Helping You to Stay Healthy in Telford and Wrekin

Helping You to Stay Healthy in Telford and Wrekin

The Annual Report of the Director of Public Healthfor Telford and Wrekin 2010/11

Contents

1

PageNumber

Introduction 2

TechnicalNotes 4

Acknowledgements 5

ImprovingLifestyleSupportServices:GettingHealthy,StayingHealthy 6

ReducingtheHealthBurdenofSmoking 8

WeightManagementServices:AddressingObesity 14

Implementingthe“HealthCheck”Programme 18

EarlyCancerDetection:TheBreast,BowelandCervical 21CancerScreeningProgrammes

Immunisation:ProtectionAgainstInfectiousDisease 25

WorkinginPartnershipwithLocalCommunities:CommunitiesforHealth 27

WorkinginPartnershipwithPeople:PeerSupportProgrammes 29

WorkinginPartnershipwithTelfordandWrekinCouncil: 36HealthThroughWarmth

WorkinginPartnershipwithTelfordandWrekinCouncil: 37Let’sCookTogether

WorkinginPartnershipwithTelfordandWrekinCouncil: 39HealthySchools

WorkinginPartnershipwithTelfordandWrekinCouncil: 41HealthyStart

Introduction

2

Welcometothe2010/11PublicHealthReportforTelfordandWrekin.

Thereportpresentsanumberofkeyhealthmessagesanddescribesjustsomeoftheworkwhichisgoingontoimprovethehealthoflocalpeople.Muchofthisworkdependsongoodpartnershipworkingatanumberoflevels,whichisalsodemonstratedinthereport.FurtherinformationaboutthehealthstatusofthepopulationofTelfordandWrekincanbefoundinthelocalJointStrategicNeedsAssessment.

ThesuiteofJSNAdocumentsisavailableat:http://www.telford.nhs.uk/About-the-PCT/PublicationsBoard-Papers/Publications/

InTelfordandWrekin:

• Peoplearelivinglonger–menarelivingover4yearslongerthantheywerein1991,womenarelivingnearly3yearslonger.Weareworkinghardtotryandmakesurethatthesepreciousextrayearsoflifeareashealthyaspossibletoo

• Relatedtothis,prematuremortalityrates(deathsbefore75years) fromcirculatorydiseaseandanumberofcommoncancersareimproving

• Hospitaladmissionratesforalcohol-relatedharmareimproving.Alcohol-relatedharmwastheonlyissueIconsideredinmy2006/7report;thereportwentontoprovidethebasisforacomprehensivejointstrategyagreedbetweenpartneragencies,includingTelfordandWrekinCouncilandthePCT

• Breastfeedingratesareimproving

• Thereisrecentevidencethatoursmokingcessationservicesarebecomingmoresuccessfulinhelpingpeopletoquitsmoking–althoughprogressonsmokingprevalenceatpopulationlevelremainspainfullyslow

Trend in All-Age All-Cause Mortality in Telford and Wrekin

Key Message for Telford and Wrekin

• Theallage,allcausemortalityratehasbeendecliningsteadilyinTelfordandWrekinoverthelast15years

Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk)

144 133 142 132 136 132 132 121 124 122 118 116 111 107 105 1010

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Introduction

3

Thisyear,Ihavedecidedtomakeonlyonerecommendationforactionanditisinrelationtosmoking.Iremainextremelyconcernedabouttheharmbeingdonetotheirbabiesbymotherswhocontinuetosmokeduringtheirpregnancy.Overall,around23%ofmothersinTelfordandWrekinsmokethroughouttheirpregnancy,althoughsmokingratesareevenhigheramongstyoungerwomen.Despitemucheffort,includingatriallocalincentivescheme,maternalsmokingrateshavechangedlittle,ifat-all,overrecentyears.Ithereforerecommendthat:

As the basis for future action, there should be a comprehensive improvement review of local arrangements to address maternal smoking. This should be led by the PCT, but include a wide range of local partner agencies, including Shrewsbury and Telford Hospitals NHS Trust, and service users

I would be pleased to receive comments on the report, including suggestions for improvement([email protected]). As ever, I hope that you will find the report clear, informative andstimulating.

DrCatherineWoodwardDirectorofHealthImprovementMay2011

Technical Notes

4

Technicalbackgroundhasbeenkepttoaminimumanddatasourcesandrelevantweblinksarereferenced.Ingeneral,comparisonsaremadebetweenTelfordandWrekinPCTandthenational(England)position.Population figures are based on the NHS Telford and Wrekin Patient Register or the mid-year population estimates of the Office for National Statistics. Where appropriate, population rates are age and/or sex standardised,thatis,adjustedtoensurethatdifferencesinageandgenderaretakenintoaccountwhencomparinghealthexperienceacrossdifferentpopulations.

Some of the analyses are based on levels of socio-economic deprivation groups based measuredthroughthe IndexofMultipleDeprivation2007 (IMD2007).This indexuses37variablesmeasuredat‘superoutputarea’,whicharesmallgeographicalareaswithanaveragepopulationof1,500people(asdefined by the 2001 Census). There are 108 of these super output areas in Telford and Wrekin, giving, on average, three super output areas per ward. To measure inequalities, the super output areas aretypicallyaggregatedinto20%bandingsorquintiles,accordingtotheircompositeIMD2007score.Someanalysesalsoencompassrankinggeneralpracticesaccordingtotherelativelevelsofoveralldeprivationexperiencedbythepopulationtheyserve,asmeasuredbyIMD2007.Mosaicanalysesarealsousedasawayofsegmentingthepopulationintosmallgroups,basedonsimilarcharacteristics.Thistypeoftoolis particularly useful as it embraces a range of marketing and consumer data, such as financial status and lifestylehabits,soaddsvaluebeyondroutinehealthanddemographicinformation.

Someanalyses,particularlyforindividualdiseaseconditions,arebasedonsmallnumbers.Thisgeneratesuncertaintyaboutthetruevalueofthevariableinquestionandincreasestheprobabilitythatanydifferencesobservedbetweenthepopulationgroupsoccurbychance.Toincreasereliability,observationsforoneyear are combined to produce three or five year rolling averages and/or 95% confidence intervals are displayedtoindicatetherangewithinwhichthetruevalueoftheindicatorlies,atthatlevelofcertainty.

Whilsteveryattempthasbeenmadetoensurethequalityandaccuracyofstatisticspresentedinthis report, it is unavoidable that certain figures may subsequently be subject to update, rebasing or revision.

Acknowledgements

5

As final editor of the report, I am ultimately responsible for its content, including any errors or omissions. ParticularthanksgotoHelenOnionsforherexpertiseandadviceinproducingthereport.ThanksalsogotoVictoriaOliverforherhelpindocumentproduction.

Iwouldalsoliketothankthefollowingpeoplewhocontributedinformation,textand/orsuggestions:

HelenBlinston PublicHealthIntelligenceAnalyst NHSTelfordandWrekinSarahEvans HealthImprovementCommissioner NHSTelfordandWrekinClareHarland HealthImprovementCommissioner NHSTelfordandWrekinJacquiMaddox TrainingSupervisor-EducationCateringServices TelfordandWrekinCouncilLouiseMills HeadofHealthInequalitiesandLifestyle NHSTelfordandWrekinHelenOnions SeniorPublicHealthSpecialist NHSTelfordandWrekinVickiPike HealthImprovementCommissioner NHSTelfordandWrekinSarahRock BreastfeedingCo-ordinator NHSTelfordandWrekinKateSumner CleaningServicesManager TelfordandWrekinCouncilSallyTyas SeniorManagerHealthySchools TelfordandWrekinCouncilChrisWeiner ConsultantinPublicHealth NHSTelfordandWrekinChrisHolmes Photographer MetroPhotographic

The report makes many references to the JSNA (Joint Strategic Needs Assessment) for Telford andWrekin.FurtherinformationontheJSNAisavailablefromHelenOnions,SeniorPublicHealthSpecialistatthePCT(01952580382)orJonPower,DeliveryandPlanningManageratTelford&WrekinCouncil(01952380141).

ThesuiteofJSNAdocumentsareavailableat:http://www.telford.nhs.uk/About-the-PCT/PublicationsBoard-Papers/Publications/

Improving Lifestyle Support Services: Getting Healthy, Staying Healthy

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“Getting Healthy, Staying Healthy” is a programme of work which builds on local experience in thecommissioningandprovisionoflifestyleriskmanagementservices.TheoverallvisionisforthepopulationofTelfordandWrekintobebetterempoweredtomake informedchoicesabouttheirhealthandwell-being,throughaccesstohealthinformationandhighqualityservicestailoredtotheirneeds.Avitalpartofthepathwayredesignisaroundsupportingtheneedsofpeoplewithlong-termconditions.

Ensuring meaningful engagement with patients and the public has been an integral part of the workprogramme. The public health team has conducted insight work to explore public awareness andunderstandingofhealthylifestyles,currenthealthstatus,theavailabilityofinformationandviewsonan“idealservice”.

Using a population segmentation approach (MOSAIC), two target groups were identified as the focus for thepublicinsightresearch:vulnerableyoungparentsneedingsubstantialstatesupportandolderfamiliesliving in low value housing in traditional industrial areas. Adults at risk of poor health and previouslyunknowntolifestyleriskmanagementserviceswerethenrecruitedfromtargetedresidentialareasandinvited to attend focus group sessions. Although eventual numbers were quite low, this was the first timethatthisgroupofpeoplehadbeensuccessfullyconsultedinthiswayinTelfordandWrekin.Thoseinterviewedhighlightedthreemainbarrierstoadoptingahealthylifestyle:notacceptingtheneedtochangetheir current lifestyle, maintaining motivation and finding it difficult to understand and use information to makeinformeddecisionsabouttheirownhealthandthehealthoftheirfamily.

Findings

• Not accepting the need to change

Manyoftheparticipantsreportedbeingcontentanddidnotwanttochangethewaytheylivedtheirlives.Respondentswerehappytocontinuesmoking,drinkingandgraduallyputtingonweightandwereunabletomakethelinksbetweentherisksofleadinganunhealthylifestyleandhowlongtheywerelikelytoliveingoodhealth.

• Maintaining motivation

Reflecting on past experiences, all respondents felt that maintaining motivation to make a lifestyle changehadbeenachallenge.Alackofmotivationhadpreventedthemajorityfromachievingtheirlifestylegoals.Thosewhohadpreviouslyembarkedonajourneytochangetheirlifestylehadsincestoppedanddescribedpressuresinlifethathadtakenprecedence,toapointthattheirhealthwasnolongerapriority.Formany,smokinganddietingappearedtobecyclicalactivities.Severalpeoplefelttheyhadnotputintherequiredtimeandefforttochangingtheirlifestyle.

• Lack of awareness and understanding

Severalpeoplewereconfusedbyhealthinformationandsomeparticularnationalcampaigns.Forthemajority,confusionand‘mixedmessages’resultedinnoactionbeingtakentoimprovetheirlifestyle.

• An ideal lifestyle service

Peopledescribedthecharacteristicsofan“ideal”serviceas:

- A‘single’service,throughwhichmultiplelifestyleissuesareaddressed–butwithaconsistentpointofcontact,suchasa‘personalcoach’

- Focusedonthe‘feelgood’factorandpromotedasaserviceforeveryone

- Neighbourhood-based

Improving Lifestyle Support Services: Getting Healthy, Staying Healthy

7

- EndorsedbyGPs

- Deliveredbypeople,whofromtheirownexperiencescanbeempatheticwiththeserviceuser(seethesectioninthereportonpeersupportservices)

- Deliveredthroughmultiplemediaandavailable(insomeform)24hours,7daysaweek

- Tailoredtotheindividual,withrealistictargetsandregularfeedback

The findings from this consultation are being used, along with perspectives from clinicians and partner agencies,toinformserviceimprovementprojects.Areasoffocusincludeservicesforsmokingcessation,reducingalcoholconsumption,reducingobesityandincreasinglevelsofphysicalactivity.AsinglepointofaccessforlifestyleserviceswillbepilotedfromJanuary2011,inpartnershipwithTelfordandWrekinCouncil.

Contactdetails:

LouiseMillsHeadofHealthInequalitiesandLifestyleNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580390Email:[email protected]

Trend in Hospital Admission Rates from Alcohol-Related Harm

Key Messages for Telford and Wrekin• Hospitaladmissionrates

fromalcohol-relatedharmhaveimprovedoverthelastthreeyearsinTelfordandWrekin

• 47%ofhospitaladmissionsforalcohol-relatedharmareduetocardiovascular(circulatory)disease;mostofthesearerelatedtohypertension(highbloodpressure)

Source: North West Public Health Observatory Local Authority Alcohol Profiles http://www.nwph.net/alcohol

855 1,097 1,290 1,476 1,3851,445 1,568 1,5430

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Reducing the Health Burden of Smoking

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FromtheJointStrategicNeedsAssessment(JSNA)forTelfordandWrekin,weknowthat:

• TheprevalenceofsmokinginadultsinTelfordandWrekinis25%(morethan33,800smokersaged16yearsandover)

• Smoking-related mortality is statistically significantly worse than the national average for England, withanestimated235deaths(ofadultsaged35yearsandover)everyyearattributedtosmoking-relateddisease

• Onaverage,1,400smokersquitsmokingeveryyearinTelfordandWrekinandtherateof4-weeksmokingquittingis:

- Statistically significantly better than the national average for England - AmongstthebestoftheWestMidlandsPCTs

• Overhalf(51%)ofsmokerssettingadateremainquitafter4weeks,whichisstatisticallysignificantly better than the average for England (50%)

• Smokingcessationserviceuptakeratesincreasewithageuntil60.Thehighestratesareseeninthe 35-44 and 45-59 year age groups. Significantly lower smoking cessation uptake rates are seen inthoseunder35andolderthan60years

• Successfulquittingincreaseswithage,with41%ofsmokersagedunder35yearsquitat4weeks,comparedto65%ofsmokersaged60+years

• Althoughsmokersaged60yearsandoverhavethelowestuptakerateofsmokingcessationservices,theyarethemostsuccessfulquitters

• Amongstpregnantwomen,theprevalenceofsmokingatdelivery(23%)hasnotchangedsignificantly during the last five years. However, there has been a marked increase in the uptake of smokingcessationservicesinrecentyears,withthenumberofpregnantwomentreatedincreasingfrom37in2005/06to137in2009/10

• Thereareinequalitiesinsmokingduringpregnancyassociatedwithsocio-economicdeprivationandmaternalage:

- Almost a third (32%) of mothers from the most deprived fifth of areas are still smoking at delivery, compared to 8% in the most affluent fifth of areas

- Thehighestratesofsmokinginpregnancyareseeninyoungmothers,with34%ofunder20yearoldsand32%of20-24yearoldsstillsmokingatdelivery(equatingto240girlsagedunder25yearssmokingthroughouttheirpregnancy)


9

Why is it So Important to Stop Smoking?

Therearefew,ifany,moreimportantdecisionsanindividualcantakeabouttheirhealththantogiveupsmoking.

Researchhas shown that smokingcessation is the singlemost cost-effective life saving interventionprovidedbytheNHS.Aftertheageof35-40years,foreveryyearofcontinuedsmoking,apersonloses3monthsoflifeexpectancy.Onaverage,alifelongsmokerloses10yearsoflife.Researchalsoshowsthatpeoplearefourtimesmorelikelytoquitwithsupportfromastopsmokingservicethangoingitalone.

The table below shows that some of the health benefits from stopping smoking can occur quite quickly.

Time since Quitting Health Benefits

8 hours Nicotineandcarbonmonoxidelevelsinbloodreducebyhalf,oxygenlevelsreturntonormal.Circulationimproves.

24 hours Carbonmonoxideandnicotineeliminatedfromthebody

48 hours Theabilitytotasteandsmellimproves

1 month Appearanceimproves–skinlosesitsgreyishpallorandbecomeslesswrinkled

3 - 9 months Coughingandwheezingdeclines

1 year Riskofaheartattackreducesbyhalfcomparedtothatofasmoker

10 years Riskoflungcancerfallstoabouthalfthatofasmoker

15 years Riskofheartattackfallstothesameassomeonewhohasneversmoked

Source: http://smokefree.nhs.uk/

Trend in Premature Mortality from Lung Cancer

Key Messages for Telford and Wrekin• Prematuremortalityfrom

lungcancerhasbeenimprovingoverallinTelfordandWrekin

• Mostofthedeclinehasbeeninmalerates

• Thereisnownostatistically significant differencebetweenlungcancerprematuremortalityratesamongstmenandwomen

Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jsp

48 50 46 48 44 47 43 33 35 34 34 31 31 32 3046 45 50 44 42 33 330

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ThesmokingtargetsinTelfordandWrekinare:

• Foradults,toreduceoverallsmokingratesfrom26%in2002to21%orlessby2010andtoreducethesmokingprevalenceamongroutineandmanualsocialclassgroupsfrom31%in2002to26%orlessby2010

• Todelivera1%reduction,yearonyear,inthenumberofwomenwhosmokeduringpregnancy,theoverallaimbeingtohavenomorethan15%ofwomensmokingduringpregnancyby2010

These targets continue to be challenging. During the past 12 months, in order to deliver continuedimprovementinitsapproachtotobaccouse,NHSTelfordandWrekinhas:

• Openedupthelocalmarkettoadditionalstopsmokingproviders.ThisisaspartofaWestMidlandspilotschemetoincreaseaccesstostopsmokingservices

• DevelopedaQuality,Innovation,PreventionandProductivity(QIPP)work-streamtoreducetheNHScostsofmanagingsmoking-relateddisease

• Improvedthehospital-basedservice,toofferstopsmokingsupport,advice,educationandwithdrawalmanagementinterventionsbeforesurgicalintervention(“StopBeforeYourOp”)

During2009/10,thelocalstopsmokingserviceshelped2,826adultstosetaquitdateand1,432(51%)toachievesuccessfulquittingat4weeks.ThepopulationofTelfordandWrekinsmokersachievedthehighestquitrateintheWestMidlands.Thehospitalbasedstopsmokingservicehasdoubleditsactivitysince it first started. In 2009/10, 1,735 patients were referred to the service.

10

Trend in Smoking Quitters

Key Messages for Telford and Wrekin• Around19%ofalldeaths

areduetosmoking

• Themortalityrateforsmoking-attributableconditionsisstatisticallysignificantly worse than thenationalaverage

• Therateofsmokingquitters(per100,000totalpopulationaged16+years)hasbeenstatistically significantly betterthanthenationalaverage for the last five years

Source: The NHS Information Centre, Statistics on NHS Stop Smoking Services http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/nhs-stop-smoking-services

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Moreimportantly,peoplearenowbeingseenseveralweeksbeforetheiroperation,ratherthanafewdaysbefore,improvingthechancesofasuccessfulquitbeforethesurgeryhappens.

In2009/10,thestopsmokinginpregnancyservicesupported137pregnantwomentosetaquitdate,ofwhom65(48%)remainedsuccessfullyquitat4weeks.

Contactdetails:

NHS Stop Smoking Services and NHS Stop Smoking in Pregnancy Providers

Forinformationonwhereservicesaredeliveredpleasecall01952582659orgotowww.stopsmokingtelford.nhs.uk

Help 2 Quit Mansion House Healthcare Limited01743366940 01475786900Website:www.shropshire.nhs.uk/ Website:www.youcanstopsmoking.org

Solution 4 Health 02476630214 Emailcontact:[email protected] Website:www.solutions4health.co.ukStop Before Your Op Service Princess Royal Hospital Royal Shrewsbury Hospital Robert Jones Agnes HuntJulieRudge JulieRudge/MarianBaskerville MarianBaskervilleBleep256 Bleep980 Bleep18801952641222ext4464 01743261000ext4464 01691404114

Emma’s Story

A whole year ago, I was 18 weeks pregnant with my third child and was smoking about 20-a-day (sometimes more, but shhhhh!). I had smoked as many for almost 20 years without a break, so you could say I was well and truly hooked. Not even the low tar cigarettes either. The full strength, Lambert and Butler silver pack. They were costing me a fortune at almost £5.50 for 20, and I had to struggle to save for the maternity clothes I desperately needed. I felt like I had a cold 24/7 and I was always out of breath. Even when sitting talking!! I suppose I had accepted that, that was just the way it was when you’re pregnant with number 3, when number 2 was just 10 months old. I couldn’t even walk to the shop for my next pack of cigarettes without having to stop for an air break. It was bad… very bad indeed. But the first thing I would do when I had my next pack, was light up (as soon as I stepped out of the shop).

Little did I know that I was actually in denial. I was denying myself a healthy lifestyle. And yeah, I can hear you sigh… “I’ve heard all this before from the doctor/midwife/hospital”. I hated being told to QUIT SMOKING. Hated it. I used to dread appointments where I would have to admit to smoking as many as I did. It was the same for 15 years and more. Embarrassment, with a capital ‘E’. Then there’s the looks, or rather… the glares you get from strangers in the street when you light up. Then there’d be the times that I would chain-smoke 2 or 3 of them

in a lunch break cos I knew I wouldn’t get a chance for another few hours. And how would I cope without one?

Well this is how I have shocked myself, because… I did cope without them. And so far, for a whole year! Oh, don’t get me wrong, there have been times that I could have easily caved. But I can probably say, hand on heart that I have wanted a cigarette about only a dozen times, but the feeling of want lasts only a few minutes and it gets easier with time.


12

I have never needed one, like I thought I would. I suppose I have just programmed myself differently and I deal with stress in a different way. Believe me… with 2 children under 2 there’s a lot of stress in my day.

A cigarette used to provide me with an excuse for a break from my kids, but it was only ever a temporary fix and I would be needy of another within another half hour or even less. Just because you don’t have the ‘cigarette excuse’ for a break, it doesn’t mean you don’t deserve a break. This was the issue I had with myself. As long as you are leaving your children in a safe place, you can leave them. I used the ‘hand lotion’ excuse for a break and it worked while I needed to have that excuse to go. After only about 4 months, I didn’t need it. And to be honest, the stresses are so far and few between anyway! I think I imagined I had big stress levels when I smoked. I dunno why, but I always seemed far more stressed-out than I am now. Maybe it was the stress of constantly being broke/skint, smelly and in poor health?!

So, a year on…

I would have never quit smoking without the help and support I had from Helen, my Help 2 Quit nurse. Before meeting Helen I thought I needed the cigarettes like I needed food and water. They were a part of my life and would leave a big hole if they were taken away from me. Truth is… they did leave a hole… for a short period of time. And, Helen helped me to bridge that gap. I used a range of different replacement therapies – I started with patches and used them for about 4 weeks, but I needed the physical element of smoking to be replaced too, so I used the inhalator at the same time for a quick-fix, which was usually in the morning before the patch had kicked in and at times of stress. I never left the house without my inhalator and cartridges. A bit like being a smoker and never leaving the house without at least one ciggy and a lighter or enough cash to get some whilst out. I realised during this time, that there was another clique forming. It was the non-smoking club and I was now a member! I had my inhalator to prove it and I never felt silly using it in public. In fact I felt proud to have it – it showed so many good qualities in my personality – courage, strength and honesty, to name only a few. It felt nice to be related to those qualities, instead of being related to being smelly, weak and ill. It was decided… THAT was my new addiction!

I feel like I was cheated by a great friend (the cigarette) for a long time. I allowed him in to my life, I took him eve-rywhere with me and I spent a lifetime of savings on him, but he was a liar and a cheat. He told me that I needed him and that I had to spend all my money on him, when I actually didn’t need him at all. He told me that it was cool to have him in my life, when it was the un-coolest thing I have ever done. He told me I looked good when he was ageing my looks more quickly than they would have without him. He told me I needed more perfume to

‘Well, I shocked myself. and for more reasons that one too … I am immenseley proud of myself, and with very good reason!’

(Emma)


13

disguise his presence, only to choke my real friends with the stench of perfume-smelling smoke. He told me that I would be liked by lots, but I was disliked by more. I have nothing to show for the money I spent on him and he could have given me a very nasty disease.

He made my children ill and he made me more susceptible to coughs and colds too. I am glad to be rid of him, once and for all. I’ve wasted almost 20 years of my life with him, but now I have a new life, a new start and I wouldn’t

trade it for another cigarette… EVER!

Trend in Smoking in Pregnancy

Key Messages for Telford and Wrekin• 23%ofmothers

smokethroughouttheirpregnancy(around480womeneachyear).Thisis statistically significantly worsethanthenationalaverage

• Therehasbeennosignificant change in smokinginpregnancyduring the past five years

• 41%ofpregnantwomenunder20yearssmokethroughouttheirpregnancy,comparedto15%ofwomenaged35andover

Smoking in Pregnancy by Age

Source: Shropshire and Telford Hospitals NHS Trust Maternity Services, Association of Public Health Observatories and Department of Health, Health Profiles © Crown Copyright www.healthprofiles.info

23% 23% 23% 22%23% 21% 22%0%

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41% 31% 19% 13% 15%0%

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% smoking in pregnancy Telford and Wrekin - All ages (22%) England - All ages (14%)

Weight Management Services: Addressing Obesity

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WeightmanagementprogrammesformanimportantelementofTelfordandWrekin’sObesityStrategy.ThisensurescompliancewithNICEguidanceonobesity,localdeliveryofthenationalstrategy(HealthyWeight,HealthyLives)andthehealthychildprogramme.

TheTelfordandWrekinJSNAtoldusthat:

• 11.7%of4-5yearoldchildreninTelfordandWrekinareobese-11.7%ofboysand11.7%ofgirls(106 boys and 100 girls). This level of obesity is significantly worse than the national average for England(9.6%)

• A significant proportion (44%) of 4-5 year olds who are classified as obese live in the most deprivedcommunitiesofTelfordandWrekin

• 16.7%ofreceptionchildrenareoverweight-16.9%ofboysand16.5%ofgirls(158boysand135 girls). This level of overweight is statistically significantly worse than the national average for England(13.2%)

• Overaquarterofreceptionchildren(28.4%)areeitheroverweightorobese(499children)

• InYear6,18.8%ofchildrenareobese,19.9%ofboysand17.5%ofgirls(186boysand143girls).ThisisnotstatisticallydifferentfromtheEnglishaverage(18.3%)

• Almosthalf(49.5%)of10-11yearoldswhoareobeseliveinthemostdeprived40%oflocalcommunities

• InYear6,15.3%ofchildrenareoverweight,14.8%ofboysand15.9%ofgirls(138boysand130girls).OverathirdofYear6children(34.1%)areeitheroverweightorobese(597children)

• Itisestimatedthatoveraquarterofadults(27.8%)areobese,whichis37,700peopleaged16yearsorover.ThiscomparestoanEnglishnationalaverageof24.2%

Childhood Obesity Prevalence by Year Group and Gender (2009/10)

Key Messages for Telford and Wrekin• InReception(4-5year

olds):

- Theprevalenceofobesityisstatisticallysignificantly worse (11.7%)thanthenationalaverageforEngland(9.6%)

- 11.7%ofboysandgirlsareobese(106and100childrenrespectively)

11.7% 11.7% 19.9% 17.5% 18.8%10.2% 8.9% 9.6% 20.0% 16.5% 18.3%11.7%0%

5%

10%

15%

20%

25%

Males Females Total Males Females Total

Reception (4-5 year olds) Year 6 (10-11 year olds)

% c

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15

Why Weight?

WhyWeight?offersarangeofweightmanagementprogrammesforpeopleofallages,includingspecialistservicesforpregnantmothersandextremelyobeseadults.ClientsarereferredbyGPsandotherhealthandsocialcareprofessionals,insomecasesclientscanreferthemselves.Membersofthepublicwhohave had their weight identified as a concern during their health check (see page 18) can also be referred toWhyWeight?iftheywish.OnreferraltoWhyWeight?,clientsareenrolledontotheprogrammebestsuitedtotheirindividualneeds.

The Why Weight? programmes support clients to choose healthy lifestyles, particularly eating morehealthilyandbecomingmorephysicallyactive.Theprogrammesincludeonetooneappointmentswithaweightlossmentorandalsogroupsessions,togainsupportfromothersinthesamesituation.Exercisesessionsandcookingcoursesmayalsobeofferedand thechildren’sprogrammes includeother funactivitiestoencouragehealthyeatingbythewholefamily.Allthesessionsareaccessibleandprovidedfromcommunityvenues,schools,GPpracticesandhospitals.

TheWhyWeight?rangeisdeliveredbyateamfromNHSTelfordandWrekincommunityhealthservices,working closely with GPs, practice nurses, community school nursing, health visitors, midwifery andleisureservices.ThemanagementoftheWhyWeight?programmeisthroughanexpertadvisorygroup,whosemembers includeclinical staff fromprimary and secondary care,medicinesmanagement andhealthimprovement.

Trend in Obesity Prevalence by Year Group and Gender Key Messages for Telford and Wrekin• InYear6(10-11yearolds):

- Theprevalenceofobesityisnotsignificantly different fromtheEnglishaverage(18.8%v18.3%)

- 19.9%ofboysand17.5%ofgirlsareobese(186and143childrenrespectively).Thedifferenceisnotstatistically significant.

National Child Measurement Programme, The Information Centre for health and social care. © Crown Copyright. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/obesity/national-child-measurement-programme:-results-from-the-school-year-2008-09

Red shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average

13.4% 13.0%11.7%

11.5%10.9%

11.7%

20.5% 20.6%19.9%

17.2%16.5%

17.5%

0%

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10%

15%

20%

25%

2007/08 2008/09 2009/10

% c

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Reception (males) Reception (females) Year 6 (males) Year 6 (females)


16

TheWhyWeight?programmesareprimarilydesignedtohelppeopleloseweight.However,clientsreportother benefits, including improved self-esteem, improvements in the symptoms of long-term conditions, increased fitness and a greater sense of well-being.

Theevidence-basedYW8?programmefor8-13yearoldswithweightproblemshelpschildrentoimprovetheirself-esteemandincreasetheirlevelsofphysicalactivity.Thechildrenloseonaverage0.7BMIpointsand75%ofparentsalsomaintainorloseweight.

AttheWhyWeightSlimmingClubtheaverageweightlossat12weeksisaround5.8%.TheWhyWeightPlusprogrammehasanaverageweightlossacrossallclientsofaround4.4%.

TheMorbidObesityprogramme(forpatientswithaBMIgreaterthan40)achievesanaverageweightlossof around 3.5%. Other benefits recorded for the group include improvements in blood pressure, blood glucoseandcholesterollevels.

Feedback from Professionals

‘The patients have nothing but praise for the service -

inspirational’ (GP)

‘It’s about changing the way you live, rather than just weight management’ (Leisure Services

Manager)

‘Diabetic control long term was 8.2 now 6.5 and BP much better due to weight

loss. (GP)

‘Its’ an intelligent and well-thought out programme’

(Paediatrician)

‘The whole family approach at YW8 is fantastic’

(School Nurse)

‘This service has closed the gap in our service, offering more specific nutritional support and lifestyle

change for our service users’ (Midwife)


17

Contactdetails:

ClareHarlandHealthImprovementCommissionerNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580391Email:[email protected]

HelenO’DonnellSeniorHealthImprovementServiceManagerChildrenandFamilySupportServicesTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWayOldParkTelfordTF34AWContacttelephonenumber:01952217474Email:helen.o’[email protected]

‘I have loved going to the gym and tast-

ing lots of new foods’ (YW8? Child)

‘Found this advice more complete than other

slimming programmes’ (Why Weight Plus Client)

‘The best thing about YW8? is that I have more

confidence in myself’ (YW8? Child)

‘I can walk anywhere and not get breathless, have lots of energy and don’t need/want a gastric band’ (Why Weight Client)

‘It works, there’s no question that if I follow the portion guidelines I lose weight’ (Why Weight Client)

‘I am striving to be a better role model for my daughter’

(YW8? Parent)

‘The supermarket tour opened my eyes’ (Why

Weight Plus Client)

‘The information made me stop and think about feeding my

unborn child a healthy diet, my other children are healthier as a

result’ (Pregnancy Client)

‘The support and encouragement from the

weight loss mentor is fantastic, not only this,

you also get support from other group members’

(Why Weight Plus Client)

‘My son is so much healthier and fitter - he enjoys exercising more’

(WY8? Parent)

‘Highly recommended, thank you for putting me back on track with my life and wellbeing’ (Why Weight

Client)

Implementing the “Health Check” Programme

18

Diseasepreventionisbetterthancure–forindividualsandforsociety.Preventingdiseasesaveslives,preventsdisabilityandsavesmoney.

Currently,148peopleundertheageof75diefromheartattacks,strokesandothercardiovasculardiseasesevery year in Telford and Wrekin. Unfortunately, Telford and Wrekin continues to have significantly worse deathandhospitaladmissionratesfromheartdiseasethantherestofEngland,althoughsomeindicatorsareimproving.

Smoking, high blood pressure, obesity and excessive alcohol use are all significant risk factors for the developmentofcardiovasculardiseases.TheJointStrategicNeedsAssessmenthasshownthatinTelfordandWrekintherearearound:

• 19,700peoplewithundiagnosedhighbloodpressure

• 33,800peoplewhosmoke

• 35,500peoplewhoareobese

• 25,500peoplewhodrinkhazardousamountsofalcohol

Thepublichealthteamhasledmodellingworkwhichhasshownthatreducingtheriskofcardiovasculardiseaseinthecommunitybyjust2%would:

• Preventaround400hospitaladmissionseachyear

• Savearound110liveseachyear

• Savearound£1.4millioninhealthcarecostseachyear

Trend in Premature Mortality from Circulatory Disease

Key Messages for Telford and Wrekin• Deathsfromcirculatorydisease

accountforaround28%ofprematuredeathsinTelfordandWrekin

• Prematuremortalityratesinmaleshaveimprovedoverrecentyearsbutremainstatisticallysignificantly higher than the nationalaverage

• Femalerateshavealsoimprovedandcurrentratesarenotsignificantly different from the nationalaverage

• Narrowinginequalitiesincirculatorydiseasemortalitycouldincreaselifeexpectancybyaround0.7yearsinmenand1yearinwomen

Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base www.nchod.nhs.uk or nww.nchod.nhs.uk

0

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Year of death registration (performance year shown in brackets)

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19

What is “Health Check”?

A“HealthCheck”takesabouthalfanhourtocomplete.TheexaminationisavailablethroughbothTelfordandWrekingeneralpracticesandselectedpharmacies.Everybodyagedbetween40and74yearswillbeoffered a health check once every five years, unless they are already being treated for a cardiovascular condition(e.g.highbloodpressure).Thecheckincludes:

• Heightandweight

• Bloodpressure

• Abloodtesttocheckcholesterolandglucoselevels

Peoplearealsoaskedquestionsabouttheirlifestyleandfamilyhistory,including:

• Smoking

• Exercise

• Alcoholuse

• Heartdiseaseinclosefamilymembers

Allthisinformationisusedtoestimatethechanceofthatpersonsufferingacardiovascularevent(suchasaheartattackorstroke)duringthenexttenyears.

Advice is then offered on how any risks identified in the check can be reduced. This may include:

• Simpleadviceaboutlifestyle

• Referraltospecialistservicesforfurtheradviceandsupport,including:

- Stopsmokingservices

- Alcoholservices

- Weightmanagementservices

• Referralfortreatmentof:

- Highbloodpressure

- Highcholesterollevels

- Diabetes

The Telford and Wrekin “Health Check” programme was first piloted in selected local pharmacies in January2010.444checkswerecompletedoverathreemonthperiod.141people(32%)werefoundtobeathighriskofcardiovasculardisease.Thisincluded:

• 102people(23%)whohadhighbloodpressure

• 78people(18%)withhighcholesterol


20

Thepilotstudyalsofoundthat:

• Nearlythreequartersofpeopleassessedwereoverweightorobese

• Twothirdsofpeopledidlittleornophysicalactivity

• A fifth of people smoked

• 10%ofpeopleweredrinkingmorealcoholthanwassafeforthem

In thepilotstudy,330people (74%)were referred to theirGP for furtheradviceand313 (70%)werereferredtoLifestyleRiskManagementServices,tohelpthemreducetheirriskofcardiovasculardiseaseinthefuture.

So How Does the Local Community Feel About “Health Check”?

NHSTelfordandWrekintooktheopportunity to learnfromthepilotstudy.Peoplewhotookpart toldthePCTthat‘wordofmouth’promotionoftheservicewasreallyimportant.Theyrecognisedthatiftheirfriendsandfamilywerekeenontheprogramme,thentheywouldalsobekeentotakepart.Butwhatelsedidpeoplehavetosayabout“HealthCheck”?ThefollowingquotesarefrompeopleinTelfordandWrekinwhotookuptheofferofhealthchecksthroughthepharmacyscheme:

AllgeneralpracticesinTelfordandWrekinarenowabletooffera“HealthCheck”fortheirpatients(aged40to74years).Thecheckisalsoavailablefromsomelocalpharmacies.ForfurtherinformationcontactDrChrisWeiner,ConsultantinPublicHealthatthePCT(01952580380)

Contactdetails:

DrChristopherWeinerConsultantinPublicHealthNHSTelfordandWrekinHalesfield 6TelfordTF74BFContacttelephonenumber:01952580380Email:[email protected]

‘For me, it means I’d be around longer for my kids. I’d be able to get about and wouldn’t have anyone caring for me in

my later years’

‘I’m probably prone to it (vascular disease)’. It’s just a health check and if I have got something highlighted then I

can do something about it

‘I was worried about giving up smoking, now I’m determined to do it. The advice about the impacts has helped. I’m unemployed and can’t afford nicotine replacement patches.

Now I know I can get help with the cost, I’m going to follow up the referral to my doctor.’

‘Most people think they lead a healthy life, but generally we don’t. I mean, I smoke; its just cutting back on things like that.

‘I was given information on alcohol units. I think that is going to help me cut down’.

Early Cancer Detection: The Breast, Bowel and Cervical Cancer Screening Programmes

21

Cancercausesaround39%ofprematuredeaths(approximately208deaths)inTelfordandWrekin.Almostaquarter(24%)oftheseprematurecancerdeathsareduetolungcancer,16%(amongstwomen)areduetobreastcancerandaround10%areduetocolorectalcancer.

Breast Cancer Screening

InTelfordandWrekin,around16,500womenarecurrentlyeligibleforbreastscreeningandonaverage13,100womenarescreenedeverythreeyears.Thislevelofbreastscreeningcoverage(81%ofeligiblewomenscreenedwithinthepastthreeyears) ishigherthanboththeEnglishaverage(76.5%)andthenationalprogrammestandard targetof 80%.NHSTelfordandWrekinhasalsobeenworkingcloselywithShropshireCountyPCTandtheShrewsburyandTelfordNHSHospitalsTrusttoimplementdigitalmammography screening and the national age extension (to 47 to 73 years). Digital mammographymachines(bothstaticandmobile)willstarttoscreenwomenintheextendedagegroupinShropshire,TelfordandWrekininearly2011.

Trend in Premature Mortality from All Cancers

Key Messages for Telford and Wrekin• Prematuremortalityrates

(under75years)forallcancershave:

• Improved significantly duringthepasttwodecades

• Stabilisedatalevelwhichis not significantly different fromthenationalaverage

Source: National Cancer Intelligence Network (NCIS) http://nww.ncis.nhs.uk/Ardentia/portal/jsp/index.jspRed shading on data labels indicates the Telford and Wrekin position is statistically significantly worse than the national average

169 170 161 165 158 166 159 158 154 129 123 122 126 125 123 123 123159 155 154 151 155 1460

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22

Bowel Cancer Screening

The NHS Bowel Cancer Screening Programme was rolled out from July 2006 and achieved nationalcoveragein2010.Screeningiscurrentlyofferedtoallmenandwomenaged60to69everytwoyears.Theprogrammebeganaphasedageextensionin2010,toincludemenandwomenaged70-75years.Bowelcancerscreening isbasedonsubmissionofastoolsample toa laboratory fora faecaloccultblood test. More information is available from http://www.cancerscreening.nhs.uk/bowel/publications/the-facts.html

ScreeningbeganinTelfordandWrekinandShropshire inOctober2009.DuringtheperiodJanuarytoJune2010,atotalof5,93060-69yearoldsfromTelfordandWrekinwereinvitedtoparticipateinbowelcancerscreening.Theuptakeofscreeningduringthisperiodwas54%,whichisanacceptablelevelforthe first year of the programme. The age extension to bowel screening will be implemented in Shropshire, TelfordandWrekinduring2011/12,oncetheexistingprogrammehasbeenoperationalfortwoyears.

Trend in Premature Mortality from Breast Cancer

Key Messages for Telford and Wrekin• Thereareonaverage26

breastcancer-relateddeathseveryyear

• Prematuremortalityratesinwomenforbreastcancerhavebeenimprovingoverrecentyearsandarenotsignificantly different from thenationalaverage


36 29 24 27 29 33 32 30 31 32 35 29 26 27 29 29 23 23 22 23 20 200

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23


Cervical Cancer Screening

TheNHSCervicalScreeningProgrammeinviteseligiblewomenbetweentheagesof25and64yearsfora cervical screening test every three to five years, depending on age as follows:

• 25years: Firstinvitation

• 25-49years: 3yearly

• 50–64years: 5yearly

InTelfordandWrekin, 13,186womenwere invited for cervical screeningduring2009/10.Theoverallscreeningcoverageforthewholeeligiblepopulationis78.6%,whichisslightlylowerthantheEnglishaverage (78.9%),but above thenationalprogrammestandardof 70%.However, screeningcoveragehas declined slightly in Telford and Wrekin over the past five years, a picture which has also been seen nationally. The main challenge is to increase coverage in younger women (aged 25-29 years); NHSTelfordandWrekinhascontinuedtosupporttheNHSWestMidlandspublicitycampaign,whichaimstoencourage all women, but specifically younger women, to have a smear test.

Trend in Premature Mortality from Colorectal Cancer

Key Messages for Telford and Wrekin• Thereareonaverage20

prematuredeathsfromcolorectalcancereveryyear

• Prematuremortalityratesfromcolorectalcancer:

- Haveimprovedduringrecentyears

- Are not significantly differentfromthenationalaverage


National Cervical Screening Programme – The Facts

http://www.cancerscreening.nhs.uk/cervical/publications/in-04.html

West Midlands Cervical Screening Programmehttp://www.pants.nhs.uk/

17 16 17 18 18 19 17 14 13 13 14 11 13 13 15 12 13 12 12 10 11 110

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24


Trend in Cervical Screening Coverage (25-64 years)

Key Messages for Telford and Wrekin• Cervicalscreening

coverageacrosstheeligiblepopulation(25-64years)hasdeclinedslightlyduringrecentyears,from82.5%in2001/02to78.6%in2009/10

• Thelowestrateofcervicalscreeningcoverageisamongstyoungwomenaged25-29years

Cervical Screening Coverage by Age Group (2009/10)

Source: The NHS Information Centre for health and social care. © Crown Copyright. Cervical Screening Programme, England 2009/10 http://www.ic.nhs.uk/statistics-and-data-collections/screening/cervical-screening/cervical-screening-programme-england-2009-10

82.5% 81.8% 81.0% 80.8% 80.3% 80.0% 79.0% 79.6% 78.6%

81.6% 81.2% 80.6% 80.3% 79.5% 79.2% 78.6% 78.9% 78.9%

0%

20%

40%

60%

80%

100%

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

% s

cree

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cov

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age

d 25

-64

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s <

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last

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66% 78% 82% 83% 84% 81% 77% 74%0%

20%

40%

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100%

25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64

Age group (years)

% s

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cov

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sinc

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test

)


Contactdetails:

HelenOnionsPublicHealthSpecialist(ScreeningLead)NHSTelfordandWrekinHalesfield 6, Telford TF7 4BF Contacttelephonenumber:01952580382Email:[email protected]

25

Immunisation: Protection Against Infectious Disease

Childhoodimmunisationprotectsyoungpeoplefrompotentiallydevastatingillnessessuchasmeasles,rubella,diphtheria,tetanus,meningitisandwhoopingcough.

InSeptember2008,thepublichealthteaminthePCTsetouttoimprovelocalimmunisationcoveragestillfurther,inordertobetterprotectchildrenthroughimmunisation.

Theprojectinvolved:

• Deliveringimprovementsinaninformationsystem,toensurethatnon-immunisedchildrencould be more accurately identified

• Reducingthenumbersofchildrenwaitingforanimmunisationappointment,byincreasingthenumberofappointmentsandclinicsingeneralpractice

• Extending the local immunisation programme to include a small but highly flexible immunisation service for families who find it difficult to use mainstream services

Duringthepastdecade,muchoftheemphasisaroundimmunisationprogrammeshasbeenonpersuadingindividualparentsandclinicalpractitionersofthemeritsofimmunisation.ThisapproachwasprobablyentirelyreasonableintheimmediateaftermathoftheallegationsagainsttheMMRimmunisationduringthelate1990s.Theneednowistorebuildstrong,reliableandeffectiveimmunisationsystems.

Byworkinginpartnershipwithgeneralpracticesandthechildhealthinformationteam,theimmunisationservice has delivered significant improvements in early childhood immunisations. Mumps, measles and rubella(MMR)coveragebetweenAprilandJune2010reached93.8%,from82.3%in2008.Althoughstilla little short of the World Health Organisation target of 95%, this is a significant improvement. The figure summarisesthetrendinMMRcoverageinTelfordandWrekinduringthelasttenyears.

NHS Telford and Wrekin MMR Coverage: 2000 - 2010

74%

76%

78%

80%

82%

84%

86%

88%

90%

92%

94%

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

% o

f tw

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ar o

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imm

unis

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kin

NHS Telford and Wrekin intervention started (September 2008)Child death from

measles in UK (April 2006)

Lancet partially retracts Dr Wakefield paper (March 2004)

26

Immunisation: Protection Against Infectious Disease

In addition, the human papilloma virus (HPV) immunisation was introduced as part of the nationalimmunisation programme in September 2008. It aims to immunise girls from 12 to 13 years of ageagainstHPV toprotect from futurecervical cancer.Under thebanner ‘ArmAgainstCervicalCancer’,theprogrammeoffersthreedosesofthevaccineoverasixmonthperiod.Evidenceindicatesthatthisprogrammecouldpreventapproximately400deathsfromcervicalcancereveryyearintheUK.Acatch-upprogrammetoensurethatallgirlsbornonorafter1stSeptember1990wasalsoofferedbetweenSeptember2008andAugust2010.

TheschoolnursingserviceisdeliveringthisprogrammeinTelfordandWrekininpartnershipwithlocalschoolsandeducationservices.TheprogrammecoversallTelfordandWrekinschools,butalsoincludeslocalcolleges,residentialunitsandNHScommunityclinics(forthecatch-upelement).

Thenationaltargetforcompletionofallthreedosesoftheimmunisationintheacademicyear2008/09was70%forYear8girls,risingto80%fortheacademicyear2009/10.InTelfordandWrekin,theuptakefigure achieved for all three doses during the 2008/09 campaign was 82.9%, exceeding both the overall national uptake (80.1%) and the average regional uptake (76%). This year’s campaign has yet to becompleted, but the figure achieved so far for Year 8 girls is around 82.4%.

Contactdetails:

DrChristopherWeinerConsultantinPublicHealthNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580380Email:[email protected]

CaroleHalesBCG/HPVCo-ordinatorNHSTelfordandWrekinCoralHouse11LongbowCloseHarlescottLaneShrewsburySY13GZContacttelephonenumber:01743450853Email:[email protected]

27

Working in Partnership with Local Communities:Communities for Health

TelfordandWrekinwasanearlyadopterofthenationalCommunitiesforHealthprogramme.Themainaimsof theprogramme include theactiveengagementof the localcommunities inhealthmatters, tosupportasustainableapproachtohealthimprovementandaddressinghealthinequalities.

The local programme currently comprises five projects as follows:

• BabyLifeCheck–informationtosupportnewparentsinimprovingthehealthandwellbeingoftheirbaby

• TeenLifeCheck–onlinesupportfor12to15yearoldstohelpthemunderstandandtakecontrolofarangeofhealthissues

• LifestyleSupportforVulnerableYoungPeople–arangeofactivitiesprovidedforyoungpeopleatriskofsocialexclusion,tohelpthemimprovetheirhealth

• ImprovingtheHealthofPeoplefromBlackandMinorityEthnicCommunities–tailoredinformationandsupport,focusingonphysicalactivity,nutritionandemotionalhealthandwellbeing

• ForwardMission–amentoringservicedeliveredbyMINDforpeoplewithsubstancemisuseand/ormentalhealthissues.

Each of the projects has been successfully evaluated as part of the recent national review of theCommunitiesforHealthprogramme.Thereport,oncepublished,shouldsupportfurtherdecisionsaboutthedevelopmentoftheprogrammeatlocallevel.

Feedback

‘Feedback from volunteer peer mentors has been very positive, they can all see the good work that they are doing is having a positive effect on their clients and they feel a real sense of achievement. Some mentors are looking for a long-term career in this type of area and they are getting some valuable experience by working with their clients’

(Health Promotion Specialist - Forward Mission)

28

Working in Partnership with Local Communities:Communities for Health

Forfurtherinformation,contactLouiseMills,HeadofHealthInequalitiesandLifestyle,NHSTelfordandWrekin(01952580390)

Contactdetails:

LouiseMillsHeadofHealthInequalitiesandLifestyleNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580390Email:[email protected]

Trend in Suicide and Deaths from Undetermined Injury

Key Messages for Telford and Wrekin• Mortalityratesfrom

suicideandundeterminedinjuryarerelativelyunstableduetosmallnumbers–therearearound13deathsrecordedeachyear

• Theratehasnotdifferedsignificantly from the nationalaverageformanyyears

Source: The Information Centre for health and social care. © Crown Copyright. Compendium of Clinical and Health Indicators / Clinical and Health Outcomes Knowledge Base (www.nchod.nhs.uk or nww.nchod.nhs.uk)

8 10 11 12 10 10 11 13 13 14 16 17 14 13 13 14 130

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Telford and Wrekin England & Wales Annual average no. of deaths shown as labels on bars

29

Working in Partnership with People: Peer Support Programmes

Peer support programmes play an important role in raising awareness of the impact that unhealthylifestylescanhaveonqualityoflifeandlifeexpectancy.Insomestudies,peereducatorsareaslikelytoimprovehealthoutcomesasnurses.

A recent report from the Department of Health (Confident Communities, Brighter Futures) suggested that:

• Instrengtheningsocialnetworks,especiallyinhighriskgroups,peersupportiseffectiveinreducingsocialisolation,lonelinessandincreasingqualityoflife

• Interventionssuchasvolunteeringimprovewell-being

• “GreenGyms”improvementalandphysicalhealth

FromtheJSNA,weknowthat:

• Thereisrobustevidencethatunhealthylifestylesincreasetheriskofpeoplesufferinglong-termillnessandsomelife-threateningconditions.TheJSNAhighlightstheeffectsofriskfactorssuchassmoking,obesity,physicalinactivityandalcoholconsumptiononmajordiseasesincludingheartdisease,strokeandcancer

• Peoplewithmentalhealthproblems,orphysicalorlearningdisabilities,areatrelativelyhighriskofsufferingill-healthandhealthinequalities

Evidence-basedprogrammes,includingpeereducation,buddyingandmentoring,havebeencommissionedbythePCT’sHealthImprovementDepartmenttoencourageandsupportpeople inadoptinghealthierlifestyles.ThishasledtothedevelopmentofeffectivepartnershipswiththeLocalAuthority,primarycare,membersofthepublicandserviceusers,whoworktogethertopromotehealth,wellbeingandreducehealthinequalities.Examplesoftheseprogrammesinclude:

“Rubberband”

Apeereducationprojectdeliveredinpartnershipbythecommunity health services health improvement teamandTelfordCollegeofArtsandTechnology (TCAT), foryoungpeopleaged16–19andotherstudents.Studentscan become volunteer peer educators, delivering amenuofhealthpromotionworkshopstootherstudents.Throughtheseworkshops,youngpeopleareguidedtomakepositiveandhealthyinformedchoicesabouttheirlifestyle.Atotalof303workshopsweredeliveredto1,077TCATstudentsaspartoftheRubberbandPeerEducationProjectin2009/10.53workshopsweredeliveredto191foundationstudentswithalearningdisability.Evaluationshowed85%ofstudentshadimprovedtheirknowledgeabouthealthylifestyles,with60%ofstudentsreportingpositive behaviour change. For further information,contactEmmaVaughan,HealthPromotionSpecialistatTelfordandWrekinCommunityHealthServices (01952217474)

Feedback

‘Telford College’s Rubberband Peer Education Project has enabled our learners to make proactive and informed health and wellbeing decisions. The project also provides invaluable experience for learners to deliver health education to their peers. It is an exceptional project which supports the health agenda and enables access to provision for all of our young people.’ (Deputy Director of Student Services, Telford College Arts & Technology)

‘They really enjoy your sessions and learn so much, thanks’ (TCAT Tutor - Rubberband)

‘Use protection when having sex’ (TCT Student - Rubberband)

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The Telford and Wrekin “Green Gym”

Anoutdoorsalternativetoconventionalgymsandtheopportunitytoincreasetheirphysicalactivitylevelsthrough involvement inpracticalconservationactivities.133 individuals registeredon theGreenGymprogrammein2009/10withover2,000contacts.Participantshavereportedimprovedemotionalhealthandwell-beingandfeelinglesssociallyisolated.Someparticipantshavegoneontofurthereducation,trainingandemployment.Forfurtherinformation,contactJulieBird,HealthPromotionSpecialistatTelfordandWrekinCommunityHealthServices(01952217474)

Trend in Teenage Conceptions (Under 18)

Key Messages for Telford and Wrekin• Duringthepastdecade

teenagepregnancyrateshaveremainedstatisticallysignificantly worse than theEnglishaverage

• Therearearound185under18conceptionseveryyear

• 21%ofteenagepregnanciesareamongstgirlsunder16yearsofage

Source: Office for National Statistics http://www.dcsf.gov.uk/everychildmatters/resources-and-practice/IG00200/


65.0 64.2 55.3 57.9 60.9 56.9 53.9 52.0 53.3 54.7 48.9 51.8 55.90

20

40

60

80

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009(Jan-Sept)

No.

of c

once

ptio

ns 1

,000

fem

ales

(ag

ed 1

5-17

yea

rs)


Feedback

‘I feel a good sense of achievement and wellbeing. The Green Gym is excellent!’ (Green Gym Participant)

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“Women in Motion”

AprogrammeworkingacrossvariouscommunitiesinTelfordandWrekintoencouragegreaterlevelsofphysicalactivity.Theschemeaimstoovercomeperceivedbarrierstoexercise,suchascostandchildcareissues. The programme recruits female volunteers to undertake training and gain qualifications in a variety ofsportandphysicalactivitydisciplines,sothattheycanleadsessionsforthe16+femalepopulationin their own community. To date, Women in Motion has supported 60 women to achieve accreditedqualifications and 40 women continue to actively volunteer in their community. More than 1400 women have benefited from the community based exercise programmes. Women in Motion received the award forProjectoftheYearattheTelfordandWrekinSportsAdvisoryCouncilAwardsandwasrunnerupattheWestMidlandsBBCPowerofSportAwards.Forfurtherinformation,contactMelParker,SeniorHealthImprovementServiceManageratTelfordandWrekinCommunityHealthServices(01952217474)

“Walk about Wrekin”

Aprogrammeprovidingweeklyguidedwalks,ledbytrainedlocalvolunteers.Walksaregradedforlength,speedandgradients,andaccessibleroutesareidentified. To date the programme has recruited and supported 138 volunteers to achieve the Walk Leader qualification. During the past year, 500 adults have attendedlocalwalkingeventsorganisedthroughtheprogramme.Forfurtherinformation, contact Jenny Stretton, Health Promotion Specialist at TelfordandWrekinCommunityHealthServices(01952217474).

Focus on Breastfeeding Peer Support

BreastfeedingpeersupporthasbeenincreasinglyrecognisedinEnglandasaneffectiveinterventionforincreasingtheinitiationanddurationofbreastfeeding.Peersupportprovidesmother-to-mothersupportforbreastfeeding.Thesupportisgivenbywomenwhohavebreastfedtheirownchildrenandwho,withspecialisedtraining,actasrolemodelssharinginformationandexperiences.Thepeersupportersoffersupporttootherwomen,whowishtobreastfeed,inanatmosphereoftrustandrespect.Researchshowsthatoneofthemajoradvantagesofpeersupportisthatsupporterscomesfromthesamecommunityandhaveexperiencedthesamechallengesasthenewmother.

Feedback

‘The project has changed my life. I’ve become a lot more confident in myself and I’ve found a career path which I want to take’ (Women in Motion Volunteer)

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Breastfeedingpeersupportersarenotintendedtoreplacehealthprofessionalsandgivemedicaladvice,butshareinformationtosupportandcomplementprofessionalsintheirroleofpromotingandsupportingbreastfeeding,particularlymidwivesandhealthvisitors.

Mothers from disadvantaged communities and younger mothers are the least likely to breastfeed.Evidencealsoshowsthatmothersfromthesegroupsarelesslikelytoreceivesupportbecauseofbottle-feedingculturewhichhasoftenprevailedforyearswithintheircommunity.

FromtheTelfordandWrekinJointStrategicNeedsAssessment,weknowthat:

• Despite a “narrowing of the gap” during the past five years, there are still significant inequalities associatedwithsocio-economicdeprivationandbreastfeedinginitiationandduration.Atthetimeofevaluation:

- 54% of mothers from the fifth most deprived communities breastfed their babies at birth, compared to 79% in the fifth most affluent communities

- 22% of infants from the most deprived fifth of communities were still breastfed at 6-8 weeks of age, compared to 48% of infants from the most affluent communities

• Therearealsoinequalitiesassociatedwithmaternalageandbreastfeedinginitiationandduration:

- 44%ofteenagemothers(under20)breastfedtheirbabiesatbirthcomparedto75%ofmothersaged35yearsandover

- By6-8weeks,only9%ofteenagemothers(under20)werestillbreastfeedingtheirbabies,comparedto53%ofmothersaged35yearsandover

• However,trendsinbreastfeedinginitiationbymother’sageindicateimprovementsduringthepastfive years for younger mothers. There was an increase of 8% amongst teenage mothers and 14% amongstmothersaged20-24yearsbetween2003/04and2008/09

Telford and Wrekin “BEST”

Therearenow40trainedpeersupportersfromacrosstheBoroughintheTelfordandWrekinBreastfeedingEncouragementSupportTeam(BEST),withagesrangingfrom18to45years.Localwomenareencouragedtojoinasrepresentativesoftheirlocalcommunity,particularlyfromareasandgroupswhichhavepoorbreastfeedingrates.BESTsupportworkersareavailabletosupportlocalmums,offeringonetooneandgroupsupport.BESTisofferedbothantenatallyandinthepostnatalperiod.AbreastfeedingsupportworkerattendsTelfordmaternityuniteveryweekday,workingincloseliaisonwithmidwivestosupportbreastfeedingmums.BESTalsoworkscloselywith thematernityobesityproject.There isamonthlynewslettertokeepmembersfullyup-to-datewithlocalbreastfeedingactivities.Theteamalsoprovidesatelephonehelpline.

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The team have also set up a breastfeeding support group specifically targeting mums who breastfeed olderbabies,inpartnershipwithSureStart.

EffectiveandcomprehensivebreastfeedingpeersupportisakeycomponentoftheUNICEFBabyFriendlyInitiative(BFI)standard.WorkingtowardsBFIaccreditationispartofthefoundationofthebreastfeedingstrategyinTelfordandWrekin.NICEhasdetailedthesavingswhichcanbegeneratedfromimprovingbreastfeedingrates,throughtheachievementoftheBFIstandardinmaternityandcommunityservices(forexample,intermsofreducedemergencyhospitaladmissionsfromgastroenteritisandchestinfections).ThepotentialcostsavingsmodelledforTelfordandWrekinindicatethatover£55kcouldbesavedfromtheachievementofBFIduringitsearlyyears.

In2009/10:

• 40BESTpeersupportersweretrainedtosupportbreastfeedinginTelfordandWrekin

• 874 women benefited from breastfeeding support groups

• 223pregnantwomenattendedantenatalbreastfeedingworkshops

• Thebreastfeedingdurationtargetwasexceededwith33%ofinfantsbreastfedat6-8weeks(comparedtoatargetof29%).Thisequatesto101additionalbreastfedbabiesabovetargetexpectations,anincreaseof2%fromthepreviousyear

• BreastfeedingpeersupporthasbeenanimportantelementincomplementingthebreastfeedingservicewithinTelfordandWrekin,toachieveUNICEFBabyFriendlyStage1Accreditation

ForfurtherinformationcontactSarahRock,NHSTelfordandWrekinBreastfeedingCoordinator(01952580392)

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MelParkerSeniorHealthImprovementServiceManagerAdults&OlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:[email protected]

JulieBirdHealth Promotion Specialist – Mental Health andWellbeingAdultsandOlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:[email protected]

KarenCollinsInclusionSupportCo-ordinatorTelfordMindWellbeingCentreAlanGoodallCentre76-83SevernWalkSuttonHill,TelfordTF74ASContacttelephonenumber:01952872474Email:[email protected]

EmmaVaughanHealthPromotionSpecialist-Alcohol&EmotionalHealth&WellbeingChildren&FamilySupportServicesTelford&WrekinCommunityHealthServicesGroundFloorWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:01952217474Email:[email protected]

JennyStrettonHealthPromotionSpecialist–PhysicalActivityAdultsandOlderPeopleTelfordandWrekinCommunityHealthServicesWrekinHousingTrustBuildingColliersWay,OldParkTelfordTF34AWContacttelephonenumber:[email protected]

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Trend in Breastfeeding Initiation and Duration

Key Messages for Telford and Wrekin• Theproportionofinfants

breastfedatbirthincreasedfrom59%in2003/04to66%in2009/10(theequivalentof145additionalinfantsbreastfedeachyear)

• Despitetheincrease,breastfeedinginitiationatbirth(66%)remainsstatisticallysignificantly worse than the nationalaverageforEngland(71%)asdoesbreastfeedingprevalenceat6-8weeks(33%,comparedtothenationalaverageforEnglandof45%)

• Breastfeedingamongstyoungmothershasimproved,withinitiationatbirthincreasingby7%inteenagemothers(under20)and13%inmothersaged20-24yearsbetween2003/04and2009/10

Source: Shropshire and Telford Hospitals NHS Trust Maternity Services and NHS Telford and Wrekin Community Health Services, NHS IC Omnibus Crown Copyright © 2009 http://www.ic.nhs.uk/services/omnibus-survey


Breastfeeding Initiation and Duration by Age Key Message for Telford and Wrekin• Only9%ofteenagemothers

(under20)arestillbreastfeedingtheirbabiesat6-8weeks,comparedto53%ofmothersaged35yearsandover

Source: Shropshire and Telford Hospitals NHS Trust Maternity Services and NHS Telford and Wrekin Community Health Services

59% 58% 63% 27% 31% 33%63% 66% 66% 65%0%

20%

40%

60%

80%

100%

2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

% o

f inf

ants

bre

astfe

d

Birth (Telford and Wrekin) 6-8 weeks (Telford and Wrekin) Birth (England)

44% 59% 69% 73% 75% 66%9% 21% 36% 44% 53% 31%0%

20%

40%

60%

80%

100%

Under 20 years 20-24 years 25-29 years 30-34 years 35+ years All ages

Age band

% o

f inf

ants

bre

astfe

d

% breastfed at birth (2009/10) % breastfed at 6-8 weeks (2008/09)

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Working in Partnership with Telford and Wrekin Council:Health Through Warmth

Warmhousingisgoodforhealth.Coldweathercanincreasehospitaladmissionsandpromotingwinterwarmthcanleadtoimprovedselfreportedhealth,reducedvisitstoaGPandfewerdaysoffwork.

Excess winter deaths (EWD) are defined as the number of deaths in the four winter months (December to March)minustheaveragenumberofdeathsduringtheprecedingfourmonths(AugusttoNovember)andsubsequentfourmonths(ApriltoJuly).Duringtheperiod2006-09,therewere82excesswinterdeathsinTelfordandWrekin,anaverageof27eachyear.TheExcessWinterDeathIndexinTelfordandWrekinforthe same period was 20, which is not statistically significantly different from the England average (18.1). AlmosthalfoftheexcessdeathsinTelfordandWrekinwereduetocirculatorydiseaseand30%wereduetorespiratorydisease.98%ofthedeathsoccurredinpeopleaged65yearsormore.

InTelfordandWrekin,partneragencieshavedevelopedanAffordableWarmthStrategyandactionplan,deliveredthroughthe‘HealththroughWarmth’project.TheHealthInequalitiesNationalSupportTeamhasdescribedthisstrategyasamodelofgoodpractice,demonstratingwidepartnershipinvolvementandcommitment.ThestrategyisledbyTelfordandWrekinCouncil,withNHSTelfordandWrekinbeinganimportantpartnerintheprogramme.

The scheme helps residents with cold and damp-related health problems, providing a coordinatedapproachtoincreasingthewarmthandcomfortoftheirpropertythroughbetterinsulationandheatinginterventions (including assessment for financial grants). A crisis fund is available to help individuals with up to half of the cost of efficiency measures, if no other grants are available to them.

In2009/10,HealththroughWarmthsupported511clients,including:

• 354peopleover60and43peopleunder16

• 264peoplewithmusculoskeletaldisease

• 132peoplewithcardiovasculardiseases

• 115peoplewithrespiratorydisease

• 89peoplewithdiabetes

Ithasbeenestimatedthat,byhelpingtokeeppeopleoutofhospital,theprojectwillgeneratearound£40,000insavingsduring2010/11.

ContactdetailsfortheHealththroughWarmthteam:

Telford&WrekinCouncilDarbyHouseLawnCentralTelfordTF34JAContacttelephonenumber:01952381864

Email:[email protected]

Website:http://www.telford.gov.uk/site/scripts/documents_info.aspx?documentID=333

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Working in Partnership with Telford and Wrekin Council:Let’s Cook Together

The chance that a child will develop obesity is influenced by their family lifestyle. It is well documented thatchildrenwhoregularlyeathealthy,homecookedmealstogetherwiththeirfamiliesarelesslikelytobecome overweight. Yet many families lack the skills and confidence to cook healthy meals at home.

Inrecognitionofthis,‘LetsCookTogether’ isdeliveredinpartnershipwithTelfordandWrekinCouncilandhelpsparentsandchildrentocookhealthymealsonabudget.Familieswithchildrenunder11aresignpostedbylocalschoolstoattendasixweekcoursewhichaimstohelpfamilies:

• Developbasiccookingskills

• Enjoycooking

• Enjoyeatingthefoodtheymake

• Applybasicfoodhygienepractice

• Takeupschoolmeals

Theprojecthasrecentlybeendevelopedtoincludecommunity-basedactivityanddeliveryoftheprojectwithinthenurseryenvironment.During2009/10,Let’sCookTogetherdeliveredcoursesto156primaryschoolfamiliesinTelfordandWrekin.95%ofthefamiliesreportedthattheyhadachievedtheaimsoftheprogramme.


‘Dad came in very nervously with his daughter and wife. He had come along to learn the basics; he had never cooked before and his wife and always cooked. She wanted to learn western dishes. She took over at first but could not come to a few sessions. As Dad had the reins he flourished and enjoyed spending quality time with his daughter. At the end of the course he had purchased a few basic cookery books and Friday night was his night to cook for the rest of the family’ (Let’s Cook Tutor)

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Working in Partnership with Telford and Wrekin Council:Let’s Cook Together

ClareHarlandHealthImprovementCommissionerNHSTelfordandWrekinHalesfield 6TelfordShropshireTF74BFContacttelephonenumber:01952580391Email:[email protected]

JacquiMaddoxFacilitiesSupportManagerTelfordandWrekinCouncilPOBox214DarbyHouseTelfordShropshireTF34LEContacttelephonenumber:01952380960Email:[email protected]

Contactdetails:


‘A family unit with a child with attention difficulties, a parent with dyslexia and poor self motivation joined our cooking group. Through the weeks I watched the family blossom with confidence. They both tried new things and supported each other when one or both of them felt uncomfortable. They were really pleased to complete the six week course with full attendance. I visited the school a month later and saw an amazing transformation as this confident, smart lady had the courage to approach the school and ask if she could volunteer to help with reading in the classroom. She said she had gained the confidence to take the step forward after completing the Let’s Cook Course’ (Let’s Cook Tutor)

Feedback from Clients

‘We are eating more fruit and vegetables’

‘I am cooking more from scratch - with the family’

‘We eat together more’

‘I buy less processed food and takeaways’

‘I have grown potatoes in my garden’

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Working in Partnership with Telford and Wrekin Council:Healthy Schools

TheNationalHealthySchoolsProgramme(NHSP)iscurrentlyajointinitiativebetweentheDepartmentofEducationandtheDepartmentofHealth.Theprogrammefocusesonfourkeythemes:personal,socialandhealtheducation(includingsexandrelationshipanddrugeducation),healthyeating,physicalactivityandemotionalhealthandwell-being (includingbullying).TheHealthySchoolsProgrammeprovidesaframeworktosupportthedeliveryoftheHealthyChildprogramme,whichisanevidencebasedprogrammeforpreventionandearlyinterventionforchildrenandyoungpeopleaged5–19.

Healthierchildrendobetterinlearningandinlife.Supportingandenablingchildrenandyoungpeopletomakepositivechangestotheirbehaviourregardinghealthandwell-beinghelpsthemreachtheirfullpotential in terms of achievement and fulfilment.

TheNHSPrequiresschoolstotakeasettings-basedor‘whole-school’approach.Schoolsworkwithinaqualityassurance framework toachieveNationalHealthySchoolStatus.SchoolswhohavegainedNationalHealthySchoolStatusareabletotakepartintheenhancedNationalHealthySchoolsProgramme,tofurtherembedhealthierbehavioursandwellbeingoutcomesintotheeverydayactivitiesofschoollife.

InTelfordandWrekintheHealthySchoolsProgrammeisco-ordinatedthroughapartnershipwhichincludes(amongstothers)colleaguesfromhealth improvement,schoolnursing,education,EarlyYearsandthepolice.Schoolshave reported that they valuehavinga localdelivery teamwhichcanoffer specialistsupport across health and education. A critical component for schools is the active engagement ofchildren, young people and their parents and carers in developing, reviewing and influencing policy and practice.

Staff Feedback

‘Children understand the importance of healthy eating and

drinking water’

‘Children and staff feel fitter and healthier’

‘Children are happy to come to school’

‘Children are becoming more skilled at expressing their feelings’

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Working in Partnership with Telford and Wrekin Council:Healthy Schools

InTelfordandWrekin:

• 71%(52outof73)oflocalschoolshaveachievedtheNationalHealthySchoolsAwardandoftheremaining21schools,mostareworkingtowardsachievingtheawardby2011.Theseschoolshavedemonstratedastrongcommitmenttoacaringandsupportivecultureinsupportingthiswholeschoolapproach,involvingstaff,governors,children,parentsandthelocalcommunity

• Ofthese52schools,31havecommittedtoworkingtowardstheenhancedmodel.11schoolshavesubmittedandcompletedanannualreviewaspartofthis

Thehealthyschoolsteamreviewtheevidencecollectedbytheschoolagainstthehealthyschoolscriteriaduringapre-validationvisit.Aspartofthevisit,theteamalsospeaktostudentsandstaffonaone-to-onebasisandingroups.Thefollowingcommentsarerepresentativeoffeedbackreceivedfromstudentsandstaffduringthesevisits.

Contactdetails:

SallyTyasSeniorManagerHealthySchoolsTelfordandWrekinCouncil62WrekinRoadWellingtonContacttelephonenumber:01952388580Email:[email protected]

Feedback from Students

‘Being at school boosts my confidence’

‘We feel valued for who and what we are’

‘I can now stop myself from being angry’

‘I feel safe at school’

‘When I do good work I feel amazing’

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Working in Partnership with Telford and Wrekin Council:Healthy Start

HealthyStartisaUK-wideGovernmentschemeaimedatimprovingthehealthofpregnantwomenandfamilies on benefits or low incomes. Healthy Start is an important scheme that can make a real difference to thehealthofpregnantwomen,newmothersandveryyoungchildren indisadvantaged families. Itprovidesanutritionalsafetynetandencouragesbreastfeedingandhealthyeating,aswellasprovidingvoucherstowardsthecostofbasicfoods.

Theschemeoffersspeciallydesignedvitaminsupplementsfreeofcharge.TheHealthyStartvitaminsmeetrecommendations of the Scientific Advisory Committee on Nutrition (SACN) with regard to supplementation andNICEguidanceplacesaresponsibilityonPCTstoensureimplementationoftheprogramme.

The Department of Health has set national targets to improve the uptake of Healthy Start. In TelfordandWrekin,aschemehasbeendevelopedinpartnershipwithPCTstaff,communitypharmaciesandmedicinesmanagement.HealthyStartvitaminsarenowfreelyavailablethroughmostlocalcommunitypharmacies.Trainingforallstaffwhoworkwithchildrenacrosspartnerorganisations,alongwithmediacoverageandpublicity,hasbeenkeytoraisingawarenessoftheHealthyStartprogramme.

InTelfordandWrekin:

• TheuptakeofHealthyStartishigher(85%)thannationalandregionalaveragesandcomparedtomanyotherWestMidlandPCTs

• AttheendofMarch2010,2,246childrenin1,737localfamilieshadregisteredwiththeHealthyStartprogramme.

Forfurtherinformationcontact:

SarahRockBreastfeedingCo-ordinatorNHSTelfordandWrekinHalesfield 6, Telford, Shropshire, TF7 4BF Contacttelephonenumber:01952580392Email:[email protected]

Proportion of Eligible Families Registering for the Healthy Start Scheme (January – March 2010)

Source: Department of Health Healthy Start Management Information

72.2%

75.6%

75.8%

76.0%

77.3%

77.7%

79.6%

82.9%

83.3%

83.4%

83.8%

83.9%

85.3%

85.4%

85.8%

86.6%

84.7%

82.3%

79.7%

0% 20% 40% 60% 80% 100%

HerefordshireWarwickshire

South Staffordshire Worcestershire

Shropshire CountyNorth StaffordshireSolihull Care Trust

DudleySandwell

Walsall Teaching Stoke On Trent

Coventry TeachingTelford and Wrekin

Heart of Birmingham Teaching Birmingham East and North

Wolverhampton City South Birmingham

West MidlandsEngland

% uptake of Healthy Start

Helping You to Stay Healthy in Telford and Wrekin

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Transcript of Helping You to Stay Healthy in Telford and Wrekin