Agreeing the Priorities of the City and Hackney Health and Wellbeing Profile

Agreeing the priorities of the Health and Wellbeing Profile for Hackney and the City of London

Revised paper to Hackney Shadow Health and Wellbeing Board following discussion at Hackney Health Transition Programme Board

The 2011/12 Health and Wellbeing Profile

The 2011/12 City and Hackney Health and Wellbeing Profile is currently being prepared. A draft will be circulated in the week commencing 5th December 2011. Following the review of the last edition, the following key changes are being made:  Where available, data on local inequalities will be included (i.e. data on inequalities within Hackney and the City)  Where available, disaggregated data for the City will be presented separately  Responses and data from a local ‘call for evidence’ will be included  The ‘what works’ evidence sections will be revised and fully referenced We are unlikely to see major changes in the core data, though some trends may become more evident. The priorities of the Health and Wellbeing Profile

There are thirteen priorities in the 2010/11 edition of the Profile. They are as follows: A. Understanding and mitigating any adverse impacts arising from welfare reform on the health and wellbeing of local people by supporting people to cope with changes in their circumstances and income (including the impact of work capability assessments on the local population receiving incapacity benefit). B. Reducing smoking by helping people to quit and encouraging young people not to start. C. Promoting healthy weight and personal wellbeing by improving access to healthier food and promoting exercise, paying special attention to the needs of overweight and obese children. D. Reducing the harm caused by alcohol and drugs by encouraging those who drink alcohol to do so at levels consistent with good health and strengthening care pathways for people who drink too much or have drug-related problems. E. Improving information about, and access to, preventative services which promote wellbeing and independence, combat isolation and exclusion, and safeguard the growing ageing population. F. Understanding and addressing the health and wellbeing needs of disadvantaged groups including victims of domestic violence and other hate crime, rough sleepers, refugees and asylum seekers, carers, people with disabilities and sex workers. G. Promoting mental health and wellbeing, including reducing inequalities in mental wellbeing between people from different ethnic backgrounds and between those living in the most and least deprived areas in the locality, and reducing the incidence of mental illness. H. Maximising the potential health and wellbeing benefits of the Olympic and Paralympic Games, including promoting the employment and volunteering opportunities of the Games and encouraging more active lifestyles, while also preparing for possible major incidents during the event. I. Getting more people to use parks, libraries and other cultural facilities and programmes, targeting people with long terms conditions and current non users J. Promoting oral health and better access to dental services, especially for young children. K. Improving the health and wellbeing of babies, the under fives and their mothers by encouraging early booking for maternity services, tackling vitamin D deficiency, increasing uptake of childhood immunisations and safeguarding children from abuse. L. Promoting the sexual wellbeing of young people, reducing the transmission of sexually transmitted infections and reducing unintended pregnancies through better sex and relationship education in schools and wider use of long-acting reversible contraception. M. Preventing illness and promoting health and wellbeing through cancer screening, health checks and new opportunities for healthy lifestyles. These priorities are a revision of the priorities in the 2009 Profile, which had been developed through an extensive process of stakeholder engagement. The revision of the priorities for the 2010/11 Profile involved review by senior officers; discussion at key forums, notably the City and Hackney Commissioning Clinical Executive, Hackney Overview and Scrutiny Committee and the Stakeholder Involvement Advisory Group; and final agreement by senior management and members in both local authorities, the PCT, ELIC and KLEAR. The Handy Guide to the 2010/11 Profile is attached. This year, a more explicit process of prioritisation is proposed. Key considerations

The following issues need to be addressed in the process of prioritisation:  We are committed to producing separate priorities for Hackney and the City of London this year.  All key stakeholders must be involved including NHS East London and the City, Hackney Council, City of London Corporation, the voluntary and community sector, the Clinical Commissioning Group and the LINks.  In Hackney, the current Profile priorities are used regularly to make the case for activity across the Council’s work. Changes to current priorities must be clearly justified. The components of prioritisation

Established methods for JSNA prioritisation follow a series of explicit steps. Firstly, an initial review of the evidence is undertaken to identify key needs. Secondly, these needs are scored against agreed criteria by stakeholders. Thirdly, the results of the scoring are reviewed. Finally, decisions are made based on the outcome of the process. The following questions, initially developed in Leeds, have been widely used for the crucial second step of this process: 1. Is this an issue which affects a significant proportion of the population (directly or indirectly)? 2. Is this an issue which significantly affects vulnerable groups? 3. Is this issue a significant contributor to inequalities in health and wellbeing? 4. Is there evidence of unmet need? 5. Is the need likely to increase if there is no intervention? These questions assume that intervention is both possible and effective. A more advanced set of criteria would include a question that examined the effectiveness and cost-effectiveness of available interventions. However this may not be necessary or appropriate at this level of decision-making. The Health and Wellbeing Profile is used to set general priorities based on an assessment of need. Although it includes ‘what works’ sections to inform commissioning decisions, it does not seek to pre-empt those decisions. Proposed process for Hackney

The following process is proposed for Hackney: 1. Officers prepare a summary of the key issues for Hackney, including changes from 2010/11 and emerging trends. 2. This summary is shared with key stakeholders including members of both the Health and Wellbeing Profile Management Group and Stakeholder Involvement Advisory Group. Revisions are made as appropriate. 3. A meeting is convened bringing together key officers to a. score the identified issues against the five questions above; b. review the current Profile priorities against the outcome of the scoring; and c. propose a long list of priorities 4. A stakeholder meeting is convened to review officer decision-making and identify short-list of priorities. 5. Agreement of revised priorities by Shadow Health and Wellbeing Board, Cabinet, NHS ELC Board and CCG. 6. Priorities inform the development of the Hackney Health and Wellbeing Strategy Proposed timetable

Week beginning: 05/12/2011 Draft of Health and Wellbeing Profile circulated to stakeholders for comment, with open consultation on what the key issues are 02/01/2012 Paper summarising key issues circulated for comment 09/01/2012 Issues paper discussed at Stakeholder Involvement Advisory Group and at Health and Wellbeing Profile Project Group 16/01/2012 Issues paper revised Officer meeting to agree long list tbc. Stakeholder meeting to finalise short list of priorities tbc. Review and sign-off of new priorities by Health and Wellbeing Board Action

The Board is asked to:  Note the priorities of the 2010/11 Health and Wellbeing Profile  Comment on the proposed questions to be used for prioritisation  Comment on the proposed prioritisation process  Note need to develop Health and Wellbeing Strategy