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Framework Summary Appendix A

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Framework Summary Appendix A Framework summary Appendix A Through a range of programme interventions targeting resources and opportunities for identified target population groups: ▪ To reduce the mortality gap between the most deprived 20% and the average by 3% percent over 5 years ▪ To reduce the strength of association between deprivation and mortality by 20% over five years. Healthy Children and Access to health Tackling the Strengthening Wider pregnancy and young people related services Major killers disadvantaged determinants early Improved To increase timely To increase and vulnerable Environment, childhood attainment and and appropriate engagement of individuals and resources and A reduction in the progression to access to primary those at greatest communities opportunities number of infant vocation/ higher care services and risk in both conducive to health deaths and in the education prevention treatment and Increased levels of number of babies amongst target programmes and prevention participation, gaining population opportunities for skills and resources Social cohesion born below agreed Mechanisms to target weight health improvement within target areas to bring about change and influence/ participate Risk/positive Screening strengthen resilience Green space/ recreation Smoking behaviours Disease Co-location Healthy town Maternity care Parenting skills management Financial resilience Local support planning Breastfeeding Skills Rehabilitation Employability services decent/ affordable Maternal nutrition confidence Condition Signposting homes Aspirations management /advocacy Food Independent living Employment Crisis resolution Safety Supporting systems To develop underpinning systems to support the implementation, resourcing and evaluation of the framework - information, resources, workforce, learning and organisational development Page 1 of 12 1 INVESTMENT WITHIN THE FRAMEWORK Healthy pregnancy, early Breast feeding childhood, children and young people To ensure a Healthy pregnancy and Healthy weight programmes optimal health in early childhood within identified target communities Teenage pregnancy / sexual health To ensure children and young people programme within identified target communities achieve the best possible health to gain their best educational outcomes. Smoking in pregnancy Family Intervention Project Access to health related services Cardiovascular disease risk and tackling the Major killers assessment and management To ensure timely access to quality programme primary care services, prevention programmes and opportunities for Health referral programme and health improvement in all ages. weight management To reduce levels of premature mortality (under 75) from the major killers; heart disease, cancer and Smoking cessation suicide by identification and increased engagement of those at greatest risk in both high quality treatment and Alcohol tier 1 and 2 services prevention programmes. Strengthening disadvantaged Citizens Advice Bureau programme and vulnerable individuals and communities and addressing the Health trainer/health champion wider determinants of health programme To increase the capacity and resilience of target vulnerable communities by improving levels of Local Strategic Partnership participation and equipping them with (districts) Priorities inequalities local skills and resources to bring about action change in their lives. Community safety – domestic To create an inclusive environment violence, where people feel safe and have access to resources and opportunities conducive to improving health Housing and homelessness Physical health of mental health Page 2 of 12service users 2 THE FULL FRAMEWORK PURPOSE To ensure a Healthy pregnancy and optimal health in early childhood within identified target communities How will know we have achieved this? We will see the number of perinatal and infant deaths across the county falling and there will be a 10% reduction in the proportion of babies born below 2.5kg in the target areas compared to the Derbyshire average. What key successes will contribute to this? • Vulnerable and “at risk” mothers (inc teenagers) identified in “Maternity Matters” will be routinely identified at the earliest opportunity and will experience timely intervention to meet their needs • We will implement care pathways and a programme of support through pregnancy and postnatally for target populations identified in Maternity Matters, e.g. drug users, those with mental illness. • Local people, in particular local women in the target areas will be aware of a proactive approach that improves access and engagement with services before and during pregnancy and after giving birth. • Local families will make use of high quality paid and unpaid support (formal and informal) as an integral part of services provided throughout the pregnancy and up to school age. • More women and their families achieve a smoke free pregnancy and home and sustain that success through the child’s early years, making use of customer focused support. • Local women who become pregnant will be accessing a programme of support to optimise their nutritional status through pregnancy including support for weight management • A greater proportion of local women will be engaged in a programme of support for initiation and sustained breastfeeding in target communities • Through uptake of Paid/unpaid/mutual Infant feeding support local families will successfully wean their child and maintain their health weight. • Greater numbers of young women under 19, in the target areas delay the age of first pregnancy and subsequent pregnancies, pursuing a career or further education How will we know we are heading in the right direction? A selection from a number of measures: Maternal obesity levels Sustained engagement in ante natal programmes Smoking status in pregnancy (and 1 year on) Breastfeeding initiation Mean age of first pregnancy Obesity levels at 2.5 years and at school entry Vaccination rates Child poverty rates Page 3 of 12 3 PURPOSE To ensure children and young people within identified target communities achieve the best possible health to gain their best educational outcomes How will know we have achieved this? Attainment and progression to vocation/higher education is improved amongst children in the identified target areas, moving them closer to national performance rates. What key successes will contribute to this? • System for early identification and intervention for children and families at risk as determined by “Every Child Matters” • Engagement of eligible families, parents and child carers in programmes to build skills and confidence • Health programmes delivered to children in care/looked after children and chaotic families • Delivery of Family intervention project/ whole family approach to families in target areas who meet threshold criteria • Engagement of children in target areas in educational programmes to develop skills in managing and minimising harm from risk behaviours • Engagement of children and family members in opportunities for physical activity both in and out of school • Improved uptake in target areas of free school meals and breakfast clubs. • Children gaining skills in buying and preparing nutritious food through delivered programmes. • Engagement of children in development programmes for managing life transition confidently and positively • Utilisation of services relating to minimising risk and supporting responsible approaches to sexual health, emotional and mental health • Engagement with accessible mutual/peer support systems • Optimal implementation of child health programme in target areas How will we know we are heading in the right direction? A selection from a number of measures: School absenteeism rates Aspiration measure - proportion advancing to FE Proportion of Not in education, employment or training(NEETS) as a % of total population Teenage conception rates Sexually transmitted disease rates Obesity levels at year 6 free school meal uptake Levels of School meal entitlement vs. Healthy school status Under 18 alcohol admission rates Dental health at age 5 Page 4 of 12 4 PURPOSE To ensure timely and appropriate access to quality primary care services, hospital services and prevention programmes and opportunities for health improvement in all ages. How will know we have achieved this? The difference in uptake of services by people in the target areas of Derbyshire compared to the levels in the county as a whole will narrow year on year and the utilisation of services will move closer to the expected level based on identified prevalence of disease in these communities. What key successes will contribute to this? • Co-location and flexible opening and/or outreach for more accessible services where people in disadvantaged/ vulnerable communities go • Equitable targeting of resources and raising quality of service provision within disadvantaged communities • Provision and/or referral mechanisms to services supporting /motivating for behaviour change: Addictions – tobacco, alcohol, drugs; weight management; physical activity; cognitive behaviour therapy • Incentive schemes run in collaboration with local communities/families to encourage adoption of desired behaviours. • Development of interagency mechanisms to monitor the most vulnerable – mental health service users, people with learning disability, frail elderly, domestic violence including possible early warning system. • Programmes targeting additional support to vulnerable service users meeting threshold criteria. • Monitoring and benchmarking of
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