helping you to stay healthy in telford and wrekin
Post on 25-May-2022
1 Views
Preview:
TRANSCRIPT
Helping You to Stay Healthy in Telford and Wrekin
The Annual Report of the Director of Public Healthfor Telford and Wrekin 2010/11
Contents
1
PageNumber
Introduction 2
TechnicalNotes 4
Acknowledgements 5
ImprovingLifestyleSupportServices:GettingHealthy,StayingHealthy 6
ReducingtheHealthBurdenofSmoking 8
WeightManagementServices:AddressingObesity 14
Implementingthe“HealthCheck”Programme 18
EarlyCancerDetection:TheBreast,BowelandCervical 21CancerScreeningProgrammes
Immunisation:ProtectionAgainstInfectiousDisease 25
WorkinginPartnershipwithLocalCommunities:CommunitiesforHealth 27
WorkinginPartnershipwithPeople:PeerSupportProgrammes 29
WorkinginPartnershipwithTelfordandWrekinCouncil: 36HealthThroughWarmth
WorkinginPartnershipwithTelfordandWrekinCouncil: 37Let’sCookTogether
WorkinginPartnershipwithTelfordandWrekinCouncil: 39HealthySchools
WorkinginPartnershipwithTelfordandWrekinCouncil: 41HealthyStart
Introduction
2
Welcometothe2010/11PublicHealthReportforTelfordandWrekin.
Thereportpresentsanumberofkeyhealthmessagesanddescribesjustsomeoftheworkwhichisgoingontoimprovethehealthoflocalpeople.Muchofthisworkdependsongoodpartnershipworkingatanumberoflevels,whichisalsodemonstratedinthereport.FurtherinformationaboutthehealthstatusofthepopulationofTelfordandWrekincanbefoundinthelocalJointStrategicNeedsAssessment.
ThesuiteofJSNAdocumentsisavailableat:http://www.telford.nhs.uk/About-the-PCT/PublicationsBoard-Papers/Publications/
InTelfordandWrekin:
• Peoplearelivinglonger–menarelivingover4yearslongerthantheywerein1991,womenarelivingnearly3yearslonger.Weareworkinghardtotryandmakesurethatthesepreciousextrayearsoflifeareashealthyaspossibletoo
• Relatedtothis,prematuremortalityrates(deathsbefore75years) fromcirculatorydiseaseandanumberofcommoncancersareimproving
• Hospitaladmissionratesforalcohol-relatedharmareimproving.Alcohol-relatedharmwastheonlyissueIconsideredinmy2006/7report;thereportwentontoprovidethebasisforacomprehensivejointstrategyagreedbetweenpartneragencies,includingTelfordandWrekinCouncilandthePCT
• Breastfeedingratesareimproving
• Thereisrecentevidencethatoursmokingcessationservicesarebecomingmoresuccessfulinhelpingpeopletoquitsmoking–althoughprogressonsmokingprevalenceatpopulationlevelremainspainfullyslow
Trend in All-Age All-Cause Mortality in Telford and Wrekin
Key Message for Telford and Wrekin
• Theallage,allcausemortalityratehasbeendecliningsteadilyinTelfordandWrekinoverthelast15years
Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk)
144 133 142 132 136 132 132 121 124 122 118 116 111 107 105 1010
20
40
60
80
100
120
140
160
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Indi
rect
ly a
ge s
tand
ardi
sed
mor
talit
y ra
tios
(SM
Rs)
(A
ll-ag
e A
ll-C
ause
)
0
100
200
300
400
500
600
700
800
900
Dire
ctly
age
sta
ndar
dise
d de
ath
rate
s (A
SD
Rs)
per
100
,000
pop
(A
ll-A
ge A
ll-C
ause
)
SMR ASDR
Introduction
3
Thisyear,Ihavedecidedtomakeonlyonerecommendationforactionanditisinrelationtosmoking.Iremainextremelyconcernedabouttheharmbeingdonetotheirbabiesbymotherswhocontinuetosmokeduringtheirpregnancy.Overall,around23%ofmothersinTelfordandWrekinsmokethroughouttheirpregnancy,althoughsmokingratesareevenhigheramongstyoungerwomen.Despitemucheffort,includingatriallocalincentivescheme,maternalsmokingrateshavechangedlittle,ifat-all,overrecentyears.Ithereforerecommendthat:
As the basis for future action, there should be a comprehensive improvement review of local arrangements to address maternal smoking. This should be led by the PCT, but include a wide range of local partner agencies, including Shrewsbury and Telford Hospitals NHS Trust, and service users
I would be pleased to receive comments on the report, including suggestions for improvement(catherine.woodward@telfordpct.nhs.uk). As ever, I hope that you will find the report clear, informative andstimulating.
DrCatherineWoodwardDirectorofHealthImprovementMay2011
Technical Notes
4
Technicalbackgroundhasbeenkepttoaminimumanddatasourcesandrelevantweblinksarereferenced.Ingeneral,comparisonsaremadebetweenTelfordandWrekinPCTandthenational(England)position.Population figures are based on the NHS Telford and Wrekin Patient Register or the mid-year population estimates of the Office for National Statistics. Where appropriate, population rates are age and/or sex standardised,thatis,adjustedtoensurethatdifferencesinageandgenderaretakenintoaccountwhencomparinghealthexperienceacrossdifferentpopulations.
Some of the analyses are based on levels of socio-economic deprivation groups based measuredthroughthe IndexofMultipleDeprivation2007 (IMD2007).This indexuses37variablesmeasuredat‘superoutputarea’,whicharesmallgeographicalareaswithanaveragepopulationof1,500people(asdefined by the 2001 Census). There are 108 of these super output areas in Telford and Wrekin, giving, on average, three super output areas per ward. To measure inequalities, the super output areas aretypicallyaggregatedinto20%bandingsorquintiles,accordingtotheircompositeIMD2007score.Someanalysesalsoencompassrankinggeneralpracticesaccordingtotherelativelevelsofoveralldeprivationexperiencedbythepopulationtheyserve,asmeasuredbyIMD2007.Mosaicanalysesarealsousedasawayofsegmentingthepopulationintosmallgroups,basedonsimilarcharacteristics.Thistypeoftoolis particularly useful as it embraces a range of marketing and consumer data, such as financial status and lifestylehabits,soaddsvaluebeyondroutinehealthanddemographicinformation.
Someanalyses,particularlyforindividualdiseaseconditions,arebasedonsmallnumbers.Thisgeneratesuncertaintyaboutthetruevalueofthevariableinquestionandincreasestheprobabilitythatanydifferencesobservedbetweenthepopulationgroupsoccurbychance.Toincreasereliability,observationsforoneyear are combined to produce three or five year rolling averages and/or 95% confidence intervals are displayedtoindicatetherangewithinwhichthetruevalueoftheindicatorlies,atthatlevelofcertainty.
Whilsteveryattempthasbeenmadetoensurethequalityandaccuracyofstatisticspresentedinthis report, it is unavoidable that certain figures may subsequently be subject to update, rebasing or revision.
Acknowledgements
5
As final editor of the report, I am ultimately responsible for its content, including any errors or omissions. ParticularthanksgotoHelenOnionsforherexpertiseandadviceinproducingthereport.ThanksalsogotoVictoriaOliverforherhelpindocumentproduction.
Iwouldalsoliketothankthefollowingpeoplewhocontributedinformation,textand/orsuggestions:
HelenBlinston PublicHealthIntelligenceAnalyst NHSTelfordandWrekinSarahEvans HealthImprovementCommissioner NHSTelfordandWrekinClareHarland HealthImprovementCommissioner NHSTelfordandWrekinJacquiMaddox TrainingSupervisor-EducationCateringServices TelfordandWrekinCouncilLouiseMills HeadofHealthInequalitiesandLifestyle NHSTelfordandWrekinHelenOnions SeniorPublicHealthSpecialist NHSTelfordandWrekinVickiPike HealthImprovementCommissioner NHSTelfordandWrekinSarahRock BreastfeedingCo-ordinator NHSTelfordandWrekinKateSumner CleaningServicesManager TelfordandWrekinCouncilSallyTyas SeniorManagerHealthySchools TelfordandWrekinCouncilChrisWeiner ConsultantinPublicHealth NHSTelfordandWrekinChrisHolmes Photographer MetroPhotographic
The report makes many references to the JSNA (Joint Strategic Needs Assessment) for Telford andWrekin.FurtherinformationontheJSNAisavailablefromHelenOnions,SeniorPublicHealthSpecialistatthePCT(01952580382)orJonPower,DeliveryandPlanningManageratTelford&WrekinCouncil(01952380141).
ThesuiteofJSNAdocumentsareavailableat:http://www.telford.nhs.uk/About-the-PCT/PublicationsBoard-Papers/Publications/
Improving Lifestyle Support Services: Getting Healthy, Staying Healthy
6
“Getting Healthy, Staying Healthy” is a programme of work which builds on local experience in thecommissioningandprovisionoflifestyleriskmanagementservices.TheoverallvisionisforthepopulationofTelfordandWrekintobebetterempoweredtomake informedchoicesabouttheirhealthandwell-being,throughaccesstohealthinformationandhighqualityservicestailoredtotheirneeds.Avitalpartofthepathwayredesignisaroundsupportingtheneedsofpeoplewithlong-termconditions.
Ensuring meaningful engagement with patients and the public has been an integral part of the workprogramme. The public health team has conducted insight work to explore public awareness andunderstandingofhealthylifestyles,currenthealthstatus,theavailabilityofinformationandviewsonan“idealservice”.
Using a population segmentation approach (MOSAIC), two target groups were identified as the focus for thepublicinsightresearch:vulnerableyoungparentsneedingsubstantialstatesupportandolderfamiliesliving in low value housing in traditional industrial areas. Adults at risk of poor health and previouslyunknowntolifestyleriskmanagementserviceswerethenrecruitedfromtargetedresidentialareasandinvited to attend focus group sessions. Although eventual numbers were quite low, this was the first timethatthisgroupofpeoplehadbeensuccessfullyconsultedinthiswayinTelfordandWrekin.Thoseinterviewedhighlightedthreemainbarrierstoadoptingahealthylifestyle:notacceptingtheneedtochangetheir current lifestyle, maintaining motivation and finding it difficult to understand and use information to makeinformeddecisionsabouttheirownhealthandthehealthoftheirfamily.
Findings
• Not accepting the need to change
Manyoftheparticipantsreportedbeingcontentanddidnotwanttochangethewaytheylivedtheirlives.Respondentswerehappytocontinuesmoking,drinkingandgraduallyputtingonweightandwereunabletomakethelinksbetweentherisksofleadinganunhealthylifestyleandhowlongtheywerelikelytoliveingoodhealth.
• Maintaining motivation
Reflecting on past experiences, all respondents felt that maintaining motivation to make a lifestyle changehadbeenachallenge.Alackofmotivationhadpreventedthemajorityfromachievingtheirlifestylegoals.Thosewhohadpreviouslyembarkedonajourneytochangetheirlifestylehadsincestoppedanddescribedpressuresinlifethathadtakenprecedence,toapointthattheirhealthwasnolongerapriority.Formany,smokinganddietingappearedtobecyclicalactivities.Severalpeoplefelttheyhadnotputintherequiredtimeandefforttochangingtheirlifestyle.
• Lack of awareness and understanding
Severalpeoplewereconfusedbyhealthinformationandsomeparticularnationalcampaigns.Forthemajority,confusionand‘mixedmessages’resultedinnoactionbeingtakentoimprovetheirlifestyle.
• An ideal lifestyle service
Peopledescribedthecharacteristicsofan“ideal”serviceas:
- A‘single’service,throughwhichmultiplelifestyleissuesareaddressed–butwithaconsistentpointofcontact,suchasa‘personalcoach’
- Focusedonthe‘feelgood’factorandpromotedasaserviceforeveryone
- Neighbourhood-based
Improving Lifestyle Support Services: Getting Healthy, Staying Healthy
7
- EndorsedbyGPs
- Deliveredbypeople,whofromtheirownexperiencescanbeempatheticwiththeserviceuser(seethesectioninthereportonpeersupportservices)
- Deliveredthroughmultiplemediaandavailable(insomeform)24hours,7daysaweek
- Tailoredtotheindividual,withrealistictargetsandregularfeedback
The findings from this consultation are being used, along with perspectives from clinicians and partner agencies,toinformserviceimprovementprojects.Areasoffocusincludeservicesforsmokingcessation,reducingalcoholconsumption,reducingobesityandincreasinglevelsofphysicalactivity.AsinglepointofaccessforlifestyleserviceswillbepilotedfromJanuary2011,inpartnershipwithTelfordandWrekinCouncil.
Contactdetails:
LouiseMillsHeadofHealthInequalitiesandLifestyleNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580390Email:louise.mills@telfordpct.nhs.uk
Trend in Hospital Admission Rates from Alcohol-Related Harm
Key Messages for Telford and Wrekin• Hospitaladmissionrates
fromalcohol-relatedharmhaveimprovedoverthelastthreeyearsinTelfordandWrekin
• 47%ofhospitaladmissionsforalcohol-relatedharmareduetocardiovascular(circulatory)disease;mostofthesearerelatedtohypertension(highbloodpressure)
Source: North West Public Health Observatory Local Authority Alcohol Profiles http://www.nwph.net/alcohol
855 1,097 1,290 1,476 1,3851,445 1,568 1,5430
500
1,000
1,500
2,000
2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
Age
sta
ndar
dise
d ad
mis
sion
rat
e pe
r 10
0,00
0 po
pula
tion
Telford and Wrekin England
Reducing the Health Burden of Smoking
8
FromtheJointStrategicNeedsAssessment(JSNA)forTelfordandWrekin,weknowthat:
• TheprevalenceofsmokinginadultsinTelfordandWrekinis25%(morethan33,800smokersaged16yearsandover)
• Smoking-related mortality is statistically significantly worse than the national average for England, withanestimated235deaths(ofadultsaged35yearsandover)everyyearattributedtosmoking-relateddisease
• Onaverage,1,400smokersquitsmokingeveryyearinTelfordandWrekinandtherateof4-weeksmokingquittingis:
- Statistically significantly better than the national average for England - AmongstthebestoftheWestMidlandsPCTs
• Overhalf(51%)ofsmokerssettingadateremainquitafter4weeks,whichisstatisticallysignificantly better than the average for England (50%)
• Smokingcessationserviceuptakeratesincreasewithageuntil60.Thehighestratesareseeninthe 35-44 and 45-59 year age groups. Significantly lower smoking cessation uptake rates are seen inthoseunder35andolderthan60years
• Successfulquittingincreaseswithage,with41%ofsmokersagedunder35yearsquitat4weeks,comparedto65%ofsmokersaged60+years
• Althoughsmokersaged60yearsandoverhavethelowestuptakerateofsmokingcessationservices,theyarethemostsuccessfulquitters
• Amongstpregnantwomen,theprevalenceofsmokingatdelivery(23%)hasnotchangedsignificantly during the last five years. However, there has been a marked increase in the uptake of smokingcessationservicesinrecentyears,withthenumberofpregnantwomentreatedincreasingfrom37in2005/06to137in2009/10
• Thereareinequalitiesinsmokingduringpregnancyassociatedwithsocio-economicdeprivationandmaternalage:
- Almost a third (32%) of mothers from the most deprived fifth of areas are still smoking at delivery, compared to 8% in the most affluent fifth of areas
- Thehighestratesofsmokinginpregnancyareseeninyoungmothers,with34%ofunder20yearoldsand32%of20-24yearoldsstillsmokingatdelivery(equatingto240girlsagedunder25yearssmokingthroughouttheirpregnancy)
Reducing the Health Burden of Smoking
9
Why is it So Important to Stop Smoking?
Therearefew,ifany,moreimportantdecisionsanindividualcantakeabouttheirhealththantogiveupsmoking.
Researchhas shown that smokingcessation is the singlemost cost-effective life saving interventionprovidedbytheNHS.Aftertheageof35-40years,foreveryyearofcontinuedsmoking,apersonloses3monthsoflifeexpectancy.Onaverage,alifelongsmokerloses10yearsoflife.Researchalsoshowsthatpeoplearefourtimesmorelikelytoquitwithsupportfromastopsmokingservicethangoingitalone.
The table below shows that some of the health benefits from stopping smoking can occur quite quickly.
Time since Quitting Health Benefits
8 hours Nicotineandcarbonmonoxidelevelsinbloodreducebyhalf,oxygenlevelsreturntonormal.Circulationimproves.
24 hours Carbonmonoxideandnicotineeliminatedfromthebody
48 hours Theabilitytotasteandsmellimproves
1 month Appearanceimproves–skinlosesitsgreyishpallorandbecomeslesswrinkled
3 - 9 months Coughingandwheezingdeclines
1 year Riskofaheartattackreducesbyhalfcomparedtothatofasmoker
10 years Riskoflungcancerfallstoabouthalfthatofasmoker
15 years Riskofheartattackfallstothesameassomeonewhohasneversmoked
Source: http://smokefree.nhs.uk/
Trend in Premature Mortality from Lung Cancer
Key Messages for Telford and Wrekin• Prematuremortalityfrom
lungcancerhasbeenimprovingoverallinTelfordandWrekin
• Mostofthedeclinehasbeeninmalerates
• Thereisnownostatistically significant differencebetweenlungcancerprematuremortalityratesamongstmenandwomen
Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jsp
48 50 46 48 44 47 43 33 35 34 34 31 31 32 3046 45 50 44 42 33 330
10
20
30
40
50
60
70
80
1985
-1987
1986
-1988
1987
-1989
1988
-1990
1989
-1991
1990
-1992
1991
-1993
1992
-1994
1993
-1995
1994
-1996
1995
-1997
1996
-1998
1997
-1999
1998
-2000
1999
-2001
2000
-2002
2001
-2003
2002
-2004
2003
-2005
2004
-2006
2005
-2007
2006
-2008
3 year rolling averages
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(un
der
75 y
ears
)
Telford and Wrekin (persons) England (persons)
Reducing the Health Burden of Smoking
ThesmokingtargetsinTelfordandWrekinare:
• Foradults,toreduceoverallsmokingratesfrom26%in2002to21%orlessby2010andtoreducethesmokingprevalenceamongroutineandmanualsocialclassgroupsfrom31%in2002to26%orlessby2010
• Todelivera1%reduction,yearonyear,inthenumberofwomenwhosmokeduringpregnancy,theoverallaimbeingtohavenomorethan15%ofwomensmokingduringpregnancyby2010
These targets continue to be challenging. During the past 12 months, in order to deliver continuedimprovementinitsapproachtotobaccouse,NHSTelfordandWrekinhas:
• Openedupthelocalmarkettoadditionalstopsmokingproviders.ThisisaspartofaWestMidlandspilotschemetoincreaseaccesstostopsmokingservices
• DevelopedaQuality,Innovation,PreventionandProductivity(QIPP)work-streamtoreducetheNHScostsofmanagingsmoking-relateddisease
• Improvedthehospital-basedservice,toofferstopsmokingsupport,advice,educationandwithdrawalmanagementinterventionsbeforesurgicalintervention(“StopBeforeYourOp”)
During2009/10,thelocalstopsmokingserviceshelped2,826adultstosetaquitdateand1,432(51%)toachievesuccessfulquittingat4weeks.ThepopulationofTelfordandWrekinsmokersachievedthehighestquitrateintheWestMidlands.Thehospitalbasedstopsmokingservicehasdoubleditsactivitysince it first started. In 2009/10, 1,735 patients were referred to the service.
10
Trend in Smoking Quitters
Key Messages for Telford and Wrekin• Around19%ofalldeaths
areduetosmoking
• Themortalityrateforsmoking-attributableconditionsisstatisticallysignificantly worse than thenationalaverage
• Therateofsmokingquitters(per100,000totalpopulationaged16+years)hasbeenstatistically significantly betterthanthenationalaverage for the last five years
Source: The NHS Information Centre, Statistics on NHS Stop Smoking Services http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/nhs-stop-smoking-services
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2005/06 2006/07 2007/08 2008/09 2009/10 2010/11(Q1-Q2)*
No.
of 4
-wee
k sm
okin
g qu
itter
s pe
r 10
0,00
0 po
p (a
ged
16+
yea
rs) Telford and Wrekin England
Reducing the Health Burden of Smoking
11
Moreimportantly,peoplearenowbeingseenseveralweeksbeforetheiroperation,ratherthanafewdaysbefore,improvingthechancesofasuccessfulquitbeforethesurgeryhappens.
In2009/10,thestopsmokinginpregnancyservicesupported137pregnantwomentosetaquitdate,ofwhom65(48%)remainedsuccessfullyquitat4weeks.
Contactdetails:
NHS Stop Smoking Services and NHS Stop Smoking in Pregnancy Providers
Forinformationonwhereservicesaredeliveredpleasecall01952582659orgotowww.stopsmokingtelford.nhs.uk
Help 2 Quit Mansion House Healthcare Limited01743366940 01475786900Website:www.shropshire.nhs.uk/ Website:www.youcanstopsmoking.org
Solution 4 Health 02476630214 Emailcontact:scaley.das@solutions4health.co.uk Website:www.solutions4health.co.ukStop Before Your Op Service Princess Royal Hospital Royal Shrewsbury Hospital Robert Jones Agnes HuntJulieRudge JulieRudge/MarianBaskerville MarianBaskervilleBleep256 Bleep980 Bleep18801952641222ext4464 01743261000ext4464 01691404114
Emma’s Story
A whole year ago, I was 18 weeks pregnant with my third child and was smoking about 20-a-day (sometimes more, but shhhhh!). I had smoked as many for almost 20 years without a break, so you could say I was well and truly hooked. Not even the low tar cigarettes either. The full strength, Lambert and Butler silver pack. They were costing me a fortune at almost £5.50 for 20, and I had to struggle to save for the maternity clothes I desperately needed. I felt like I had a cold 24/7 and I was always out of breath. Even when sitting talking!! I suppose I had accepted that, that was just the way it was when you’re pregnant with number 3, when number 2 was just 10 months old. I couldn’t even walk to the shop for my next pack of cigarettes without having to stop for an air break. It was bad… very bad indeed. But the first thing I would do when I had my next pack, was light up (as soon as I stepped out of the shop).
Little did I know that I was actually in denial. I was denying myself a healthy lifestyle. And yeah, I can hear you sigh… “I’ve heard all this before from the doctor/midwife/hospital”. I hated being told to QUIT SMOKING. Hated it. I used to dread appointments where I would have to admit to smoking as many as I did. It was the same for 15 years and more. Embarrassment, with a capital ‘E’. Then there’s the looks, or rather… the glares you get from strangers in the street when you light up. Then there’d be the times that I would chain-smoke 2 or 3 of them
in a lunch break cos I knew I wouldn’t get a chance for another few hours. And how would I cope without one?
Well this is how I have shocked myself, because… I did cope without them. And so far, for a whole year! Oh, don’t get me wrong, there have been times that I could have easily caved. But I can probably say, hand on heart that I have wanted a cigarette about only a dozen times, but the feeling of want lasts only a few minutes and it gets easier with time.
Reducing the Health Burden of Smoking
12
I have never needed one, like I thought I would. I suppose I have just programmed myself differently and I deal with stress in a different way. Believe me… with 2 children under 2 there’s a lot of stress in my day.
A cigarette used to provide me with an excuse for a break from my kids, but it was only ever a temporary fix and I would be needy of another within another half hour or even less. Just because you don’t have the ‘cigarette excuse’ for a break, it doesn’t mean you don’t deserve a break. This was the issue I had with myself. As long as you are leaving your children in a safe place, you can leave them. I used the ‘hand lotion’ excuse for a break and it worked while I needed to have that excuse to go. After only about 4 months, I didn’t need it. And to be honest, the stresses are so far and few between anyway! I think I imagined I had big stress levels when I smoked. I dunno why, but I always seemed far more stressed-out than I am now. Maybe it was the stress of constantly being broke/skint, smelly and in poor health?!
So, a year on…
I would have never quit smoking without the help and support I had from Helen, my Help 2 Quit nurse. Before meeting Helen I thought I needed the cigarettes like I needed food and water. They were a part of my life and would leave a big hole if they were taken away from me. Truth is… they did leave a hole… for a short period of time. And, Helen helped me to bridge that gap. I used a range of different replacement therapies – I started with patches and used them for about 4 weeks, but I needed the physical element of smoking to be replaced too, so I used the inhalator at the same time for a quick-fix, which was usually in the morning before the patch had kicked in and at times of stress. I never left the house without my inhalator and cartridges. A bit like being a smoker and never leaving the house without at least one ciggy and a lighter or enough cash to get some whilst out. I realised during this time, that there was another clique forming. It was the non-smoking club and I was now a member! I had my inhalator to prove it and I never felt silly using it in public. In fact I felt proud to have it – it showed so many good qualities in my personality – courage, strength and honesty, to name only a few. It felt nice to be related to those qualities, instead of being related to being smelly, weak and ill. It was decided… THAT was my new addiction!
I feel like I was cheated by a great friend (the cigarette) for a long time. I allowed him in to my life, I took him eve-rywhere with me and I spent a lifetime of savings on him, but he was a liar and a cheat. He told me that I needed him and that I had to spend all my money on him, when I actually didn’t need him at all. He told me that it was cool to have him in my life, when it was the un-coolest thing I have ever done. He told me I looked good when he was ageing my looks more quickly than they would have without him. He told me I needed more perfume to
‘Well, I shocked myself. and for more reasons that one too … I am immenseley proud of myself, and with very good reason!’
(Emma)
Reducing the Health Burden of Smoking
13
disguise his presence, only to choke my real friends with the stench of perfume-smelling smoke. He told me that I would be liked by lots, but I was disliked by more. I have nothing to show for the money I spent on him and he could have given me a very nasty disease.
He made my children ill and he made me more susceptible to coughs and colds too. I am glad to be rid of him, once and for all. I’ve wasted almost 20 years of my life with him, but now I have a new life, a new start and I wouldn’t
trade it for another cigarette… EVER!
Trend in Smoking in Pregnancy
Key Messages for Telford and Wrekin• 23%ofmothers
smokethroughouttheirpregnancy(around480womeneachyear).Thisis statistically significantly worsethanthenationalaverage
• Therehasbeennosignificant change in smokinginpregnancyduring the past five years
• 41%ofpregnantwomenunder20yearssmokethroughouttheirpregnancy,comparedto15%ofwomenaged35andover
Smoking in Pregnancy by Age
Source: Shropshire and Telford Hospitals NHS Trust Maternity Services, Association of Public Health Observatories and Department of Health, Health Profiles © Crown Copyright www.healthprofiles.info
23% 23% 23% 22%23% 21% 22%0%
5%
10%
15%
20%
25%
30%
2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
% o
f wom
en s
mok
ing
at d
eliv
ery
Telford and Wrekin England
41% 31% 19% 13% 15%0%
10%
20%
30%
40%
50%
Under 20 years 20-24 years 25-29 years 30-34 years 35+ years
Age band
% o
f wom
en s
mok
ing
at d
eliv
ery
% smoking in pregnancy Telford and Wrekin - All ages (22%) England - All ages (14%)
Weight Management Services: Addressing Obesity
14
WeightmanagementprogrammesformanimportantelementofTelfordandWrekin’sObesityStrategy.ThisensurescompliancewithNICEguidanceonobesity,localdeliveryofthenationalstrategy(HealthyWeight,HealthyLives)andthehealthychildprogramme.
TheTelfordandWrekinJSNAtoldusthat:
• 11.7%of4-5yearoldchildreninTelfordandWrekinareobese-11.7%ofboysand11.7%ofgirls(106 boys and 100 girls). This level of obesity is significantly worse than the national average for England(9.6%)
• A significant proportion (44%) of 4-5 year olds who are classified as obese live in the most deprivedcommunitiesofTelfordandWrekin
• 16.7%ofreceptionchildrenareoverweight-16.9%ofboysand16.5%ofgirls(158boysand135 girls). This level of overweight is statistically significantly worse than the national average for England(13.2%)
• Overaquarterofreceptionchildren(28.4%)areeitheroverweightorobese(499children)
• InYear6,18.8%ofchildrenareobese,19.9%ofboysand17.5%ofgirls(186boysand143girls).ThisisnotstatisticallydifferentfromtheEnglishaverage(18.3%)
• Almosthalf(49.5%)of10-11yearoldswhoareobeseliveinthemostdeprived40%oflocalcommunities
• InYear6,15.3%ofchildrenareoverweight,14.8%ofboysand15.9%ofgirls(138boysand130girls).OverathirdofYear6children(34.1%)areeitheroverweightorobese(597children)
• Itisestimatedthatoveraquarterofadults(27.8%)areobese,whichis37,700peopleaged16yearsorover.ThiscomparestoanEnglishnationalaverageof24.2%
Childhood Obesity Prevalence by Year Group and Gender (2009/10)
Key Messages for Telford and Wrekin• InReception(4-5year
olds):
- Theprevalenceofobesityisstatisticallysignificantly worse (11.7%)thanthenationalaverageforEngland(9.6%)
- 11.7%ofboysandgirlsareobese(106and100childrenrespectively)
11.7% 11.7% 19.9% 17.5% 18.8%10.2% 8.9% 9.6% 20.0% 16.5% 18.3%11.7%0%
5%
10%
15%
20%
25%
Males Females Total Males Females Total
Reception (4-5 year olds) Year 6 (10-11 year olds)
% c
hild
ren
clas
sifie
d as
obe
se
Telford and Wrekin England
Weight Management Services: Addressing Obesity
15
Why Weight?
WhyWeight?offersarangeofweightmanagementprogrammesforpeopleofallages,includingspecialistservicesforpregnantmothersandextremelyobeseadults.ClientsarereferredbyGPsandotherhealthandsocialcareprofessionals,insomecasesclientscanreferthemselves.Membersofthepublicwhohave had their weight identified as a concern during their health check (see page 18) can also be referred toWhyWeight?iftheywish.OnreferraltoWhyWeight?,clientsareenrolledontotheprogrammebestsuitedtotheirindividualneeds.
The Why Weight? programmes support clients to choose healthy lifestyles, particularly eating morehealthilyandbecomingmorephysicallyactive.Theprogrammesincludeonetooneappointmentswithaweightlossmentorandalsogroupsessions,togainsupportfromothersinthesamesituation.Exercisesessionsandcookingcoursesmayalsobeofferedand thechildren’sprogrammes includeother funactivitiestoencouragehealthyeatingbythewholefamily.Allthesessionsareaccessibleandprovidedfromcommunityvenues,schools,GPpracticesandhospitals.
TheWhyWeight?rangeisdeliveredbyateamfromNHSTelfordandWrekincommunityhealthservices,working closely with GPs, practice nurses, community school nursing, health visitors, midwifery andleisureservices.ThemanagementoftheWhyWeight?programmeisthroughanexpertadvisorygroup,whosemembers includeclinical staff fromprimary and secondary care,medicinesmanagement andhealthimprovement.
Trend in Obesity Prevalence by Year Group and Gender Key Messages for Telford and Wrekin• InYear6(10-11yearolds):
- Theprevalenceofobesityisnotsignificantly different fromtheEnglishaverage(18.8%v18.3%)
- 19.9%ofboysand17.5%ofgirlsareobese(186and143childrenrespectively).Thedifferenceisnotstatistically significant.
National Child Measurement Programme, The Information Centre for health and social care. © Crown Copyright. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme:-results-from-the-school-year-2008-09
Red shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average
13.4% 13.0%11.7%
11.5%10.9%
11.7%
20.5% 20.6%19.9%
17.2%16.5%
17.5%
0%
5%
10%
15%
20%
25%
2007/08 2008/09 2009/10
% c
hild
ren
clas
sifie
d as
obe
se
Reception (males) Reception (females) Year 6 (males) Year 6 (females)
Weight Management Services: Addressing Obesity
16
TheWhyWeight?programmesareprimarilydesignedtohelppeopleloseweight.However,clientsreportother benefits, including improved self-esteem, improvements in the symptoms of long-term conditions, increased fitness and a greater sense of well-being.
Theevidence-basedYW8?programmefor8-13yearoldswithweightproblemshelpschildrentoimprovetheirself-esteemandincreasetheirlevelsofphysicalactivity.Thechildrenloseonaverage0.7BMIpointsand75%ofparentsalsomaintainorloseweight.
AttheWhyWeightSlimmingClubtheaverageweightlossat12weeksisaround5.8%.TheWhyWeightPlusprogrammehasanaverageweightlossacrossallclientsofaround4.4%.
TheMorbidObesityprogramme(forpatientswithaBMIgreaterthan40)achievesanaverageweightlossof around 3.5%. Other benefits recorded for the group include improvements in blood pressure, blood glucoseandcholesterollevels.
Feedback from Professionals
‘The patients have nothing but praise for the service -
inspirational’ (GP)
‘It’s about changing the way you live, rather than just weight management’ (Leisure Services
Manager)
‘Diabetic control long term was 8.2 now 6.5 and BP much better due to weight
loss. (GP)
‘Its’ an intelligent and well-thought out programme’
(Paediatrician)
‘The whole family approach at YW8 is fantastic’
(School Nurse)
‘This service has closed the gap in our service, offering more specific nutritional support and lifestyle
change for our service users’ (Midwife)
Weight Management Services: Addressing Obesity
17
Contactdetails:
ClareHarlandHealthImprovementCommissionerNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580391Email:clare.harland@telfordpct.nhs.uk
HelenO’DonnellSeniorHealthImprovementServiceManagerChildrenandFamilySupportServicesTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWayOldParkTelfordTF34AWContacttelephonenumber:01952217474Email:helen.o’donnell@telfordpct.nhs.uk
‘I have loved going to the gym and tast-
ing lots of new foods’ (YW8? Child)
‘Found this advice more complete than other
slimming programmes’ (Why Weight Plus Client)
‘The best thing about YW8? is that I have more
confidence in myself’ (YW8? Child)
‘I can walk anywhere and not get breathless, have lots of energy and don’t need/want a gastric band’ (Why Weight Client)
‘It works, there’s no question that if I follow the portion guidelines I lose weight’ (Why Weight Client)
‘I am striving to be a better role model for my daughter’
(YW8? Parent)
‘The supermarket tour opened my eyes’ (Why
Weight Plus Client)
‘The information made me stop and think about feeding my
unborn child a healthy diet, my other children are healthier as a
result’ (Pregnancy Client)
‘The support and encouragement from the
weight loss mentor is fantastic, not only this,
you also get support from other group members’
(Why Weight Plus Client)
‘My son is so much healthier and fitter - he enjoys exercising more’
(WY8? Parent)
‘Highly recommended, thank you for putting me back on track with my life and wellbeing’ (Why Weight
Client)
Implementing the “Health Check” Programme
18
Diseasepreventionisbetterthancure–forindividualsandforsociety.Preventingdiseasesaveslives,preventsdisabilityandsavesmoney.
Currently,148peopleundertheageof75diefromheartattacks,strokesandothercardiovasculardiseasesevery year in Telford and Wrekin. Unfortunately, Telford and Wrekin continues to have significantly worse deathandhospitaladmissionratesfromheartdiseasethantherestofEngland,althoughsomeindicatorsareimproving.
Smoking, high blood pressure, obesity and excessive alcohol use are all significant risk factors for the developmentofcardiovasculardiseases.TheJointStrategicNeedsAssessmenthasshownthatinTelfordandWrekintherearearound:
• 19,700peoplewithundiagnosedhighbloodpressure
• 33,800peoplewhosmoke
• 35,500peoplewhoareobese
• 25,500peoplewhodrinkhazardousamountsofalcohol
Thepublichealthteamhasledmodellingworkwhichhasshownthatreducingtheriskofcardiovasculardiseaseinthecommunitybyjust2%would:
• Preventaround400hospitaladmissionseachyear
• Savearound110liveseachyear
• Savearound£1.4millioninhealthcarecostseachyear
Trend in Premature Mortality from Circulatory Disease
Key Messages for Telford and Wrekin• Deathsfromcirculatorydisease
accountforaround28%ofprematuredeathsinTelfordandWrekin
• Prematuremortalityratesinmaleshaveimprovedoverrecentyearsbutremainstatisticallysignificantly higher than the nationalaverage
• Femalerateshavealsoimprovedandcurrentratesarenotsignificantly different from the nationalaverage
• Narrowinginequalitiesincirculatorydiseasemortalitycouldincreaselifeexpectancybyaround0.7yearsinmenand1yearinwomen
Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base www.nchod.nhs.uk or nww.nchod.nhs.uk
0
50
100
150
200
250
300
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Year of death registration (performance year shown in brackets)
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(un
der
75 y
ears
) Telford and Wrekin (males) Telford and Wrekin (females)
Implementing the “Health Check” Programme
19
What is “Health Check”?
A“HealthCheck”takesabouthalfanhourtocomplete.TheexaminationisavailablethroughbothTelfordandWrekingeneralpracticesandselectedpharmacies.Everybodyagedbetween40and74yearswillbeoffered a health check once every five years, unless they are already being treated for a cardiovascular condition(e.g.highbloodpressure).Thecheckincludes:
• Heightandweight
• Bloodpressure
• Abloodtesttocheckcholesterolandglucoselevels
Peoplearealsoaskedquestionsabouttheirlifestyleandfamilyhistory,including:
• Smoking
• Exercise
• Alcoholuse
• Heartdiseaseinclosefamilymembers
Allthisinformationisusedtoestimatethechanceofthatpersonsufferingacardiovascularevent(suchasaheartattackorstroke)duringthenexttenyears.
Advice is then offered on how any risks identified in the check can be reduced. This may include:
• Simpleadviceaboutlifestyle
• Referraltospecialistservicesforfurtheradviceandsupport,including:
- Stopsmokingservices
- Alcoholservices
- Weightmanagementservices
• Referralfortreatmentof:
- Highbloodpressure
- Highcholesterollevels
- Diabetes
The Telford and Wrekin “Health Check” programme was first piloted in selected local pharmacies in January2010.444checkswerecompletedoverathreemonthperiod.141people(32%)werefoundtobeathighriskofcardiovasculardisease.Thisincluded:
• 102people(23%)whohadhighbloodpressure
• 78people(18%)withhighcholesterol
Implementing the “Health Check” Programme
20
Thepilotstudyalsofoundthat:
• Nearlythreequartersofpeopleassessedwereoverweightorobese
• Twothirdsofpeopledidlittleornophysicalactivity
• A fifth of people smoked
• 10%ofpeopleweredrinkingmorealcoholthanwassafeforthem
In thepilotstudy,330people (74%)were referred to theirGP for furtheradviceand313 (70%)werereferredtoLifestyleRiskManagementServices,tohelpthemreducetheirriskofcardiovasculardiseaseinthefuture.
So How Does the Local Community Feel About “Health Check”?
NHSTelfordandWrekintooktheopportunity to learnfromthepilotstudy.Peoplewhotookpart toldthePCTthat‘wordofmouth’promotionoftheservicewasreallyimportant.Theyrecognisedthatiftheirfriendsandfamilywerekeenontheprogramme,thentheywouldalsobekeentotakepart.Butwhatelsedidpeoplehavetosayabout“HealthCheck”?ThefollowingquotesarefrompeopleinTelfordandWrekinwhotookuptheofferofhealthchecksthroughthepharmacyscheme:
AllgeneralpracticesinTelfordandWrekinarenowabletooffera“HealthCheck”fortheirpatients(aged40to74years).Thecheckisalsoavailablefromsomelocalpharmacies.ForfurtherinformationcontactDrChrisWeiner,ConsultantinPublicHealthatthePCT(01952580380)
Contactdetails:
DrChristopherWeinerConsultantinPublicHealthNHSTelfordandWrekinHalesfield 6TelfordTF74BFContacttelephonenumber:01952580380Email:chris.weiner@telfordpct.nhs.uk
‘For me, it means I’d be around longer for my kids. I’d be able to get about and wouldn’t have anyone caring for me in
my later years’
‘I’m probably prone to it (vascular disease)’. It’s just a health check and if I have got something highlighted then I
can do something about it
‘I was worried about giving up smoking, now I’m determined to do it. The advice about the impacts has helped. I’m unemployed and can’t afford nicotine replacement patches.
Now I know I can get help with the cost, I’m going to follow up the referral to my doctor.’
‘Most people think they lead a healthy life, but generally we don’t. I mean, I smoke; its just cutting back on things like that.
‘I was given information on alcohol units. I think that is going to help me cut down’.
Early Cancer Detection: The Breast, Bowel and Cervical Cancer Screening Programmes
21
Cancercausesaround39%ofprematuredeaths(approximately208deaths)inTelfordandWrekin.Almostaquarter(24%)oftheseprematurecancerdeathsareduetolungcancer,16%(amongstwomen)areduetobreastcancerandaround10%areduetocolorectalcancer.
Breast Cancer Screening
InTelfordandWrekin,around16,500womenarecurrentlyeligibleforbreastscreeningandonaverage13,100womenarescreenedeverythreeyears.Thislevelofbreastscreeningcoverage(81%ofeligiblewomenscreenedwithinthepastthreeyears) ishigherthanboththeEnglishaverage(76.5%)andthenationalprogrammestandard targetof 80%.NHSTelfordandWrekinhasalsobeenworkingcloselywithShropshireCountyPCTandtheShrewsburyandTelfordNHSHospitalsTrusttoimplementdigitalmammography screening and the national age extension (to 47 to 73 years). Digital mammographymachines(bothstaticandmobile)willstarttoscreenwomenintheextendedagegroupinShropshire,TelfordandWrekininearly2011.
Trend in Premature Mortality from All Cancers
Key Messages for Telford and Wrekin• Prematuremortalityrates
(under75years)forallcancershave:
• Improved significantly duringthepasttwodecades
• Stabilisedatalevelwhichis not significantly different fromthenationalaverage
Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jspRed shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average
169 170 161 165 158 166 159 158 154 129 123 122 126 125 123 123 123159 155 154 151 155 1460
50
100
150
200
250
1985
-87
1986
-88
1987
-89
1988
-90
1989
-91
1990
-92
1991
-93
1992
-94
1993
-95
1994
-96
1995
-97
1996
-98
1997
-99
1998
-00
1999
-01
2000
-02
2001
-03
2002
-04
2003
-05
2004
-06
2005
-07
2006
-08
2007
-09
3 year rolling averages
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(un
der
75 y
ears
)
Telford and Wrekin (persons) England (persons)
Early Cancer Detection: The Breast, Bowel and Cervical Cancer Screening Programmes
22
Bowel Cancer Screening
The NHS Bowel Cancer Screening Programme was rolled out from July 2006 and achieved nationalcoveragein2010.Screeningiscurrentlyofferedtoallmenandwomenaged60to69everytwoyears.Theprogrammebeganaphasedageextensionin2010,toincludemenandwomenaged70-75years.Bowelcancerscreening isbasedonsubmissionofastoolsample toa laboratory fora faecaloccultblood test. More information is available from http://www.cancerscreening.nhs.uk/bowel/publications/the-facts.html
ScreeningbeganinTelfordandWrekinandShropshire inOctober2009.DuringtheperiodJanuarytoJune2010,atotalof5,93060-69yearoldsfromTelfordandWrekinwereinvitedtoparticipateinbowelcancerscreening.Theuptakeofscreeningduringthisperiodwas54%,whichisanacceptablelevelforthe first year of the programme. The age extension to bowel screening will be implemented in Shropshire, TelfordandWrekinduring2011/12,oncetheexistingprogrammehasbeenoperationalfortwoyears.
Trend in Premature Mortality from Breast Cancer
Key Messages for Telford and Wrekin• Thereareonaverage26
breastcancer-relateddeathseveryyear
• Prematuremortalityratesinwomenforbreastcancerhavebeenimprovingoverrecentyearsandarenotsignificantly different from thenationalaverage
Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jsp
36 29 24 27 29 33 32 30 31 32 35 29 26 27 29 29 23 23 22 23 20 200
20
40
60
80
100
1985
-87
1986
-88
1987
-89
1988
-90
1989
-91
1990
-92
1991
-93
1992
-94
1993
-95
1994
-96
1995
-97
1996
-98
1997
-99
1998
-00
1999
-01
2000
-02
2001
-03
2002
-04
2003
-05
2004
-06
2005
-07
2006
-08
3 year rolling averages
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(un
der
75 y
ears
) Telford and Wrekin (females) England (females)
23
Early Cancer Detection: The Breast, Bowel and Cervical Cancer Screening Programmes
Cervical Cancer Screening
TheNHSCervicalScreeningProgrammeinviteseligiblewomenbetweentheagesof25and64yearsfora cervical screening test every three to five years, depending on age as follows:
• 25years: Firstinvitation
• 25-49years: 3yearly
• 50–64years: 5yearly
InTelfordandWrekin, 13,186womenwere invited for cervical screeningduring2009/10.Theoverallscreeningcoverageforthewholeeligiblepopulationis78.6%,whichisslightlylowerthantheEnglishaverage (78.9%),but above thenationalprogrammestandardof 70%.However, screeningcoveragehas declined slightly in Telford and Wrekin over the past five years, a picture which has also been seen nationally. The main challenge is to increase coverage in younger women (aged 25-29 years); NHSTelfordandWrekinhascontinuedtosupporttheNHSWestMidlandspublicitycampaign,whichaimstoencourage all women, but specifically younger women, to have a smear test.
Trend in Premature Mortality from Colorectal Cancer
Key Messages for Telford and Wrekin• Thereareonaverage20
prematuredeathsfromcolorectalcancereveryyear
• Prematuremortalityratesfromcolorectalcancer:
- Haveimprovedduringrecentyears
- Are not significantly differentfromthenationalaverage
Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jsp
National Cervical Screening Programme – The Facts
http://www.cancerscreening.nhs.uk/cervical/publications/in-04.html
West Midlands Cervical Screening Programmehttp://www.pants.nhs.uk/
17 16 17 18 18 19 17 14 13 13 14 11 13 13 15 12 13 12 12 10 11 110
10
20
30
1985
-87
1986
-88
1987
-89
1988
-90
1989
-91
1990
-92
1991
-93
1992
-94
1993
-95
1994
-96
1995
-97
1996
-98
1997
-99
1998
-00
1999
-01
2000
-02
2001
-03
2002
-04
2003
-05
2004
-06
2005
-07
2006
-08
3 year rolling averages
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(un
der
75 y
ears
) Telford and Wrekin (persons) England (persons)
24
Early Cancer Detection: The Breast, Bowel and Cervical Cancer Screening Programmes
Trend in Cervical Screening Coverage (25-64 years)
Key Messages for Telford and Wrekin• Cervicalscreening
coverageacrosstheeligiblepopulation(25-64years)hasdeclinedslightlyduringrecentyears,from82.5%in2001/02to78.6%in2009/10
• Thelowestrateofcervicalscreeningcoverageisamongstyoungwomenaged25-29years
Cervical Screening Coverage by Age Group (2009/10)
Source: The NHS Information Centre for health and social care. © Crown Copyright. Cervical Screening Programme, England 2009/10 http://www.ic.nhs.uk/statistics-and-data-collections/screening/cervical-screening/cervical-screening-programme-england-2009-10
82.5% 81.8% 81.0% 80.8% 80.3% 80.0% 79.0% 79.6% 78.6%
81.6% 81.2% 80.6% 80.3% 79.5% 79.2% 78.6% 78.9% 78.9%
0%
20%
40%
60%
80%
100%
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
% s
cree
ning
cov
erag
e (w
omen
age
d 25
-64
year
s <
5 si
nce
last
ade
quat
e te
st)
Telford and Wrekin England
66% 78% 82% 83% 84% 81% 77% 74%0%
20%
40%
60%
80%
100%
25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
Age group (years)
% s
cree
ning
cov
erag
e (<
5 ye
ars
sinc
e la
st a
dequ
ate
test
)
Telford and Wrekin England
Contactdetails:
HelenOnionsPublicHealthSpecialist(ScreeningLead)NHSTelfordandWrekinHalesfield 6, Telford TF7 4BF Contacttelephonenumber:01952580382Email:helen.onions@telfordpct.nhs.uk
25
Immunisation: Protection Against Infectious Disease
Childhoodimmunisationprotectsyoungpeoplefrompotentiallydevastatingillnessessuchasmeasles,rubella,diphtheria,tetanus,meningitisandwhoopingcough.
InSeptember2008,thepublichealthteaminthePCTsetouttoimprovelocalimmunisationcoveragestillfurther,inordertobetterprotectchildrenthroughimmunisation.
Theprojectinvolved:
• Deliveringimprovementsinaninformationsystem,toensurethatnon-immunisedchildrencould be more accurately identified
• Reducingthenumbersofchildrenwaitingforanimmunisationappointment,byincreasingthenumberofappointmentsandclinicsingeneralpractice
• Extending the local immunisation programme to include a small but highly flexible immunisation service for families who find it difficult to use mainstream services
Duringthepastdecade,muchoftheemphasisaroundimmunisationprogrammeshasbeenonpersuadingindividualparentsandclinicalpractitionersofthemeritsofimmunisation.ThisapproachwasprobablyentirelyreasonableintheimmediateaftermathoftheallegationsagainsttheMMRimmunisationduringthelate1990s.Theneednowistorebuildstrong,reliableandeffectiveimmunisationsystems.
Byworkinginpartnershipwithgeneralpracticesandthechildhealthinformationteam,theimmunisationservice has delivered significant improvements in early childhood immunisations. Mumps, measles and rubella(MMR)coveragebetweenAprilandJune2010reached93.8%,from82.3%in2008.Althoughstilla little short of the World Health Organisation target of 95%, this is a significant improvement. The figure summarisesthetrendinMMRcoverageinTelfordandWrekinduringthelasttenyears.
NHS Telford and Wrekin MMR Coverage: 2000 - 2010
74%
76%
78%
80%
82%
84%
86%
88%
90%
92%
94%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
% o
f tw
o ye
ar o
lds
imm
unis
ed in
Tel
ford
and
Wre
kin
NHS Telford and Wrekin intervention started (September 2008)Child death from
measles in UK (April 2006)
Lancet partially retracts Dr Wakefield paper (March 2004)
26
Immunisation: Protection Against Infectious Disease
In addition, the human papilloma virus (HPV) immunisation was introduced as part of the nationalimmunisation programme in September 2008. It aims to immunise girls from 12 to 13 years of ageagainstHPV toprotect from futurecervical cancer.Under thebanner ‘ArmAgainstCervicalCancer’,theprogrammeoffersthreedosesofthevaccineoverasixmonthperiod.Evidenceindicatesthatthisprogrammecouldpreventapproximately400deathsfromcervicalcancereveryyearintheUK.Acatch-upprogrammetoensurethatallgirlsbornonorafter1stSeptember1990wasalsoofferedbetweenSeptember2008andAugust2010.
TheschoolnursingserviceisdeliveringthisprogrammeinTelfordandWrekininpartnershipwithlocalschoolsandeducationservices.TheprogrammecoversallTelfordandWrekinschools,butalsoincludeslocalcolleges,residentialunitsandNHScommunityclinics(forthecatch-upelement).
Thenationaltargetforcompletionofallthreedosesoftheimmunisationintheacademicyear2008/09was70%forYear8girls,risingto80%fortheacademicyear2009/10.InTelfordandWrekin,theuptakefigure achieved for all three doses during the 2008/09 campaign was 82.9%, exceeding both the overall national uptake (80.1%) and the average regional uptake (76%). This year’s campaign has yet to becompleted, but the figure achieved so far for Year 8 girls is around 82.4%.
Contactdetails:
DrChristopherWeinerConsultantinPublicHealthNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580380Email:chris.weiner@telfordpct.nhs.uk
CaroleHalesBCG/HPVCo-ordinatorNHSTelfordandWrekinCoralHouse11LongbowCloseHarlescottLaneShrewsburySY13GZContacttelephonenumber:01743450853Email:carole.hales@telfordpct.nhs.uk
27
Working in Partnership with Local Communities:Communities for Health
TelfordandWrekinwasanearlyadopterofthenationalCommunitiesforHealthprogramme.Themainaimsof theprogramme include theactiveengagementof the localcommunities inhealthmatters, tosupportasustainableapproachtohealthimprovementandaddressinghealthinequalities.
The local programme currently comprises five projects as follows:
• BabyLifeCheck–informationtosupportnewparentsinimprovingthehealthandwellbeingoftheirbaby
• TeenLifeCheck–onlinesupportfor12to15yearoldstohelpthemunderstandandtakecontrolofarangeofhealthissues
• LifestyleSupportforVulnerableYoungPeople–arangeofactivitiesprovidedforyoungpeopleatriskofsocialexclusion,tohelpthemimprovetheirhealth
• ImprovingtheHealthofPeoplefromBlackandMinorityEthnicCommunities–tailoredinformationandsupport,focusingonphysicalactivity,nutritionandemotionalhealthandwellbeing
• ForwardMission–amentoringservicedeliveredbyMINDforpeoplewithsubstancemisuseand/ormentalhealthissues.
Each of the projects has been successfully evaluated as part of the recent national review of theCommunitiesforHealthprogramme.Thereport,oncepublished,shouldsupportfurtherdecisionsaboutthedevelopmentoftheprogrammeatlocallevel.
Feedback
‘Feedback from volunteer peer mentors has been very positive, they can all see the good work that they are doing is having a positive effect on their clients and they feel a real sense of achievement. Some mentors are looking for a long-term career in this type of area and they are getting some valuable experience by working with their clients’
(Health Promotion Specialist - Forward Mission)
28
Working in Partnership with Local Communities:Communities for Health
Forfurtherinformation,contactLouiseMills,HeadofHealthInequalitiesandLifestyle,NHSTelfordandWrekin(01952580390)
Contactdetails:
LouiseMillsHeadofHealthInequalitiesandLifestyleNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580390Email:louise.mills@telfordpct.nhs.uk
Trend in Suicide and Deaths from Undetermined Injury
Key Messages for Telford and Wrekin• Mortalityratesfrom
suicideandundeterminedinjuryarerelativelyunstableduetosmallnumbers–therearearound13deathsrecordedeachyear
• Theratehasnotdifferedsignificantly from the nationalaverageformanyyears
Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk)
8 10 11 12 10 10 11 13 13 14 16 17 14 13 13 14 130
5
10
15
20
1990
-92
1991
-93
1992
-94
1993
-95
1994
-96
1995
-97
1996
-98
1997
-99
1998
-00
1999
-01
2000
-02
2001
-03
2002
-04
2003
-05
2004
-06
2005
-07
2006
-08
3 year rolling averages
Age
sta
ndar
dise
d de
ath
rate
per
100
,000
pop
(al
l age
s)
Telford and Wrekin England & Wales Annual average no. of deaths shown as labels on bars
29
Working in Partnership with People: Peer Support Programmes
Peer support programmes play an important role in raising awareness of the impact that unhealthylifestylescanhaveonqualityoflifeandlifeexpectancy.Insomestudies,peereducatorsareaslikelytoimprovehealthoutcomesasnurses.
A recent report from the Department of Health (Confident Communities, Brighter Futures) suggested that:
• Instrengtheningsocialnetworks,especiallyinhighriskgroups,peersupportiseffectiveinreducingsocialisolation,lonelinessandincreasingqualityoflife
• Interventionssuchasvolunteeringimprovewell-being
• “GreenGyms”improvementalandphysicalhealth
FromtheJSNA,weknowthat:
• Thereisrobustevidencethatunhealthylifestylesincreasetheriskofpeoplesufferinglong-termillnessandsomelife-threateningconditions.TheJSNAhighlightstheeffectsofriskfactorssuchassmoking,obesity,physicalinactivityandalcoholconsumptiononmajordiseasesincludingheartdisease,strokeandcancer
• Peoplewithmentalhealthproblems,orphysicalorlearningdisabilities,areatrelativelyhighriskofsufferingill-healthandhealthinequalities
Evidence-basedprogrammes,includingpeereducation,buddyingandmentoring,havebeencommissionedbythePCT’sHealthImprovementDepartmenttoencourageandsupportpeople inadoptinghealthierlifestyles.ThishasledtothedevelopmentofeffectivepartnershipswiththeLocalAuthority,primarycare,membersofthepublicandserviceusers,whoworktogethertopromotehealth,wellbeingandreducehealthinequalities.Examplesoftheseprogrammesinclude:
“Rubberband”
Apeereducationprojectdeliveredinpartnershipbythecommunity health services health improvement teamandTelfordCollegeofArtsandTechnology (TCAT), foryoungpeopleaged16–19andotherstudents.Studentscan become volunteer peer educators, delivering amenuofhealthpromotionworkshopstootherstudents.Throughtheseworkshops,youngpeopleareguidedtomakepositiveandhealthyinformedchoicesabouttheirlifestyle.Atotalof303workshopsweredeliveredto1,077TCATstudentsaspartoftheRubberbandPeerEducationProjectin2009/10.53workshopsweredeliveredto191foundationstudentswithalearningdisability.Evaluationshowed85%ofstudentshadimprovedtheirknowledgeabouthealthylifestyles,with60%ofstudentsreportingpositive behaviour change. For further information,contactEmmaVaughan,HealthPromotionSpecialistatTelfordandWrekinCommunityHealthServices (01952217474)
Feedback
‘Telford College’s Rubberband Peer Education Project has enabled our learners to make proactive and informed health and wellbeing decisions. The project also provides invaluable experience for learners to deliver health education to their peers. It is an exceptional project which supports the health agenda and enables access to provision for all of our young people.’ (Deputy Director of Student Services, Telford College Arts & Technology)
‘They really enjoy your sessions and learn so much, thanks’ (TCAT Tutor - Rubberband)
‘Use protection when having sex’ (TCT Student - Rubberband)
30
Working in Partnership with People: Peer Support Programmes
The Telford and Wrekin “Green Gym”
Anoutdoorsalternativetoconventionalgymsandtheopportunitytoincreasetheirphysicalactivitylevelsthrough involvement inpracticalconservationactivities.133 individuals registeredon theGreenGymprogrammein2009/10withover2,000contacts.Participantshavereportedimprovedemotionalhealthandwell-beingandfeelinglesssociallyisolated.Someparticipantshavegoneontofurthereducation,trainingandemployment.Forfurtherinformation,contactJulieBird,HealthPromotionSpecialistatTelfordandWrekinCommunityHealthServices(01952217474)
Trend in Teenage Conceptions (Under 18)
Key Messages for Telford and Wrekin• Duringthepastdecade
teenagepregnancyrateshaveremainedstatisticallysignificantly worse than theEnglishaverage
• Therearearound185under18conceptionseveryyear
• 21%ofteenagepregnanciesareamongstgirlsunder16yearsofage
Source: Office for National Statistics http://www.dcsf.gov.uk/everychildmatters/resources-and-practice/IG00200/
Red shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average
65.0 64.2 55.3 57.9 60.9 56.9 53.9 52.0 53.3 54.7 48.9 51.8 55.90
20
40
60
80
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009(Jan-Sept)
No.
of c
once
ptio
ns 1
,000
fem
ales
(ag
ed 1
5-17
yea
rs)
Telford and Wrekin England
Feedback
‘I feel a good sense of achievement and wellbeing. The Green Gym is excellent!’ (Green Gym Participant)
31
Working in Partnership with People: Peer Support Programmes
“Women in Motion”
AprogrammeworkingacrossvariouscommunitiesinTelfordandWrekintoencouragegreaterlevelsofphysicalactivity.Theschemeaimstoovercomeperceivedbarrierstoexercise,suchascostandchildcareissues. The programme recruits female volunteers to undertake training and gain qualifications in a variety ofsportandphysicalactivitydisciplines,sothattheycanleadsessionsforthe16+femalepopulationin their own community. To date, Women in Motion has supported 60 women to achieve accreditedqualifications and 40 women continue to actively volunteer in their community. More than 1400 women have benefited from the community based exercise programmes. Women in Motion received the award forProjectoftheYearattheTelfordandWrekinSportsAdvisoryCouncilAwardsandwasrunnerupattheWestMidlandsBBCPowerofSportAwards.Forfurtherinformation,contactMelParker,SeniorHealthImprovementServiceManageratTelfordandWrekinCommunityHealthServices(01952217474)
“Walk about Wrekin”
Aprogrammeprovidingweeklyguidedwalks,ledbytrainedlocalvolunteers.Walksaregradedforlength,speedandgradients,andaccessibleroutesareidentified. To date the programme has recruited and supported 138 volunteers to achieve the Walk Leader qualification. During the past year, 500 adults have attendedlocalwalkingeventsorganisedthroughtheprogramme.Forfurtherinformation, contact Jenny Stretton, Health Promotion Specialist at TelfordandWrekinCommunityHealthServices(01952217474).
Focus on Breastfeeding Peer Support
BreastfeedingpeersupporthasbeenincreasinglyrecognisedinEnglandasaneffectiveinterventionforincreasingtheinitiationanddurationofbreastfeeding.Peersupportprovidesmother-to-mothersupportforbreastfeeding.Thesupportisgivenbywomenwhohavebreastfedtheirownchildrenandwho,withspecialisedtraining,actasrolemodelssharinginformationandexperiences.Thepeersupportersoffersupporttootherwomen,whowishtobreastfeed,inanatmosphereoftrustandrespect.Researchshowsthatoneofthemajoradvantagesofpeersupportisthatsupporterscomesfromthesamecommunityandhaveexperiencedthesamechallengesasthenewmother.
Feedback
‘The project has changed my life. I’ve become a lot more confident in myself and I’ve found a career path which I want to take’ (Women in Motion Volunteer)
32
Working in Partnership with People: Peer Support Programmes
Breastfeedingpeersupportersarenotintendedtoreplacehealthprofessionalsandgivemedicaladvice,butshareinformationtosupportandcomplementprofessionalsintheirroleofpromotingandsupportingbreastfeeding,particularlymidwivesandhealthvisitors.
Mothers from disadvantaged communities and younger mothers are the least likely to breastfeed.Evidencealsoshowsthatmothersfromthesegroupsarelesslikelytoreceivesupportbecauseofbottle-feedingculturewhichhasoftenprevailedforyearswithintheircommunity.
FromtheTelfordandWrekinJointStrategicNeedsAssessment,weknowthat:
• Despite a “narrowing of the gap” during the past five years, there are still significant inequalities associatedwithsocio-economicdeprivationandbreastfeedinginitiationandduration.Atthetimeofevaluation:
- 54% of mothers from the fifth most deprived communities breastfed their babies at birth, compared to 79% in the fifth most affluent communities
- 22% of infants from the most deprived fifth of communities were still breastfed at 6-8 weeks of age, compared to 48% of infants from the most affluent communities
• Therearealsoinequalitiesassociatedwithmaternalageandbreastfeedinginitiationandduration:
- 44%ofteenagemothers(under20)breastfedtheirbabiesatbirthcomparedto75%ofmothersaged35yearsandover
- By6-8weeks,only9%ofteenagemothers(under20)werestillbreastfeedingtheirbabies,comparedto53%ofmothersaged35yearsandover
• However,trendsinbreastfeedinginitiationbymother’sageindicateimprovementsduringthepastfive years for younger mothers. There was an increase of 8% amongst teenage mothers and 14% amongstmothersaged20-24yearsbetween2003/04and2008/09
Telford and Wrekin “BEST”
Therearenow40trainedpeersupportersfromacrosstheBoroughintheTelfordandWrekinBreastfeedingEncouragementSupportTeam(BEST),withagesrangingfrom18to45years.Localwomenareencouragedtojoinasrepresentativesoftheirlocalcommunity,particularlyfromareasandgroupswhichhavepoorbreastfeedingrates.BESTsupportworkersareavailabletosupportlocalmums,offeringonetooneandgroupsupport.BESTisofferedbothantenatallyandinthepostnatalperiod.AbreastfeedingsupportworkerattendsTelfordmaternityuniteveryweekday,workingincloseliaisonwithmidwivestosupportbreastfeedingmums.BESTalsoworkscloselywith thematernityobesityproject.There isamonthlynewslettertokeepmembersfullyup-to-datewithlocalbreastfeedingactivities.Theteamalsoprovidesatelephonehelpline.
33
Working in Partnership with People: Peer Support Programmes
The team have also set up a breastfeeding support group specifically targeting mums who breastfeed olderbabies,inpartnershipwithSureStart.
EffectiveandcomprehensivebreastfeedingpeersupportisakeycomponentoftheUNICEFBabyFriendlyInitiative(BFI)standard.WorkingtowardsBFIaccreditationispartofthefoundationofthebreastfeedingstrategyinTelfordandWrekin.NICEhasdetailedthesavingswhichcanbegeneratedfromimprovingbreastfeedingrates,throughtheachievementoftheBFIstandardinmaternityandcommunityservices(forexample,intermsofreducedemergencyhospitaladmissionsfromgastroenteritisandchestinfections).ThepotentialcostsavingsmodelledforTelfordandWrekinindicatethatover£55kcouldbesavedfromtheachievementofBFIduringitsearlyyears.
In2009/10:
• 40BESTpeersupportersweretrainedtosupportbreastfeedinginTelfordandWrekin
• 874 women benefited from breastfeeding support groups
• 223pregnantwomenattendedantenatalbreastfeedingworkshops
• Thebreastfeedingdurationtargetwasexceededwith33%ofinfantsbreastfedat6-8weeks(comparedtoatargetof29%).Thisequatesto101additionalbreastfedbabiesabovetargetexpectations,anincreaseof2%fromthepreviousyear
• BreastfeedingpeersupporthasbeenanimportantelementincomplementingthebreastfeedingservicewithinTelfordandWrekin,toachieveUNICEFBabyFriendlyStage1Accreditation
ForfurtherinformationcontactSarahRock,NHSTelfordandWrekinBreastfeedingCoordinator(01952580392)
34
Working in Partnership with People: Peer Support Programmes
MelParkerSeniorHealthImprovementServiceManagerAdults&OlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:mel.parker@telfordpct.nhs.uk
JulieBirdHealth Promotion Specialist – Mental Health andWellbeingAdultsandOlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:julie.bird@telfordpct.nhs.uk
KarenCollinsInclusionSupportCo-ordinatorTelfordMindWellbeingCentreAlanGoodallCentre76-83SevernWalkSuttonHill,TelfordTF74ASContacttelephonenumber:01952872474Email:karen.collins@telfordmind.co.uk
EmmaVaughanHealthPromotionSpecialist-Alcohol&EmotionalHealth&WellbeingChildren&FamilySupportServicesTelford&WrekinCommunityHealthServicesGroundFloorWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:emma.vaughan@telfordpct.nhs.uk
JennyStrettonHealthPromotionSpecialist–PhysicalActivityAdultsandOlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474jenny.stretton@telfordpct.nhs.uk
35
Working in Partnership with People: Peer Support Programmes
Trend in Breastfeeding Initiation and Duration
Key Messages for Telford and Wrekin• Theproportionofinfants
breastfedatbirthincreasedfrom59%in2003/04to66%in2009/10(theequivalentof145additionalinfantsbreastfedeachyear)
• Despitetheincrease,breastfeedinginitiationatbirth(66%)remainsstatisticallysignificantly worse than the nationalaverageforEngland(71%)asdoesbreastfeedingprevalenceat6-8weeks(33%,comparedtothenationalaverageforEnglandof45%)
• Breastfeedingamongstyoungmothershasimproved,withinitiationatbirthincreasingby7%inteenagemothers(under20)and13%inmothersaged20-24yearsbetween2003/04and2009/10
Source: Shropshire and Telford Hospitals NHS Trust Maternity Services and NHS Telford and Wrekin Community Health Services, NHS IC Omnibus Crown Copyright © 2009 http://www.ic.nhs.uk/services/omnibus-survey
Red shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average
Breastfeeding Initiation and Duration by Age Key Message for Telford and Wrekin• Only9%ofteenagemothers
(under20)arestillbreastfeedingtheirbabiesat6-8weeks,comparedto53%ofmothersaged35yearsandover
Source: Shropshire and Telford Hospitals NHS Trust Maternity Services and NHS Telford and Wrekin Community Health Services
59% 58% 63% 27% 31% 33%63% 66% 66% 65%0%
20%
40%
60%
80%
100%
2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
% o
f inf
ants
bre
astfe
d
Birth (Telford and Wrekin) 6-8 weeks (Telford and Wrekin) Birth (England)
44% 59% 69% 73% 75% 66%9% 21% 36% 44% 53% 31%0%
20%
40%
60%
80%
100%
Under 20 years 20-24 years 25-29 years 30-34 years 35+ years All ages
Age band
% o
f inf
ants
bre
astfe
d
% breastfed at birth (2009/10) % breastfed at 6-8 weeks (2008/09)
36
Working in Partnership with Telford and Wrekin Council:Health Through Warmth
Warmhousingisgoodforhealth.Coldweathercanincreasehospitaladmissionsandpromotingwinterwarmthcanleadtoimprovedselfreportedhealth,reducedvisitstoaGPandfewerdaysoffwork.
Excess winter deaths (EWD) are defined as the number of deaths in the four winter months (December to March)minustheaveragenumberofdeathsduringtheprecedingfourmonths(AugusttoNovember)andsubsequentfourmonths(ApriltoJuly).Duringtheperiod2006-09,therewere82excesswinterdeathsinTelfordandWrekin,anaverageof27eachyear.TheExcessWinterDeathIndexinTelfordandWrekinforthe same period was 20, which is not statistically significantly different from the England average (18.1). AlmosthalfoftheexcessdeathsinTelfordandWrekinwereduetocirculatorydiseaseand30%wereduetorespiratorydisease.98%ofthedeathsoccurredinpeopleaged65yearsormore.
InTelfordandWrekin,partneragencieshavedevelopedanAffordableWarmthStrategyandactionplan,deliveredthroughthe‘HealththroughWarmth’project.TheHealthInequalitiesNationalSupportTeamhasdescribedthisstrategyasamodelofgoodpractice,demonstratingwidepartnershipinvolvementandcommitment.ThestrategyisledbyTelfordandWrekinCouncil,withNHSTelfordandWrekinbeinganimportantpartnerintheprogramme.
The scheme helps residents with cold and damp-related health problems, providing a coordinatedapproachtoincreasingthewarmthandcomfortoftheirpropertythroughbetterinsulationandheatinginterventions (including assessment for financial grants). A crisis fund is available to help individuals with up to half of the cost of efficiency measures, if no other grants are available to them.
In2009/10,HealththroughWarmthsupported511clients,including:
• 354peopleover60and43peopleunder16
• 264peoplewithmusculoskeletaldisease
• 132peoplewithcardiovasculardiseases
• 115peoplewithrespiratorydisease
• 89peoplewithdiabetes
Ithasbeenestimatedthat,byhelpingtokeeppeopleoutofhospital,theprojectwillgeneratearound£40,000insavingsduring2010/11.
ContactdetailsfortheHealththroughWarmthteam:
Telford&WrekinCouncilDarbyHouseLawnCentralTelfordTF34JAContacttelephonenumber:01952381864
Email:htw@telford.gov.uk
Website:http://www.telford.gov.uk/site/scripts/documents_info.aspx?documentID=333
37
Working in Partnership with Telford and Wrekin Council:Let’s Cook Together
The chance that a child will develop obesity is influenced by their family lifestyle. It is well documented thatchildrenwhoregularlyeathealthy,homecookedmealstogetherwiththeirfamiliesarelesslikelytobecome overweight. Yet many families lack the skills and confidence to cook healthy meals at home.
Inrecognitionofthis,‘LetsCookTogether’ isdeliveredinpartnershipwithTelfordandWrekinCouncilandhelpsparentsandchildrentocookhealthymealsonabudget.Familieswithchildrenunder11aresignpostedbylocalschoolstoattendasixweekcoursewhichaimstohelpfamilies:
• Developbasiccookingskills
• Enjoycooking
• Enjoyeatingthefoodtheymake
• Applybasicfoodhygienepractice
• Takeupschoolmeals
Theprojecthasrecentlybeendevelopedtoincludecommunity-basedactivityanddeliveryoftheprojectwithinthenurseryenvironment.During2009/10,Let’sCookTogetherdeliveredcoursesto156primaryschoolfamiliesinTelfordandWrekin.95%ofthefamiliesreportedthattheyhadachievedtheaimsoftheprogramme.
Feedback from Professionals
‘Dad came in very nervously with his daughter and wife. He had come along to learn the basics; he had never cooked before and his wife and always cooked. She wanted to learn western dishes. She took over at first but could not come to a few sessions. As Dad had the reins he flourished and enjoyed spending quality time with his daughter. At the end of the course he had purchased a few basic cookery books and Friday night was his night to cook for the rest of the family’ (Let’s Cook Tutor)
38
Working in Partnership with Telford and Wrekin Council:Let’s Cook Together
ClareHarlandHealthImprovementCommissionerNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580391Email:clare.harland@telfordpct.nhs.uk
JacquiMaddoxFacilitiesSupportManagerTelfordandWrekinCouncilPOBox214DarbyHouseTelfordShropshireTF34LEContacttelephonenumber:01952380960Email:jacqui.maddox@telford.gov.uk
Contactdetails:
Feedback from Professionals
‘A family unit with a child with attention difficulties, a parent with dyslexia and poor self motivation joined our cooking group. Through the weeks I watched the family blossom with confidence. They both tried new things and supported each other when one or both of them felt uncomfortable. They were really pleased to complete the six week course with full attendance. I visited the school a month later and saw an amazing transformation as this confident, smart lady had the courage to approach the school and ask if she could volunteer to help with reading in the classroom. She said she had gained the confidence to take the step forward after completing the Let’s Cook Course’ (Let’s Cook Tutor)
Feedback from Clients
‘We are eating more fruit and vegetables’
‘I am cooking more from scratch - with the family’
‘We eat together more’
‘I buy less processed food and takeaways’
‘I have grown potatoes in my garden’
39
Working in Partnership with Telford and Wrekin Council:Healthy Schools
TheNationalHealthySchoolsProgramme(NHSP)iscurrentlyajointinitiativebetweentheDepartmentofEducationandtheDepartmentofHealth.Theprogrammefocusesonfourkeythemes:personal,socialandhealtheducation(includingsexandrelationshipanddrugeducation),healthyeating,physicalactivityandemotionalhealthandwell-being (includingbullying).TheHealthySchoolsProgrammeprovidesaframeworktosupportthedeliveryoftheHealthyChildprogramme,whichisanevidencebasedprogrammeforpreventionandearlyinterventionforchildrenandyoungpeopleaged5–19.
Healthierchildrendobetterinlearningandinlife.Supportingandenablingchildrenandyoungpeopletomakepositivechangestotheirbehaviourregardinghealthandwell-beinghelpsthemreachtheirfullpotential in terms of achievement and fulfilment.
TheNHSPrequiresschoolstotakeasettings-basedor‘whole-school’approach.Schoolsworkwithinaqualityassurance framework toachieveNationalHealthySchoolStatus.SchoolswhohavegainedNationalHealthySchoolStatusareabletotakepartintheenhancedNationalHealthySchoolsProgramme,tofurtherembedhealthierbehavioursandwellbeingoutcomesintotheeverydayactivitiesofschoollife.
InTelfordandWrekintheHealthySchoolsProgrammeisco-ordinatedthroughapartnershipwhichincludes(amongstothers)colleaguesfromhealth improvement,schoolnursing,education,EarlyYearsandthepolice.Schoolshave reported that they valuehavinga localdelivery teamwhichcanoffer specialistsupport across health and education. A critical component for schools is the active engagement ofchildren, young people and their parents and carers in developing, reviewing and influencing policy and practice.
Staff Feedback
‘Children understand the importance of healthy eating and
drinking water’
‘Children and staff feel fitter and healthier’
‘Children are happy to come to school’
‘Children are becoming more skilled at expressing their feelings’
40
Working in Partnership with Telford and Wrekin Council:Healthy Schools
InTelfordandWrekin:
• 71%(52outof73)oflocalschoolshaveachievedtheNationalHealthySchoolsAwardandoftheremaining21schools,mostareworkingtowardsachievingtheawardby2011.Theseschoolshavedemonstratedastrongcommitmenttoacaringandsupportivecultureinsupportingthiswholeschoolapproach,involvingstaff,governors,children,parentsandthelocalcommunity
• Ofthese52schools,31havecommittedtoworkingtowardstheenhancedmodel.11schoolshavesubmittedandcompletedanannualreviewaspartofthis
Thehealthyschoolsteamreviewtheevidencecollectedbytheschoolagainstthehealthyschoolscriteriaduringapre-validationvisit.Aspartofthevisit,theteamalsospeaktostudentsandstaffonaone-to-onebasisandingroups.Thefollowingcommentsarerepresentativeoffeedbackreceivedfromstudentsandstaffduringthesevisits.
Contactdetails:
SallyTyasSeniorManagerHealthySchoolsTelfordandWrekinCouncil62WrekinRoadWellingtonContacttelephonenumber:01952388580Email:Sally.Tyas@telford.gov.uk
Feedback from Students
‘Being at school boosts my confidence’
‘We feel valued for who and what we are’
‘I can now stop myself from being angry’
‘I feel safe at school’
‘When I do good work I feel amazing’
41
Working in Partnership with Telford and Wrekin Council:Healthy Start
HealthyStartisaUK-wideGovernmentschemeaimedatimprovingthehealthofpregnantwomenandfamilies on benefits or low incomes. Healthy Start is an important scheme that can make a real difference to thehealthofpregnantwomen,newmothersandveryyoungchildren indisadvantaged families. Itprovidesanutritionalsafetynetandencouragesbreastfeedingandhealthyeating,aswellasprovidingvoucherstowardsthecostofbasicfoods.
Theschemeoffersspeciallydesignedvitaminsupplementsfreeofcharge.TheHealthyStartvitaminsmeetrecommendations of the Scientific Advisory Committee on Nutrition (SACN) with regard to supplementation andNICEguidanceplacesaresponsibilityonPCTstoensureimplementationoftheprogramme.
The Department of Health has set national targets to improve the uptake of Healthy Start. In TelfordandWrekin,aschemehasbeendevelopedinpartnershipwithPCTstaff,communitypharmaciesandmedicinesmanagement.HealthyStartvitaminsarenowfreelyavailablethroughmostlocalcommunitypharmacies.Trainingforallstaffwhoworkwithchildrenacrosspartnerorganisations,alongwithmediacoverageandpublicity,hasbeenkeytoraisingawarenessoftheHealthyStartprogramme.
InTelfordandWrekin:
• TheuptakeofHealthyStartishigher(85%)thannationalandregionalaveragesandcomparedtomanyotherWestMidlandPCTs
• AttheendofMarch2010,2,246childrenin1,737localfamilieshadregisteredwiththeHealthyStartprogramme.
Forfurtherinformationcontact:
SarahRockBreastfeedingCo-ordinatorNHSTelfordandWrekinHalesfield 6, Telford, Shropshire, TF7 4BF Contacttelephonenumber:01952580392Email:sarah.rock@telfordpct.nhs.uk
Proportion of Eligible Families Registering for the Healthy Start Scheme (January – March 2010)
Source: Department of Health Healthy Start Management Information
72.2%
75.6%
75.8%
76.0%
77.3%
77.7%
79.6%
82.9%
83.3%
83.4%
83.8%
83.9%
85.3%
85.4%
85.8%
86.6%
84.7%
82.3%
79.7%
0% 20% 40% 60% 80% 100%
HerefordshireWarwickshire
South Staffordshire Worcestershire
Shropshire CountyNorth StaffordshireSolihull Care Trust
DudleySandwell
Walsall Teaching Stoke On Trent
Coventry TeachingTelford and Wrekin
Heart of Birmingham Teaching Birmingham East and North
Wolverhampton City South Birmingham
West MidlandsEngland
% uptake of Healthy Start
42
43
44
top related