FPH ANNUAL CONFERENCE – The Politics of Healthy Change
1. Developing a competency-based
framework for public health
education and training in India
Dr Sushma Acquilla FFPHM, FRCP
International Faculty Advisor, UK
Faculty of Public Health
Honorary Senior Lecturer, Imperial
College London
2. The politics of localisation: Building
resilient communities – From idea to
sustainable action
Margaret Jones
Betty Boner
Sefton CVS
3. Preparation for pregnancy in women
with type 1 and type 2 diabetes:
lessons from a regional audit
Ruth Bell
Newcastle University
4. The relevance and understanding of
programme sustainability within the
public health policy context: lessons
learned from injury prevention
Gail Errington
University of Nottingham
5. An education in self-management of
asthma: an epidemiological study of
rules governing carriage of inhalers
in secondary schools in North East
England
Simon John Howard
Public Health England
6. An Exploration of the reasons
influencing health care seeking
behaviours of parents of young
children in Sheffield
Frederike Garbe
NHS
7. Do alcohol and pregnancy mix?
Insight from the development of a
social marketing campaign to reduce
alcohol consumption during
pregnancy
Julia Rosser, Halton Borough Council
8. Persuading the last 12%: could
carrots or sticks help achieve full
infant immunisation?
Rebekah Jayne McNaughton
Teesside University
9.
The introduction in Dudley of the
Dried Blood Spot (DBS) testing
service for babies born to hepatitis B
positive mothers
Lesley Cliff,
Dudley Metropolitan Borough Council
10. Early nutrition for later health: why
‘early’ should start in pregnancy
Judy More, Infant & Toddler Forum
member
11. Making the case for more equitable
investment in the Health Visiting
programme: Using data to
benchmark local need in Redbridge,
London
Katie Ferguson
London Borough of Redbridge
12. MeTime Club: An integrated
Approach Supporting Mums and
Mums-to-Be to Stop Smoking. A Case
Study in The Wirral
Leena Sankla
Solutions4health
13. The effectiveness of an outreach
sexual health intervention designed
to prevent repeat teenage pregnancy
Catriona Christine G Jones, University
of Hull
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
14. Improving the help and support
provided to people who take New
Psychoactive Substances (‘legal
highs’)
Emma H. Fletcher
15. Clustering health-related behaviours
in two British birth cohort studies
Claire Mawditt
University College London
16. Transforming the ‘foodscape’: A
systematic assessment of Out of
home food outlet (OHFO)
interventions in England
Amelia A Lake, Durham University
17. Protecting children from secondhand
smoke: The success of an integrated
approach in the North East of
England
Lisa Surtees
FRESH NE
18. Alcohol and cancer, re-establishing
the links through a social marketing
campaign
Colin Shevills
Balance NorthEast
19. Television-based health promotion in
General Practice waiting rooms: a
cross-sectional study evaluating
propensity to seek healthcare
services
Dr Mohammed Jawad
Southampton City Council
20. Physical Activity Facilitation for older
adults at risk of disability - a
feasibility study and exploratory
pilot RCT
Gemma Morgan
University of Bristol
21. A smooth path or a rocky road? Five
‘I’s of Influencing change in the local
authority setting
Dr Jane Bethea, Lecturer in Public
Health & Epidemiology, The
University of Leicester.
22. Co-production evaluation of an asset
based tobacco control programme
Grant McGeechan, Teesside
University
23. Embedding Making Every Contact
Count (MECC) in Nursing and
Midwifery
Ann Crosland, University of
Sunderland
McCabe, K; Wilson, K; Ling, J;
Wallace, A
24. Co-production evaluation of an
Exercise Referral Scheme (ERS) for
adults with existing health conditions
(in association with FUSE)
Grant McGeechan
Teesside University
25. What factors influence smoking
behaviour in young females?
Professor Robert Atenstaedt
Public Health Wales & Institute of
Health, Medical Science and Society
26. Implementing prudent practice:
optimising outcomes of elective
surgery in Cardiff and Vale through
systematic lifestyle risk factor
management
Dr. Sian Griffiths, Cardiff and Vale
Public Health Team
Absi, C; Hopkins, S. (Dr); Lewis, R;
Nealon, T; Nicholls, H; Poole, H;
Prygodzicz, J; Wood, S. (Dr)
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
27. Explore More Outdoors with
Hackney Wild Walks: Encouraging
children to get active by making
walking fun and getting families
exploring green spaces
Kathryn Scott, Hackney Council
35. First National Childhood
Measurement Programme (NCMP)
Cohort Study in Dudley
Gregory Barbosa, Dudley
Metropolitan Borough Council
Lewis, L; Moss, A
28. The North East Better Health at Work
Award: improving health through
partnership and collaboration
Denise Orange; Public Health England,
Tyne & Wear
36. Knowledge Translation in Oral Health
Promotion
Omotayo Joan Olajide
FUSE
29. Implementing Detect Cancer Early
(DCE) in a remote and rural
environment
Norma Macleod, Medical Director,
NHS Western Isles
37. Food and Cornwall: Creating Food
Wealth so that no one in Cornwall is
Hungry
A Systems Leadership Approach to
tackling Food Poverty
Cindy Marsh NHS Cornwall
30. Development of Geographic Profiles
to demonstrate health inequalities in
the Western Isles
Martin Malcolm, NHS Western Isles,
Hall, F
38. Room on the Broom Adventure Trail
– Health by Stealth!
Jane Stark, Wakefield MDC
Sharp, A; Blenkinsop, L; Thomas, K
31. Business Healthy – promoting the
business benefits of workplace
health and wellbeing
Sarah Thomas, Hackney Council
Nicole Klynman, Hackney Council
32. The Final Countdown
Joanne O'Donnell, Mrs Mairead
MacDonald, Health Promotion
Department, Smokefree Hebrides
33. Wessex Public Health Community
Fellowship
Walmsley, Emily; Helen Cruickshank;
Cochrane, S; O’Sullivan, C; Poole, R;
Taplin, S; Kitsell, F; Parkes, J; Health
Education Wessex
34. Self reported takeaway use among
Brent's school students
Lauren Ensor, Brent Council
39. Exploring notions of ‘community’ in
the case of Gypsy and Traveller
health
Natalie Forster, FUSE
Carr, SM; Lhussier, M; Bancroft, A
40. Understanding factors that influence
young women’s participation in
cervical cancer screening-A focus on
North East of England
Mabel Okoeki, Faculty of Health and
Life Sciences, Northumbria University
A. Steven, L. Geddes
41. Smokefree Diabetes: The Innovative
Education Programme Supporting
People with Type 2 Diabetes to Stop
Smoking
Leena Sankla, Solutions4health
Walker, K
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
42. Evaluation of a pharmacy-based flu
immunisation scheme
Gerald Tompkins
Public Health England
43. Newborn Screening Results
Disclosure for Cystic Fibrosis: a
Qualitative Descriptive Study
Dr Mohammad S Razai, University of
Cambridge
Jan Williams, Rachel Nestel, Dermot
Dalton
44. Childhood flu vaccination pilot in the
north east: using evaluation to
improve delivery
Glen Wilson, Cumbria and North East
Sub Region NHS England
Darke, J; Flinn, J; Bunce, J; Jobling, M;
Walker, S; Cresswell, T
45. Infection control measures in wet
cupping (Hijama): An alternative
therapy that involves bloodletting
Dr Bayad Abdalrahman, Speciality
Registrar, Public Health, Leicester City
Council
Zzizinga-Johnstone, V, (Leicester City
Council): Environmental Health
Student. Monk, P, (Public Health
England): Communicable Disease
Control Consultant. Browne, I
(Leicester City Council): Public Health
Consultant. Mandora, G (Leicester
City Council): Team manager (public
safety). Wowczuk, L (Leicester City
Council): Environmental Health
Officer.
Hare, J (Leicester City Council):
Trading Standards Officer.
46. Child drowning and the use of bath
seats:Public Health England
London(PHEL) response to
preventing accidental child injury
and mortality across London
Korkodilos, M, Public Health England
Omonijo, M; Panjwani, S; Wijemanne,
C
47. Exploring community pharmacy’s
contribution towards public health
Aloisia Katsande, West Sussex County
Council
Mcgonigle F
48. NHS Health Checks: are they just a
tick box exercise?
Shelagh Cleary, Office of Public
Health, West Midlands, Wakefield, S
49. Prevalence, predictors and patterns
of waterpipe smoking among young
people in London: a cross-sectional
study
Dr Mohammed Jawad, Southampton
City Council
Power, G
50. Waterpipe industry products and
marketing strategies: analysis of an
industry trade exhibition
Dr Mohammed Jawad, Southampton
City Council
Nakkash, RT; Hawkins, B; Akl, EA
51. Sharpening Public Health’s teeth?
Strengthening public health
outcomes through regulatory
delivery. Halton Council’s solution
Sarah Johnson Griffiths, Halton
Borough Council
Burrows, S; Perchard, D; Salisbury, W
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
52. Socio-economic differences in the
association between self-reported
and clinically-present diabetes and
hypertension in the Scottish Health
Survey
Gerald Tompkins, Public Health
England
Forrest, L; Adams, J
53. Access to food retail outlets in
County Durham, UK: a crosssectional study
Tim Wright, Public Health Durham;
Mills, S.
54. Co-production evaluation of the
County Durham Alcohol Hospital
Liaison Team (AHLT) (in association
with FUSE)
Grant McGeechan, Teesside
University; Wilkinson, K. G
55. Embedding health impact
assessment into the organisational
culture of Durham County Council
Tim Wright, Public Health Durham;
Curtis, S. Dr.; Learmonth, A. Dr.
56. Rebalancing the Outer Estates
Foundation, a partnership approach
to reduce health inequalities through
engagement; education and
innovation
Lynne McNiven, Nottingham City
Council; Jobarteh J
57. “You just, like, exist – you just
survive in the best way you can”: a
qualitative study of the impact of the
‘bedroom tax’
Dr Jim Brown, Gateshead Council
58. Dual Recovery: Meeting the needs of
people with co-existing mental illhealth and substance misuse
Dr David Edwards
Lancashire Care Foundation Trust
59. Implementing NICE guidance PH48
(smoking cessation in secondary
care) in a mental health and
community trust’
Jane Beenstock at Lancashire Care
NHS Foundation Trust
60. A review of psychotropic
medications prescribed in people
with a learning disability and the
outcomes of Second Opinion
Approved Doctor reviews
Claire Currie
61. Improving cardiovascular (CVD) risk
of those with enduring severe
mental illness in contact with a
specialist mental health Trust
Dr Caroline Hird, Nottinghamshire
Healthcare NHS Trust
62. The Dementia Gap in Primary Care –
An Ecological Study of Variations in
Diagnosis Rates in GP Practices
across England
Ian Walker, University of Leeds
63. Situational awareness for controlling
and managing infectious diseases
during armed conflict: The example
of polio in Syria
Dr. Balsam Ahmad, Department of
Applied Health Research, UCL
64. Tackling the obesogenic environment
in hospitals through partnerships
with retail outlets on hospital
premises
Sarah Perman, Public Health Registrar
City University London
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
65. Measuring the impact NGO advocacy
Hannah Brinsden, City University
London
66. The free movement of patients and
labour mobility within the EU at San
Donato Group University and
Research Hospitals
Francesca Ramondetti, MD, MPH
Public Health England
67. Operational Aspects of a Tees
Schools’ Fluoride Varnish
Programme: Recruitment, Consent
Rates and Improving Dental Access
Kamini Shah; Vidya Venkatesh
Tees Valley Public Health Shared
Service
68. A shared public health service for the
five local authorities - Darlington,
Hartlepool, Middlesbrough, Redcar &
Cleveland and Stockton- in Tees
Valley
Dr Tanja Braun, Consultant in Public
Health Medicine, Tees Valley Public
Health Shared Service
Sangowawa O, Clinical Director of
Public Health
Linton J, Senior Pharmaceutical
Adviser
69. Real time suicide early alert system
in County Durham
Catherine Richardson, Public Health
Lead
McGeechan, G
Durham County Council
70. Publishing Five Health and Wellbeing
Board (HWB) Pharmaceutical Needs
Assessments (PNAs) in the Tees
Valley in 2015; job done….or a new
beginning?
Dr Philippa Walters, Tees Valley Public
Health Shared Service; Linton, J
71. Dudley Council – Workplace Health
and Wellbeing Project
Bal Kaur, Dudley Metropolitan
Borough Council;, Jackson K.
72. Creating a compelling narrative: How
bespoke JSNAs enable practice to
understand their local population
and effect a positive health change
Dr Ifeoma Onyia
Halton Borough Council
73. Application and limitations of
epidemiological analysis in planning
access to specialised cardiology
services
Mark Lambert, Health Education
England
Plummer, C
74. New Communities in Bradford:
Assessing need to inform a proactive
and strategic multi-agency response
Kathryn Ingold, Durham County
Council
McCullough, B; Brierley, S.
75. Measuring the impact of Stop
Smoking Services (SSS) on reducing
health inequalities in County Durham
Dianne Woodall, Durham County
Council; Roe, K
76. “It made me realise how important
the work that I am doing is.”
Research and practice meetings as
vehicles for co-production and
knowledge exchange
Mandy Cheetham; McNaughton R;
Rushmer R; Shucksmith J; Van Der
Graaf FUSE
77. Delaying parenthood in looked after
children (LAC) in Warwickshire
Dr Christos Mousoulis; Robinson, R
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
78. An evaluation of the establishment
of multidisciplinary higher specialist
public health training in the UK,
1999-2014
Katie Ferguson
London Borough of Redbridge
79. Evaluation of Candidate Perceptions
of Participating in National Public
Health Recruitment
Clare Ebberson
Parkes, J (on behalf of Recruitment
Executive Group); Chatt, C; Crick, J
80. Smile 4 Life oral health promotion
pilot in Derby
Burgess-Allen, J
Millward, K.
Derby City Council
81. Creating resilience and reducing
vulnerability in respite care
Susan M Carr
Faculty of Health & Life Sciences &
Fuse
82. How can more pregnant women be
supported to stop smoking?
Evaluating the implementation of a
stop smoking initiative across the
north east of England.
Jones, S. Shucksmith, J. Hamilton, S.
FUSE
83. Help people live healthier lives
PHAST
84. Sex is risky– so why not test?
Munasinghe S; Howard N
Liew-Bedford F; Pereira A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No1
Developing a competency-based framework for public health education
and training in India.
Abstract topic & Manifesto - A good start
Submitted By
Dr Acquilla S. D
International Faculty Advisor,
Honorary Senior Lecturer at Imperial
College London
Visiting Professor at RDG Medical
College Ujjain, MP, India
Background
In India, there is growing recognition for the importance of public health and workforce
that is fit to deliver the PH. This has led to demand for appropriate public health
education and training to address health needs of communities
Aim
To
- Identify and define the functions for Public Health in India
- Identify competencies to deliver those functions.
-Use these competencies in the curriculum design of the Masters programs in IIPH/PHFI
Method
We engaged 20 academics from the PHFI and IIPH over an interactive five-day workshop.
Initially, to gain support on the approach to competency-based teaching and explored
the state of competency-based education. We helped them identify current public health
activities and problems, and then knowledge, skills and attributes required to address
these by identifying the learning outcomes for the future.
Results
We identified public health functions and functionaries at various levels within the health
system and organised these into broad categories. We then identified the knowledge,
skills and attributes that were necessary to deliver these functions at the specified level
of the health system. This activity helped us to identify specific learning outcomes for
public health education. Participants have shared experience of using the competency
framework in the design of the curriculum for Masters in Public Health. This initial
framework will be tested on public health workers.
Conclusions
This work helped us think conceptually about a competency based framework for public
health education, training and skills needed in service work. We recognise the need to
build a common goal for the benefits of a contextual framework. Further test and
dissemination of the framework is expected, to provide guidelines on its use in designing
public health care and management programs and defining public health cadre in India.
Learning
Outcomes
understand
-mechanics of working overseas in defined projects
-importance of correct methodology for acceptance of the outcome by those responsible
for delivery of function in an overseas setting.
-importance of ownership of the working document by those who are responsible for
implementation of the policy
-wider dissemination and acceptance of framework in the Country
Other
Presenters
Dr Kalliecharan Ricky Van
Nuffield Centre for International Health and Development
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Professor Zodpey. Sanjay PHFI
Dr Negandhi Himanshu IIPHD and PHFI
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No2
The politics of localisation: Building resilient communities – From idea to
sustainable action.
Abstract topic & Manifesto - A good start
Submitted By
Chan, K.L, Sefton CVS
Background
Today's fiscal climate means organisations are experiencing disruptive changes. To
preserve its legacy, Sefton Maternity Services Liaison Committee (MSLC) collaborated
with its partners on developing a doula service in Sefton.
Aim
The primary aim was to develop a doula programme to support vulnerable women
having a baby in Sefton and improve outcomes for families. The secondary aim was to
develop its parent group by developing their skills and knowledge in planning services.
Method
In May 2012, the MSLC and parent group agreed to develop a doula programme in
Sefton. The objective was to provide consistent and tailored support for vulnerable
women and their families throughout the latter stages of pregnancy, childbirth and for
the first 6 weeks of family life. Training was provided to the parents on enabling creative
and inclusive participation at meetings. From May 2013 to November 2014, wide spread
consultations were held with the local community, voluntary sectors, Clinical
Commissioning Groups (CCGs) and local NHS trust.
Results
Work on the doula programme is ongoing. Nevertheless, as a measure of its success, in
November 2014, the working group was able to produce a bid to the Big Lottery fund to
secure funding . This was made possible through multi agency collaboration. Another
very real achievement is the growth in confidence and skills of the parent group,
reflected in its recognition by outside agencies eg. Cheshire and Merseyside strategic
network and neighbouring councils. To date, the group have continued to develop and
drive other local initiatives .
Conclusions
User involvement is talked about in terms of ‘co-production’. Co-production is defined
as delivering public services in an equal and reciprocal relationship between
professionals and people using services. In Sefton, an aspiration brought people with
different levels of power and status to meet and learn from one another and access
resources beyond their immediate community. The partnership has flourished and has
been mutually beneficial as the parents grew in experience and confidence ,both to
sustain self-management and, more widely, to influence the shape of health services.
Learning
Outcomes
Professionals can collaborate between sectors and disciplines to serve local agendas: this
involves learning new, enabling roles and taking a ‘humbler approach’ to management.
The design of services would be ‘with people, not on them’. By shifting some of the
responsibility of planning and management to communities and individuals, institutions
can increase their own capacity
Other
Presenters
Jones, M.
Boner, B
McCaskill, S
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No3
Preparation for pregnancy in women with type 1 and type 2 diabetes:
lessons from a regional audit
Abstract topic & Manifesto - A good start
Submitted By
Bell, R
Newcastle University
Background
Women with diabetes are at high risk of adverse pregnancy outcome, which can be
reduced by improved peri-conception glucose control. Preconception care is
recommended but many women do not access it.
Aim
To audit performance over time against indicators of preparation for pregnancy in
women with diabetes, and to identify factors associated with preparation for pregnancy.
To disseminate findings and agree new standards of care.
Method
Audit data from the Northern Diabetes in Pregnancy Survey for women pregnancy
between 1996 and 2010 were analysed. Three indicators of pregnancy preparation were
used to assess trends and identify risk groups. These were: attendance at preconception
care, folate supplementation prepregnancy, and glucose control peri-conception.
Consensus methods were used to develop regional standards of care for preparation for
pregnancy which were discussed at two regional workshops in 2012 and 2013 and
disseminated within the region. Analysis of audit data for 2011-2013 was subsequently
undertaken.
Results
The number of pregnancies in women with diabetes rose substantially over the study
period, due to an increase in women with type 2 diabetes to 40% of pregnancies by
2008-10. Overall, 40% of women attended pre-conception care, 37% reported preconception folate consumption; and 28% had adequate glucose control at conception.
Folate consumption improved over time, but glucose control did not. Women with type 1
diabetes were more likely to attend pre-conception care, but the proportion attending
declined over time. Women from deprived areas, smokers and younger women were less
likely to be prepared for pregnancy
Conclusions
In developing standards of care, the challenges of supporting preparation for pregnancy
in primary care settings, and in providing easy access to preconception advice at the right
time for women, were highlighted, particularly by users. The re-audit showed
improvement in folate consumption but similar rates of attendance at preconception
care and of achievement of good prepregnancy glucose control. More work is needed to
develop alternative models of promoting good preparation for pregnancy particularly
outside specialist settings and which address the diverse needs of women with diabetes.
Learning
Outcomes
Appreciation of the risks of diabetes and pregnancy and the growing importance of this
problem. Understanding the potential value of preparing for pregnancy for this group
and the challenges of improving this. Awareness of the value of multi-centre population
audit for monitoring trends in care and outcomes.
Other
Presenters
no additional presenters
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No4
The relevance and understanding of programme sustainability within the
public health policy context: lessons learned from injury prevention.
Abstract topic & Manifesto - A good start
Submitted By
Errington,G
University of Nottingham
Background
Sustaining public health programmes can maximise the associated health benefits but
presents a challenge to those delivering local interventions. There is currently a paucity
of research into programme sustainability in the UK setting.
Aim
To explore the conceptualisation and role of programme sustainability within the context
of global and national public health policy and to consider the relevance of this to the
sustainability of local child injury prevention programmes.
Method
Policy documents that included goals or objectives for improving child health and/or
strategies for injury prevention were identified. Twenty global and 29 English public
health policies published between 1981 and 2014 were reviewed for reference to
sustainability. In-text key word searches for associated terms were undertaken. One-toone telephone interviews were conducted with senior representatives of six agencies
involved in child health policy development to obtain their views and understanding of
programme sustainability. The findings were identified using thematic analysis.
Results
Thirty-six policy documents (73%) included the term sustain or its derivatives. Most were
used with respect to environmental rather than health programme sustainability. Policies
failed to make an association between long term public health outcomes and the need to
sustain programme activities. Supportive strategies for sustainability did not feature
within policy documents. Programme sustainability was regarded as relevant by all of the
policy stakeholders. However their conceptualisation and views on sustainability varied
reflecting individual experience and professional expectations.
Conclusions
Public health policy to-date has failed to address the issue of programme sustainability.
Recommendations and guidance that may offer potential mechanisms for sustainability
have not been incorporated consistently into policy. As a consequence the policy context
is not supportive of local efforts to achieve programme sustainability and does not
reflect the views of policy stakeholders.The usage of a range of terms to denote
sustainability, together with a lack of consensus as to its definition and conceptualisation
may have served to dilute the issue.
Learning
Outcomes
To provide an appreciation of the relevance of programme sustainability in achieving
public health aims.
To understand the public health policy stance taken on sustainability and the likely
impact of this on local programmes.
To stimulate interest in programme sustainability within public health and encourage
contributions to the evidence base, particularly from the European and UK contexts.
Other
Presenters
Watson, M
Evans, C
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No5
An education in self-management of asthma: an epidemiological study of
rules governing carriage of inhalers in secondary schools in North East
England
Abstract topic & Manifesto - A good start
Submitted By
Howard, SJ
Public Health Specialty Registrar
Background
Teaching children to self-manage long-term conditions (LTC) has been shown to improve
clinical outcomes and reduce healthcare costs. Asthma is a highly prevalent LTC in
children. Correct use of inhalers is key to successfully self-managing asthma.
Aim
To assess the extent to which schools in the North East of England allow children with a
diagnosis of asthma who are above the age of assumed medical capacity (16 years) are
allowed to self-manage their condition though carrying their own inhalers.
Method
We considered mainstream state-funded secondary schools in two local authorities in
the North East of England: South Tyneside and Newcastle upon Tyne. Where available,
the school's policy governing inhaler carriage was accessed via the website. Where this
was not available, schools were invited by email and letter to complete a brief online or
postal questionnaire describing their school's policy. Policies and questionnaire
responses were considered and categorised by two reviewers (one clinical and one nonclinical), with discussion used to reach consensus where categorisations differed.
Results
Only 14% of schools had a policy relevant to the research question publicly available on
their website. A questionnaire response rate of 47% increased the total sample size to
57% of the 21 schools considered. In 50% of schools, agreement between the school and
parents or guardians was required before pupils were allowed to carry their inhalers; in
the remaining 50% of schools, pupils were allowed to carry their own inhalers without
special permission. There were no associations between asthma policy and Local
Authority, suggesting that schools developed policies independently.
Conclusions
The finding that 100% of included secondary schools in two North East Local Authorities
allowed pupils to carry inhalers contrasts with a similar study of primary schools in
Birmingham, where only 48% allowed pupils to carry inhalers. The requirement for
parental permission in 50% of schools may be pragmatic, but is ethically dubious for
children above the age of capacity whose parents may not be involved in medical care.
Schools and Local Authorities may be missing opportunities to develop high-quality
evidence-based asthma policies through intra- or inter-Authority collaboration.
Learning
Outcomes
While the Literature describes the benefits of self-management of many paediatric LTCs,
little focus has been given to self-management within the school environment. Delegates
reading this poster will be inspired to explore ways in which Local Authority Public Health
teams can influence practice to help ensure that schools do not squander opportunities
to imbue self-management skills in children.
Other
Presenters
Funston, W
(Respiratory and General Medicine Specialty Registrar)
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No6
An Exploration of the reasons influencing health care seeking behaviours
of parents of young children in Sheffield
Abstract topic & Manifesto - A good start
Submitted By
Garbe, F
NHS
Background
Parents' health seeking behaviour has changed, leading to increasing levels of A&E
attendances for children.Understanding parents’ reasons for their healthcare seeking
behaviour, is essential to develop services appropriately to address their needs.
Aim
This study aims to identify and explore the reasons behind parents’ different health care
seeking behaviour, for their children aged under 5 years in Sheffield for minor illnesses.
Method
A qualitative design was applied to allow an in depth exploration of the factors
influencing parents’ health care seeking behaviour. A single researcher conducted semistructured interviews of parents in Sharrow, SureStart centre in Sheffield. The data was
then collected by the single researcher. Thematic analysis was performed of the
transcribed data in an inductive exploration of influencing factors. The study had ethical
approval from the University of Sheffield Ethics Committee, and full informed consent
was obtained prior to performing the interviews.
Results
9 interviews were conducted ;8 females and 1 male, age range: 22 - 39 years (average:
29.4 years). All participants were registered with a GP. The most recurrent theme arising
from this study was that parents lacked confidence, and were seeking reassurance and
support to develop confidence in their decision making process when their young
children were perceived to be ill. Lack of family support networks as well as issues of a
lack of trust in primary care services, and confusion about service identity of the services
available lead to presentations at the Children’s Hospital A&E department.
Conclusions
This study shows that the needs of parents for support in developing their parenting
skills and coping strategies around dealing with their children’s illnesses are the primary
reason for their health seeking behaviour.This study suggests that it is not a lack of
choices and services available,that is driving the increase in A&E attendances but,lack of
clarity about and trust in primary care services, coupled with parents' trust in A&E.More
supportive and proactive primary care provisions are likely to be required to reduce A&E
attendances for minor illnesses of children under 5 years of age.
Learning
Outcomes
Other
Presenters
Owen, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No7
Do alcohol and pregnancy mix?
Insight from the development of a social marketing campaign to reduce
alcohol consumption during pregnancy.
Abstract topic & Manifesto - A good start
Submitted By
Rosser, J. Mrs
Halton Borough Council
Background
Foetal Alcohol spectrum disorder (FASD) causes a range of medical conditions, including
neurological damage. It is 100% preventable. Estimating the prevalence of FASD is
difficult but we know alcohol is negatively impacting upon child development.
Aim
We aimed to investigate women’s knowledge of national guidance and the potential harms
of drinking during pregnancy in order to develop a local social marketing campaign to
encourage them not to drink alcohol when planning for, or during pregnancy.
Method
In order to investigate knowledge and beliefs a mixture of quantitative and qualitative
methods were used. Based upon a literature review and local needs assessment a
quantitative questionnaire was developed. To further explore the questionnaire findings
qualitative interviews were also undertaken. Women were eligible to participate if they were
of childbearing age (age 16 to 44) and resided within the Local Authority boundaries. In total
210 questionnaires were completed (150 street based, 60 online). In addition interviews
were conducted with 40 women recruited via local children’s centres.
Results
Results show that local women:
-Found current national guidance on drinking during pregnancy unclear and confusing
- Do not understand alcohol units
-Had not heard of FASD, and were not aware that drinking during pregnancy could cause
long-term health harms
-Can feel under scrutiny when discussing drinking habits, and indirectly criticised.
Based upon the insight work a social marketing campaign and leaflet for midwives has been
created. When asked about the campaign women wanted:
-Simple, clear, hard hitting messages
-More information on alcohol from midwives.
-Not to use the term FASD
Conclusions
England lags behind countries such as Canada in raising awareness of the risks to the foetus
from alcohol during pregnancy. This research found that women did not know how alcohol
can harm their child, and the conditions that it can cause. The current national guidance is
unclear and confusing, and women do not know what a safe level of drinking is. Social
marketing campaigns on FASD need to be aimed at all women of child bearing age, be clear,
with a simple, easily understood message, that doesn’t refer to FASD and focuses on
stopping drinking when planning for a baby and during pregnancy.
Learning
Outcomes
to develop a better Understanding of FASD and the health impact of alcohol during
pregnancy
-to gain Insight into women’s views on the department of health guidance on drinking during
pregnancy and How it is interpreted and acted upon.
-an example of a locally developed social marketing campaign, aimed at reducing alcohol
consumption in pregnant women and women trying for a baby.
Presenters
Anwar, E. Dr Robinson, H. Ms
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No8
Persuading the last 12%: could carrots or sticks help achieve full infant
immunisation?
Abstract topic & Manifesto - A good start
Submitted By
McNaughton, R. J.
Teesside University
Background
Since the MMR debacle of the ‘90s, attempts have been made to rebuild trust in
childhood immunisations. In 2011-12 MMR uptake stood at 88% - too low to achieve
herd immunity & prevent epidemic flares
Aim
To understand the views, wants & needs of stakeholders to promote uptake of preschool
immunisations (PSI) & assess acceptability of introducing financial incentives (FI) (cash
reward) or quasi-mandatory schemes (QMS) (e.g. mandated for school entry)
Method
Part of a larger NIHR HTA funded study to explore evidence on FI/QMS, this component
used qualitative methods (focus groups & 1:1 interviews) to explore the needs of:
parents and carers of preschool children (n=91); health & other professionals (n=18); &
those responsible for developing & commissioning immunisation services (n=6).
Framework Analysis was used to develop a coding framework that was applied to the
whole dataset. Interpretations of the emergent themes were verified between
researchers & presented back to the project’s Parent Reference Group to ensure their
coherence & relevance.
Results
Parents & professionals felt introducing FI was inappropriate. FI may encourage families
living in disadvantage to prioritise immunisation, but unintended consequences could
outweigh any advantage. FI essentially changes behaviour into a cash transaction which
equated to bribery that had the potential to inadvertently create inequalities. Parents &
professionals highlighted positives of introducing QMS, stating it felt natural, fair & less
likely to create inequality. Despite QMS’ potential to positively impact on uptake there
were concerns about implementation & workability of such schemes
Conclusions
FI for immunisation may not be acceptable, within a UK context. Introducing FI could
have detrimental effects on uptake if it were associated with bribery & coercion, leading
to the potential of herd immunity being insufficient to stop any future flares of infection.
Mandating immunisation for school entry was the most acceptable option to all
stakeholders & could contribute to the normalising of immunisation. However, future
work would be needed to assess how this could be successfully implemented.
Learning
Outcomes
An appreciation of the complexities associated with making changes to the UK childhood
immunisation programme for preschool children.
Other
Presenters
Shucksmith, J. and Adams, J.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No9
The introduction in Dudley of the Dried Blood Spot (DBS) testing service
for babies born to hepatitis B positive mothers.
Abstract topic & Manifesto - A good start
Submitted By
Cliff, LA
Dudley Metropolitan Borough Council
Background
Dudley has achieved 100% uptake in Hep B vaccination for children born to positive
mothers since 2009, but uptake of venous blood test at 12 month was considerably
lower.
Aim
The initiative aimed to ensure that all babies born to Hepatitis B positive mothers in
Dudley are tested post vaccination in a timely manner, and provide assurance to the
Director of Public Health.
Method
Following consultation with Public Health England, the Office of Public Health
Immunisation Team (OPHIT), were successfully designated as local Co-ordinators of the
Dried Blood Spot Service in Dudley.
Results
Following the introduction of the DBS testing service in Dudley in June 2014, 100% of
babies have been tested. All results have been negative for hepatitis B infection.
Conclusions
The only method previously available for testing the child’s blood was via a venous blood
sample, which can be unpleasant for both the child and parent, and requires a visit to the
local hospital as paediatric blood samples are not routinely taken in General Practice.
The DBS has proved a simple easy test which is acceptable to both parents and Practice
staff. It has a quick and efficient reporting system and increases compliance of post
vaccination blood testing.
Encourages the fulfilment of recommendations in Reducing differences in the uptake of
immunisations. (NICE PH Guidance 21).
Learning
Outcomes
Delegates will be informed and updated on the effectiveness and efficiency of this
procedure. This will provide the background needed to enable the introduction of this
programme in their own areas. Introduction of this service will lead to an improved
service to patients.
Other
Presenters
Jones,B
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No10
Early nutrition for later health: why ‘early’ should start in pregnancy
Abstract topic & Manifesto - A good start
Submitted By
Background
Judy More, Infant & Toddler Forum
member
Evidence shows that interventions during pregnancy and the first two years of life affect
later health outcomes, particularly childhood obesity. Improving nutrition and lifestyle
during this window of opportunity is crucial.
Aim
Method
- An extensive literature search and interviews with key experts in the field
- Qualitative and quantitative surveys of 150 healthcare professionals and 1,000
mothers/mothers-to-be to understand perceptions/attitudes and the level of knowledge
about the
Results
- Maternal nutritional status and BMI during preconception and pregnancy impacts on
programming and development in the fetus, and birth and health outcomes in the
mother and child. Assessment of BMI and weighing during pregnancy is not routine
- Knowledg
Conclusions
Families need updated, consistent evidence based information on nutrition and weight
management preconception, during pregnancy and early life and HCPs need more time,
resources and training to effectively deliver this.
Learning
Outcomes
•
Nutritional status of preconception and pregnant mothers has an impact on
health outcomes in children
•
Nutrition advice should be given as early as possible, ideally before conception
•
More healthcare professionals working with preconception & pregnant women
and young families are needed and they need more evidence based training, up to date
knowledge and resources on nutrition and lifestyles
Other
Presenters
Singhal, A, Professor of Paediatric Nutrition, Institute of Child Health, UCL and Chair of
the Infant & Toddler Forum
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No11
Making the case for more equitable investment in the Health Visiting
programme: Using data to benchmark local need in Redbridge, London
Abstract topic & Manifesto - A good start
Submitted By
Ferguson, K
London Borough of Redbridge
Background
In October 2015, the 0-5 Healthy Child Programme will transfer from NHS England to
Local Authorities, with each local authority receiving a grant to cover commissioning
costs. In Redbridge, there was concern that the proposed grant would be insufficient t
Aim
We wanted to make the case for a more equitable funding allocation, so that Redbridge
would have access to a similar level of funding per under-five head of population to
other boroughs, in order to adequately deliver the Health Visiting service as mandat
Method
Our current provider calculated the cost of delivering the 0-5 Healthy Child Programme
locally. We compared this with the proposed grant allocation to calculate the funding
shortfall. We benchmarked the Redbridge allocation with that in other London boroughs,
using Index of Multiple Deprivation and child poverty as proxies for need. We used the
Cowley (caseload) Model to calculate the optimal number of Health Visitors for
Redbridge, based on deprivation. Our calculations informed advocacy work with other
London Councils as well as a letter from key Council/partnership committees in
Redbridge to the Secretary of State for Health, expressing concern at the inadequate
levels of funding.
Results
The cost of providing a mandated service was calculated as £4.67 million in Redbridge.
The proposed allocation of £2.9 million represented a 38% shortfall in funding.
Benchmarking showed Redbridge had the 8th lowest grant in London, despite
deprivation and child poverty being comparable with boroughs with higher allocations.
Using the Cowley Model, we calculated that Redbridge would require 59 additional
Health Visitors to provide a service appropriate for its deprivation level. Following
communication of this information to the Secretary of State for Health, revised
allocations were issued. Redbridge’s grant was increased to £4.25 million.
Conclusions
In conjunction with other London Councils, we appealed against the low Health Visitor
grants that had been allocated to some councils. Following our appeal 12 councils,
including Redbridge received an increased allocation. This reduces the projected funding
shortfall in Redbridge to 9%, increasing the opportunity for us to provide an adequate
health visiting service. National government have also committed to move towards a
grant allocation based on need from 2016/17. While we cannot directly attribute these
decisions to action taken in Redbridge and by Councils in London, we are pleased to have
made a contribution to this positive outcome.
Learning
Outcomes
•
To understand about the transfer of Health Visiting and the implications for local
authorities in accepting the service
•
To understand what data is available to estimate levels of need in the under 5s
and its limitations
•
To understand how collaboration and engagement in the political process can
lead to positive outcomes for population health
Other
Presenters
Ogilvie, F; McCusker, V; Xavier, G; Meeran, M
Sher-Arami, D; Hobart, V
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No12
MeTime Club: An integrated Approach Supporting Mums and Mums-to-Be
to Stop Smoking. A Case Study in The Wirral.
Abstract topic & Manifesto - A good start
Submitted By
Sankla, L, MFPH and FRSPH
Solutions4health
Background
Smoking in pregnancy remains a major Public Health concern with a prevalence in
England of around 12%. Not only is the mother and her unborn child at risk of developing
resultant health inequalities, there is also the significant cost to the NHS.
Aim
The aims were to increase:
•
health, wellbeing and self esteem of pregnant women smokers living in the 20%
most deprived areas
•
The numbers stopping smoking during pregnancy; two months post-partum
•
referrals to other relevant lifestyle services
Method
The innovative programme, combined professional advice, support and a supply of
patches or other nicotine replacement therapies, with fun and interactive activities. The
integrated model included:
•
A 12 week course delivered for an hour and a half each week
•
Transport and a crèche were provided
•
Section A of the session focused on providing smoking cessation
•
Section B of the session delivered self-management topics;
o
Stress/triggers; Peer Pressure /Social Influence
o
Body Image; Practical Exercise Class
o
Cookery classes/tips
o
Feeling down
o
Communication
o
Visitors
o
Looking back and the future
Results
The MeTime Club places a strong emphasis on raising self-esteem through smoking
cessation and delivering a range of holistic therapies.
•
Eliminated attendance boundaries by offering transport; a crèche and home visits
•
Integrated model, with innovative user participation has resulted in high CO
verification rates
•
100% of 112 signs up SAQD with 63% quitting at 4 weeks and 42% at 12 weeks
•
73% lived in the 20% most deprived wards
•
40 out of 44 women increased their self esteem and four had maintained a
constant score
•
Out of 112 women, 11 of their significant others signed up to the service
Conclusions
The MeTime integrated model approach not only helps mothers and mothers-to-be to
successfully quit smoking it also raises their levels of self reported self-esteem.
Learning
Outcomes
•
Recognise, explain and implement methods of breaking down access barriers for
mums and mums to be to stop smoking services
•
Recognise and explain the power of integrating fun and interactive activities to
adherence and positive outcomes for smoking cessation
•
Develop local programmes based on an evidence based model
•
Raise awareness of effective tailored services to pregnant women
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No13
The effectiveness of an outreach sexual health intervention designed to
prevent repeat teenage pregnancy
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Jones, C
Senior Research Fellow in Maternal
and Reproductive Health
Faculty of Health and Social Care,
University of Hull
Background
Teenage pregnancy is a global problem (WHO 2014) and preventing unplanned repeat
teenage pregnancies (URPs) is an important strand of sexual and public health
promotion.
Aim
We used qualitative methods to explore teenage mothers (n = 40) experiences of home
based sexual health care. The aim was to understand how the service equipped teenage
mothers to make informed choices about contraception and prevent a URP.
Method
The study took place within a Young Person’s Sexual Health Service responsible for the
delivery of home based sexual health care to new mothers aged 16 – 19. The ‘Preventing
Second Pregnancy’ (P2P) service as it is called provides care for 200 teenage mothers a
year. Semi structured interviews were undertaken. NHS ethical approvals were
obtained. Following data analysis (Ritchie & Spencer 1994), data were arranged into the
3 themes; Teenage mothers experiences of P2P; Teenage mothers reflections of the
attitudes of the P2P nurses; Impact and understanding.
Results
P2P provided a flexible approach to service delivery, which in turn facilitated positive
engagement. Overall the data reflects that teenager’s engagement with home-based
contraception is motivated by a need for privacy, convenience, flexibility and
appropriately timed access. Furthermore, the data highlighted the positive impact of a
brief intervention after childbirth on sexual and reproductive health with respect to
preventing URPs in teenage mothers. Teenage mothers in this area now use the support
systems, and sexual health services around them with much less hesitation.
Conclusions
P2P equipped teenage mothers to make informed choices about contraception and
future sexual health. Firstly, the findings highlight the reasons why teenage mothers find
nurse led outreach services more engaging than traditional clinic based services;
furthermore, in the UK and on a global level, for commissioners and service providers,
the data illustrates the positive effects of this model of service provision in ensuring
implementation of the NICE (2007) guidance on prevention of STIs and under 18
conceptions.
Learning
Outcomes
There is considerable stigma of accessing sexual health care via GPs and clinics for
teenage mothers and young people in general. The UK still has the highest rate of
teenage pregnancies in Western Europe (NICE 2007), and qualitative accounts of teenage
mothers highlight that home based contraceptive care can prevent unplanned pregnancy
after childbirth and promote good sexual health.
Other
Presenters
Hayter, M
Professor of Reproductive and Sexual Health
Faculty of Health and Social Care, University of Hull
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No14
Improving the help and support provided to people who take New
Psychoactive Substances (‘legal highs’)
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Fletcher, EH
NHS
Background
Year on year the number of New Psychoactive Substances (NPS) produced increases.
The concern about the impact of NPS on public health is such that the Scottish
Government has made tackling NPS a priority for local Alcohol and Drug Partnerships.
Aim
1)
To improve our understanding of NPS
2)
To identify issues, concerns and needs of people who either take NPS themselves,
or are affected by others’ use
3)
To improve the help and support offered to people who either take NPS or know
others who do
Method
In collaboration with local Alcohol and Drug Partnerships we conducted a Needs
Assessment comprising i) routine data analysis, ii) population survey and iii) discussions
with professionals and local community groups. Routine data were sought from various
organisations including Police Scotland, Scottish Ambulance Service and NHS. The
anonymous online population survey ran for 5 weeks and was promoted by local radio,
television and print media. We spoke with professionals in health, trading standards,
police and the voluntary sector and with individuals with first-hand experience of NPS.
Results
Data concerning NPS are not routinely collected by most services. The survey attracted
687 responses and together with the various discussions provided a wealth of
information concerning the impact of NPS. The ease of access and availability of NPS
through shops was highlighted as were the significant adverse effects experienced by
users. The Needs Assessment makes recommendations which are being considered and
adopted at both a local and a national level. The report formed the basis for a Members’
debate at the Scottish Parliament on the 6th January 2015.
Conclusions
NPS are a rapidly evolving entity. The Needs Assessment made recommendations which
can be broadly grouped into i) improving data collection to monitor NPS-associated
trends ii) raising awareness of NPS iii) advocating the restriction of access to NPS iv)
facilitating information sharing of current NPS trends and v) the development,
monitoring and evaluation of NPS-specific support delivered by services. This report
provides a platform through which to consider and improve the way in which we provide
help and support to those who take NPS or know others who do in future.
Learning
Outcomes
The presentation will explore the current public health concerns associated with NPS. It
will summarise the results from the Needs Assessment and reflect on the successes and
challenges of conducting such a piece of work for future learning. The recommendations
will also be presented with consideration as to their future implementation.
Other
Presenters
Tasker, S
Easton, P
Denvir, L
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No15
Clustering health-related behaviours in two British birth cohort studies.
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Mawditt, C
NHS University College London
Background
Research findings indicate that health-related behaviours are associated with one
another and do not co-occur within individuals by chance alone. There is a growing body
of research evidencing the clustering of health-related behaviours.
Aim
This research aims to extract the clustered patterns of four health behaviours (smoking,
alcohol, diet, physical activity) in two British birth cohort studies born 12 years apart.
Method
This study uses data from two British birth cohort studies: the 1958 National Child
Development Study (NCDS) and the 1970 British Birth Cohort Study (BCS70). The four
health-related behaviours are: smoking (current numbers of cigarettes per day), alcohol
use (number of units consumed in the last week), diet (average consumption frequency
of 5 food groups) and physical activity (average leisure time frequency).
Latent Profile Analysis will be used to extract the clustered patterns of health-related
behaviours in each birth cohort study.
Results
Three clusters were extracted at age 33 in the NCDS and at age 34 in the BCS70. The
three clusters were labelled; “Multiple Risky Behaviours”, “Smokers”, “Healthy lifestyle”.
“Multiple Risky Behaviours” were the smallest cluster in both studies (6.4% NCDS; 4.5%
BCS70) followed by “Smokers” (25.2% NCDS; 19.7% BCS70) and "Healthy lifestyle" were
the largest cluster in both studies (68.4% NCDS; 75.7% BCS70).
Conclusions
The results of this study can contribute to the development of health-related behaviour
policies and interventions that target homogeneous subgroups of the population.
Learning
Outcomes
That health-related behaviours do cluster together and that the current approach to
addressing health-related behaviours as individual entities, is no longer appropriate. The
audience will also learn the basic principles of Latent Profile Analysis to identify clustered
patterns.
Other
Presenters
N/A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No16
Transforming the ‘foodscape’: A systematic assessment of Out of home
food outlet (OHFO) interventions in England
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Ashley Adamson
University of Newcastle
Background
Eating out of the home is increasingly common and contributes approximately 10% of
total energy intake. These foods are usually high in energy, fat and low in
micronutrients. These outlets are a potential target for interventions to tackle obesity.
Aim
To conduct a systematic search and documentation of the range and any evaluations of
out of home food outlet (OHFO) interventions completed, ongoing or planned in
England.
Method
Academic, UK trial and research, grey literature and media databases, along with UK
internet pages and relevant websites were searched using combinations of keywords. All
355 councils in England were contacted and enquiry email messages were directed to
appropriate individuals. Relevant professionals were targeted via email and bulletins.
Information was also requested using social media. Information received was screened
to identify interventions that met the inclusion criteria. Data extractions were completed
by researchers and sent to intervention teams to check accuracy.
Results
The searches identified 102 interventions. Further information was obtained for 75
interventions and included 43 ‘award scheme’ interventions and 32 ‘non-award scheme’
interventions. The majority were delivered by environmental health officers. There were
37 with outcome evaluation results. Most evaluations focused on the acceptability of the
intervention to OHFOs rather than to customers. Evaluations highlighted the need for a
cost neutral intervention (to the outlet) and recognised the need for a significant
investment of time on behalf of the intervention deliverer.
Conclusions
A broad suite of interventions were identified but ‘award scheme’ were most popular.
Details about set-up and running costs were limited. This evaluation evidence suggests
that while delivering interventions in OHFOs requires significant commitment, these
OHFOs have the potential to provide healthier options.
Learning
Outcomes
This study provides a description of the type, location and evaluation of mostly
unpublished interventions in OHFOs in England. The evaluation results will help
determine the best candidate interventions for further investigation and intervention
development.
Other
Presenters
Moore, HJ
Summerbell, CD
Wrieden, WL
Abraham, C
Adams, J
Araujo-Soares, V
White, M
Lake, AA
Hiller-Brown, F
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No17
Protecting children from secondhand smoke: The success of an integrated
approach in the North East of England
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Surtees, L
FRESH NE
Background
Smoking rates in North East England have fallen from 29% in 2005 to 22% in 2013 because
of comprehensive tobacco control delivery. UK smokefree legislation has achieved high
compliance but children’s exposure to secondhand smoke (SHS) is a concern.
Aim
Reducing SHS exposure is a priority for Fresh, the North East's locally-commissioned
comprehensive tobacco control programme, has developed an integrated approach to
protecting children from SHS to broaden the protection afforded through legislation.
Method
The Fresh integrated approach supports stakeholders in promoting smokefree lifestyles and
includes:
•an insight-led media campaign 'Take 7 Steps Out' to keep homes
smokefree, in partnership with Tobacco Free Futures who led this work
•a training programme for staff working in the community to support
smokers to keep their homes and cars smokefree
•a tobacco control module for further education to build capacity
amongst future community staff
•resources to help local authorities implement smokefree playgrounds
•ongoing advocacy around the need for further legislative protection of non-smokers
Results
The proportion of smokefree homes in the North East has risen from 43% in 2009 to 67% in
2014, demonstrating ongoing shifts in social norms of smoking behaviour. ‘Take 7 Steps
Out’ was seen by 2 million North East people and hundreds of community staff have been
trained to promote smokefree lifestyles among their clients. Many North East councils are
implementing or discussing smokefree playgrounds as part of local strategies. The North
East public has high support – currently 84% - for a law to protect children from SHS while
travelling in cars which is soon to be considered by Parliament.
Conclusions
Reducing exposure to SHS is a key objective towards the North East’s goal of making
smoking history and much progress has been made over the last 10 years. In addition to
comprehensive smokefree legislation, integrated complementary resources delivered
consistently across a regional footprint, supported by local and national action, help to
develop infrastructure, raise awareness and change social norms. Public and stakeholder
support for further measures can be harnessed to make the case for new regulations, e.g.
smokefree cars. The challenge ahead is to ensure continued progress is made.
Learning
Outcomes
The audience can expect to learn about:
• Why secondhand smoke is a concern in the North East
• What is being done to reduce exposure and how the integrated
resources support each other
• The added value of regional collaboration on tobacco control,
supported by local and national action;
• The North East vision of making smoking history and how
delegates can support this
Other Presenter
Lloyd, A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No18
Alcohol and cancer, re-establishing the links through a social marketing
campaign
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Shevills C.
BALANCE NE
Background
The North East suffers from the worst rates of alcohol-related health harms in England.
In 2009 a regional office was launched to reduce consumption and harm. A commitment
of 'Balance' is to annually produce a mass media social marketing campaign.
Aim
The objective was to run a hard-hitting alcohol and cancer campaign to re-position
alcohol closer to tobacco in terms of the health harms it causes; encourage people to
consider their drinking; and promote Alcohol Concern's Dry January.
Method
A marketing campaign ran on TV and online in November 2013, supported by PR and
partner communications. It featured a father preparing dinner for his children while
drinking a beer in which a tumour is seen growing. The message stated alcohol is a class
one carcinogen like tobacco and that risk increases with consumption. A linked TV
campaign and engagement process followed to recruit sign-ups to Dry January.
Results
The evaluation revealed 7 in 10 rated the campaign 'good' or 'excellent' and agreed
alcohol, like tobacco, causes cancer. Half of those drinking above the guidelines said it
would encourage them to cut down. Alcohol industry efforts to ban the advertisement
via the Advertising Standards Authority failed. The Dry January recruitment process saw
significant partner involvement while 28% of sign-ups to the national campaign were
from the North East. An evaluation of longer term behaviour change is awaited.
Conclusions
While the results are promising more work is required to understand whether linking
hard-hitting campaigns with calls for changes in individual behaviour delivers improved
results, though it's clear a regional focus on Dry January improves recruitment, with the
NE performing better than any other region.
Learning
Outcomes
Audience members will leave with an understanding around how an alcohol related mass
media social marketing campaign can be successfully implemented across an English
region. The presentation will also talk in depth about evaluation and the impacts of the
campaign on the target population.
Other
Presenters
n/a
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No19
Television-based health promotion in General Practice waiting rooms: a
cross-sectional study evaluating propensity to seek healthcare services
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Jawad, M
Southampton City Council
Background
Primary care settings play an important role in health promotion, but no studies to date
have evaluated television-based health promotion initiatives in clinical waiting rooms.
Aim
To evaluate whether a television-based health promotion initiative would increase
propensity to seek healthcare services.
Method
This cross-sectional survey of 1,696 patients attending 49 General Practices in Brent,
northwest London, evaluated the ‘Life Channel’ – a series of six brief health promotion
advertisements displayed over ten minutes on TV in the General Practice waiting rooms.
Logistic regression identified sociodemographic predictors of an intention to access
dental and ‘other healthcare services’ as a result of viewing the Life Channel.
Results
10.7% of patients intended to contact a dentist, and 31.6% intended to contact another
health service because of the Life Channel. Intention to contact a dentist was
significantly associated with younger, male patients of black ethnicity. Intention to
contact other health services was significantly associated with younger patients and
smokers.
Conclusions
General Practice waiting rooms are suitable settings for television-based health
promotion, which may increase awareness of and trigger propensity to access healthcare
services. Television-based health promotion may appeal more to certain ethnic groups
and high risk groups in society (e.g. smokers), thereby narrowing inequalities. More
research is needed to identify longer term outcomes of television-based health
promotion.
Learning
Outcomes
Health promotion is possible in a variety of clinical settings, and these should be
evaluated by sociodemographic characteristics of patients in order to identify evaluative
inequalities.
Other
Presenters
Ingram, S
Choudhury, I
Airebamen, A
Christodoulou, K
Wilson Sharma, A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No20
Physical Activity Facilitation for older adults at risk of disability - a
feasibility study and exploratory pilot RCT.
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Morgan, GS
University of Bristol
Background
As people live longer, their risk of disability increases. Age-related disability affects
quality of life and increases health and social care costs. Preventing or delaying disability
is therefore a key public health objective, and an effective interventi
Aim
A new theory-driven behavioural intervention has been developed with the aim of
increasing physical activity in older adults at risk of disability. This pilot RCT tests the
feasibility and acceptability of this intervention with older adults.
Method
Participants were recruited from GP practices around Bristol and were eligible to
participate if they were aged 65 or over, inactive, not disabled, and at risk of developing
disability (Short Physical Performance Battery score <10/12).
Participants were randomised to intervention or control arms and will be followed up
after 6 months. Those in the intervention arm receive sessions with a trained Physical
Activity Facilitator, delivering a theory-based intervention.
The main outcomes of interest are recruitment, adherence, and acceptability. Data were
also collected on physical function; objective physical activity; mood; wellbeing; cognitive
function; social support; QoL; healthcare use.
Results
Out of 1875 postal invitations sent out by practices 1313 (70%) of patients responded
with 347 (26%) expressing an interest in the study. 200 (58%) fitted the initial eligibility
criteria and were invited to a clinical screening appointment. 51 (26%) patients fitted the
full criteria and were enrolled in the RCT and randomised at a 2:1 ratio to intervention or
control arms.
Early results on the variability of important outcome measures and qualitative findings
on participant experiences will be presented.
This is an exploratory trial and feasibility study of a novel, theory-based physical activity
intervention in older adults.
Conclusions
The intervention, if effective, has the potential to reduce disability and improve quality
of life in older adults. Before proceeding to a full-scale trial a pilot trial is necessary to
ensure intervention feasibility and acceptability, and that the intervention shows
evidence of promise. We present early findings from a pilot study aiming to address
these objectives.
Learning
Outcomes
1) To learn about a novel, theory-based physical activity intervention designed for older
adults at risk of disability - Physical Activity Facilitation
2) To understand the methods used in the exploratory pilot RCT and feasibility study
3) To hear about the early findings of the study and how these may influence future work
in this field
Other
Presenters
Haase, AM
Campbell, R
Ben-Shlomo, Y
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No21
A smooth path or a rocky road? Five ‘I’s of Influencing change in the local
authority setting.
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Bethea, J.
Lecturer in Public Health &
Epidemiology
The University of Leicester.
Background
Public health has a long tradition of presenting the evidence for change and in providing
recommendations around how change might be realised. This has arguably become
more challenging since the move to Local Authorities that are both complex and politica
Aim
To describe the levers and potential barriers to influencing change in the local authority
setting, illustrated through a cross-organisational piece of work around transition to
adult services for young disabled people.
Method
A joint specific needs assessment was completed and this generated a range of
recommendations. These were prioritised through action planning sessions with key
stakeholders, leading to the development of specific working groups. Through this
process a number of levers to facilitate or potentially hinder change were identified.
Results
Five key levers were identified:
Need for Impetus - a requirement to conform to statutory requirements/new policy
and/or having high level support for change.
Inclusion– ensuring the right individuals/organisations are included and able to commit
to actions.
Acting as an Intermediary- working with/ between organisations, understanding
issues/relationships, maintaining momentum in taking forward actions and
recommendations.
Influence – developing relationships with stakeholders, meeting commitments,
maintaining enthusiasm.
Independence- objectivity in providing evidence for change and in making associated
recommendations.
Conclusions
Influencing change can be challenging, particularly in the relatively new and politically
orientated environment of a Local Authority. Many of the levers or conversely the
potential barriers to change are orientated around developing and maintaining trust and
relationships. Being perceived as having a degree of independence within the
organisation may itself help develop and maintain trust. Public health is also well
situated in terms of being the ‘lynch pin’ that maintains relationships between
organisations and also maintains momentum during the change process.
Learning
Outcomes
The audience will learn how a cross-organisational piece of work and the associated
recommendations highlighted a number of potential levers or potential pitfalls to
change. Recognising these could help facilitate working both within the Local Authority
setting and in working across a number of sectors or organisations.
Other
Presenters
Moore, R.
Director of Public Health.
Leicester City Council.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No22
Co-production evaluation of an asset based tobacco control programme
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
McGeechan, G. J.
Teesside University
Background
In areas of high deprivation smoking prevalence is higher than the national average.
Tobacco control may impact less on these populations due to wider determinants of
health which hinder their impact on changing social norms. A FUSE project
Aim
Use an asset based community approach to reduce smoking prevalence in a socially
deprived community of County Durham by tackling wider determinants of health.
Method
An integrated asset based approach involving Health Trainers, community volunteers,
and asset mapping was used to promote wellbeing and tackle wider-determinants of
health which impact on smoking. Local volunteers were trained to deliver a survey to
establish smoking prevalence. An asset mapping tool will be used to measure the impact
on the community looking at skills development and future employment of volunteers,
new community groups established, and improved access to existing groups. Results will
be fed back to the community to inform work aimed at addressing wider determinants of
health
Results
An asset mapping exercise has identified a number of community groups and begun
engaging with the local community, council, local area partnerships, and the local
housing association. Furthermore, 2 additional groups have been set up to deliver walk 4
life within the community. To date 10 volunteers have been trained to deliver the
survey, with 98 surveys completed to date. Results of the survey will be reported to the
community via social media, community newsletters, and community networks before
work begins on wider-determinants of health.
Conclusions
An asset based approach has identified an appetite for change within the community and
has brought volunteers together with local organisations and a range of partners to
address wider-determinants of health. Having a health trainer form the local community
engaged in this project, along with the asset mapping exercise has been a key
component in bringing the community together to promote healthy behaviour change.
Learning
Outcomes
As smoking behaviour is influenced by a number of factors, any intervention should
target wider-determinants of health. An asset based approach is an ideal way to engage
local residents with policy makers and local organisations to ensure that issues that
matter to the community are addressed, with the hope that improving these issues will
have a positive impact on smoking behaviour
Other
Presenters
Woodall, D.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No23
Embedding Making Every Contact Count (MECC) in Nursing and Midwifery
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Crosland, A
University of Sunderland
Background
Making Every Contact Count (MECC), a tool for providing evidence-based brief advice,
interventions or signposting, encourages all staff in public sector organisations to
consider how all contacts with service users could improve health and wellbeing.
Aim
The study explores how, following a programme of skill development, staff in Foundation
Trusts are prepared to offer brief advice, brief interventions or signposting to patients
and what is required within an organisations to allow this to happen.
Method
Senior staff in two Foundation Trusts identified current priorities and opportunities for
implementing MECC and to identify how best to achieve this and with whom, a staff
training programme was developed. There were two levels of training: low intensity,
focussing on signposting and high intensity which used brief interventions. Evaluation
involved interviews with senior staff, structured questionnaires for staff at the end of
each training session and one month later and interviews with five staff per participating
Foundation Trust to explore barriers and facilitators to using MECC.
Results
Engagement differed between departments but where senior support existed the
intervention was well received with recognition that MECC had a place within trusts.
Senior staff considered MECC gave legitimacy to nurses and midwives to talk about
public health. Early discussions identified a need for low intensity sessions to
contextualise MECC and training on opening and closing healthy conversations before
high intensity training in brief interventions. MECC was easier to implement where it
fitted with existing priorities, without this it was difficult to justify the time involved.
Conclusions
Successful implementation of evidence-based interventions within organisations requires
both engagement of staff at all levels and suitable skill and knowledge development,
especially contextual information on how MECC aligns with local and national priorities.
Staff at all levels recognised the value of such interventions but adoption was dependent
on the model and the context in which it was used. While public health is typically not
seen as part of the role in secondary care, MECC provides a significant opportunity for
staff to instigate health improvement conversations with patients.
Learning
Outcomes
An understanding of the facilitators and barriers to implementing an evidence-based
intervention with nursing and midwifery staff in Foundation Trusts.
Training in opening and closing healthy conversations is an important aspect of
developing the public health role of staff based in Foundation Trusts.
Other
Presenters
McCabe, K
Wilson, K
Ling, J
Wallace, A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No24
Co-production evaluation of an Exercise Referral Scheme (ERS) for adults
with existing health conditions (in association with FUSE)
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
McGeechan, G. J
Teesside University
Background
Physical activity should be seen as a clinical need which can improve both physical and
mental health, participation in which is associated with a reduced risk of over 20 health
conditions. This relationship is linear meaning even a small increase in phys
Aim
The primary aim was to assess the effectiveness of the scheme at improving physical
health outcomes for a cohort of people with existing health conditions who were
sedentary on entry to the service.
Method
A mixture of survey data and anthropometric measures were used for this evaluation.
Each participant was measured on a number of anthropometric measures on entry to
the service, exit from the service and at 6-months follow-up to assess changes in health
outcomes, such as waist circumference and weight. Participants were also asked to selfreport levels of physical activity using the 7-day recall tool to assess what impact the
service had on engagement in physical activity over time.
Results
Participants who completed the 12-week programme were significantly more likely to
have become physically active than to have remained inactive. At 6-month follow up
participants were still more likely to be physically active than inactive. Significant
reductions in waist circumference and BMI were observed when comparing baseline
with exit review. Furthermore a significant increase in physical activity was observed
when comparing baseline with exit review, and baseline 6-month follow up. Attrition
rates were high with only 41% of those starting the service completing the 12-week
programme.
Conclusions
While attrition rates for this service were quite high, they were no higher than for other
services of this type. The results of this evaluation seem to indicate that when working
with clients who are ready to change their behaviour some quite positive results can be
achieved even months after leaving the service. However, as this service was quite
costly, it remains to be seen whether or not this service represents good value for
money.
Learning
Outcomes
NICE guidelines recommend that ERS should only be used in the management of existing
health conditions, but should not be used solely for the purpose of increasing physical
activity. The results of this evaluation have highlighted that such schemes can improve
the physical health outcomes of individuals with existing health conditions.
Other
Presenters
Phillips, D
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No25
What factors influence smoking behaviour in young females?
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Atenstaedt, R.L.
Public Health Wales & Institute of
Health, Medical Science and Society
Background
Smoking is the single biggest cause of cancer in the world. Although there is a lot of
research on youth smoking, very few studies have looked at females in the 11-12 year
age group – the age at which studies suggest females start to smoke.
Aim
The aim of this study was to address a research gap by estimating the prevalence of
smoking in young females in North Wales and by exploring in depth current knowledge,
attitudes and behaviours to smoking in this demographic.
Method
A two page bilingual survey was sent out to all 11-12 year old females in a total of 63
secondary schools, including special schools in North Wales. In addition, five focus
groups were conducted in areas with high levels of deprivation and high adult smoking
prevalence.
Results
There is an average smoking prevalence of 2% in 11-12 year old females in North Wales,
although this more than doubled in deprived communities. Young females with low
aspirations that did not take part in sport or after-school activities were more likely to
smoke or use e-cigarettes. Most participants knew where to purchase e-cigarettes and
were aware that they contain nicotine. Young females felt that smoking was generally
unappealing, especially due to the more superficial consequences such as impact on
their appearance.
Conclusions
Anti-smoking campaigns should target both parents and young people; campaigns also
need to focus on raising aspirations and confidence in young women and stand alone
anti-smoking messages are unlikely to work; young females respond best when they
perceive themselves or a family member being harmed by smoking.
Learning
Outcomes
Learn more about prevalence of smoking in 11-12 year old females
Learn more about knowledge, attitudes and behaviours to smoking in this demographic.
Learn more about how to design an anti-smoking campaigns
Other
Presenters
Evans, K.
Lloyd-Jones, N.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No26
Implementing prudent practice: optimising outcomes of elective surgery in
Cardiff and Vale through systematic lifestyle risk factor management.
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Griffiths, S. (Dr)
Cardiff and Vale Public Health Team
Background
Lifestyle risk factors are associated with significant morbidity. Novel approaches are
needed to increase awareness and to support patients and the clinicians responsible for
their care to improve their outcomes.
Aim
To improve operative outcomes for patients by ensuring that behaviour change support
is systematically available for people who smoke and/or people who are obese, as a
routine part of elective surgical pathways.
Method
A multidisciplinary team undertook wide ranging activities across primary and secondary
care:
-Stakeholder consultation
-A test phase in selected clinical settings
-Seeking legal advice
-Equality Impact Assessment
-Care pathway mapping
-Service capacity modelling exercise
The Health Board was informed of policy development through regular briefings.
Results
GP feedback suggested the policy built upon normal referral practice. Secondary care
feedback about the implementation process was supportive. Discussions with
community and clinical groups were overwhelmingly positive, although some raised
concerns. All comments were collated and informed policy
development/implementation. The Policy was formally adopted from 01/12/13.
A clear rise in referrals to both smoking cessation and weight management is evident.
Interim outcomes (quit rates/weight loss) are being monitored. It is not yet possible to
demonstrate an effect on operative outcomes.
Conclusions
Our work demonstrates that it is possible to implement a policy approach spanning
primary and secondary care which can support prudent healthcare principles, positively
influence clinical practice and potentially improve patient outcomes.
Learning
Outcomes
To share an example of how a policy has been developed and implemented to improve
operative outcomes for patients.
Other
Presenters
Absi, C.
Hopkins, S. (Dr)
Lewis, R.
Nealon, T.
Nicholls, H.
Poole, H.
Prygodzicz, J.
Wood, S. (Dr)
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No27
Explore More Outdoors with Hackney Wild Walks: Encouraging children to
get active by making walking fun and getting families exploring green
spaces.
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Scott, K.
Hackney Council
Background
Hackney is inner London’s greenest borough. The 3.3 million square metres of parks and
open spaces are one of the borough’s greatest assets. It’s an easy place to get active
outdoors but 25% are overweight by reception age.
Aim
To create a fun walking guide putting children in charge. The aim was to design an
attractive useful product that would encourage families to explore their community and
connect with nature. The focus was on fun, and increase activity by stealth.
Method
The project was based on the principle that people – especially children - are more likely
to do something if it's fun. To subtly reach the target audience, each walk started in an
area with the highest rates of childhood obesity. Each route went past local facilities that
could be revisited after the walk and used to either increase connection with nature,
such as a park or community garden; increase physical activity, such as a playground or
skate park; or to improve general health, such as a children’s centre. The walks were
designed to be manageable for young children.
Results
The Wild Walks guide received consistently positive feedback from parents, children and
online from Hackney residents and walking organisations. Around 90,000 guides were
distributed and additional copies placed in public places ran out within days. Over 2,200
people visited the Wild Walks web page.
It was identified that front-line staff who work with children lacked confidence in
promoting walking locally. To overcome this barrier a set of professional development
sessions to explore each of the three walks, which were delivered to 65 people.
Conclusions
Whilst it is difficult to evaluate the impact of Wild Walks, it has contributed to the culture
change within the borough. It is a fun useful resource and supported residents to make
use of local assets, without need for expensive infrastructure changes.
The next stage is to build on Wild Walks, increasing community involvement and
developing and signposting walks and helping interested residents and community
groups to deliver the Wild Walks.
Encouraging residents to be more confident exploring and playing outdoors, making
priorities around physical activity easier to achieve.
Learning
Outcomes
* An understanding of hidden barriers to physical activity and how to overcome them
* Inspiration for making the most of local assets, discovering hidden gems and ‘healthy
resources’
* A practical application of ‘fun theory’ of behaviour change
*Delivering physical activity by stealth.
* For a PH product to be most effective it must aim to be as useful and attractive as
possible
Other
Presenters
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No28
The North East Better Health at Work Award: improving health through
partnership and collaboration
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Orange, D.
Public Health England, North East
Background
WHO supports workplace health programmes as a means of promoting healthy
workplaces and the North East Better Health at Work Award is a nationally-recognised,
externally evaluated example of good practice with a unique partnership approach.
Aim
The aims are:
• To improve the health and wellbeing of North East workers
• An inclusive, standardised framework
• Recognition for workplaces which actively promote health
• Sharing of good practice
Method
The programme consists of four levels, with a range of progressively challenging criteria.
Central to its success is the identification of ‘health advocates’ within the workforce who,
with the support of senior management and health improvement specialists, drive the
initiative from within, organising activities to meet the criteria and offering peer support
and encouragement to their colleagues adding capacity, in effect, to the wider public
health workforce.
All 12 North East local authorities support the programme and it is co-ordinated by the
TUC on their behalf.
Results
Over 400 companies have taken part so far, with current participants representing
150,000 employees. All sectors are represented and the size of organisation ranges from
a nursery with 5 employees to a local authority of 10,000. To date 925 health advocates
have been identified and supported across the North East.
An external evaluation in July 2012 highlighted growing participation year on year, with
coverage of 21.4% of the working age population in employment in the North East,
reduced sickness absence, at a cost of £3 per sickness absence day saved, and improved
morale.
Conclusions
The programme demonstrates the powerful contribution employers can make to
improving mental and physical health, a role described by PHE as a ‘game-changer’.
Sharing of resources and expertise across organisational boundaries and the support of
all 12 DsPH, enabling co-ordination at a North East level, have been key to its success.
In 2014, the effectiveness of this approach led to its inclusion in an evidence review
‘Increasing employment opportunities and improving workplace health’ produced by the
Institute of Health Equity and also endorsement in the NHS Five Year Forward View.
Learning
Outcomes
There is considerable interest in this approach from other parts of the country and the
model has also been used outside the UK by companies with an international presence,
using the experience gained at their North East sites. Lessons from the establishment
and embedding of the programme will be shared with the audience, specifically the
partnership approach which is fundamental to its success.
Other
Presenters
Ross, T.
Seery, L.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
POSTER No29
Implementing Detect Cancer Early (DCE) in a remote and rural
environment
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Macleod N
Medical Director, NHS Western Isles
Background
Cancer diagnosis and treatment for people living in the Western Isles can often mean
that they will have to access mainland services, which potentially adds emotional,
practical and financial stress to the individual and their family.
Aim
The local implementation of the Detect Cancer Early (DCE) Programme in the Western
Isles to improve the early diagnosis and survival of people with cancer.
Method
Activities included:
DCE social marketing campaigns.
Working with partners raising awareness of impact of diagnosis, increase support and
signpost to services.
Promotion of materials, website, newsletters using range of media.
Use of patients stories.
Interactive breast awareness demonstrations
Specific male-focussed activities to reduce the stigma associated with prostate and
testicular cancer (using 'Movember')
Building the confidence of individuals to attend the Scottish Cancer Conference to
represent local Cancer Groups.
Results
Short term evaluation measures include:
Dedicated NHSWI Cancer webpage developed.
High attendance at community events, perceived reduction in stigma and greater
openness to discuss cancer.
Support for 14 people to attend the Scottish Cancer Conference.
'Movember' fundraising supporting Heb Men's Cancer Group for local men being treated
with cancer.
Cancer support groups set up in Uists & Barra (previously none existed).
Increased breast screening uptake.
Conclusions
DCE has successfully implemented activites targeting increased individual support and
building community support group capacity in rural locations.
Learning
Outcomes
The importance of developing partnership working.
Overcoming the challenges of living in a rural area with a long term condition.
Developing asset-based approaches.
Community capacity building.
Other
Presenters
MacLennan M
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster30
Development of Geographic Profiles to demonstrate health inequalities in
the Western Isles
Abstract topic & Manifesto - Help people live
Submitted By
healthier lives
Malcolm, M
Head of Public Health Intelligence &
Information Services; NHS Western Isles
Background
Traditionally, multiple deprivation indices have been used in measuring health
inequalities. These are best suited to concentrations of deprivation which are not
typically found in dispersed rural communities where alternative approaches are needed.
Aim
The aim was to map geographic differences between local planning areas (LPGs) that
would provide a local resource to healthcare and health improvement planners in
geographically targeting resources and interventions.
Method
Data was collected on 45 indicators covering a range of domains mapped to English PH
Outcomes Framework and Scottish PH Observatory Profiles. Datasets were gathered
from the Scottish Morbidity Records, QOF, NRS, Child Health, Popgroup projections &
other sources. The data was allocated to LPGs and sets of indicators created for each
domain. Maps were created using ArcGIS mapping software to show rates at LPG level in
a geographical format. Accompanying boxplots and bar charts were created to compare
geographical inequalities at LPG level and relative to Health Board and Scotland rates.
Results
A suite of reports was produced containing comprehensive profiles for each LPG
containing a map, boxplot and bar chart for each indicator and in addition themed
mapping analyses eg.CHD. These highlighted significant geographical variations across
the island population for a number of indicators . Key findings were greater rates of
CHD, CVD and heart failure hospitalisations and premature deaths in the most remote
area despite lower prevalence and no clear negative health behaviours. This has
influenced health inequalities approaches to consider geographical and access based
issues.
Conclusions
The project provided epidemiological visualisation tools that quickly showed potential
inequalities that may be hidden in traditional data. Their accessibility has been a key to
their use in a no. of projects:
•
Third Sector health inequalities projects – as evidence of impacts.
•
Community capacity building projects - supporting community needs
prioritisation community capacity.
•
Community participatory mapping project.
•
Enhanced healthcare at home initiative - to identify geographical pilot sites.
Future work to develop these into interactive online tools is underway as a result.
Learning
Outcomes
These include:
•
Benefits of novel data visualisation tools such as mapping for quickly identifying
issues for further exploration.
•
Value of alternative approaches to health inequalities to fit local circumstances
eg. rural areas where inequalities may be hidden by traditional measures.
•
Potential use of complex epidemiological data by communities and practitioners
if made accessible.
Other Presenter
Hall, F
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster31
Business Healthy – promoting the business benefits of workplace health
and wellbeing
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Thomas, S.
Hackney Council
Background
Hundreds of thousands of people commute into the Square Mile every day and the
“work hard, play hard” culture in the City presents some specific health issues around
mental health, smoking, alcohol and substance misuse.
Aim
The City of London aims to encourage more businesses to think about the health and
wellbeing of their employees. We work with businesses to help them build the business
case for workplace health, promote employee wellbeing and tackle health problems.
Method
We have established Business Healthy, a business engagement programme focused on
workplace health and wellbeing in the City. This includes a networking group for business
leaders who are committed to improving the health and wellbeing of their employees, a
series of master classes on key workplace health issues such as addiction and managing
stress and a website which provides a hub of resources and an online forum for sharing
ideas. We also promote the GLA’s Healthy Workplace Charter and support local
businesses to achieve this quality mark.
Results
Since establishing Business Healthy we have grown our membership to over 50
organisations. Through regular networking meetings, master classes and interaction
through our website and social media, we have been able to increase their level of
engagement with Business Healthy. Put simply, this means that more local businesses
are thinking about workplace health and taking it more seriously. We’ve also been able
to provide practical support and best practice sharing so that businesses can make a real
difference and implement changes that will address key health issues for their
employees.
Conclusions
Business Healthy is an example of how local authorities in urban areas can improve the
health and wellbeing of the people who work there, even though the majority of the
population is not entitled to local health services. We have chosen to engage with
business leaders rather than with workers themselves, as we believe that change will
come from the top, with businesses understanding the benefits of investing in the health
of their workforce in terms of corporate image, employee engagement and productivity,
staff retention and of course a reduction in time lost through sick days.
Learning
Outcomes
1. Example of a public health campaign that reaches out to businesses, rather than
individuals, to encourage corporate investment in improved health and wellbeing
outcomes
2. This is not just an awareness raising campaign; ongoing engagement and support is
provided to businesses to help them make real changes
3. Innovative ways to improve the health of working age population
Other
Presenters
Klynman, N
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster32
The Final Countdown
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Joanne O'Donnell
Smoking Cessation Coordinator
Background
NHS Western Isles has introduced a smoke-free policy in all its premises. Thisaligns with
their mission of improving the health of the individuals and local communities it serves
by taking a lead inchallenging health issues.
Aim
To implement a smoke-free premises policy across NHS Western Isles (NHSWI), in line
with Scottish Government pledge that by 2015 all NHS grounds will be smoke free.
Method
An extensive consultation with staff and community was undertaken, using a
combination of focus groups, questionnaires and awareness-raising events:
• Open days for staff to talk about what smoke-free grounds mean
• One day awareness-raising event in Stornoway, video-conferencing to Uist/Barra
• NHSWI website
• Comments boxes
• Posters/business cards in English/Gaelic
• Ads in media in English/Gaelic
• Local radio
• Stands with visual aids for comments
• Comments for discussion on NHS sounding boards
Results
Both staff and the wider community supported the concept of smoke free grounds
· All NHSWI premises smoke-free since November 30th 2013
· Smoking Policy group monitoring and reviewing annually
· Staff have access to Health Behaviour change to support patients who are smokers
make a change
· Awareness-raising of the dangers of smoking/ second hand smoke
· Increased information in workplaces
· Other organisations supported to develop their own policy
· Local authority using the NHSWI model for their approach to smoke-free grounds.
Conclusions
A comprehensive consultation with staff and public has led to the successful
implementation of smoke-free premises.
Learning
Outcomes
Why did we introduce smoke-free grounds?
What did we do to become smoke-free?
What is our Smoking Policy and its purpose?
How did we promote our ‘Countdown’?
Other
Presenters
Mrs Mairead MacDonald
Smoking Cessation Advisor
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster33
Wessex Public Health Community Fellowship
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Cruickshank, H
Health Education Wessex
Background
The Public Health Community Fellowship was established in Wessex in 2014 to offer
Foundation doctors a unique opportunity to work with community organisations on a
defined public health project, to gain experience across wider determinants of health.
Aim
The aim of the Fellowship was to develop public health leadership in Wessex through
building relationships between Foundation year 2 (FY2) doctors, community
organisations and Health Education Wessex.
Method
FY2 doctors in Wessex were invited to apply for the Fellowship. The 14 successful
applicants were allocated into four teams and each Fellow was asked to commit a total
of eight days between September and December 2014.
Four community organisations were recruited through local umbrella bodies in
Southampton and Portsmouth. Specialty Registrars in Public Health worked with each
organisation to develop a project brief and also acted as a mentor to a group of Fellows.
Four projects were developed: two service evaluations, a health needs assessment and a
health education workshop.
Results
All four projects were delivered on time and presented at an event in December 2014.
Key learning points reported by the Fellows were: a clearer understanding of public
health; thinking about a patient’s journey in a wider sense; and that everyone has the
opportunity to promote health. Challenges included managing expectations and
practicalities of negotiating a team project around different locations and rotas.
All four community organisations reported that their experience of taking part in the
Fellowship was ‘very positive’ and all would recommend participation to other
organisations.
Conclusions
This Fellowship has facilitated strong partnerships between early career clinicians,
community organisations and Health Education Wessex and raised the profile of public
health within local communities. It has given FY2 doctors the opportunity to gain an
appreciation of public health tools which they have been able to put into practice in a
community setting. The community organisations have benefited from an increased
capacity to deliver a project they might not otherwise have been able to do and the
Registrars have had experience in devising and leading a new programme and acting as
mentors.
Learning
Outcomes
1. Learning about an innovative programme which develops public health leadership
through the pooled experience and expertise of clinicians, community workers and
public health specialists.
2. Understanding of how such a programme may be developed in other localities to
foster relationships between clinical and community settings.
Other
Presenters
Cochrane, S; O’Sullivan, C
Poole, R; Taplin, S
Walmsley, E; Kitsell, F
Parkes, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster34
Self reported takeaway use among Brent's school students
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Ensor, L
Brent Council
Background
A popular planning amendment by councils is to implement a 400m takeaway buffer
zone around schools, however little evidence to support this is available. This research
was done to determine whether local evidence supports the policy changes.
Aim
Provide the planning team with local evidence as to whether there is any measurable
difference in takeaway use, healthy eating and family eating habits between students
depending on the proximity of their school to local takeaway outlets.
Method
A questionnaire was designed to measure student’s takeaway habits, perception of
healthy eating and families eating habits. Selected local secondary schools were
approached, by a team member, depending on their geographical location throughout
the borough and proximity to takeaway outlets. All year 7 and 10 students from the 7
participating schools completed the self administered questionnaire. Schools were split
into two groups for analysis, those with and those without takeaway outlets within 400
m from their boundaries.
Results
2418 students completed the questionnaire. 96% thought healthy eating was important.
43% of students from outside the buffer zone had takeaway on the way home at least
once a week and 34% had a weekly takeaway lunch compared to 62% and 40% for those
inside. School dinners were the most popular lunch accounting for 52% of lunches;
takeaways accounted for 12%. 34% of students from outside the buffer zone had
takeaways with their family for dinner more than once a week compared to 50% inside.
27% of students said that if there was no takeaway within an 8 minute walk (400m) they
wouldn’t go.
Conclusions
Students who attend schools near takeaway outlets did eat more takeaways at lunch
time, after school and with their families. The introduction of a buffer zone around
schools may help to reduce takeaway consumption by students. With 42% of students
thinking takeaways aren’t unhealthy, this policy amendment needs to be supported with
an increase in education and skills in the healthy eating agenda in students and families if
we’re to combat rising obesity levels.
Learning
Outcomes
The first large scale school survey of its type in the UK, this research answers questions
about students takeaway consumption, their perception of healthy eating and their own
diet and motivations for eating takeaway food. Only 12% of students eat what they like
and don’t care about eating healthily – which shows that this population group are
amenable to changing their diet.
Other
Presenters
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster35
First National Childhood Measurement Programme (NCMP) Cohort Study
in Dudley
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Barbosa, G
Dudley Metropolitan Borough Council
Background
Obesity is one of the greatest Public Health issues in the UK today. Childhood obesity
increases the risk of obesity in adulthood and the related burden of ill health is well
documented.
Aim
The aim of the project was to identify factors that impact on weight change in children in
order to develop targeted strategies in tackling childhood obesity.
Method
For the first time weight and height data has been collected for the same individuals in
two time periods as part of the NCMP. NCMP 2006/07 and 2012/13 datasets were linked
and 2870 out of 3350 records were matched. Changes in Body Mass Index (BMI) for
specific individuals were investigated and the data were linked to a range of variables
including deprivation, walking distance to school and proximity to green spaces. A
number of techniques were used to investigate the data including, linear regression,
logistic regression and divisive analysis clustering.
Results
25.3% of children aged 4-5 were classed overweight or obese compared to 37.1% aged
10-11.
Exploratory analysis investigating the effect of deprivation, ethnicity, school of
attendance, change in residence or school has been performed. The results are
inconclusive and no single factor has been identified as significantly influencing weight
gain or loss.
Multivariate analysis has considered a much wider range of variables to develop a model,
for example, walking distance to schools, availability of sports facilities in the schools and
proximity to green space.
Conclusions
The poster will describe the project, demonstrating the complex picture of BMI change in
a specific cohort of children, detail the results of the multivariate analysis and suggest
how the results can be used to inform the childhood obesity campaign in Dudley. Lessons
learned from analysing the first cohort of data will also be detailed in order to allow for
improved analysis in the following NCMP cohorts.
Learning
Outcomes
Gain an understanding of the potential of NCMP data to help identify factors in BMI
change in children and how it can be used to evaluate local and national interventions
when effectively linked to other data sources. Highlight how complex the obesity
situation is and that a holistic approach is required.
Other
Presenters
Lewis, L
Moss, A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster36
Knowledge Translation in Oral Health Promotion
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Olajide, O.J.
FUSE
Background
The most recent national oral health survey in England revealed wide variations in
prevalence and severity of dental caries in children, with poorer oral health in children in
the North and in deprived areas. This indicates the need for more effective ora
Aim
To investigate the most effective method(s) for delivery of oral hygiene and/or
nutritional interventions to children and parents.
Method
A mixed methods approach (phase 1- systematic reviews; phase 2-qualitative research
interviews and focus groups) was utilised to explore; (i) evidence of the most effective
intervention method(s) for improving oral hygiene and diet in children and; (ii) existing
barriers to implementation of oral health promotion interventions (OHPI) that are
effective in reducing dental caries.
Results
In phase 1, systematic reviews assessed the effectiveness of a range of OHPIs in children.
Regular fluoride use and the involvement of parents & OHP specialists were found to
have contributed to reduction in dental caries. A major gap observed was lack of
understanding of the dynamics and complexities of processes in workability & effective
implementation of OHPIs. This was investigated in Phase 2 and thematic analysis of data
collected revealed patterns in commissioning, leadership, cohesive working, fidelity &
monitoring of interventions delivered in schools which influenced effectiveness of OHPIs
in reducing dental caries.
Conclusions
Although the clinical effectiveness of OHPI in reducing caries experience was clearly
demonstrated in several studies, barriers to implementation of OHPI for optimal
effectiveness remain. Availability of evidence for effectiveness of an intervention does
not imply that the intervention would be successful when rolled out. In this study,
Normalisation Process Theory (NPT) enabled the exploration of factors that could
facilitate knowledge translation and successful implementation of OHPI.
Learning
Outcomes
To provide portable insights into knowledge translation and the dynamics of
implementation of OHPI.
Other
Presenters
Shucksmith, J.
Maguire, A.
Zohoori, V.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster37
Food and Cornwall: Creating Food Wealth so that no one in Cornwall is
Hungry; A Systems Leadership Approach to tackling Food Poverty
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Marsh C
NHS Cornwall
Background
Food and Cornwall is based on a strategic partnership across local health and well being,
economic and nature partnership structures to increase;
•
population access to good nutrition
•
food growing, preparation & production skills
•
jobs and careers
Aim
The overall aim of Food and Cornwall is to create food ‘wealth’ so that no one in
Cornwall is hungry.
Method
Piloting a ‘Systems Leadership’ methodology, developing;
•
networks; markets; collaborations; social movements
The programme method focuses on mobilising commitment to action, generating and
supporting ‘Food Activists’.
Using ‘public narrative’ as a leadership practice of translating values into action.
Priorities include;
•
Implementing projects identified and led by local ‘Food Activists’
•
Empowering local people and local communities
•
Engaging economic, environmental, social & political leaders to be Systems
Leaders
•
social media platform to increase awareness and commitment to action
Results
Early process evaluation shows overall delivery to plans and positive participation and
engagement across target groups.
Specific outputs include;
•
Conference attended by 80 ‘Food Activists’
•
Scoping Review: A systematic review of community food interventions
•
All Party Parliamentary Inquiry into Hunger and Food Poverty - Evidence
Presented: The National report is now published, ‘Feeding Britain’ (2014)
Multiple objectives delivered across Programme workstreams.
Conclusions
The Programme brings together leaders with diverse backgrounds from across the
boundaries of different organisations and from across the environmental, economic,
political, social and community systems. Systems Leaders work together and focus small
resource towards building shared commitment and agreeing a clear set of objectives.
Collaborative actions are focused on reducing food poverty via a set of interconnected
project work streams.
Early indicators suggest the System Leadership approach has already had an influence on
asset building for food wealth in Cornwall.
Learning
Outcomes
What leads to food poverty, who is affected, where does food poverty exist in Cornwall
Complexities of the local and national food system and the impact on health and well
being
Engaging senior leaders in the local economic, environmental, political, health and well
being arena – use of Public Narrative
Systems Leadership methodology to tackle food poverty and create food ‘wealth’.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster38
Room on the Broom Adventure Trail – Health by Stealth!
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Stark, J
Wakefield MDC
Background
Wakefield District has a good green space offer but very low physical activity levels. With
research telling us to avoid terms such as sport, innovative ideas were needed to
increase participation and attract a new audience outdoors.
Aim
Increase participation and use of walks through a magical and interactive adventure trail
for families; linking green space activity with culture and libraries
Method
The project idea came from an Outcomes Based Accountability (OBA) event for healthy
and active lifestyles. Delegates from a range of backgrounds and professions attended,
proposing ideas for behaviour change.
Informed by the OBA, NICE guidance, local experience and the National Forestry
Commission Gruffalo walks, a business case was developed.
Local and natural resources are used where possible; all marketing and relevant
materials adhere to the licence agreement. With hidden sculptures and activities along
the way; families can walk, cycle or run to enjoy this fun outdoor experience.
Results
At present, we are still in the implementation phase of the project. However, it has
already achieved a great deal of interest from local families, schools and professionals.
We will direct our marketing materials to specific targets groups and be looking at a
number of different measures to determine whether anyone is better off as a result.
We are particularly focussed on encouraging inactive families to become active;
providing a green space offer that will provide year round interest. Both traditional and
newer technology methods will be used to gather this evidence.
Conclusions
Thus far, linking green space with culture to achieve behaviour change has felt a natural
partnership; particularly by using the well-known book “Room on the Broom” as a focus.
With the professional partnerships that have been created, we have embedded a new
understanding of public health outcomes and methodology.
Raising awareness of green space offer by using social media marketing appears an
effective method of encouraging local people to visit.
Whether we achieve our project outcomes remains to be seen, but so far the excitement
and commitment to achieving them is refreshing and motivating.
Learning
Outcomes
Linking green space assets with culture and social media marketing, you can create:
• Physical activity by stealth– it is not just a walk, it is an adventure trail!
• Intergenerational health and well-being – fun for the whole family!
• Active transport opportunities – links to public transport, cycle and bus routes
•New feedback and evaluation leads – use of websites such as trip advisor
Other
Presenters
Sharp, A
Blenkinsop, L
Thomas, K
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster39
Exploring notions of ‘community’ in the case of Gypsy and Traveller health
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Forster, N
FUSE
Background
In addressing the needs of specific groups, such as Gypsies and Travellers, there is a
tension between the need for understanding distinct cultural beliefs, while also avoiding
categorising these groups as homogeneous, or reinforcing their exclusion by em
Aim
This poster combines reflections from two distinct pieces of research in order to begin to
explore the distinctiveness and commonality of Gypsies and Travellers with other groups;
and in what respects Gypsies and Travellers might be seen, or see themselve
Method
The first piece of research is an evidence synthesis funded by the National Institute for
Health Research and undertaken in conjunction with FUSE (the Centre for Translational
Research in Public Health) which examined how, and in what circumstances outreach
interventions work to improve the health of Traveller Communities. The second is
ongoing PhD research which uses narrative methodology to guide interviews with
Gypsies, Travellers and public health practitioners, in order to collate and compare the
stories told about Gypsy and Traveller health and episodes of public health service
provision for these groups.
Results
Many features of outreach found through the evidence synthesis to increase the
likelihood of success in engaging with Traveller Communities (such as the importance of
outreach workers being trusted, or having flexibility to respond to immediate needs) are
potentially appropriate for other socially excluded groups. The use of narrative
methodology in the PhD research described highlights both culturally shared and
individually distinct narratives of health. It enables attention to how other identities such
as being a mother, or a carer may intersect with those of ethnicity in Gypsy and Traveller
accounts of health and accessing services.
Conclusions
These two distinct projects together contribute insights around where there may be
differences and similarities both within Traveller Communities and between Traveller
Communities and other groups.
Learning
Outcomes
This poster contributes learning around if and how public health services need to be
tailored to the specific needs of Gypsy and Traveller Communities, as well as where
commonalities exist in terms of need and service design across socially excluded groups.
Other
Presenters
Carr, SM
Lhussier, M
Bancroft, A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster40
Understanding factors that influence young women’s participation in
cervical cancer screening-A focus on North East of England
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Okoeki M.O
Faculty of Health and Life Sciences,
Northumbria University
Background
In spite of the success of the cervical screening programme there is still a significant
decline in the proportion of young women attending for screening. Understanding
factors influencing participation would help in creating age specific interventions ai
Aim
This study aims to investigate participation and non-participation of cervical screening
among young women aged 25-35 living in the North East of England
Method
Constructivist grounded theory methods was utilized in the conduct of the study.
Participants were recruited within a cross section of communities and individuals across
the North east. Participants were recruited purposively and theoretically. Data collection
was through semi structured face to face interviews and 2 focus groups. A total of 28
participants took part in the study, 16 in the focus groups and 12 in the interviews. Both
recruitment and data analysis were carried out using grounded theory techniques.
Results
The study is in its analysis stage and themes are emerging from cultural factors, personal
factors to practical factors. Analysis of result is still in its early stages. Analysis are been
done by organization of data into codes, themes, and categories through Nvivo and Mind
Genius software.
Conclusions
The findings from this study are expected to inform practice and service provision
through specific recommendations that could be useful in the development of age
appropriate interventions to promote uptake of the screening offered. It will also add in
a unique manner to the limited existing body of knowledge in England around cervical
screening participation.
Learning
Outcomes
understanding factors that influences participation
Grounded theory methodology
Other
Presenters
A. Steven, L. Geddes
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster41
Smokefree Diabetes: The Innovative Education Programme Supporting
People with Type 2 Diabetes to Stop Smoking
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Sankla, L, MFPH, FRSPH
Solutions4health
Background
Diabetes UK is calling for more support for people with diabetes to stop smoking as many
are not being offered support & advice about quitting. Solutions4Health has proactively
developed this innovative model to support those specifically with LTC’s.
Aim
Steps 4 Your Health programme is to improve health outcomes for clients with type 2
diabetes; reduce admittance rates and integrate with wider services.
Method
Smokefree Diabetes is an innovative, free support service helping type 2 diabetes clients
to stop smoking and manage their condition. The model meets NICE guidelines and QOF
targets. The Steps 4 Your Health programme includes:
•
A six week group course with sessions lasting two and a half hours
•
Sessions include:
o
Preparing to quit smoking
o
What is type 2 diabetes? What impact does smoking and diabetes pose to my
health?
o
My Quit Date – Managing a Smokefree life and Nutrition for life
o
NRT and understanding your habits
o
Movement that matters
o
Ripple effect and support
o
How to stay healthy
Results
The early results of this innovative integrated approach are extremely encouraging:
•
Clients have successfully quit smoking
•
Clients have a greater understanding of how to manage their condition through
simple lifestyle changes.
Conclusions
Steps 4 Your Health is a unique programme providing behaviour change for those who
want to stop smoking and have type 2 diabetes. Participants have successfully quit
smoking on the programme and have reported that they have a greater understanding of
how to self-manage their diabetes through simple life style changes. Steps 4 Your Health
is currently being rolled out across Berkshire West CCG and is going through clinical
research with Portsmouth University. We have received great feedback and support
from all healthcare professionals and we aspire to roll the programme nationally.
Learning
Outcomes
We expect the following:
•
How to invigorate your local stop smoking service by engaging with local GP
partners
•
Recognise and explain the power of integrating a self management course and
smoking programme to adherence and positive outcomes for diabetic patients
•
Develop local programmes based on an evidence based model
•
Raise awareness of effective tailored services to diabetic patients
Other Presenter
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster42
Evaluation of a pharmacy-based flu immunisation scheme
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Tompkins , G
Public Health England
Background
Uptake of flu immunisation amongst at-risk groups is below the Government’s target
levels. NHS England and PHE commissioned a pharmacy flu immunisation scheme for
winter 13/14 for Durham/Tees, on a pilot basis with an evaluation.
Aim
The pharmacy flu immunisation scheme aimed to increase uptake and provide choice for
eligible adults in targeted risk groups. The evaluation considered whether the aims were
met, to inform future commissioning.
Method
The evaluation considered the structure (service specification, training, costs, numbers of
pharmacies, coverage), process (commissioning, recruitment of patients, information
flows), outputs (numbers vaccinated) and outcomes (performance against the aims –
uptake and choice) of the scheme.
It comprised quantitative assessment of inputs and activity, using data from NHS
England, Pharmoutcomes and Immform, and qualitative interviews with stakeholders
including pharmacies, practices and commissioners.
The evaluation was conducted retrospectively by one researcher.
Results
More than 100 pharmacies participated, covering the main settlements. 4528 people
received their flu vaccination from pharmacies - 2% of the total vaccinated. GP activity in
targeted groups also increased. Almost 90% of pharmacy patients had been vaccinated
by practices in previous years. Users went to pharmacies mainly because of
convenience.
Overall uptake rates measured by performance against target did not increase.
Pharmacies responded positively to the scheme, but practices saw it as a threat to
income. The scheme will be continued for two more winters to gather further
information.
Conclusions
The scheme provided choice but did not increase uptake of flu immunisation.
Practices remain the core provider of flu immunisation, but there is scope to increase
activity in target groups. Practices acknowledge the potential role of other providers, but
there is concern that the pharmacy scheme may threaten the viability of practice-based
flu vaccination programmes.
There was insufficient evidence to conclude whether the pharmacy scheme can make a
significant contribution to raising the level of uptake of the flu vaccination, and whether
it represents value for money, hence the extension.
Learning
Outcomes
This poster will provide insight into the practicalities of pharmacy-based flu schemes, and
a framework for issues to consider:
• Safety for individuals & the population;
• Choice of provider;
• Capacity – can we raise uptake without identifying providers in addition to practices?
• Acceptability of other providers to patients;
• Uptake – will alternative providers increase it?
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
• Cost (vfm)
Other Presenter
Birkenhead, K
Poster Title
Poster43
Newborn Screening Results Disclosure for Cystic Fibrosis: a Qualitative
Descriptive Study
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Mohammad S Razai
University of Cambridge
Background
Communicating newborn screening (NBS) results have been highlighted as challenging
for healthcare providers and distressing for parents.
Aim
To obtain parents' recommendations on the most acceptable way to be notified of
positive NBS result for CF. To explore parents' views about the initial phase of care
coordination and their use of internet and social media in sharing information.
Method
Thematic analysis of semi-structured open-ended interviews with 11 parents of 7
children with confirmed diagnosis of CF.
Results
Parents preferred face to face disclosure of positive NBS results by a paediatrician with
CF professional qualification. Parents recommended that health professionals provide
clear and understandable information, and explore parents concerns and acknowledge
feelings. Most parents preferred immediate results disclosure and a majority specified
their need for open access to providers. Most parents used internet as important source
of information, interaction and exchange of experiences.
Conclusions
This study provides significant new evidence emphasising the pivotal role of good
communication skills, deployed by a knowledgeable CF specialist through face to face
consultation, in reducing parental distress and improving the quality of care. Internet has
replaced some traditional methods of information exchange and may reduce the need
for professional input.
Learning
Outcomes
Learn about parents' preferences and recommendations for newborn screening results
disclosure for cystic fibrosis.
Improve quality of service delivery by improving communications skills, notification
process and care coordination.
Other
Presenters
Jan Williams, Rachel Nestel, Dermot Dalton
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster44
Childhood flu vaccination pilot in the north east: using evaluation to
improve delivery
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Wilson, G
Cumbria and North East Sub Region
NHS England
Background
In response to the roll out of the national childhood flu vaccination programme, a
primary school based pilot was developed for Gateshead in 2013 and extended to
include Sunderland and South Tyneside the following year.
Aim
To evaluate the impact of the changes made to the delivery and uptake of the pilot in
2014 subsequent to the evaluation of the 2013 pilot.
Method
The 2013 pilot was evaluated using a mixed methods approach including analysis of
uptake by school year, school, session date, deprivation and ethnicity. Questionnaires
and face to face discussions targeted parents, head teachers and other stakeholders.
The key findings were subsequently incorporated in planning for the 2014 pilot. To
evaluate the impact of the changes made, uptake was then analysed and questionnaires
and face to face discussions held with headteachers, staff and non-consenting parents.
Costs and resource utilisation were compared between the two years.
Results
52.3% of the total eligible population were vaccinated in 2013. Parental presence, use of
a central delivery point and exclusive use of qualified nurses to administer vaccines were
identified as key improvement areas.
Planning for 2014 removed the requirement for parental presence, offered a classroom
delivery model, and used a modified skill mix to administer the vaccine. Unlike 2013,
children in clinical risk groups were included in the 2014 pilot, thereby improving equity
of access.
Uptake in 2014 was 57.8% across the three local authorities. Cost per dose reduced from
£15 to £12.
Conclusions
Overall uptake increased by 5.5% from 2013 to 2014. Removing the requirement for
parental presence was well received by headteachers, and was perceived to reduce
disruption. Although offered, classroom based delivery was found to present logistical
challenges and was not widely adopted.
The use of broader skill mix, including health care assistants, reduced the cost of
vaccination markedly. Inclusion of children in clinical risk groups in the pilot served to
ensure that those at most risk of complications from influenza infection were offered
protection.
Learning
Outcomes
This project highlights the importance and benefit of using robust evaluation processes
to improve the uptake of new vaccination programmes. Evaluation and improvement
through piloting is essential in order to develop effective and efficient delivery models.
Evidence based changes to models can improve equity of access to vaccinations.
Other
Presenters
Darke, J; Flinn, J
Bunce, J; Jobling, M
Walker, S
Cresswell, T
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster45
Infection control measures in wet cupping (Hijama): An alternative
therapy that involves bloodletting.
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Abdalrahman, B
Leicester City Council
Background
Wet cupping involves bloodletting through the use of rubber cups as suction devices that
are placed on the skin. Blood is drawn by making small cuts. It is seen as a remedial cure.
There is limited evidence about infections linked with it.
Aim
This presentation aims to identify the risks associated with the practice and the interim
infection control measures to minimise those risks which are mainly related to the
transmission of blood borne viruses (BBV).
Method
This was based on literature review and stakeholder consultations including hijama
practitioners. For example, extensive discussions were carried out with environmental
health officers, health protection professionals, trading standards, legal services and the
hijama practitioners. The measures were prompted by a local response to the practice in
Leicester City.
Results
We identified a list of possible harmful effects of wet cupping primarily linked to BBV.
We produced a set of interim infection control guidelines to advice on reducing the risks
associated with the practice. We believe this is the first set of infection control guidelines
developed in the UK for this purpose. We applied the basic principles of infection control
from the national tattooing and body piercing guidance. Local Authorities do not have
licensing powers for this type of health treatment and have very limited enforcement
power if such treatments are carried out in domestic premises.
Conclusions
There are serious risks associated with wet cupping mainly related to BBV transmission.
The market is not regulated thus poses a considerable risk to the public’s health
especially that wet cupping is seen as a curative treatment by many people. Lack of
evidence in this field highlights the need for further research into this practice to inform
future national policy. Local Authorities need stronger proactive enforcement powers to
protect the public such as a licensing regime.
Learning
Outcomes
Response historically has been crisis driven. Public health professionals must be prepared
to face a significant challenge represented by emerging unregulated health related
practices such as wet cupping, Intense Pulsed Light (IPL) hair removal, and fish spa.
Partnership working is essential to encompasses all aspects of these practices.
Other
Presenters
Zzizinga-Johnstone, V, (Leicester City Council): Environmental Health Student.
victoria.zj72@googlemail.com
Monk, P, (Public Health England): Communicable Disease Control Consultant.
philip.monk@phe.gov.uk
Browne, I
(Leicester City Council): Public Health Consultant. Ivan.Browne@leicester.gov.uk
Mandora, G
(Leicester City Council): Team manager (public safety). govind.mandora@leicester.gov.uk
Wowczuk, L
(Leicester City Council): Environmental Health Officer. Lesia.Wowczuk@leicester.gov.uk
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Hare, J
(Leicester City Council): Trading Standards Officer. John.Hare@leicester.gov.uk
Poster Title
Poster46
Child drowning and the use of bath seats:Public Health England
London(PHEL) response to preventing accidental child injury and mortality
across London
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Korkodilos, M
Public Health England
Background
Unintentional drowning causes unnecessary child injury and death. London Child Death
Overview Panels(CDOPs) informed PHEL of child deaths which occurred in baths and
requested more awareness on preventing child drowning involving bath seats.
Aim
To summarise the evidence about child drowning and develop an evidence-based
resource on the prevention of child drowning in baths including bath seat safety advice
that can be shared with London CDOPs and other key stakeholders.
Method
Literature review of peer reviewed and grey literature since 2003 from developed
country settings. Cross-sectional survey of 25 London CDOPs via email with 2-week
deadline and reminder email a day before deadline to increase response. Follow-up
telephone calls to non-responders and any responders who provided relevant local
experience. Key experts from statutory and voluntary stakeholder organisations were
consulted via email, telephone and face-to-face interviews. Simple quantitative and
qualitative analysis of findings were synthesised into a visual layout for distribution.
Results
• The survey response rate was 96%.
• In the UK, around thirteen child deaths, under 5 years, annually are due to drowning.
25% of these occurred in a bath. For each fatality, there are eight non-fatal events
serious enough to require hospitalisation.
• From 2008 to 2012, nine times more children under 5 years died while in a bath than in
natural water (sea, rivers/lakes).
• Parents/carers develop a false sense of security from bath seats. One in three
accidental drowning deaths in children, 2 years or under, involve bath seats and risk
increases with poor bathtime supervision.
Conclusions
PHEL aims to improve the health of London’s children and young people and reduce
inequalities. Due to local events, London CDOPs requested a pan-London consistent bath
safety message. PHEL summarised its findings in a safety update developed through
cross-boundary multidisciplinary engagement to support local areas in effecting healthy
change. Stakeholders embraced the initiative as a useful resource for professionals,
carers and parents.
Learning
Outcomes
Identification of key players, effective communication and collaboration are vital to
improving population health. This evidence resource has been recognised by
professionals both regionally and nationally as a useful tool for highlighting avoidable
child injury and death which cuts across boundaries. This resource is available for use in
settings accessible to professionals, carers and parents.
Other Presenters
Omonijo, M; Panjwani, S; Wijemanne, C
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster47
Exploring community pharmacy’s contribution towards public health
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Katsande A
West Sussex County Council
Background
Community pharmacies are increasingly recognised as an important resource in public
health. Their accessibility and unique position enables them to work with local
communities in tackling health inequalities and the wider determinants of health.
Aim
The project aim was to identify how community pharmacies can contribute towards the
West Sussex public health and wellbeing agenda at an individual pharmacy level, local
level or a county level.
Method
Three focus groups, held in different localities, were used to collect data from the
pharmacy staff. The key areas of discussion in the focus groups were; health, wider
determinants of health and partnership working. Discussions were preceded by
presentations that gave a brief overview of the current situation. All pharmacies in West
Sussex were invited to participate and the sample was therefore self-selecting. The
average number of participants in each group was eight. Discussions were recorded on
flip charts by two facilitators and analysed thematically.
Results
There were positive findings from the focus groups, with a majority of the participants
identifying how they can contribute towards tackling wider determinants of health such
as social isolation. They identified how medication delivery drivers and domiciliary
medicine use reviews can be used as an opportunity to visit the client and to identify
those at risk. However, pharmacy teams need awareness of where to signpost if there
are concerns. All groups agreed that opportunities existed to strengthen local
partnership working between pharmacy teams and the local health and wellbeing
services.
Conclusions
Pharmacy teams are more confident in providing public health services. However, they
are less familiar with providing services in relation to the wider determinants of health.
This resonates with the current research findings. Opportunities exist within the
community pharmacy contract to support the provision of wider interventions and
making every contact count. With training, pharmacy teams can play a key role in
tackling health inequalities and the wider determinants of health. However, such services
need to be integrated within existing systems to allow for effective partnership working.
Learning
Outcomes
Pharmacies are in a unique position to engage in both health and social determinants of
health in order to tackle health inequalities. The utilisation of the whole pharmacy team
is paramount to the successful delivery of innovative services directed at the wider
determinants of health.
Other
Presenters
Mcgonigle F
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster48
NHS Health Checks: are they just a tick box exercise?
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Cleary, S
Office of Public Health
West Midlands
Background
NHS Health Checks assess the risk of developing a vascular condition, aiming to reduce
premature mortality and secondary care use.
The Vascular Team monitor Provider quality and performance, deliver Health Checks,
and have developed software to ensure sm
Aim
To evaluate the impact of NHS Health Checks on identifying undiagnosed vascular
conditions following confirmatory checks via the GP practice.
To identify further action needed to assess the true impact of an NHS Health Check on a
patient.
Method
Currently, only predictive outcome data have been available. To understand the impact
having a Health Check was having on patients, data was extracted from the bespoke
software the Vascular Team developed. This data was for all Health Checks completed in
2012/13.
The data was analysed to show the diagnosed prevalence of Atrial Fibrillation (AF),
Chronic Kidney Disease (CKD), and Hypercholesterolaemia in Dudley, compared to the
nationally derived expected prevalence.
Results
Analysis of the 7713 health checks completed in 2012/13 showed:
AF: 50 had an irregular pulse, 10 confirmed AF diagnosis (0.13%): Expected
prevalence 1.4%.
CKD: 31 diagnosed (0.4%): Expected prevalence 9.6%.
Hypercholesterolaemia: 90 confirmed diagnoses, but 1023 had raised lipids
(8.8%): Expected prevalence 4.0%.
To understand why the prevalence differs, an audit will be conducted tracking patients
along the appropriate diagnostic pathway. A proforma has been developed to carry out
the audit, and Patient satisfaction surveys will also be sent out to investigate the
experience of the Health Check and follow up at their GP practice.
Conclusions
Expected numbers of AF, CKD or hypercholesterolaemia haven’t been identified through
the NHS Health Checks. Recommend conducting a clinical audit to identify possible
reasons for this: NICE guidance diagnostic pathways not being followed? DNA/DNR an
issue in low prevalence or over zealousness with raised lipids? Without follow-up, the
health check impact is diluted, but increases possibility of over-diagnosis and treatment
if standardised pathways are not followed.
Caveat: Audit has been delayed by IG issues with data sharing between GP practices and
PH, arisen since the PH move from NHS to LA; currently attempting to resolve this.
Learning
Outcomes
To look beyond simple NHS Health Check uptake rates.
To emphasise the importance of follow-up after the initial health check to meet
the overarching aim of the programme to reduce vascular disease, premature mortality
and potentially avoidable hospita
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Other Presenter
Wakefield, S
Poster Title
Poster49
Prevalence, predictors and patterns of waterpipe smoking among young
people in London: a cross-sectional study
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Jawad, M
Southampton City Council
Background
Waterpipe smoking is growing worldwide, but little is known of its epidemiology in the
UK due to its absence from national health surveys.
Aim
We sought to address this by calculating the prevalence of waterpipe smoking among
young people in London.
Method
In 2014 we conducted a cross-sectional study among 2,231 young people in three
ethnically-diverse areas of southeast London. We calculated ever waterpipe prevalence,
and compared its sociodemographic predictors to cigarette use. In one area we collected
data on patterns of use and calculated the prevalence of waterpipe smoking in proximity
to waterpipe-serving premises.
Results
Our sample was aged 14.1±1.7 years, 55.7% were male and 46.6% were considered of
black ethnicity. The prevalence of waterpipe was 39.6%; higher than that for cigarettes
(32.4%). Cigarette users were more likely to be older, female and of white ethnicity,
whereas waterpipe users were more likely to be male and of non-white ethnicities, with
no clear age gradient. The prevalence of waterpipe increased as residential proximity to
waterpipe-serving premises increased.
Conclusions
Waterpipe smoking is alarmingly prevalent in southeast London, and users exhibit a
different sociodemographic profile to cigarette users. National surveillance is warranted
to help develop suitable interventions to prevent uptake and promote cessation.
Learning
Outcomes
Waterpipe smoking is a public health concern in the UK and it may undermine the
progress made in curbing the cigarette epidemic. End users are likely to differ in
sociodemographic characteristics compared to cigarettes users; this should be borne in
mind in the development of interventions.
Other
Presenters
Power, G
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster50
Waterpipe industry products and marketing strategies: analysis of an
industry trade exhibition
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Jawad, M
Southampton City Council
Background
Understanding product development and marketing strategies of tobacco companies is
important in developing policy. However, comparatively little is known of the waterpipe
tobacco industry, which tobacco companies have recently entered.
Aim
This study aimed gain an understanding of waterpipe tobacco products and marketing
strategies by visiting a waterpipe trade exhibition.
Method
In April 2014 the first author attended an international waterpipe trade exhibition,
recording descriptions of products and collecting all marketing material available. We
described the purpose and function of all products, and performed a thematic analysis of
messages in marketing material.
Results
We classified the waterpipe products into seven categories and noted product variation
within categories. Electronic waterpipe products (which mimic electronic cigarettes)
rarely appeared on waterpipe tobacco marketing material, but were displayed just as
widely. Claims of reduced harm, safety and quality were paramount on marketing
materials, regardless of whether they were promoting waterpipe tobacco, waterpipe
tobacco-substitutes, electronic waterpipes or charcoal.
Conclusions
Waterpipe products are diverse in nature and are marketed as healthy and safe
products. Furthermore, the development of electronic waterpipe products appear to be
closely connected with the electronic cigarette industry, rather than the waterpipe
tobacco manufacturers. Tobacco control policy must evolve to take account of the vast
and expanding array of waterpipe products, and potentially also charcoal products
developed for waterpipe smokers. We recommend tobacco-substitutes be classified as
tobacco products. Continued surveillance of the waterpipe industry is warranted.
Learning
Outcomes
Waterpipe tobacco industry product development and marketing strategies may be
analagous to that of the cigarette tobacco industry. Tobacco control policy needs to
account for the product mimicry shown by tobacco-related industries such as the
electronic waterpipe and waterpipe tobacco industries.
Other
Presenters
Nakkash, RT
Hawkins, B
Akl, EA
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster51
Sharpening Public Health’s teeth?
Strengthening public health outcomes through regulatory delivery. Halton
Council’s solution
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Johnson Griffiths, S
Halton Borough Council
Background
The new public health world was designed to more effectively improve and protect the
public’s health. Local authority existing regulatory functions protect health. Are public
health and regulatory functions best aligned to improve health outcomes?
Aim
To show how integration across public health and regulatory services, embedding
environmental health: food/health and Safety; environmental protection, trading
standards and health improvement within core public health can improve health
outcomes.
Method
Halton saw a need for stronger links between Public Health, Environmental Health and
Public Protection to improve health outcomes.
Wider public health and public protection functions were transferred into the core public
health directorate, including Environmental Health, Trading Standards and health
improvement teams with associated commissioned services.
This aligned priorities, workforce and budgets across a range of issues: tobacco control;
alcohol: workplaces; mental health; cancer; pollution; older people; health checks,
physical activity; healthy weight; planning etc. to achieve joint outcomes.
Results
• Strong united voice within Authority across all public health issues; single structure
• Recruited an EHO for workplaces: undertake regulatory functions alongside health
improvement. Developing healthy workplaces within local businesses
• Joint tobacco control role: smoking cessation, health improvement, enforcement
activities aligned across whole community and all ages
• Innovative Scams Project: working with victims of Scams, change behaviour, develop
resilience, reduce isolation, improve mental health.
• Aligns Public Health, Social Care, Children’s outcome framework activity
Conclusions
One of the few Authorities to merge Public Health, Environmental Health, Trading
Standards and Health Improvement Functions under one Public Health and Protection
team. It has developed a better understanding of what public health is within the council
and is one point of contact for the public to identify with.
Better aligned to work across the range of wider determinants and improve outcomes
across the public health, adult social care and children’s outcome frameworks.
Using the regulatory powers to promote, protect and change health and behaviour adds
weight to the public health voice
Learning
Outcomes
Develop new thinking around wider public health functions, working across regulatory
services, aligning resource, priorities and opportunities to improve health outcomes,
strengthen wider public health functions
Opportunities to build local public health workforce and capacity
Strengthen a single, aligned, authoritative public health voice within the local political
arena and local communities.
Other Presenters Burrows, S; Perchard, D; Salisbury, W
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster52
Socio-economic differences in the association between self-reported and
clinically-present diabetes and hypertension in the Scottish Health Survey
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Tompkins, G
Public Health England
Background
Diabetes & hypertension are key risk factors for coronary heart disease. Prevalence of
both conditions is socio-economically patterned. It is estimated that in the UK a third of
diabetes is undiagnosed and millions are unaware they have hypertension.
Aim
To examine whether there are socio-economic differences in the association between
self-reported and clinically present hypertension and diabetes in a UK population.
Method
Data were from the 2008-2011 Scottish Health Survey. 4273 adults reported whether
they had diabetes or hypertension and were examined by a nurse. Hypertension was
defined as systolic blood pressure>140 or diastolic >90 mmHg. Diabetes was defined as
glycated haemoglobin of 6.5% or more in a non-fasting sample. Socio-economic position
was measured using occupation, education and income. Odds ratios of self-reporting
amongst those with clinically present conditions and sensitivity, specificity & predictive
value of self-reporting were calculated. Analyses were adjusted for relevant variables.
Results
Self-reporting and clinical presence of both conditions tended to increase with
decreasing affluence. Amongst those with clinically present conditions, there were no
socio-economic differences in self-reporting once other factors had been taken into
account. Those in the least affluent groups (by education or income) were most likely to
be aware they had hypertension (sensitivity). Those in the most affluent groups (by all
measures) were most likely to be aware they did not have hypertension (specificity).
There were few differences of note for diabetes.
Conclusions
We found no consistent socio-economic differences in self-reported awareness of
hypertension and diabetes amongst those found to have these conditions on
examination. Awareness of the presence of the conditions may influence risk behaviour
and use of preventative services. Without evidence of differences, it is important that
universal approaches continue to be applied to the identification and management of
those at risk of these and other conditions that underpin cardiovascular disease.
Learning
Outcomes
Learning will include understanding of how the prevalence, awareness and underreporting of diabetes and hypertension varies in the Scottish population by SEP; and of
how secondary data can be used to examine public health phenomena.
Other
Presenters
Forrest, L
Adams, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster53
Access to food retail outlets in County Durham, UK: a cross-sectional study
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Wright, T.
Public Health Durham
Background
The aim of this food mapping project was to establish current access to food, and
specifically healthy food, in County Durham. This was considered in terms of physical
access, affordability, and food provision (range and quality).
Aim
The aim of this food mapping project was to establish current access to food, and
specifically healthy food, in County Durham. This was considered in terms of physical
access, affordability, and food provision (range and quality).
Method
This was a cross-sectional study using quantitative and qualitative methods to investigate
food retail outlets.
Information from the Durham County Council Town Centre Survey 2014 and the Food
Business Database was used to locate and identify food outlets.
GIS was used to produce maps showing the prevalence of deprivation; obesity; retail
outlets; takeaways; and ratio of outlets to takeaways. Travel times were also mapped.
Eight focus groups and 400 on street surveys were undertaken with a cross-section of the
resident population, to ascertain their views and experiences of local food retail.
Results
The majority of survey respondents were highly satisfied with local food retail although
financial constraints and transport inconvenience were identified as barriers.
Most residents shopped at least weekly for food, used a supermarket, travelled for up to
15 minutes and used a car for transport.
Difficulties with food shopping were more widely described in the focus groups. Some
people felt that local shopping provision had declined, with an emergent excess of
takeaway outlets.
Food retail access was reduced for the disabled, full-time workers, elderly people, and
people with children.
Conclusions
The findings indicate the prevalence of obesity despite awareness of the healthy eating
message. Most people have access to a supermarket by car and public transport, except
in the most rural areas. They shop once a week for food and show high levels of
satisfaction with their food shopping provision. The focus groups identified accessibility
issues for certain population groups particuarly the elderly, those with children, people
working full-time, and the disabled.
Learning
Outcomes
These will include:
•Understanding the value of a pragmatic approach to this type of work
•Gaining an insight into the shortfalls of the collection, collation, analysis of the data.
•Explore how the recommendations have been translated into action
Other
Presenters
Mills, S.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster54
Co-production evaluation of the County Durham Alcohol Hospital Liaison
Team (AHLT) (in association with FUSE)
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
McGeechan, G. J.
Teesside University
Background
County Durham has higher than average hospital admissions for alcohol use, costing
£212 million per year. The royal college of physicians recommends hospitals have
specialised alcohol care teams which should be evaluated for effectiveness.
Aim
The primary aim was to assess the effectiveness of the AHLT at reducing alcohol specific
hospital admissions for a cohort of patients. A secondary aim was to gain feedback on
the service from clients and staff to shape future commissioning.
Method
A mixed methods approach was used for this evaluation. For the primary aim, admission
records for the cohort for a period of 6-months prior to engaging with the AHLT were
compared with admissions recorded whilst working with the AHLT and any admissions
for a period of 6-months after discharge by the AHLT. A short survey was sent to clients
to gain feedback on their experience of the AHLT. Furthermore, two-clients were
identified who participated in an interview to provide more in depth feedback on the
service. Finally a focus group was conducted with staff who work for the AHLT to gain
feedback in the service from the providers perspective.
Results
There is a small reduction in hospital admissions when comparing pre-engagement with
the period after discharge; however admissions increased significantly whilst engaged
with the AHLT compared to pre-engagement. Furthermore, A&E attendances increased
slightly when comparing pre-engagement with the period after discharge; attendances
increased significantly whilst engaged with the AHLT compared to pre-engagement.
Clients were satisfied with the service and felt working with the AHLT had impacted on
their drinking. AHLT staff reported feeling isolated, and that hospital staff relied on them
for providing brief advice.
Conclusions
It is not possible to say that the fluctuation in admissions was due to engagement with
the AHLT. However, A&E attendances have continued to rise after engagement with the
AHLT, whilst admissions decreased, suggesting that there has been some impact on
alcohol specific admissions. Feedback survey and focus group results indicate there may
be an over reliance on the AHLT to provide detox medication. Future services should be
designed to work with people who are frequent A&E attenders who have not developed
chronic health conditions; provision of brief advice should have strong clinical leadership
within the hospital.
Learning
Outcomes
We know that providing brief advice in secondary care can reduce drinking, however as
only 50% of this cohort seems to have been advised to reduce drinking, this still does not
appear to have been routinely accepted into practice
Other
Presenters
Wilkinson, K. G
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster55
Embedding health impact assessment into the organisational culture of
Durham County Council.
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Wright, T.
Public Health Durham
Background
The draft County Durham Plan (CDP) is a 30 year spatial plan for the area. It was in its
final iteration prior to sign off and submission when the organisation’s Directors agreed
to Public Health facilitating two health impact assessment workshops.
Aim
The aim was to maximise the effectiveness of the County Durham Plan in creating health
and wellbeing and to identify significant areas requiring more detailed work.
Method
A rapid scrutiny of Health Impact Assessment (HIA) tools resulted in one developed by
the Department of Health (2011) being chosen.
A search was carried out for published reviews which consider the evidence about causal
pathways related to each of the five themes identified from the CDP
The workshops consisted of a series of multi-disciplinary roundtables groups who
discussed the respective themes. Key points were highlighted on a flip chart and the
whole group asked to use three dots to prioritise the issues. A follow up event explored a
process for translating issues into action.
Results
The workshops made a series of recommendations. These included:
•Integrating health and wellbeing into the CDP.
•Creating opportunities to undertake further HIAs’ on emerging plans or policies.
•Support for workforce development both within Durham County Council but also the
Town and Parish Councils.
.
•The contribution of Public Health to Supplementary Planning Documents was stressed
as an important opportunity to operationalise the high level commitment as stated in the
CDP
Conclusions
HIA is an evidenced base approach to improving health and wellbeing and reducing
health inequalities in the population. Building workforce capacity can enable this
process to occur but it needs to adopted as part of a series of measures including a
selective use of HIA on two/three key policies and review of the outcomes. In addition, a
quick short term gain will be the inclusion of health and wellbeing as part of
Management Team and Cabinet papers.
Learning
Outcomes
These will include:
•Understanding the value of a pragmatic approach to this type of work, recognising that
compromise is required to achieve a greater good.
•Exploring process and spheres of influence within an organisation.
Other
Presenters
Curtis, S. Dr.
Learmonth, A. Dr.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster56
Rebalancing the Outer Estates Foundation, a partnership approach to
reduce health inequalities through engagement; education and innovation
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
McNiven L
Nottingham City Council
Background
The Foundation is chaired by Graham Allen MP, his vision is to drive forward innovative
approaches to break the intergenerational deprivation of the housing estates which
make up his constituency; tackling causes and not symptoms, and using collaboration
Aim
To rebalance the outer estates of Nottingham North and return them to the balanced,
sustainable communities they once were. There are 3 initial Public Health projects which
aim to impact on the wider determinants of health; improve the health inequalities
Method
The 3 Rebalancing Foundation projects will focus on: Ensuring women do not drink
alcohol in pregnancy & supporting national pioneering research on prevalence of FASD.
Encouraging families to access the free dental care their children are entitled to. Finally,
improving access to services using innovative methods of engagement & community
development to improve lung health; offering lung health checks, identifying citizens at
greatest risk of lung cancer, offering additional intervention where appropriate & most
importantly increasing access to stop smoking services.
Results
The 3 specific public health projects will develop a step change in the delivery and uptake
of preventive, early intervention services. This will be achieved through unique
partnership working, unique in that the Graham Allen has personally sought and
delivered engagement from senior physicians; the CCG; universities, Nottingham City
Council, PHE, community groups, not for profit organisations; residents of his
constituency; various Ministers, secretaries of State and Whitehall departments. Since
the launch in June 2014, the sum total of this engagement has created a momentum and
delivered progress that has surpassed expectations.
Conclusions
The success of these projects is dependent on the coordination of wide ranging partners
and service users alike, this is a difficult and complicated task. Furthermore the
development and organisation of the 3 projects fit seamlessly with the rest of the
Rebalancing Foundation’s regeneration work. This project has fostered & encouraged
enthusiasm, joint working and creative thinking to ultimately improve the health and
social outcomes of the people living in Nottingham North.
Learning
Outcomes
Recognise the importance of working collaboratively with political partners to support
sustainable reductions in health inequalities and improve health and social outcomes in
areas of high deprivation and stark inequalities
Reflect on alternative approaches to impact on health inequalities at scale
Acknowledge the necessity of community development when attempting to elicit social
change
Other
Presenters
Jobarteh J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster57
“You just, like, exist – you just survive in the best way you can”: a
qualitative study of the impact of the ‘bedroom tax’
Abstract topic & Manifesto - Prevent bad health & save lives
Submitted By
Brown, JG
Background
The Removal of the Spare Room Subsidy (‘bedroom tax’) in 2013, which was aimed at
working age social housing tenants in receipt of Housing Benefit, resulted in those
affected losing at least £12 per week from their Housing Benefit.
Aim
To explore the impact of the bedroom tax on health and wellbeing, social relationships
and the wider community in an area of the city of Newcastle upon Tyne, UK.
Method
This was a qualitative study using semi-structured interviews with social housing tenants
(n=38), and one focus group (n=7) and interviews (n=5) with service providers. The
setting was an urban neighbourhood in North East England with a population of 11,701
and ranked in the top 10 per cent most deprived areas of the UK. Sixty-nine per cent of
the residents live in social housing, and approximately 700 households were affected by
the bedroom tax. A qualitative interpretive approach was used to analyse data, using line
by line coding and constant comparison.
Results
Income reduction and debt harmed purchasing power for essentials, familial
relationships and mental health. Participants singled out children as being significantly
affected. Residents experienced shame and felt stigma. Residents socialised less and
spent less in local businesses. Residents and service providers highlighted added
pressure on already strained local services. There was an overwhelming sense that, as a
result of the bedroom tax, ‘home’ was regarded as a disposable asset, negating the
attachment to home and community that many had built up over years.
Conclusions
Contrary to the Government’s own Impact Assessment, the reduction of income from
the bedroom tax appears to be having a negative impact on the health and wellbeing of
an already disadvantaged group of people through its effects on individuals, families and
the community. The bedroom tax is likely to increase health inequalities as well as the
use of health and other services, and should be withdrawn. Government options of
mitigating the impact by downsizing, taking in a lodger, gaining employment or
increasing working hours were extremely difficult to achieve.
Learning
Outcomes
This study provides further insight into the impact of poverty and income reduction on
health and wellbeing and will inform the development of interventions to mitigate the
impact of income reduction resulting from welfare reform, such as income maximisation
and employment initiatives. It reinforces the importance of fully considering in advance
the impact of policy on health and health equity.
Other
Presenters
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster58
Dual Recovery: Meeting the needs of people with co-existing mental illhealth and substance misuse
Abstract topic & Other
Submitted By
Dr David Edwards
Background
Mental ill health is common across the population as is substance misuse with both often
hidden due to stigma and limited case ascertainment. A complex interaction often
develops between mental ill-health, increasing a person’s susceptibility to misuse of
Aim
Co-existing mental ill-health and substance misuse is commonly referred to as dual
diagnosis, an inaccurate term that further stigmatises patients, affecting their access to
treatment by mental health providers. In reality substance misuse by people with
Method
A needs assessment by Norfolk Public Health identified what is required to improve
patient outcomes including dual recovery, through effective utilisation of existing
services. The presentation will outline how Norfolk Public Health is supporting
commissioners and providers to develop:
1. A shared vision for dual recovery agreed across health, social care, housing and
criminal justice sectors in Norfolk.
2. A dual recovery competency framework linked to a rolling programme of training at
different levels for staff across agencies.
3. A clear pathway from presentation to recovery, including access to psychological
therapies.
4. Standardised data collection across agencies.
Results
Mental Health, Alcohol and Drug services have traditionally operated separately with
different commissioning drivers. A ‘dual diagnosis’ stigma has developed that hampers
partnership working and patient access. This is further institutionalised through clinical
pathways and policies that mean patients with complex needs face major hurdles to
even get assessed. Appointment non-attendance is then perceived by staff as a failure on
the part of the patient rather than a consequence of barriers created by the service.
Conclusions
Learning
Outcomes
Other
Presenters
Dr Sofia Habib, Mr Stuart Keeble, Dr Augustine Pereira
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster59
Implementing NICE guidance PH48, smoking cessation in secondary care,
in a mental health and community trust.
Abstract topic & Mental Health
Submitted By
Beenstock, J
Lancashire Care Foundation Trust
Background
Although NICE guidance, PH48, was published in 2013, the sight of staff and patients
smoking at the gates and in the grounds of NHS organisations is still commonplace. In
mental health trusts the culture of smoking can be strong and pervasive.
Aim
To implement the NICE guidance (PH48) by 5th January 2015; ensuring policies and
procedures in place to support staff and service users in the use of nicotine replacement
therapy and smoking cessation, and effective communication of key messages.
Method
An implementation plan, based on the Scottish model (1), was devised encompassing the
key elements needed for implementation; a new nicotine management policy,
communication strategy, supporting materials, involvement of staff and service users.
We were grateful for the shared learning and advice received from Cheshire and Wirral
Partnership NHS Foundation Trust and South London and Maudsley NHS Foundation
Trust who have already implemented the guidance.
Results
Staff and service users expressed mixed views about the guidance’s acceptability. Some
people perceived smoking to be a service user’s ‘only pleasure’ and were unaware of the
10-15 year life expectancy gap between the general population and people with a mental
health disorder. Implementation tools developed included: posters designed by service
users and an animation and ongoing messages stressing that “an addiction is not a
choice, quitting smoking is”. (2,p.5) A staff survey conducted shortly after
implementation identified areas requiring additional support.
Conclusions
Implementing this NICE guidance within a mental health and community trust is
challenging due to the cultural shift needed for both staff and service users. Stopping
smoking is an important public health intervention and addresses a key driver of health
inequalities. Addressing staff and service users’ concerns without losing focus on this aim
can be difficult. Lancaster University academics are leading an action learning approach
to evaluation with staff, along with on-going monitoring so policy and practice can be
amended as needed.
Learning
Outcomes
. An overview of the key challenges to be addressed when developing a nicotine
management policy that will support a smokefree environment.
2. An insight into one mental health and community trust’s communication and training
programme used to implement NICE guidance PH48.
Other
Presenters
Jane Beenstock
Nicholson, L (2011) Smoke-free mental health
Guilfoyle, Y; Lewis, G; McGlynn, L; Tester, P
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster60
A review of psychotropic medications prescribed in people with a learning
disability and the outcomes of Second Opinion Approved Doctor reviews
Abstract topic & Mental Health
Submitted By
Currie, C
East of England Deanery
Background
Winterbourne View exposed concern of overuse of psychotropic medications in people
with learning disabilities (LD). Maintaining high quality care within residential
environments is a key public health priority.
Aim
To understand whether psychotropic medications (antipsychotics, anxiolytics, mood
stabilisers, antidepressants and CNS stimulants) are used in an appropriate and
proportionate way in people with LD across England.
Method
Retrospective review of psychotropic medicines requested to be authorised by a second
opinion approved doctor (SOAD) for people with LD and detained under the Mental
Health Act across England was undertaken. These reviews (n=945), recorded by the Care
Quality Commission, covered a 10 month period (Oct 2012-Aug 2013). Licensed
indications and single agent high dose thresholds were identified using the BNF.
Combined high doses were identified for each drug class using the method described by
the Royal College of Psychiatrists. Relevant ICD-10 codes were used to justify medication
usage.
Results
Antipsychotic polypharmacy was identified in 21% of reviews (with less seen in other
medication classes). Roughly half of antipsychotics (52%) had a relevant psychiatric
diagnosis recorded (range from 12% of anxiolytics to 67% of CNS stimulants and drugs
used for ADHD). Use of high dose agents was observed, most often in the antipsychotic
class where 28% of reviews had a high combined dose for ‘any’ antipsychotic. SOADs
made changes to medication regimens in 21% of reviews overall. Changes appeared to
be made more often where high doses were present.
Conclusions
This study raises concern that overuse of psychotropic medications is commonplace
across England and that little progress has been made since the Winterbourne View
crisis. This work will be presented within the context of other relevant work.
Learning
Outcomes
- To be aware of the slow progress made in tackling failings in care highlighted by the
Winterbourne View crisis.
- To understand the benefit of a rigorous academic approach in building a case for action
and in steering national policy.
- To be aware th
Other
Presenters
Marlow,D
Branford, D
Holland, A
Glover, G
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster61
Improving cardiovascular (CVD) risk of those with enduring severe mental
illness in contact with a specialist mental health Trust
Abstract topic & Mental Health
Submitted By
Dr Caroline Hird, Honorary Consultant
Public Health Physician,
Nottinghamshire Healthcare NHS Trust,
Background
Improving the physical health of people with mental health problems is a national
priority. Working collaboratively, GP commissioners, the mental health trust and public
health developed a physical healthcare data form, (the ‘physform’).
Aim
The physform and accompanying CQUIN aimed to incentivise physical health checks
within the mental health trust and improve communication regarding physical health
between GPs and the mental health trust for the target patient group
Method
A cohort of patients with enduring severe mental illness were defined as those aged over
18 who had been on a Care Programme Approach in the mental health trust for >12
months. Practices at which these patients were registered were requested to complete
and return a physform listing CVD risk factors (BP, lipids, diet, DM, activity, smoking,
BMI) Returned forms were reviewed and missing information collected by mental health
teams where possible, which was then returned to GP practices. Analysis of the
information available from completed forms was undertaken
Results
The enduring severe mental illness cohort consisted of 1389 individuals and completed
data was received for 582 (43.1%). Returns were higher in younger age groups (<age 45).
Risk factors for CVD were generally more prevalent than the general population: 52%
were reported to be current smokers with the highest rates in males aged 25-49 years.
BMI was raised in 65% of those for who a result was available, blood pressure was
≥140/90 in 20%, blood lipids were raised in 45%, and blood glucose was raised in 18%
after excluding those with known diabetes.
Conclusions
These data suggest that for those with severe enduring mental illness smoking rates and
abnormal blood sugar levels are substantially higher than those in the general
population Being overweight,or obese, being hypertensive, and having raised blood
lipids are common but similar to population norms. In order to reduce the health
inequalities associated with severe mental illness, tackling smoking and addressing
impaired glucose tolerance may be relatively more important contributors to future
cardiovascular risk in comparison with the general population.
Learning
Outcomes
Specialist data not accessible from primary care identified this high risk population and
led to increased knowledge about important risk factors for CVD in this patient group. A
strong collaborative approach between primary care and specialists is required especially in implementing NICE PH48 guidance on smoking cessation. The findings have
training implications for mental health staff.
Other
Presenters
Professor Chris Packham, Associate Medical Director
Dr Marcus Bicknell, GP and CCG Lead
Dr Michele Hampson, Emeritus Consultant Psychiatrist
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster62
The Dementia Gap in Primary Care – An Ecological Study of Variations in
Diagnosis Rates in GP Practices across England
Abstract topic & Mental Health
Submitted By
Walker, I
University of Leeds
Background
Improving dementia diagnosis rates in England is a key strategic aim of the Government
but the variation and low diagnosis rates are poorly understood.
Aim
To identify how much variation exists in dementia diagnosis rates in GP practices across
England and whether this variation is associated with GP practice characteristics.
Method
A cross-sectional ecological study design was undertaken, using secondary data sources.
Median regression modelling was used to establish the size of effect and statistical
significance of associations. Data from the year 2011 for 7,711 of the GP practices in
England (92.7%) were included in this study. Dementia diagnosis rates (%) per practice
was the outcome of interest, calculated using NHS England’s 'Dementia Prevalence
Calculator' and QOF registers.
Results
Dementia diagnosis rates varied between 0% and 1,164%. The variation in dementia
diagnosis rates across GP practices in England were significantly associated with
deprivation, GP years of experience, QOF performance, GP contract type, practice size
and percentage of practice list over 65 years old. A difference of up to 24% in average
dementia diagnosis rates in GP practices across England was found to be associated with
these characteristics.
Conclusions
This ecological study has found independent associations between dementia diagnosis
rates and a number of characteristics of practice populations, GPs and the primary care
system in England. Local exploration of these characteristics may assist commissioners in
identifying support measures for constituent GP practices to increase dementia diagnosis
rates.
Learning
Outcomes
Despite the Government's drive to improve dementia diagnosis rates, the variation
across the country is little understood. This study highlights associations that may help to
understand this variation further and generates new hypotheses that warrant testing by
further research.
Other
Presenters
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster63
Situational awareness for controlling and managing infectious diseases
during armed conflict: The example of polio in Syria
Abstract topic & Global Health
Submitted By
Ahmad, B
Durham County Council
Background
Controlling infectious diseases in countries experiencing armed conflict represents a
major challenge to global health actors. In Syria, a large cluster of wild poliovirus type 1
was identified in October 2013 in the north eastern province of Deir Al Zour
Aim
The aim of this paper is to shed the light on salient factors that help predict future
outbreaks of polio virus as well as strengthen the public health response to control polio
cases in a country that is experiencing armed conflict.
Method
I use a PEST framework to disentangle the political, economic, social and technological
challenges that have resulted in a large decline in routine vaccine coverage with the oral
polio vaccine (OPV) since the beginning of the armed conflict four years ago.
Results
The main political challenges are the mass displacement of population; lack of security
and the fragmented reality on the ground with more than 1000 armed groups and over
55% of the country outside government control. Key economic barriers include a large
drop in government spending as well as damage to healthcare infrastructure and basic
services. The social barriers include the wide destruction of the social fabric and loss of
communities. The technological barriers include a demanding routine schedule for the
oral polio vaccine and difficulties in routine surveillance and maintaining a cold chain
during delivery.
Conclusions
A better understanding of barriers to low vaccine coverage in an armed conflict situation
is important to ensure access to a conflict-ridden population in a public health
emergency such as a polio outbreak. In the case of Syria, there is an urgent need to
achieve better coordination between humanitarian and donor agencies to ensure
coordinated surveillance and a rapid response to prevent and control any future
outbreaks of polio.
Learning
Outcomes
•
Understand challenges in surveillance and control of infectious diseases in fragile
healthcare systems.
•
Identify the political, economic, social and technological barriers to low vaccine
coverage in a country that is experiencing an armed conflict.
Other
Presenters
Ahmad, B
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster64
Tackling the obesogenic environment in hospitals through partnerships
with retail outlets on hospital premises.
Abstract topic & Health promoting hospitals
Submitted By
Sarah Perman
Public Health Registrar
City University London
Background
There has been criticism of hospitals in the UK for allowing practices damaging to health
to occur on their premises. Hospitals have been accused of fuelling obesity by allowing
fast food chains and retailers to market junk food to patients.
Aim
A London acute trust worked with a major high street retailer to increase the range of
healthy food and drink on sale in the hospital shop. The goal was to develop a Trust-wide
policy for including public health principles in commercial contracts.
Method
Meetings between senior hospital managers and retail directors to agree reductions in
the sale of products in the hospital which are high in sugar, salt and saturated fat, and to
increase the range of healthier alternatives
- Review of the nutrition content of shop products and agreement to a new healthier
stock list for patient ward trolley
- Explaining and promoting the changes to staff, visitors and patients through training
- Customer feedback through face to face surveys pre and post changes
- Processes to monitor change in buying behaviours and impact on sales and profit
Results
Improvements to the layout of the hospital shop to make healthier food and drink
alternatives clearly visible; increased range of healthier fresh food and drinks by up to
40%, including more bottled water, salads, fresh fruit, and healthy snacks; decrease in
the quantity of processed food items and drinks with high sugar content; removal of
confectionery specifically marketed to children; Trust-wide policy for public health
screening during the procurement process; retailers agreed to act as a pilot site for roll
out of provision of healthier options to their premises in other hospitals.
Conclusions
First hospital store in the country operated by this retailer which has a radical new shop
layout and stocks a healthier food and drink range
- Little impact so far on commercial profits
- Significant personal influence of champions including a senior retail director prepared
to tackle the issue of unhealthy food and drink being sold through their premises
- Some resistance to change from shop staff and hospital volunteers who saw their role
to provide “treats” for the ill. But widespread support from clinical staff concerned about
the impact of poor diet and obesity in their patients.
Learning
Outcomes
Healthy food in hospitals is an important component of WHO Health Promoting
Hospitals; how the power of a leading retailer can be harnessed to support public health;
public health teams need to understand the strategic vision of commercial firms; how a
systematic approach to procurement which gives a central role to public health teams is
the only way to secure strategic change in this area.
Other
Presenters
Perman, S
Davies, A
Rodger, A
Flint, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster65
Measuring the impact NGO advocacy
Abstract topic & Policy change
Submitted By
Brinsden, H
City University London
Background
NGO advocacy aims to influence policies, actions and decisions of the institutional elite,
e.g. on the issue of food marketing. Understanding the impact that advocacy has on
policy change would be useful for NGOs, however research on this is limited.
Aim
To explore the range of indicators being used to evaluate the impact of NGO advocacy
within the context of policies that restrict food marketing to children.
Method
The websites and annual reports of four different NGOs known for their advocacy on the
issue of food marketing were reviewed and compared based on a) the description of
activities carried out and b) the efforts to evaluate or judge the result that these actions
had.
Results
A common theme across the reports of the 4 NGOs was a large amount of description of
the advocacy itself, with limited attention given to the policy outcomes. Where results
were described, it was common for them to be output based, e.g. number of
consultations responded to, extent of media coverage received or number of website
hits. Only where policy had been introduced in line with advocacy calls, was this noted as
a ‘success’. Lacking from the reports was an attempt to assess progress made towards
policy goals. Indicators for progress would aid understanding of what works well in
advocacy.
Conclusions
Indicators of progress are needed to aid NGO advocacy evaluations. Food policies, such
as marketing restrictions, often attract extensive lobbying by vested interests seeking to
block public health policies. NGO advocates need to equip themselves against such
challenges. This will require the development of better tools for assessing advocacy
impact and to develop understanding on how to best influence policies that protect the
public good.
Learning
Outcomes
NGOs and academics seek to influence policy. Understanding what actions have the most
impact for achieving desired change would therefore be valuable. This research
highlights ways in which actions can be evaluated for impact, while also identifying the
gaps in current evaluations. It opens up the debate on how to best determine advocacy
impact so as to enhance efforts to protect public health.
Other
Presenters
Lang, T
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster66
The free movement of patients and labour mobility within the EU at San
Donato Group University and Research Hospitals.
Abstract topic & Healthcare quality improvement
Submitted By
Ramondetti F.
Assistant Medical Chief Executive
IRCCS Policlinico San Donato, Milan,
Italy
Background
The latest directive about cross-border mobility (EU 2011/24) leads to innovative health
assets expected to improve the known health care conditions on a national basis, in
compliance with the free movement of patients and labour mobility within the EU.
Aim
The rules for implementation of the goals are accomplished with differentiated care
where patients are grouped according to the intensity of their need of assistance
determined by the degree of illness, rather than the medical specialisation.
Method
The integration among nations is strongly enhanced by the implementation of the
directive on the free movement of patients and health professionals working in the
hospital settings. Multilingual staff training is the main objective with referral to the
spread of procedures and innovations introduced by the EU Directive 24/2011.
Furthermore, bilateral and multilateral conventions have been stipulated, especially with
the neighboring states with the Lombardy Region, not only when concerning direct
assistance, but also when it comes to research and education for health professionals.
Results
Both the Policlinico San Donato and Ospedale San Raffaele are university and research
hospitals where a wide international network was created. International specialty
registrars are welcome for training and researchers are recruited at all career levels. The
first is one of the largest European cardiac surgery authorities with over 1500 cardiac
surgery interventions per year, the latter manages over 50 European projects such as
ERANET and an International Postdoctoral Program funded by the European Union was
established in 2013.
Conclusions
The implementation of the above directive has determined the set-up of a national
contact office, a system of prior authorisation and European reference networks through
an e-health connection. In the framework of shared comparison of health care across EU
countries, the Policlinico San Donato and Ospedale San Raffaele in Milan aim to extend
their knowledge and quality of health care delivery, in particular for high skills and heavy
technologies through an expanding information system of facilities, resources, personnel
in order to build clinical, teaching and research networks.
Learning
Outcomes
It is necessary to draw attention to the patients' rights and to the quality and safety of
healthcare services across the EU, creating a structure of cooperation in the field of
healthcare. The European Union seems ready to use its economies of scale to improve
healthcare for all European patients.
Other
Presenters
Cerri A.
Scientific Research Manager
IRCCS Policlinico San Donato, Milan, Italy
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster67
Operational Aspects of a Tees Schools’ Fluoride Varnish Programme:
Recruitment, Consent Rates and Improving Dental Access
Abstract topic & Dental public health
Submitted By
Shah, K
Public Health England
Background
This programme aimed to improve oral health and dental access of children living in
deprived areas of Middlesbrough and Redcar and Cleveland. Some schools had decay
rates almost four times the national average.
Achieving high consent rates for children
Aim
• To implement a school based fluoride varnish programme.
• To maximise consent rates for a dental health intervention in areas of deprivation.
• To improve dental access rates for children.
Method
Twenty schools with the highest dental decay rates in Middlesbrough and Redcar and
Cleveland were recruited to the programme.
A multi-strategy approach was taken to engage with parents and children to maximise
consent rates. Parents were engaged through provision of information leaflets, invitation
to information sessions, face-to-face recruitment by school staff and dental team
attendance at school events, for example, sports days. Children were engaged through
school-based activities such as oral health themed assemblies, competitions and lessons.
Results
• In 20 schools 2,787 pupils from nursery classes up to year 4 provided positive consent.
• Positive consent rates varied between schools from 49% to 100% with a mean value of
73%.
• Effective engagement strategies for parents included dental teams attending school
events and face-to-face recruitment by schools using parent support advisers (PSAs)
• Schools with PSAs had the highest consent rates.
• Briefing meetings for parents had very poor attendance.
• Only 11% (n=37) of children who reported not having a dentist and who needed
treatment took up the offer of dental care.
Conclusions
• Consent rates can be maximised in areas of deprivation by using a multi-strategy
approach which engages both parents and children.
• Offers of care to children without a dentist did not result in improved access for this
cohort.
Learning
Outcomes
Insight into strategies that can be used to optimise positive consent rates for school
based dental health improvement programmes.
Other
Presenters
Shenfine, R
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster68
A shared public health service for the five local authorities
- Darlington, Hartlepool, Middlesbrough, Redcar & Cleveland and
Stockton- in Tees Valley
Abstract topic & Public health infrastructure in the UK
Submitted By
Braun T
Consultant in Public Health Medicine,
Tees Valley Public Health Shared
Service
Background
Tees Valley (TV) has a population of 665 100 across 5 unitary local authorities (LA) and 3
CCGs. Some of the LAs rank amongst the smallest in the country and therefore only have
limited public health (PH) resources. A shared PH service across a larger foo
Aim
The aim was to maintain and develop a Public Health function across Tees Valley,
including shared arrangements to provide economies of scale and best use of scarce PH
specialist resources, knowledge, expertise and skills, and foster close partnership work
Method
An appraisal of the different options for the shape, structure and hosting of the Tees
Valley Public Health Shared Service (TVPHSS) was commenced in late 2011 and informed
by the new responsibilities for the PH function, following the NHS reforms. The appraisal
addressed the shape and PH services within the TVPHSS; operational and governance
framework including operational and performance responsibilities and accountability;
and hosting arrangement. Transition groups were formed to implement the approved
option by the Tees Valley LA Leaders and Chief Executives for April 2013.
Results
The TVPHSS is led by a clinical director and has 20 staff. A governance board oversees the
service and reports to the TV Chief Executives. There is a hosting agreement between the
five local authorities. The TVPHSS has supported DsPH to deliver key outcomes under
the 5 core functions of the service - clinical PH leadership; PH intelligence; PH
commissioning and contracts; PH business support; and training and workforce
development. These include mandated PH services such as the JSNA, PNA, NHS health
check, sexual health services and the PH core offer to CCGs. The results of an external
peer review of the service are expected in May.
Conclusions
The TVPHSS is supporting local authorities in delivering mandated public health services
as well as providing information and specialist support to local public health teams. The
service enables small public health teams to draw on specialist public health expertise
and has achieved efficiency savings. The shared service also provides a place to share
local experience and best practice and enables partnership working between local
authorities and with other partners.
Learning
Outcomes
The presentation will demonstrate the potential of a shared public health service or
function
to enable small public health team to access specialist expertise as well as clinical
knowledge and services
to support DPH/ public health teams in working across larger areas
to support partnership working ; - to achieve efficiency savings
Other
Presenters
Sangowawa O, Clinical Director of Public Health
Linton J, Senior Pharmaceutical Adviser
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster69
Real time suicide early alert system in County Durham
Abstract topic & Mental Health
Submitted By
Catherine Richardson
Public Health Lead, PH Team
Durham County Council
Background
The development of a real time suicide alert system shows how organisations are able to
respond in a timely way to an increasing trend or cluster of suicides. This process
resulted in identification of suspected suicides and clusters plus provides support
services to prevent contagion.
Aim
Evaluate effectiveness of suicide early alert process at identifying suspected suicides and
clusters.
Secondary aims:
Immediate support to the bereaved
Prevent contagion
Identify networks & trends
Respond to suicides within institutions, communities
Identify hot spots
Method
Process evaluation of the County Durham Suicide Early Alert and Community Response
Guidelines utilising a mixed method approach. The study used aggregated anonymous
local data on suicides to identify trends and clusters and a series of focus groups and
interviews with key stakeholders to gain feedback on the process.
A whole system suicide response is triggered by the information provided via the
real time alert system which includes post-vention support (bereavement support
for those bereaved by suicide).
Results
This process has resulted in organisations having increased control over their ability to
respond characterised by timely evidence based interventions and improved partnership
working.
The development of a suicide alert system can reduce the delay in the reporting of
suspected suicides, can identify trends, clusters and supports a community response
including immediate bereavement support. This process allows for more than simple
data collection of demographics with the data revealing risk factors including
bereavement, relationship difficulties and financial problems.
Conclusions
This process is an innovative multiagency approach to the problem of delay in the
notification of suicides and informs a timely community response to prevent contagion.
Immediate access to post vention support is a key preventative approach. This will be of
interest to commissioners and providers who may want to develop similar systems so
that they can immediately identify an escalation of deaths due to suicide and respond in
timely manner.
Learning
Outcomes
Implementing a multi-agency process for suicide early alert requires information sharing
agreements across agencies and agreement to support suicide community response
from range of services and resources. Key is partnership working to shared vision of
suicide prevention and providing support related to risk factors.
Other Presenter
McGeechan, G
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster70
Publishing Five Health and Wellbeing Board (HWB) Pharmaceutical Needs
Assessments (PNAs) in the Tees Valley in 2015; job done….or a new
beginning?
Abstract topic & Pharmaceutical needs assessments
Submitted By
Walters, P
Tees Valley Public Health Shared
Service
Background
Five HWB areas co-terminus with unitary local authorities: Darlington; Hartlepool;
Middlesbrough; Stockton-on-Tees; Redcar and Cleveland, worked together to each
publish by 1.4.15 their first PNAs since HWBs acquired statutory responsibility in 2013.
Aim
To publish PNAs fit for the purpose of NHS England’s statutory decision-making on
market entry/commissioning services as defined in NHS Pharmaceutical Services
Regulations 2013 and to develop stakeholder collaboration to facilitate their
maintenance.
Method
Tees Valley Public Health Shared Service (TVPHSS) led PNA development via steering
groups, champions in local authority public health (LAPH) teams, document templates,
specialist pharmaceutical and health intelligence expertise to produce suitable
documents. Four years since each former PCTs’ last PNA and in the context of a new
commissioning environment, local partners include the Durham Darlington Tees Local
Professional Network (Pharmacy) to support the quality improvement agenda; LPN
involves leads from LAPH, NHS England, Healthwatch, hospitals, mental health, CCGs,
academia and community.
Results
At population level, the areas’ similarities are well documented with deprivation/health
need among the highest in England. Fundamental pharmaceutical need for access
(including proximity, opening times and choice) to essential services such as dispensing,
medicines disposal, advice to support self-care/health improvement were readily
identified and largely well-met by community pharmacies located in the heart of
community, social and commercial areas. However, the detail of population differences
offer complexity to opportunities for improvement/better access to pharmaceutical
services.
Conclusions
2015 PNAs are complete, but their collaborative development as the foundation for
future quality improvement in pharmaceutical services also has value. It would be a
missed opportunity to view publication as an end-point (other than requirements for
statutory PNA maintenance) or as ‘only about community pharmacy’. If community
pharmacy is where health and social care meet, where ill-health and wellness meet,
where many visitors attend monthly, and opening hours in the area already extend into
the traditional ‘out-of-hours period’, then up to date PNAs offer all stakeholders a new
beginning.
Learning
Outcomes
Experience of Tees Valley areas’ collaborative approach to produce HWB PNAs in 2015;
consideration of opportunities to extend collaboration beyond the need for PNA
maintenance and facilitate quality enhancement in pharmaceutical services e.g.,
implementing Professional Standards for Public Health Practice for Pharmacy (2014) or
better access to pharmaceutical services information for patients.
Other Presenters
Linton, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster71
Dudley Council – Workplace Health and Wellbeing Project
Abstract topic & Other
Submitted By
Kaur B.
Dudley Metropolitan Borough Council
Background
In September 2012, Corporate Board approved the development of a joint Workplace
Health and Wellbeing Pilot, with the then PCT, using the Workplace Charter framework.
In July 14, the Board agreed to rollout the programme across the Council.
Aim
Prevention and Health Improvement via:
• Onsite health check opportunities ; Promote and support healthy lifestyle choices
• Easier access to local lifestyle services; Support local businesses with achieving
Workplace Wellbeing Charter
Method
3 Pilot sites used had:
o
Geographical dispersed workforce across the borough
o
Predominance of Male or Female workforce
o
Sedentary and Physically demanding roles
o
Mix of part time and full time workers
• Mix of virtual and hard copy communication needs
• Use of manual and on line Health Needs Questionnaire
• New, Innovative DIY Health Checker on site machine to measure physical health
• Train Workplace Wellbeing Champions
• Developing Data set for programme evaluation
• Providing on site access to established public health services
Results
Pilot:
• Up to 35% return rate for Health Need Questionnaires
• 14 Champions trained
• Up to 47% staff engagement in on site physical health checks
• 17 people supported in one pilot area on site stop smoking sessions
Early data identified priority areas for health interventions relating to:
high levels of body fat; elevated risk in Visceral fat levels; elevated risk in blood pressure
results
First quarter since rollout:
• 9 events held; 1041 staff taken a health check; 42 staff accessed stop smoking service
• 385 staff had mini vascular checks; • 73 staff had full NHS checks
Conclusions
Pilot site results showed positive health outcomes both for physical and mental health.
Sickness in the pilot areas either fell or increased at a much reduced rate. Comments
from staff in the first quarter of the roll out of the health checks have been universally
popular. Attendance at 5 ways to wellbeing courses has increased so courses are now
fully booked. It is too early in the rollout of the project to say whether the positive
results achieved in the pilot will be replicated, but first quarter data bodes well.
Learning
Outcomes
Colleagues will see evidence of a positive impact of a workplace wellbeing project as a
result of joint working by the Office of Public Health and the Human Resources Division.
The success of the pilot provided a solid business case to support the investment of time
in continued joint working to roll out a workplace wellbeing project accross the Council.
Other Presenter
Jackson K.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster72
Creating a compelling narrative: How bespoke JSNAs enable practice to
understand their local population and effect a positive health change
Abstract topic & Other
Submitted By
Onyia, I M
Halton Borough Council
Background
JSNA look at the health and care needs of local populations to inform planning and
commissioning of their health and care services. Bespoke general practice level reports
enable a focus on local activity to improve health and reduce inequalities
Aim
Translate into clear evidence for action a range of locally available data to influence
decision making in general practice
Method
Joint Strategic Needs Assessment (JSNA) produced on a practice size footprint are shared
with general practices to provide an overview of key areas of need for the practice
population. The document includes a summary of intelligence on screening,
immunisation, CVD, COPD, obesity, alcohol, smoking, breast feeding uptake and A&E
admissions for individual practices. Ward health, economic, academic and crime
indicators are included. A separate pack summarises intelligence for all practices Results
from local as well as national averages and targets are included for comparison
Results
• Personalised recommendations made to each practice
• Accurate and timely information for better patient care and target management
• Outstanding numbers to achieve set standards and targets provided
• Practices focus activity on areas of prevention
• Positive feedback on packs - from practice managers, GPs and practice nurses
• Healthy competition develops to improve health outcomes
• Inspired by the packs a practice ran competition among receptionists to increase
HealthChecks invites
• Packs are informing development of primary care groupings
• Directory of services enclosed for GP referral
Conclusions
The “Practice JSNAs” have proved so popular with practices and CCG that they are
renewed annually with planning underway to create similar intelligence based on the
population of emerging primary care groupings. The JSNA packs have enabled practices
to find areas of common purpose and motivated practice managers to increase uptake of
a range of public health interventions.
The national GP Practice Profiles provide good general detail, the JSNA localise the
content and provide interpretation of the data and advise on the actions needed to
respond to the story the data tells
Learning
Outcomes
Accurate intelligence is at the heart of improvement for the population; General Practice
is under growing multiple opposing demands. Data is poured in continuously and a range
of practice staff access this. Bringing together key information and interpreting what this
means at a practice level and then providing peer, local and national comparators
encourages a focus on improving local health
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Other Presenter
Poster Title
Poster73
Application and limitations of epidemiological analysis in planning access
to specialised cardiology services
Abstract topic & Other
Submitted By
Lambert, M
Public Health England, Tyne & Wear
Background
Cardiac Resynchronisation Therapy (CRT) devices can improve quality and length of life
for some people with heart failure. Implantation in England has grown more than fourfold in ten years to exceed 8,000 of these costly devices in 2013/14.
Aim
To quantify the prevalent population with an indication for CRT under NICE guidance (TA
314, 2014), which extends eligibility for these devices, and compare this to prior
experience of implementing guidance on complex devices.
Method
Eligible populations were quantified by identifying relevant clinical characteristics of left
ventricular function (LVEF ≤35%), QRS duration (≥120ms) on the ECG and heart failure
symptoms (New York Heart Association classification) in both published epidemiological
studies and monitoring of the Quality and Outcome Framework in the national GP
contract.
This was compared with uptake of previous NICE guidance on Implantable Cardiac
Defibrillators (NICE 2001, 2006) and CRT (NICE 2007) using data from published national
audit (NICOR).
Results
Calculations from literature-based and contractual sources gave estimates of the
prevalence of CRT indications in England between 39-43,000 symptomatic individuals.
The precision of this estimate is limited by the incomplete correlation between clinical
characteristics in the sources and NICE guidance.
8852 CRT devices were implanted in the UK in 2013 (NICOR 2014) but there are no
reliable estimates of the prevalence of patients with previous CRT device implantation.
Publication of previous NICE guidance in 2001 and 2006 did not result in step changes in
implantation rates of devices.
Conclusions
Estimating the prevalence of patients with CRT indications is possible using existing
sources. The pool of eligible patients is large compared to current implantation rates.
Even small changes in referral patterns could place considerable demands on services.
Experience from implementing NICE device guidance suggests that only a small
proportion of patients with CRT indications will receive this therapy.
NICE guidance that widens eligibility and reduces diagnostic requirements is likely to
increase demand for CRT implantation. The magnitude of that increase remains
uncertain.
Learning
Outcomes
This work demonstrates the usefulness of epidemiological measurement in health
service planning and highlights the limitations of this methodology when estimating
demand for services. The example of CRT shows the uncertainty inherent in demand for
a technology with a high prevalence of indications compared to low historic implantation
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
rates.
Other
Presenters
Plummer, C
Poster Title
Poster74
New Communities in Bradford: Assessing need to inform a proactive and
strategic multi-agency response.
Abstract topic & Other
Submitted By
Ingold, K.
Background
Bradford Council is responding reactively to increased need for services for Central and
Eastern European migrants. A robust assessment of need was required to inform a
proactive and strategic response to this demographic change.
Aim
To produce a robust, accurate and up to date assessment of the needs of Bradford
District’s CEE communities, to inform proactive health and social care planning.
Method
• A literature review, structured using Dahglren and Whitehead’s factors influencing
health, with additional categories of poverty and assets.
•An epidemiological needs assessment, describing the demographics of Bradford’s CEE
community, their health status, service mapping and an assessment of how services are
used by CEE communities.
• A corporate needs assessment, based on two Masters level dissertations undertaken in
Bradford focusing on the views of service providers, alongside perspectives of CEE
community members gathered through involvement events.
Results
There are at least 12,000 CEE individuals, and 6,000 Roma living in Bradford District. This
is likely to be an under estimate. 3.2% of the school population are CEE as are 2.0% of
people included on the electoral register. There are a significant and rising number of
CEE migrants who are no longer entitled to housing benefit. CEE migrants are
disproportionately sanctioned from Jobseekers Allowance. CEE migrants are not a
homogenous group, some face few problems and others are open to exploitation from
rogue landlords, exploitation in the grey economy and unscrupulous employers.
Conclusions
The assets of CEE communities in Bradford should be built upon. We should ensure
migrant families are aware of their responsibilities and entitlements; all staff have
information to plan and provide services in a culturally sensitive way and services work
together to provide a joined up and holistic response to the needs of CEE families and
individuals. New needs are emerging. There is growing need against a backdrop of
reducing resources. A district-wide policy response agreed between partners is
imperative.
Learning
Outcomes
Gain an understanding of both existing and new emerging needs in a growing minority
population. Gain an understanding of the need for culturally competent service delivery
and the growing demand. Understand the need for a district-wide strategic response to
a changing population, integrated between and across partnerships.
Other
McCullough, B.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Presenters
Brierley, S.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster75
Measuring the impact of Stop Smoking Services (SSS) on reducing health
inequalities in County Durham.
Abstract topic & Other
Submitted By
Woodall, D
Durham County Council
Background
In areas of high deprivation smoking prevalence is higher. Stop Smoking Services should
ensure that rates of those accessing and quitting are higher from more deprived areas of
County Durham. This will contribute to reducing health inequalities.
Aim
To use the Health Equity Audit (HEA) cycle to identify if Stop Smoking Services are
distributed relative to the deprivation levels across County Durham.
Method
Data was taken from Quitmanager (a web based patient data management system).
23,350 records were used. Analysis was conducted to create directly age standardised
rates for access and quit by middle super output area (MSOA). The Slope Index and
Relative Index of Inequality (Sii and Rii) were used to establish the gap between the least
and most deprived areas, for both access and quit, across all MSOAs. Data analysed to
selected geographies, by the three main SSS providers and analysis of pregnant smokers
referred to the SSS. A direct comparison was made of this HEA with one conducted in
2007.
Results
Rates accessing and quitting are higher in the more deprived areas across the county.
This was consistent for the selected geographies and the three main SSS providers. The
2007 HEA showed the gap between the Rii for access and quit was -69. In the 2014 HEA
the gap was -16. In pregnant smokers the conversion from referral to access was
negative (change in Rii of -83). From access to quit this change was positive (+34).
Conclusions
The 2014 HEA shows there is a higher rate of people accessing and quitting through the
SSS in the more deprived areas. All 3 of the main providers that deliver the service have
higher rates of access and quitters in the more deprived MSOAs. For pregnant smokers,
once they enter the service the quit rate is higher in more deprived areas. Compared to
the results of the 2007 HEA there has been an increase in the Rii for access and quit rates
as well as a reduction in the difference between the two. This demonstrates that the
County Durham SSS is contributing to a reduction in health inequalities.
Learning
Outcomes
When commissioning services to improve Public Health outcomes, it is important to
utilise recognised tools to support service delivery and review. The HEA specifically
demonstrates if resources are distributed relative to need and contribute to reducing
health inequalities and inequities in the provision of appropriate services.
Other
Presenters
Roe, K
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster76
“It made me realise how important the work that I am doing is.” Research
and practice meetings as vehicles for co-production and knowledge
exchange
Abstract topic & Other
Submitted By
Cheetham M
FUSE
Background
Fuse, the Centre for Translational Research in Public Health, brings stakeholders together
to share findings from research, policy and practice through research meetings. This
poster explores the legacy of these events for collaborative working.
Aim
Our aim is to present findings on what makes a single event develop into a long term
working relationship between practitioners, policy makers and academics, to develop a
virtuous circle that allows research and practice to inform each other.
Method
Collation of information from a range of sources: Anecdotal feedback from practice
partners during and after events, about follow up activity
Audit of:
• Follow up work attributable to the event itself, including sequel events, networks and
changes in commissioning, policy and practice
• New or improved working relationships, evidenced in a preference for working with
Fuse as an academic and research partner
• Subsequent invitations to expert speakers, invited first to a Fuse event
•Enquiries made to AskFuse, the Fuse responsive and research evaluation service for
public health
Results
Exemplars are given, e.g. a meeting on young people and sexual health led to:
• A seminar on achievements and challenges of work on teenage pregnancy
• Events to scope service provision and areas for improvement
• A Council-led workshop to update the evidence base and consider young parents
within the wider children’s agenda
•Targeted PHE expertise to support areas aiming to improve
• Forming a sexual health research and practice network
Conclusions
Developing one-off events into productive long term relationships between practitioners
and academics entails:
• Working with practitioners to plan events; Bringing together academics and
practitioners committed to knowledge exchange as speakers; Ensuring a diverse multisector audience
•Ensuring participants share skills, knowledge and expertise with one another
• Encouraging robust debate
Learning
Outcomes
• Better understanding of building co-production, integrating research and practice and
the value academics and practitioners working together to improve events’ quality,
relevance and build relationships, awareness of the outcome types flowing from event(s)
• Recognition of this as a long term metho & making of links between ‘knowledge
exchange’ and potential practical service improvements.
Other Presenters
McNaughton R; Rushmer R; Shucksmith J; Van Der Graaf P
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster77
Delaying parenthood in looked after children (LAC) in Warwickshire
Abstract topic & Other
Submitted By
Mousoulis, C
Background
The topic of LAC and teenage pregnancy has been chosen because there are high levels
of teenage pregnancy in this population and if action is taken to reduce these levels,
both LAC and their children will benefit.
Aim
Children of care leavers frequently go into care and an objective of this project is to
understand how to break this cycle.
The aim of the needs assessment is to find the causes of early pregnancies and ways to
delay them.
Method
A literature review was completed which formed the basis of the discussion with
professionals as part of two focus groups.
The focus groups of professionals were held at Warwickshire County council (June and
September 2014).
Professionals that attended the focus groups worked in the following areas: social
workers, dedicated nurses for LAC, support for foster carers, leaving care managers,
sexual health experts (not specific to LAC), birth family support - Adoption services, and
personal advisors – leaving care.
Results
The reasons why LAC have an early pregnancy are summarised below:
Positive: wanting to be loved, to prove themselves, wanting to belong, it makes them
adults, to attract attention, it is seen as a sign of masculinity to father a child, want to do
better than their parents.
Negative: failure of forward planning (this does not apply to looked after children only),
failure to say ‘no’, lack of knowledge of contraception (unprotected sex without
awareness of the consequences), from sexual abuse, low self esteem, can be used to
speed up process, of being able to do what they want.
Conclusions
The focus of this work is to delay parenthood in LAC, even if it is only for 6-12 months. An
early pregnancy is less likely to have positive outcomes for the mother, father and the
baby. The longer they leave it, the more resources they will have for the child.
This could be achieved by: building LAC self-esteem from an early age, encourage them
to have aspirations in life, through relationship and sex education, training foster carers,
working on health promotion activities, and helping LAC who have become pregnant.
Learning
Outcomes
The audience will get informed about our work and reflect on a topic that is of major
public health importance. Public Health practitioners could do similar projects in their
area or apply recommendations based on our results.
Other
Presenters
Robinson, R
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster78
An evaluation of the establishment of multidisciplinary higher specialist
public health training in the UK, 1999-2014
Abstract topic & Other
Submitted By
Ferguson, K
London Borough of Redbridge
Background
Public health has always been a multidisciplinary endeavour and yet the specialist public
health workforce was historically dominated by medicine, with other staff in support
roles with few training opportunities or formal recognition of their professiona
Aim
Opening the training scheme to public health professionals from non-medical
backgrounds changed the shape of the senior public health workforce. This study
evaluates how it happened and assesses its impact.
Method
This study examines the historical and policy context to the changes. It reviews published
and grey literature, including public health workforce policy documents and two Witness
Seminars; uses archival research, principally from committee papers held by the Faculty
of Public Health (FPH); provides data on the profile of specialist registrars in training and
new recruits, complied through correspondence with Training Programme Directors,
individual Deaneries, the UK Public Health Register (UKPHR) and the FPH; and
incorporates six semi-structured interviews with key individuals involved in the
development of multidisciplinary public health training to fill gaps in the archival records.
Results
The development of an integrated multidisciplinary model of public health training took
over ten years. It was achieved through the combined efforts of key multidisciplinary
public health advocates, Training Programme Directors, the FPH, the Department of
Health, the UKPHR and trainees themselves, in the face of significant barriers. The result
is that in the UK we have gone from the position of having no specialist training
opportunities for graduates from backgrounds other than medicine to a position today
where there is an almost even split between medical and non-medical recruits to public
health training.
Conclusions
The UK multidisciplinary training model has helped to break the glass ceiling in public
health careers and has had a strong impact on the composition and rich contribution of
public health specialists in the workplace. This has been achieved with no perceived fall
in standards. Indeed, public health entry is highly competitive for doctors and those from
other backgrounds with annually around 700 people competing for 70 places nationally.
Although this achievement has been recognised within the wider literature on the
history of multidisciplinary public health and policy, this study for the first time provides
a history of how it came to be.
Learning
Outcomes
•
Understanding the stages involved in large-scale workforce changes through the
example of public health training
•
Recognition of the uniqueness of the UK training model
•
Reflection on the achievements in establishing multidisciplinary training and how
far opportunities for non-medics in public health have changed since 1999
Other
Presenters
None
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster79
Evaluation of Candidate Perceptions of Participating in National Public
Health Recruitment
Abstract topic & Other
Submitted By
Ebberson, C
Background
Recruitment for public health specialty training is run nationally, consisting of an
assessment centre and a selection centre. Candidates must pass the assessment centre
to be eligible to attend the selection centre.
Aim
The aim of this project was to evaluate the recruitment process from the perspective of
the candidates. This will allow the process to be refined and improved if necessary for
following years.
Method
Once candidates completed the selection centre, they were encouraged to complete a
written feedback form regarding the process. The feedback form was arranged in three
sections, covering the individual components of the selection centre, the candidates’
perceptions of the whole selection process and the candidates’ perceptions of the
selection centre process itself.
The form included free text comments in addition to questions with Likert scale
responses.
Data was extracted from the feedback forms and analysed. Descriptive summaries were
produced and free text comments were grouped into themes.
Results
97% of selection centre candidates completed a feedback form. The majority agreed that
the overall process was fair and were satisfied with it.
The majority of the questions regarding the overall process received positive responses.
Those relating to how well the process allowed candidates to show their skills and
abilities were scored lower and were replicated in the section relating to the individual
components.
The three themes which emerged from the free text comments were related to the
logistics of the day, the perceived fairness of the process and the information that was
provided prior to the day.
Conclusions
The high response rate suggests that the feedback received from candidates is
representative of the 2014 recruitment cohort. The selection centre evaluated well
overall. Candidates were particularly complimentary about the cohort managers who
guided them through the selection centre process.
While candidates felt that the activities were fair and related to public health, they did
not see the connection between the task and the relevance to the role of a public health
consultant. Therefore, explicitly communicating the relevance of the components to
candidates may improve overall satisfaction.
Learning
Outcomes
•
Increased understanding of the national process for Public Health Specialty
Registrar recruitment
•
Increased awareness of the importance of collecting candidate feedback during
recruitment and the value of providing clear information about the recruitment process
to candidates
Other Presenters
Parkes, J (on behalf of Recruitment Executive Group); Chatt, C; Crick, J
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster80
Smile 4 Life oral health promotion pilot in Derby
Abstract topic & Manifesto - A good start
Submitted By
Burgess-Allen, J
Millward, K, Derby City Council
Background
Tooth decay is the most common oral disease affecting children and is largely
preventable. Children from poor socio-economic areas are less likely to own a
toothbrush or to brush regularly, and consume more sugar.
Aim
Smile 4 Life is a preventive programme designed to help young children in the most
deprived quintile of Derby develop positive oral health skills for life.
Method
The evaluation of the Smile4Life pilot has adopted a 'Theory of Planned Behaviour'
approach, and comprises:
- Surveying children’s teeth for decayed-missing-filled teeth (dmft) and cleanliness at the
beginning of the programme and at the end
- parent questionnaire re child’s dental visits, tooth-brushing behaviours, dietary
behaviour, and behavioural determinants (knowledge/attitudes, social norms, perceived
behavioural control)
- Process evaluation using nursery / school staff survey
Results
Of 338 children at baseline:
48% required treatment from a dentist (compared to national level of 28%)
47% had no dentist
Mean dmft of 2.87 (compared to 0.94 for England)
175 parents completed baseline questionnaires. Key findings:
38% said their child had not yet been to the dentist
19% felt there was no need for their child to visit the dentist
Over half of respondent said their child brushes their teeth less than the
recommended two times per day
15% agreed that ‘No matter what I do, my child is likely to get tooth decay’
60% respondents said they give their child a sugary snack or drink after school
Conclusions
The pilot has identified high levels of poor oral health in nursery and reception children
in parts of Derby.
The pilot raised issues locally around the potential impact of poor oral health on health
inequalities and school readiness, safeguarding, cultural issues, poor knowledge and
behaviours around oral health and access to care.
In response:
more funding has been made available to local dentists so they can register more
patients.
Additional safeguarding arrangements have been put in place as a result of the
project to share information between healthcare professionals.
Learning
Outcomes
The poster will:
Highlight the importance of children's oral health as a Public Health issue
Share an innovative project model for the promotion of good oral health in
nurseries and reception
Share the evaluation approach used for this health promotion project
Share key findings from the evaluation and recommendations for further
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
improving oral health and reducing local oral health inequalities
Poster Title
Poster81
Creating resilience and reducing vulernability in respite care
Abstract topic & Manifesto - National action to tackle a
Submitted By
global problem
Prof Susan M Carr
Faculty of Health & Life Sciences &
Fuse
Background
Sustaining a care system to meet the requirements of an ageing population with
complex needs is an urgent public health challenge. The potential for informal carers to
experience health inequalities is significant. Building models of support for informal
carers is an essential component.
Aim
Respite care, in its multiple guises, is a cornerstone of informal care giving. This research
seeks to better understand the concept of respite care, exploring what it means for users
and carers? Specifically, it seeks to expose alternatives to the dominant carer burden
model.
Method
Design was driven by the theoretical underpinnings of learning from the experiences of
service users and carers, embracing principles of critical practice and learning through
relational endeavour. Qualitative, interpretive methods were used to capture
experiences of respite care in a hospice setting. Data collection was carried out by
unstructured informal interview with three couples and two bereaved carers who had
experienced hospice respite care. The participants were interviewed on two occasions
and social network circle activity was undertaken as part of theoretical sampling.
Results
Results showed that respite care was valued by service users and carers although there
are some fundamental tensions in service models which limit its potential. A theory of
vulnerability and resilience was developed which accommodated issues of needs and
acceptance, choice and risk, loss and gains. The importance of the dynamics of the
caring relationship and the importance of recognising and assessing the impact of
respite care on the continuity of that relationship was highlighted. Different approaches
to respite care can positively create resilience or negatively increase vulnerability.
Conclusions
The centrality of the carer:cared for relationship must be recognised in models of
respite care. Caring creates a relationship fragility relationship making it vulernbale to
fracture when put under stress. Resilience in the caring relationship can also, most
importantly, be strengthened with the right care and support.
The articulation of respite care needs and the insights gained in this study have
the potential to influence practice and provide a platform for innovative service
development and improvement across a range of need trajectories.
Learning
Outcomes
To appreciate that the burden of care model may not best fit the support and
sustainacne of informal care
To understand how resilience and vulnerability can be influenced.
To comprehend the centrality of the carer:cared for relationship must be recognised in
models of respite care.
Other
Presenters
Carr S M
Wolkowski A M
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster No 82
How can more pregnant women be supported to stop smoking? Evaluating the
implementation of a stop smoking initiative across the north east of England.
Abstract topic & Manifesto – A Good Start
Submitted By
Susan Jones
FUSE
Background
Mothers who continue to smoke during pregnancy increase the risk of adverse outcomes
for themselves and their baby. NICE: Public Health guidance 26 (2010) reflected the
need for additional support for women smoking during pregnancy to quit.
Aim
To evaluate whether a novel intervention (babyClear©) improves the effectiveness of
smoking cessation messages to pregnant smokers using a “tough love” approach and
promoting greater integration between stop smoking and maternity services.
Method
To evaluate whether a novel intervention (babyClear©) improves the effectiveness of
smoking cessation messages to pregnant smokers using a “tough love” approach and
promoting greater integration between stop smoking and maternity services.
Results
A qualitative methodology was used including observation of training sessions,
interviews with pregnant women, trainers, maternity and stop smoking service staff
(n=115). Question schedules were based on Normalisation Process Theory (May & Finch,
2009).
A conceptual framework was used (Ritchie et al, 2003). Within themes, case-ordered
matrices were used to enable examination of differences across cases (Miles &
Huberman, 1994). Themes were built into an explanatory model to demonstrate how
various factors might influence successful implementation of the intervention.
Conclusions
This paper will discuss to what extent the training and intervention model were
normalised in stop smoking and maternity staff practice. The factors that influenced the
ability of the host organisations to implement the intervention, maintain fidelity and
enhance the chances of sustainability, including aspects of organisational structures and
cultures will be explored. Identification of core elements of the model and examples of
good practice will be shared to promote effectiveness.
Learning
Outcomes
Although acceptability and fidelity were established across the region, this clearly
manualised intervention was implemented quite differently in each host organisation.
The natural experimental design highlighted the value of process evaluation. Core
elements of the babyClear© model were clearly identified. Motivation and prioritisation
were essential. When developing, evaluating and implementing complex interventions, it
may be critical to use process evaluation to identify: core and peripheral aspects, how to
maintain fidelity whilst allowing for adaptation to local contexts/resources.
Other
presenters
Jones, S; Shucksmith, J; Hamilton, S.
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
Poster Title
Poster No 84
Sex is risky– so why not test?
Abstract topic & Manifesto - Help people live healthier lives
Submitted By
Munasinghe S
Background
In 2013, Norwich had an outbreak of syphilis among men who had sex with men (MSM),
and in the same year Norwich local authority area reported a HIV prevalence over 2 per
1000 population. Both these set the backdrop for the launch of a STI self-sampling p
Aim
•To increase the opportunity to test for HIV, Syphilis, Hepatitis B and C for MSM
•To raise awareness of the importance of regular testing for STIs
•To understand patients’ views on self-sampling testing experience
Method
Norfolk Public Health, LGBT project, and Sexual Health Promotion Unit and local GUM
clinic developed the care pathway for self-testing. Based on the local MSM figures we
decided to purchase 150 kits. Kits were made available through LGBT website and office
and also distributed across all gay venues in Norfolk. At these venues, men were offered
a test, with support from an LGBT worker, if required. The testing was carried out in
Manchester PHE laboratory and the results reported back to the SHPU, and, if
positive/reactive a local GUM service.Testing kits were promoted via Facebook, LGBT
website, SHPU and condom packs made up by LGBT Project and distributed via the gay
venues.
Results
Three months after implementation of this pilot, 93 kits were used. 42 test kits were
returned (45%). One reactive test result for syphilis was reported and this patient was
referred to the local GUM clinic. The demographic details were available for 48 clients
who accessed the kits through the website and at the LGBT office. Around 27% of the
clients had never tested for an STI before. Reasons given for not attending a GUM clinic
were due to fear of breach in confidentiality and access problems to the GUM clinics. A
third (35%) of the clients reported that they would be happy to take up a self sampling
test than attending a GUM clinic.
Conclusions
Availability of HIV, Syphilis, Hepatitis B and C self-sampling testing is a useful strategy to
target MSM in gay venues who do not routinely access local GUM services. This is a
feasible and acceptable option for most MSM and a major contribution to national HIV
testing strategy and local STI testing strategy. Given the occurrence of Syphilis outbreak
in Norfolk and the Norwich being a high prevalence area (>2 per 1000 population) for
HIV, it is appropriate for this self-samplingrvice to continue to be available for MSM in
future.
Learning
Outcomes
A proportion of MSM do not access main GUM services for STI testing
Alternative methods of STI testing should be available for people who are at high risk.
Self-sampling testing can contribute to national HIV testing strategy and local STI testing
strategy
Confidentiality is a key for people who access main GUM services and the services should
be accessible and widely promoted
Other
Howard N; Liew-Bedford F; Pereira A
23 – 24 JUNE 2015
FPH ANNUAL CONFERENCE – The Politics of Healthy Change
presenters
23 – 24 JUNE 2015