Neath Port Talbot County Borough Council Local Development Plan 2011 –2026
Health Topic Paper August 2013
www.npt.gov.uk/ldp Contents
1 Introduction 1 2013) 2 Background 3
3 Policy: National & Local 5 (August 3.1 National Policy Context 5 Paper
3.2 Local Policy Context 9 opic T 4 Current Situation and Trends 15 Health 5 Summary of Consultation Responses 31 - LDP 6 Issues to be Addressed 33
7 Objectives 35 Deposit 8 Strategic Policy Development 37 9 Detailed Policy Development 41
Appendices
A Council Plans & Strategies 1 B Data from Welsh Health Survey 2010 9 Contents Deposit LDP - Health T opic Paper (August 2013) 1 . Introduction
1 Introduction 2013) 1.0.1 This topic paper is one of a range of papers prepared to offer more detailed
information and to provide an explanation of the approach taken in the Local Development (August Plan (LDP) in relation to different topics and issues affecting the County Borough. Paper 1.0.2 This paper specifically considers Health. opic T 1.0.3 A previous version of this paper was published at the Pre-Deposit consultation stage in September 2011. The Pre-Deposit consultation was the first statutory stage of Health - the LDP and set out the Council's overall Preferred Strategy. Following the consultation, the comments received have been taken into account and the topic papers have been LDP amended accordingly. Deposit 1.0.4 The Deposit Plan consultation is the second statutory stage of the plan and allows a further period of formal public consultation. Comments received at this stage will be considered by an Independent Planning Inspector who will hold an Examination in Public into the Plan. If the Inspector considers the Plan to be 'sound' it will be recommended for adoption and once adopted it will supersede the current Neath Port Talbot Unitary Development Plan (UDP) and be the primary document for use in the determination of planning applications.
1.0.5 This topic paper can be read in isolation or in conjunction with the other topic papers and background papers that have been prepared to give a full picture of Neath Port Talbot(1).
1
1 The information contained within this Topic Paper is correct as of the date sent to print. 1 . Introduction Deposit LDP - Health T opic Paper (August 2013)
2 2 . Background
2 Background 2013) 2.0.1 The World Health Organisation (WHO) definition of health is: (August
'Health is a state of complete physical, mental and social well-being and not merely Paper the absence of disease or infirmity'. opic T Health
2.0.2 It is evident that health issues and the way they are addressed are key issues for - the Council. This topic paper has the WHO definition at its core and seeks to address these issues wherever possible via the LDP process. LDP
2.0.3 Health impacts on all of our lives. For the majority of us, our health is good and Deposit we can carry on our daily business and work activities. For those who have poor health however, this limits their opportunities to work and participate in every day life. Their condition may mean that they need higher levels of health care or support. It may affect their disposable income if they are reliant on benefits, and that will impact on the choices they have available to them. In many ways it is a spiral which can be difficult to reverse.
2.0.4 Understanding what causes us to experience poor health is as important as determining what health and social care and other community services are needed. There are many reasons why people living in some areas of Wales have shorter lives or are diagnosed with some cancers, some of the reasons can be attributed to the way people live their lives (e.g. smoking, poor diet or lack of exercise). Sometimes poor health can be attributed to poor housing, poverty or environmental factors such as air quality or sanitation. These range of factors are known as determinants of health and it is these that the Planning system aims to address.
2.0.5 Health problems in Neath Port Talbot are particularly acute and the general levels of health vary across the County Borough. Health issues and the way they are addressed is a key issue for the Authority and for the LDP. The Sustainability Appraisal (SA) of the LDP will assess to what extent the LDP is likely to create healthier, safer and more active communities.
3 2 . Background Deposit LDP - Health T opic Paper (August 2013)
4 3 . Policy: National & Local
3 Policy: National & Local 2013) 3.1 National Policy Context (August Wales Spatial Plan (2008) Paper 3.1.1 The Wales Spatial Plan aims to create a strong and well run network of streamlined opic and integrated care services which are appropriate for each area. The Plan states that T future plans for health care reorganisation will follow the principles of locating services within or close to key settlements and in locations easily accessible by public transport. Health - At the local level increasing emphasis should be placed on illness prevention and strengthening primary and community-based services. LDP
Planning Policy Wales Edition 5 (2012) Deposit
3.1.2 Planning Policy Wales (PPW) sets out the land use planning policies of the Welsh Government (WG). It is supplemented by a series of Technical Advice Notes (TANs). It identifies that several impacts of plans upon health and its determinants should be considered. A key theme is sustainable development and PPW identifies that health is an important consideration in delivering this.
Technical Advice Note (TAN) 16 Sport Recreation and Open Space (2009)
3.1.3 This document acknowledges the need to integrate the links between health and wellbeing, sport, recreational activity and sustainable development in Wales through the development of land use planning guidance in accordance with policies set out in PPW.
3.1.4 It identifies the importance of outdoor facilities (e.g. playing fields, recreation grounds, play areas, footpaths, cycle routes and woodland) which can provide significant health and environmental benefits for communities.
Technical Advice Note (TAN) 18 Transport (2007)
3.1.5 This document identifies that accessibility planning has the potential to contribute to a number of WG priorities including addressing social exclusion and contributing to the health and well being of the population.
Technical Advice Note (TAN) 22 Design (2009)
3.1.6 This document identifies that sustainable buildings can make the internal environment of a building a pleasant and healthy place for people to live and work in. Health and well being can be incorporated into environmentally sustainable design solutions (e.g the orientation of buildings, fenestration, windows, private space, external lighting 5 and lifetime homes standards). 3 . Policy: National & Local
Deposit Climbing Higher (2006)
LDP 3.1.7 Climbing Higher sets out the Welsh Government’s long term strategy for an active, healthy and inclusive Wales where sport and physical activity are used to enhance the -
Health quality of life nationally and in local communities. The report identifies a number of targets primarily relating to access to and use of open space and recreational land. T opic 3.1.8 The strategy states that young people’s needs (including those who are disabled)
Paper are a priority. The Welsh Government recognises the critical importance of play for the development of children’s physical, social, mental, emotional and creative skills. It (August recognises that providing opportunities for physical health can help address wider health and well-being issues, particularly obesity, and that the closer a play area is to home, the
2013) more likely it is to be used by children.
National Strategy for Older People (2008-2013)
3.1.9 The strategy considers the importance of taking into account older people in all policy areas including within Community Strategies, Health, Social Care and Well being Strategies and Local Development Plans. The needs of older people have to be taken into account as the planning process shapes land use and the built environment. It is important that planning facilitates a sense of community and that older people feel more confident to use their local environment to help develop a more vibrant and cohesive community.
Older People’s Dementia Plan Consultation Draft (2009)
3.1.10 The National Dementia Action Plan will work to strengthen communities, creating a key resource for people affected by dementia at the local and national level. The objective is that the individual communities within Wales, along with the nation as a whole, become a dementia supportive community.
Ten Year Homeless Plan for Wales (2009-2019)
3.1.11 The links between poor health and homelessness are well established. This plan seeks a change of culture so that access to good health care and sustainable tenancies are viewed as equally important and interdependent, with each having a positive impact on each other, whilst addressing the wider determinants of health. Short-term accommodation provision is viewed as an opportunity to treat underlying causal links to homelessness.
3.1.12 The strategy seeks to determine and then disseminate what works, through the development and implementation of a range of health care standards, so that all people who are homeless or living in temporary accommodation are able to access good quality 6 health care services tailored to meet their individual needs. Good practice initiatives need to be extended to form a comprehensive network of accessible services across Wales. Partnership working will be promoted.
3.1.13 Children and young people are to be considered a priority group, where early interventions are more likely to succeed before unsuitable housing and/or health damaging lifestyles become established. Priority will also be given to preventing homelessness 3 . Policy: National & Local
amongst people with physical, mental health or substance misuse problems, enabling them to access the appropriate accommodation and services they need. Housing standards 2013) need to promote health and wellbeing.
Environment Strategy (2006) (August
3.1.14 Provides the framework within which to achieve an environment which is clean, Paper opic healthy, biologically diverse and valued by the people of Wales. T
Designed to Improve Health and Management of Chronic Conditions (2007) Health -
3.1.15 Two of the most relevant objectives to the LDP identified in this document are to LDP improve healthy lifestyles and well being in the community and reduce health inequalities and improve economic activity. Deposit Welsh Government Walking and Cycling Strategy (2009)
3.1.16 Identifies the key steps planned to secure a walking and cycling culture in Wales.
Creating an Active Wales (2010)
3.1.17 Sets out the steps the Welsh Government will take with partners to achieve an active, healthy and inclusive Wales.
Our Healthy Future Technical Working Paper (2009)
3.1.18 The 'Our Healthy Future Technical Working Paper' contains six strategic themes and sums-up the inputs required to provide improved quality and length of life and fairer outcomes for all. These themes and their linkages with planning and the LDP process are detailed and explained below:
[a] Health through the Life Course
3.1.19 There should be a holistic approach to health from the cradle to the grave which ensures equity of provision.
3.1.20 Health issues in Neath Port Talbot are particularly acute and residents experience some of the worst health in Wales. People living in the County Borough have shorter and less healthy lives than people elsewhere in Wales. The situation is likely to worsen as the population is ageing which means that a changing focus of possible health problems is likely to be experienced.
3.1.21 The Paper indicates that 'the conditions in which people are born, grow, live, work and age and the decisions they, their families and others make can promote or detract 7 from their health and wellbeing. Adopting a lifelong health and wellbeing approach will therefore be essential if Our Healthy Future’s aims are to be achieved'. 3 . Policy: National & Local
Deposit Figure 3.1 The Six Strategic Themes of Our Healthy Future LDP - Health T opic Paper (August 2013)
[b] Reducing Inequities in Health
3.1.22 This theme seeks to improve the health of those individuals with the greatest disadvantage to the levels found among the more advantaged. There are a range of inequalities that can impact on health. Fuel poverty is of particular concern as its effects are particularly severe for those in poor quality, cold housing. Spending a larger proportion of income on heating means less is available for other things necessary for health such as healthy food, leisure and recreation.
[c] Healthy and Sustainable Communities
3.1.23 This theme seeks to provide communities which are places where people want to live, work play and flourish. Delivering sustainable development is one of the key issues for the LDP and this can be achieved in many ways (e.g. by locating new development such as housing, health services, leisure, shopping etc) in locations which have good access to services and transport options, and ensuring that wherever possible facilities are grouped or buildings shared (e.g. the new Primary Care Centre in Baglan Moors contains meeting rooms for Community use). In addition issues such as air quality, noise, poverty and housing quality also affect health and access to recreational facilities and 8 open space are also important in improving health and wellbeing.
[d] Prevention and Early Intervention
3.1.24 The emphasis is on a sustainable way of working such as re-balancing services with more emphasis on promoting, protecting, maintaining and restoring health and independence and less on avoidable, more expensive options such as treatment and care. 3 . Policy: National & Local
[e] Health as a Shared Goal 2013) 3.1.25 Health is a joint responsibility and delivery of better health can be achieved by adopting a coordinated approach. Whilst the health sector and Local Authority provide a range of services for the residents of the County Borough, commitment is needed from (August public, private and third sector organisations to address the determinants of ill health(2). Paper opic
[f] Strengthening Evidence and Monitoring Progress T
3.1.26 It is important to assess whether policies are achieving their desired effect. The Health LDP will be the subject of annual monitoring to assess the effectiveness of policies. - LDP Welsh Health Survey (2010)
3.1.27 This provides a range of information in a standard format and details how people Deposit report some of their health related lifestyle issues and understandings. It does not provide statistically significant data on year on year changes for Local Authority populations, but provides a lot of information about how people perceive their health and about lifestyle behaviours.
3.2 Local Policy Context
Neath Port Talbot Working In Partnership 2013-2023: Single Integrated Plan (SIP)
3.2.1 The Single Integrated Plan (SIP) replaces a number of current Council Plans and Strategies. For information purposes only, Appendix A sets out the scope of the Plans and Strategies that are being replaced.
3.2.2 The SIP sets out the following vision for Neath Port Talbot: ‘Create a Neath Port Talbot where everyone has an equal opportunity to be healthier, happier, safer and prosperous’. The Plan outlines steps to protect and improve local services and support our communities over the period 2013-2023 and prioritises action in the following areas:
Children and Young People - working to ensure that children and young people get the best possible start in life and achieve their potential.
Anti-Poverty - supporting families on low incomes, prioritising mitigating impacts of welfare reform and make best use of available European funding.
Health Inequities - working to integrate local health and social care services for older and disabled people, with a strong focus on enabling people to retain or regain their. Transport - identifying transport issues locally and explore how these might be 9 addressed through local, regional and national mechanisms.
3.2.3 The Plan has five main outcomes to achieve the vision:
2 These are factors which affect people's health and could include physical inactivity, poor housing, poor diet, poverty and deprivation, pollution, access to facilities community cohesion etc. 3 . Policy: National & Local
Deposit 3.2.4 Outcome 1 - Healthier: Children and Young People in Neath Port Talbot are physically and emotionally healthy; Adults of working age in Neath Port Talbot are
LDP physically and emotionally healthy; and Older People are independent and enjoy a good quality of life. - Health 3.2.5 This outcome aims to improve the health and wellbeing of Neath Port Talbot’
T residents and reduce the gap between the least and most healthy. To achieve this, a opic number of measures are identified, including: Paper Encouraging healthier lifestyles; (August
Embed health improvement into policy making and service delivery arrangements; 2013) and
Remodel and Integrate Health and Social Care Services.
3.2.6 Outcome 2 - Safer: People in Neath Port Talbot 'Feel Safe and are Safe'.
3.2.7 This outcome aims to improve people’s safety through:
Reducing the impact of Crime and the Fear of Crime;
Mitigating the effects of Fire on the Community;
Improving Public Confidence and Satisfaction around levels of Anti-Social Behaviour;
Reducing the incidence and impact of Domestic Abuse
Reducing the numbers of Young People involved in criminal behaviour; and
Reducing the harm of Substance Misuse.
3.2.8 Outcome 3 - Sustainable: Neath Port Talbot’s communities and environment are sustainable.
3.2.9 This outcome will improve the sustainability of our communities and environment to create strong and sustainable communities to face increasing challenges. The following measures have been identified:
Develop communities that are strong and sustainable through meeting housing needs 10 across all tenures;
Ensure environmental sustainability by living within our limits and ensuring healthy and clean air, land and water;
Protect, enhance and conserve our natural and built environment; 3 . Policy: National & Local
Develop Sustainable Transport; 2013) Reduce waste and move towards maximising recycling; and
Support opportunities for the building of safe, resilient, economically viable and (August sustainable communities. Paper opic T 3.2.10 Outcome 4 - Prosperous: Neath Port Talbot has a strong and prosperous economy leading to reduced poverty. Health -
3.2.11 The outcome aims to improve our local economy and help reduce poverty, LDP addressing the loss of industry within the area and the challenging economic climate through the following: Deposit Developing key sites, projects and infrastructure to retain and attract investment into the local economy;
Create high quality jobs and economic growth across the County Borough through development and investment;
Maximise the number of people who are able to access employment, by addressing barriers to employment; and
Develop a strong network of local businesses who are able to generate economic growth.
3.2.12 Outcome 5 - Learning: People in Neath Port Talbot fulfil their learning potential.
3.2.13 This outcome will help and support people fulfil their learning potential to address instances of under achievement and raise standards in school and pupil performance through:
Improving education, ensuring schools are fit for purpose and are capable of delivering high quality education;
Supporting children and young people to fulfil their potential; and
Improving learning outcomes for adults. 11 The Western Valleys Strategy (2006)
3.2.14 The Valleys Strategy seeks to improve life in Neath Port Talbot Valleys and improve the social and economic prospects of those who live there. It aims to ensure the sustenance of a good range of public, community, private services and accessible facilities in the Valley areas. In terms of health provision the plan envisages Pontardawe to act as 3 . Policy: National & Local
Deposit a growth point for social care services for both the Swansea and Upper Amman Valleys. In addition the strategy will examine opportunities for ‘cross-border working’ and provision
LDP of services in collaboration with neighbouring areas (e.g. policing, access to health, transport and tourism). - Health Strategy for Older People Living In Neath Port Talbot (2009-2013) T opic 3.2.15 The strategy aims to enable older people to live as actively and independently
Paper as possible in a suitable and safe environment of their choice. This will require the investigation and creation of support options to allow older people to remain as independent (August as possible and continue to live within their own homes. A further aim is to prevent a deterioration of wellbeing and independence with considerations including the quality of
2013) housing, receiving adequate income, along with combating social isolation through increased community activity amongst others.
Neath Port Talbot Nutrition and Health Action Plan (2006-2015)
3.2.16 The action plan specifically aims to:
Improve the health and well-being of the local population through the promotion of good nutrition; ensure improved availability and accessibility to a healthy balanced diet.
Promote and share good practice and avoid duplication of work through partnership collaboration.
Ensure all stakeholders have a clear focus in promoting good nutrition as part of normal daily living.
Further develop local services that motivate and support the population in achieving a continued intake of a healthy balanced diet.
Neath Port Talbot Physical Activity and Health Action Plan (2006-2016)
3.2.17 This Action Plan is intended to encourage and support local people in being physically active and to improve and sustain their health and well-being.
3.2.18 The Plan specifically aims to:
Increase the proportion of the adult population who undertake moderate intensity physical activity for 30 minutes on at least five days every week. 12 Increase the proportion of children and young people who undertake one hour of at least moderate intensity activity per day.
Reduce the percentage of the adult population who undertake no physical activity. 3 . Policy: National & Local
Neath Port Talbot Risk of Infection Health Action Plan (2006) 2013) 3.2.19 The aim of this plan is to ensure appropriate development of partnership opportunities for health improvement in Neath Port Talbot in relation to: (August Vaccine preventable diseases; Paper opic
Health information and education; T
Sexual health; Health -
Food hygiene; LDP
Healthcare Acquired Infections; Deposit Infection in institutional settings.
Neath Port Talbot Strategic Health Improvement Plan Tobacco (2006)
3.2.20 This is the first phase of a long-term strategy amongst partners in Neath Port Talbot to tackle the harm caused by tobacco. Nicotine is highly addictive and it will take time to achieve the aim of a tobacco-free society.
3.2.21 The key objectives of this action plan are:
Preventing people from starting to smoke;
Helping smokers to quit; and
Protecting non-smokers from tobacco smoke.
Neath Port Talbot Walking and Cycling Strategy and Action Plan (2010-2014)
3.2.22 The strategy states that walking and cycling offers a convenient, accessible, environmentally friendly and healthy alternative to the private car. It is important to health, the economy and the environment. The Strategy aims to increase awareness and to change social attitudes towards walking and cycling through promotion and improvement of facilities, thereby creating a healthier society. It will also encourage more effective partnership working both within the authority and with partners. Abertawe Bro Morgannwg University (ABMU) Public Health Strategy (2011) 13 3.2.23 The strategy details the health issues facing the Trust and the locality. These are not reproduced here as they are detailed in previous sections. The Strategy identifies that the most effective way to improve health across the population is to reduce avoidable health inequalities by upstream policy interventions that create an environment that fosters 3 . Policy: National & Local
Deposit healthy living (e.g. improving access to high nutrient foods, safe places for physical activity, improving the quality of housing or increasing levels of employment). Much of the data is
LDP taken from the Health Needs Assessment. -
Health Neath Port Talbot Health Needs Assessment support 2010: Key Small Area Indicators ABMU (2010) T opic 3.2.24 This document and the data it provides feeds into the Health Social Care and
Paper Wellbeing Strategy. The assessment contains a range of information in relation to various health issues including mortality for a range of causes, hospital admissions, general fertility (August rates, low birth weights etc. The data is referred to later in this paper.
2013) Neath Port Talbot County Borough Council Unitary Development Plan (2008)
3.2.25 The UDP does not contain any specific strategies or policies relating to health but as a result of other policies (e.g. recreation and open space, transport, housing, community and social considerations, employment, environment, general considerations), these offer the potential to improve health.
14 4 . Current Situation and Trends
4 Current Situation and Trends 2013) 4.0.1 Health issues in Neath Port Talbot are particularly acute and residents experience
some of the worst health in Wales. People living in the County Borough have shorter and (August less healthy lives than people elsewhere in Wales. The situation is likely to worsen as the population of Neath Port Talbot is ageing which means that a new range of possible health Paper problems are likely to be experienced. opic T 4.0.2 Data from the 2011 Census recorded that in Neath Port Talbot only 28.4% of the Health population class their health as good compared to the average in Wales of 31.1%. This - also corresponds to a higher percentage of the population describing their health as 'fairly good' or 'not good'. In addition there are startling differences between the wards: Dyffryn LDP has the highest percentage of residents describing their health as good at 32% compared to Cymmer which has the lowest percentage at 23.5%. Deposit
4.0.3 As part of the 2011 Census, residents were asked about their long term health and disability. A long-term health problem or disability is classed as one that limits a person's day-to-day activities, and has lasted, or is expected to last, at least 12 months. This includes problems that are related to old age. People were asked to assess whether their daily activities were limited a lot or a little by such a health problem, or whether their daily activities were not limited at all. Of those indicating that their day to day activities were limited a lot, Neath Port Talbot ranked 1 in England and Wales (16.1%) and in respect of those reporting as not being limited the figure of 72% was the lowest figure in England and Wales.
4.0.4 A number of key messages regarding the health of residents are described in the Neath Port Talbot Health Needs Assessment (HNA)(3) and the Welsh Health Survey both published in 2010. There are a number of specific health issues which need to be tackled in Neath Port Talbot.
4.0.5 This section of the paper, informed by the Health Needs Assessment, details the current position in Neath Port Talbot. It should be noted that in March 2012 a Sub Authority analysis of the Welsh Health Survey was published by the Welsh Health Observatory, however the data is presented using Upper Super Output Areas(4). However for the purposes of this document it is considered that the information would not allow a comparison across smaller geographies in the County Borough, so the data referred to is that from the 2010 Health Needs Assessment.
Population Profile
4.0.6 The population of Neath Port Talbot is ageing, and this offers the opportunity for people to live a longer, more active and fulfilling lifestyle into older age. For some, health 15 conditions will limit their ability to be active, but positive steps to encourage greater activity levels can help to improve this situation.
3 The Health Needs Assessment Support 2010: Key Small Area Indicators ABMU Paper. 4 The document states: "USOAs have been designed to provide a geography of a similar population size that is more detailed than local authority but still large enough to allow a wide range of statistics to be produced, with each of the 94 USOAs in Wales having an average population of 32,000 people". 4 . Current Situation and Trends
Deposit 4.0.7 According to the latest data taken from the 2011 Census, the population aged 65 years of age and over has increased from 24,636 (2001 Census) to around 26,000 or
LDP 5.5%. People aged 65 and over now make up over 19% of the total population. The 2008 based population projections show that in 2026 this will increase by almost 44% to 36,549. - Health 4.0.8 This has implications for the County Borough in so far as there will need to be
T appropriate housing, services and facilities to cater for this increasing older population. opic
Paper 4.0.9 Within Neath Port Talbot life expectancy of residents is lower than other people living in Wales. There are also wide variations between the wards. There is a difference (August of 11 years between the ward having the highest life expectancy (Godre'r Graig in the Swansea Valley) and that with the lowest (Port Talbot). 2013) Mortality Rates
4.0.10 Mortality rates are measured in the Health Needs Assessment and these are illustrated on maps which allow some comparison with Swansea and Bridgend which are also within the Abertawe Bro Morgannwg Health Board.
4.0.11 The following maps show the mortality for all causes, all cancers, circulatory disease, coronary heart disease and respiratory disease. All maps use the European Age Standardised Rate (EASR)(5); the darkest shaded areas on the maps have the highest mortality rates per 100,000 population for that particular cause; and the maps use Middle Super Output Area geography(6).
16
5 A summary measure of e.g. mortality that a population would have if it had a standard age structure. 6 A geographical area (not a ward and not generally subject to boundary change) based on population (average 7,200). 4 . Current Situation and Trends
Map 4.1 EASR for All Causes by MSOA (2004-2008) 2013) (August Paper opic T Health - LDP Deposit
4.0.12 The map shows that MSOAs in parts of the Neath and Afan Valleys, Sandfields West, part of Aberavon, and Neath (North East and South) have the highest mortality rates in the County Borough. However, when compared with the figures elsewhere within the ABMU area the 'highs' are lower than those in the adjacent Authorities. It should be noted that those areas which are numbered on the plan are significantly higher than the overall EASR for Wales. As a result, the Pontardawe area, Sandfields East and part of Aberavon are also included.
17 4 . Current Situation and Trends
Deposit Map 4.2 EASR Mortality from All Cancers by MSOA (2004-2008) LDP - Health T opic Paper (August 2013)
4.0.13 The map shows that there are higher rates of cancer deaths in the Afan Valley, parts of Sandfields and Aberafan and Neath Town Centre areas. All of these areas are numbered on the plan which indicates that the rate is significantly higher than the overall EASR for Wales.
18 4 . Current Situation and Trends
Map 4.3 EASR Mortality from Circulatory Disease by MSOA (2004-2008) 2013) (August Paper opic T Health - LDP Deposit
4.0.14 The areas with the highest rates in Neath Port Talbot include central Neath (which is also significantly higher than the overall EASR for Wales), Sandfields and Aberavon, the Afan Valley, Cwmafan, Bryn and Pelenna.
19 4 . Current Situation and Trends
Deposit Map 4.4 EASR Mortality from Coronary Heart Disease by MSOA (2004-2008) LDP - Health T opic Paper (August 2013)
4.0.15 The areas with the highest rates of mortality from coronary heart disease in Neath Port Talbot include parts of the Dulais Valley and Bryn and Cwmafan. The Afan Valley, Sandfields East and Aberavon are also significantly higher than the overall EASR for Wales. The map also identifies that Neath has rates significantly higher than the overall EASR for Wales.
20 4 . Current Situation and Trends
Map 4.5 EASR Mortality from Respiratory Disease by MSOA (2004-2008) 2013) (August Paper opic T Health - LDP Deposit
4.0.16 The areas with the highest rates of mortality from respiratory disease in Neath Port Talbot include central Neath (parts of the Cimla, Neath, Briton Ferry West and Tonna wards), Resolven, Sandfields and Aberavon, the Afan Valley, Port Talbot and Taibach. The rates in Sandfields, Aberavon, central Neath, Taibach and the Afan Valley are also significantly higher than the overall EASR for Wales.
4.0.17 When evaluating the maps it is evident that some areas appear in a number of these maps including central Neath, Sandfields and Aberavon and the Afan Valley. This suggests that these areas have multiple health problems which are likely to impact on health services.
Long Term Limiting Illness
4.0.18 A long term limiting illness is a self diagnosed, long term illness, health problem or disability which limits daily activities or work undertaken. In Neath Port Talbot the 2011 Census shows that 28% of the population recorded themselves as having a Long Term 21 Limiting Illness (LTLI) compared with the Welsh average of 22.7%. It is the second highest rate in Wales. Within the County Borough there are some wide variations between wards Gwynfi in the Afan Valley has the highest rate in the County at 36.1% and Coedffranc West lowest at 19.4%. 4 . Current Situation and Trends
Deposit 4.0.19 The following map shows the spatial spread across the County Borough of people reporting LTLI by lower super output area. There is a high incidence in communities in the
LDP Afan Valley, central Neath, Sandfields and Port Talbot. -
Health Map 4.6 % of Working Age Population Whose Daily Activities are Limited T opic Paper (August 2013)
4.0.20 The 2010 Welsh Health Survey indicates that 33% of people in Neath Port Talbot have a LTLI which is the highest rate in Wales and above the Welsh average of 27%.
Table 4.1 Long Term Limiting Illness Statistics for Neath Port Talbot (2010 Welsh Health Survey)
2003/4 2004/5 2005/6 2006/7 2008/9 2009/10
22 Long Term Limiting 33% 33% 31% 29% 32% 33% Illness 4 . Current Situation and Trends
General Medical Practice Quality and Outcomes Framework Data 2013) 4.0.21 This presents a summary of data from the national General Medical Services (GMS) Quality and Outcomes Framework (QOF). The QOF is a system of financial incentives and is about rewarding contractors for good practice (and associated workload) (August through participation in an annual quality improvement cycle. Paper opic
4.0.22 The data is illustrated in terms of achievement, exception reporting and the T number of patients on disease registers (i.e. Prevalence). Achievement is measured
against a range of clinical indicators and a range of indicators relating to practice Health organisation and management. - LDP 4.0.23 The following table shows the prevalence of chronic conditions in Neath Port Talbot compared with other Local Authorities - the data is derived from 2008/09 General Deposit Medical Practice Quality and Outcomes Framework data and is the latest available.
Table 4.2 Prevalence of Chronic Conditions in Neath Port Talbot
Condition Wales Wales Neath Port Neath Port Talbot Highest Lowest Talbot Ranking (where 1 is the highest) (2) Diabetes Mellitus(1) 46 14 43 =3
Asthma 73 51 73 1
Chronic Obstructive Pulmonary Disease 21 8 15 =6 (COPD)
Coronary Heart Disease (CHD) 32 21 30 =6
Hypertension 133 88 116 7
Stroke/ TIA 16 11 14 =2
1. Diabetes rate is for those aged over 17 2. = shows a joint ranking
Note: All rates are given as Age Standardised rates per 1000 population for patients registered with GPs in Unitary Authority Areas (i.e. not necessarily resident within that Authority).
4.0.24 The above table shows that there are a number of specific health issues in Neath Port Talbot:
Asthma – highest rate in Wales;
Stroke/ TIA - joint second highest rate in Wales; 23
Diabetes – joint third highest incidence in Wales; 4 . Current Situation and Trends
Deposit Coronary Heart Disease – (this is linked to physical inactivity, smoking and obesity) joint sixth highest incidence in Wales; LDP Chronic Obstructive Pulmonary Disease (COPD) – joint sixth highest incidence in -
Health Wales; T opic Hypertension - seventh highest incidence in Wales. Paper
(August 4.0.25 There are also issues relating to:
High rates of Cancer – specifically smoking related cancers; 2013) Mental Health – Neath Port Talbot has the highest male suicide rate in Wales. The greatest risk is for young men between the age of 25 and 29 years, where there is a strong association with alcohol abuse, violence and unemployment;
Alcohol – locally elevated levels of drug and alcohol misuse;
Sexual health – 20% increase in rate of sexually transmitted infection between 1999 and 2004.
Welsh Health Survey
4.0.26 The Welsh Health Survey is carried out continuously across Wales to a standard format and provides us with the best available information regarding how local people report some of their health-related lifestyle issues and understandings(7). It is not powerful enough (i.e. does not include enough people in its sample) to provide us with statistically significant year on year changes for local authority populations, nor between them, and as with all samples, will inevitably give misleading results on a number of occasions depending on the power of the survey.
4.0.27 It does however, provide a lot of information about how the people of the County Borough perceive their health and about lifestyle behaviours that can influence it for better or worse. This information becomes more powerful when it follows a consistent trend over a period of time and also in terms of where it positions the Council when ranked against other authorities.
Table 4.3 Neath Port Talbot Welsh Health Survey Data
24 2003/4 2004/5 2005/6 2007/08 2008/09 2009/10 Health Status & Illness - currently being treated for:
High blood pressure 18% 19% 21% 23% 23% 21%
7 A self report study is one where respondents read the question and select a response without researcher interference. These studies have validity problems e.g. exaggerating problems or under reporting symptoms. 4 . Current Situation and Trends
Any heart condition excluding 12% 11% 10% 10% 10% 9%
high blood pressure 2013)
Any respiratory illness 16% 17% 17% 16% 14% 14% (August Any mental illness 9% 10% 11% 12% 12% 11% Paper Arthritis 17% 17% 17% 17% 16% 15% opic T Diabetes 6% 7% 8% 8% 8% 8% Health - Having a Long Term Limiting 33% 33% 31% 29% 32% 33%
Illness LDP
(1) SF 36 Deposit
Physical component summary 47 46.8 47.1 47.6 47.4 47.4 score
Mental component summary 49.3 48.9 48.8 49.3 49.3 49.1 score
Health Related Lifestyle
Smoker 29% 29% 28% 26% 25% 25%
Non smoking adult regularly 28% exposed to passive smoking indoors
Consumption of alcohol: above 45% 45% 42% 36% 48% 47% guidelines
Consumption of alcohol: binge 21% 20% 18% 20% 33% 32%
Consumption of fruit and 37% 40% 41% 42% 34% 33% vegetables: meets guidelines
Exercise or physical activity 25% 26% 28% 27% 26% 28% done: meets guidelines
Overweight or obese 56% 56% 59% 60% 61% 60%
Obese 22% 24% 33% 21%
1. A higher score equals better health.
4.0.28 Appendix B provides a table showing the data across Wales, by Local Authority 25 for the last Welsh Health Survey (2010).
4.0.29 In comparison with other Local Authorities in Wales, the 2010 data for Neath Port Talbot shows (where a ranking of 1 shows the worst position across Wales):
Long term limiting illness – ranks 1st; 4 . Current Situation and Trends
Deposit Binge alcohol consumption – ranks 1st;
LDP Diabetes – ranks equal 1st; -
Health SF36 physical component score – ranks 2nd;
T Alcohol consumption over daily guidelines – ranks 3rd; opic
Paper Being overweight / obese – ranks equal 5th;
(August SF36 mental health component score – ranks 6th;
2013) Arthritis – ranks joint 6th.
4.0.30 Whilst these figures appear quite stark, it should be acknowledged that to an extent it represents an incomplete picture and should only be considered a snapshot in time and a guide. The information does however give an idea of the types of problems that are evident and the need to address the causes of these problems.
Physical Activity
4.0.31 Many of the conditions discussed above are known to be related to inadequate physical activity and data has shown that in Neath Port Talbot most adults do not regularly participate in any physical activity with many reporting a sedentary lifestyle in the Welsh Health Survey. However, the latest information in the Welsh Health Survey (2010) shows that in Neath Port Talbot the percentage of adults who meet the guideline for exercise or physical activity has increased by 2% to 28% between 2009 and 2010, but is still slightly below the Welsh average of 29%. Increasing levels of physical activity can help to improve people’s health and wellbeing and the planning system has a role to play in ensuring that there are adequate opportunities for people to be physically active in their local environments. Greater physical activity can reduce the development of chronic conditions and use of health services and also improve people’s quality of life.
4.0.32 It should be noted however that some communities experience a shortfall in the provision of recreational facilities. However, these are not essential for exercise bearing in mind that lots of people go walking or jogging, or attend exercise classes at Leisure Centres or in the private sector which are becoming more affordable(8).
Poverty and Deprivation
4.0.33 Housing condition can have a major impact on a person's health and well being, 26 as can inappropriate housing. Fuel poverty is of particular concern as the effects are particularly severe for those in poor quality, cold housing. Spending a larger proportion of income on heating means less is available for other things necessary for health such as healthy food and leisure and recreation. Poverty can have a detrimental effect on people’s health and wellbeing.
8 Such issues are considered further in the 'Deposit - Open Space and Indoor Leisure Topic Paper' (August 2013). 4 . Current Situation and Trends
4.0.34 An indicator of deprivation is mean income level. The 2012 Paycheck data published by CACI shows that the mean income in Neath Port Talbot is £29,549. The table 2013) below illustrates that there is a difference of £8,605 per annum between the highest and lowest ranking spatial area. (August
Table 4.4 Mean Income by Spatial Area (CACI 2012) Paper opic
Spatial Area Mean Income (£) Ranking T
Neath 31,289 1 Health - Port Talbot 31,577 2 LDP Pontardawe 30,871 3
Dulais Valley 27,530 4 Deposit
Swansea Valley 27,448 5
Amman Valley 26,681 6
Neath Valley 25,282 7
Afan Valley 22,684 8
4.0.35 The Welsh Index of Multiple Deprivation is used by the Welsh Government to identify in geographical areas, clusters of people who are experiencing deprivation. The domains used to establish deprivation are:
Health;
Education;
Income;
Employment;
Housing;
Access to services;
Physical environment; and
Community safety. 27 4.0.36 The table below highlights the Lower Super Output Areas (LSOAs)(9) in Neath Port Talbot that are within the top 10% of most deprived LSOAs in Wales (WIMD 2011).
9 A LSOA is a geographical area based on a mean population of approximately 1500. 4 . Current Situation and Trends
Deposit Table 4.5 Neath Port Talbot LSOAs Ranked Within the Top 10% of most Deprived in Wales LDP Spatial Lower Super Output Rank(10) -
Health Area Area
Afan Valley Cymmer 2 25 T opic Port Talbot Aberavon 4 46 Paper Port Talbot Sandfields West 2 58 (August Port Talbot Sandfields East 2 82
2013) Neath Neath North 2 92
Port Talbot Aberavon 3 101
Neath Briton Ferry West 1 105
Port Talbot Sandfields West 3 124
Port Talbot Sandfields West 4 135
Neath Neath East 2 141
Port Talbot Aberavon 2 164
Neath Neath East 1 167
Afan Valley Glyncorrwg 168
Neath Neath South 2 176
4.0.37 Neath Port Talbot has 91 LSOAs, and 14 of these lie within the top 10% of LSOAs in Wales. Since the previous WIMD was published (2010) four LSOAs are no longer in the top 10% these are Sandfields East 1, Neath East 4, Bryn and Cwmafan 3 and Gwynfi. These areas have been replaced by Neath East 1. It is evident that there are still issues with poverty and deprivation which affect the lives of residents of the County Borough, but it is positive that the number of LSOAs within the top 10% in Wales has reduced.
Pollution
4.0.38 Exposure to poor air quality or pollution can have a serious detrimental effect on a person’s health. The County Borough has an 'Air Quality Management Area' (AQMA) in the Margam / Taibach area, within which the quality of the air is monitored to check the 28 number of exceedences for air quality on a given number of days in a year. 4.0.39 Exposure to noise can also affect a person’s health and well being. The European Council Directive relating to the assessment and management of environmental noise 2002/49/ERC (commonly known as the European Noise Directive) requires member states to produce strategic noise maps for roads, rail and agglomerations and then, using these
10 LSOAs are ranked out of 1896 LSOAs in Wales. 4 . Current Situation and Trends
maps, produce action plans to manage noise issues. In Neath Port Talbot, noise mapping has been carried out and Noise Action areas identified. Quiet areas have also been 2013) identified where the tranquillity and beneficial health qualities will be protected by planning policy. (August
Access to Services and Facilities Paper opic
4.0.40 The 2003 British Medical Association publication 'Housing and Health:Building T for the Future states "...Poor provision of services is an aspect of neighbourhoods that is
likely to influence health and that has been taken into account in many health initiatives. Health Important issues are the availability of neighbourhood health services, shops selling a - range of cheap healthy food, and affordable, easily accessible facilities for physical exercise LDP etc. These considerations are particularly important for deprived communities whose
residents may not be able to afford to travel elsewhere. Easy access to user-friendly Deposit services may improve the health of a neighbourhood by reducing stress and increasing the sense of empowerment and involvement".
4.0.41 In Neath Port Talbot, there has been some rationalisation of the health services over recent years which has resulted in the creation of larger medical centres offering a wider range of services within the community but has also resulted in the closure of some of the local GP practices which has made access to the new service difficult at times for people without access to a car. There are presently only two of these in Neath Port Talbot at Baglan Moors and Seven Sisters, both of which are served by public transport and provide a greater range of services. Both have pharmacies within or adjacent to them.
4.0.42 A similar situation arises when local food shops, post offices or other community facilities including playgrounds are closed for economic reasons. This results in people who most need the local facilities being disadvantaged due to lack of transport.
29 4 . Current Situation and Trends Deposit LDP - Health T opic Paper (August 2013)
30 5 . Summary of Consultation Responses
5 Summary of Consultation Responses 2013) 5.0.1 This section of the paper summarises the main issues and comments raised
following: (August
The formal Pre-Deposit Consultation (September / October 2011); and Paper opic The informal Emerging Deposit Plan Proposals Consultation (September / October T 2012). Health -
5.0.2 The Pre-Deposit Consultation was the first of two formal consultations on the LDP LDP and focused on the Authority's vision, strategic options, preferred strategy and key
policies. A previous version of this Topic Paper was published alongside the Pre-Deposit Deposit Plan.
5.0.3 The Emerging Deposit Plan Proposals were discussed at a series of informal meetings with a variety of stakeholder organisations. These included representatives of the many interest and community groups in the County Borough. At the same time all of the information presented at the stakeholder meetings was made available on the Council's website and anyone or organisation that is interested in the future development of Neath Port Talbot was invited to comment.
5.0.4 The Deposit Plan Proposals Report (Sept’12) set out the emerging picture both in terms of the overall strategy for the LDP and the various topic based policies that will be included. The report was accompanied by the emerging Proposals Map which showed the geographical location of the emerging policies and proposals.
5.0.5 It should be noted however that no significant issues or representations relating to health were raised following the two consultation periods outlined above. Those health related comments that were received related more to minor rewording issues and are therefore not summarised here. Full details of comments received and the Council's responses to those comments are however set out in the Initial Consultation Report(11).
31
11 LDP Initial Consultation Report (August 2013). 5 . Summary of Consultation Responses Deposit LDP - Health T opic Paper (August 2013)
32 6 . Issues to be Addressed
6 Issues to be Addressed 2013) 6.0.1 Having considered (1) the national and local policy context, and (2) the matters
that have emerged from the evidence base, this section of the paper highlights the key (August issues that the LDP has to address. Paper Pre-Deposit Key Issues opic T 6.0.2 The Pre-Deposit Plan identified the following specific key issue linked to health: Health Residents in Neath Port Talbot experience some of the worst health in Wales. - LDP
6.0.3 The Pre-Deposit Plan identified a number of other key issues which can impact on health, including: Deposit
The County Borough has an ageing population.
Neath Port Talbot has poor housing conditions (above the Welsh average) across all tenures.
Some communities experience a shortfall in the provision of community and recreational facilities.
The rationalisation and centralisation of education and health facilities respectively, may have a significant impact on individual communities.
There are higher than average levels of unemployment particularly amongst the younger generation.
The valley communities are losing people, jobs and services and are increasingly becoming dormitories with residents travelling elsewhere for an increasing range of facilities, services and employment.
There are a number of traffic hot-spots where congestion is an issue.
Vehicle ownership is increasing within Neath Port Talbot. This is leading to a rise in greenhouse gas emissions.
Noise from everyday activities is increasing. It is important to reduce this and protect certain areas from noise pollution in an attempt to enhance the general health and well being of the community. 33
Deposit Key Issues
6.0.4 The specific key issue linked to health has been retained for the Deposit Plan:
Residents in Neath Port Talbot experience some of the worst health in Wales. 6 . Issues to be Addressed
Deposit 6.0.5 As a result of new and emerging guidance, an improved understanding of an up-to-date evidence base and consideration of responses received to the Pre-Deposit (12)
LDP consultation, the key issues as identified in the Pre-Deposit Plan have been reviewed . -
Health 6.0.6 The following revised key issues which can have an impact on health, have been identified for the Deposit Plan: T opic There is a shortfall in the provision of open space in some communities. Paper Some areas of the County Borough experience issues with air quality. (August 2013)
34
12 The Pre-Deposit Plan identified a total of 29 key issues. The Deposit Plan is now better informed by a strengthened identification of just 18 key issues. 7 . Objectives
7 Objectives 2013) 7.0.1 The objectives are at the centre of the LDP, they emerge from the vision and key
issues and form the basis for future policy development. (August
Pre-Deposit Objectives Paper opic 7.0.2 The Pre-Deposit Plan identified a number of objectives, the following are relevant T to health and health improvements (the numbering follows the numbering in the Pre-Deposit
Plan): Health -
[1] Deliver sustainable, safe and confident communities via the co location of jobs LDP and facilities and the development of community hubs and services in accordance
with the settlement framework. This will deliver a better and more equitable quality of Deposit life for all residents.
[2] Provide an adequate supply, mix and type of housing with good design, to meet the needs of all residents in safe, sustainable locations to promote integrated and thriving communities.
[4] Maintain, enhance and develop a hierarchy of retail centres in line with the settlement framework which are easily accessible and form the focus for the community to meet the needs of all residents.
[5] Provide for the required quantity and range of accessible leisure, recreational, health, social and community facilities throughout the County Borough.
[6] Reduce people's exposure to the determinants of poor health and provide an environment that encourages healthy, active and safer lifestyles.
[7] Minimise the adverse impacts from noise generating and polluting activities.
[16] Provide opportunities for integrated sustainable transport for increased walking, cycling, car sharing and use of public and community transport.
Deposit Objectives
7.0.3 The following specific objective is retained for the Deposit Plan:
Reduce people's exposure to the determinants of poor health and provide an environment that encourages healthy, active and safer lifestyles. 35
7.0.4 In addition, there are a number of other objectives identified for the Deposit Plan which will have the potential for a positive influence on health issues:
Deliver sustainable, safe and confident communities and develop vibrant settlements supporting a range and mix of facilities and services. 7 . Objectives
Deposit Maximise accessibility to a range of leisure, recreational, health, social and community facilities in line with the role and function of settlements. LDP Provide an adequate supply, mix, type and tenure of housing within sustainable -
Health settlements to meet the needs of the projected population. T opic Deliver more equitable open space provision within and around settlements. Paper Improve and strengthen the economic base of Neath Port Talbot to increase
(August economic activity, reduce the unemployment rate in line with the Welsh average and negate some of the impacts of a reduced working age population. 2013) Address air quality issues and minimise the adverse impacts from noise generating and polluting activities.
Reduce impacts of traffic growth and congestion and promote the efficient and effective use of the transport network.
36 8 . Strategic Policy Development
8 Strategic Policy Development 2013) 8.0.1 At the Pre-Deposit stage, the overall Preferred Strategy was underpinned by a
number of topic based and area based strategies. (August
8.0.2 Having considered the issues and objectives outlined in previous chapters, this Paper section of the paper sets out how the strategy has evolved since the Pre-Deposit stage. opic Where appropriate, amendments and additions to the strategies are highlighted and T explained. Health - Pre-Deposit Strategy LDP 8.0.3 The Pre-Deposit Plan did not include a specific topic based strategy for health,
nor did it include specific reference to health related issues in the area based spatial Deposit strategies. The Pre-Deposit Plan relied on a number of other topic based strategies to deliver improvements to health and well being.
8.0.4 The Pre-Deposit Plan did however include the following Strategic Policies under the sub-heading 'Health and Well Being' (the numbering follows the numbering in the Pre-Deposit Plan):
Policy 12 - Open Space, Leisure and Recreational Facilities
The LDP will seek to ensure the provision of sufficient open space, leisure and recreational facilities within the County Borough by:
Prioritising the provision of open space, green space or community facilities, within existing urban areas, in redevelopment schemes;
Retaining and, wherever possible, enhancing existing open space and recreational facilities;
Ensuring new developments address local needs and thus allocate land for public open space, children’s play facilities, green space and allotments;
Improving walking and cycling routes.
Policy 13 - Noise, Contamination and Air Quality 37 Development proposals should wherever possible help address existing environmental problems and otherwise minimise their adverse effects. 8 . Strategic Policy Development
Deposit Deposit Plan Strategy
LDP 8.0.5 Improving the health and well being of residents in Neath Port Talbot is a central objective of the LDP. The health of residents and the physical environment in which they -
Health live are intrinsically linked, positive interventions will therefore be sought through the policies in the LDP. T opic 8.0.6 The approach to be taken in the Deposit Plan is largely the same as that taken in
Paper the Pre-Deposit Plan in that improvements to health and well being will be delivered through a variety of other topic based strategies. However, the following specific health related (August overarching strategic policy has been developed for the Deposit Plan.
2013) 8.0.7 Overarching strategic policies are those relating to matters considered to be of primary importance for the whole County Borough and they set out measures that will be implemented through all the themes and topic areas of the LDP.
8.0.8 Strategic Policy: Health
Health
The following measures will be taken in relation to the high levels of poor long term health and sickness in Neath Port Talbot:
1. The development of sustainable, safe and confident communities will be promoted through the co-location of jobs and facilities and the development of community facilities and services in accordance with the settlement framework;
2. People's exposure to the determinants of poor health will be reduced where possible through consideration of the environmental and safety impacts of new developments;
3. Healthier, more active and safer lifestyles will be encouraged through the retention of a range of accessible leisure, recreational, health, social and community facilities throughout the County Borough;
4. Accessibility within and between communities will be improved to encourage active travel;
5. The provision of new employment opportunities will be promoted to reduce unemployment and economic inactivity rates. 38
8.0.9 Within Neath Port Talbot there are some significant health issues affecting the population. Within the LDP, health is considered to be an overarching topic area as it will be addressed through a range of policies and interventions which can have positive health benefits. 8 . Strategic Policy Development
8.0.10 As with Policy SP1 Climate Change, the measures outlined to address health issues will be implemented through all the Plan policies and proposals, focusing on 2013) sustainable development principles, strengthening communities and encouraging more healthy lifestyles through the provision of facilities. Environmental and housing issues will (August be addressed, and increased employment opportunities encouraged. Paper opic T Health - LDP Deposit
39 8 . Strategic Policy Development Deposit LDP - Health T opic Paper (August 2013)
40 9 . Detailed Policy Development
9 Detailed Policy Development 2013) 9.0.1 Health is one of the most fundamental issues that the LDP will need to address.
It should be acknowledged however that the interventions that can be made by the planning (August system alone are limited, tackling health issues in the County Borough will therefore require a multi-agency approach. Paper opic 9.0.2 A response to the challenges posed in tackling health issues is embodied in all T parts of the Plan. As a consequence, there are no detailed policies in the Deposit Plan Health that deal specifically with health. Moreover, the various elements of the health strategy - are addressed and implemented through a range of topic based strategic and detailed policies. LDP
Sustainable Settlements Deposit
9.0.3 The development of sustainable, healthy and cohesive communities, either newly-built settlements such as Coed Darcy or through the enhancement and improvement of existing settlements is a fundamental element of the LDP's strategic approach.
9.0.4 In defining a 'Settlement Hierarchy', development is directed to the most sustainable locations helping to sustain the existing services and facilities on offer and also provide the opportunity to deliver additional services and facilities for the benefit of the wider community.
9.0.5 More information is provided in the Settlement Topic Paper(13).
Housing Allocations
9.0.6 Housing Allocations are identified in the Plan along with the provision for affordable housing. The location of the major new housing developments takes account of the need to reduce people's exposure to the determinants of poor health, including siting sensitive developments away from sources of noise, air pollution and flood risk. Furthermore, new housing is built to strict environmental standards to increase energy efficiency.
9.0.7 More information is provided in the Population and Housing Topic Paper(14).
Protection of Community Facilities
9.0.8 Healthier, more active and safer lifestyles are encouraged through policies seeking the retention of a range of accessible leisure, recreational, health, social and community facilities throughout the County Borough. Multi-use facilities and the co-location of new health and community facilities are also encouraged. 41 9.0.9 More information is provided in the Settlement Topic Paper(15).
13 Deposit - Settlement Topic Paper (August 2013). 14 Deposit - Population and Housing Topic Paper (August 2013). 15 Deposit - Settlement Topic Paper (August 2013). 9 . Detailed Policy Development
Deposit Provision and Protection of Open Space
LDP 9.0.10 Policies seek to ensure that all residents have access to adequate open space through ensuring that new development addresses local needs and that existing open -
Health spaces are retained and protected. Such provision includes outdoor sport facilities, children's play facilities, informal open space and allotments. T opic 9.0.11 More information is provided in the Open Space and Indoor Leisure Topic
Paper Paper(16).
(August Accessibility
9.0.12 Policies seek to improve accessibility between communities, encouraging active 2013) travel wherever possible. New developments are required to be served by sustainable transport options and facilitate connectivity between existing and new development, providing footpath / cycle links where feasible.
9.0.13 More information is provided in the Transport Topic Paper(17).
Employment
9.0.14 Policies seek to provide new employment opportunities to reduce unemployment and economic inactivity rates.
9.0.15 More information is provided in the Economy and Employment Topic Paper(18).
Environment
9.0.16 The quality of the environment and the basic natural needs that it provides for are of great importance for human health and well being. Policies therefore seek to protect the environment and the amenity of local communities. Air, water, ground quality and the environment generally are protected. In particular, policies seek to ensure that developments do not increase the number of people exposed to significant levels of pollution.
9.0.17 More information is provided in the Environment Topic Paper(19).
42
16 Deposit - Open Space and Indoor Leisure Topic Paper (August 2013). 17 Deposit - Transport Topic Paper (August 2013). 18 Deposit - Economy and Employment Topic Paper (August 2013). 19 Deposit - Environment Topic Paper (August 2013). A . Council Plans & Strategies
A Council Plans & Strategies 2013) A.0.1 The Single Integrated Plan (SIP) was recently adopted by Neath Port Talbot
County Borough Council, replacing a number of Plans and Strategies. For information (August purposes only, the section below sets out the scope of the Plans and Strategies that are being replaced. Paper opic The Community Plan (2010-2020) T
A.0.2 All of the themes contribute to health and well being. It specifically identifies the Health - following: LDP A.0.3 The priorities of the Health Social Care and Wellbeing Theme are that by 2014: Deposit More people, with the appropriate support, look after themselves, each other and their communities with the emphasis on healthier lifestyles and preventative services.
There are stronger health improvement connections between the different strategies, plans and services. This includes information and support to encourage physical activity and healthier food choices; and tackle smoking, alcohol consumption and drug taking.
Residential and nursing homes are modern and fit for purpose.
Social and affordable housing has been, and continues to be, improved and modernised and there is also more support for everyone in independent accommodation. In particular, gaps in provision for young people and the homeless are reduced; with easier access to healthcare services for the vulnerable homeless.
Intensive support for families with complex needs is available, accessible and effective and more joined up health and social care services are provided between children and adult services.
Health and social care services are integrated and citizen centred, delivered in partnership across agencies. There will be a particular emphasis upon tackling the factors leading to children being at risk of abuse and neglect and maximising independent living for older people with individualised, cost effective and high quality care and support.
Services have been and continue to be improved for mental health and well being, learning disability, physical and sensory disability and carers; helping safeguard vulnerable adults and children. 1
A.0.4 In terms of Confident Communities by 2014:
People’s sense of independence, pride and confidence are maximised, encouraging a greater sense of community belonging. A . Council Plans & Strategies
Deposit Poverty in all aspects of people’s lives, particularly where it affects children, continues to be tackled. LDP People’s language, culture and heritage are celebrated, giving a strong sense of place -
Health and identity.
T Active citizenship and levels of inclusive community engagement is increased; helping opic citizens have their say. Paper The impact of public services upon the environment, including the physical (August infrastructure required for sustainable communities, will be reflected in the Local Development Plan and planning processes. 2013) Fairness and diversity is valued and reflected in public services.
A partnership approach to neighbourhood management has been tested and is being implemented.
A.0.5 In terms of transport by 2014:
The Stage 2 Port Talbot Peripheral Distributor Road is completed and congestion on the M4 is reduced.
The Port Talbot Parkway and Neath Railway Stations have been improved and are fully accessible.
A more comprehensive network of accessible public and community transport, including taxi services, is providing local communities and employment sites with a range of travel options.
The highway network is efficient and the maintenance backlog reduced.
The awareness, acceptability and use of sustainable transport, such as public transport, walking and cycling has increased.
A.0.6 In terms of the Environment by 2014:
Significantly reduce our carbon footprint by reducing the contributory factors, as well as adapting to the effects of climate change. Energy resources are also used efficiently with actions to reduce the impact of climate change being implemented to include 2 rapid responses to flooding and flood risk.
The public’s sense of responsibility to re-use, minimise, reduce and recycle waste is being demonstrated, with national targets being exceeded. A . Council Plans & Strategies
To help improve the health and well-being of all citizens; healthy and clean air, land
and water are secured by robust environmental management systems. Also the 2013) diversity of local habitats and species is successfully managed, protected and enhanced; helping citizens enjoy wildlife and a healthy environment. (August
The quality of the built environment is improved, including its accessibility and energy Paper efficient street lighting is provided, which also helps people feel safer. opic T All citizens have safe, litter-free, accessible green spaces within walking distance
from their homes. Health - LDP Health Social Care & Wellbeing Strategy (2011-2014) Healthier Neath Port Talbot 'Making a Real Difference' Deposit
A.0.7 The document identifies the previous plans and what they have achieved. It then considers the revised Health Needs Assessment which informs the Strategy.
A.0.8 Key chronic disease inequity ‘hot spots’ for Neath Port Talbot compared to Wales include:
Highest incidence of asthma;
Second highest incidence of stroke / TIA;
Second highest incidence of diabetes;
Third highest incidence of obesity and overweight;
High rates of suicide in young males;
Fifth highest death rate from heart disease;
Highest number of smokers.
A.0.9 The wider determinants that have a significant impact on health which the partnership will need to continue to focus on are:
The economy; and
The environment and housing. 3 A.0.10 Lifestyle continues to have a significant impact on health with the County Borough still having very high levels of risk to health behaviours within the population such as:
Higher levels of smoking than the national average;
Obesity and overweight and lower levels of physical activity and poor diet; A . Council Plans & Strategies
Deposit A marked increase in teen aged conceptions particularly in the 13 – 15 year age group; LDP Substance misuse with significantly worse hospital admissions for alcohol misuse in -
Health the County compared to the Welsh average;
T Communicable disease and Immunisation - lower than average uptake of immunisation opic in children under 5; Paper Long Term Conditions. (August
2013) A.0.11 The partnership has agreed a number of priority projects for the next strategy round including:
[a] Health Improvement Priorities
1. Reducing obesity;
2. Reducing risk tackling lifestyle behaviour;
3. Increasing uptake levels of Immunisation and Vaccination;
4. Improving emotional wellbeing in targeted groups;
5. Health Improvement in the Workplace;
6. Dental Health in Younger Children;
7. Cancer Screening (breast and testicular).
[b] Service Remodelling and Service Integration Priorities
8. Transforming Older People Services;
9. Developing Community Networks;
10. Improving Community Mental Health Services;
11. Community Support for people with learning disabilities; 4 12. Improving Transition and Transfer of Care; 13. Reducing inequity in service access for vulnerable groups;
14. Stroke. A . Council Plans & Strategies
[c] From the updated Health Needs Assessment the partnership will also have to consider: 2013)
Sexual Health - under-age pregnancy and sexually transmitted infection. (August
[d] Community Services Paper opic A.0.12 The community services that have an influence or the potential to address some T of the health inequalities that were identified in the previous section include: Health - 1. General Practice (GPs) – list sizes are higher in Neath Port Talbot (NPT) than the LDP Welsh average with many services concentrated around the main population centres of Neath and Port Talbot town centres and Pontardawe. There are services available in branch surgeries and satellite centres but they do not provide the same range of Deposit services. A new Primary Care Resource Centre in Port Talbot contains a wide range of primary, community, social and third sector care services from one building with a range of community outreach services. It is the first of its kind in Wales.
2. Dental Services - there is a significant inequity in the number of children aged 5 with decayed missing and filled teeth in NPT compared to the national average. Dental services are being audited, and a new dental suite has opened in the Primary Care Resource Centre providing a range of community services that will help to address this inequity.
3. Pharmaceutical Services - all pharmacies provide core services but many do not have the capacity to offer a wide range of services.
4. Ophthalmic (Eye Care) Services - are provided by independent optometrists across the County Borough and an established diabetic retinopathy screening service and cataract referral service has helped to speed up access to more specialised services when these are needed.
5. A Community Integrated Intermediate Care Service (CIIS) - this provides a wide range of assessment and support from a wide range of staff to reduce the numbers of people going into hospital and residential care and to help people remain independent at home.
6. Nursing and Therapy Community Services - a range of services are available at the local level.
7. Unscheduled Care - Refers to care which is unplanned (e.g. emergency admissions to hospital). Partnership working will be used to prevent unnecessary admissions to 5 hospital using services such as CIIS.
8. Mental Health Services – are being remodelled and modernised with an emphasis on joint planning and service development. Prevention and early intervention are a significant part of these developments to take pressure away from core Long Term Care Services. A . Council Plans & Strategies
Deposit 9. Older People Social Care Services – are being completely remodelled. A range of projects as part of the Transforming Older Person's (TOPs) scheme are ongoing
LDP including the replacement of seven of the Long Term Council Care Homes with four new homes; Redesigning Day Service provision; moving forward with Extra Care - Health housing developments; developing services for dementia and widening prevention and self care. T opic 10. Continuing Care - a collaborative approach will strive to deliver continuing care as Paper close to the individual's home as possible or in the patient's own home.
(August 11. Learning Disability - the main areas of work include repatriation of people with complex needs, placed out of County Borough provision back to their originating community
2013) and the development of affordable housing and supported housing options.
12. Physical and Sensory Disabilities - a range of services are provided in the County Borough.
13. Carers - the County Borough has the highest number of unpaid carers in England and Wales and a number of initiatives have been progressed since the last strategy.
Children and Young Person's Plan (2011-2014)
A.0.13 The vision of the Partnership is that 'Children and Young People in Neath Port Talbot will be healthy, confident, active individuals who achieve their potential within a safe home and community that is free from poverty, abuse and exploitation'.
A.0.14 The plan has the following seven Core Aims:
1. Have a flying start in life;
2. Have a comprehensive range of education and learning opportunities;
3. Enjoy the best possible health, and are free from abuse, victimisation and exploitation;
4. Have access to play, leisure, sporting and cultural activities;
5. Are listened to, treated with respect, and have their race and cultural identity recognised;
6. Have a safe home and a community that supports physical and emotional wellbeing;
6 7. Are not disadvantaged by child poverty.
A.0.15 Organising services to deliver better outcomes will:
Identify problems and intervene as early as possible to avoid them escalating; A . Council Plans & Strategies
Develop more integrated ways of working and delivering services locally, helping front
line workers develop the skills and confidence to work closely together and to deliver 2013) the most effective interventions; (August Extend the involvement and participation of children, young people and their families
in planning and delivering services; Paper opic
Work with third sector organisations at a strategic and operational level to promote T effective partnerships and maximise all resources; Health - Promote fairness and equality of opportunity and access to services for all; LDP Develop clear, coordinated public information about all the Council's services; Deposit Continually challenge mainstream universal services to ensure that they address the needs of the most vulnerable children, young people and families.
A.0.16 The Plan has undertaken an analysis of the County Borough and provides a summary of key needs and issues.
A.0.17 The report highlights the health problems of the County Borough (as detailed in the Health Social Care and Wellbeing Strategy) and identifies that a major challenge for the Partnership is improving the health of the population.
A.0.18 The Plan has the following seven key priorities:
1. Further develop prevention, parenting and family support services;
2. Support children and young people to fulfil their potential;
3. To improve the physical health and emotional wellbeing of children and young people (this links very closely with the Health Social Care and Wellbeing Strategy);
4. Ensure that disabled children can access mainstream, universal and specialist services;
5. Further develop participation, engagement and advocacy for children, young people and their families;
6. All children and young people have a safe home and a community which supports physical and emotional wellbeing;
7. To ensure that children and young people living in poverty have the same life chances 7 and opportunities as others.
A.0.19 The Plan also identifies that the Authority is required by the WG to prepare a 'Local Creating an Active Wales Plan' to ensure local implementation of the targets and vision in the national physical activity plan for Wales: Creating an Active Wales (2010). In 2006, partners in Neath Port Talbot worked together in developing two key plans for A . Council Plans & Strategies
Deposit Physical Activity: a Strategic Health Improvement Plan (SHIP) and a Sport and Active Living Strategy. In 2008, these plans were used to support the development and monitoring
LDP of our Local Authority Partnership Agreement (LAPA) with the Sports Council for Wales, which has attracted resources to implement the Plans. - Health A.0.20 Since the Plans were developed the WG has developed other policy initiatives
T and it is proposed to bring together the work of the Healthy Eating and Physical Activity opic Partnership groups, with the Core Aim 4 Group for Play, Sport, Leisure and Culture. The Paper remit of this combined group will be to revise and update the physical activity and healthy eating plans so as to create one integrated plan which will include actions to: (August Align its work with the priorities within Creating an Active Wales; 2013) Implement the Obesity Pathway;
Achieve priorities relating to play, sport, leisure and culture identified in this Children and Young People’s Plan and Child Poverty Strategy, the Children and Families (Wales) Measure 2010 and the Health, Social Care and Well-being Strategy;
Support the transition of healthy lifestyle into adult life.
8 B Data from Welsh Health Survey 2010
B.0.1 Figures highlighted are worse than the Neath Port Talbot figure in that category.
Table B.1 Data from the Welsh Health Survey 2010
Angle- Neath V of M B Wales Gwy-nedd Conwy Den-bigh Flint Wrex-ham Powys Cere-digion Pem-broke Carm-arthen Swansea Port Bridgend Cardiff RCT Caer-philly Torfaen Mon-mouth New-port sey Glam Tydfil Gwent Talbot
Health Status & Illness
Currently being treated for B
High blood pressure 20% 18% 19% 16% 18% 18% 20% 18% 18% 16% 18% 19% 21% 20% 18% 20% 23% 23% 24% 25% 23% 17% 21% .
Any heart condition excl high blood Data pressure 9% 9% 9% 7% 8% 9% 9% 7% 8% 8% 9% 10% 9% 11% 8% 9% 9% 9% 10% 10% 10% 8% 9%
Any respiratory illness 13% 13% 10% 10% 14% 12% 12% 11% 11% 13% 18% 15% 14% 15% 12% 14% 15% 15% 14% 15% 14% 11% 12% from Any mental illness 10% 8% 6% 8% 9% 9% 10% 7% 7% 8% 10% 8% 11% 12% 10% 10% 13% 13% 11% 15% 14% 8% 10%
Arthritis 13% 12% 10% 12% 12% 12% 12% 10% 11% 11% 14% 13% 15% 17% 11% 12% 16% 16% 16% 17% 15% 8% 14%
Diabetes 6% 5% 5% 6% 5% 5% 6% 6% 5% 5% 6% 8% 8% 6% 6% 7% 7% 7% 7% 8% 8% 5% 8% W elsh
Having a long term limiting illness 27% 27% 24% 23% 25% 24% 24% 26% 24% 26% 30% 28% 33% 30% 26% 26% 29% 31% 31% 32% 31% 25% 29% Health
SF 36 (higher score means better health
Physical component summary score 48.8 49.3 49.2 49.9 50 50.3 49.5 49.7 49.7 49.8 48.1 48.6 47.4 48.1 49.3 49 48.2 47.5 47.7 47 47.7 50.2 48.4 Survey
Mental component summary score 49.9 51 50.7 51 50 51.2 50.2 51.6 51.3 51.3 49.3 49.7 49.1 49.7 50.2 49.6 48.7 47.7 48.6 48 48.9 51 49.4
Health related lifestyle 2010 Smoker 24% 22% 25% 22% 25% 22% 26% 22% 22% 22% 24% 23% 25% 23% 23% 24% 24% 30% 24% 27% 26% 20% 26%
Deposit LDP - Health Topic Paper (August 2013) 9
10
2013) (August Paper opic T Health - LDP Deposit B Angle- Neath . V of M B
Wales Gwy-nedd Conwy Den-bigh Flint Wrex-ham Powys Cere-digion Pem-broke Carm-arthen Swansea Port Bridgend Cardiff RCT Caer-philly Torfaen Mon-mouth New-port Data sey Glam Tydfil Gwent Talbot
Non smoking adult regularly exposed to passive smoking indoors 22% 25% 20% 20% 20% 20% 19% 19% 21% 21% 23% 23% 28% 24% 21% 20% 28% 28% 28% 35% 22% 14% 23% from
Consumption of alcohol: above guidelines 45% 43% 47% 42% 43% 46% 43% 41% 43% 39% 39% 47% 47% 48% 48% 46% 44% 45% 44% 45% 43% 45% 47%
Consumption of alcohol: binge 28% 27% 29% 26% 28% 27% 27% 25% 23% 22% 23% 30% 32% 30% 29% 28% 29% 31% 28% 29% 28% 27% 29% W elsh Consumption of fruit and vegetables: meets guidelines 36% 39% 42% 37% 37% 37% 31% 39% 41% 39% 38% 37% 33% 29% 35% 40% 28% 32% 33% 29% 32% 38% 33%
Exercise or physical activity done: meets guidelines 29% 30% 34% 33% 33% 30% 28% 39% 34% 36% 30% 27% 28% 30% 30% 25% 27% 29% 28% 26% 28% 31% 26% Health
Overweight or obese 57% 56% 57% 52% 53% 55% 52% 56% 54% 62% 60% 57% 60% 61% 53% 55% 60% 60% 61% 63% 60% 55% 58%
Obese 21% 20% 19% 17% 17% 18% 16% 16% 20% 24% 21% 23% 21% 24% 20% 20% 26% 24% 25% 27% 23% 18% 23% Survey 2010 Local Development Plan Cynllun Datblygu Lleol
August 2013 ENVT1548 www.npt.gov.uk/ldp