Public health in Newham Local health needs of the
Borough
André Pinto
Regeneration and Social Determinants of Health Specialist
1
Slide 2
In context…
3
Index of Multiple Deprivation by
LSOA
….within Newham…
5
Trend of life expectancy at birth for
males and females in Newham, London
and England, 1991-1993 to 2008-2010
86
84
82
80
78
Males Newham
76
Males London
74
Males England
72
Females Newham
70
Females London
68
Females England
66
64
Source: The NHS Information Centre for health and social care
Slide 6
Dahlgren and Whitehead
(M Benzeval, K. Judge and M. Whitehead (ed.s)
Tackling Inequalities In Health: An Agenda For Action. Kings Fund.)
7
Life expectancy and disability free life expectancy at birth, persons by
neighbourhood income level, England, 1999-2003
Age
85
80
75
70
65
60
55
Life expectancy
DFLE
50
Pension age increase
2026-46
Poly. (DFLE)
45
0
5
10
15
Source: ONS
20
25
30
35 40 45 50 55 60 65 70 Poly.
75 (Life
80 85
90 95 100
expectancy)
Neighbourhood Income Deprivation
(Population Percentiles)
The scale of the challenge
Local Authorities
in London
compared to the
Strategic Health
Authority
average
Source: Health Profiles
2011, Public Health
Observatories
Slide 9
Significant worse than England average
PHOF Indicators for Newham
Deprivation
Children in poverty
GCSEs achieved
Violent crime
Long term unemployment
Physically active adults
Hospital stays for alcohol related hard
Drug misuse
People diagnosed with diabetes
New cases of tuberculosis
Life expectancy – male
Life expectancy – female
Deaths from smoking
Early deaths: heart disease and stroke
Pharmaceutical
Needs Assessment
JSNA
10
Pharmacies delivering Public Health –
Track record
Stop Smoking
Medicines Use Review
Minor ailments service
Emergency Hormonal Contraception Service
Condom Distribution Service
Chlamydia Screening Service
Needle Exchange Service and Supervised Consumption Service
Tuberculosis Treatment Supervision Scheme
NHS Health Checks
New cases of tuberculosis
Flu vaccination
11
Pharmacies delivering Public Health in Newham –
scope for improvement
Stop Smoking – make process easier.
Medicines Use Review – develop further. Address concerns regarding quality. Encourage uptake.
Minor ailments service – Provide additional primary care capacity.
NHS Health Checks – Encourage uptake. Extend existing scope? (atrial fibrillation, hypertension,
weight management and lifestyle interventions.
Flu vaccination – increase uptake and training. Widen the scope (target groups)?
HIV Point of Care testing – consider expanding pilot
Anticoagulant Monitoring Service – Therapy initiated in the hospital but then monitored in
community setting.
Self Care – Promote community ownership of health outcomes and disease management
(diabetes).
Overcome resistance and access EMIS as a standard. Integrate pharmacy in care pathway.
Communications Strategy
12
Health Inequalities
Different Gestation Times for Interventions
For example supporting individuals to reduce risk of
mortality in people with established disease such as
CVD, cancer, diabetes
A
For example supporting individuals through lifestyle and
behavioural change such as stopping smoking,
reducing alcohol related harm and weight
management to reduce mortality in the medium term
B
For example intervening to modify the social determinants
of health such as worklessness, poor housing,
poverty and poor education attainment to impact on
mortality in the long term
C
2005
2010
2015
2020
Population Level
Interventions
Systematic community
engagement
Systematic and scaled
interventions through
services
Partnership,
Vision and Strategy,
Leadership and
Engagement
Intervention
Through
Services
Service engagement
with the community
Intervention
Through
Communities
Producing Percentage Change at Population Level
C. Bentley
2007
Achieving Percentage Change in Population
Outcomes
Programme characteristics will include being :– Evidence based – concentrate on interventions where research
findings and professional consensus are strongest
– Outcomes orientated – with measurements locally relevant
and locally owned
– Systematically applied – not depending on exceptional
circumstances and exceptional champions
– Scaled up appropriately – “industrial scale” processes require
different thinking to small “ bench experiments”
– Appropriately resourced – refocus on core budgets and
services rather than short bursts of project funding
– Persistent – continue for the long haul, capitalising on, but not
dependant on fads, fashion and policy priorities
Making every contact count