1. Student Health Needs Assessment Dr Elizabeth Orton Lecturer and Specialty Registrar in Public Health, NHS Nottingham City

2. What is a health needs assessment? Assess population need Commission services Audit services Are they Effective? Adapt and improve services

3. Nottingham Student Health Needs Assessment –Who is at risk and why –The level of need in the population –Current services in relation to need –Projected service use – next 3/5 years –Evidence of what works –User views –Unmet needs and service gaps –Recommendations for commissioners

4. –Who is at risk and why –The level of need in the population –Current services in relation to need –Projected service use – next 3/5 years –Evidence of what works –User views –Unmet needs and service gaps –Recommendations for commissioners

5. What makes Students ‘different’? Transitory –Live at ‘home’ and ‘uni’ –Continuity of support networks –Re-registering with the GP

6. May be from overseas

7. Live in close proximity Hepatitis A Meningococcal Meningitis Measles Mumps Rubella TB STIs

8. Health behaviours

9. –Who is at risk and why –The level of need in the population –Current services in relation to need –Projected service use – next 3/5 years –Evidence of what works –User views –Unmet needs and service gaps –Recommendations for commissioners

10. Significant part of Nottingham’s population 58,499 university students in 2009/10 19% of the population

11. Accommodation Concentrated G32 G34

12. Ethnicity % Nottingham City % Nottingham Trent University % University of Nottingham Asian or Asian British - Bangladeshi. 0.200.420.24 Asian or Asian British - Indian. 2.286.956.41 Asian or Asian British - Pakistani. 3.642.601.20 Asian other. 0.371.844.14 Black or Black British - African. 0.481.632.42 Black or Black British - Caribbean. 3.443.030.58 Black other. 0.420.570.62 Chinese 0.643.648.20 Other mixed background 0.480.821.28 Other White background 2.500.040.09 Other. 0.471.082.03 White, White - British 81.0566.3064.89 White - Irish 1.36<0.010.01 White and Asian 0.470.701.43 White and Black African 0.200.370.57 White and Black Caribbean 1.980.940.46 Unknown 0.009.075.44

13. Mental health Leeds University needs assessment –20% to 30% of undergraduate full-time students above the clinical cut off for requiring counselling Financial concerns Additional paid work pressures Social support Disadvantaged socio-economic background

14. Common mental health disorders GP health system codesDenominator SunriseRadfordCripps Neurotic disorders Affective psychosis Mental + behavioural disorder Depressed Depressed mood Low mood All registered patients aged 18-30 4369592077 Prevalence 11%9%8%

15. Comparison with all Nottingham City residents

16. Counselling services RCP report 2011 –Expect 4% of students to use counselling 2009/10 –1541 students/staff seen by University of Nottingham (4.05%) –779 students seen at Nottingham Trent University (3.7%)

17. Smoking SunriseRadfordCripps 9.4%9.6%10% Nottingham City residents (2011 Survey) 27.5% prevalence Take up smoking at uni? All recorded at registration? Really have a lower prevalence?

18. Alcohol SunriseRadfordCripps Prevalence of high consumption (audit score over 5) 40%41%33% Impact of Welcome Week – EMAS 50% increase

19. Drug use No local direct data Mosaic suggests G32 and G34 more likely to take cannabis and cocaine

20. Healthy weight SunriseRadfordCripps Prevalence of BMI 31+1.8%3.8%2.7% Prevalence of BMI 25-3014%15%14% Nottingham City residents (2011 survey) 15.2% obese 30% overweight

21. Infectious diseases Outbreak plans agreed MMR catch up at UoN All offered MenC TB screening at UoN Sexual health –Chlamydia screening (most common STI) –Sexual health screening (Chlamydia, gonorrhoea, syphilis, HIV) –C-card scheme

22. –Who is at risk and why –The level of need in the population –Current services in relation to need –Projected service use – next 3/5 years –Evidence of what works –User views –Unmet needs and service gaps –Recommendations for commissioners

23. Unmet need International students (and some UK!) –Unclear about how the NHS works Lower smoking cessation uptake Differences in City and County service provision High alcohol consumption Eating disorders (UoN) Lack of ethnicity data Lack of student-specific data

24. –Who is at risk and why –The level of need in the population –Current services in relation to need –Projected service use – next 3/5 years –Evidence of what works –User views –Unmet needs and service gaps –Recommendations for commissioners

25. Recommendations Establish links with NHS and Local Authority commissioners –Utilise expertise Strengthen links with mainstream services Monitor equity of services –TB screening –Eating disorders services –Sexual health, smoking cessation and alcohol treatment services (County/City) Student-specific data in future?