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Stroud & Berkeley Vale Locality Development Plan

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STROUD & BERKELEY VALE LOCALITY DEVELOPMENT PLAN 2013-15 1 PURPOSE 1.1 This Locality Development Plan has been produced to describe the specific health needs for the population of Stroud & Berkeley Vale, and sets out how the Locality Executive Group will lead work to address these needs over the next two years. 2 BACKGROUND 2.1 Gloucestershire Clinical Commissioning Group (CCG) was formally constituted in April 2013 as a requirement of the Health and Social Care Act 2012, replacing Gloucestershire Primary Care Trust (PCT) as the organisation responsible for the local NHS. A central aim of creating the CCG is to ensure a clinical focus on the commissioning of healthcare services for the county’s population. 2.2 The county of Gloucestershire covers a diverse range of populations, from the very deprived to the very affluent, from people living in very rural areas to people living in one of two large urban areas where there are a significant number of immigrant populations. This leads to a countywide population with very different health and social care needs, spread over a large geographic area. In recognition of the need to understand and represent these differences, the CCG has formed seven Localities; one of these is for the Stroud & Berkeley Vale area. In each Locality lead GPs work alongside key partners to help determine how best to meet the needs of its population, informing the wider work of the CCG; this is known as the Locality Executive Group. 2.3 Two major strategies have recently been produced by the CCG (and its predecessor PCT), working with Gloucestershire County Council. The first is the Health and Wellbeing Strategy (‘Fit for the Future’), which sets out the priorities for improving health and outcomes of the population of Gloucestershire over the next twenty years, focusing on supporting preventative measures and self-care. The priorities within this Strategy during 2013/14 are: Stroud & Berkeley Vale Locality Development Plan Page 1 of 16 Reducing obesity; Reducing the harm caused by alcohol; Improving mental health; Improving health and wellbeing into older age; Tackling health inequalities. 2.4 The second major strategy, as the NHS response to the Health and Wellbeing Strategy, is ‘Your Health, Your Care’, which sets out the vision for health and social care services and community support in Gloucestershire for the next five years. 2.5 This Locality Development Plan must be seen in the context of these two important strategy documents – we do not intend to replicate them. The CCG has also produced an Annual Operating Plan for 2013/14, which sets out its work programme for the coming year. This Locality Development Plan therefore fits within this wider context as follows: Health and Wellbeing Strategy Your Health Your Care CCG Annual Operating Plan Locality Development Plans Delivery of the actions contained within these plans will be measured in a number of ways, including against the NHS Outcomes Framework. 2.6 Producing this Locality Development Plan - To identify the health needs of the population of Stroud & Berkeley Vale the Locality Executive Group has identified three main sources of information: Public Health Intelligence (through the Joint Strategic Needs Assessment); Activity and financial data on the use of services, highlighting those areas where the Locality is significantly over or below ‘expected’ levels; ‘On the ground’ intelligence – i.e. conversations with local colleagues who are working directly with patients to understand their views about need. Stroud & Berkeley Vale Locality Development Plan Page 2 of 16 2.7 The Locality Executive Group has worked closely with key stakeholders to ensure they have the opportunity to fully contribute to identifying the health and social care needs of the local population, prioritising actions, and providing ideas for how these needs could be addressed, including: Local GP Practices and their staff; Gloucestershire Care Services; Gloucestershire Hospitals NHS Foundation Trust; Gloucestershire County Council and Stroud District Council; Local voluntary organisations; Local MPs/councilors; Patients and their representatives. In future, the Locality Executive Group will seek to work with others, including library services, Turning Point, Food Bank, financial advice agencies, churches/faith groups, and schools/colleges. 3 KEY ACHIEVEMENTS TO DATE 3.1 Whilst the CCG was only formally constituted recently, the Localities have been working in shadow form for much of 2012/13. Key achievements of the Stroud & Berkeley Vale Locality during this time are as follows: Participation in the Living Well Programme; Commissioning of factsforlife (education of primary school children), iVitae (community development work), Kitchen Challenge (cooking with vulnerable adults), Art Therapy at St Luke’s GP Practice, and new equipment trials with GP Practices; Practice Manager Time Management training; The Locality Executive Group visited each Practice, including discussions on prescribing, referrals and general updates; Worked hard to engage beyond health service colleagues, for example with patients, voluntary organisations and the public health team. Also, starting to work together with the Stroud and Berkeley Vale Health and Wellbeing Partnership through quarterly meetings and joint planning around health and wellbeing priorities. 4 LOCAL SERVICE PROVISION 4.1 The Stroud & Berkeley Vale Locality is comprised of Stonehouse, Nailsworth, Frampton-on-Severn, Wotton-under-Edge, Painswick, Dursley, Stroud, Berkeley, Minchinhampton and Cam – the total area covers around 113,000 people. There are 20 GP Practices in the Locality. Stroud & Berkeley Vale Locality Development Plan Page 3 of 16 4.2 In addition to the main acute hospitals in Gloucester and Cheltenham and the GP Practice sites, local NHS health services are also delivered from: Stroud General Hospital; The Vale Community Hospital; Hospitals in Bristol, including Emersons Green Treatment Centre, particularly those people living on the South Gloucestershire border in Wotton-Under-Edge; Weavers Croft Mental Health Unit. We recognise too the growing number of residents in local Care Homes and the need to meet their increasingly complex needs. 5 WHAT ARE THE ISSUES WE FACE? 5.1 The NHS and Local Authority in Gloucestershire produce a Joint Strategic Needs Assessment (JSNA) – this brings together the latest information on the health and wellbeing of people in the county, and its localities, including factors which influence health and wellbeing such as income, employment, environment and housing. The JSNA also highlights population changes over the coming 20 years. 5.1.1 The most significant issue facing the population of Stroud and Berkeley Vale is shown in the graph below (the population projection from 2010 to 2035), which highlights a considerable % increase in the proportion of people aged 65 and over. However, there is expected to be a reduction in the number of infants and those aged 5 to 19. Stroud & Berkeley Vale Locality Development Plan Page 4 of 16 5.1.2 As well as showing the geographical area covered by the Locality, the map below shows the levels of deprivation. There are clear pockets of deprivation in Cam West, Stonehouse, Dursley, Slade (Stroud), Central (Stroud), Caincross and Minchinhampton. 5.1.3 Overall the health population of the Locality varies most significantly from the Gloucestershire/national picture as follows: • Health & life expectancy of people in the Locality is generally better than Gloucestershire and England averages; • Over the last 10 years, all cause death rates have fallen. Early deaths from cancer, heart disease and stroke have fallen and are better than Gloucestershire and England averages; • Life expectancy is 5.1 years lower for men in the most deprived areas of the Locality than in the least deprived areas. 5.1.4 The JSNA highlights the following issues to be addressed for the Stroud and Berkeley Vale Locality: • CHD mortality; • Cancer incidence (including breast) • A&E admissions (overall and for intentional self-harm, fractured neck of femur, diabetes, cancer, asthma); • Early identification: NHS Health Checks, diabetes and dementia registers; • Obesity – variation in obesity levels across the Locality and high levels of overweight (but not obese) children. Stroud & Berkeley Vale Locality Development Plan Page 5 of 16 5.2 In addition to the JSNA intelligence, the CCG information team has reviewed activity and finance data from commissioned services to assess where there are significant variances from expected levels; this has highlighted areas for further consideration. 5.3 As well as the information provided through the JSNA and CCG activity data, we want to strengthen this with understanding the views of people working alongside our patients in the community/’on the ground’, so we have also worked with our local colleagues (see section 2.7 above) to better understand the needs of our population, and priorities for improvement. 5.4 Nationally, the government is seeking to ensure services offered by the NHS and Local Authorities are as ‘joined-up’ as possible, and so will be investing heavily in integrated health and social care over the coming five years. We have already worked closely in Stroud and Berkeley Vale with our colleagues at Stroud District Council, and will work to strength this relationship further. The Stroud District Council’s priorities are as follows: Adopt the Gloucestershire Health and Well Being Strategy by June 2013; Support and expand the ‘Living Well’
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