Poole S Local Area Agreement in Relation To

FOR INFORMATION ONLY

BOROUGH OF POOLE

HEALTH SCRUTINY COMMITTEE

13 FEBRUARY 2007

REPORT OF THE DIRECTOR OF PUBLIC HEALTH (POOLE AND BOURNEMOUTH) AND STRATEGIC DIRECTOR (SOCIAL SERVICES)

ON POOLE’S LOCAL AREA AGREEMENT IN RELATION TO

HEALTH OUTCOMES AND HEALTHIER COMMUNITIES

1.Purpose of the Report

1.1The report is to provide an update to members of the Health Scrutiny Committee on areas of Poole’s Local Area Agreement which relate to Health Outcomes and to inform Elected Members of the progress in negotiating Stretch Targets within the Local Area Agreement related to health outcomes.

2.Decisions Required

2.1There are no formal decisions required as the report is for information only but Elected Members are asked to note:

i)the content of the report;

ii)that if they wish to contribute to the consultation on the Alcohol Harm Reduction Strategy, submissions can be made via email or hard copy to Katharine Watters, Strategic Planning, until 26 February 2007.

iii)Members will be asked in May 2007 to consider how in the forward programme for Health Scrutiny Committee, they wish to consider issues of healthier lifestyles, health promotion, reducing health inequalities and the delivery of outcomes and performance measures contained in the Local Area Agreement.

3.Implementation of Poole’s Local Area Agreement in Relation to Heath Outcomes and Healthier Communities

3.1Poole’s Local Area Agreement (LAA) has been implemented since 1 April 2006 and is a three year programme of work. The full text of the LAA can be viewed online at It was developed on the basis of widespread consultation with the public and statutory, community and voluntary and faith sector organisations. It identified priority local issues that could be tackled collectively under four broad headings:

Children and Young People;
Healthier Communities and Older People;
Safer, Stronger Communities;
Enterprise and Economic Development.

3.2Issues relating to Health Outcomes were included under all of the first three blocks above. Appendix A provides information on the implementation of relevant sections of the LAA. The information provided sets out actions taken and progress made by November 2006.

4.Further Development of the Local Area Agreement to be Implemented 2007-2010

4.1During the financial year 2006/07, Poole Partnership has been working to identify priority issues for Poole’s community where collective action should be taken to improve further outcomes and services. Agencies have been working together to establish ‘stretch targets’ which will be supported by pump-priming monies provided by central Government and, if the targets are attained at the end of three years, ‘reward grant’ monies will be given by Government in 2010 onwards in proportion to achievement against original target.

4.2In relation to Health outcomes, there are four ‘stretch targets’ being negotiated as follows:

Improving the emotional well being and mental health of adults in Poole by increasing the number of people successfully completing Brief Intervention Treatment therapies.

Improving the Health and well-being of targeted populations in Poole currently experiencing below average levels of physical activity by increasing the numbers of people taking part in regular exercise/ physical activity on at least 3 days a week for 30 minutes of moderate intensity.

Reducing the harm caused by alcohol misuse to the individual, family and community in Poole and increasing access to treatment services by introducing Brief Intervention Therapy services to people who are drinking alcohol in a harmful or hazardous way.

Improving the oral health of young children by reducing the level of poor dental health in areas of Poole where children have the worst dental outcomes.

4.3Negotiations are taking place with the Government Office South West and central Government on the final detail of the above ‘stretch targets’. The Government sign-off for the targets is due in March 2007 so that implementation action can begin from April 2007.

Report Authors

Jan Thurgood, Strategic Director (Social Services), Borough of Poole

(01202) 633023

Dr Adrian Dawson, Director of Public Health, Bournemouth and Poole PCT

(01202) 688880

Appendix A

HEALTH OUTCOMES - POOLE’S LOCAL AREA AGREEMENT

UPDATE ON PROGRESS - NOVEMBER 2006

CYP 3Health inequalities for children and young people are reduced in targeted areas

3.1 – Improve healthy lifestyles in children and young people
New Healthy Schools criteria established to strengthen the commitment of schools to healthy lifestyles work. All Poole schools have signed up to the new criteria.
Healthy Schools Co-ordinator post has been created and appointed to enable the actions in this sub outcome to be implemented. Hot meals in schools are being commissioned.
Work with the early years settings is taking place to improve oral health through the provision of toothbrushes and advice.
Play Strategy is being developed with Bournemouth. Sports coaches from Active Dorset are being co-ordinated by BoP Leisure Services staff to provide activities for young people with ADHD.
Turlin Moor support group for parents includes physical activity for parents and young children. Recent positive evaluation has been produced.
Health mapping is continuing on a locality basis and Health Visitors with a public health specialism have been recruited for each locality. The multi-agency alcohol strategy has been developed to include improved educational and health focus.
Further action:
Positive action as identified above and increase in Community Sports Coaching activity together with the rise in use of Access to Leisure Cards in the 4 targeted Wards are contributing to achieving the outcome. There are concerns over the suitability of the indicators to measure progress on improved healthy lifestyles for children and young people. This will be reviewed at the Refresh of the LAA.

Performance Measure

/ Progress at November 2006
LAA 8: Reduce the number of young people admitted to A&E as a result of alcohol abuse. / Baseline being set in 2006/07
LAA 9: Increase take up of access to leisure cards in four targeted wards. / Baseline being set in 2006/07

LAA 10: Sustain current level of reduction rate to achieve 2010 target - BV 197: (ie percentage reduction in teenage pregnancies).

/ Recent data indicates concern re reaching in year target but long-term trend is a substantial reduction in teenage pregnancies.
LAA 11: Measure of obesity in children - establish indicator from National Guidance Implementation. / Baseline being set in 2006/07

CYP 3.2 – Improve emotional resilience of children and young people

There is improved co-ordination across different services resulting in better services to meet identified need.
An updated survey of bullying has been carried out and all Poole schools are signed up to an Anti-Bullying Strategy. Already there is some evidence that there is a reduction in repeat bullying by the same perpetrator.
The emotional well being strand of the healthy schools programme is in place with pastoral care workers in most schools.
AS-U-R group have been supported in running a holiday scheme.
The local CAMHS (Children & Adolescent Mental Health Services) Strategy has been developed to achieve agreed priorities including the de-commissioning of services.
A feasibility study is taking place on the relocation of the primary care behaviour service alongside the family support service.
Family support workers have been appointed in each locality – starting in 11/06 and Health Visitors are now ‘facing’ localities.

Performance Measure

/ Progress at November 2006
LAA 12: Increase number of referrals through Tier 2 CAMHS. / On target.
LAA 13: Increase the proportion of schools who take part in bullying surveys and provide information. / Baseline being set in 2006/07
LAA 14: Reduce the number of repeat incidents of bullying from Summer 2007. / Baseline being set in 2006/07

Healthier Communities and Older People

HCOP 1 – Reduce health inequalities in Poole

HCOP 1.1 - Promote healthy lifestyles in more deprived localities in Poole

Over 500 children have been engaged in sports activities delivered by Community Sports Coaches in Turlin Moor and Bourne Valley through fun days, multi-sports camps and Youth Centre Programmes.
The number of non-maintained early years settings engaged in HEY (Healthy Early Years Scheme) has increased from 6 out of 52, to 12 of 59 - 20% of non-maintained settings are now engaged against a target of 15%.
The work ranges from healthy eating, through physical activity and emotional health and well being. One setting reports 100% of children now bringing fruit/vegetables in their lunchboxes, compared with 20% a year earlier.
An area of concern is to ensure that this work is maintained and developed into 2007/8 (the Early Years Co-ordinator leaves the PCT on 1 November 2006 and ongoing staffing will be required).
Within schools, data has been collected for levels of obesity from Reception and Year 6 students but there is a concern that the national data set is showing our local PCT as having more obese children as the Department of Health has changed the BMI parameters.
Further action:
To review, with the Department of Health, the baseline and data set for obesity levels in 4 ½ year olds.

Performance Measure

/ Progress at November 2006
LAA 21 - Sport England: Increase by 1% per annum the percentage of adults participating in at least 30 minutes moderate intensity physical activity (including sport) on three or more days per week in the targeted areas / On target
LAA 22: Halt the rise in the level of obesity in 4½ year olds (using 05/06 baseline) / Baseline to be set in 2006/07
LAA 23: Increase the percentage of non-maintained early years settings engaged in HEY / On target
HCOP 1.2 – To improve mental and emotional health for targeted groups
Poole Primary Mental Health Pilot has achieved an average waiting time for assessment of between 6-8 weeks (from previous 9 week wait) in the last year, since its launch. The employment of a Gateway Co-ordinator who manages booking centrally, patient choice on the location for the assessment and protected assessment slots by clinicians have all contributed to the reduction in waiting times. This figure is expected to improve further, to achieve the target of 6 weeks set for 2007/8.
The reconfiguration of Poole and Bournemouth PCT’s and an expected requirement to standardise services in Poole and Bournemouth may lead to revision of this sub-outcome. Further work is being undertaken to review services for older people across Health and Social Care and to produce an inter-agency action plan to fulfil the requirement of the Government’s Everybody’s Business initiative.
Further Action:
The Primary Mental Health Team is also in the process of working with the “Project for Older People” service, which should significantly increase numbers accessing this service.

Performance Measure

/ Progress at November 2006
LAA 24: Increase by 15% the number of those over 65 receiving treatment in primary mental health services by 2008. / On target
LAA 25: Reduce wait times for assessment in Health and Social Care for those receiving psychological therapies to six weeks by 2008. / On target
LAA 26: The percentage of patients with diabetes and/or heart disease for whom case finding for depression has been undertaken on one occasion during the previous 15 months using the two standard screening questions (DEP1). / Baseline to be set in 2006/07
LAA 27: In those patients with a new diagnosis of depression, recorded between the preceding 1 April and 31 March, the percentage of patients who had an assessment of severity at the outset of treatment using an assessment tool validated for use in primary care (DEP2). / Baseline to be set in 2006/7

HCOP 2 Improved health through changing lifestyles

HCOP 2.1 – Promote opportunities for healthy lifestyles including increased participation in physical activities and sports
From four dietician-led weight management/healthy lifestyle programmes run in Poole since April 2006, 14 people have lost the required 2.25 kg in 12 weeks (out of 51 people who started the course) – with two patients losing 9.5 kg and 11 kg. The groups continue to be well evaluated by those who complete the programme – but drop out rates are high.
As a result weight management groups in Poole are being re-modelled with results from the latest programme, linked to a new Nordic walking group, are demonstrating much better attendance rates. Further data will be analysed from other group settings.
Numbers through Smoking Cessation services have seen a drop for the first half of the year 2006/07. For those setting a quit date between April to end of September, 300 smokers have quit at 4 weeks. This is below the expected number compared with the same period last year. The reason has been attributed to services now reaching more difficult hardened smokers and the withdrawal of the national advertising campaign. There has always been a seasonal variation with summer numbers accessing services the lowest. The highest numbers are likely to be between January and March but this year the challenge is greater although the implementation of the smoke-free legislation may be a motivating factor to drive more smokers into services.
Further Action:
An increase in provision of services has been planned to address the drop in the number of smoker quitters. New criteria established by DOH for measuring obesity require this measure to be reviewed and it is hoped that with the return of national advertising and thelegislation that this will help services reach the target. Close monitoring of services is in place and a revised action plan with actions to increase numbers into services.

Performance Measure

/ Progress at November 2006
LAA 29: Increased numbers of Healthy Lifestyles Education Programme - PCT LDP 1 / On target
LAA 30: Increase the numbers of people who lose weight through Healthy Lifestyles Education Programme - PCT LDP 2 / On target
LAA 31: Increased number of four week smoking quitters who attended National Health Services Stop Smoking Services per 100,000 population - PCT PSA 08A / Not meeting targets
LAA 32: Increased participation in physical activities - using Active People survey data as baseline and future residents surveys to measure progress / Baseline being set in 2006/07

SSC 1Reassure the public by reducing crime, the fear of crime, anti-social behaviour and the harm caused by illegal (an inappropriate) drug use and alcohol misuse – particularly for those 0 – 16 year olds affected by living in households where there is misuse of drugs and alcohol

SSC 1.1 – Reduce the crime, anti-social behaviour and harm caused by alcohol misuse in targeted areas
Poole’s Drug Action Team has on behalf of Poole Partnership has led on the development of a comprehensive Alcohol Harm Reduction Strategy which analyses local issues, sets clear outcomes and targets to be achieved, and has a comprehensive inter-agency action plan. The strategy is out for consultation until the end of February 2007 and can be found online at

Performance Measure

/ Progress at November 2006
LAA 41: Using the total number of persons arrested in the Poole Police based boundary, reduce the proportion that are flagged as ‘alcohol related’: this will not be used as an outcome measure. / The Alcohol Harm Reduction Strategy will establish appropriate outcome measures.

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