Social Wellbeing
North Norfolk District Council – Health Strategy Progress Report
Key strategic priorities
1. Localism of health delivery by all relevant stakeholders
2. Prevention of ill health and promotion of healthy lifestyles
3. Maintaining activity, independence and support for older people
Current work
Localism of health delivery by all relevant stakeholders
This strategic priority recognises within a rural area such as North Norfolk the need to
ensure that where ever possible organisations responsible for health, social care and well
being services work together to offer and deliver co ordinated, local services.
The North Norfolk Health Improvement Forum (NNHIF) which is led by the Council has been
recognised as a Forum which can not only deliver joint working to meet the Health Strategy
priorities but can also potentially provide the multiagency structure that some external
organisations require to fulfil service functions. Discussions have recently taken place with
the North Norfolk Clinical Commissioning Group (NNCCG) which will take on commissioning
responsibilities for North Norfolk from April 2013 to identify issues of mutual interest and how
the Forum structure can inform and support the delivery of NNCCG priorities.
The Norfolk Supporting People Commissioning Body are discussing the development of
Locality Commissioning Bodies. The next Forum meeting will receive a presentation on
whether the Forum could adapt to take on this function rather than set up a new
commissioning body.
An example of more integrated working is that within the next 6 months an Occupational
Therapist and Assistant Practitioner employed by Norfolk County Council will be based at
NNDC to improve the co ordination and customer experience in respect of Disabled
Facilities Grants.
Prevention of ill health and promotion of healthy lifestyles
North Norfolk Activity Referral Scheme – An activity referral scheme has been
established at the 3 main sports and leisure centres for some years. Unfortunately not all
surgeries participated in the scheme so many patients that could have benefitted were not
referred. The Council has proactively worked with NNCCG to their endorsement of a revised
scheme in which all surgeries have been asked to participate. Issues relating to the
electronic transfer and storage of patient data meant that surgeries in North Norfolk were not
officially invited to participate in the scheme until August. From September all eligible
patients regardless of which surgery in North Norfolk they are registered with will have the
opportunity to participate in the Activity Referral Scheme. These will be run by DC Leisure at
the three NNDC sports and leisure facilities. Despite the delay in the official launch of the
scheme participation numbers have been steadily increasing. The number of patients
participating in the scheme between August 2010 and August 2011 was 1,538. Between
August 2011 and August 2012 this rose to 2,216 and increase of 44%.
North Norfolk Work Out Project – This externally funded project will end on 30th
September. One of the grant criteria was for the project to be sustainable. This was achieved
by supporting some of the current volunteers to form a separate community group. This has
now secured some funding of its own. The Council was eligible to bid for some additional
funding from the Supporting Change and Supporting Impact funds. We had identified a
range of ways to use this money to improve the activities and conservation opportunities
offered by the Countryside Team. Unfortunately only the Supporting Change bid was
successful which means the Council will only receive an additional £10,000. We are
currently discussing how best to use this grant in line with the grant criteria and to enhance
our existing countryside offer.
North Norfolk Health Trainer Service This NHS Norfolk service is based at the Council. In
addition to the benefits of working in partnership the Council receives income from the NHS
for the office space and associated support services. The service was established in
November 2011 and started fully seeing clients in April/May 2012 when all Health Trainers
were qualified. The Service covers The North Norfolk Clinical Commissioning Group
(NNCCG) which therefore means the service encompasses North Norfolk, most of
Broadland and parts of Norwich.
To date we have processed over 150 referrals from all over North Norfolk. Our highest areas
of health deprivation are Cromer, Fakenham, North Walsham, Stalham and Areas of
Southern Holt. We receive most referrals from the following areas in Descending order
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Fakenham (Most)
North Walsham
Cromer
Stalham
Hoveton & Wroxham
Holt
Aylsham
All Others
Approximately 80% of the clients we see wish to change their Eating habits and/or lose
weight. The other 20% is made from goals that include increasing physical activity, reducing
alcohol consumption and quitting smoking. The average age of people accessing the service
is 51 years.
Most referrals come directly from Health Professionals, although a high number of SelfReferrals and Non-professional referrals are also received.
The service has good links with both the Broadland and North Norfolk Activity Referral
Schemes, Council sports and leisure centres and the mobile gym. The Service has worked
extensively with the North Norfolk District Council who have helped facilitate the
conversations necessary to make a real improvement in people’s health, lifestyle and
wellbeing.
Warm and Well in Norfolk – Following a successful multi agency bid Norfolk received
approximately £320,000 to implement a range of county wide prevention, safety net and
legacy interventions to reduce the incidence in vulnerable people of preventable illness and
death in which cold housing was a contributing factor. In North Norfolk we worked with
external organisations to distribute our allocation of 1,000 warm packs and with Age UK
North Norfolk to offer free low level insulation. Procurement issues meant the delay in the
implementation of some of the initiatives such as the heater loan scheme. Evaluation
demonstrated the benefit of the project with over 83% of people finding the warm pack
beneficial. The Council is currently working with a range of organisations including Town and
Parish Councils to continue the delivery of some of the practical and awareness raising
interventions.
Maintaining activity, independence and support for older people
Ageing Well aims to reduce rural isolation predominantly by older people and the potential
associated impact on their physical and mental health. A multiagency workshop hosted by
NNHIF was held in June. This brought together Town and Parish Councils, statutory and
voluntary groups to look at rural isolation issues in North Norfolk, the impact of reduced
statutory funding and new opportunities such as the village agent scheme. A barrier to
providing facilities to reduce rural isolation was raised by one village at the workshop. This
has subsequently led to a funding application to the North Norfolk Big Society Fund.
Local Health Service Update
Health and Social Care Act 2012
From 1st April 2013 NHS Norfolk as a Primary Care Trust will be abolished. It will be
replaced by North Norfolk Clinical Commissioning Group (NNCCG) which is a formal
collaboration of 20 GP Practices.
NNCCG which has been a shadow CCG since April 2012 is currently undergoing the
required accreditation process to demonstrate competence in 6 key areas prior to
taking full responsibility for commissioning health care services for £166,500 patients
in North Norfolk and rural parts of Broadland.
The Council’s relationship with NNCCG is strong. We currently work with the CCG on
a number of projects and discussions have been held at all levels to consider further
mutually beneficial opportunities for joint working at an organisational level and for
the benefit of the resident population.
Health and Wellbeing Board are being established in each top tier or borough
authority. NNDC has Member representation on the Norfolk Board. The Boards main
functions are to:
1. Assess the needs of the local population through the Joint Strategic Needs
Assessment process.
2. Produce a local Health and Wellbeing Strategy,
3. Promote greater integration and partnership.
The Board has stated the importance it places on health and well being improvement
and reducing health inequalities. However there is a danger that it will be dominated
by the issues arising from the ongoing financial pressures on the NHS and social
care.
Clarity is still required around geographical and thematic sub structures which may
be of more relevance to District Councils.
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Public Health England will be established to improve public health and reduce health
inequalities. Public Health will transfer from the NHS to Local Authorities.
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Health Watch England and local Healthwatch will be established. Until then the
existing Local Involvement Networks (LINks) will continue. The aim of local
Healthwatch will be to give citizens and communities a stronger voice to influence and
challenge how health and social care services are provided within their locality
Cromer Hospital
The new £15 million hospital is now fully open. Facilities include an ophthalmic operating
theatre plus new diagnostic services including a permanent on-site mammography (breast
screening) service, and a DEXA scanner for osteoporosis diagnosis. A brand new MRI
scanner was also installed in late 2010.
The Minor Injuries Unit on the ground floor has been named after Mrs Bernstein and the
Procedure Unit on the first floor of the new hospital has been named after her sister Muriel
Thoms. The Audiology Unit on the first floor has been named after Phyllis Cox.
The old Davison and Barclay ward areas of the current hospital have been retained and
refurbished for use as a permanent renal dialysis unit with room for expansion.
North Walsham and District War Memorial Hospital
The new hospital was officially opened on 1st August. There are 24 in patient beds which is
an increase from the 16 at the old hospital. The refurbished outpatients provides a range of
clinical services including physiotherapy, speech and language therapy, neurological
support, continence care, podiatry and services which include rehabilitation care on the
ward.
The opening of both of these facilities is a significant achievement and will provide more
local outpatient services for residents and increased in patient beds. A few years ago both of
these facilities were at risk of closure which the Council and the local community proactively
opposed.
East of England Ambulance Service
Concern has been expressed about proposed changes to ambulance provision in North
Walsham, Cromer and Fakenham. If implemented North Walsham’s double staffed
ambulance would be cut and replaced by a Rapid Response Vehicle. Cromer would lose 138
hours of a double staffed ambulance to be replaced by 52 hours of a Rapid Response Vehicle.
Fakenham would lose 5 hours each day of their Rapid Response Vehicle. The Trust has said
that ambulance services are not being cut overall but reconfigured to match to demand.