PAPER B
Towards a Public Health Strategy for the Isle of Wight
The Choosing Health Public Health White Paper published in 2004 sets out a programme of priorities for tackling the causes of ill-health and reducing inequalities in health and well-being. The Primary Care Trust’s specialist core Public Health Team is working across all sectors to develop a Public Health Strategy for the Island that will meet these challenges in ways that respond to the particular needs of our local communities and make the most difference to the health of our population.
This Strategy will focus on improving health and increasing healthy life expectancy. Improving public health and well-being is crucial to the ongoing financial viability of affordable health and care services, Sir Liam Donaldson, the Chief Medical Officer summed this up in 2004, “if we don’t get upstream and start making real in-roads in terms of prevention then a publicly funded health service will not be sustainable”. The importance of this approach was also reiterated by Sir Derek Wanless brought in as a Government Advisor from a merchant banking background who undertook detailed scenario planning to inform the future funding of the NHS. He noted that what is needed is “a massive shift away from seeing the NHS primarily as a sickness service” and that health services should aim to “keep healthy people fit and people with morbidities and chronic conditions as active as possible”.
Meeting with the Commission is the start of a process of consultation and development with partner organisations that will be taken forward over the next few months leading to publication of the Strategy. The Director of Public Health will also be publishing his Annual Report for 2005 in April which will provide an update on key target areas and make recommendations for action.
As can be seen from the priorities identified in the Choosing Health White Paper, a focus is required on lifestyles and behaviour to reduce levels of risk of chronic disease for both individuals and whole populations. However, it is clear that wider social and economic determinants of health also have significant bearing on the capacity of individuals and communities to achieve optimum health leading to clear health inequalities. Therefore, as well as tackling issues such as smoking, poor diet and low levels of physical activity we also need to address issues such as educational attainment, income and employment, housing quality, transport, community safety, access to other services and community facilities and community regeneration.
Choosing Health recognises the vital role of Local Authorities, “the key to success will be effective local partnerships led by local government and the NHS working to a common purpose and reflecting local needs” Locally we already have a well-developed collaborative approach to delivering the public health agenda in partnership with the Council. This is apparent through to the heart of the core team which includes a number of joint and linked posts covering areas including public health intelligence, agenda 21, community safety, substance misuse, teenage pregnancy and physical activity.
Much of the core business of the
Council relates to the wider determinants of health as described above and
makes a major contribution to public health and well-being. The recent Our
Health, Our Care White paper endorses seven outcomes for social care
encompassing key objectives for promoting health and well-being and tackling
health inequalities and social inclusion and emphasising that in future greater
focus should be placed on preventative services and services delivered in
community settings to address the wider well-being agenda. These are to be delivered
alongside the five outcomes for the well-being of children in Every Child
Matters. The new White paper provides further opportunities for new
partnership approaches between Councils and PCTs operating within the overall
context of the Local Strategic Partnership. Improving the health and quality of
life of the population has been identified as a key component of the shared
vision for the forthcoming new Community Strategy A 2020 Vision.
The Local Area Agreement has provided us with an opportunity to co-ordinate and deliver innovative new programmes focused on improving the health and well-being of the population in some key priority areas:
Councils also have an important power of well-being under the Local Government Act 2000 which enables them to consider the wider economic, social and environmental well-being of their area. Community strategies are recognised as important vehicles for this work, providing key opportunities for improving health and quality of life and delivering council’s improvement objectives.
Public health can be defined as “the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals”.
The work of the core specialist public health team to address this agenda focuses on four main areas:
All these areas will be reflected in our Public Health Strategy, but the specific focus for our joint workshop will be to identify scope for collaboration in the final area.
Partnership working is crucial to successful delivery of public health priorities and the specialist public health team works within a number of networks to maximise opportunities, expertise and resources to achieve these objectives. The Isle of Wight specialist team operates within a public health network that spans Hampshire and the Isle of Wight, currently covering 10 Primary Care Trusts. Members of the network work collectively to undertake common programmes of work to reduce health inequalities, improve access to services and improve health and social well-being by adding value to the work being undertaken in individual PCTs. Unusually, the Isle of Wight core team also provides a service under contract to the Health Protection Agency to protect people from infectious diseases and preventing harm when hazards involving chemicals, poisons or radiation occur. The Strategy will therefore also address the strategic priorities for these organisations.
The Healthy Communities Partnership (HCP) is one of the four theme groups of the LSP. Its purpose is to bring together partners to deliver a healthier Island, reduce health inequalities and promote social inclusion and it is responsible for the delivery of the Healthy Communities block of the Isle of Wight Local Area Agreement. Membership includes officers from the Public Health Team and most departments of the Council, together with representatives of the community and voluntary sector. The group works through a structure of sub-groups to deliver the key priority work programmes of the Partnership and to report regularly on progress against agreed action plans. The group is striving to develop a comprehensive picture of the health and well-being of the Island population, through a collaborative approach to data sharing, audit and research.
The HCP works to identify opportunities for relevant local policies and strategies to promote health and well-being and minimise health inequalities and social exclusion. The group works to monitor delivery of work programmes against key targets, to share evidence of best practice and to maximise efficiency and effectiveness. The HCP has a strong focus on community engagement and also works across all Island agencies to support public health education and training opportunities to ensure staff are equipped with the skills to address the broader health and well-being agenda for the Island.
The challenges facing us are significant:
· Looking ahead towards 2020, a significant increase in the proportion of older people in the population is anticipated. This increase is likely to be considerably higher than in adjacent areas of the South East, such as Hampshire.
· Some of our communities experience significant levels of deprivation, linked to greater risk of health inequalities and social exclusion.
We are keen the Strategy adds value to work programmes partner organisations have undertaken to improve health and well-being to date.
Choosing Health identifies six key areas for action to improve health and well-being:
The following key tasks have been identified in each area as follows:
v Continue delivery of Specialist Stop Smoking Service.
v Deliver DoH Local Delivery Plan targets and LPSA2 stretch target (subject to ODPM approval) for 4-week quitters.
v Target smoking cessation support programmes to priority groups of manual workers, young people and pregnant women.
v Continue to use the multi-agency Tobacco Control Alliance as a focus for this work including supporting the NHS Trust to move to Smoke Free status from April 2006 and supporting the wider business community to move towards smoke free status ahead of legislation through the IW Public Health Smoke Free Award scheme.
v Halt the year-on-year increase in rates of obesity in children under 11 by 2010, within the context of a population-wide approach to reducing overweight and obesity.
v Implement a multi-agency action plan to reduce and prevent overweight and obesity in adults and children.
v Implement the Hampshire and Isle of Wight care pathway for obesity prevention and weight management.
v Work through the Healthy Eating Alliance to continue to increase awareness of healthy eating and improve access to affordable, fresh and local foods.
v Work with the Healthy Schools Programme to implement whole school approaches to healthy eating through the implementation of the new nutritional standards for school meals, use of the Food in Schools toolkit and delivery of the Community Chef programme.
v Increase planned physical activity by 1% year on year.
v Conduct a non-user survey for leisure and sports facilities and the barriers for non-use.
v Review exercise referrals within the community to improve access and health benefits through physical activity.
v
Review and increase sports and physical activity within
the schools curriculum and out of school, including through extended schools.
v Encourage and promote whole family, individual and group physical activity opportunities.
v Continue to develop the multi agency Physical Activity Alliance through coordination funded through Sport England and the Big Lottery
To improve sexual health we
will:
v Continue to lead the multi-agency Sexual Health Forum to co-ordinate work in this area.
v Develop and deliver comprehensive HIV and blood borne virus interventions for identified target groups.
v Continue
to deliver APAUSE programme and educational awareness and support within
schools and educational settings around sexual health and personal behaviour.
v Deliver specific programmes with Social Services Learning Disabilities team relating to sexual health and this target group.
v Continue and strengthen work with the Local Authority, through links with Healthy Schools, the Social Services Learning Disability Team and Safer Communities Partnership.
To improve mental health and
well-being we will:
v Continue to work through the multi- agency Suicide prevention forum to reduce rates of suicide.
v Work in partnership to reduce discrimination and stigma around mental illness.
v Support Mental Health Awareness Week in October as a means of raising awareness about mental ill health.
v Work through all themes of the LAA to improve mental health and well-being, particularly through improving educational attainment and increasing opportunities for training and employment.
To reduce harm and encourage
sensible drinking we will:
v Link with Safer Communities Partnership to
decrease anti-social behaviour in under age young people.
v Develop and deliver comprehensive
interventions and training for schools, colleges and young people and
vulnerable groups relating to alcohol and drug awareness and the impact of
dependency and binge drinking on health and well-being.
v Link with Trading Standards regarding under
age/excessive drinking and the buying of, and access to, alcohol.
v Develop a joint Alcohol Strategy through the
combined data analyst post for both the Safer Communities Partnership and the
Public Health team. The Local Authority is a key partner in this work and we
would wish this for partnership to continue and develop.