Healthier, Happier, Better Developing Birmingham’s Joint Health and Wellbeing Strategy 2012 - 2015 FOREWORD Thank you for agreeing to be part of the consultation process for Birmingham Health and Wellbeing Strategy. This strategy is an opportunity for us to be clear about our vision for the health and wellbeing of our City, and identify what the key partners – the City Council, NHS and others – will do together to achieve it. We want our citizens to be able to live healthier and happier lives, and for the services we commission to be better at supporting this. The Strategy is not a statement of everything we need to do in health, public health and social care in Birmingham. The strategy is a statement of what our most important priorities in health and care should be. These priorities have been chosen through consensus by stakeholders reflecting on the JSNA, the evidence, their knowledge and experience. This strategy is not just about health and social care. Many of the most challenging health issues in Birmingham are significantly affected by educational attainment, standard of living (good employment) and other factors like the places we live in. This strategy seeks to reflect that. This consultation version asks whether you agree with these priorities and asks for additional comments. This is your opportunity to help shape our strategy further; I would welcome your input, so we can get this right. Councillor Steve Bedser Cabinet Member, Health and Wellbeing Birmingham City Council Chair, Birmingham Health and Wellbeing Board INTRODUCTION The Health and Wellbeing Strategy is required by the Health and Social Care Act 2012. It is part of the roadmap of getting to shared understanding of what we need to commission. The Health and Wellbeing Board is a new partnership which will deliver real improvements in people’s health and wellbeing. With representatives from health, councils and the Local Involvement Network (LINk), the Board will work across organisations to improve the health and wellbeing of people living in Birmingham. The Board wants to focus on the areas where working together in new ways will have the largest impact on people’s health and wellbeing. The health and wellbeing strategy for Birmingham is a plan which will set out how the Board will help as many people as live equally healthy and fulfilling lives. We’ve made a start in identifying the main areas we think we should focus on in this plan, but we want to know what you think before we develop the strategy any further. As the diagram below shows, this starts with gathering evidence and insight, goes on to bringing this together in the JSNA and then goes on to development of the Strategy. Our plan needs to address both health and wellbeing. A huge range of factors can influence people’s health and wellbeing – not only health issues like smoking and obesity, but also feeling safe, independent and part of their communities. But we can't do everything we would like to do all at once. So we have picked priorities where the health service and local government can make a real difference by working together. And there are some issues which we cannot afford to ignore. The Strategy is not intended to be an exhaustive compendium of everything we need to do in health, public health and social care in Birmingham; it is intended to identify those most important issues. Equally, it is not a detailed plan of everything Birmingham City Council, the NHS and other partners will do to improve and protect the health of our population. Just as the Joint Strategic Needs Assessment seeks to identify the most pressing priorities which we need to work on together, so the strategy is a statement of the most pressing needs which cause high levels of avoidable illhealth, death or disability and/or where there is significant opportunity to improve outcomes for people and the efficiency of services. The specific priorities suggested are identified below. Further on in this document, we have a more detailed table where we want your help. That table identifies the priorities, the need from the Overview JSNA, what we and partners can do and why should we do those things, and asks you for your views. WHAT PRIORITIES HAVE WE CHOSEN? Giving every child the best start in life Enabling all children to young people and adults to maximise their capabilities and have control over their lives Developing well – childhood into adulthood Ageing well Dying well Create fair employment and good work for all. Ensure Healthy Standard of living for all REDUCE LIFE EXPECTANCY DIFFERENCES WITH A FOCUS ON PERINATAL AND INFANT MORTALITY GOOD MENTAL WELLBEING ACROSS THE POPULATION REDUCE CHILD POVERT IN THE CITY IMPROVE HEALTH AND WELLBEING AND REDUCE HEALTH INEQUALITIES FOR CHILDREN AND YOUNG PEOPLE GOOD MENTAL WELLBEING ACROSS THE POPULATION REDUCE CHILD POVERTY IN THE CITY THERE ARE SIGNIFICANT VARIATIONS IN HEALTHY LIFE EXPECTANCY ACROSS BIRMINGHAM REDUCING AND MANAGING FRAILTY IN OLDER PEOPLE IMPROVE HEALTH AND WELLBEING FOR OLDER PEOPLE ACCESS TO AND QUALITY OF CARE FOR CARERS VARIES SIGNIFICANTLY ACROSS THE CITY WE PERFORM SIGNIFICANTLY BEHIND ENGLAND IN ENABLING PEOPLE TO CHOOSE THEIR PLACE OF DEATH MORE NEEDS TO BE KNOWN ABOUT THE QUALITY OF CARE RECEIVED AT END OF LIFE INCREASE EMPLOYMENT OPPORTUNITIES IN BIRMINGHAM IMPROVE EDUCATIONAL OPPORTUNITIES AND ATTAINMENT IN POOREST AREAS PROMOTE HEALTHIER LIFESTYLES IN THE WORKPLACE REDUCE CHILD POVERTY IN THE CITY REDUCE INEQUALITIES IN HEALTH FACED BY COMMUNITIES OF INTEREST AND IDENTITY IMPROVE THE EMPLOYMENT PROSPECTS OF THOSE WITH DISABILITIES Create and develop healthy sustainable homes and communities Strengthen the role and impact of ill Health prevention ENSURE DECENT HOMES FOR CITIZENS WITH A FOCUS ON PRIVATE SECTOR DELIVER A HEALTHIER AND SAFER ENVIRONMENT IMPROVING POPULATION MENTAL WELLBEING REDUCE THE BURDEN OF PREVENTABLE NONCOMMUNICABLE DISEASE INCLUDING HARM FROM TOBACCO, ALCOHOL AND DRUGS IMPROVING MENTAL WELLBEING SUPPORT CARERS HOW HAVE WE CHOSEN OUR PRIORITIES? The priorities in this draft strategy have been chosen through consensus by stakeholders reflecting on the JSNA, the evidence, their knowledge and experience. There will almost certainly be detailed implementation plans for specific issues which sit underneath this. That’s why, because health inequalities in Birmingham remain a significant issue, a separate health inequalities plan is being produced. The needs and priorities in the Strategy have come from the Overview Joint Strategic Needs Assessment (JSNA) chosen by the many stakeholders who have worked with us so far. The JSNA is a process that results in a document that identifies at a city-wide level the health and care needs of its population. In Birmingham we have through discussion and agreement adopted the Marmot Priorities (Headings of the tables below) as the structure for the Overview JSNA and the Health and Wellbeing Strategy PRIORITIES AND YOUR INPUT In this document, we’ve explained why and how we’ve chosen these initial priority areas for the health and wellbeing strategy. We want to know what you think about the way we’ve chosen them, and if you think we should include anything else. We’d like to hear from individuals, groups and organisations. Do you agree with these priorities? If no, what do you feel we should do? Are there any specific actions we need to take within each priority? Which partnerships are currently in place that can help us deliver against these priorities? We will be arranging stakeholder events and also putting this document online to encourage as many stakeholders as possible to comment and give their input and insight. This consultation runs from July to September 2012. WAYS TO RESPOND By email to: [email protected] Or by post to: Kulwant Ghaleigh, Information and Intelligence, Birmingham Public Health, Gee House, Holborn Hill, Aston, Birmingham, B7 5JR This process would be helped if respondents making comments could make them directly in the relevant boxes in this document Thank You Giving every child the best start in life What does the JSNA say? What should we and partners do REDUCE LIFE EXPECTANCY DIFFERENCES WITH A FOCUS ON PERINATAL AND INFANT MORTALITY Invest resources in home visiting programmes through professional and Para professional services for both pre and post birth Use children’s centres more effectively for early years development and parenting in deprived communities including cognitive and social development pathways for deprived children (to help with school readiness) Target mothers at high risk of perinatal mortality for early intervention and support Effective targeting of these services through intelligence led commissioning Why should we do these things (Evidence/Nice Guidance) Home visiting programmes show evidence of improved parenting skills, child development, reduced behavioural problems and improved maternal mental health and social functioning. Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Focus on young children in troubled families Invest in good quality nursery provision and both they and children’s centres apply easy interventions for emotional wellbeing Reduce bullying and selfharm in school-age children Effective targeting of these services through intelligence led commissioning Develop and implement consistent universal to specialist mental health model for children Continue to develop emotional resilience work in schools Develop interventions for looked after children using the Scottish experience GOOD MENTAL WELLBEING ACROSS THE POPULATION Attending high quality pre-school acts as a protective factor and has a disproportionately positive impact on the development of disadvantaged children. Targeted health programmes are effective in impacting on certain health outcomes namely in mental health, healthy eating and physical activity. Early identification for children at risk and early referral into appropriate mental wellbeing services REDUCE CHILD POVERTY IN THE CITY Use intelligence to target families and children in most poverty Bring together financial inclusion interventions in a single package (school meals, benefits etc) Proactively work with children in poverty on developmental goals including early school performance and cognitive and emotional development Develop pathways into skills development and work for parents/carers of children Improving the environment that the child grows up in, ensuring access to health care services, good quality education, providing financial incentives either through benefit schemes or tax regime and promoting family values impacts on breaking the cycle of poverty Enabling all children to young people and adults to maximise their capabilities and have control over their lives. Developing well – childhood into adulthood What does the JSNA say? What should we and partners do IMPROVE HEALTH AND WELLBEING AND REDUCE HEALTH INEQUALITIES FOR CHILDREN AND YOUNG PEOPLE GOOD MENTAL WELLBEING ACROSS THE POPULATION REDUCE CHILD POVERTY IN THE CITY In addition to interventions above: Emotional resilience programmes in schools as part of development A whole school day approach to nutrition and physical activity Including parents/carers of obese/overweight children in nutrition and weight management programmes Target young people who start smoking Continue modernising learning disabilities commissioning and services Why should we do these things (Evidence/Nice Guidance) Good Quality early childhood education and care can help address inequalities in life chance. High quality pre-school programmes are effective in improving self-esteem and behaviour especially on those children from disadvantaged backgrounds. It has enduring effects on both health and other outcomes. Evidence based and targeted across the social gradient parenting programmes can improve maternal psycho social health , contribute to emotional Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Continue to develop the joint commissioning of wellbeing and mental health services to focus on prevention and early intervention for all ages Commission a pathway for people with mental health problems which focuses on prevention and recovery Ensure that that health and dental care assessments and health care plans are part of the overall care plan for looked after children and this is carried out on all children looked after by the authority. PCTs have a duty to comply with requests by local authorities for help in the exercise of their functions. and behavioural improvements and , contribute to safer home environments and reduce unintentional injury. Looked after children and young people share many of the same health risks and problems as their peers, but often to a greater degree. They often enter care with a worse level of health than their peers in part due to the impact of poverty, abuse and neglect. . Enabling all children to young people and adults to maximise their capabilities and have control over their lives. Living well across the life course What does the JSNA say? What should we and partners do Continue the adult learning offer for the city and target those most deprived for inclusion Commission appropriately for communities of identity (e.g. non-Eurocentric mental health models, lifestyle advice suitable for all cultures, LGBT health) Why should we do these things (Evidence/Nice Guidance) Participation in adult learning contributes to positive and substantial changes in health behaviours Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Enabling all children to young people and adults to maximise their capabilities and have control over their lives. Ageing Well What does the JSNA say? What should we and partners do THERE ARE SIGNIFICANT VARIATIONS IN HEALTHY LIFE EXPECTANCY ACROSS BIRMINGHAM REDUCING AND MANAGING FRAILTY IN OLDER PEOPLE IMPROVE HEALTH AND WELLBEING FOR OLDER PEOPLE ACCESS TO AND QUALITY OF CARE FOR CARERS VARIES SIGNIFICANTLY ACROSS THE CITY A universal offer for older people designed to keep people well Invest in selfmanagement and prevention for people with existing disease to keep them independent and out of hospital/residential care Continue to develop early identification and prevention programmes for older people especially (Falls, stroke, dementia etc.) Evidence based lifestyle services should be tailored and targeted at the older age population. Why should we do these things (Evidence/Nice Guidance) Social contact, rewarding activity, opportunities for engagement and participation are essential for the promotion of wellbeing and mental health. Vaccination- Influenza and pneumococcal vaccines are the most relevant and effective for preventing illness in old people. Screening programmes are effective in diagnosing early signs or symptoms of disease and increase likelihood of condition being cured or managed effectively. Falls prevention programmes have shown to be effective in Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Detailed pathway for frail elderly from early identification to intensive management including community geriatric models Encourage employers to work with NHS and social care on preparation for older age programmes Continue to invest in tele care and expand into tele health improving health outcomes and quality of life for older people. Falls Pathways A housing for life pathway to ensure peoples’ homes are suitable to support maximum independence Ensure that intermediate care is available as part of a pathway for management back to independence. Link this pathway to enablement etc. Tele care and technology is focused primarily on preventative secondary care. The current evidence base in the UK is growing and shows positive gains for individuals and services. . The evidence base for which components are more effective is still under developed. Housing adaptations and practical support to improve older people’s homes can promote autonomy, to prevent illness and reduce demands on both families and services. Low level practical interventions can have an impact on both quality of life and health and wellbeing. Effective Intermediate Care – qualitative and quantitative evidence to suggest that effective intermediate care makes a significant difference to people’s lives, reduce avoidable hospital admissions and premature admission to long term residential care. Enabling all children to young people and adults to maximise their capabilities and have control over their lives. Dying well What does the JSNA say? What should we and partners do WE PERFORM SIGNIFICANTLY BEHIND ENGLAND IN ENABLING PEOPLE TO CHOOSE THEIR PLACE OF DEATH MORE NEEDS TO BE KNOWN ABOUT THE QUALITY OF CARE RECEIVED AT END OF LIFE Implement the Gold Standards Framework (Nice Guidance) across the city Ensure that there is a detailed pathway for end of life care Why should we do these things (Evidence/Nice Guidance) Gold Standards Framework is a systematic evidence based approach that has been developed to deliver the best care for patients nearing their end of life Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Create fair employment and good work for all. What does the JSNA say? What should we and partners do INCREASE EMPLOYMENT OPPORTUNITIES IN BIRMINGHAM IMPROVE EDUCATIONAL OPPORTUNITIES AND ATTAINMENT IN POOREST AREAS PROMOTE HEALTHIER LIFESTYLES IN THE WORKPLACE Develop pathways for people with mental health problems on incapacity benefit for return to work Develop programmes for people who have been out of work for more than five years Continue economic development agenda to create more jobs Join up return to work agenda with adult education Why should we do these things (Evidence/Nice Guidance) Evidence suggests that increasing pay and qualifications contributes to a good quality early years workforce which in turn has a positive impact on health outcomes. From the 10 core components that protects good health and promotes health- the three most effective areas to focus on are – reducing physical and chemical hazards and injuries at work: Shift work and other work time factors Improving the psychosocial environment. Combining changes to the work environment with healthy lifestyle interventions increases changes in health adopting Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? behaviours across the social gradient. Ensure Healthy Standard of living for all What does the JSNA say? What should we and partners do REDUCE CHILD POVERTY IN THE CITY REDUCE INEQUALITIES IN HEALTH FACED BY COMMUNITIES OF INTEREST AND IDENTITY IMPROVE THE EMPLOYMENT PROSPECTS OF THOSE WITH DISABILITIES In addition to the interventions above and below: Ensure a specific plan for health inequalities is implemented Increase the educational attainment of the City’s children and young people Continue with inward investment and economic renewal strategies Why should we do these things (Evidence/Nice Guidance) Citizens need to have a sufficient income to live a healthy life. Evidence suggests that social protection systems lead to better population health outcomes. Local initiatives that help support people with benefits advice and employment initiatives that guarantee minimum income have proven to be successful in helping people move into work. Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? Create and develop healthy sustainable homes and communities What does the JSNA say? What should we and partners do ENSURE DECENT HOMES FOR CITIZENS WITH A FOCUS ON PRIVATE SECTOR DELIVER A HEALTHIER AND SAFER ENVIRONMENT IMPROVING POPULATION MENTAL WELLBEING Using a Healthy Urban Development focus along the lines developed in Bristol and elsewhere Continue the health and climate change plan work to address extreme weather Ensure green space and environmental infrastructure is an essential part of development plans Improve public realm especially streetscapes for cycling and safety for older people (Cochrane systematic reviews on this) including traffic calming in hotspots Reduce dependency on cars and a shift to public transport Ensure a high quality Why should we do these things (Evidence/Nice Guidance) NICE guidance reports that an integrated approach between policies that impact on the climate and policies that create healthier communities with a focus on addressing health inequalities Interventions need to both improve road safety as well as increase physical activity.(NICE) Well maintained and good street lighting of pavements and footpaths, with cycling paths increases number of walkers and cyclist. Targeted traffic calming zones and pedestrian crossing can help reduce inequalities in road injuries in deaths. Targeting should not be just based on high accident prone areas but based on deprived residential areas Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? public realm which is safe and secure, starting with most deprived areas Continue work on housing decency especially energy efficiency and target homes with children in poverty Work with business s and economic development to improve choice of healthy food Work with business on a local health responsibility deal for healthy living Food access programme to improve coverage of healthy food across the city Continue healthy catering awards for schools and caterers focusing on deprived areas and areas of a higher density of older population. Access to good quality green space has positive impact on both physical and mental health and wellbeing. Some evidence suggests that the proximity or lack of access to unhealthy food contributes to obesity or malnutrition. Relationship with poor housing and health is well evidenced. Improvements in housing conditions have a number of positive impacts on health. Addressing fuel poverty will improve health outcomes, especially when targeted at those living in private rented or owner occupied tenures. Area based initiatives have demonstrated some limited successes, strategic input and long term commitment to such programmes is recommended interventions need to both improve road safety as well as increase physical activity.(NICE) Well maintained and good street lighting of pavements and footpaths, with cycling paths increases number of walkers and cyclist. Access to good quality green space has positive impact on both physical and mental health and wellbeing. Some evidence suggests that the proximity or lack of access to unhealthy food contributes to obesity or malnutrition. Relationship with poor housing and health is well evidenced. Improvements in housing conditions have a number of positive impacts on health. Initiatives include warm front, decent homes programme and programmes to address fuel poverty can contribute to improvements in health and wellbeing. Initiatives including warm front, decent homes programme and Addressing fuel poverty will improve health outcomes, especially when targeted at those programmes to address fuel poverty need ongoing investment particularly in the private rented sector. living in private rented or owner occupied tenures. Evidence suggests that including communities and individuals in the design of interventions that tackle social isolation at a local level helps improve the effectiveness of those interventions. Area based initiatives have demonstrated some limited successes, strategic input and long term commitment to such programmes is recommended. Strengthen the role and impact of ill Health prevention What does the JSNA say? What should we and partners do REDUCE THE BURDEN OF PREVENTABLE NONCOMMUNICABLE DISEASE INCLUDING HARM FROM TOBACCO, ALCOHOL AND DRUGS IMPROVING MENTAL WELLBEING SUPPORT CARERS In addition to interventions above Ensure primary care screens adults of working age early for noncommunicable disease risk Develop a pathway with strong behavioural science input for people identified at increased risk Identify and target young people who are obese or who smoke for early intervention Use an intelligence led approach to target those with ill health most at risk of avoidable hospitalisation for selfmanagement programmes Invest in self- Why should we do these things (Evidence/Nice Guidance) Citizens need to have a sufficient income to live a healthy life. Evidence suggests that social protection systems lead to better population health outcomes. Local initiatives that help support people with benefits advice and employment initiatives that guarantee minimum income have proven to be successful in helping people move into work. Integrated approach between those policies that impact on the climate and policies that create healthier communities – with a focus on addressing health inequalities Interventions need to both improve road safety as well as increase physical activity.(NICE) Improved cycling infrastructure Are these priorities broadly right for Birmingham? YES / NO COMMENTS – What have we missed? management programmes which have higher behavioural science content Continue with fuel poverty, winter warmth and environmental agendas especially in more populated areas increases the number of cyclists and number of cycling trips. Well maintained and good street lighting of pavements and footpaths, with cycling paths increases number of walkers and cyclist. Targeted traffic calming zones and pedestrian crossing can help reduce inequalities in road injuries in deaths. Targeting should not be just based on high accident prone areas but based on deprived residential areas and also with regards to higher density of older population. Access to good quality green space has positive impact on both physical and mental health and wellbeing. Some evidence suggests that the proximity or lack of access to unhealthy food contributes to obesity or malnutrition. Relationship with poor housing and health is well evidenced. Improvements in housing conditions have a number of positive impacts on health. Initiatives include warm front, decent homes programme and programmes to address fuel poverty can contribute to improvements in health and wellbeing. Addressing fuel poverty will improve health outcomes, especially when targeted at those living in private rented or owner occupied tenures. Evidence suggests that including communities and individuals in the design of interventions that tackle social isolation at a local level helps improve the effectiveness of those interventions. Area based initiatives have demonstrated some limited successes, strategic input and long term commitment to such programmes is recommended. What happens next? This document is an introduction to the priority areas we think we need to focus on first. We need to continue developing a final strategy which explains how, as well as what, we will focus on, and which incorporates the views of people who live in Birmingham. To do so, we will: Listen to your feedback Write up a final version of the health and wellbeing strategy Have conversations with key organisations and partner agencies about how we might deliver improvements in health and wellbeing in these areas – and how we will measure those improvements Publish the final strategy in the late summer 2012 Continue to talk to you about the health and wellbeing issues that matter to you The table below shows the timeline we are working to Joint Health and Wellbeing Strategy consultation TIMELINE Who are we looking to work with What are we working with them on WHEN HOW 3rd Sector Organisations JSNA 6 events March 2012 Conferences x 4 JHWBS Overview Lead commissioners in statutory agencies JSNA Overview Template JHWB /partners/teachers/3rd 22nd April 2012 Event (140 people BHWB Partnership attended) Summit Draft JHWBS Sector organisations/community Indicator Scrutiny groups CCG’s Link to the JSNA Overview Key headings of the JHWBS Thursday 21st June Email CCG Link to draft JWWBS 5th July 2012 Email PH Consultants Draft 5th July 2012 Email Marmot champions Draft 5th July 2012 Email Cllr Bedser Draft 5th July 2012 Email 5th July 2012 Email 31st July 2012 Panel 2nd week of July to end of July . Faith Groups and LGBT groups done initially in March and April and June to develop proposals. Focus Groups Lead Councillors Draft Peoples Panel Peoples Panel (40 attendees) EINA groups include; Draft and Consultation document age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex, sexual orientation Golden Age – Older African Caribbean women One Stop – Older Irish/white women in Perry Barr Mothers and mothers to be – Pakistani/Bengali women in Sparkbrook Working Well and 3rd Sector – Aston, Lozells, Newtown Birmingham and Solihull Cluster Stakeholders Draft and consultation Document 2nd week of July Email Established groups Meetings Draft and consultation document 2nd Week July to August Attendance at existing meetings Established engagement groups, Community Connectors, Community researchers. Patient Network Groups Draft and consultation document 2nd week July to August Focus Groups Digital Presence Draft on websites BVSC plus newsletter Digital www.bhwbb.net Lead commissioners /partners/teachers/3rd Sector organisations Draft 12 July 2012 BHWB Partnership Summit on Wellbeing
© Copyright 2026 Paperzz