Health Promoting Health Service

Dr Aileen Keel CBEDeputy Chief Medical Officer for

Scotland

“Every healthcare contact is a health improvement opportunity”

Better Health, Better Care Action Plan (2007)

“We will roll out simple but effective healthpromoting interventions within acute caresettings”.

This commitment is set out within the broadcontext of many actions to tackle healthinequalities.

Alcohol Brief Intervention Measure: Scale of the Challenge

15 of the top 20 UK LAs ranked by male alcohol-related death rate are in Scotland (1998-2004).

Top 5 are:

1. Glasgow City

2. Inverclyde

3. West Dunbartonshire

4. Renfrewshire

5. Dundee City

Smoking : The scale of the challenge

Prevalence of smoking by area deprivation, Scotland 2005/06

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5

10

15

20

25

30

35

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45

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Mos

tde

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SIMD 2004 decile

% s

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Chief Executive Letter 14(2008) Health Promoting Health Service:

Action in Acute Care Settings• Guidance issued to all Boards with focus on targetted

actions in acute care settings.• Each action offers significant potential to improve health

and reduce health inequalities. • Implementation of the measures will create hospital

environments which promote healthy life choices for patients, carers, staff and the wider community.

• Emphasis on the prevention of ill health, not just treatment of illness.

Health Promotion Health Service Actions

• Smoking: provide brief interventions to support smoking cessation for both outpatients and in-patients in maternity units and all acute care settings.

• Alcohol: to screen opportunistically patients attending A&E departments with certain clinical presentations. For patients identified with harmful or hazardous drinking, to offer and deliver a brief intervention in accordance with SIGN 74. For patients identified as dependent drinkers, and those with harmful or hazardous drinking patterns who request further help, to direct to an appropriate support service (including health, social services, local authority and voluntary).

Health Promotion Health Service Actions

• Food and Health: increase access to competitively priced fruit and vegetables through retail outlets in acute settings.

• Food and Health: remove all soft drinks with a sugar content greater than 0.5g per 100ml from vending machines in hospitals.

Health Promotion Health Service Actions

• Breastfeeding: implement the UNICEF Baby Friendly Initiative Awards Scheme in all maternity units.

• Health at Work: attainment of a Healthy Working Lives (HWL) award. All acute sector units are to take part in the HWL awards scheme and work towards an award if they have not already done so.

Health Promotion Health Service Actions

Actions aligned with public health priorities, HEAT targets and the national performance framework.

Implementation has the potential to: increase healthy life expectancy; break the link between early life adversity and adult disease; and reduce health inequalities.

Key messages:• The need to shift the focus of NHSScotland more towards prevention

rather than simply treatment of illness

• The enormous opportunity available to NHSScotland to use its 150,000+ staff to promote health, and to improve the health of staff themselves

• The need to challenge NHS senior management to fully engage with this:

– Recognising the considerable efforts already being made by health promotion staff

– Supporting the education and training of other (non-health promotion) staff to deliver these messages

– Embedding the health promoting culture into the redesign and delivery of services

Health Promoting Health Service

For discussion:• Will this approach change the way that you

work/plan services?• Are there any barriers to implementation?• What support and skills do you need to apply

the health promoting health service approach in your everyday job?

• What else could we all do to develop a health promoting health service culture at work?