National Health Promotion in Hospitals Audit 2011/12 Cheshire and Merseyside

1. National Health Promotion in Hospitals Audit 2011/12Cheshire and Merseyside Steven Knuckey Research and Projects Lead Stockport NHS Foundation Trust

2. NHS Future Forum NHS Future Forum Summary Report – Second Phase 2012 “Every healthcare professional should ‘make every contact count’: use every contact with an individual to maintain or improve their mental and physical health and wellbeing where possible, whatever their specialty or the purpose of the contact. To emphasise the importance of this responsibility, the Secretary of State should seek to include it in the NHS Constitution.”

3. Background to National Audit • First national audit completed 2009/10 • (53 hospitals across England ) • Second audit 2011 • 56 participating hospitals • 5407 case notes assessed in 2011 • (5,300 notes in 2009) • 100 general medicine/surgery cases per hospital, aged 17+, March 2011

4. Objectives • Determine the extent to which adult hospitalised patients are: • assessed for their need for health promotion • delivered health promotion • Enable benchmarking between organisations • Topics: Smoking; Alcohol; Obesity; Physical activity • Covers assessments, brief interventions, NRT prescriptions, referrals etc

5. Standards ASSESSED Smoking: 100% patients Alcohol: 95% patients Obesity: 45% patients Physical activity: 35% patients HEALTH PROMOTION 35% of smokers 50% of patients misusing alcohol 45% of obese 45% of physically inactive • Based on • Previous audit findings • Steering group • Research

6. Organisational survey Source: 2011/2 National Health Promotion in Hospitals Audit – 51 hospitals surveyed

7. Case note audit • - • Assessment, evidence and health promotion

8. Smoking - Assessment CoC 100% Mean 84% WU 96% S&F 91% Lei 84% LHCH 83% RLUH 90% Source: 2011/2 National Health Promotion in Hospitals Audit - 5407 patients notes audited

9. Alcohol misuse - Assessment Lei 77% CoC 95% RLUHT 76% WU 80% LHCH 30% S&F 75% Mean 71%

10. Obesity - Assessment CoC 90% Lei 75% WU 48% LHCH 43% RLUHT 34% S&F 18% Mean 52%

11. Smoking - Evidence Lei 21% LHCH 23% CoC 20% WU 34% S&F 18% RLUH 33% Mean 25% Source: 2011/2 National Health Promotion in Hospitals Audit - 5407 patients notes audited

12. Evidence (in CHaMPs trusts) • Alcohol misuse rates of assessed patients • In CHaMPs hospitals, this varies between 21% higher or increasing alcohol use (S&F) and 6% (WUHT). (Compared with 11% overall). • Obesity in assessed patients • Varies between 33% (S&F) and 22% (Leighton). (NB high uncertainty here). • Compares with 21% overall.

13. Smoking – Health promotion Mean 23% Source: 2011/2 National Health Promotion in Hospitals Audit - 1125 smoking patients

14. Demographics

15. Smoking rate by age(All hospitals) Source: 2011/2 National Health Prom in Hospitals Audit (all patients assessed for smoking, 4543)

16. Deprivation (National) • Patients from most deprived areas twice as likely to be smokers as those from least deprived areas • Alcohol misuse appears similar in all areas Source: 2011/2 National Health Promotion in Hospitals Audit - 5407 patients notes audited Deprivation modelled by postcode area

17. Overall – All hospitals • Improvements in assessments vs 2009, but most hospitals did not meet the standards • Patients from most deprived areas twice as likely to be smokers as those in the least deprived areas (similar to national population) • Young hospital patients are twice as likely to be smokers as young people in the wider population • Only two in five smokers asked want to quit.

18. Overall - CHaMPs • Good results for smoking and alcohol assessments, obesity varies from 90% to 18% • Good results on health promotion for smoking, but more can be done • Two trusts did not have HP strategy and group – these are linked to performance • Need energy and enthusiasm from centre, teams coordinator and senior management to encourage referrals • Needs continuous monitoring and evaluation and good links with community and LAs

19. Thank you