Health and wellbeing - Is it the LCPGs’ business? Health Improvement Officer Strategy

1. Health and wellbeing - Is it the LCPGs’ business? Health Improvement Officer Strategy Aberdeenshire CHP

2. Outline Policy context Health and Wellbeing in Banff and Buchan Factors Influencing Health Role of the LCPG?

3. Scottish Government – Strategic Drivers Healthier Wealthier & Fairer Safer and Stronger Smarter Greener ‘Help people to sustain and improve their health, especially in disadvantaged communities, ensuring better, local and faster access to health care.’

4. 15 National Outcomes … • attractive place for business • realise full economic potential with more and better employment opport. • better educated, more skilled and more successful • young people are successful learners, confident individuals • children have the best start in life, ready to succeed • live longer, healthier lives • have tackled the significant inequalities in Scottish society. • improved the life chances for children, yp and families at risk • live our lives safe from crime, disorder and danger • live in well-designed, sustainable places with access to facilities • strong, resilient and supportive communities, people take responsibility • value and enjoy our built and natural environment and protect it • take pride in a strong, fair and inclusive national identity • reduce local and global environmental impact • public services are high quality, improving, efficient, responsive

5. “Better Health, Better Care” (Aug, ’07) Improve patients’ experience of care Secure best value Encourage to take responsibility Focus on tackling health inequalities Provide anticipatory care (services for ltc) Give children the best possible start Continuous improvement in services

6. Inequalities and health Mental Wellbeing Tobacco Alcohol Obesity Early Years Health Improvement Priorities For Scotland (with cross system outcomes) (http://www.healthscotland.com/documents/2348.aspx)

7. Aberdeenshire Joint Health Improvement Plan, 2007 - 2010 Three strand approach -: • The Must – Do Priorities for Aberdeenshire generally • Targeted Effort to Address Specific Communities and Themes of Disadvantage • Improving Access To Services, to overcome rural disadvantage and exclusion. (www.hi-netgrampian.org)

8. Identified JHIP Priorities - Reduce health inequalities - Improve mental health and wellbeing - Reduce smoking - Reduce substance misuse (especially alcohol) - Reduce the rate of obesity - Improve sexual health - Improve oral health

9. Reducing Health Inequalities • What are health inequalities? • Measuring health inequalities • Rural Health inequalities

10. What can we do together to tackle inequalities? • Structural change • Legislative and regulatory controls • Physical policy • Income support • Reducing prices/ barriers • Improving accessibility of services • Prioritising disadvantaged groups • Offering intensive support • Starting young

11. Summary of Traffic Lights by Council Admin. Area

12. How are Health Inequalities measured • SIMD 2004 and 2006 • Traffic Lights Report, NHS Grampian • Other Sources- SNS, Census, Scottish Household Survey

13. Geographical Access • Drive time to a GP, post office, shopping facility and schools • Public transport to a GP, post office and shopping facility

14. Rural Deprivation • Aberdeenshire is a rural area with majority of population living outside major settlements • 64.1% of the 15% most deprived are in urban areas, 1.9% are in remote small towns and 1.2% in accessible rural areas. • Rural Deprivation extremely difficult to measure • Information from SIMD

15. Rural deprivation / rural equity? • “Difficulties of access compound difficulties of deprivation” • “Rural areas require different methods of targeting” • “Rural areas tend to be more heterogeneous” • “Confidentiality is an issue for lower level data” • “general consensus that rural issues are insufficiently understood or considered in public service provision” • “Access in SIMD has low weighting yet of huge importance in rural areas”

16. Rural groups most likely to be suffering rural deprivation.. • Young people and young families • Homeless • Disability and Long Term Conditions • Elderly • Mental health problems • Alcohol misuse • Those reliant on public transport • Gypsies and travellers

17. Influences on Health

18. NHS is largely focussed downstream - dealing with the consequences of poor health • Need upstream approaches to reduce the likelihood of poor health in the first instance. Wide range of stakeholders have a role.

19. Role for LCPGs? Community Engagement Role – keep in touch with and get feedback from local community to identify community health and wellbeing needs. Partnership role – identify opportunities for joint work to address wider determinants of health. Scrutiny role - ensure health and well-being priorities are incorporated into local community plans, and ensure action on priorities are incorporated in your own organisation’s service plans / activity. Influencing Role - influence strategy / policy to address the wider determinants of health

20. Making The Local Connectivity Local Community Planning Group CSN CLG HiWGs CSG LRP