Progress Through Partnership Improving Health Dr Yvonne Arthurs Deputy Regional Director of Public Health in South East Public Health Group

15 th June 2007 Recent National Policy Context Emerging Health Strategy in South East

Individual Life style choices and risk factors Broad range of economic and related factors :- education, employment, housing and leisure Social and Cultural influences Environment – climate, air quality Access to good quality service for prevention, treatment and care Factors Influencing Health

Choosing Health – Making Healthy Choices Easier - (DH2004) Health Challenge England – Next steps in Choosing Health - (DH Oct 2006) Our Health, Our Care, Our Say – A new direction for community services - (DH 2006) Commissioning Framework for Health and Wellbeing - March 2007 Health and Social Care Outcomes Accountability Framework – 2008/9 – 2010/11now open to consultation to 27 th July 2007 National Context

Tobacco control & reducing smoking prevalence Halting increasing rates of obesity Increasing physical activity Improve sexual health – reducing teenage conception rates Reducing inequalities – narrowing the gap Alcohol misuse Children and Young People getting the best start in life – linked to “ Every Child Matters ” Local community leading for health, Work, wellbeing and health Health promoting NHS Choosing Health Focused on:-

- Leadership across government – local and national joining up complementary policies and plans - Partnership with community, voluntary sector, business, industry and others - Local Authorities bring together a range of agencies that influence peoples health and wellbeing e.g. in Local Strategic Partnerships, Children ’ s Trusts - Understanding the population – Joint Strategic Needs Assessment - Strong focus on understanding people and their lives and then what influences life style choices or behavioural decisions in different sections of the population Recent policy taken together signals a new direction for health:-

Social marketing campaign to reduce obesity and to promote lifestyle changes multiple approaches and a targeted message A shift towards services that are personal, sensitive to individual need – people at the centre of own health A strategic shift towards promoting health and well-being – investing to reduce further ill health. Increasing control e.g. direct payments. Shift in focus towards prevention and early intervention, on maintaining independence, by health and social care services

More support for mental health and well-being - including employment Choice Care closer to home Tackling inequalities including improving access to community services More support for people with long term conditions – Expert Patient Programme And…..

Commissioning for the best possible outcomes for the local population, underpinned by understanding of population and individual needs Joint accountability Framework that aligns health and social care encouraging working between PCTs, Local Authorities and other And...

Health Strategy South East Discussion draft to be launched on 20/6/07

Re-emphasise contribution of healthy a population and high quality health and social services make to improving quality of life and the economy Ensure other regional polices and plans take account of health and inequalities Maximise the role of NHS, working with other partners in reducing inequalities in health and promoting sustainable communities. Maximise the effectiveness of old and new partnership and synergistic ways of working. Create an ongoing dialogue among regional partners to create an environment which fosters innovative thinking and coordinated action to improve health and well being in the South East. The strategy seeks to:

GOSE South East Coast SHA South Central SHA South East Regional Assembly South East Regional Development Agency Strategy led by Regional Directors of Public Health in association with:

Initiated in November 2006 Healthy Region Summit Discussion – March 2007 Discussion draft to stakeholders – 20 th June Discussion at Regional Health Challenge England/Healthy Region Forum – 20 th June Discussion period to July 31 st Final Plan – by end September A dynamic plan- to be updated regularly Process of Development

The strategy is based on five key themes: Reducing health Inequalities Promoting healthy sustainable communities and sustainable activities Employment and health Improving outcomes for children and young people. Improving outcomes for older people. Themes

Linked to: Integrated Regional Framework for Sustainability South East Plan Regional Economic Strategy Health Strategy- one of suite of regional strategies.

Distribution of health deprivation in the South East Key fact Health deprivation is particularly concentrated in the coastal cities and towns, and the major urban centres Source: Department for Communities & Local Government. Indices of Deprivation 2004.

Carbon dioxide emissions the South East Key fact The South East has the highest total CO 2 emissions in England, although emissions per head of population are lower than the national average Source: Department for Environment, Food & Rural Affairs. Regional Sustainable Development Indicators 2004.

Sickness absence rate in the South East Key fact The South East has the equal second highest sickness absence rate in the UK Source: Office for National Statistics. Labour Force Survey 2005.

Teenage pregnancy in the South East Key facts The teenage pregnancy rate in the South East is 17% lower than the England average (2005) But inequalities are apparent – the teenage pregnancy rate in Hastings is over 4.5 times higher than that in Chiltern Source: Office for National Statistics. Under 18 Conceptions for Local Authorities

Healthy life expectancy at 65 for males in the South East Key facts Healthy life expectancy at age 65 for males in the South East is over one year higher than the England average But inequalities are apparent – healthy life expectancy varies from 12 years in Medway to 15 years in Winchester Source: Office for National Statistics. Healthy Expectancies for Local Authorities in England and Wales 2001.

Reduction of Health Inequalities –Reduction of mortality from CHD & Cancer and reduce inequalities between social groups. –Reduce infant mortality and inequalities between social groups. –Improve the coverage of screening and immunisations. –Reduce alcohol related harm –Enhanced inequalities reduction in decision making processes. Improving Health of Children and Young People Reduction of Obesity Promotion of mental health and well-being, preventative and early intervention Strengthening commissioning of children's services Closing the gap on infant mortality Reduction of teenage pregnancy Proposed priority areas include:

Employment and Health Improve Health and Wellbeing in the workplace Improve employment levels in socially excluded people e.g. people on incapacity benefit And……

Healthy and Sustainable Communities Increase awareness of health benefits of sustainable development Support the implementation of sustainable travel plans Maximise the capacity for sustainable food procurement in the pubic sector Increase sustainable development in the public sector Promote the development of sustainable community And……

Older People Promotion of independence and engagement of older people Promote Healthy Active Living Promote material wellbeing and financial security of older people Support the development of Commissioning Framework for Older People Support implementation of Dignity in Care standards and end of life care And……