Alison Iliff/Joanna Saunders, Public Health, to report
Minutes:
Joanna Saunders, Head of Health Improvement, and Alison Illiff, Public Health Principal (Health Improvement), gave the following powerpoint presentation:-
Overarching Outcome in Healthy Lifestyles Theme
- People in Rotherham will be aware of health risks and be able to take up opportunities to adopt healthy lifestyles
Priorities in Healthy Lifestyles Theme
- We will work together to understand our community assets; identifying what and where they are across the borough and how we use them effectively
- We will use the Health and Wellbeing Strategy to influence local planning and transport services to help us promote healthy lifestyles
- We will promote active leisure and ensure those who wish to are able to access affordable, accessible leisure centres and activities
The Determinants of Health (1992)
- General socioeconomic, Cultural and Environmental Conditions
- Agriculture and food production
- Education
- Work environment
- Living and working conditions
- Unemployment
- Water and sanitation
- Health care services
- Housing
- Social and Community networks
- Individual lifestyle factors
- Age, sex and hereditary factors
Healthy Lifestyles Work Plan
- Specific actions for overarching outcome and priorities – most not target driven
- Headline achievements
- Challenges
- What do we need to do next?
Achievements – Overarching Outcome
- Tobacco Control and Weight Management Services recommissioned in 2014/15
- Strengthening performance management through data management systems and reporting/review
- Promotion of social norms and social marketing – linking with national programmes and local ones
- Higher profile for public Mental health linked to Welfare Reform Programme and self-harm
Achievements – Priorities
- Increased awareness of behaviour change services in communities – networks, marketing and social media) links with EI&P theme)
- Service review following feedback (links with Expectations and Aspirations theme)
- Building community capacity to support behaviour change (links with Dependence-Independence theme)
- Stronger links with Planning Department and health proofing of local plan
- National recognition (academic and policy publications) of Affordable Warmth Programme including social marketing tools (links with Poverty theme)
- Successful Safer Roads Partnership and Casualty Reduction Programme
- Increased opportunities for accessible and affordable physical activity
- Physical activity rehabilitation programmes (links with Long Term Conditions theme)
- Successful bids for external funding to support physical activity programmes
Challenges
- Premature mortality and years of life lost
- Challenges of measuring improvements
- Progressing Making Every Contact Count
- Sustaining investment in health improvement/prevention programmes
What could we do in a refreshed strategy?
- Review priorities (within this theme/strategy priorities)
- Still about investment in prevention and early intervention
- Mandated Public Health priorities
- Local priorities
- Early diagnosis and referral to treatment
- Continued role for partners
Tobacco Control Priority
A smokefree town
- Goal 1: Preventing the initiation of tobacco use among children and young people
- Goal 2: Reducing harm to adults from tobacco consumption
- Specific actions and targets for each goal
- Headline achievements
- Challenges
- What do we need to do next
Achievements
- New suite of Tobacco Control Services commissioned
- Joint commissioning across South Yorkshire to provide best value for money and economies of scale
Performance
- Adult smoking prevalence 2013: 18.9% (England: 18.4%) – lowest ever rate for the Borough
- Smoking at delivery 2013/14: 19.9% (England: 12%) – 6.2% point reduction over 5 years (England: 2% point reduction)
- Regular smoking rate in Year 10: 9.1% (England: 8% at age 15) – rate in Years 7 and 10 static according to local Lifestyle Survey results
Challenges
- Smoking at delivery rates – reductions have stalled following significant drop between 2009 and 2013
- Nicotine delivery devices (electronic cigarettes) – renormalisation/glamourisation of smoking? Use among young people
- Using cheap and illicit tobacco is a ‘Robin Hood’ crime
- Changing behaviour in our most vulnerable communities
What do we need to do next?
- Focus on the prevention of uptake
- Extend smokefree spaces to promote non-smoking as the social norm
- Promote harm reduction messages
- Continue to innovate in-service delivery and development – vaper-friendly stop smoking services?
- Embed stop smoking support in clinical pathways – opt out referral into Service for certain key conditions
Discussion ensued with the following issues raised/clarified:-
- Safer Roads - the Transportation Planning Team had identified areas across the Borough where there had been accidents and there were a number of programmes in delivery. However, there was no clear message nationally on what the best method was and the Police did not have the resources for enforcement action. It was about creating a culture where everyone recognised areas where children played and people exercised outside and drivers drove more slowly
- Although not fitting into the Strategy, promotion of Mental Health and Wellbeing was carried out. There was an excellent programme of training, Mental Health First Aid, and work around assisting prevention carried out by very small resources within Public Health. It was seen as a much bigger priority going forward
- There were increased numbers of people living alone with 1 of the biggest contributors to poor healthy lifestyles being isolation and loneliness particularly in elderly people. This had featured in the Expectations and Aspirations Theme and work carried out with Age UK about recognising the impact of social isolation and loneliness particularly in older adults and the impact it had in terms of higher risk and potential higher use of health services
- Should be a continued prioritisation to catch people at the points in their life when something changed. If they could be caught at that point with social prescribers it would have an impact on admissions to hospital which translated into cost savings
- In the Jay report it stated that 1/3 of the girls suffered mental health issues which was consistent with the Serious Case Reviews findings as well as drugs, alcohol and substance misuse. Joint commissioning was the way forward in an attempt to reduce births of babies with complex needs. A behaviour pathway needed to be developed to identify the critical signs and signpost children and families
- The update raised questions as to what should be included in the Strategy refresh and how collectively the Board determined and agreed what those priorities were. There also needed to be a sharing of what partners were doing separately which contributed to the health and wellbeing of the people of Rotherham and what they were doing well
- There was a lot of good work taking place in Smoking, Obesity and Alcohol but there were no agreed trajectories to measure even though they had been priorities for 2 years. These were needed by the end of February
- There had been some confusion amongst practitioners when the new Smoking Service had started. A single provider was now commissioned who then sub-contracted to GPs. The agreement was agreed by the Local Medical Council in Doncaster but rejected by Rotherham, however, they had contacted all practices in Rotherham to ascertain if they wished to continue with Stop Smoking support. 5 practices in Rotherham had agreed to provide the support as well as a number of pharmacies. The LMCs in both areas had agreed 42-45 pharmacies across both areas so far. The number that would have been expected to receive support in Primary Care had reduced as a result, however, provision had been made to ensure referrals were made and there was capacity in GP services to provide the support. In the last couple of years a number of GP practices had said that the time and effort required to provide the service directly was not sufficient for the income they achieved and a number had ceased and arranged for Smoking Services to come into their practices to deliver instead
- Tobacco was still the single biggest killer in Rotherham. The work carried out across South Yorkshire, with the support of Public Health and Public Health England, had been innovative
- There was a lot more support for and recognition of electronic cigarettes. The long term effects were not known but it could be said that they were safer than tobacco. If people were not looking to quit they would be the approach to reduce the harm
- Rotherham United was a member of the Tobacco Liaison Group. The Club carried out a number of diversionary activities and activities that related to smoking. The leisure centres had lifestyle agendas and would promote No Smoking Day etc. and encourage people, however, there was more that could be done
- An additional Trading Standards Officer was funded to enable more work on tobacco control. There was a Service Level Agreement with a certain number of activities that were required over a 12 months period which could be educational and informational activities
Joanna and Alison were thanked for their presentation.