1. ‘Imagining 2020’: key demographics Cheshire & Warrington Sub-regional Conference 11 July 2014

2. Content What are the shared challenges? Where are we now? What can we do? Case study – alcohol use

3. What are the shared challenges? We’re changing Aging population Becoming heavier Drinking more Stress Result Increase in long term conditions Increased use of services Financial constraints Increased demand Services

4. 19922012 2031 Births41864013 ↓ 9.6% Deaths37803420 ↓ 9.0% Population342k371k ↑ 8.3% Smokers28%17% ↓ 40% Heart adm.13471209 ↓ 10% Lung cancer216246 ↑ 14% Bowel cancer160267 ↑ 67% 374 Breast cancer165323 ↑ 96% 481 Diabetics558117268↑ 309% 28955 Drug users3191139↑ 380% 1959 During the next twenty years there will be substantial rises in the number of people over 80, and fewer people aged 30 to 55 Example from Cheshire East

5. Implications of an aging population More dementia Increased cancer Increased comorbidity Loss of function

6. : Warrington In 2012, 6.8% adults estimated to have diabetes, by 2020, if current trends continue this could be 7.6% by 2030, 8.5%

8. 44% rise in cancer over next 10 years (ageing and PREVENTABLE lifestyle factors) 13/15 th when compared to similar LAs Early detection of cancer may not be improving Challenge of Bowel Screening Cancer key facts- Cheshire East

9. Where are we now? April 2012 – the All Party Parliamentary Group on Primary Care & Public Health held a roundtable discussion on: Ten years on from Wanless, how “fully-engaged” are we? some success in meeting smoking cessation targets but a rise in other serious public health challenges (obesity, alcohol) huge reductions in treatment waiting times (although is this changing?) but GP consultation rates have risen as people still do not self-care no shift in resources out of hospitals no switch of activity from GPs to pharmacies we still do not have no good information to support personal decisions and the ability to have consistency of care ‘’ the rhetoric of engagement has risen – but paternalistic services continue and the public remains dependent on these’’

10. What can we do???? Move from cure to prevention People at the centre, instead of “what's the matter” ask “what matters to you” Healthy people, healthy place, healthy communities Healthy policy (health equity and health impact) Collaboration (service improvement, efficiency, resilience) Agree priorities for action

11. Case study: Alcohol MAKING THE MOST OF THE OPPORTUNITIES

12. Alcohol Use – Trends in Related Harm

13. Alcohol misuse harms families and communities (source: PHE)

14. Alcohol Use – The response (source: PHE)

15. The Response - Prevention (source: PHE)

16. The Response - Partnership (source: PHE)

17. Questions and comments ? Eileen O’Meara Director of Public Health and Public Protection Department Halton Borough Council / Runcorn Town Hall / Heath Road / Runcorn / Cheshire / WA7 5TD Email: Eileen.omeara@halton.gov.ukEileen.omeara@halton.gov.uk Tel : 0151 511 6848