Healthy Lives, Healthy People event February 2011
Public health challenges throughout people‘s lives: Priorities in Newcastle
Introduction
During the Public Health White Paper event for the voluntary and community sector which Newcastle CVS held in February, participants took part in discussion groups to articulate the voluntary and community sector offer in response to the public health challenges in Newcastle. The Director of Public Health Dr Fu-Meng Khaw had outlined the public health challenge and his presentation is available on Newcastle CVS website.
Visit http://www.cvsnewcastle.org.uk/networkinginvolving/adult-wellbeing-and-social-care/nhs-changes-and-other-consultations
Within the themes of the public health challenge the participants were asked to
· develop ideas to meet them,
· consider any barriers for Newcastle’s voluntary and community sector
· articulate the voluntary and community sector offer to the Newcastle health agenda including low cost/no cost ideas.
Participants were asked to focus on
· proportionate universalism
· cross cutting action
· prevention
· long term work
The discussion group themes were
1 Behaviour change and supporting healthy lifestyles:
such as eating, nutrition and exercise; alcohol use; smoking; drug use etc
2 Social and environmental factors that impact on people’s health and wellbeing
such as built environment; pollution and poor air quality; lack of green space, lack of safe play space; higher rate of crime; poverty; domestic violence; community cohesion
3 Children and young people who have poorer health and wellbeing:
starting well, developing well, growing up well
4 Adults who have poorer health and wellbeing:
growing up well, living well, working well, ageing well
Topic 1 Behaviour change and supporting healthy lifestylesIssue / Solution/Comments
Group 1
Food / § Availability of quality food at affordable prices
§ Not Iceland ready meals – take-aways
§ Information /skills around food/cooking
§ Cultural differences – staff need to have a better understanding in relation to this in order to avoid misconceptions/misunderstanding
Alcohol, smoking/drugs etc / § If life is awful and you have no chance of breaking the cycle what is the motivation not to smoke, drink etc
§ Depression and desperation leading to alcohol and drug use
§ Culture of drinking as being the basis of social life in the region
§ Try to reduce binge
§ Alcohol, drug abuse, depression leading to general and domestic violence
Schools to prepare youngsters for life / § Poor education leading to lack of expectation, motivation for a secure adulthood
Eating disorders / § Lack of support from appropriate organisations
§ More awareness among public sectors in eating/disorders
Physical activity / § Couch potato children of ambivalent parents
§ Childhood and adult obesity
§ Obesity, diabetes, stroke, heart attack, cirrhosis, crime and disorder, reduces life expectancy, lung cancer
Peer involvement / § Generational long-term and family linked
§ Not just GPs – what about all the non traditional services (VCS)
§ Information/skills around food/cooking
Mental health / § Collaborative work – partner agencies
§ Where to start
§ Whole picture
§ IAPT
§ Inclusion
§ Pick your fight
§ Better substitutes
General / § Accessibility to services; transport; financial; knowledge
§ Reduce poverty; financial; motivational; inspirational; educational
§ Lack of motivation to change
§ Health beliefs could influence people’s behaviours towards their health and wellbeing
§ Never too late to start stopping and start starting
group2
Create a safe and supporting space for people to explore their beliefs that underpin unhealthy behaviours / § Behaviour is all an individual has ever known – brought up with drugs/alcohol/smoking etc so this is the norm for them
§ Empathy and understanding the reasons for harmful behaviours
§ People need varying input to help engage and to support change
§ Interventions good but we need to really focus on engagement – capacity building of individuals and communities – social networks and capital
Stigma and secrecy can be obstacles for people coming forward / § Lack of behaviour change in local authorities and NHS a barrier – way things are measured
Give importance to engagement of individuals as well as communities / § What is one way of changing behaviour is not necessarily relevant to “everyone”
§ Provide individual support as everyone’s problems are different
§ The role of the “nanny” state
§ Creating/nurturing a desire to change
§ Change takes time and isn’t one package fits all. Some people need basic love/care/family/community before they can even think about change
Collaborative working between VCS and GP’s / § Peer support model – longer term “interventions” people moving on to help others
§ Citizens voice on GP Commissioning Board
§ Train people on JSA as mystery shoppers, using evaluation, monitoring money
§ Need better engagement with GP Consortium
§ More peer support models
Complimentary therapies / § Complimentary therapies offer support – can help when feeling wasted etc
§ Value non traditional interventions e.g. arts
Environmental issues / § Family
§ Housing
§ Not supportive
Using food, alcohol, self harm, drug use etc can be coping mechanisms / § Motivation/incentive to change
General / § Need go question amount of money spent on gathering “meaningless evidence”
topic 2 Social and environmental factors that impact on people’s health and wellbeing
Issue / Solution
group1
Personalisation can increase social isolation / § Advice and support to more decisions
§ Main benefit stays with the person
Housing lack of variety to match need / § Different way of looking at how we manage our housing stock
§ Encourage more bonding together locally to effect change
§ Look at good innovative practice (e.g. mixing students and older people)
Availability of green spaces / § Temporary allotments
§ Role of friends groups
§ More use of Localism Bill but ensure weaker voices are supported (VCS)
Getting out and about / § Re personalisation and prescribing VCS needs to be more “high street”
§ Use universities for research
§ Put services back into localities so less travelling
§ Small changes – benches etc Elders Council audit
§ Transport – think about non traditional e.g. call forward
General comments / § VCS come together to research
§ Social empirical research
§ Pilot ideas more
§ We need evidence – make better use of existing evidence
group 2
Regeneration / § Small pots of money that are awarded to community groups – leading to community led projects
Capitalism / § Revolution
Oppression / § Shared experience – in community centres
Poverty / § Projects working with/supporting individuals/families with practical advice
§ Advice, support and guidance on this issue from CVS
§ Say organisation to go to
§ Level of campaigning around this
§ Education on issue (energy efficiency)
§ Food co-operatives
Homophobia and Racism – hate crime / § Not just work in schools – think creatively about how to access young people
§ Use of technology/face book/Bluetooth etc
Domestic abuse – both in heterosexual and LGBT relationships – including effects on children / § Informal settings to talk about this issue
§ Not talked about in public health – whose role
§ Personal health and social education to deal with this issue
§ Massive cultural change needed
§ Role for GPs and front line staff
§ Addressed in communities
§ Provision for accommodation and access to re-housing
§ Social marketing – raise the issue
Transport / § Integrated transport system through quality contacts
§ Cheap and affordable
§ Force bus operators to enforce certain routes
Lack of all weather play space / § Multi use games area
§ Consider building more of these
Industrial illness / § Joined action between local groups
§ Community cohesion
Air quality / § Local Authority and transport to think about their policies around air quality
§ Traffic management for example should be looked at
Access to green spaces / § Joint action – park users groups – local residents
§ City Council – parks manages
Unemployment / § Job creation schemes for work in voluntary sector
§ Training on prescription
§ GPs to advise on where to go
§ Offering training to suit the needs of communities
Community safety – perception of crime / § Clearer lines of communication
§ Communicate the good things
§ Intergenerational working
General / § Volunteering helps deal with loads of these issues
§ Employment
§ Poverty
§ Transport
§ Homophobia & Racism
§ Green space
Accessible environment – safe streets / Blank
topic 3 Children and young people who have poorer health and wellbeing, starting well, developing well, growing up well
Issue / Solution
Childcare provision and access to services e.g. parents with other children / § Services come to children i.e. dentist coming out to families
Lack of opportunities for young people = no hope, aspirations etc (motivation?)! / § Positive role model
§ Peer mentoring
GPs/statutory organisations don’t know about local VCS and how to refer / § Training/visits
§ Shadowing: Your welcome
§ 24hr service for GP
§ GP market place “speed dating” event showcase of VCS
Lots of isolated young people (socially) / § Support for “care leavers” isolated without a social network
§ Peer mentor
Alcohol is normalised – risk taking behaviours / § Police – non alcoholic “bars” – who are supporting underage drinking
Benefit system / § Government stop single room supplement – forcing young people onto streets – poor health
Access – opening hours / § GP practice for children and young people only
§ Positive relationship with a known/named GP
§ Not “hard to read” services “hard to listen to” !! “seldom heard”
§ Open when young people need to use them
§ Better school health services
§ Young people centred outreach service – dentist
Attitudes of staff e.g. young people’s rights / § “Your Welcome” – quality mark
§ Youthlinx – quality mark
§ Understand UNCRC
§ Training/shadowing of staff
§ Mystery shopping
§ Birthday card to 14 years young person (ensure parent included)?
Focus on medical e.g. diagnosis rather than social (holistic) / § Acknowledge “cause” not just “symptoms”
Social networking = lack of person to person contact / Blank
Homelessness (at risk – sofa surfers) “hidden” provision reducing / Blank
Ever-changing culture of young people e.g. IT/tech and porn as a health issue / Blank
Lack of resources for young people and mental health issues (ever increasing) / Blank
Communication = one of biggest barriers et actually listening to young people / Blank
Geography of poverty has stayed the same / Blank
topic 4 adults who have poorer health and wellbeing, growing up well, living well, working well, ageing well
Issue / Solution
group 1
Low aspiration and self esteem / § Creating the opportunities for people to come together
§ Offering mentoring opportunities, access to new skills and experiences
§ Volunteering (but there has to be a return for it
Carers emergency scheme – needs to be all singing and dancing / § Emergency carers bank
Choice / § Brokerage but different approach to thinking about our services
Access to mainstream services (socio, economic and physical barriers) / § Better marketing to disadvantaged communities
§ Training and support for providers and individuals
Education – quality and access
group 2
Unemployment / Everyone together – statutory and voluntary
Volunteering opportunities
Sound and well funded advice services
Continue with ‘Better Health, Fairer Health’ (Regional Strategy)
Access to arts activities
Link in with regional expertise – Institute for Ageing and Health
Breaking cycles of unemployment and poverty across generations
Poor mental health / Managing workplace wellbeing positively
Isolation
Loss of independence
Dementia / Listen and preserve people’s dignity
Reminiscence therapy
Low levels of/poor wellbeing / Better incentives to live well, e.g. food and exercise
Who cares for those who have no one?
Poor preparation for adulthood / Self management as part of the curriculum
Lack of hope, opportunities and prospects leading to crime and mental and physical poor health
How to remain independent
Ward based services don’t always reflect the levels of poverty in mixed wards, e.g. Ouseburn/Heaton
Barriers for the voluntary and community sector in Newcastle
· Internal competition
· VCS cheaper to cut
· Lack of involvement in JSNA type work
· Current commissioning frameworks happen behind closed doors – Timescales!
· Locked out of solution designs
· Hung up on just being worthy! Need to shape up
· Lack of coherent front
· Lack of sectoral leadership
· Lack of effective communication throughout sector
· Lack of buy-in to the social prescribing model of intervention
· Low cost/no cost pressures
· 2,200 of us
· Huge agendas
Public health challenges and the voluntary and community sector offer
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