Cheshire West & Chester Council
Health and Wellbeing
Strategy
2015-2020
Visit: cheshirewestandchester.gov.uk
Visit: cheshirewestandchester.gov.uk
02 Cheshire West and Chester Council Health and Wellbeing Strategy
Contents
Foreword
3
Strategy
4
Introduction and background
5
Where are we now?
6
Our vision
7
Our principles
8
Our approach to improving health and wellbeing
8
Priority 1: Starting Well
9
Priority 2: Living Well
9
Priority 3: Mental Health and Wellbeing
10
Priority 4: Ageing Well
10
Performance framework for the strategy
11
Conclusion
11
Cheshire West and Chester Council Health and Wellbeing Strategy 03
Health and Wellbeing Strategy
Foreword
We are delighted to present Cheshire West and Chester’s second Health and Wellbeing
Strategy, which covers the years 2015-2020. In it, we recognise that our health and
wellbeing is fundamentally affected by conditions outside of the healthcare setting,
including the social, economic and environmental conditions in which we work, live
and play.
.................................................................................................................................................
The strategy marks a new era for health and wellbeing
in the borough. It is intended to be a starting point for
action which we will build on over time. It sets out the
first steps we need to take to bring about real
improvements that will change lives for the better.
As the Council’s public health function develops, this
strategy will evolve, taking account of any lessons
learned along the way and ensuring that the priorities
continually meet local need and opinion.
We believe that this strategy can only be effective by
working in partnership with local people. Therefore,
throughout its development, we have consulted with
a wide range of residents across Cheshire West and
Chester through an extensive community engagement
process. The views and recommendations raised by
those involved have - along with a sound evidence
base - shaped the principles and priorities of our Health
and Wellbeing Strategy.
Councillor Sam Dixon
Chair, Health and Wellbeing Board
Leader of Cheshire West and
Chester Council
We are committed to ensuring that engagement
is ongoing and we will continue to listen to the
views of local people in developing and shaping our
action plans.
The Health and Wellbeing Board and the strategy bring
together leaders from key organisations to enable
change for the better. This document explains what
we are trying to achieve, focusing on our priorities and
how we will make a difference. This is the first step
in a bold vision to achieve change and progress through
integration and collaboration.
Cheshire West and Chester can and should be a
place where everyone can lead a healthy and fulfilling
life - and everything we do must aspire to improving
the health and wellbeing of everyone.
Councillor Louise Gittins
Deputy Leader and Cabinet
Member for Culture Leisure
and Wellbeing
04 Cheshire West and Chester Council Health and Wellbeing Strategy
Strategy
Cheshire West and Chester Council 05
Health and Wellbeing Strategy
Introduction and background
This Health and Wellbeing Strategy sets out the
strategic framework for improving health and reducing
inequalities across Cheshire West and Chester. It builds
on the work of the local organisations that form the
Health and Wellbeing Board and is a result of our
shared commitment to making the borough an even
more healthy, vibrant and resilient place to live.
The emphasis in this strategy is on prevention,
improved coordination and integration of health and
social care. This vision will be achieved through
effective leadership of the Board, in collaboration with
our partners, including the residents of the borough.
The strategy will help us make better decisions
about how we:
•
Influence the wider determinants of health
and wellbeing through our partnership and
local organisations.
•
Use our existing assets and resources.
•
Design and provide services.
•
Encourage service providers to work together.
Each of our partner organisations has strategies and
action plans to address health and wellbeing needs.
We believe that the value of our role as a Health and
Wellbeing Board - and of this strategy - is in working
together as a network over several years, not just in
one financial year. The aim of the strategy is not to
provide an extensive list of initiatives that partners
will implement to promote better health; rather it
focuses on the most complex and critical needs of
our residents. It will be evaluated and updated on a
regular basis in the light of progress, feedback and the
evolving needs of our communities.
The current state of the economy makes our ambition
for health and wellbeing even more pressing.
Increasing unemployment, falling incomes and rises in
the cost of food, fuel and services are creating
additional challenges to people’s health and wellbeing.
We need to support the resilience of people, so that
they can withstand the recession and support and
maintain individual and community mental wellbeing.
The Health and Wellbeing Board therefore faces the
challenge of responding to the priorities in this strategy
during difficult financial times.
This will require the Council and its partners to think
differently about how the priorities are delivered and
how care is commissioned locally. This includes a shift
away from care in hospitals towards a more
preventative approach that promotes self-care and is
much more personalised and coordinated around the
needs of the individual. The Health and Wellbeing
Board will deliver this change through strong local
leadership across the NHS, public health and social care
and by jointly planning and delivering services.
Joint Strategic Needs Assessment (JSNA)
Whilst mindful of national plans and priorities, we
have built this strategy to address the key priorities in
Cheshire West and Chester’s Joint Strategic Needs
Assessment (JSNA), along with those highlighted in
consultation with residents and partners. The JSNA
is a process undertaken jointly by the council and its
partners. Information on the health and wellbeing
of people living in Cheshire West and Chester, for
example their care needs and key wider factors
(including housing and employment) can be viewed
at: www.cheshirewestandchester.gov.uk/JSNA
Our JSNA shows a number of key health and wellbeing
priorities. The Health and Wellbeing Board, its member
organisations and key partners will focus on improving
health and wellbeing outcomes. Each partner will lead
specific actions in relation to each of these priorities
and embed the strategy priorities into their own
organisations, ensuring their commissioning and
delivery plans reflect the priorities and approaches for
working agreed within this strategy.
Specific challenges highlighted include:
•
The health inequalities facing those living within
our most disadvantaged communities.
•
An increasing proportion of older people - a large
proportion of whom have complex needs.
•
The increase in unhealthy lifestyles leading to
preventable diseases and early death.
•
The need to ensure access to services for
vulnerable groups including those living with
mental ill health, physical disabilities, and / or
learning disabilities, children living in care, gypsies
and travellers and the lesbian, gay, bisexual and
transgender community.
06 Cheshire West and Chester Council Health and Wellbeing Strategy
Where are we now?
The health of our children is important in order to
support the best start in life.
Cheshire West and Chester has a population of
approximately 332,200 and covers 350 square miles.
It includes the historic city of Chester and the industrial
and market towns of Ellesmere Port, Frodsham, Helsby,
Malpas, Neston, Northwich and Winsford. About a
third of the population lives in rural areas. According to
the government’s ‘Indices of Deprivation’, the overall
quality of life is good for many residents. However,
there are places where some communities experience
multiple disadvantage.
•
Breastfeeding rates are lower than the England
average. Three out of ten mothers do not
breastfeed their babies at birth and a further three
out of ten mothers have given up by six to eight
weeks.
•
Almost one in four children (23.1%) in their school
reception year are either overweight or obese,
slightly higher than the England average of 21.9%.
•
One in three children (32.3%) aged 10-11 are
either overweight or obese, similar to the England
average of 33.2%.
In Cheshire West and Chester, 54,197 residents live in
the 20% most deprived areas (ranked nationally); and
102,684 residents live in the 40% most deprived areas
(ranked nationally).
Our population has an ageing profile, with the number
of residents aged over 65 expected to increase by over
50 per cent by 2029 and those over 85 will more than
double.
Key lifestyle issues facing us locally are smoking,
unhealthy weight, physical activity and substance
misuse.
•
Smoking levels have fallen markedly in recent
decades but our smoking rates are higher than the
England average. One in five of our adults are
current smokers.
•
Almost half of Cheshire West and Chester’s adults
do not exercise enough.
•
Estimated levels of adult excess weight (64.6%) are
the same as the England average (64.6%).
•
Estimates indicate that a higher percentage of
residents aged 16 and over drink alcohol compared
to the England average.
Life expectancy in Cheshire West and Chester is
similar to the England average but there is variation
across the borough.
•
Male life expectancy is 79.2 years compared to
79.4 years in England.
•
Female life expectancy is 83.3 years compared to
83.1 years in England.
•
Life expectancy is 10.1 years lower for men and
7.9 years lower for women in the most deprived
areas of Cheshire West and Chester than in the
least deprived areas.
•
Heart disease and cancer are the key diseases that
contribute to inequalities for men. Cancer,
particularly lung cancer, is important for women.
Over the next 10 years there will be a rise in the
number of people aged over 65 years.
•
Injuries due to falls in people aged 65 and over are
significantly higher than the England average.
•
13.2% of households consist of a resident aged
65 plus living alone.
•
There are around 170 excess winter deaths each
year. Almost 40% of our excess winter deaths are
people aged 85 and over.
Cheshire West and Chester Council 07
Health and Wellbeing Strategy
Our vision
Our vision for this strategy is:
‘to reduce health inequalities and improve the health and wellbeing of people in the borough, enabling our
residents to live more fulfilling, independent and healthy lives. We will do this by working with communities and
residents to improve opportunities for all to have a healthy, safe and fulfilling life’.
Outcomes related to our priorities include:
08 Cheshire West and Chester Council Health and Wellbeing Strategy
Our principles
1. Outcomes-focused
The Health and Wellbeing Board will work in partnership to tackle the underlying causes of poor health and wellbeing in the
borough. We will monitor the impact that the strategy has on people’s lives: the outcomes that we want to achieve are listed on
page 7.
2. Emphasis on local action
The strategy has been developed with, and shaped by, local people and communities. Involving our residents helps us better
understand the issues affecting them. Individuals who use services know what needs to be done to improve them and should
have a say on where, when and how they are delivered.
3. Innovation
We will find new ways of working that will serve people better. We will develop new models of service delivery through best
practice and being creative, working across the health and social care system.
Our approach to improving health and wellbeing
1. Reducing health inequalities
3. Partnership working
Cheshire West and Chester is often
viewed as affluent and prosperous, but
there are parts of our borough that are
not. Our goal is to ensure that we
improve the health and wellbeing of
all our residents, but with extra efforts
focused on where they are needed
most.
Health and wellbeing issues should not
been seen in isolation and it is
important that we address the wider
agenda, including housing, education,
employment, leisure and recreation.
2. Prevention and early detection
We know that prevention, early
detection and intervening early leads
to much better health and wellbeing
results. Prevention and early
intervention can happen at any time
during a person’s life, so we must build
both into all our plans for the priorities
outlined in this strategy.
The needs of our residents are
managed by a wide variety of
organisations in the public, voluntary
and community sectors. Many of the
challenges are shared and require
shared solutions.
4. Evidence base
Decisions about services and
programmes should be based upon the
best available information and our
strategy is based on our knowledge of
local need as shown in the Joint
Strategic Needs Assessment.
This ensures we focus on the most
significant health and wellbeing needs
in the borough, making best use of
resources, providing people with the
best possible services and support.
5. Personal responsibility and
empowerment
We want to develop a health and care
system which emphasises prevention
and health promotion, and empowers
people to improve their own, and their
families’ health and wellbeing. We will
encourage people to take
responsibility for making their own
healthy choices.
CHESHIRE WEST AND CHESTER
Cheshire West and Chester Council 09
Health and Wellbeing Strategy
Priority 1: Starting Well
Why is this a priority for Cheshire West and
Chester?
Giving every child the best start in life and supporting
children and young people, together with their
families and carers, to realise their full potential, is
key to reducing inequalities.
In Cheshire West and Chester we want to create an
environment that ensures children and young people
have the best start in life, are ready to start school,
and are able to thrive and develop skills to enable
them to live well. We want to ensure that every
child and young person grows up in a safe environment
that enables them to achieve their full potential.
Outcomes
Every child and young person has the best start in life.
Many factors combine together to affect the health of
individuals and communities. Factors such as our
income and education level, our employment, the
environment in which we live and our relationships
with friends and family all have considerable impacts
on our health, as well as the more commonly
considered factors such as access to, and use of health
care services.
Local authorities, health services and others can
do much to support and promote healthy lives. In
Cheshire West and Chester we want to create an
environment that enables people to lead more
healthy lifestyles and to make the healthy choice
the easy choice. We want to ensure individuals are
engaged and able to participate.
Outcomes
People have healthier lifestyles.
Indicators
Indicators
1. Percentage of adults over 18 that smoke.
1. Percentage of children achieving a good level of
development at the end of reception.
2. Excess weight in adults.
2. Breastfeeding rates.
3. Excess weight in 4-5 and 10-11 year olds.
4. Hospital admissions caused by unintentional and
deliberate injuries in children aged 0-14 years.
3. Physical activity in adults.
4. Rate of alcohol related admissions to hospital.
5. Successful completion of drug treatment.
6. Number of households in fuel poverty.
5. Emotional wellbeing of looked after children.
7. Killed and seriously injured (KSI) road casualties.
6. Safeguarding referrals.
8. Air quality.
7. Local 16-18 year olds not in education,
employment or training (NEET).
9. People manage their own support as much as
they wish.
Priority 2: Living Well
Why is this a priority for Cheshire West and
Chester?
Health and wellbeing is influenced by a wide range of
social, economic and environmental factors, some
of which are influenced by large-scale universal trends
and others by individual behaviour.
10. Carers can balance their caring roles and maintain
their desired quality of life.
11. Number of properties achieving the decency
standard.
12. Percentage of children achieving five GCSEs at
grade C and above including Maths and English.
13. Proportion of adults with learning disabilities in
employment.
10 Cheshire West and Chester Council Health and Wellbeing Strategy
Priority 3: Mental Health
and Wellbeing
Priority 4: Ageing Well
Why is this a priority for Cheshire West and Chester?
Why is this a priority for Cheshire West and Chester?
Our mental health is as important as our physical health. Poor
mental health and wellbeing, including social isolation and
loneliness and the stigma that surrounds these conditions,
presents one of the biggest burdens of ill health for the
people of Cheshire West and Chester. Within the borough,
the prevalence of diagnosed depression is higher than the
England average and one in ten children aged 5-16 years has
a mental health issue.
Cheshire West and Chester has a high proportion of people in
their 50s and 60s (27%), compared to England (24%).
Around 19% of our residents are over the age of 65
compared with England (16%).
Even more are suffering from emotional and behavioural
problems. A wide range of factors affect the mental health
and wellbeing of children and young people, including
deprivation, parenting style and adverse peer influences such
as bullying. Early diagnosis of mental health conditions is
important so that people can receive the appropriate support
or treatment.
Indicators
Outcomes
Older people live healthier and more independent lives,
feel supported and have a good quality of life.
1. Health related quality of life for older people.
2. Number of hip fractures.
3. Excess winter deaths in the over 85s.
Outcomes
4. Permanent admissions to residential and nursing care
homes per 100,000 population.
Improved mental health, wellbeing and personal resilience
where mental health is valued equally with physical health.
5. Injuries due to falls.
Indicators
1. Diagnosed depression in adults.
2. Number of children known to services with a mental
health condition.
3. Proportion of adult social care users who have as much
social contact as they would like.
4. Proportion of adult social carers who have as much
social contact as they would like.
5. Number of people who recover following the use of
psychological therapy.
6. Proportion of adults in contact with secondary mental
health services living independently.
7. Proportion of adults in contact with secondary mental
health services in employment.
8. Suicide rate.
6. Proportion of people feeling supported to manage
their condition.
7. Proportion of older people (65 and over) who were
still at home 91 days after discharge from hospital
into reablement/rehabilitation service.
Cheshire West and Chester Council 11
Health and Wellbeing Strategy
Performance framework for
the strategy
•
Joint Scorecard
Key statistical data monitored regularly by the
Health and Wellbeing Board.
•
Exception reporting
Statistical data which is escalated to the Health and
Wellbeing Board requiring review and action.
•
Health and wellbeing partnerships updates
A report will be presented at every Health and
Wellbeing Board meeting, bringing together
updates from across the Health and Wellbeing
Partnerships.
•
Themed discussions
An external speaker will challenge the Health and
Wellbeing Board to take action on key issues.
•
Peer review
An evaluation by a group of external Health and
Wellbeing Board representatives to improve
and enhance performance and share learning.
•
The voices of local people and wider
partnership
There will be regular opportunities for groups and
communities to feedback their own views and
experiences.
Conclusion
This strategy sets out our ambition to deliver real
improvements to health and wellbeing and reduce
health inequalities across Cheshire West and Chester.
The focus on prevention will enable more people to
live healthier, more active and fulfilling lives, and
provide a greater proportion of resources to support
the most vulnerable and needy people living in our
borough. Whilst some of the challenges identified will
respond to shorter term actions, others will take
much longer to change. The Health and Wellbeing
Board will be mindful of the varying timeframes
relating to different priorities set out in this strategy.
The strategy will develop over the coming years as
goals are achieved and circumstances change. To
reflect this and stay relevant, the strategy will be
refreshed annually. We will seek to continually involve
local people, groups and organisations. Key indicators
for success will be identified and action plans will be
developed to support the delivery of the outcomes.
The indicators identified will use existing performance
measures which align to the outcomes identified within
the strategy. The Health and Wellbeing Board will
review the action plan and the outcome measures at
least annually.
CHESHIRE WEST AND CHESTER