National Public Health Service for Wales / “Keep Well This Winter” National Public Health Service for Wales evaluation of the 2006/2007 campaign

“Keep Well This Winter”

National Public Health Service for Wales evaluation of the 2006/2007 campaign

CONTENTS

Page
1 / RECOMMENDATIONS / 3
2 / PURPOSE / 4
3 / BACKGROUND / 4
3.1 / Overview / 4
3.2 / Key themes/objectives / 5
3.3 / Funding and the NPHS input / 5
4 / EVALUATION / 6
4.1 / Methodology / 6
4.2 / Overall observations / 6
4.3 / Specific findings / 7
4.3.1 / Range of activities / 7
4.3.2 / Use of funding / 8
4.3.3 / Usefulness of national resources / 8
4.3.4 / Local resources / 8
4.3.5 / Participants at KWTW events / 9
4.3.6 / Media coverage / 9
4.3.7 / General comments from respondents / 10
4.3.8 / Continued support / 10
5 / CONCLUSIONS / 11
6 / WAY FORWARD FOR 2007 /8 / 12
Appendix / Local Public Health Team Contacts / 14

©2007 National Public Health Service for Wales

1RECOMMENDATIONS

The evaluation of the 2006/7 Keel Well This Winter (KWTW) Campaign has lead to the following recommendations from the National Public Health Service (NPHS) Vulnerable Adults Team:

  • The NPHS supports the combination of the KWTW and the Healthy Ageing Action plan as the two address the same public health issues such as healthy eating, physical activity, health protection and safety promotion. As the branding of KWTW is now well known within the service this should remain to support specific initiatives e.g. increasing flu vaccine uptake.
  • Dedicated personnel, time and resources should be made available for the NPHS to lead on the KWTW and Health Ageing Action plan at local level utilising the extensive networks, partnership working and additional professional skills available in the service.
  • There should be flexibilitywith regard to the type of initiatives required at local level reflectinglocal need and experience.
  • Local Public Health Teams should strengthen relationships with immunisation co-ordinators to prevent duplication of effort and enable the delivery of a more co-ordinated approach to increasing the uptake of flu vaccine.
  • Local Public Health Teams should be encouraged to ensure that all KWTW themes are embedded in local work and action plans and local Health, Social Care and Well-being Strategies.
  • The NPHS supports the production of a KWTW ‘booklet’ but would suggest that this is produced in a format that will enable additional information to be incorporated if required.
  • It would be beneficial if the Ambulance Service could identify a named contact for KWTW within each area who could be contacted by Local Public Health Teams or partners.

2PURPOSE

This report aims to provide an evaluation of the involvement of the local NPHS teams in the implementation of the KWTW campaign commissioned by the Welsh Assembly Government (WAG). It also makes recommendations for the 2007/08 programme, based upon an evaluation of the scheme conducted at a Local Public Health Team (LPHT) level.

3BACKGROUND

3.1Overview

KWTW is a national campaign in Wales which aims to provide information and support for people aged 65 and over and those in ‘at risk’ population groups e.g. younger people at risk (suffering from CHD, diabetes, stroke, renal), to help them maintain their health during the winter months.

KWTW is organised by WAG. The campaign links a number of initiatives in a systematic approach and focuses the expertise and resources of a number of statutory and voluntary sector organisations in a nationally co-ordinated campaign.

A steering group oversees the development of initiatives and resources to support the campaign themes and involves representation from a number of statutory and voluntary organisations, including the NPHS. The steering group meetings are organised bi-monthly by Age Concern Cymru on behalf of WAG.

In terms of the NPHS Business Plan for 2005/8 the strategic goalandstrategicobjective for KWTW were:

Strategic Goal

  • Reduce the impact of social, demographic, economic, and seasonal and climate change on health and well-being.

Strategic Objective

  • Reduce the impact on health of winter conditions.

KWTW is part of the NPHS work programme and Service Level Agreement with Welsh Assembly Government. The NPHS is a strategic national partner, and has undertaken to develop local partnerships to deliver the campaign locally through LPHTs. The NPHS nominated a lead for the campaign who represented the NPHS at national steering group meetings and who acted as the first point of contact for the campaign and briefed colleagues in the service on campaign developments. The NPHS was required to contribute to the monitoring, evaluation and future development of the campaign and produce an annual report.

3.2Key themes /objectives

The campaign was essentially aimed at engaging the target audience through a combination of community action, media promotion and informative materials. The three key themes of KWTW were:

  • Keep Well – encouraging people in the 65 and over age group and those in ‘at risk’ population groups to have a flu vaccination, to eat nutritious food and to take appropriate exercise.
  • Keep Warm – promoting the uptake of the Home Energy Efficiency Scheme (HEES) grants and energy efficiency measures generally, and raising awareness of the importance of adequate heating during the winter.
  • Keep Safe – addressing issues such as falls in the home, electric blanket safety and promoting a befriending scheme.

The key objectives were:

  • to increase awareness among the target audience of the key issues that will enable them to keep well this winter.
  • to increase the uptake of flu vaccine among the target audience.
  • to improve access to help and support for those most vulnerable within the target audience.
  • to encourage a co-ordinated and multi-agency approach among service providers.

WAG has a number of key initiatives, of which KWTW and its themes were key components, namely:

  • Health Ageing Action Plan for Older People
  • National Service Framework for Older People (NSF)
  • Health Challenge Wales
  • Wanless Implementation

3.3Funding and the NPHS input

LPHTs were well positioned within local communities to make a key contribution to the development of initiatives to promote and support KWTW. Welsh AssemblyGovernment provided funding to the NPHS to enable the local teams to facilitate local action. The funding of £2,000 per LPHT was intended to support activity that would engage with the general public, be brought about by local partnerships and be appropriately evaluated so that lessons may be learnt for the future.

The key priorities for this year’s campaign were to increase the uptake of the flu vaccination, contribute to a reduction in fuel poverty and access the ‘hard to reach’ people within the target audience.

The funding was intended to help with the cost of staff time, venue hire, refreshments, local promotion and for commissioning partner agencies to undertake activities.

An associate member of the NPHS Vulnerable Adults Team acted as the co-ordinator for the campaign for the NPHS. All Directors and Associate Directors of Public Health were contacted in May 2006 with an outline of the proposed KWTW campaign 2006-07, the NPHS role and the funding structure was agreed with WAG and NPHS Finance.

The funding was only made available to LPHTs if the following criteria were met:

  • a KWTW lead was to be identified in each LPHT and contact details forwarded to the NPHS KWTW lead
  • a brief outline of proposals and costings on how best to utilise the £2,000 was submitted for each team to the NPHS KWTW lead.

The response to this request was excellent with a 100% return. Each LPHT identified a lead person and submitted a brief action plan. Funding was provided to each team with the condition that an evaluation report was submitted to the NPHS lead following the end of the campaign period, to enable a report to be produced on behalf of the NPHS for Welsh Assembly Government. Regular contact with the LPHT leads was maintained by the NPHS lead and the national KWTW co-ordinator.

4EVALUATION

4.1Methodology

As in previous years the evaluation was carried out by means of the completion of an evaluation formsent to all LPHTs in February 2006.The responsewas comprehensive i.e. 95% return with a considerable amount of locally produced, additionalsupportive material included.

This report endeavours to capture the key points identified in the evaluation form responses in a concise but accurate manner.

4.2Overallobservations

  • All twenty two LPHTs across Wales submitted action plans to the NPHS lead forthe campaign by June 2006 and subsequently received the £2,000 funding. Atthe time of producing this report nineteen evaluation forms had been returnedto the NPHS lead, covering a total of twenty LPHTs, as some teams cover twocounties in North Wales. Although the national NPHS lead was aware that there had been support for the campaign by all LPHTs indicated in the original action plans one LHB did not submit formal evidence. This may have been due to staff changeswithin the NPHS during the campaign period.
  • Once again the evaluation forms returned suggested that the NPHS was either leading or playing a key role in organising initiatives to support the KWTW campaign themes. In the majority of areas local steering groups were established, or existing groups were used e.g. Ageing Well Steering group to oversee local activity, these had either been organised or attended by the LPHT. Other agencies that led in some geographical areas includedAge Concern, Strategy for Older People Co-ordinators, Community First Partnerships, Local Authorities and Care and Repair.
  • The majority of respondents reported covering all three campaign themes but there were only six areas which reported incorporating electric blanket testing at events this year due to lack of availability or inhibitive costs.
  • One issue that did arise repeatedly throughout the evaluation responses was the fact that local KWTW events were time consuming to organise and that although they may had been considered successful in some areas, they were not well attended in others despite the considerable time commitment. Some respondents suggested having a dedicated KWTW co-ordinator in each LPHT, focused solely on the campaign themes throughout the year, particularly as KWTW is often viewed as an additional pressure.

4.3Specific findings

4.3.1Range of activities

The range of activities continued to broaden but without exception the initiatives were inclusive of other agencies and provided excellent examples of strong partnership working. The range of activities was extensiveand included:

  • Information markets
  • Cookery demonstrations
  • Physical activity workshops
  • Training for carers
  • Presentations
  • Localised KWTW booklets
  • Media articles
  • Information cards, placemats and information sheets

The evaluation form requested information on whether respondents would do anything differently in future years. The response wasthorough with many positive and enthusiastic replies, such as “...we would have an even bigger and better event”.

Others suggestions included:

  • Using the available funding to produce a condensed information leaflet.
  • Focus on Keep Well and Keep Safe during the first few months of the campaign due to the milder winters, and have less emphasis on Keep Warm.
  • Hold consultations with older people to seek advice on producing localised booklets.
  • Use more local venues such as Post Offices.
  • Incorporate KWTW messages with Health Through Warmth training and publicity.
  • Introduce a drama sketch to demonstrate the benefits of ‘flu vaccination.

4.3.2Use of funding

The funding provided by WAG was primarily used to meet the cost of venue hire, refreshments, Royal Society for the Prevention of Accidents (RoSPA) home safety tea towels, promotional leaflets, printing costs, display materials, advertising, fleece blankets, transport, road closure for information market and demonstrators. Once again many areas produced their own resources.

LPHTs spent considerable time organising and attending events, producing and distributing materials, and networking with partner agencies.

4.3.3Usefulness of national resources

The evaluation form requested information on what resources people would have found helpful if they had been available nationally. The response was varied with teams highlighting the needs for more KWTW information packs as demand outstripped supply. This was specifically with initiatives being held in GP surgeries, flu clinics and the participation of community pharmacies.

Also identified was possibly a larger ‘free’ allocation of RoSPA home safety tea towels, KWTW pens and notepads, banners and exhibition boards.

One team suggested the production of a catalogue of recommended resources that supported all the KWTW themes, whilst another queried whether the production of a nationally produced KWTW booklet would be a better resource than the current information bags.

4.3.4Local resources

The KWTW packs were disseminated via the national KWTW co-ordinator to all areas upon request with some purchasing additional supplies. A number of areas also produced their own resources to meet the local requirements. The evaluation requested information on what resources the teams produced. As in previous years many teams had been inventive and some of the responses included:

  • A professional checklist with key messages and local contacts
  • Updated local ‘flu posters
  • Pharmacy labels
  • Reprinted Eat Well Keep Well leaflets from last year
  • Top Tips booklets
  • Information credit cards
  • Newsletters
  • Word search
  • Training day information booklet
  • Banners
  • Placemats
  • KWTW resource file for phone line volunteers

4.3.5Participants at KWTW events

The evaluation form requested information on the number of people attending events or receiving information on KWTW, specifically those aged 65 and overand in excess of 6000 people were reported tohaveattended local events. Two teams provided training for volunteers and carers which were attended by more than 150 people. One Team accessed 1172 people over a twelve day period at ‘flu clinics and at a market stall. One Team organised five events throughout the county but reported attendance was down by 500 from the 2005/06 campaign. Approximately 15,000 KWTW information packs were reported to have been distributed in addition to other local information(e.g. 10,000 place mats).

When asked if the teams felt that attendance/ involvement could have been improved, approximately 50% of teams reported ‘yes’. This could have been achieved by better planning, providing transport, better locations, better targeting of ‘hard to reach’ people and a dedicated lead who could allocate more time to the campaign.

Some stated mild weather as being a disadvantage when they held their events.

Delays in the supply of flu vaccine made it difficult for teams to promote ‘flu vaccination when there were delays in GPs being able to run clinics. Also as the ‘flu immunisation programme was well advertised nationally via the media, participants reported members of the public stating that they already felt well informed.

Participants also reported that from a public health team perspective, there was limited capacity to organise and support local events such as roadshows. Their long term health gain/benefitwas also difficult to evaluate. As KWTW funding was limited it was difficult to implement a programme that would provide more beneficial impact to larger numbers of the targeted age group at a local level. Such events held to date only benefited a relatively small number of people.

4.3.6Media coverage

In addition to the national KWTW newsletter which was widely distributed, many teams reported producing a myriad of articles or series of articles for local newsletters, websites and press, whilst others indicated that improved advertising and media coverage would have been advantageous. Some areas also successfully achieved local radio coverage. Some complained that although the media attended events it was not possible to guarantee press coverage unless paid advertising space was used.

One team reported that feedback from partners had been that events were not publicised enough and that more people could have been attracted. However, publicity was carried out through a number of channels and it was felt that on the whole many people were not attracted to events of this nature no matter how well publicised.

4.3.7General comments from respondents

General comments made by respondents and reiterated by a number of teams, included:

  • Supporting KWTW had developed strong networks of agencies involved with older people and seemed to have enabled those agencies to link up more.
  • A number of participants stated that the mild weather did not encourage people to think about the winter and its affects.
  • The KWTW campaign needed to be part of a co-ordinated, sustainable programme linked, for example, to the priorities within local Health, Social Care and Well-being strategies, and the Older People’s Strategy with ongoing committed funding.
  • KWTW required a person with dedicated time allotted to leading the campaign.
  • The same people turned up annually at events.
  • Partners felt that vulnerable older people were unable to attend events/information days.
  • Supporting KWTW cemented existing partnerships and created new partnerships amongst agencies.
  • Staff resources dictated how much time was dedicated to the campaign.
  • The model of holding local events had worked successfully for the last five years.
  • Organising events was time consuming and the events were often poorly attended.
  • The KWTW themes were all part of ongoing actions and programmes.

4.3.8Continued support