Health and Social Wellbeing Improvement Team (West) 2012 / 2013 Annual Report An Insight into the work of the Western Health & Social Wellbeing Improvement Team through 2012-2013 Ailish O’Neill Health & Social Wellbeing Improvement Officer, PHA Brendan Bonner Head of Health & Social Wellbeing (West), PHA 1 Contents Executive Summary Page 3 Background to the Public Health Agency Page 6 Background to Investing for Health Page 7 Western Health Improvement Division: Western Investing for Health Page 9 Drugs & Alcohol Page 79 Healthy Living Centres Page 126 Hidden Harm Page 126 Accident Prevention Page 133 Local Government Page 141 Mental Health Promotion Page 148 Protect Life Suicide Prevention Page 162 Obesity/Fit Futures Page 191 Smoking Cessation Page 219 Teenage Pregnancy/Sexual Health Page 277 Workplace Health Page 243 One Stop Shop Page 248 2 Executive Summary In 2012/13 the Western Health Improvement Team invested over £4 million in a range of initiatives to address health and social well-being improvement and target inequalities. The range of initiatives access over 170 projects, which includes a mix of regular commissioning work and innovative development work testing new ideas. Over 250,000 individuals and groups were direct beneficiaries of the programmes; however, previous evaluations have demonstrated that the cascade effect of these initiatives was at least threefold. One of the major challenges this year was addressing a fluent financial environment; in one hand having to yield baseline funding for efficiencies while on the other bidding for in-year non-recurrent funding from new funding earmarked under the Programme for Government for Public Health. Despite the uncertainty the teams achieved their financial targets and ensured they broke even, Table 1 summarises the financial allocation for the team. There have been a number of key developments in terms of business processes and procurement. The findings from the 2011/12 internal audit focused the spotlight on the recording and monitoring processes; this added to the work burden of staff but was a critical lesson in project management, value for money and business case development which will benefit the team in the longer term. Capacity within the team was also challenged with a number of key staff being absent due to long term sickness. In credit to the commitment from their colleagues the team pulled together to overcome the shortfall and ensure service delivery was sustained. The City of Culture 2013 initiative acted as a springboard to look at some alternative and innovative solutions to addressing health and well-being, in particular addressing inequalities. Key developments in the past year include: Access and Inclusion officer Baby’s Day Out book Velo Bikes Project Volunteer Project – Welcome Host training One of the highlights of the year was the 10th Anniversary celebration of the WIFH Partnership. The event reflected on the success of the last 10 years and examined the opportunities for the future. One of the longest running initiatives, Health Promoting Homes, continued to prove effective with over 100 families participating in the programme. The Neighbourhood Renewal Health Improvement Programme reached over 21,000 beneficiaries alone with a range of training, information and support programmes. A further 3, 759 participated in the Green Gym initiative completing a staggering 6130 hours of voluntary work. 3 Drugs and alcohol remains a major challenge to our society and the PHA has continued to invest over £1 million in a range of initiatives at community level. Projects like the Lifeskills initiative by Action Mental Health in Fermanagh reached almost 700 beneficiaries while Foyle Haven facilitated an estimated 5000 drop-in sessions for those living with a chronic alcohol addiction. The PHA remains fully committed to the implementation of the Mental Health Promotion and Suicide Prevention strategies. Through a small grants programme 465 people benefitted from a range of counselling, training and support programmes in their own locality outlining the link to alcohol and drugs and mental health. In the wider mental health sector 82 organisations underwent a self-assessment process in terms of their corporate and client standards and 547 people underwent a range of training courses on suicide prevention. Over 5,400 individuals benefitted from 19 initiatives funded under the small grants programme. Despite the body of evidence and legislation smoking remains a major challenge to the well- being of the local population. The PHA in the West has continued to address this challenge head on. Over 6460 children enrolled in the Smokebusters Club while 400 further education students participated in a range of education programmes. The PHA remains concerns at the rising number of sexually transmitted infections (STI). To help address the issue, focus has been placed on awareness and referral initiatives. 150 third level students participated in an awareness programme and 1000 people engaged in a Health Fair event. Over 25,000 booklets and related materials were distributed over the past year. The Healthy Living Centres have been key partners to the PHA in terms of reaching local communities, over 50,000 people use the facilities and their health and well-being projects. One of the most exciting developments in the past year had been the proposed development of a Health Village Centre for ARC HLC in Irvinestown and the PHA have provided non-recurrent investment to support the project. Accidents remain a major cause of attendance at Emergency Departments and in particular for older people. Through the WHEAP Project over 2000 people have been provided with information and resources. Furthermore work has commenced on developing a Falls Prevention Strategy for the Western area in partnership with the LCG. In addition to the local initiatives the Western team are also responsible for two major regional initiatives, the Lifeline Crisis Service and the rural isolation project MARA which have a combined budget of £3.9 million pa. The Lifeline contract is not reported on in this review while the MARA Project is subject to a separate evaluation process. 4 In conclusion this gives a flavour of the activity for the past year. The success in delivery has been down to the commitment of staff and the willing collaboration of so many partners from our colleagues in the Trust, Local Government, other agencies and the community and voluntary sector. Despite the challenges, the health improvement agenda continues to be championed and opportunities for future development and innovation will continue to be exploited. Brendan Bonner Head of Health & Social Wellbeing (West) Public Health Agency Table 1: Budget Breakdown 2012/2013 Operational Budget Drugs and Alcohol (Local) £1,118,447.56 Healthy Living Centres £288,787.00 Hidden Harm £84,999.25 Accident Prevention £73,713.76 Investing for Health £522,607.14 Local Government Allocation £92,480.07 Mental Health Promotion (Local) £97,973.00 Obesity/Fit Futures (Local) £423,777.27 One Stop Shop (Local) £115,139.05 Smoking Cessation (Local) £376,103.17 Suicide Prevention Strategy (Local) £582,663.92 Teen Pregnancy/Sexual Health (Local) £219,442.29 Workplace Health (Local) £33,620.00 Local Total £4,029,753.48 Lifeline (Regional) £3,267,312.00 Mara (Regional) £618,971.42 Overall Total £7,916,037.20 5 Background to the Public Health Agency The Public Health Agency (PHA) was established in April 2009 as part of the reforms to Health and Social Care (HSC) introduced by Health Minister Michael McGimpsey. It is the major regional organisation in Northern Ireland for health improvement and health protection. Its purpose is: . to protect public health and improve the health and social wellbeing of people in Northern Ireland; . to reduce inequalities in health and social wellbeing through targeted, effective action; . to build strong partnerships with individuals, communities and other key stakeholders to achieve tangible improvements in health and social wellbeing. The PHA was set up to provide a renewed and enhanced focus on public health and wellbeing by bringing together a wide range of public health functions under one organisation. It is also required to create better inter-sectoral working, including enhanced partnership arrangements with local government, to tackle the underlying causes of poor health and reduce health inequalities. There is five building blocks that underpin the Public Health Agency’s Strategy, they are: Building Blocks for a Happy Healthy Life 1. Give every child & young person the best start in life 2. Ensure a decent standard of living for all 3. Build sustainable communities 4. Make healthy choices easier 5. Ensure high quality care for all Under the overarching themes of the Public Health Agency falls the Investing for Health Strategy and Health Improvement agenda. 6 Addressing Health Inequalities Investing for Health was the first cross-departmental public health strategy, published back in 2002. It focuses on tackling the wide range of complex and inter-related factors that can impact on the health of the population. The Strategy is based upon the recognition that the inequalities, which exist in health between rich and poor are widening and argues that the wider determinants of health can be addressed by integrated interventions and a co- ordinated approach between all Sectors. In terms of local implementation the Western Investing for Health Partnership was developed in 2002, and consists of 30 member organisations, in pursuit of the aims of improving health and reducing inequalities with seven main objectives in mind: 1. To reduce poverty in families with children 2. To enable all people and young people in particular to develop their skills and attitudes 3. To promote mental health and emotional wellbeing 4. To offer everyone the opportunity to live and work in a healthy environment 5. To improve our neighbourhoods and wider environment 6. To reduce accidental deaths and injuries in the home, workplace and collisions on the road 7.