Floor Target Action Planning

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Floor Target Action Planning for Neighbourhood
Renewal Outcomes Health Housing John
Priestley Associate Director Health
Partnerships North East Lincolnshire Primary Care
Trust 30th June 2006
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Purpose of Floor Target Action Plans In Health
what are the key priorities for
improvement? The evidence clearly demonstrates
that an inactive lifestyle has a substantial,
negative impact on both individual and public
health specifically, that physical inactivity
is a primary contributor to a broad range of
chronic diseases such as coronary heart disease,
stroke, diabetes and some cancers. Smoking
cigarettes and an unhealthy diet have long been
established as major causal factors for chronic
disease.
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• At least five a week -
• Evidence on the impact of physical activity and
  its relationship to health
• A report from the Chief Medical Officer,
  Professor Sir Liam Donaldson - April 2004
• The message in this report is clear.
• Physical activity not only contributes to
  well-being, but is also essential for good
  health.
• People who are physically active reduce their
  risk of developing major chronic diseases such
  as coronary heart disease, stroke and type 2
  diabetes by up to 50
• and the risk of premature death by about 20-30.
  

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• Being active is no longer simply an option it
  is essential if we are to live healthy and
  fulfilling lives into old age.
• The future choosing a more active lifestyle
• No single organisation will have sufficient
  impact alone.
• All will need to work in a coordinated and
  comprehensive way to influence the way we live.

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• The Floor Targets in Health
• Increase Life Expectancy
• Reduce Infant Mortality
• Reduction in premature death from circulatory
  diseases
• and cancer
• Reducing smoking
• Reducing Teenage Pregnancy

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Life Expectancy at Birth
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Infant Mortality
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Premature Death
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• Health Deprivation and disability domain
• The NRF Neighbourhoods with most significant
  health deprivation
• East Marsh Freeman Street
• Nunsthorpe Bradley Park
• East Marsh Grant Thorold
• West Marsh - Macaulay

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• Project Responses
• Obesity Strategy Healthier Communities
  section
• Schools Healthy Eating Food Workers Project
• Health Trainers
• Active Lifestyles
• Tobacco Control Proposal
• Hope Street Clinic
• Teenage Pregnancy Proposals Change for
  Children
• Mental Health Employment Strategy Economic
  Development Enterprise
• Chronic Pain Management Service Economic
  Development Enterprise

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Obesity Strategy - Healthier Communities section

• Sustained focus of investment in the areas of
  greatest need
• Address cultural norms to prevent a further
  generation of obesity
• Well planned Community intervention
• Detail to be worked up but minimum investment is
  seen as 100k over next five years

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Healthier Communities Collaborative
Principle The HCC will enable older people to
make decisions about living the lives they want
to lead. It will provide a way for older people
to be at the heart of, and take ownership of the
decisions about what and how services are
provided in their community. Older people
throughout North East Lincs have identified the
main things that affect their quality of
life Social Exclusion Lack of physical
activity Pour access to healthy diet Fear of
crime and anti-social behaviour They have
demonstrated that the best way to address the
issues that are meaningful to them, is to empower
older people using the collaborative method.
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Healthier Communities Collaborative
The HCC will have a collaborative team in each
of the 15 local wards, made up from Local older
people Other interested residents Key personnel
from the voluntary, statutory and independent
sectors The main thrust of the HCC will be to
create a network of older citizens supported by
community workers and professionals. The HCC
teams will look at and implement a wide variety
of innovative, simple and low cost interventions
to improve the quality of life for older people
in their areas. At the same time they will
interact with service suppliers, transport,
leisure services, social services, health
providers to influence decision making and
provision of services. North East Lincolnshires
bid builds on a successful community action model
that has been used by Older People in our
community as part the NPDT Healthy Communities
Collaborative (Falls).
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Schools Healthy Eating Food Workers Project

• Healthier eating is acknowledged to be an
  integral part of the school environment.
• Better nutrition plays a role in increasing
  concentration, general health and social skills
  of children whether it is through encouraging
  breakfast or eating healthier snacks, meals and
  drinks in a welcoming dining environment. This is
  associated with a positive correlation to
  educational standards in schools nationally.
• A dietitian and foodworker can have input in a
  range of nutrition related areas within the
  school environment such as Food policies,
  Breakfast Clubs, Tuck Shops, Water Provision,
  Vending machines, Lunches, Dining Room
  Environment, Catering, cookery Clubs and Growing
  Clubs.
• Project Costs
• 2 Foodworkers and Dietetic input
• Total Cost 57.500 pa

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Health Trainers

• Role
• Health Trainers are a new workforce and will be
  recruited from the local community.
• The suggested approach and techniques for
  delivering the role are evidence based.
• Health Trainers will be working in local
  organisations across the voluntary, business and
  statutory sectors.
• The Health Trainer will come from local
  communities, accredited will be friendly,
  approachable, understanding and supportive
• will help people to develop a personal health
  guide if they wish
• will provide advice and practical support on what
  they can do, e.g. stop smoking, healthy eating,
  stress management, safer sex, tackling social
  isolation, will build peoples confidence to make
  the changes they want
• Personal Health Guides
• are unique to the individual allow them to work
  out for themselves how healthy their current
  lifestyle is set out their ambitions for their
  health, determine what action they want to take
  and what support they expect from the NHS and
  others.

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Health Trainers
Proposal To augment the current proposals for
rolling out Health Trainers by having a specific
Health Trainer for each of the four NRF
Neighbourhoods with the greatest problems in
terms of health. Total cost circa 80k per
annum
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Active Lifestyles

• The proposal centres around the development of an
  Active Lifestyles (AL) Advisor post.
• Health professionals would be able to refer
  patients, and their families, to the AL Advisor.
  
• The AL Advisor would act as a life coach helping
  them to become more active, develop healthier
  lifestyles to gain an overall improvement in
  their health and well-being.
• The AL Advisor would work with the patient on a
  weekly basis over an 8 week period, with the
  initial session being 1hr 1.5hr consultation to
  include motivational goal setting.
• To access the service patients, and in terms of
  families a member of the family, would be
  obese (bmigt30) already be suffering from a
  chronic disease eg diabetes, CHD and living in
  one of the most deprived areas of North East
  Lincolnshire.

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Active Lifestyles

• AL would complement the proposed programme in
  respect of Health Trainers Health Trainers able
  to signpost to the AL Advisors in the same way as
  they might to the smoking cessation service etc.
• Also AL Advisors would be able to signpost to the
  Health Trainer programme if they think a client
  might need broader lifestyle support.
• RESOURCE REQUIRED FOR PILOT IMPLEMENTATION
• Cost of Active Lifestyles Advisor per year
  35,000
• Non-recurrent costs (establishing base, leaflets
  etc) 5,000
• Total Cost of a 2 year pilot 75,000
• Number of individuals and their families
  supported over the pilot period 150.
• Pilot to include on-going evaluation and
  development.

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Tobacco Control Proposal

• Key Priority
• To reduce the rate of smoking prevalence in North
  East Lincolnshire
• Why?
• Smoking remains the number one cause of
  preventable premature death in the UK
• Second hand smoke is injurious to health
• Smoking is a major contributory factor to
  coronary heart disease, cancer,
• respiratory disease, stroke and low birth
  weight
• Rates of smoking are closely linked to health
  inequalities

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Tobacco Control Proposal

• Improvements to close the gap
• Improve access to advice and stop smoking
  provision in targeted communities via public
  health initiatives including Extended healthy
  schools programmes, Health trainers, Specialist
  Health Promotion Services Programme
  co-ordinators, Intermediate stop smoking
  advisors, etc
• Likely cost 2k pa (Delivery of training and
  material resources)
• Establishment of a young peoples advice and
  stop smoking provision within youth settings,
  facilitated by NEL NHS Stop Smoking Service.
  Delivered by key young peoples workers school
  nurses, connexions, drug action teams, etc
• Likely cost 20k pa (Part funded Community
  Programme Co-ordinator)
• Establishment of Smoke-free Homes initiatives
  in target areas
• Likely cost 15k pa (Project Worker)
• Local Authority to carry out targeted underage
  test purchase initiatives
• Potential costs - Awaiting information

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Hope Street Clinic
Aim To provide essential health and social care
services to a number of vulnerable groups in
North East Lincolnshire who traditionally
struggle to access a full range of services. To
achieve this aim service delivery will need to be
imaginative, flexible and built around the needs
of the individual users, rather than the usual
service provision using a virtual practice model.
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Hope Street Clinic

• Target Groups
• Workers in the sex trade, asylums seekers and
  the homeless etc
• We have just been awarded funding from the Home
  Office to develop a bespoke primary care
  service for ex-offenders who are revolving in and
  out penal institutions.
• Temporary residents (Holiday Parks)
• Patients who, due to serious misconduct are
  registered with a Secure practice in Doncaster
  (repatriation).
• West Marsh Community Centre -The proposed virtual
  practice would look to provide a satellite
  service in the West Marsh 2-3 times each week,
  and to work with the community centre to promote
  wellbeing and healthy behaviours.

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Hope Street Clinic
The project is reaching the stage where it needs
a lot of coordination and the development of a
comprehensive business plan. To this end, The
PCT are seeking short term funding from the
Neighbourhood Renewal Board to employ a project
manager for the remainder of the current 2006/07
financial year. Budget Required 46,274
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• The Floor Targets in Housing
• Reduction in the number of homes that fall
  below decent homes standard
• The majority of this reduction taking place in
  deprived areas
• and vulnerable households in the private
  sector
• Increase the proportion who live in homes that
  are in decent condition

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Housing Project responses

• Existing work is underway within Shoreline and
  NELC to target resources to improve housing 
  conditions in some of these key areas
• If this work could be further integrated under
  NRF and prioritised by the NRF Board this would
  reap more sustainable benefits 2 dedicated
  Empty Homes Officers employed to concentrate
  multi agency action to bring back empty
  properties into productive use in the some
  neighbourhoods. 
• These workers would need to be situated in the
  larger Neighbourhood Teams to ensure effective
  communication across the relevant agencies.
• A small degree of co-ordination support would
  enable this to happen.
• This proposal is about redirecting existing plans
  into NRF areas and to change timescales to
  prioritise key areas - this work would be
  sustainable and would be more likely to deliver
  long term solutions.