healthy life - gmhsc€¦ · bury 35.1% tameside 35.0% oldham 31.8% wigan 31.4% stockport 30.8%...

Value Trend* Gap Change** Value Trend* Gap Change**

Healthy Life

Expectancy

*From 2009-11 to 2011-13 **Change in gap compared to England (***HLE > England)

Greater Manchester

Trafford 63.27 months

65.711 months

Salford 58.812 months 16 months

57.914 months 13 months

Tameside 58.622 months 25 months


Rochdale 58.88 months 12 months


Oldham 59.312 months 8 months


Manchester 56.817 months 20 months


Stockport 65.813 months 17 months***

65.61 month 0 months***

Bury 61.614 months 11 months


Wigan 62.537 months 41 months


Bolton 62.22 months 1 month


4 months 10 months***

Value Trend* Gap Change** Value Trend* Gap Change**

Wigan 62.537 months 41 months


Barnsley 56.211 months 7 months


Rotherham 59.011 months 7 months


Wakefield 62.012 months 16 months


Tameside 58.622 months 25 months


England 63.9 63.3

Healthy Life

Expectancy

*From 2009-11 to 2011-13 **Reduction in gap compared to England

4 months 1 month

Statistical Neighbours

*Compared to England

Healthy Life

Expectancy

Up 18 months

in last 2 years.

Gap* down 17

months in last

2 years.

62.5Up 3 years in

last 2 years.

Gap* down

over 3 years

in last 2 years.

61.1


Cardiovascular

Mortality (under 75)

Down 25% in

last 5 years.

Gap* down

40% in last 5

years.

58.1/100,000

Down 27% in

last 5 years.

Gap* down

50% in last 5

years.

133.7/100,000


Cancer Mortality

(under 75)

Down 12% in

last 5 years.

Gap* down

42% in last 5

years.

137.8/100,000

Down 6% in

last 5 years.

Gap* up 12%

in last 5 years.

169.1/100,000


Suicide

(All ages)

Down 20% in

last 5 years.

Gap* down

73% in last 5

years.

Each suicide is a

tragedy. However as

the number is small

for women (6 deaths

a year), Public Health

England has not

calculated a rate.

15.9/100,000

Public Health Outcomes FrameworkThe Public Health Outcomes Framework provides indicators that relate to the absolute health within Wigan Borough

The key indicators below show that health in Wigan Borough is improving and the gap with England is reducing

Challenges

1.To reduce the gap in health experience between areas across the Borough

2.To help people make lifestyle choices that improve their health

3.To focus on what individuals and communities can do to improve health

Deal for the

Future

Local Authority Smoking Prevalence

Salford 36.0%

Bury 35.1%

Tameside 35.0%

Oldham 31.8%

Wigan 31.4%

Stockport 30.8%

Rochdale 30.0%

Trafford 27.8%

Bolton 27.3%

Manchester 27.3%

England 28.0%

Adult smoking rates in Wigan in 2010 25.5% (Eng av 20.8%)

By 2015 this had reduced to 20.6% (Eng av 18.0%).

Wigan is improving at a faster rate than England!

Smoking prevalence in Wigan

Within the borough the highest prevalence is in routine and manual

workers. Despite improvement in reducing prevalence in this cohort, who

account for the majority of our smokers, continual monitoring and

improvement is needed. Our expanded support offer, including digital and

app solutions, 7 day access and an increased presence targeted at

workplaces will be continually evaluated to ensure that the improvement

of the past five years is continued

-3

-2

-1

0

1

2

3

Non-elective admissions age 65+

Non elective bed days age 65+

A&E (Type 1) 4hr Performance

Readmissions 30 day age 65+

Readmissions 90 day age 65+Delayed Transfers of Care per 100,000 age

18+

Discharges to residential care per 1000

Permanent admissions to residential care

aged 65+ per 100,000

Proportion of LA spend on res/nursing care

65+

Wigan: Standardised Score compared to North West: Local Government

April 2015 - March 2016

Wigan

Key

0 = Average for the North West

1 = 1 standard deviation from the average

2 = 2 standard deviations from the average

3 = 3 standard deviations from the average

Positive values are worse than average

Negative values are better than average

An Asset Based Approach

Asset based thinking Deficit based thinking

• Problem orientated

• How to fix the problem

• Us vs Them

• Problems are embedded

• Do things to people

• People are a problem

• People can’t be trusted to

be in control / make

decisions

• Strengths based

• What can I do, what can you

do?

• We’re all in this together

• People have the answers

• People can control their

lives and make decisions

• How can we create

community spirit?

Integrated Neighbourhood Teams

• 16 INTs. Meet monthly.

• GPs, Community Matrons, District

Nurses, place based workers.

• Risk Stratefication Tool– risk of

attending hospital in next 12

months.

• Drug & Alcohol Service now core

members of INTs.

• GPs can identify if a patient has had

previous alcohol specific admissions.

Active Case Management

• ACM team part of Wigan & Leigh Recovery Partnership.

• Team works with high risk,

complex clients – intensive

support and home visits due to lower case loads.

• Capacity to work with up to 100

clients at any one time.• Work closely with Alcohol and

Drugs Specialist Nurse Team.

• Some referred patients by INTS

will be known to drug & alcohol

service. For those that are not,

a flag is put on hospital system GPs have also helped with consent and

engagement by asking patients to come in

for appointment and introduced drug &

alcohol staff.

Let’s get movin’ …

New weight management solution

•Integrated working

•Targeted schools programme

•Specialist service

•Supporting Wigan’s Deal for Children and

Young People.

•Impact on oral health

•Lose weight feel great

Making Health Everyone’s Business

The key staff behaviours

Principles of Reform Applied to

Health and Care

• A different conversation with residents leading to a better understanding of their interests and assets and not their deficits and needs.

• Working with – rather than doing to or for.

• Taking an asset based approach and building on community, family and individual’s strengths.

• Working with the whole family in a joined up and coordinated way.

• Utilising evidence based interventions and developing an evidence base for new interventions.

• Understanding and supporting the assets of a community

• People in control, not passively receiving services

Place Base Prevention and

Early Intervention in Wigan Borough

Public Service Reform

•Staff from different agencies working together in a

place,

•knowing the community,

•solving problems not referring,

•connecting public services in the place,

•having new conversations with residents

•Linking to voluntary community

•Promoting independence and wellness

•Primary care and schools are cornerstones

•Start well, live well, age well

Health and Care Out of Hospital Services

•New models of cluster based primary care

•Integrated Teams

•Community Nursing and Therapies Contract

•Substantial shift of outpatient and diagnostics

services to community

•Deal for Adult Care and Health

•Deal for Children/Start Well

•New models of housing/care

Integrated Care OrganisationPartnership led by Council, 5BP, WWL,

Bridgewater, Primary Care (representation –

tbc)

Early intervention and prevention

hubs(and with schools as partners)

Multi Community Providers (MCPs)

based around clustered primary

care

ma

nd

ate

Natural

communities –

more than 3,

less than 16

3 localities as a

unit of

administration/

management

Borough Wide

Organised borough Wide

e.g.

•MASH

•Single Point of Access

Wigan Ashton Leigh

In same

place as

Lessons Learnt

• Identifying and linking with change agents, people who have an enthusiasm for promoting health and wellbeing, is a good way of building system-wide commitment

• Training customised to the needs of individuals and groups helps to make public health messages real to both individuals and organisations

• Highlighting & sharing examples of what works builds an understanding of the benefits of change

• Involvement of councillors leading task and finish groups, e.g. under-18s alcohol reduction and Heart of Wigan, means that there is senior leader engagement in promoting health and wellbeing.

In Conclusion:

• Public health is a key part of wider reform.

• Health, care and wellbeing are tackled on an integrated basis

across the council, the NHS, Police, Fire, community and other

partners.

• Our Wellness organisation (ICO) will formalise.

healthy life - gmhsc€¦ · bury 35.1% tameside 35.0% oldham 31.8% wigan 31.4% stockport 30.8%...

Documents