DC arrangements but most incidents have
      been specific to North Worcestershire and so the DC has taken the lead.

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      RKG shared some learning from the recent Legionnaires’ outbreak in
      Herefordshire and also the Sandwell DGH A&E fire. He stressed that it is
      important not to under-estimate the size of the task of dealing with a major
      incident and the effect it has on the whole of an organisation.

      Finally on emergency planning, RKG referred to the “bird flu” outbreak in
      South East Asia (which was ongoing). The longer the virus is prevalent, the
      greater the risk it will mutate into human form and spread rapidly. RKG
      expected that the Department of Health would issue revised guidance for
      dealing with flu pandemics some time after Easter and suggested the PCT aim
      to have a flu plan, which should include a contingency plan for the health
      service, in place by the end of the summer.


      Ray Duffell is the Chair of the local Local Strategic Partnership (LSP), Wyre
      Forest Matters, which fits into the County-wide LSP. The Partnership is due to
      launch its first ten-year community strategy in April. Members of the LSP have
      gone out into the community - to find out what the people of Wyre Forest
      wanted to see in the strategy. Improving Health and Well Being has emerged
      as one of five key themes. Once launched, the partners of the LSP will need
      to work together to ensure effective delivery.

      Alison Braithwaite from the DC currently provides support for the LSP (without
      specific financial resource) by way of briefings and co-ordination. The LSP
      Board meets bi-monthly in addition to the meetings of the five key theme
      groups. The theme groups provide the briefings for the LSP Board and so it
      does not operate a top-down process. There are around 100 people involved
      in the LSP process.

      The LSP receives regular coverage in the district-wide newspaper newswyre
      and there are plans for a website and newsletter.

      The following partnership initiatives were highlighted:-

      Oldington and Foley Park Pathfinder

      Wyre Forest has been recognised as a good model for LSP and £2.5 million
      has recently been awarded for the Oldington and Foley Park district of
      Kidderminster to become one of the ODPM’s round two Pathfinder
      Neighbourhood Management Programmes.


      Wyre Forest transferred its entire stock of 6,000 units to a Registered Social
      Landlord (RSL), Wyre Forest Community Housing. The DC has retained
      responsibility for providing housing advice, operating a housing waiting list and
      nominating people from the housing waiting list to the RSL properties. The
      condition of the social housing stock is “not too bad”, it is the issues behind the

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      doors, including health, drugs, crime and fear of crime, which are of concern.
      There is greater concern about the poor state of some of the private housing
      stock in the area. A Neighbourhood Manager has recently been appointed.

      Tobacco Control

      Worcestershire’s Smoking Cessation Co-ordinator is due to attend the next
      West Midlands South DsPH meeting to give an update on what is happening
      around tobacco control in the County. Smoke Free Worcestershire was
      launched on 17th March. Ray Duffell is keen to see an increase in the number
      of smoke free public places and plans to include something about this in his
      DPH Annual Report.

      Fuel Poverty

      A steering group has been set up to tackle this issue and a referral
      mechanism established in Wyre Forest. Pilot work will inform a roll out across
      the District. Private sector housing is now of greater concern than the social


      The Community Safety Partnership, the Communities Partnership, the Crime
      and Disorder Partnership and the Drugs Action Team have worked together
      and designated Bewdley town centre as an alcohol free zone and
      Kidderminster town centre a alcohol free zone at weekend. While alcohol is
      recognised as the source of some anti-social behaviour, it is thought that the
      problem comes from one or two public houses only – and Rod suggested it
      might be possible to draw this to the attention of the licensing magistrates.

      A 55% reduction in crime in Bewdley has been reported, though it is not
      known if this is a result of designating the alcohol free zone or not.

      There is a young people and alcohol strategy (children aged 9-12 years).
      Whilst no local data is available, the EXETER data provides challenges, with
      regard to supervised and unsupervised drinking in the home.

      Ray Duffell believes that Worcestershire’s Healthy Schools Scheme could do
      more work to engage with parents – and this needs too be addressed.

      Waiting Time for Drugs Treatment

      There are high access rates to drug treatment services in Wyre Forest.
      Eleven of the thirteen GP practices offer shared care arrangements and each
      practice has direct access to alcohol counselling services. Rod stressed the
      importance of providing quick access to services for people wishing to access
      drug services.

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      Wyre Forest is covered by a two-tier overview & scrutiny system, at both
      County and District level. The County’s Overview & Scrutiny Committee has a
      very strong infrastructure and is supported by Worcestershire Acute Hospitals
      NHS Trust and all the PCTs in the county. The agenda has shifted to a much
      more considered approach as the network has developed.
      Two members of the District committee sit on the County committee.

      The County scrutiny system has considered: cancelled operations, the Elderly
      People’s NSF, Community Pharmacy Network and palliative care. Many
      issues affect Wyre Forest has a community and issues considered at District
      level have included: birthing, Lucy Baldwin Hospital, Mental Health CHAI and
      out of hours GP service contracts.

      The Acute Hospitals’ Patients Forum and scrutiny committee spark each other
      off and a CHAI visit is planned for April. The public meetings are well
      attended by local people (and these are longer just those interested in the
      future of the acute hospital).


      RKG thanked everyone for their attendance and contribution to the meeting
      and acknowledged the very good work going on in the District.

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