Hinckley and Bosworth Primary Care Trust Public Health Annual Report 2002-2003 Mary Gee Director of Public Health November 2003 Hinckley and Bosworth Public Health Report 2002/03 Acknowledgements Hannah Blackledge Di Spalding, Director of LNDS, Public Health Analyst, Leicester & and Alison Scott, Primary Care, Rutland Health Informatics Service Leicestershire Nutrition and Dietetics Services Sue Read Specialist in Public Health, Peter Wilson Eastern Leicester PCT Public Health Specialist, Hinckley and Bosworth PCT Mandy Wardle Assistant Director of Public Mark Braham Health, Hinckley and Bosworth Resolution Manager, PCT Smoking Cessation Services Jama Warsame Michele Carruthers Trainee Specialist Registrar, PA, Hinckley and Bosworth PCT Public Health Mary Fitzgerald Ginny Copley PA, Hinckley and Bosworth PCT Public Health Specialist, Hinckley and Bosworth PCT Contents Mission Statement 1 Coronary Heart Disease 13 Introduction 2 Diabetes Care 17 The Way Forward 3 Smoking Prevention and Cessation 21 The Population of Hinckley and Bosworth 5 Food and Health 23 Inequalities in Health 6 Physical Activity 25 Addressing Health Inequalities 8 1 Hinckley and Bosworth Public Health Report: 2002/03 Public Health aims to improve the physical, social, mental and environmental health of the people of Hinckley and Bosworth. By working in partnership with and empowering individuals, communities and organisations, we aim to reduce the health inequalities between different groups within the community. We would like to hear from you. Our address is: Hinckley and Bosworth PCT Swan House Business Centre The Park Market Bosworth CV13 0LJ Telephone: 01455 293200 Fax: 01455 290700 Alternatively, please visit our website at: www.hinckleybosworthpct.nhs.uk 2 Hinckley and Bosworth Public Health Report 2002/03 Introduction: Tackling Health Inequalities THE EXISTENCE OF INEQUALITIES IN HEALTH across England is well known, with the life expectancy of a child born in some parts of the north of England being up to 10 years shorter than that of a child born in parts of the south. Inequalities in health can also be seen locally. The important point about health inequalities is that they are both unjust and very often avoidable. “Everyone has a part to At the end of each section of this As the Director of Public Health play, from the individual report are suggested ways forward. for Hinckley and Bosworth, I am looking after his or her own These will become the basis for required to write an annual report health through to statutory our Public Health Strategy, and are on the health of the residents of and voluntary organisations aimed not only at the health the PCT. Each year I will aim to working with communities, community but at our partners and explore certain aspects of health, a the importance of whose individuals living within Hinckley particular group of people or a role as public health and Bosworth. serious preventable illness. Although the report will describe practitioners cannot be The role of the Public Health the disease or disorder and the stressed too much.” Department of Hinckley and prevalence of the problem, I want Bosworth PCT is to recognise such to focus on the positive aspects of inequalities and, together with what can be done, and is being partner agencies, to address them. done, to improve matters. I shall Our partners are vital, because also suggest ways forward. they are often the key to preventing ill health in the first This year, my focus is on health place. The NHS can go on forever inequalities and how they are improving services, but this will measured, and on coronary heart never stem the tide of ill health. disease, diabetes, obesity and their prevention and management. The Everyone has a part to play, from “This year, my focus is on directions for us to work in, along the individual looking after his or health inequalities and how with specific recommendations, are her own health through to they are measured, and on highlighted at the beginning of the statutory and voluntary coronary heart disease, document. diabetes, obesity and their organisations working with prevention and communities, the importance of management. The whose role as public health directions for us to work practitioners cannot be stressed Mary Gee in, along with specific too much. Director of Public Health recommendations, are highlighted at the beginning Two words of caution: At the local level the numbers referred to are small. Care of the document.” must be taken in interpreting such statistics. They should therefore be interpreted relative to one another and not as absolute values. The Primary Care Trust is almost, though not completely, coterminous with Hinckley and Bosworth Borough Council. There are areas outside the Council’s boundaries (Stanton and Broughton) which are part of the PCT, while Markfield is outside the PCT boundaries but is part of the Borough Council. It has not always been possible to obtain information which reflects the PCT’s boundaries exactly, so some information has been included (especially maps and nationally available data) which refers to the local authority. No offence to those living in these areas was meant, and I hope, none taken. 3 The Way Forward - Priorities for Action Health Improvement address primary prevention as well as clinical intervention, and Inequalities which is arguably not currently The Public Health Strategy will address adequately actioned or resourced. health improvement and inequalities in Hinckley and Bosworth by: l There is a need for continued investment in physical activity and l providing a framework to co-ordinate the development of further development of smoking public health skills and capacity, cessation/tobacco control both inside and outside the NHS; initiatives and food and health programmes. l addressing the key public health issues identified in this report and l The PCT needs to improve the ensuring that reduction of quality and volume of locally inequalities is specifically specific data to inform action, targeted for action. especially between primary, secondary care and the community The Primary Care Trust and its Public services. This should improve the Health team should: effectiveness of its use, in turn ensuring that patients are provided l develop robust partnerships with more appropriate support and “The Public Health Strategy with other organisations, information. will address health communities and individuals improvement and l The PCT should support the (This will also enable clear inequalities in Hinckley and understanding of the variety of implementation of the Bosworth by developing contributions necessary to address Leicestershire-wide strategies for this agenda); heart failure, cardiac rehabilitation, robust partnerships with including Phase 4 (community other organisations, l support the development and based rehabilitation) and communities and implementation of relevant local revascularisation. individuals.” strategies, (e.g., the Leicestershire County Plan); Diabetes l support implementation of the l The quality and volume of local Homelessness Strategy and services for diabetes need to be Community Plan. raised so that the health care needs of increasing numbers of The Public Health team should: patients with diabetes can be met l lead a co-ordinated approach to at all levels. the development of community l The PCT should review the nurses’ public health role; baseline assessment of diabetes l carry out a local health equity services in primary care and from audit and develop and agree an it develop a future action plan. action plan. (This should improve l Approved ways or models should the targeting of health service be identified and adopted to detect provision at all stages - primary and treat patients with care, secondary care and in the undiagnosed diabetes as early as community); possible. l support a review of the role of l the Hinckley and Bosworth Mechanisms need to be developed and implemented which provide Health Forum and the PCT/Public appropriate education and Health contribution. support for patients with diabetes, making sure that patients Coronary Heart Disease gain the knowledge and skills they l The PCT needs to invest in and need for effectively controlling 4 Hinckley and Bosworth Public Health Report 2002/03 their condition and minimising Food and Health potential diabetes complications. The PCT should work with its l The training and development partners to: needs of all staff, including those in l develop an action plan for the primary care, should be assessed, prevention and management of and the necessary action taken to overweight and obesity within the ensure that professionals have local population; the skills and confidence to l expand local initiatives to support patient management of promote food and health issues; diabetes. l continue to promote and develop l Service development should include an effective education and effective preventive interventions training programme for for reducing the incidence of community workers and diabetes, including tackling obesity healthcare professionals involved and overweight and promoting in the prevention and management healthy eating and physical activity. of overweight and obesity, and l Primary care should offer all other nutrition-related issues, patients with known diabetes an alongside local dieticians; annual review to assess the risk l develop referral pathways for of diabetes complications and weight management, with follow their prevention or mitigation, and up and on-going