Agenda item

Developing a Prevention Led System in Rotherham

Presentation by Ben Anderson, Director of Public Health


Ben Anderson, Director of Public Health, gave the following powerpoint presentation:-


Why Prevention

-        95% of liver disease was attributable to 3 preventable causes – alcohol, obesity and viral hepatitis

-        90% of first heart attacks related to 1 of 9 modifiable factors

-        80% of diabetes spend was treating avoidable illness and complications

-        2/3s of premature deaths could be avoided through improved prevention, early detection and better treatment

-        42% of cancers in the UK were preventable

-        17% of deaths in adults over 35 were attributable to smoking


Twin Paradigms for Sustainable Care Systems

Managing Demand

Preventing Demand

Increasing supply

Improved lifestyles and tackling the winder determinants of health

Waiting targets

Prevention services

Service flow and efficiency

Health checks

Improving discharge

Screening and immunisation

Changing skill mis


New models of care

Tackling variations


Drives expectation, increases throughput, creates demand and cost

Supports empowerment, reduces throughput, stems demand and costs


Extends life expectancy and prolongs health and care service need

Extends healthy life expectancy, reduces inequalities, delays health and care service need


Prevention and Health Inequalities

-        Demonstrating the gaps in Rotherham males and females – treatment and care effect/prevention effect

-        Obese children Year 6 (2015/16-2017/18)

-        Hospital stays for alcohol-relating harm (2013/14-2017/18)

-        Incidence of lung cancer (2012-16)

-        Emergency hospital admissions for all causes (2013/14-2017/18)

-        Emergency hospital admissions for CHD (2013/14-2017/18)

-        Emergency hospital admissions for COPD (2013/14-2017/18)

-        Hospital admission rates


A Whole System Approach to Prevention

-        Joint report “Meeting the Prevention Challenge in the East Midlands: A Call to Action” supporting a direct response to the NHS 5YFV

-        Practical recommendations for Providers and Commissioners across Health and Care covering:-

Leadership and Governance

Commissioning and Delivery Services

Staff Wellbeing

Sustainability and Corporate Responsibility


Leadership and Governance

-        Embed prevention within NHS leadership with an identified broad level prevention champion

-        Create the governance structures required to deliver on prevention from policies to performance management including the use of health Impact Assessment and Health Equity Audit tools

-        Ensure strategic level Public Health input to NHS planning and delivery through the ‘Core Offer’ from the local authority

-        Working through the health and Wellbeing Board to deliver system level prevention

-        Advocate for prevention within the wider system


Commissioning and Delivery Services

-        Adopt a whole pathway approach considering opportunities for Primary, Secondary and Tertiary Prevention across services

-        Ensure that prevention was systematic and delivered at the required scale to deliver a population level impact

-        Embed Making Everything Count within services, maximising support for lifestyle change with clear pathways to support

-        Rigorously challenge clinical variation raising the bar for all in the management of risk factors and chronic conditions

-        Adopt the ‘Proportionate Universalism’ approach to target investment to maximise impact on the ‘window of need’


Staff Wellbeing

-        NHS staff and their families make up a significant proportion of our local populations.  Supporting them to achieve and maintain good health delivered business and population health benefits

-        Develop policies to support good health in relation to active travel, workplace food and drink offers, smoking and alcohol use, work/life balance

-        Ensure good quality management of staff absence and ill health adopting policies that supported staff to manage long term conditions and balanced their health needs with their work

-        Consider sign up to the Workplace Wellbeing Charter


Sustainability and Corporate Responsibility

-        Develop a Corporate Responsibility Strategy that considered how NHS organisation’s impacted upon population level prevention

-        Consider the impact of estates, transport, commissioning and procurement policies and activities on the local population and economy

-        Consider the food and beverage retail offer within NHS buildings promoting healthy options and working to remove sugary snacks and beverages from the offer

-        Consider how NHS organisations can support employability within the local population through placement and apprenticeship options to support the local worklessness agenda



-        Rotherham’s four Health and Wellbeing aims were prevention focussed:-

Children getting the best start in life

Rotherham people enjoying the best possible mental health and wellbeing and having a good quality of life

Rotherham people living well for longer

Rotherham people living in healthy, safe and resilient communities

-        Prevention and reducing inequalities were our strategic principles

-        But do we have the systematic approach to prevention across our organisations to maximise our delivery?


Michael Wright, Assistant Chief Executive, TRFT, stated that the Trust was keen to work collectively and interrogate the data that underpinned emergency admissions in an effort to understand why some patients were not getting earlier intervention and thereby came through on a more planned elective pathway rather than as an emergency admission. 


Discussion ensued with the following issues raised/clarified:-


·        Further work was required to understand the different pathways and what was happening in different Wards of the Borough


·        There was a need to build expectation and aspiration to enable people to come forward at an early stage when at a preventable level of taking therapy rather than higher level treatments.  It was a massive piece of work to raise that aspiration and understanding of the health literacy in the population


·        Prevention and early intervention had been discussed for some time.  The Board would need to explore this over the coming months.  Developing local matrix and through the population health management workstream would assist


·        The driver should be to extend healthy good life and delay people joining a disease register


·        Nationally the focus wouldill always be on access to treatment


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


(2)  That if any Board member had any further comments, they should email Ben directly.

Action:-  All Board members/Ben Anderson


(3)  That the presentation slides be provided to all Board members.

Action:-  Ben Anderson/Becky Woolley/Dawn Mitchell

Supporting documents: