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Duncan Selbie's Friday message 21 June 2019

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Listeria outbreak

Nine people have been seriously ill following an outbreak of Listeria linked to pre-packed sandwiches and salads served in hospitals and five of those have very sadly died. Our heartfelt sympathies and condolences are with the people affected and their families and loved ones. Our microbiologists and epidemiologists have been central to understanding and responding to this outbreak working closely with the NHS and the Food Standards Agency. For most healthy people, Listeria causes a mild illness but for the immunosuppressed, it can be extremely serious. Secretary of State Matt Hancock MP made a statement to the House of Commons about this on Monday and made a commitment to look again at the way we provide food in our hospitals, and more on this will follow.

Ebola in the Democratic Republic of Congo

In August 2018 an outbreak of Ebola was declared in North Kivu in the Democratic Republic of Congo (DRC) and has now become the second biggest on record, after West Africa in 2013. The outbreak remains ongoing, with over 2,000 cases reported so far, over 1,400 deaths and cases now confirmed in neighbouring Uganda from people travelling from DRC.

Members of the UK Public Health Rapid Support Team (UKPHRST) deployed shortly after the first cases were confirmed last year alongside other organisations working with the DRC Government and have had a constant presence since. The response is extremely challenging in a region affected by protracted civil conflict and political instability and the situation is constantly changing. PHE’s Dr Olivier le Polain, who is an epidemiologist and deputy director for operations of the UKPHRST has deployed twice to DRC and has spoken about his experiences, the situation and why this is such a complex outbreak. You can read his full interview here on the outbreak and the UKPHRST and more on the incident from the WHO here.

Dr Olivier le Polain working with colleagues in the Democratic Republic of Congo during the ongoing Ebola outbreak.

Putting prevention at the heart of mental health

This week the Prime Minister announced a new push on mental health, putting prevention centre stage. The Number 10 plan aims to drive a step-change in public awareness and provide practical support, in particular for young people. PHE is at the forefront of this work and this October will be launching “Every Mind Matters” - England’s first mental health literacy campaign letting people know what they can do day-to-day to improve their mental health and support others. Following Monday’s announcement, PHE will be developing additional content for young people and parents which will be added to the campaign in 2020.

This week has also been loneliness awareness week, highlighting a problem that affects many people from all walks of life and is also a key issue within Every Mind Matters. As set out in the Government’s 2018 loneliness strategy, we have consulted on updates to our Public Health Outcomes Framework which includes a consideration for a national measure for loneliness, to inform and focus future work on this area. A new campaign called Let's Talk Loneliness was also announced this week by Minister for Loneliness Mims Davies MP which aims to remove some of the stigma around feeling lonely. You can learn more here.

Preventing musculoskeletal conditions

Being in good work is better for your health than being out of work, but for many with long-term conditions such as musculoskeletal conditions (MSK), health issues can be a barrier to gaining and retaining employment. After coughs and colds, MSK is the biggest cause of lost working days in the UK, causing a £7 billion loss to the economy and costing the NHS £5 billion each year and this was recognised in the NHS Long Term Plan.

This week, along with NHS England and Versus Arthritis, we published a 5 Year strategic framework for preventing MSK conditions across every stage of life and you can find out more here.

NHS Providers

The Framework for Population Health in Healthcare Providers published this week by the Provider Public Health Network and NHS Providers sets out principles for a population health approach that NHS Trusts can think about and embed as part of their day-to-day business. The Framework describes a range of ways that Trusts can increase their impact through local partnerships and collaboration, their work on health improvement and prevention, through system-wide approaches to health protection, and as anchor institutions within their local neighbourhood. I was delighted to see this development and commend NHS Providers and the Provider Public Health Network for sharing frontline experience of what works in busy, operational settings.

Patient information on water fluoridation

Tooth decay is still a significant problem for children and adults in England and tooth extraction caused by this is the most common reason for 6-10 year old children to be admitted to hospital to have an operation under general anaesthetic. Tooth decay can be largely prevented by cutting down on sugar and increasing access to fluoride and one way of doing this is through community water fluoridation schemes.

Water has been fluoridated in England for over 50 years and currently benefits around 6 million people. PHE's 2018 Health Monitoring report showed that if 5-year-olds with the most tooth decay drank fluoridated water they would have 28% less tooth decay and be 45-68% less likely to need teeth removed in hospital. To help dental teams talk with their patients about water fluoridation, PHE has worked with dentists to develop a new package of resources including banners for events, posters and conversation starters, which provide which provide information about the effectiveness and safety of fluoridation.

And finally, I will be overseas next week and my next message will be on Friday 5 July.

Best wishes, Duncan

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