One State, One Health System, Better Outcomes

HEALTHY TASMANIA FIVE YEAR STRATEGIC PLAN

JULY 2016

Department of Health and Human Services 2 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN FOREWORD

We know that the solution requires grassroots partnerships and innovation

Since coming to office at 19.3%. In addition, the prevalence of in 2014, the Hodgman overweight and obese adults in Tasmania Liberal Government continued to increase between 2011–12 has been pursuing and 2014–15 to 65.9%, compared to a slight an ambitious reform decrease in the national rate. This has led agenda in our health to significant increases in our health budget system. We’ve made it but it also undermines social and economic clear that building and development in Tasmania. strengthening core services, including health, is one of our top priorities. We know how That is why the Hodgman Liberal important these services are to Tasmanians, Government came to office in 2014 with as some of the essential building blocks for a goal to make Tasmania the healthiest us to lead good lives. That is why we have population by 2025, supported by a new developed bold strategies to reform our preventative health strategy. Given our health system from end to end, from our health statistics, this is the only goal worth One Health System reforms through to striving for. We have consulted with experts our Rethink Mental Health Plan and our and the general community, and now I am Suicide Prevention Strategy. pleased to deliver the next part of our work to overhaul our health system, the Healthy As we work to deliver these improvements Tasmania Five Year Strategic Plan on behalf to our acute and primary health services, of the Tasmanian Government. there is another critical piece of the ‘puzzle’ which we must also address. This is what Leadership for our vision is being provided we call preventative health. This is how we at a whole-of-government level, with as individuals, communities and government additional input sought from all government work together to ensure people stay agencies and government businesses at a healthier for longer. Heads of Agency and CEO forum co-chaired with the Premier earlier this year. Actions The challenge is significant, and very real, from multiple agencies are included in the with Tasmanians currently experiencing Strategic Plan and will continue to emerge. some of the worst population health outcomes in the country. Unfortunately, and We are committed to measuring our progress as we extensively outlined in our Healthy and have set new targets for one of our key Tasmania Consultation Draft, our state priority areas for action – smoking. experiences high rates of chronic disease and For Tasmanians under the age of 25, our health risk factors like smoking, obesity, poor target is to halve the gap between the nutrition and low physical activity levels. Tasmanian and national smoking rates For example, although Tasmanian smoking by 2020 and we will have smoking rates rates have decreased significantly over the better than the national average by 2025. last decade, we still have the second highest rate of current daily smokers in the country,

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 3 For all ages, we will aim to reduce the The Tasmanian Government would like Tasmanian smoking rate down to 10% by to acknowledge and sincerely thank the 2020, in line with the current Tobacco many organisations and people who Control Coalition target, and down to 5% contributed to, challenged and helped by 2025. If this target is not met, we will develop our strategic thinking as we revisit other policy options, including the crafted this Strategic Plan. It is my hope Minimum Legal Smoking Age proposal that Tasmanians will continue to enjoy that we included in the Consultation Draft. commitment to work positively together as the Strategic Plan is progressively put At its heart, this Strategic Plan is about in place. people and the communities they belong to. Its actions are very deliberately designed to I commend this Healthy Tasmania Five give people the information and tools they Year Strategic Plan to you as a fresh need to make positive and healthy changes approach to help us achieve our vision in their lives. This Strategic Plan supports for a brighter future, and for Tasmanians people from all walks of life to become more to enjoy our beautiful state in better aware, interested, engaged and more in health, living happier, longer lives. control of their own health and wellbeing. The Strategic Plan also fosters community connectedness in the process, bringing Hon Michael Ferguson MP people together to support each other Minister for Health toward better health.

We know that this community ownership is crucial – the solutions require grassroots partnerships and innovation. We want Tasmanians to further tell us what is important to them and what they would like to see happen in their communities.

4 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN “A priority area for action is to develop and resource strategies that ensure people in Tasmanian communities have ease of access to making healthy choices.”

Tasmanian Council of Social Service, submission on the Consultation Draft

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 5 OUR PRIORITIES FOR ACTION

The Tasmanian Government will take the lead in preventative health by supporting Tasmanians to initiate and maintain healthy choices through our priority areas for action

It is critical that we develop new approaches SMOKING to support our communities to get engaged and to encourage each other to make 1 I nvest in additional social marketing at healthy lifestyle changes. the levels the evidence tells us will make a difference in Tasmania, as well as We have identified a range of new undertaking highly targeted quit campaigns actions under four priority areas that are community-led, based on grassroots action 2 S upporting pregnant women to quit and a shared responsibility for health and smoking through a multi-strategy wellbeing. approach

Our actions have been developed to 3 T arget a decrease in smoking rates complement and better connect the good through additional enforcement and work already happening in Tasmania. The targeted educational material, subject Tasmanian Government already invests to tripling the cost of the Tobacco Seller’s approximately $70 million per year across Licence fee and pursuing options for all sectors on activity that has a positive the provision of additional quit smoking impact on our health and wellbeing. information at the point of sale

4 T arget smoking uptake by young To build on our response to preventative people through additional enforcement health, we will invest an additional activity, including increasing penalties for $6.4 million on new actions over the supplying a tobacco product to someone next four years. underage to match the highest penalties in Australia, currently $18 120 The new initiatives have been designed to engage Tasmanians in new ways to 5 T arget smoking uptake by young encourage us all to take steps to adopt people by hiring more compliance a healthier lifestyle. The Tasmanian and education officers to undertake Government considers the community to additional enforcement activity be a key partner in these initiatives as we will all need to work together to achieve 6 C ontrolling the sale, use and positive health outcomes. promotion of electronic cigarettes to prevent normalisation of smoking and sale to children

7 Action to target the illicit tobacco trade

6 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN HEALTHY EATING AND 16 S upport community planning by PHYSICAL ACTIVITY mapping preventative health and community activity 8 I ncrease student health and wellbeing by supporting school and community 17 G et people connected to community partnerships through the Student activities and educational resources Health Initiative through the Healthy Tasmania Portal, a one stop shop for preventative 9 H elp kids make healthy choices by health information providing a toolkit of resources to support parents, carers and educational 18 I ncrease health literacy by supporting settings through Healthy Kids Tasmania all State-funded health care services to champion prevention 10 I ncentivise Tasmanians to get healthier through the Healthy Tasmania Challenge 19 W ork with the media to spread positive health messages 11 I nform people of the risks of obesity and support healthy choices through 20 E ngage older Tasmanians in creating the LiveLighter campaign a productive, inclusive and supportive community through a new Active 12 E stablish new ways to encourage Ageing Plan Tasmanians to use our parks and reserves to increase their physical activity 21 S trengthen the Child Health and Parenting Service’s (CHaPS) role in 13 I ncrease physical activity via low cost providing child health information and promotion of active tourism through our parenting support significant physical and digital footprint

14 H elp workplaces turn their good CHRONIC CONDITION intentions into sustainable healthy SCREENING AND habits through the Tasmania Healthy MANAGEMENT and Safe Workplace Initiative 22 S upport people with chronic conditions COMMUNITY to manage their condition at home and in their community by identifying and CONNECTIONS trialling new models of anticipatory care

15 S upport innovative community 23 E ncourage all Tasmanians of appropriate partnership approaches to better ages to have their heart disease and health through the Healthy diabetes risk assessed Tasmanian Communities Innovation Pool grants program 24 E nsure Tasmania benefits from future national reforms to coordinated care and chronic condition management by working with the Australian Government and Primary Health Tasmania

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 7 TARGETING ACTION ACROSS THE LIFE STAGES

We will support Tasmanians to make healthy lifestyle changes across all stages of life

EARLY YEARS I ncreased fines for retailers and others who supply tobacco products to The health of a child is influenced by the someone underage mother’s health and nutritional status prior to and during pregnancy. I ncreasing social marketing on the dangers of smoking Supporting parents to adopt healthy S chool nurses to support student attitudes and practices right from the start, health and wellbeing such as breastfeeding, builds the foundation of life-long health. YOUTH AND ADOLESCENT Our actions include: C hild Health and Parenting Service Adolescence is an important transition reforms to models of care period where we need to support young people to continue healthy habits and resist H ealthy Kids Tasmania unhealthy ones, such as smoking, as they S tudent Health Initiative start to make choices more independently.

Our actions include: SCHOOL YEARS S tudent Health Initiative Teaching children and young people about H ealthy Tasmania Challenge the health benefits of physical activity, S moking related actions, as per nutrition and respectful relationships, and school years encouraging these behaviours is important. It helps them to maintain good health for Y outh Suicide Prevention Plan for growth and development. Tasmania (2016–20)

Our actions include: S tudent Health Initiative H ealthy Kids Tasmania H ealthy Tasmania Challenge I ncreased licence fees for tobacco sellers

8 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN WORKING AGE ALL AGES

Many adults are leading more sedentary The following initiatives should assist lifestyles, often as a result of the type of Tasmanians to live healthier lives at all work that they do, and this is a risk factor stages of life: for ill health. Engaging adults to make H ealthy Tasmanian Communities healthy lifestyle choices can protect Innovation Pool against these risks. H ealth Care Services Champion H ealthy Tasmania Challenge Prevention initiative T asmanian Healthy and Safe M apping of preventative health and Workplaces Initiative community activity LiveLighter H ealthy Tasmania Portal C ontribute to Fifth National Mental C ost-effectiveness Assessment Tool Health Plan Health-in-all-policies R ethink Mental Health Plan and Suicide P reventative health commissioning Prevention Strategy C ontribute to Fifth National Mental A ssessment of heart disease and Health Plan diabetes risk R ethink Mental Health Plan and Suicide T rial new anticipatory care models Prevention Strategy W ork with Australian Government on national chronic condition reforms “Menzies recognises the importance of investing in the early years, but given OLDER AGE Tasmania’s ageing population and the opportunities to effectively promote health Early detection and control of disease, at all ages, we believe a focus on prevention healthy eating and engaging in physical across the life-course is needed” – Menzies activity are important components of health Institute for Medical Research, submission and wellbeing as people get older. Physical on the Consultation Draft. activity can also help older people stay connected to their communities, particularly where activities are undertaken in groups.

H ealthy Tasmania Challenge C ontribute to Fifth National Mental Health Plan R ethink Mental Health Plan and Suicide Prevention Strategy A ssessment of heart disease and diabetes risk A ctive Ageing Plan LiveLighter W ork with Australian Government on national chronic condition reforms T rial new anticipatory care models HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 9 SMOKING

The Tasmanian Government will commit $1.8 million over four years to increase smoking control, education and targeted intervention activity

Tobacco smoking kills more than 500 We have consulted on the best approaches Tasmanians each year and imposes a to targeting smoking throughout the significant burden on individuals, families, development of the Strategic Plan. It is communities, businesses and governments. clear that this is a complex issue and there It is clear from Tasmania’s continued high are a wide variety of views on what action smoking rates that more needs to be done. should be taken.

As part of our commitment, we are setting We will initially target our action towards ambitious targets to reduce smoking. For those who supply tobacco and education people under 25, we are committing to and marketing to help people quit. We halving the gap between the Tasmanian and will continue to review our approaches national youth smoking rates by 2020 and to smoking and if our targets to reduce to reduce smoking rates to better than the youth and overall smoking rates are not national average by 2025. met within the designated timeframes, we will reconsider stronger measures For all ages, we are aiming to reduce the including revisiting the concept of raising Tasmanian smoking rate to 10% by 2020 the Minimum Legal Smoking Age. and down to 5% by 2025. This is in line with targets set by the expert Tobacco Control Coalition group.

18.9% of Tasmanian adults are current smokers, compared to 16% nationally.

10 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 16.7% of Tasmanian women who gave birth smoked during the first 20 weeks of pregnancy, compared to 11.3% nationally.

15.1% of Tasmanian women continued to smoke after 20 weeks of pregnancy, compared to 8.6% nationally.

Invest in additional social Supporting pregnant women 1 marketing at the levels the 2 to quit smoking through a evidence tells us will make a difference multi-strategy approach. in Tasmania, as well as undertaking highly targeted quit campaigns. Through this approach we will seek to partner with health professionals in a range We are committed to retaining social of settings, including GPs, pharmacists, marketing activity at optimal levels for ante-natal staff and midwives to make sure Tasmania. This means advertising that is that pregnant women fully understand the on air for 32 weeks a year (or 700 Target ongoing danger to their baby from smoking. Audience Rating Points). Advertising at this level will commence subject to an increase Building on the action we are already taking, in licence fees. Increasing licence fees will it will enable us to better support pregnant enable us to resource this activity on an women to quit smoking before they conceive ongoing basis. or from the earliest stages of pregnancy.

We will also invest in highly targeted quit We will engage with Primary Health campaigns to direct our resources at key Tasmania and other relevant bodies groups, such as young people. during the second half of 2016 to establish approaches that will best support health professionals to relay messages about smoking harm, including the development of educational materials.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 11 44% of 12–17 year olds in Tasmania who smoke obtained their last cigarette from a friend, 25% had someone buy it for them and 6% got it from a parent.

Of those who had someone buy their cigarettes for them, 79% were by a friend over 18 years of age.

Target a decrease in smoking rates Target smoking uptake by 3 through additional enforcement 4 young people through additional and targeted educational material, subject enforcement activity, including increasing to tripling the cost of the Tobacco Seller’s penalties for supplying a tobacco product Licence fee and investigating options for to someone underage to match the the provision of additional quit smoking highest penalties in Australia, currently information at the point of sale. $18 120.

We will increase our licence fees to reflect In Tasmania it is an offence for any person the full cost of regulation, administration, to sell, lend, give or supply tobacco products enforcement and compliance of the licensing to someone underage. The new fine regime. The fee increase will be phased represents a significant increase from the over a two year period, rising to $731.34 current level of $7 850. on 1 January 2017 and approximately $1 097.00 from 1 January 2018. Reducing the uptake of smoking by young people is critical to reducing smoking rates By taking this step we will be able to over time – evidence suggests that if a undertake additional compliance and young person is not smoking by their early control activity. Recovering the full cost of twenties, they are unlikely to ever start. our regulatory action through licensing fees will also enable us to fund additional social Many underage smokers in Tasmania source marketing and education activity (as outlined their cigarettes from friends and family. under Action 1). Taking action to reduce this secondary supply of tobacco through increased fines We will also pursue options for the provision will have a positive impact on smoking of additional quit smoking information at the rates by reducing the uptake of smoking. point of sale.

12 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN Target smoking uptake by young 5 These actions are based on the best people by hiring more compliance available evidence and the feedback we and education officers to undertake received through consultation. A number additional enforcement activity. of states and territories have also acted to regulate electronic cigarettes in various ways. It is an offence in Tasmania for a person under the age of 18 to smoke, use or Action to target the illicit possess tobacco. Our approach to 7 enforcement is an educative one, where tobacco trade. young smokers are provided with warnings The Tasmanian Government works in and approved information, supplemented partnership with the Australian Government by the consequence of having tobacco to target the illicit tobacco trade, however products in their possession seized by there is potential for us to do more. an authorised officer. A number of other states and territories Subject to increasing the Tobacco Seller’s have legislated additional powers to Licence fee, we will hire new compliance target this trade, including fines for tobacco and education officers to enable more work retailing or wholesaling businesses for to be done to educate underage smokers possessing illicit tobacco products and on the dangers of smoking, through these providing inspectors with the power to enforcement mechanisms. seize illegal tobacco products.

Controlling the sale, use and We will investigate and implement the 6 promotion of electronic cigarettes options for targeting the illicit tobacco to prevent normalisation of smoking trade that would work best in the and sale to children. Tasmanian context.

We will take action to improve public All required regulatory and legislative education regarding electronic cigarettes amendments to give effect to the actions and establish a monitoring and compliance listed in this section will be tabled in system. However, we will prohibit the sale Parliament as a priority. of electronic cigarettes to people under the minimum age, display and advertising and use in smoke free areas.

While we will leave open the option of supporting electronic cigarettes as a cessation aid in the future as further evidence emerges, our approach seeks to strike a balance and provide responsible education for Tasmanians about the potential health risks associated with these products. This way we can prevent the re-normalisation of smoking-like behaviour and ensure that uptake is minimalised (particularly by young people).

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 13 “An investment in social marketing and a clever ‘healthy living’ campaign would have a large benefit to support the key cancer risk areas.”

Cancer Council, submission on the Consultation Draft

14 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN HEALTHY EATING AND PHYSICAL ACTIVITY

The Tasmanian Government will invest $3.5 million in activity to support and incentivise communities and individuals to take positive steps towards a healthier lifestyle

Healthy eating and active living are School and community partners will be key factors in maintaining good health. encouraged to focus on activity related to: Overweight and obesity are associated H ealthy school canteens and with a number of chronic conditions, breakfast clubs and losing weight lowers your risk of developing them. K itchen garden and agricultural initiatives Tasmania has the highest overweight Physical activity and obesity rates of any Australian state or territory. The action we are taking aims D rug education and relationships to reduce our overweight and obesity rates. It also aims to prevent young people who Activity will commence in Term 1 of 2017 are a healthy weight now from becoming and will be supported by the Department overweight or obese later in life. of Education. In addition, by no later than 2020, all Increase student health and Government schools will have commenced 8 wellbeing by supporting school and a process to achieve canteen accreditation. community partnerships through the Student Health Initiative, our flagship initiative for children and young people, supported by $2 million over four years.

Engaging children to make sure that healthy habits are learned early will ensure good health later in life. This initiative will help us achieve generational change and is the most cost-effective way that we can make a real difference over the long term.

It will encourage partnerships between schools and communities to promote opportunities for students to contribute to building positive school environments that supports healthy, safe and active choices.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 15 Help kids make healthy choices by Inform people of the risks of 9 providing a toolkit of resources to 11 obesity and support healthy support parents, carers and educational choices through the LiveLighter campaign. settings through Healthy Kids Tasmania. We will work with the Department of Healthy Kids Tasmania is an integrated Health of Western Australia to bring its program, which will build on existing LiveLighter campaign to Tasmania. platforms to provide lots of resources and online support for parents, carers, early LiveLighter is supported by the Heart childhood centres and schools to assist Foundation and Cancer Council and has them with educating children on nutrition been taken up by a number of other states and physical activity. and territories with positive results.

Alongside the Student Health Initiative, It is a comprehensive, evidence-based Healthy Kids Tasmania resources will be statewide public education campaign which designed to strengthen links with parents aims to raise awareness of the serious health and local communities. They will be made effects of being an unhealthy weight and progressively available from the start of 2017. motivate active living and healthier eating. It will also provide Tasmanians will a toolkit 29.8% of 2–17 year old Tasmanians are of practical resources to help them make overweight or obese, compared to healthy choices, including recipies and meal 25.8% nationally. and activity planners.

Establish new ways to encourage Incentivise Tasmanians to get 12 10 Tasmanians to use our parks and healthy through the Healthy reserves to increase their physical activity. Tasmania Challenge. Through the Challenge, Tasmanians will be supported Time spent being active outdoors is great to set activity and nutrition goals appropriate for our mental and physical health. With to their health status and age to guide national parks and reserves accounting for health improvement. approximately 50% of our state, Tasmanians, wherever they live, are ideally placed to reap While individuals will be able to participate, the benefits of this outstanding public asset. we will encourage people to enter the Challenge as part of a team, which could be This initiative will include a range of activities based on their community, their workplace to encourage Tasmanians to use our parks or school, or any other network or club and reserves more often to be more active. they belong to. This will include open days to select parks and increasing opportunities for volunteer The Challenge will encourage everyday involvement in education and management activity such as walking buses or park and initiatives. walk schemes. We will explore innovative partnerships A fund will be established to reward teams across government and with other sectors that achieve their goals. It will fund rewards to encourage and support Tasmanians to such as community infrastructure and take part in healthy activities in our parks activities to encourage healthy eating and and reserves. physical activity in Tasmanian communities. This initiative will be launched alongside The Challenge will be launched in 2017. the Healthy Tasmania Challenge.

16 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 65.9% of adult Tasmanians are overweight or obese, compared to 62.8% nationally.

67.0% of adult Tasmanians have sedentary and low levels exercise, compared with 65.9% nationally.

Increase physical activity via low Help workplaces and 13 cost promotion of active tourism 14 communities turn their good through our significant physical and intentions into sustainable healthy digital footprint. This initative will provide habits through the Tasmania Healthy at cost adverstising opportunities for places and Safe Workplaces Initiative. and events that encourage us to be physically active. Advertising opportunities will be As an employer of over 27 000 Tasmanians, provided across the Tasmanian the Tasmanian Government seeks to be Government’s physical and digital assets. a leader in workplace health, safety and wellbeing. Promoting healthy lifestyle choices This initative will also have benefits for in the workplace can have a positive impact our wellbeing, as well as increase on the prevention of injury, illness and economic activity and employment, absences from work. particularly for regional areas. Worksafe Tasmania and the Department of Premier and Cabinet will partner with employers, peak industry groups and service providers to deliver the Tasmania Healthy and Safe Workplaces Initiative.

The initiative will focus on a holistic approach to both physical and psychosocial lifestyle habits and will build on existing resources, tools and partnerships.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 17 COMMUNITY CONNECTIONS

The Tasmanian Government will invest $1.1 million in activity that drives community partnership approaches to find innovative place-based solutions to poor health

People who are connected to their The Healthy Tasmania Challenge also community live longer and healthier lives. incentivises communities to support each Community connections help initiate and other to take healthy action. Additional maintain healthier choices and lifestyles and new actions are listed below. support better mental health. Understanding community needs allows services to be Support innovative community better focused and more accessible. 15 partnership approaches to We will enhance community connections better health through the Healthy in the following ways: Tasmanian Communities Innovation Pool grants program. E ncouraging people to engage more with their community, providing physical We will invest $1 million in seed funding activity and mental health benefits for community driven approaches to improving health and wellbeing. P roviding incentives for communities to support and encourage each other Community-led approaches are of growing to make changes to achieve better health importance to improving health and and develop their own preventative reducing health inequalities. They empower health Community Action Plans communities to shape and build the services E nhancing the way we provide and programs they need and use. information so that individuals and The grants will be particularly targeted at communities can better understand their communities that have the poorest health own health needs and form partnerships outcomes. These communities will be to plan activities and responses encouraged to identify the risks they C hanging our models of care to provide want to address and how potential new the right mix of services in the right activities will support or fill gaps in places so that communities can connect current approaches. and access them easily We will help communities to do this by A number of our actions primarily related mapping activity and including it on the to healthy eating and physical activity will Healthy Tasmania Portal (Actions 16 and drive community partnership approaches 17). We will also provide resources to guide and innovative place-based solutions to poor communities to develop their Community health, including the Student Health Initiative. Action Plans for preventative health.

18 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN The Innovation Pool will encourage The Portal will help individual Tasmanians communities to develop partnerships, to get connected to organisations in their including with health providers and local community to encourage physical, commercial enterprises or businesses. social and recreational activities.

The first grant round will be held in 2017. The Healthy Tasmania Portal will be developed during 2016. Information will be uploaded as it becomes available and Support community planning by will be monitored and kept up to date 16 mapping preventative health and with new activity and information. community activity across Tasmania and make this information publicly available. Increase health literacy by This will assist individuals and communities to 18 get connected, get involved and get healthier. supporting all State-funded health care services to champion prevention. There is so much great activity already happening in our communities and it is This will increase patient skills and important for people to know what is out knowledge so that individuals can act there and how it might be built on or linked on their own health. to new ideas. Our hospitals and health care services It will also help communities to plan activity will work to find more and different ways that might receive seed funding through to set an example for health promotion the Healthy Tasmanian Communities and prevention. This will include looking Innovation Pool. at options to provide environments that better support healthy choices and behaviours, including increased healthy Get people connected to food options. 17 community activities and educational resources through the We will connect our hospitals and health Healthy Tasmania Portal, a one stop care services with the community through shop for preventative health information. supporting them to develop Community Action Plans for preventative health or The Portal will include information and links through partnerships for projects under on activity, community health profiles and the Healthy Tasmanian Communities other information to support community Innovation Pool. planning and the development of Community Action Plans. Work with the media to promote The Portal will also house a toolkit of 19 positive health messages. educational resources to guide preventative health activity that could be used by We will work with Tasmanian media to Neighbourhood Houses, Community promote messages such as the benefits Health Centres, Child and Family Centres, of healthy lifestyles and encouraging GPs, seniors groups and other community people to make healthy choices. organisations. In addition, it will link to resources provided through our Healthy This will include messages about quitting Kids Tasmania and LiveLighter initiatives. smoking, the importance of good nutrition and being physically active.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 19 Engage older Tasmanians in Strengthen the Child Health and 20 creating a productive, inclusive 21 Parenting Service’s (CHaPS) role and supportive community through in providing child health information a new Active Ageing Plan. and parenting support.

A new Active Ageing Plan will build on CHaPS is a community based child health current activity and identify new actions service that focuses on the early years of that capitalise on Tasmania’s ageing a child’s life, from birth to age five. CHaPS population profile and engage older is currently undertaking a review of its Tasmanians in creating a productive, Model of Care (MOC) with the aim of the inclusive and supportive community. redesign being to prioritise clinical service delivery in partnership with families to meet We have provided funding of $125 000 the family’s identified goals. It is anticipated to the Council of the Ageing (COTA) that the MOC will improve access and to commence work on the Plan. appropriateness of service by including service pathways which recognise that individual families require service models which have the flexibility to respond to family need.

The MOC will allow a multidisciplinary team of clinicians to offer a full range of child health services. The MOC will also incorporate collaborative service planning and case management with other service providers where appropriate. Options to better align CHaPS with other relevant health services are also being considered with the aim of strengthening present governance arrangements.

The new CHaPS MOC is focused on supporting and strengthening parenting across the community.

20 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN “Community led approaches to build community capacity are well recognised as a strategy to increase health and wellbeing”

Local Government Association of Tasmania, submission on the Consultation Draft

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 21 CHRONIC CONDITIONS SCREENING AND MANAGEMENT

The Tasmanian Government will support those people who are at risk of, and who live with, chronic conditions to remain healthier at home and in their communities

Support people with chronic While it is important to prevent people from 22 getting sick in the first place, we also need conditions to manage their to refocus our efforts to better support condition at home and in their community those people who already have a chronic by identifying and trialling new models condition. of anticipatory care.

Increasing rates of chronic conditions, along This work will focus on priority risk factors with the pressures of an ageing population, and providing care in the community are contributing to growing health for people with chronic conditions. expenditure across all governments. The approach will embed prevention Prevention is an important element in across the continuum of care and will health care, and we will look for new ways assist in strengthening participation and to embed prevention, early intervention, relationships across a broader range self-management and care coordination of stakeholders, including acute and across all of our health and community sub-acute care services. care services. The Department of Health and Human This approach picks up on the key theme Services and the Tasmanian Health Service in the White Paper on Delivering Safe and will seek to partner with Primary Health Sustainable Clinical Services, which shifts Tasmania and key chronic disease community focus to a greater emphasis on primary sector organisations to develop and and community care. implement anticipatory care approaches that will help Tasmanians with chronic disease to remain well in their home and community.

This will also include engaging with the Australian Government, including Primary Health Tasmania, to ensure that any new anticipatory care models work well with any future national reforms and that our health professionals are supported to trial and implement them.

22 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN Encourage all Tasmanians of Our high rates of lifestyle-related risk 23 appropriate ages to have their factors have contributed to Tasmania heart disease and diabetes risk assessed. having higher rates of multimorbidity (three or more self reported chronic Heart disease and diabetes are very conditions) than any other jurisdiction common chronic diseases in Tasmania. and this problem is getting worse. These diseases are associated with heart attack, stroke, chronic kidney disease and 50.3% of Tasmanians had three or more other health problems that impact on the chronic conditions in 2014–15, increasing lives of many Tasmanians. from 41.8% in 2011–12.

A person’s risk for heart disease and diabetes Our new approaches aim to prevent can be assessed and managed to prevent the development of chronic conditions them from developing these diseases. as well as support people to better We will use our available communication manage a condition if they have one. channels to encourage all Tasmanians 45 By reducing the prevalence of risk factors years of age and older (35 and older for and rates of chronic conditions, we can Aboriginal Tasmanians) to have their risk reduce their impact on individuals and for heart disease assessed, and Tasmanians their families, but also on our community 35 and older (18 and older for Aboriginal and economy. When people are healthier Tasmanians) to have their risk for diabetes and feel better, they will not need to assessed by their GP. use health services as much, and are likely to have higher rates of workforce Ensure Tasmania benefits from participation and be more productive 24 future national reforms to while at work. coordinated care and chronic condition management by working with the Australian Government and Primary Health Tasmania.

The Australian Government has signalled a commitment to collaborate with states and territories to better coordinate care between health services.

We have successfully worked in partnership with Primary Health Tasmania in the past to develop coordinated care models for people with chronic conditions. We will build on this relationship as new opportunities arise.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 23 CURRENT APPROACHES AND ACTIVITY

The Tasmanian Government currently invests $70 million per year on preventative health activity across all of our agencies and businesses

SMOKING E ncouraging families to be active in our parks and reserves through Discovery S upport people to quit through Ranger Program, delivered by the Quitline support, social marketing of Department of Primary Industries, quit campaigns and brief interventions Parks, Water and Environment by health professionals I ncreasing physical activity with support S upport pregnant women to quit to sporting clubs through A Smoke Free Start for Every Tasmanian Baby: A Plan for Action I ncrease participation in sport and recreation by Aboriginal and Torres R educe smoking uptake through the Strait Islanders and people with Smoke-Free Young People resources disability through targeted programs M onitor the compliance of tobacco P lanning, facilities and environments sellers and at smoke free areas, including investment, including infrastructure operations to test compliance with age to support physical activity, sport based laws and recreation, delivered by the I mprove the health of prisoners and Departments of Premier and Cabinet staff via smoke free prisons policy and State Growth E ncouraging activity by expanding bus HEALTHY EATING AND services to facilitate walking between PHYSICAL ACTIVITY destinations and bus stops P romoting bush walks of varying lengths D eliver healthy food messages via and difficulty through the 60 Great Short community nutrition programs Walks brochure P romote good nutrition and physical P rovide low cost, positive, sporting, activity for children through Child and recreational, social and cultural programs Family Centres’ healthy start to life for ‘at risk’ youth through Police and programs and through programs in Community Youth Clubs, delivered early childhood and school settings by the Department of Police, Fire and I mprove access to affordable and Emergency Management nutritious food, via programs such as food cooperatives, school breakfast programs and emergency food relief

24 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN COMMUNITY P revention and early intervention CONNECTIONS approach to supporting at risk families through Child Protection S upport families to establish healthy Redesign reforms habits early in life through Child I ncrease volunteering by support Health Centre Network and Parenting for volunteer-involving organisations Centres services I ncrease health literacy via approaches, such as 26Ten campaign and Health CHRONIC CONDITION Literacy Network, and health promotion SCREENING AND activity, education and program support, MANAGEMENT delivered by the Departments of Health and Human Services and Education E arly detection of cancer via screening services, and community education, H elp people to increase control over prevention and early detection programs and improve their health through Adult Day Centres S upport GPs to refer patients to services that respond quickly in a C reate strong social bonds within non-hospital setting via Community groups via physical activity in a natural Rapid Response trial setting, supported through the Wildcare Volunteer Partnership R educe likelihood of developing a chronic condition, disease or disorder B uild the social inclusion of culturally through nurse led primary health and linguistically diverse groups via Get programs Outside with Community activity C hronic condition promotion and P revent intimate partner violence, which support activity, including information contributes more to the disease burden provision, education and condition than any other risk factor in women management and coaching, obesity aged 18–44 years, through Safe Homes, clinics, rehabilitation programs and Safe Families falls and balance clinics A dminister grants related to community D evelopment of coordinated care life, sport and recreation models for people with chronic F ocus on early childhood development, conditions, in partnership with economic participation and support Primary Health Tasmania for Aboriginal children to be safe in their families and communities via the Resetting the Relationship with the Aboriginal Community in Tasmania agenda T est if lead support coordination improves outcomes for families at risk and clients with multiple and complex needs through Joined Up Human Services Project

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 25 “The necessity to collect timely, regular data cannot be understated to measure the effectiveness (or otherwise) of our interventions, and to give a sense of the health of our population”

Tasmanian Chronic Disease Prevention Alliance, submission on the Consultation Draft

26 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN GOVERNANCE AND EVALUATION

Our governance and evaluation arrangements reflect a whole-of-government approach and our commitment to taking cost-effective action

A HEALTHY TASMANIA IS PRINCIPLES FOR ACTION EVERYBODY’S RESPONSIBILITY When implementing our actions, we The reforms and initiatives outlined in the will be guided by the following principles, Strategic Plan are designed to engage each established by the Healthy Tasmania and every Tasmanian in activity that will Committee of the Health Council of improve their health. We will not achieve Tasmania: the outcomes we are striving for unless we F ocus on people and communities all take responsibility for our own health. F acilitate coordination, communication We can also take steps to encourage our and collaboration between sectors friends and family to make healthy choices, to improve health outcomes and participate in conversations and activities T ake action that promotes health within our communities that aim to drive through responsible partnerships good health. R educe inequities in health IMPLEMENTATION AND M ake health information publicly OVERSIGHT accessible S trengthen prevention by building The Minister for Health will oversee the the evidence-base and understanding delivery of the Strategic Plan and will be of what works responsible for monitoring progress.

The Department of Health and Human A NEW ROLE FOR THE Services will be responsible for overseeing PREMIER’S PHYSICAL the implementation of the bulk of the ACTIVITY COUNCIL reforms outlined in the Strategic Plan, with support from other agencies where relevant. The Premier’s Physical Activity Council will be renamed and have its remit To assist the Minister for Health to monitor extended to provide strategic advice progress against the Strategic Plan, the across government in alignment with Department of Health and Human Services the Strategic Plan. will work with other agencies across government to prepare an annual report for the Minister.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 27 TAKING A HEALTH-IN-ALL- We will also establish the following smoking POLICIES APPROACH rate targets: F or Tasmanians under the age of 25, Life factors for good health and the we will halve the gap between the systems that influence the health status of Tasmanian and national smoking rates populations often sit outside of the health by 2020 and we will have smoking rates sector. They include employment, education, better than the national average by 2025 income, housing, transport and the creation of environments that support personal F or all ages, we will aim to reduce the responsibility and individuals to make Tasmanian smoking rate to 10% by healthier choices. 2020, in line with the current Tobacco Control Coalition target, and down The Tasmanian Government will support to 5% by 2025 our agencies and government businesses to better understand and consider the health In addition, we are committed to setting impacts of their policies through improved new targets related to reducing health information sharing utilising the new Healthy inequities. This will be an important measure Tasmania Portal and support from the of our progress, given the significant impact refocused Premier’s Physical Activity Council. that social and economic factors can have Critically, an annual Heads of Agency forum on health outcomes. will provide the leadership across the state service to ensure we are working across government to develop long term solutions ASSESSMENT OF PROGRAMS to address the social and economic factors Our first step will be to develop an that influence poor health outcomes. assessment tool that is based on recent evidence about the most cost-effective MEASURING SUCCESS action to prevent and manage lifestyle- related chronic diseases. The tool will use The Tasmanian Government is undertaking existing studies which have been developed the next Tasmanian Population Health by preventative health experts, including the Survey in 2016. This will provide a picture Assessing Cost-Effectiveness in Prevention of Tasmania’s health status at the beginning Report (ACE Prevention Report)1. of the Strategic Plan. Future surveys will help us measure progress. The assessment tool will take into account the quality of the evidence that is available We committed to a range of existing to measure the effectiveness of preventative targets for preventative health in the health programs, as well as the context Consultation Draft of the Strategic Plan. for delivering programs in Tasmania. It will also consider issues such as the impact of delivering multiple programs in one location, which might increase the effectiveness of a program when compared to being delivered in isolation.

1Vos T. Carter R, Barendregt J et al. for the ACE Prevention team. Assessing Cost-Effectiveness in Prevention. Final Report. Melbourne: University of Queensland, Brisbane and Deakin University; September 2010

28 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN The assessment tool will be developed PREVENTATIVE HEALTH in quarter two of 2016 (by the end of COMMISSIONING MODEL September). It will first be used to help us understand the effectiveness of programs The Tasmanian Government will implement we are already delivering. The results of a commissioning model for preventative these assessments will be announced in health programs and activity over the life quarter four (by the end of March 2017). of the Strategic Plan. The tool will also be used to assess new The commissioning model will allow initiatives, after they have been implemented us to identify and prioritise needs and and have been given a chance to opportunities for good health based on demonstrate their impact. the best available evidence on the Making sure we collect the right data effectiveness of programs. to evaluate new activities is important. We will work closely with Primary Health We will also support organisations that Tasmania on the development of a deliver programs for us to measure and commissioning model for preventative demonstrate evidence of their impact health to make sure that the programs on health outcomes. we fund are well integrated. Along with the findings from the assessment Local government will also be important tool, the data we collect will help us players in conversations about the most to understand the effectiveness of the appropriate preventative health programs approaches we are taking, including the to commission. new initiatives outlined in the Strategic Plan. Increasing health literacy rates and The Strategic Plan is a guide to the type of supporting community planning through action the Tasmanian Government will take our new initiatives will assist local over the next five years. We will continue governments and their broader communities to adapt and improve our actions, taking to take part in the identification of activity into account any lessons learned through that best suits their needs. This will build these assessment and evaluation processes. capacity within communities to shape the services and programs they need and use and will ensure future approaches are locally driven.

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 29 OUR COMMITMENT TO CONSULTATION AND PARTNERSHIP

We will have ongoing conversations with the community and stakeholders about our actions

CONSULTATION We also acknowledge the important work of the recent Joint Select Committee Inquiry The Tasmanian Government’s Healthy into Preventative Health. The Strategic Tasmania Consultation Draft was released Plan and the Joint Select Committee’s on 20 December 2015. We received over report contain several themes and ideas 100 public submissions in response to in common. the Consultation Draft over a two month period, to the end of February 2016. The Tasmanian Government will continue to welcome expert input and advice on We held four community forums around preventative health from existing advisory the state in February 2016, facilitated bodies, such as the Health Council of by the Health Council of Tasmania. The Tasmania, the Health Literacy Network Department of Health and Human Services and the Tobacco Control Coalition. also ran four forums in conjunction with local councils. The Health Council of Tasmania will continue its important role of consulting We would like to thank everyone who took with the Tasmanian community on the time to reflect on the Consultation preventative health, including action taken Draft and provide us with your feedback. under the Plan. We will also consider the It has been invaluable in developing the best way for the roles of the Health approach outlined in the Strategic Plan. Council of Tasmania and refocused Premier’s Physical Activity Council to The heads of each Tasmanian Government complement one another for the benefit agency and government business met in of the community and the health system. early 2016 to discuss the Healthy Tasmania agenda. This forum highlighted the wide The Tasmanian Government is also range of activity we already undertake and committed to having ongoing some new actions outlined in the Strategic conversations with the community Plan, such as the initiative to get people and key stakeholders about the actions more active in our parks and reserves. outlined in the Strategic Plan. It underscored the commitment we have as a government to work together to improve the health of Tasmanians.

30 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN We will establish a Healthy Tasmania Annual This will be important, as Tasmanian Roundtable to seek stakeholder and expert communities will be key partners in input on progress of the reforms, showcase delivering the actions outlined in the successful programs and approaches, and Strategic Plan. provide an avenue for the suggestion of new initiatives, including advice about what We recognise how important it will emerging evidence tells us about the best, be to increase health literacy to support cost-effective, practice. communities and individuals to partner with us in this activity and to take control The Health Council of Tasmania will be a over their health. key participant of the Roundtable and will provide advice to the Minister for Health Our Health Literacy Network is already on how potential new activities raised doing some great work to improve the through this forum could be integrated health literacy of Tasmanians and provides into the broader health system. a number of practical resources that can be used to help people to build the “A whole of governmental, whole of system knowledge and skills they need to find, approach, including recognition of the vital understand and use information to 2 importance of community, social services improve their health and wellbeing . and local governmental partnerships is In addition, all of our new initiatives are required to effect sustainable, generational designed to get Tasmanians thinking about change.” – Primary Health Tasmania, submission their health in new ways and encourage on the Consultation Draft new action to improve health outcomes.

To help people to participate in these PARTNERSHIP initiatives, the new initiatives will be supported by a range of health information, The Tasmania Government will continue messages and support that is accessible to work collaboratively with federal and and useful. The media also has a key role local governments, through Primary Health in making sure the community is receiving Tasmania, the Premier’s Local Government the right health messages. Council and other appropriate avenues, in recognition of the important role they Communities will be encouraged and can and do play in preventative health. supported to develop health messages that they think will encourage members In addition, we will seek to work with our of their community to take some new sporting partners to develop unique ways action to improve their health. that we can promote our new activities and get Tasmanians engaged and participating.

2Resources are housed online at: https://www.dhhs.tas.gov.au/publichealth/health_literacy

HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 31 NEXT STEPS

We will immediately commence working We will also actively communicate on the development and implementation with those organisations that are delivering of key reforms and our new initiatives. programs that will be assessed through processes established under the Strategic We will continue to communicate with the Plan, in particular the assessment tool Tasmanian community about our progress which will be developed by the end of in implementing our actions to make sure September 2016. that individuals and communities understand what we are doing and can get prepared to participate.

32 HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN HEALTHY TASMANIA | FIVE YEAR STRATEGIC PLAN 33