Public Health & Prevention - Bridgend Approach PUBLIC HEALTH WALES ANNUAL GENERAL MEETING Abigail Harris & Peter Mannion 19th September 2011

Overview Public Health & Prevention Team Strategic Background Local Context –Setting the scene Public Health & Prevention Team Positioning the team – a new focus Example – Weight Management in the Community Overview

Local Context Wellbeing Directorate Integration Adult Social Care Healthy Living Integration Joint Locality Director Bridgend Care Partnership Local Service Board Local Context

Bridgend Care Partnership Integrated Referral Management Public Health & Prevention Long Term Care Integrated Operational Teams Integrated Community Networks Community Resource Team Secondary & Community Services

Public Health & Prevention Team Develop an integrated team which will lead the public health and prevention agenda across Bridgend Team incorporates: HSCWB Partnership personnel (ABMU/BCBC) Health Challenge Bridgend Officer (BCBC) Older Persons Strategy Resources (BCBC) Local Public Health Team (PHW) Substance Misuse Service Team (ABMU/BCBC) Public Health & Prevention Team

Strategic Change – from upstream to ...

Repositioning -Down Stream Pressure Establishing a clear link between PH & P Activity and System pressure Unscheduled Care Residential Care Primary Care Home Care Carers

Plan Filter Limited No of Priority Areas ABMU PH Framework Locality & Wellbeing Business Plans CYP & HSCWB Strategies ABMU PH Framework Plan Filter

Our Team Lens – Tangible Outcomes Priority Areas Obesity Tobacco Alcohol Frailty Settings Workplace Community Network Schools Project Management Intelligence Evidence Whole system planning Evaluation Our Team Lens – Tangible Outcomes

Local Context – Bridgend

Example Project Weight Management Project Priority Settings Obesity Tobacco Alcohol Frailty Settings Workplace Community Network Schools Project Weight Management Project Example

Weight Management Project The North Network has the highest EASR prevalence for Diabetes, CHD and Hypertension within ABMU 25% of adults in Bridgend are reported Obese – higher practice prevalence rates in the North Network If you are clinically obese you are 80x more likely to develop diabetes than someone of normal weight (Prof Alan Maryon-Davies) Weight Management Project

Weight Management Project A non-clinical programme giving individuals support to make sustainable changes to their lifestyle to improve their health and wellbeing. Links up local activities, groups and initiatives that already exist within the community Weight Management Project

Weight Management – What Happens Weightwatchers referral Scheme 12 weeks Exercise Referral Scheme (NERS) 16weeks Exit Strategy via Wellbeing Broker Sustainable health behaviour change Engagement in Community activities/ return to work/ volunteering etc Referral From Primary Care (BMI 30 or 28 with co morbidities) Weight Management – What Happens

Outputs Rolling Program : 147active referrals since Sept 2010 90% retention rate on WW programme (UK national rate only 57% complete 12 weeks) 90% engaging in Exercise referral (NERS) 51 have achieved 5% weight loss 18 have achieved 10% weight loss Group cumulative loss -154 Stone Average 1-2lb per week per person Outputs

Evaluation Quantitative Improved clinical indicators – HbA1c, BP Medication changes a significant reduction in weight, BMI and waist measurements A significant change in diet and eating habits A significant increase in perceived well-being Qualitative Increased confidence Reduced social isolation Increased activity Economic Cost effectiveness Evaluation

Outcome

Integrated Team – The Value Integrating & Repositioning Public Health Lens Priorities Settings Process Projects Public Health / Maintenance Prevention Workforce Health Intelligence Value Patient / citizen / service user BCBC Outcome Agreement Unscheduled Care Meeting HSCWB Outcomes Promoting OP Independence - Pressure AS Services CCM Priority Integrated Team – The Value