Subject: Healthy Lifestyles Strategy - Get Moneysmart

Status: For Publication

Report to: Health and Wellbeing Board Cabinet Member: Councillor Cecile Biant

Date: Tuesday, 31 March 2015

Report of: Director of Public Health Author Email: helen.skidmore@rochdale.gov.uk

Author: Helen Skidmore Tel: Tel: 01706 927074

1 Purpose of Report

1.1 This report provides the Board with the agreed 6 monthly update summary of some of the key Healthier Lifestyle related activities delivered during 2014/15

1.2 To provide a summary evaluation of the Get Moneysmart campaign, which covers multiple lifestyles behaviours and wider determinants of Public Health.

2 Recommendations

2.1 The Board notes and accepts the update report for Healthy Lifestyles and the evaluation of the reported feedback for Get Moneysmart. Reason for recommendation 2. To assure the Board of delivery of the borough’s Healthy Lifestyles Strategy, which is one of the priority areas within the Health and Wellbeing Strategy.

3 Background

3.1 The Healthy Lifestyles Strategy was approved by the Health & Wellbeing Board in July 2013. An update was last provided in July 2014 and this report provides the 6 monthly update on a selection of some of the key areas of work of the Multi Agency Healthy Lifestyles (MAHLS) group over the past 12 months, and the multi-agency Get Moneysmart campaign. The Healthy Lifestyles strategy is due for refresh for 2015-18 and will be developed in the coming months. 3.2 A New Integrated Healthy Lifestyles Service The Big Life Company was selected as the new provider for the Integrated Healthy Lifestyles Service, with weight management services being sub-contracted with Pennine Acute Trust. The service began delivery on 1 April 2014 with a central base at Lock 50 in central Rochdale and has recently restructured the team to provide a transformational delivery model, whilst ensuring high quality services continue to be provided. The end of year performance report will include a summary of key

achievements in Year 1. These will be shared with the Health and Wellbeing Board at a subsequent meeting 3.3 Health Chats We now have over 2,000 trained Health Chatters in the borough (Table 1). Table 1 - Health Chatters Trained and Accredited in Rochdale Borough

Phase/Group Numbers trained

Numbers sitting exam

Numbers passed

Exam % pass rate

1 - pilot 259 259 219 85

2 - 900+ trained by Pennine Care 908 908 894 98

3 - young people in training or education 116 116 107 92

2013 14 schools & LAC 251 114 72 63

2013 14 generic groups 208 195 188 96

2013 14 veterans 11 10 10 100

Big Life 2014/15 Total to date - varied groups 376 376 358 95

Total 2129 1978 1848 93

Phases and Organisations The 2014/15 programme is currently underway to train 600 more Health Chatters, working with some new groups including faith groups, PCSOs and Police Special Constables, Fire Service volunteers, RMBC Youth Service and youth groups, a pilot with dental and GP staff, Groundwork, Agilisys, Adult Care staff and providers, rugby and football club staff and volunteers and CAB staff. The programme will be commissioned for a further two years, 2015/16 and 2016/17, to work with groups that have been suggested during consultation with existing Health Chatters and stakeholders, along with additional training for some groups requiring further sessions for staff or community members.

3.4 Tobacco Prevalence Smoking prevalence in the borough is now at an all-time low of 22.7% (Health Survey for England, Integrated Household Survey, 2013), having reduced from 28.7% in 2000. This is still above the England average of 18.4% and we clearly have some way still to go. The JSNA also shows evidence of a reduction in smoking uptake in children and young people as can be seen in the chart below.

Smoking in pregnancy remains an ongoing challenge as can be seen on the following chart.

Stop smoking support The challenge of falling numbers of quits through the Stop Smoking Service continues, not just in Rochdale borough but across Greater Manchester and indeed the whole country. The role of e-cigarettes in migrating smokers off traditional cigarettes is one potential reason for the falling numbers accessing stop smoking support. This brings with it concerns over people switching to an alternative that appears (but is not yet proven) to be less harmful than traditional cigarettes but still leaves smokers addicted to nicotine. Quits from GP surgeries and pharmacies via the Locally Commissioned Service (LCS) are also falling, with competing priorities for resource in those organisations having an impact. Stop smoking advisors across the area are also now working with those who are more difficult to support and those who have been smokers for many years, which presents challenges in terms of numbers of successful quits. In response to this, Public Health has developed a new incentive scheme for men, based on the successful pregnancy stop smoking incentive scheme. Quit & Get Fit incentivises men to stop smoking with free Link4Life gym passes issued at crucial points in their quit journey. The aim is to support more men to set a quit date and ultimately quit for good, whilst encouraging them to increase physical activity through the free gym passes gained at 4, 12 and 26 week quit stages. Since October 2014 we have had 25 men sign up to the scheme, with 21 having reached a 4-week quit and 4 having reached a 12-week quit. 10 of the men have activated their gym passes with 6 having attended at least once. In addressing the falling quits from GP surgeries and pharmacies, for 2015/16 we are currently commissioning a pilot community outreach LCS. This will be delivered by partners from the third sector, housing associations and other stakeholders who do not traditionally provide stop smoking quits. Smoke-free cars From October 1 2015, anyone smoking a cigarette in a car with a child under 18 present, will be breaking the law and could be fined. The Regulations were passed in the Commons on the 11th February after 342 MPs voted in favour of legislation while just 74 voted against. The new Regulations, to be enforced by the Police, will protect children from being exposed to second hand smoke whilst travelling in cars. The Health and Wellbeing Board responded in support of these Regulations during the consultation period in August 2014. Rochdale Borough Council has had a voluntary smoke free homes and cars scheme within the borough since 2006. Each year families sign a pledge to make their homes and cars smoke free. To date in 2014-15, 136 local families have made the voluntary pledge not to smoke or allow smoking within in their home and car. Decifer Assist

The Public Protection Service has continued to deliver the Decipher-Assist

programme, a smoking prevention programme to high schools within the borough. The

programme involves training influential Year 8 students to work as ‘peer supporters’.

Peer supporters are trained and supported to have informal conversations with other

Year 8 students about the risks of smoking and the benefits of being smoke-free. ASSIST has been evaluated by a randomised controlled trial funded by the Medical Research Council. The trial found the ASSIST programme to be effective in reducing smoking prevalence over a two year period of follow-up.

The Public Protection Service delivered the programme to 4 schools in 2013/14, and trained over 130 peer supporters. The peer supporters are requested to record their conversations in diaries and these are collated and evaluated Since September 2014, the Public Protection Service has delivered the programme to 3 more schools within the borough; Wardle High School, St Ann’s Academy and Siddall Moor. The programme has been completed in 2 of the 3 schools, and once the third school is complete, there will be a total of over 85 peer educators within the 3 schools who will lead other pupils to increase their knowledge about tobacco and the negative effects of smoking as well as the benefits of being smokefree.

Feedback from both the pupils and teachers from the 2 completed schools has again been very positive; pupils have enjoyed the experience and expressed how their confidence has grown. Teachers have been impressed as they have seen a different side to some of their pupils.

3.5 Healthy Weight

Children Children in Reception and Year 6 are weighed and measured each year as part of the National Child Measurement Programme (NCMP). For many years the percentage of overweight and obese children has been increasing. Levels of obesity and overweight increased in 2013/14 apart from obesity in Year 6, although none of the changes were statistically significant.

• Obesity in Reception Year rose from 8.8% in 2012/13 to 9.8% in 2013/14

• Overweight in Reception Year rose from 12.9% in 2012/13 to 13.0% in 2013/14

• Obesity in Year 6 fell from 20.7% in 2012/13 to 19.8% in 2013/14

• Overweight in Year 6 rose from 13.0% in 2012/13 to 14.6% in 2013/14 There was a slight increase in the combined measure from 2012/13 to 2013/14:

Reception Year 6

2013/14 22.8% 34.4%

2012/13 21.8% 33.7% Adults Public Health England’s data on excess weight in adults for all local authorities in England shows that 68.6% of adults in Rochdale are obese or overweight, which is the 7th highest out of all local authorities in the North West and is higher than the North West and England averages. Tackling Obesity A broad range of healthy eating and physical activity interventions for children, families and adults continues to be promoted and offered within the borough to support people to reach and maintain a healthy weight. As part of a programme of continuous improvement, the Healthy Weight Team and partners are reviewing the current provision to ensure improvements are made where required.

3.6 Get Moneysmart Overview The ‘GET MONEYSMART’ campaign was initially rolled-out by Public Health during April and May 2013, with a series of community engagement and outreach events held in target areas across the borough. The aim of the project was to raise awareness of the positive financial impact achieved by making small changes to everyday behaviours, specifically reducing expenditure on smoking, alcohol and convenience foods. The campaign was refreshed with the addition of shisha and gambling behaviours, and following community co-creation and it was re-launched in September 2014, running until the end of December. The refreshed campaign included the original briefing packs for partners to support them to deliver community engagement using the packs, local media and press coverage, a series of video case studies and vox pops from local people, a Facebook campaign page and Facebook advertising to drive awareness. Campaign implementation

• Over 200 partners signed up to support the campaign, including a large number of housing associations which were instrumental in the roll out of the campaign’s community engagement.

• All 6,000 packs from the initial print run were distributed by partners and a further 2,000 packs were printed on request from partners who required more packs.

• A Facebook page was set up and people were encouraged to share their moneysaving tips, video case studies for each of the five behaviours were uploaded onto the page along with a vox pops video of numerous local people sharing moneysaving tips.

• Posts on the Facebook page were shared and re-tweeted by RMBC and some partners and paid for advertising ran for 75 days to increase awareness and engagement.

• The Facebook page reached over 58,000 people across the borough.

• We received over 800 ‘likes’ for the Get Moneysmart Facebook page, with 707 of these (88.2%) as a direct result of the paid for ads and 95 from organic traffic (actions as a result of unpaid distribution, through partners for example).

• There were 2,536 video views, with 1,760 resulting from paid for ads and 776 from organic traffic. 34 comments were made on various posts on the page.

• Almost a third (31.7%) of the page ‘likes’ were from within the Rochdale borough, with 47.6% being from Manchester. However, it is likely that a large number of those classed as ‘Manchester’ were local to our borough as many people, especially from Middleton, identify as from their closest city as a way of being less identifiable.

Impact of the campaign

An on-street survey was undertaken with over 200 residents to establish the impact of the campaign. Respondents were representative of the demographics of the area. Awareness and recall When asked about the campaign 32.7% were able to recall the campaign without being prompted and when shown the posters as a reminder that figure rose to 46.2%. This was a 15.7% increase on unprompted recall and a 12.2% increase in overall campaign recognition. This is a very encouraging result as the baseline from last year’s campaign was high to start with. When asked where they saw the campaign, the majority had seen the marketing materials around the borough. The next highest was the social media Facebook page, followed by engagement with stakeholders or partners. Thoughts on the campaign When asked what they thought about the campaign, respondents were overwhelmingly positive and supportive of the campaign. In particular, respondents commented on how helpful and useful the Get Moneysmart packs and budget planners were in terms of money-saving advice and budgeting:- “I didn’t realise how much you can spend on smoking and drinking in a month, it’s scary when you think about it.” “I’m saving for a holiday at the moment. I’m a single mum, so the packs and information are really helpful for different ways to save money. It all helps.” Some respondents had also recommended the campaign and GET MON£YSMART packs to their friends and family to help them better manage their money and rethink unhealthy lifestyle choices:- “My brother smokes shisha, so I want to get a pack for him as well and show him how much it costs and harms his health. He thinks it’s healthy.” “I’m skint at the moment, so the pack really helped me and my dad try and save a bit of money.” A few respondents made particular reference to the effectiveness of the campaign Facebook page and videos:- “It looks good, I’ve watched some of the videos on Facebook for useful tips and things I can do, but I’m not disciplined enough to use the budget planner.”

Behaviour change

When asked if they had done anything to save money or change how they spend or manage their money as a result of seeing/hearing about the campaign, almost a quarter (22.9%) of those who remembered seeing the campaign said that they had made changes to their behaviour such as spending decisions, lifestyle choices and budgeting. This is a 3.5% increase in actual behaviour change compared to the previous campaign in 2013. A number of respondents also commented on what changes they had made as a result of the campaign, including changes to unhealthy lifestyle behaviours:- “I’ve cut down on alcohol when I realised how much I was spending, it was silly but I just hadn’t really thought about it before… I didn’t realise how much alcohol was costing me every week. I now spend a lot less on drinking.” “I’m now getting help to manage my money better. I’m also trying to stop smoking so the money I save can go towards Christmas for my kids. I want them to have a good Christmas. Plus, it’ll be good for my health.” “I’m trying to stop smoking so I can save some more money towards buying a new car when I finally pass my driving test. I need the money and smoking costs me loads, it’s just really hard to give up.” Other respondents had made changes to their food shopping habits in order to save money, as well as started to budget and manage their money more:- “I’ve cut down on expensive shopping and now shop at Aldi for my food, it’s a lot cheaper. You get a lot more food for your money. I’ve found a lot more deals on food by shopping around more, and you can get a lot cheaper fruit and veg than I thought.” “I’ve started to budget more and really think about what I spend my money on. I use the budget planner and keep more of an eye on what I spend, making sure I only spend what money I’ve got. It’s so easy to lose track of how much you spend, but I just ask myself do I really need it.” Throughout the duration of the campaign, a number of people also left comments and posts on the Facebook page, sharing their own stories and healthy money-saving tips, such as:- “My top tip would be to never go shopping on an empty stomach! It may sound silly, but the hungrier you are, the more likely you are to buy things you don’t necessarily need – or things that are ‘more convenient’ (and therefore probably more processed / less healthy).” “If it’s less than a mile to your nearest corner shop, walk. Just a little bit of extra exercise in the day can drastically improve fitness, help you to sleep, save money, de-stress and is also better for the environment.” “Send kids to school with fruit / take fruit to work instead of buying unhealthy snacks. A 30p bar of chocolate will satisfy you for one break, whereas a bag of 8 apples can be 60p or less. Swapping snacks can also help you feel more awake and less sluggish.” “Take water to school / college / work, it’s great for you to keep hydrated (improving skin, hair, digestion and almost everything else) and this reduces temptation to buy snacks or fizzy drinks, which easily add up to around £30 a month if you use expensive vending machines.”

What Next? Funding has been confirmed for a reduced cost campaign for 2015/16 which will use the same packs, social media as in 2014/15, with the addition of new video content.

4 Financial Implications

4.1 Budgets for these schemes will be extended into 2015/16, and whilst they are marginally lower than the 2014/15 budgets, it is anticipated that the service will be able to effectively manage the schemes within the available budgets.

5 Legal Implications

5.1 There are no legal implications associated with this report

6 Personnel Implications 6.1 There are no personnel implications arising from this report.

7 Corporate Priorities

7.1

8. Risk Assessment Implications

8.1

9. Equalities Impacts 9.1 Workforce Equality Impacts Assessment

There are no workforce equality issues arising from this report. 9.2 Equality/Community Impact Assessments

There are no (significant) equality/community issues arising from this report.

Background Papers

Document Place of Inspection

None