Progress Through Partnership

Improving Health

Dr Yvonne Arthurs

Deputy Regional Director of Public Health inSouth East Public Health Group

15th June 2007

• Recent National Policy Context

• Emerging Health Strategy in South East

• Individual

• Life style choices and risk factors

• Broad range of economic and related factors :- education, employment, housing and leisure

• Social and Cultural influences

• Environment – climate, air quality

• Access to good quality service for prevention, treatment and care

Factors Influencing Health

• Choosing Health – Making Healthy Choices Easier - (DH2004)

• Health Challenge England – Next steps in Choosing Health - (DH Oct 2006)

• Our Health, Our Care, Our Say – A new direction for community services - (DH 2006)

• Commissioning Framework for Health and Wellbeing - March 2007

• Health and Social Care Outcomes Accountability Framework – 2008/9 – 2010/11now open to consultation to 27th July 2007

National Context

• Tobacco control & reducing smoking prevalence

• Halting increasing rates of obesity

• Increasing physical activity

• Improve sexual health – reducing teenage conception rates

• Reducing inequalities – narrowing the gap

• Alcohol misuse

• Children and Young People getting the best start in life – linked to “Every Child Matters”

• Local community leading for health,

• Work, wellbeing and health

• Health promoting NHS

Choosing Health Focused on:-

- Leadership across government – local and national joining up complementary policies and plans

- Partnership with community, voluntary sector, business, industry and others

- Local Authorities bring together a range of agencies that influence peoples health and wellbeing e.g. in Local Strategic Partnerships, Children’s Trusts

- Understanding the population – Joint Strategic Needs Assessment

- Strong focus on understanding people and their lives and then what influences life style choices or behavioural decisions in different sections of the population

Recent policy taken together signals a new direction for health:-

• Social marketing campaign to reduce obesity and

• to promote lifestyle changes

• multiple approaches and a targeted message

• A shift towards services that are personal, sensitive to individual need – people at the centre of own health

• A strategic shift towards promoting health and well-being – investing to reduce further ill health.

• Increasing control e.g. direct payments.

• Shift in focus towards prevention and early intervention, on maintaining independence, by health and social care services

• More support for mental health and well-being - including employment

• Choice

• Care closer to home

• Tackling inequalities including improving access to community services

• More support for people with long term conditions – Expert Patient Programme

And…..

• Commissioning for the best possible outcomes for the local population, underpinned by understanding of population and individual needs

• Joint accountability Framework that aligns health and social care encouraging working between PCTs, Local Authorities and other

And...

Health Strategy South East

Discussion draft to be launched on 20/6/07

• Re-emphasise contribution of healthy a population and high quality health and social services make to improving quality of life and the economy

• Ensure other regional polices and plans take account of health and inequalities

• Maximise the role of NHS, working with other partners in reducing inequalities in health and promoting sustainable communities.

• Maximise the effectiveness of old and new partnership and synergistic ways of working.

• Create an ongoing dialogue among regional partners to create an environment which fosters innovative thinking and coordinated action to improve health and well being in the South East.

The strategy seeks to:

• GOSE

• South East Coast SHA

• South Central SHA

• South East Regional Assembly

• South East Regional Development Agency

Strategy led by Regional Directorsof Public Health in association with:

• Initiated in November 2006• Healthy Region Summit Discussion – March

2007• Discussion draft to stakeholders – 20th June • Discussion at Regional Health Challenge

England/Healthy Region Forum – 20th June• Discussion period to July 31st 2007.• Final Plan – by end September 2007.• A dynamic plan- to be updated regularly

Process of Development

The strategy is based on five key themes:• Reducing health Inequalities • Promoting healthy sustainable communities

and sustainable activities• Employment and health• Improving outcomes for children and young

people. • Improving outcomes for older people.

Themes

Linked to:

• Integrated Regional Framework for Sustainability

• South East Plan

• Regional Economic Strategy

Health Strategy- one of suite of regional strategies.

Distribution of health deprivation in the South East

Key fact• Health deprivation

is particularly concentrated in the coastal cities and towns, and the major urban centres

Source: Department for Communities & Local Government. Indices of Deprivation 2004.

Carbon dioxide emissions the South East

Key fact• The South East has

the highest total CO2 emissions in England, although emissions per head of population are lower than the national average

Source: Department for Environment, Food & Rural Affairs. Regional Sustainable Development Indicators 2004.

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Key fact• The South East has

the equal second highest sickness absence rate in the UK

Source: Office for National Statistics. Labour Force Survey 2005.

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Teenage pregnancy in the South East

Key facts• The teenage

pregnancy rate in the South East is 17% lower than the England average (2005)

• But inequalities are apparent – the teenage pregnancy rate in Hastings is over 4.5 times higher than that in Chiltern

Source: Office for National Statistics. Under 18 Conceptions for Local Authorities 2003-5.

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Healthy life expectancy at 65 for males in the South East

Key facts• Healthy life

expectancy at age 65 for males in the South East is over one year higher than the England average

• But inequalities are apparent – healthy life expectancy varies from 12 years in Medway to 15 years in Winchester

Source: Office for National Statistics. Healthy Expectancies for Local Authorities in England and Wales 2001.

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Reduction of Health Inequalities– Reduction of mortality from CHD & Cancer and reduce

inequalities between social groups.– Reduce infant mortality and inequalities between social groups.– Improve the coverage of screening and immunisations.– Reduce alcohol related harm– Enhanced inequalities reduction in decision making processes.

Improving Health of Children and Young People• Reduction of Obesity• Promotion of mental health and well-being, preventative and

early intervention• Strengthening commissioning of children's services• Closing the gap on infant mortality• Reduction of teenage pregnancy

Proposed priority areas include:

Employment and Health

• Improve Health and Wellbeing in the workplace

• Improve employment levels in socially excluded people e.g. people on incapacity benefit

And……

Healthy and Sustainable Communities• Increase awareness of health benefits of

sustainable development• Support the implementation of sustainable travel

plans• Maximise the capacity for sustainable food

procurement in the pubic sector• Increase sustainable development in the public

sector• Promote the development of sustainable

community

And……

Older People • Promotion of independence and engagement of

older people• Promote Healthy Active Living• Promote material wellbeing and financial

security of older people• Support the development of Commissioning

Framework for Older People• Support implementation of Dignity in Care

standards and end of life care

And……