Agenda item

Terri Roche, Director of Public Health, to present

Giles Ratcliffe, Public Health Consultant, introduced the 2015/16 independent report which highlighted some of the successes in Rotherham as well as a frank assessment of some of the challenges faced as a community.  A powerpoint presentation was given on healthy ageing living well and living longer as follows:-

 

Why focus on healthy ageing?

“Provides the opportunity to shine the light on the rich asset that older people are within our society and also to consider the changes that are developing within our older population”

Considerations include:-

-          Ageing population

-          Changing communities

-          Older people as local asset

-          Value of focussing on prevention

-          Improving quality of later life

 

Local data highlights

-          Rotherham’s over 65s population is growing the fastest.  By 2025:-

21.7% of population will be over 65

Over 85s population will rise by over 40%

-          Rotherham has lower life expectancy than England (men and women)

-          Life expectancy and healthy life expectancy gap is greater than England average (men and women)

-          Poor perception of “their own health” reported in Census surveys by older people in Rotherham

 

Healthy Ageing Framework Structure

Four sections

-          Healthy behaviours and lifestyles

-          Age friendly environment and community support health

-          Encouraging social inclusion

-          Quality integrated services and prevention interventions

 

Healthy behaviours and lifestyles – adding life to years and years to life

Includes

-          Obesity

-          Fruit and veg

-          Inactivity

-          Alcohol

-          Tobacco

-          Sexual health

-          Living with long term conditions (LTCs)

-          Making Every Contact Count (MECC)

 

Key messages

-          To promote the 5 a day and balanced diet messages and their importance in later life including hydration

-          Older adults to be more active and meet CMO guidelines of 150 minutes per week including strength and balance activities

-          It is never too late to stop smoking

-          Alcohol misuse in later life leads to increased hospital admissions

-          Older people are made aware of the health risks of regular and excessive alcohol use

 

Recommendation 1

-          All services should encourage lifestyle behaviour change in older people where appropriate particularly in the most disadvantaged communities.  This could be achieved through taking a systematic approach to MECC

 

Age friendly environment and community supporting health

The impact of where we live on our health in later life and includes

-          Role older people play in their communities (e.g. volunteering)

-          WHO Age friendly cities and communities

-          Excess winter deaths

-          Poor quality housing impact

-          Cold homes and fuel poverty

-          Falls prevention and support

 

Key messages are to:

-          Plan together

Use a Framework or plan to join activity and work towards a common goal for Healthy Ageing

Housing need to plan adequately for the ageing population, considering account of tenure changes and promoting independence

Preventing falls and providing early intervention for those who have fell is an important factor in maintaining independence

-          Work together

A wide range of people can identify vulnerable people who may be at increased risk (e.g. cold weather, falls)

 

Recommendation 2

-          Rotherham’s Health and Wellbeing Board considers implementing the WHO ‘Age Friendly Cities and Communities’ and become the first area in South Yorkshire to achieve this accreditation, learning from other UK cities that have already begun this work.  This would be complimentary to the Borough’s aspiration to be young people and dementia friendly

 

Encouraging social inclusion

Challenges and opportunities that have an impact in later life includes:-

-          Maintaining independence

-          Carer responsibilities – for partners, friends, grandchildren

-          Income, work, benefits and volunteering (giving back)

-          Education and literacy

-          Discrimination

-          Mental health

-          Dementia

-          Loneliness and social isolation

 

Key messages

-          Maintaining independence requires all stakeholders to work together and with individuals

-          Older people play a significant role as car givers

-          Opportunities for over 65s to remain in work are greater

-          Volunteering is important as a social activity to combat social isolation and loneliness

-          Health literacy is an important factor to support self-management

-          Age discrimination needs to continue to be in policy developments

-          Dementia prevention and support agenda needs to continue to be considered

-          Mental health within later life needs to be responsibility of all organisations across the system

 

Recommendation 3

-          The social inclusion of older people in Rotherham needs to be at the heart of policy and delivery across the Rotherham Partnership, addressing issues such as maintaining independence, income and participation, mental health, loneliness and isolation.  To achieve this goal, older people must experience proactive involvement and participation in life and society as a whole

 

Quality integrated services and preventative interventions

Working together to commission and deliver the best services for older people in Rotherham.  Includes:-

-          Health and social care integration

-          Asset based approaches

-          Screening and immunisations

-          NHS Healthchecks

-          Personalised End of Life Care planning

-          Integrated Wellness Services

 

Key Messages

-          Health and social care integration is underway

-          Screening programmes identify and treat individuals early

-          People 65+ have higher health risks from flu, pneumococcal and shingles

-          NHS Health checks detect early signs of illness and disease

-          Personalised end of life care planning will increase in importance as our population ages

-          Integrated wellness service will target communities and individuals of the greatest need providing a comprehensive behaviour change pathway

 

Recommendation 4

-          All partners to deliver against the aspirations and commitments within the Rotherham Integrated Health and Social Care Place Plan and to continue to strive for the highest quality services for older people.  This is to include an increased focus on prevention, early identification and self-management, with clear pathways for lifestyle behaviour change for older people that support individuals to make changes when the time is right for them

 

Next Steps

-          Sharing the report with key stakeholders

-          Facilitating the development of key actions

-          Developing an action plan

-          Monitoring and reporting on progress

 

Discussion ensued on the report and presentation with the following issues raised/clarified:-

 

·           Rotherham suffered from legacies of its past heavy industries both in terms of individuals in those jobs and a cultural legacy

 

·           Behaviour change was very challenging i.e. how do you change the culture of someone for whom it was tradition e.g. portion size

 

·           The health literacy function was related to overall levels of literacy and what the public’s understanding was of health and wellbeing, wellness and fitness.  The services and routes into them were not easy to navigate – the  single point of access/single digital offer for lifestyle services was out to tender with the contract to commence in April, 2018

 

·           The rate of smoking in young people had reduced year on year and, although high rates of smoking in adults, Rotherham was better than most areas for quitting smoking.  There were issues with alcohol use with the area being one of the highest in terms of admissions to hospital and similarly with substance misuse

 

·           MECC (or Healthy Chats) were part of the Health and Wellbeing Strategy.  The commitment from partners had been developed over the past 4 months to train frontline staff to be sufficiently confident to offer advice and signposting to any member of the public they came into contact with and the conversation led into issues of healthy living

 

·           The approach to smoking and nicotine consumption was old fashioned.  “Vaping” was something that had progressed far quicker than anticipated and had taken tobacco companies and the Government by surprise.  Presently the science had not caught up with the increasing trend and there was no evidence as to its impact.  It was not licensed in the same way as tobacco and there were fewer controls on production methods and contents.  There was a reluctance on the Department of Health to make any clear statements in support or otherwise of vaping and the Local Authority was limited by national guidance due to there being no evidence base to support an alternative and no guidance as to desired message to young people with regard to e-cigarettes

 

·           Many of the functions the Authority provided were mandatory functions that had to be provided through the Public Health Grant.  However, that limited the approach to people who wanted to reduce or cut down smoking with Stop Smoking only allowed to support quitting

 

·           Manchester had done a lot of work on WHO Age Friendly environment taking a whole place view.  It was about everybody at every level thinking and reflecting on every decision/policy and whether it helped or hindered older people and hopefully contributed to it being a better place to live.  Manchester had used its local communities to develop plans and ideas to develop their own areas to make it age friendly and a more inclusive place for all people to reduce cost and barriers.  Some of the things that mattered to young people were the same as to the elderly

 

·           The Local Authority had a good understanding of Health and service assets, however, there were others that were harder to define and measure such as which of the communities were resilient, which had good social networks.  Work had/was taking place with regard to Ward profiles and Ward Plans but there was a need to look at it in further detail and understand the full depth of assets

 

·           The Warm Homes funding had focussed on improving housing conditions via installing updated boilers to make properties fit for purpose and fuel efficient.  Obviously this was not the whole story with regard to excess winter deaths and still work required on isolation in communities and family finances

 

·           The newly established Financial Inclusion Team within Housing Services focussed on vulnerable peoples’ finances

 

·           How RMBC made services such as parks accessible

 

·           The risk factor for social isolation and loneliness was the same as smoking 15 cigarettes a day

 

Resolved:-  (1)  That the report be noted.

 

(2)  That a further progress report be submitted on the detailed action plan.

 

(3)  That the previous spotlight review on urinary incontinence be considered in developing the action plan.