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HEALTH _ WELLBEING OVERVIEW AND SCRUTINY COMMITTEE

VIEWS: 11 PAGES: 12

									Item 4                                                                         Appendix A

                        BRIDGEND COUNTY BOROUGH COUNCIL

           HEALTH & WELLBEING OVERVIEW AND SCRUTINY COMMITTEE
                               11 May 2009

                REPORT OF THE CORPORATE DIRECTOR, WELLBEING


HEALTH, SOCIAL CARE AND WELLBEING STRATEGY

1.       Purpose of the Report

1.1      To present the Committee with information on the progress of the Health, Social
         Care and Wellbeing (HSCWB) Strategy 2008-11.

2.       Connections to Corporate Improvement Plan

2.1      The Corporate Improvement Plan 2008/11 contains the Authority’s corporate
         objectives, which in turn are directed by the priorities embedded in the
         Community Strategy.

        This report relates to the following aims of the Corporate Improvement Plan:
      o Achieve a healthier county borough by tackling health inequalities and promoting
        healthy lifestyles.
      o Have a more inclusive county borough where everyone is supported to maximize
        their potential and live life to the full.
      o Improve quality of life for all - to create a place where everyone can enjoy living,
        working and relaxing, and live life to the full.

2.2      The HSCWB strategy relates to and is a driver for important corporate priorities
         including the remodelling of Adult Social Care, and the development of an
         integrated sport and recreation strategy to reshape current provision in the
         County Borough.

2.3     The report relates to the following aims of the current Community Strategy:
      o To improve quality of life for all – to create a place where everyone can enjoy
        living, working and relaxing, and live life to the full.
      o To achieve a healthier County Borough by tackling health inequalities and
        promoting healthy lifestyles.
      o To have a more inclusive County Borough where vulnerable people and
        excluded people are supported to maximize their potential and live a full life.

2.4      The HSCWB partnership & strategy is currently contributing to the formation of
         the new community Strategy 2009 - 2013




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3.       Background

3.1      The Health, Social Care and Well-Being (HSCWB) Strategy 2008 -2011 was
         considered by the then Social Services and Housing Overview and Scrutiny
         Committee, on the 27th March 2008. At this meeting, representatives from the
         Health Social Care and Wellbeing Partnership were invited to discuss the
         Development of the new HSCWB Strategy and report on how the Partnership had
         consulted with citizens during the development phase.

3.2      Following consideration of the report and their discussions with Officers, the
         Committee expressed their wish that the future relevant Overview and Scrutiny
         Committee continue to be involved in the Health, Social Care and Well-being
         Strategy. Members agreed that the proposed action plan should be considered
         by the future Committee, which would either contain or be accompanied by,
         information on the following issues:

                Overall priorities
                Basis of prioritisation


4.       Current Situation

4.1      The Committee should be aware that during the financial year 2008/09 there has
         been considerable change in the personnel from Bridgend County Borough
         Council who have been involved with the Health Social Care & Wellbeing
         Agenda. The Partnership has also been without a Partnership Manager between
         October 2008 and March 2009. Therefore the Partnership did undertake a
         prioritisation exercise but did not finalise an action plan. Both the development of
         a performance Management Framework and an action plan for the Strategy are
         priorities within the work plan of the new Health Social Care and Well being
         Partnership Manager.

4.2      To identify the Health Social Care & Wellbeing Priorities the partnership
         undertook a Health Needs assessment. The detailed information that was
         collated and analysed included information from the following sources:

            The general population of the county borough including information from the
             census.
            Numbers of people registered with a doctor.
            The average age of death of people.
            The percentage of people who have health problems compared to the rest of
             Wales.
            The average numbers of people leaving school with recognised qualifications.
            The percentage of people working or claiming benefits.
            The numbers of people needing help with housing.


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            The percentage of areas within the county borough where there are groups of
             people who could be more socially disadvantaged.
            The percentage of people making lifestyle choices that could have a negative
             impact on health in the longer-term like smoking, drinking too much alcohol,
             taking drugs, over-eating or not eating enough fruit and vegetables or not
             taking any exercise.
            Environmental issues that could have an impact on health like the quality of
             the air we breathe and the county borough’s record on recycling.
            Safety matters like higher-level road traffic accidents and lower than average
             reported crime.

4.3      In addition to the Health Needs Assessment a comprehensive Public and Stake
         holder consultation exercise was undertaken. The consultation was aimed at
         maximising both awareness and opportunities for stakeholders and the public to
         provide their views. The consultation process included engaging with the
         following:

            LHB, ABMU Trust, BAVO, BCBC Directorates
            Operational / Service staff
            A number of partnership community groups facilitated by BAVO
            Targeted hard to reach groups facilitated by BAVO
            Formal Media release to general public
            Public Consultation event which over 250 people attended
            Community First Partnerships

         The engagement and consultation process has been identified as an example of
         best practice by the Welsh Assembly Government. With regard to the HSCWB
         priorities the consultation process reinforced the finding of the Needs
         Assessment.

         Resources

4.4      As with the previous strategy, the HSCWB Partnership will achieve the aims of
         this strategy through service re-modelling within the existing health, social care
         and wellbeing services. The Partnership will continue to develop integrated
         systems of working as a means of improving services.

         The Local Health Board exercises its statutory responsibility for the
         commissioning of health care services. The base line budgets for the LHB are:

                                                                    £m
              Primary Care Services                                62.5
              Secondary Care Services                              126.2
              Continuing / NHS Funding Care                         7.8
              Other - Voluntary Sector, Local Authority etc         1.6
              Total                                                198.1


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         Bridgend County Borough Council also commission or provides a range of
         services that assist the implementation of the Strategy through services that are
         designed to promote independence. These services include the Well-being and
         Regeneration services. The gross and net budgets for these services are outlined
         in the table below.

         Adult Social Care and Healthy Living Services
                          Gross Budget £m Grants £m                   Net Budget £m
          Adult Social 39.7                  - 6.6                    33.1
          Care
          Healthy Living 12.0                -1.1                     10.9
          / Leisure
          Total     Well- 51.7               - 7.7                    44.0
          being
          Directorate

         Regeneration Services
          Service Area                 Net Budget
          Community Safety             £88,000
          Housing & Homelessness £976,000
          Physical Regeneration        £349,000
          Economic Development         £486,000
         (All Figures taken from the 2008-2011 HSCWB strategy)

4.5      Considerable progress has been made in implementing the HSCWB Strategy
         during 2008/09 as the rest of this paper will demonstrate.

4.6      The Health Social Care and Wellbeing strategy was published in April 2008. The
         HSCWB strategy is one of four high level partnership strategies.

                                 Community
                                  Strategy




             Community          Health Social         Children &
             Safety Plan           Care &               Young
                                 Wellbeing           People’s Plan
                                  Strategy


4.7      The Health & Wellbeing Overview and Scrutiny Committee have requested an
         opportunity to examine the progress that has been made with the HSCWB
         strategy during the financial year 2008/09. A number of invitees The Cabinet
         Member – Wellbeing, The Director of Wellbeing, the Head of Service – Healthy

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         Living (BCBC), the HSCWB Partnership Manager (BCBC & LHB), the Partnership
         Development Manager (ABMU NHS Trust), the Director of BAVO and the Director
         of Healthy Improvement and Performance (LHB) have been asked to attend to
         answer questions on the Strategy rather than general questions on the provision
         of health services within the County Borough. Each agency has its own
         governance and scrutiny arrangements for service delivery and it is not within the
         remit of the Health and Well-Being Partnership to override these statutory
         responsibilities.


4.8      This plan for 2008-11 is the second Strategy of its kind to be produced using a
         health needs assessment process to consider what the priorities should be for
         service planning for the next three years. The HSCWB Partnership recognises
         that partners are unable to improve all aspects of health and wellbeing over a
         three year period and have therefore chosen to target areas for improvement
         where particular vulnerability exists within the local population at the present time.
         Specifically the Health Needs Assessment process indicated that the Health &
         Wellbeing Partnership should focus its attention over the next three years on the
         following priorities:

         o   Increasing physical activity and improving nutrition.
         o   Chronic disease prevention and management.
         o   Improving mental health and emotional well-being.
         o   Tackling alcohol misuse.

4.9      Significant progress has been made on all of the priority areas in the last year
         and the following section of this report will highlight key areas of progress and
         examples of current good practice.

         Improving Healthy Living - Increasing physical activity and improving
         nutrition

         Development of the Food & nutrition Action Plan

4.10     This has been prepared by the Bridgend Local Public Health Team, and has been
         the subject of wide consultation. It will be formally launched in April 2009. It looks
         at food in terms of production, retailing, consumption and distribution.

         Development of the Local Authority Physical Activity Agreement (LAPA)

4.11     The Local Authority Partnership Agreement is between BCBC Sport & Physical
         Activity Service and Sports Council for Wales. The LAPA focuses on increasing
         physical activity rates through a wide range of community sporting and physical
         activity opportunities both formal and informal. The agreement is delivering
         projects across the County Borough and being delivered by a wide range of
         partners.


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Item 4                                                                            Appendix A

         Access to Leisure

4.12     This project which was initially partially funded by the Local Health Board aims to
         improve access to services (indoor leisure facilities - leisure centres’ and pools),
         for those in the community who are most financially vulnerable. The project
         virtually removes cost as a barrier for citizens when participating in services.
         Eligible residents are offered significantly reduced costs to access facilities for
         them, their partner and their Children at the cost of £1 per family. Before the
         scheme commenced there were only 35 people registered with the service paying
         a 50% discounted rate, 9 months after introducing the scheme the number stood
         at circa 3000 members.

         Development and piloting of the Joint Impact Screening Tool

4.13     The impact screening tool has been developed to cover sustainability, equality,
         community safety, and health issues. It has been used on the Health, Social
         Care, and Well Being Strategy, regeneration Strategy, and the Information
         Technology Strategy. Other policies and programmes will be subject to
         assessments. The assessments have taken the form of stakeholder workshops.
         The impact screening tool can be used to highlight the need for full health
         impacts assessment and other assessments.

         Development & Launch of the Health Challenge Bridgend Website

4.14     The website has been prepared and is now being put on the Bridgend CBC IT
         network. It contains information on healthy living, the determinants of health, and
         also a dairy of local activities. It also interacts with other websites such as Health
         Challenge Wales. The content of the website will be developed and expanded
         with the support of our partners. A Welsh version of the website will be completed
         during 2009/10.

         Healthy Schools Scheme

4.15     All 73 schools have been recruited to the Bridgend Healthy Schools Scheme (The
         Welsh Assembly Government’s target is for all state schools to be part of the
         scheme by 2010).

         The Development and Launch of the Health Improvement / Determinants
         Pack

4.16     The pack has been prepared by staff from Bridgend CBC. NPHS, BAVO, and
         Bridgend Care and Repair. It has been launched through a series of workshops.
         These have been done for Bridgend CBC staff, partner organisations, and for
         Communities First Staff. We have been in discussion with BAVO to launch it in
         the voluntary sector.

         Launch of Health Challenge Bridgend May 2008


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Item 4                                                                         Appendix A

4.17     This was a launch for people working in organizations (voluntary, private, and
         statutory), and also an opportunity to identify ways of taking health challenge
         forward and to identify current activity. This was organised by Bridgend CBC and
         Bridgend NPHS team.

         Newsletter

4.18     A regular newsletter for people working in organizations is prepared and
         circulated on a regular basis. It brings together information on local and national
         events. It also provides some information on evidence based practice.

         Housing Needs Assessment

4.19     Work has been completed on ensuring that health issues are addressed in the
         housing needs assessment, both in terms of highlighting needs of people with
         disabilities and long term health problems, but also ensuring that housing
         promotes health.

         Healthy Living Week

4.20     Bridgend CBC contributed to National Healthy Living Week by encouraging staff
         to identify a personal health challenge, e.g., doing more exercise. The winning
         entry won a prize.

         Regeneration Activity

4.21     Work has been carried out to ensure the health dimension is reflected in
         regeneration bids, such as the Western valley’s regeneration. The basic
         approach has been to ensure that all projects have a health dimension.


         Reducing Alcohol Misuse

         Additional treatment places in the Community Drug and Alcohol Team

4.22     An additional health care support worker post was been created who will carry a
         mixed case load including alcohol clients.

         A hospital liaison worker

4.23     To support clients whose drug or alcohol problem might only come to light when
         they are in hospital, for example people who are admitted for surgery who require
         alcohol detoxification.

         Binge drinking group work

4.24     Funding has been given for the delivery of binge drinking groups within
         WGCADA, including groups targeting young people.

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Item 4                                                                         Appendix A



         Binge drinking referral project

4.25     Home Office funding was secured to recruit a fixed-term referral worker, based
         within the police cells to provide advice, support for people arrested due to binge
         drinking.

         Training for front line workers

4.26     Alcohol awareness training has been delivered to front line workers, including
         Street Pastors, Police Officers, youth workers and community members in dealing
         with alcohol misuse.

         An additional alcohol counsellor in Ogwr DASH

4.27     Bridgend SMAT used additional non-recurring WAG funding to recruit a
         counsellor working with alcohol clients in Ogwr DASH.

         An additional worker within the Community Drug and Alcohol Team

4.28     Non-recurring monies were used to recruit a nurse tasked with reducing the
         waiting list for alcohol clients.

         Christmas alcohol campaign

4.29     A campaign linking prevention messages with work to stifle the illegal availability
         of alcohol to children and young people ran over the Christmas period.

         Chronic disease prevention and management

         Lifestyle Directory
4.30     A community lifestyle directory has been developed. The directory of community
         activities and resources can be accessed by local people on the NHS Direct
         Website. The research to develop the website is being carried out within the
         voluntary sector specifically Bridgend Association of Voluntary Organisations,
         with support by the LHB Communications Officer.

         Lifestyle Coaches

4.31     The placing of Lifestyle coaches in two general medical practices in the county
         borough (Oak tree and Llynfi/ Riversdale practices). The lifestyle coaches will
         work with the individual client to identify their own personal interests, hopes,
         problems etc and then to agree with them a personal plan to manage their life
         actively, making use of the resources which are available in the community.

         GP referrals



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Item 4                                                                           Appendix A

4.32     GPs and other health professionals are now able to refer patients at risk of
         chronic disease to a structured exercise programme that will help them to
         improve their health. This project, developed jointly with local Health partners
         and Bridgend County Borough Council has seen Bridgend achieving the most
         referrals in Wales.

         Chronic Obstructive Pulmonary Disorder (COPD) Rehabilitation Programme

4.33     Bridgend County Borough Council, Abertawe Bro Morgannwg University NHS
         Trust and the Local Health Board are now able to offer patients with Chronic
         Obstructive Pulmonary Disorder (COPD) access to a Community Based
         Rehabilitation programme. Instead of having to go into hospital, patients are
         offered a seven week rehabilitation programme at three leisure sites across
         Bridgend. Those who successfully complete the programme can go on to receive
         a further 16 weeks of support via the GP referral programme.

         Community Integrated Intermediate Services

4.34     During 2008 /09 the new model for Community Integrated Intermediate Services
         was agreed and has begun to be implemented across Bridgend.


         Chronic Conditions Management Local Delivery Plan

4.35     During 2008 /09 a Chronic Conditions Management Local Delivery Plan has been
         developed this is a high level delivery plan that has been produced for all of the
         areas covered by the ABM Health Community. The document sets a visions for
         how this agenda is to be taken forward over the next two years but also is flexible
         enough to reflect the different local arrangements that each of the different areas
         have established.


         Mental & Emotional Wellbeing

         Improving Futures

4.36     This important strategy and action plan is a partnership approach towards the
         reduction and prevention of suicide and self harming behaviour across Bridgend
         and Neath Port Talbot County Boroughs and was launched in May 2008. The
         implementation action plan is in place, and is to be delivered through the local
         strategic planning teams in Bridgend, reporting to the Health Social care and
         Well-being Partnership Board on Behalf of the LSB.

         Siaradwn Ni ‘Lets talk’

4.37     In late 2008 a £1million, five year Big Lottery fund bid, Siaradwn Ni ‘Lets talk’ was
         approved. The aim of the grant is to increase public awareness about mental
         health issues, resulting in mental ill health being viewed more positively by the
                                              26
Item 4                                                                             Appendix A

         public, therefore resulting in reduced stigma, resulting in earlier intervention and
         signposting to appropriate services. The bid includes an anti-stigma campaign
         and ASIST training (Applied Suicide Intervention Skills Training) amongst others.

         Developing Community Advocacy Service

4.38     The Joint Mental Health Strategy Planning Team has prioritised new
         development grant funding for 2009-10 for community advocacy service. The
         service will be delivered through an established local mental health voluntary
         organisation.

         Mental Health Day Service

4.39     Bridgend County Borough Council and Abertawe Bro Morgannwg University NHS
         Trust have created a shared budget for the creation of an Integrated Service
         Provision. The joint service is seeing real benefits for more service users and
         referrals to the service have doubled. In May 2008 the service received an NHS
         Wales Award – for ‘putting citizens at the centre of service design and delivery’

         Supported accommodation service developments

4.40     Core and Cluster Floating Support accommodation in Park Street and Maesteg
         came online in June 2008. The first discharge of a service user into their new
         home in the community from the Park Street base of the Core and Cluster
         Floating Support service was achieved in early February 2009.

         Mental Health Promotion

4.41     There continues to be ongoing Mental Health Promotion work in 2008/09 there
         was a successful awareness campaign held in October 2008 to promote World
         Mental health Day, and a local mental health promotion website, the website is
         now being linked to the Health Challenge Bridgend website

         Service User Engagement

4.42     During this year a Mental Health Service User and Carer post has been
         commissioned, which is being delivered through the voluntary sector with the aim
         of increasing the engagement and participation of Mental Health Service Users
         and Carers across the work of the Joint Mental Health planning team.

         Future Plans

4.43     The HSCWB Partnership believes that considerable progress has been made
         with all of the priorities identified within the Strategy. This is a strong partnership
         that is consistently delivering innovative and improved services for citizens. The
         partnership is not complacent and plans to develop the following action in the
         next year to further strengthen and improve Health Social Care and Wellbeing in
         Bridgend.
                                               27
Item 4                                                                               Appendix A



                 Develop a HSCWB Strategy Performance Management Framework
                 Continue to deliver the agreed actions identified for each priority area
                 Review and improve specific Health & Social care services
                 Develop the profile of the Strategy and its key themes with stakeholders
                  and citizens to support the implementation of the strategy
                 Further develop links with the other key partnerships to support the
                  implementation of the strategy
                 Develop Health Challenge Bridgend to drive the Health Improvement
                  Agenda

           Committee Considerations

4.44       In considering the HSCWB Strategy 2008-11, Members may wish to consider:

              how the vision, themes and priorities within the draft strategy address the
               health and well-being needs of the people in Bridgend County Borough;
              the progress made during the first year in regard to the four priorities identified
               within the strategy
              how other Directorates and Sections within the BCBC can contribute to the
               successful delivery of the strategy
              the partnership arrangements in place to implement and monitor the strategy.
              how citizens can remain engaged with the Health Social Care & Wellbeing
               Agenda.


5.         Effect upon Policy Framework & Procedure Rules

5.1        There is no impact on the Policy Framework and Procedure Rules.


6.         Legal Implications

6.1        There are no legal implications


7.         Financial Implications

7.1        There are no direct financial implications arising from this report. As indicated in
           paragraph 4.4 the HSCWB Strategy is being achieved within the resources
           available to the Partners.


8.         Recommendations

       The Committee is asked to consider the information contained within the report.


                                                 28
Item 4                                                                      Appendix A



         Contact Officer
         Peter Mannion
         Health Social Care and Wellbeing Partnership Manager
         Email: peter.mannion@bridgend.gov.uk

         Background Documents

        Bridgend Health Social Care and Wellbeing Strategy 2008 -2011
        Route to Health Improvement WLGA 2006
        Bridgend Corporate Improvement Plan 2008 -2011
        Designed to add Value – a third Dimension November 2008
        Improving Futures Strategy ‘a partnership approach towards reduction and
         prevention of self harming behaviour and suicide across Bridgend and Neath Port
         Talbot’ May 2008
        ABM Health Community Chronic Conditions Management Local Delivery Plan
         2009 2011




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