Our Lives, Our Health Health and Wellbeing Strategy 2018-2023

1. Our Lives, Our HealthHealth and Wellbeing Strategy 2018-2023

2. The Health of Derbyshire The population of 785,760 is expected to increase by 10% over the next 20 years Average life expectancy at birth = 79.1 for men 82.8 for women Healthy life expectancy = 63.9 for men 63.5 for women Big variation in healthy life expectancy between least and most deprived communities = 13.7 for men 13.5 for women

3. The Health of Derbyshire In Derbyshire we have higher levels of a range of mental and physical health conditions than average. We are also significantly worse than average for a range of underlying determinants of health, for example: Mothers smoking at the time of delivery Adult obesity Breastfeeding at 6-8 weeks Households living in fuel poverty Teenagers achieving 5 A*-C grades (incl. English and Maths) at GCSE

4. Our Lives, Our Health: Vision “To reduce health inequalities and improve health and wellbeing across all stages of life by working in partnership with our communities.”

5. A Population Level Approach Dahlgren and Whitehead, 1991

6. Priorities Enable people in Derbyshire to live healthy lives Work to lower levels of air pollution Build mental health and wellbeing across the life course Support our vulnerable populations to live in well-planned and healthy homes Strengthen opportunities for good quality employment and lifelong learning

7. We will achieve our ambitions by: Building on our assets - supporting and enhancing existing strategic groups working across our agenda Providing systems leadership - identifying opportunities for linking across different parts of the system and facilitating working together in partnership Culture shift - engendering a culture of sharing successes and challenges and working together to remove barriers to progress Understanding what works - evaluating so that we know what is working well and what we may need to change within and across the system

8. Measuring Success

9. Cancer High Blood Pressure Impact Across the System: an example Obesity Type 2 Diabetes Type 2 Diabetes Osteoarthritis Coronary Heart Disease Stroke

10. Treatment Costs (e.g. primary care, prescriptions, screening, lifestyle interventions, etc… Economy (e.g. absenteeism, presenteeism, early retirement…) Impact Across the System: an example Type 2 Diabetes Social Care (e.g. residential care, nursing care, home care…) Diabetes Complications (e.g. MI, blindness, excess inpatient days, ulcers and amputations, stroke…

11. Obesity Attributable Type 2 Diabetes in Derbyshire 41,275 people with Type 2 diabetes 24,760 cases attributable to obesity Reduce obesity by 5% by 2023= 250 fewer cases of Type 2 Diabetes each year

12. Impact across the system: Primary Care 250 fewer cases attributable to obesity would mean: 2,750 fewer consultations £85K in Nurse and GP consultation costs for Derbyshire every year Each person with Type 2 diabetes has on average 11 consultations per year

13. Impact across the system: Community Prescribing 250 fewer cases attributable to obesity would mean: 5,100 fewer items prescribed £91k saved on drug costs for Derbyshire every year £15 million spend across Derbyshire in 2017 on Drugs Used in Diabetes* • *BNF Chapter 6.1 including Insulin, Antidiabetic drugs, Treatment of Hypoglycaemia, Diabetic Diagnostic & Monitoring Agents)

14. Impact across the system: Diabetic Footcare 250 fewer cases attributable to obesity would mean: £36k saved in admission costs 1 person saved from a lower limb amputation and ongoing costs of £400 p.a. for Derbyshire every year 1 diabetes admission with ulceration for every 33 people with diabetes at a cost of £5m 58 lower limb amputations in 2017/18, 671 bed days, £450k

15. Impact across the system: Productivity Loss 250 fewer cases attributable to obesity would mean: 750 working days gained £405k saved in productivity costs for Derbyshire every year Estimated costs to UK due to Type 2 Diabetes Absenteeism = £850 million Presenteeism = £2.9 billion Average 3 days lost per person

16. Impact across the system: Total for 1 disease Based on 4 impacts only: Estimated savings of £617,000 every year for Type 2 diabetes attributable to obesity Other diseases attributable to obesity… All Cancers: 276 new cases each year Hypertension: 44,000 people currently diagnosed Acute MI: 250 admissions per year Dementia: 188 deaths per year

17. Key Contacts Enable people in Derbyshire to live healthy lives Physical Activity and Nutrition: Jackie Wagstaffe - Jackie.Wagstaffe@derbyshire.gov.uk Alcohol, Drugs and Tobacco: Rosalie Weetman - Rosalie.Weetman@derbyshire.gov.uk Sexual Health: Mary Hague - Mary.Hague@derbyshire.gov.uk Work to lower levels of air pollution Jane Careless - Jane.Careless@derbyshire.gov.uk Build mental health and wellbeing across the life course James Creaghan - James.Creaghan@derbyshire.gov.uk Support our vulnerable populations to live in well-planned and healthy homes Vicky Smyth - Vicky.Smyth@derbyshire.gov.uk Strengthen opportunities for good quality employment and lifelong learning Vicky Smyth - Vicky.Smyth@derbyshire.gov.uk

18. Our Lives, Our Health Available at: https://www.derbyshire.gov.uk/social-health/health-and-wellbeing/about-public-health/health-and-wellbeing-board/health-and-wellbeing-strategy/health-and-wellbeing-strategy.aspx