NHS Health Check: Tackling health inequalities in community settings

Transcription

1 NHS Health Check: Tackling health inequalities in community settings Andrea Hare: Health and Wellbeing Leader, PHE (Feb 27 th 2014)

2 Aim of the workshop: To gain an understanding of the importance of addressing health inequalities within the health check programme Share two successful local approaches to tackling health inequalities within a community setting Share opportunities, challenges and solutions Offer an opportunity to ask questions and generate discussion 2 NHS Health check: tackling health inequalities in community settings

3 Why should we address health inequalities? Tackling health inequalities is an important part of creating a fairer and healthier society Inequalities in health outcomes arise because of the conditions in which people are born, grow, live, work and age the social determinants of health A holistic approach is required to reduce health inequalities in life expectancy between different sections of the population According to Marmot (Heart UK report 2010) inequality in illness has a significant economic impact on society 3 NHS Health check: tackling health inequalities in community settings

4 Inequalities and CVD Although life expectancy has increased for both men and women over last three decades inequalities remain The variation in life expectancy between the wealthiest and most deprived neighbourhoods has risen in England. And there is a similar pattern with cardiovascular disease (CVD) mortality Although deaths from CVD have fallen, the decline has been smaller in the more deprived communities Distinct divide between the North and South of England on prevalence of the condition higher in the North of England Progress has been made in reducing CVD inequalities, but the evidence shows that a much more focused and intensive effort needs to take place to address its causes. Source: Bridging the Gaps: Tackling inequalities in cardiovascular disease, Heart UK NHS Health check: tackling health inequalities in community settings

5 NHS Health Check programme: addressing health inequalities One of the main aims of the NHS Health Check programme is to help narrow health inequalities from the conditions covered by it. The roll out of the NHS Health Check programme is vitally important in addressing premature death, disability and reducing health inequalities The programme has been designed so that the majority of the check can be delivered in different settings, ensuring the programme is as accessible to as wide a range of people as possible. National agencies need to continue working closely together to support local government and the NHS to implement this programme for the 15 million eligible people in England. PHE are committed to strengthening the evidence base and sharing good practice. 5 NHS Health check: tackling health inequalities in community settings

6 The NHS Health Check Tackling Health Inequalities in Manchester National Conference: NHS Health Check share, listen, act

7 Sue Longden Consultant in Public Health Manchester City Council Dr Paul Wright GP Northenden Group Practice, Manchester Sr Alison Morgan Practice Nurse - Northenden Group Practice, Manchester

8 Public Health Now and Then Slide 8

9 Public Health Challenges Slide 9

10 Headlines Manchester has the lowest life expectancy for women in England and the second lowest for men People in Manchester have the lowest Healthy Life Expectancy in England (i.e. they spend more years suffering from chronic ill health than their counterparts in the rest of the country) Slide 10

11 Public Service Reform Supporting individuals to take control, enabling them to take decisions that support their own health and wellbeing, and reducing their dependence on other public services. Slide 11

12 The Manchester Approach Mixed model of provision Local programme commenced in May GP practice providers - Pharmacy - The First Stop Health bus - Dental Slide 12

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14 What has had the greatest impact? Calculate where the First Stop Health Bus will have greatest effect Poor access to GP based NHS Health Checks High prevalence of risk factors High CVD mortality Slide 14

15 A sample of our data 44% male. 56% female 23% current smokers 71% overweight 43% Audit-C positive 11% with 10 year CVD risk >20% 62% referred for intervention High numbers of pre-diabetics Slide 15

16 NHS Health Checks on the First Stop Health Bus A provider perspective Slide 16

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29 NHS Health Check PLUS - Tackling Health Inequalities in the borough of Greenwich (Story of a place) Chima Olughu Public Health Programme Manager Name of presentation

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33 Royal Facts one of the five host boroughs of the 2012 Olympic and Paralympic Games Population of 255,500 19th most deprived Local Authority in England Life expectancy in Greenwich is substantially shorter than the national average. Name of presentation

34 Life Expectancy at birth Greenwich and England and Name of presentation

35 Greenwich NHS Health Check PLUS Inclusion of RBG JSNA priorities Improve mental well-being Detect previously undiagnosed disease Raise awareness of cancer screening Decrease falls and improve bone health Decrease alcohol related harm Depression filter FEV1 predicted (lung age) Cancer screening Falls filter Alcohol filter Name of presentation

36 The impact of improved CVD prevention on life expectancy Name of presentation

37 Early work GP practice set up an opportunistic Health Check project at a local supermarket, screening 1,024 men over eight weeks The project helped PH assess the benefits of opportunistic Health Checks through an outreach model, which has since been rolled out to other major public places Name of presentation

38 Early work At the Local Mosque & temples A relationship building exercise in collaboration with colleagues who already had a presence in these places Name of presentation

39 As the Imam of Woolwich mosque I am delighted by the services offered by NHS Greenwich to my community. They have brought awareness to health issues much needed, especially during the month of Ramadan when people fasting have to be conscious about their health and sustainable needs. I sincerely hope they will continue to provide these services; their popularity has increased and now they have begun to tap into the hardly reached members of the community. Imam Ali Woolwich mosque Name of presentation

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41 Objectives: To provide NHS Health Checks in community locations specifically targeting people who do not ordinarily engage primary care services To make the service available to a younger cohort To target specific areas of deprivation Name of presentation

42 To help find the missing To identify risk factors associated with other disease areas, for example, respiratory health, cancer and mental health and manage this risk or signpost to other services as appropriate. Name of presentation

43 Describe the service Name of service we commissioned Robust service specification Regular contract monitoring meetings Regular 2-way communication Name of presentation

44 Outcomes 2018 people had a Health Check in the 1 st six months of the programme across 33 different locations Of all participants undergoing health checks 61% were female and 39% male 74% were registered with a GP and 26% were not. Name of presentation

45 Name of presentation Ethnicity

46 HbA1C Name of presentation

47 Pulse Rhythm Name of presentation

48 FEV1 Predicted Name of presentation

49 Opportunities Partnership building Use of the deep wealth of knowledge Working with LA colleagues using PH intelligence to address the wider determinants of health Promote the service across the borough Name of presentation

50 Challenges & Risks Reaching those who do not access services IT Continued ring-fenced funding for the programme Lack of follow-up for high risk patients Patients having several Health Checks Population turnover Name of presentation

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52 Any questions?