NW Health & Physical Activity Forum. Martin Ashton Service Manager: Commissioning for Health Improvement NHSALW / Wigan Council

Transcription

1 NW Health & Physical Activity Forum Martin Ashton Service Manager: Commissioning for Health Improvement NHSALW / Wigan Council

2 Team Purpose Strategically lead CYP Health Improvement & early intervention initiatives across the health economy & on behalf of NHSALW & Wigan Council. Influence resource decisions & developing trust across organisational boundaries. Commission new & existing services: Evidence based Needs-led Innovative Collaborative Value for money Continuous improvement Gap Analysis. Team objectives: Give every child the best start in life Enable all children, young people and adults to maximise their capabilities and have control over their lives.

3 Selected areas of work Teenage Pregnancy Sexual Health Drugs Alcohol Tobacco Gambling Breastfeeding Healthy Start School Health Oral Health Youth Offending. Family Nurse Partnership Early Years Healthy Weight Physical Activity Nutrition Communication campaigns 0-19 pathway (Gateway) Screening Immunisation School readiness. CYP Health Consultation Health Visiting School Nursing Audiology Dietetics Speech & Language Children s Centres Childcare sufficiency etc

4 Background - Summary data for Wigan

5 Needs-led services When comparing adults (33 yrs) who have no GCSE qualifications with those who do: Smoking = 4.7 times higher (women) & 3.5 times higher (men). Drinking heavily = 1.5 times higher. Taking exercise less than once a week = 1.5 times higher. Having depression = 2.4 times higher (women) & 2 times higher (men). Teenage mothers are 20% more likely to have no qualifications at age 30 than mothers giving birth aged 24 or over.

6 The Commissioning cycle

7 Value for money

8 Service mapping Healthy Colleges Healthy Early Years 2.5 Year BMI Check Breastfeeding Service Sports Unlimited Active Life School Nurse Service Fit Crew Healthy Business Award Food in Schools lunchtime training Health Visiting Service Healthy Start Free Swimming Antenatal/postnatal exercise Maternity Service BMI Check Life Education Centre Oral Health strategy Making Every Contact Count PE CYP Food & Health Team T1: Universal You re Choice Fit 4 Fun Physical Activity Program PEPASS Research School Nurse Support Service Health Visitor Additional Visits HENRY T2: Targeted Health Trainers T3: Targeted CAMHS 1.1 Parent Support Service Fit 4 Fun Weight Management Service Free School Meals Triple P College Family Seal Nurse Active Service Travel Breastfeeding Service - targeted Policy Guidance T4: Specialist Dietetics Consultant Paediatrician Eating disorder service

9 Working together The importance of working together, developing pathways to maximise contacts. Making Every Contact Count - providing frontline staff with the skills, tools & confidence to embed prevention in their day-to-day work with clients. We can all add value to each others work, looking at the child, young person or family holistically can only improve the outcomes of those we are working with.

10 What do Commissioners want? (1) Suggested tender requirements: Value for money Fully-costed service with projected financial efficiencies Include the vision for the organisation & service. Collaborate where appropriate. Utilise current language / terminology & recognise the evidence base. Show evidence of : Previous successes (& failures = learning) Knowledge / skills. Stakeholder engagement Effective evaluation Needs-led service design & delivery. Understanding of wider areas of health, where relevant. Succession planning.

11 What do Commissioners want? (2) Managing / building the relationship: Involve the right people from the start to ensure effective commissioner-provider communication at the right level (operational & strategic knowledge recommended). Manage Commissioner expectations. Agree appropriate targets & outcomes. Trust / Honesty / Openness are essential. Equitable relationship. 2-way discussions on service development. Share your knowledge Providers are the experts. Ongoing effective service user feedback to help commissioners plan service development.

12 What do Commissioners want? (3) Robust timely and efficient reporting systems: Manage commissioners expectations & challenge regarding unachievable outcomes. Quality quantitative data that can ideally be broken down demographically. Qualitative data is often useful in addition to give the service-user perspective. Agree appropriate milestones. Build the evidence base; effective evaluation of overall service is essential cost this into plans.

13 What do Commissioners want? (4) Evolution of a contract: Vision now & in 3 / 5 / 10 years Innovation = essential. Proactively identify improvements / challenges / risks / projected financial efficiencies etc. Continuous improvement through ongoing service user & stakeholder engagement Sustainability & succession planning.

14 Example Outputs and Outcomes 0-5 Healthy Weight Service Generic outcomes e.g.: Support CYP&F to gain confidence and the appropriate skills to make lifelong positive healthy lifestyle choices. Specific outcomes e.g.: Increase in the number of parents delaying weaning until 6 months. Percentage of families reporting an increase in levels of physical activity No. of parents completing a weaning programme delaying weaning until 6 months. Outputs e.g.: Provide a comprehensive report to the Commissioner within the agreed time frame. No. of service users signposted to wraparound services. No. of qualitative case studies completed per quarter. No. of Children Centres with physical activity & food policies. Activity e.g.: No. of weaning courses delivered (& numbers of completers). No. of progs delivered to families identified as high risk (& numbers of completers). No. of Programmes delivered within Early Years and Primary Settings. No. of frontline staff receiving physical activity training.

15 Example Outputs & Outcomes CWMS Generic outcomes e.g.: Reduce obesity prevalence in the Borough by halting the year on year rise in obesity and moving forwards to reducing the actual prevalence. Specific outcomes e.g.: No. of CYP who have successfully maintained or reduce BMI at 3 / 6 / 9 / 12 / 18m. No. of CYP who have reported improved eating patterns at 3 / 6 / 9 / 12 / 18m. No. of CYP who have reported increases in physical activity levels at 3 / 6 / 9 / 12 / 18m. No. of CYP who have improved fitness capacity at 3 / 6 / 9 / 12 / 18m. No. of CYP who have improved Self Esteem at 3 / 6 / 9 / 12 / 18m. Outputs e.g.: No. & % of participants completing multi-component intervention. No. & % of participants progressing into Food and Health Cooking Programme. No. & % of participants progressing into another service post intervention inc family members. No. & % of participants attending maintenance programme for a period of 12 months post intervention.

16 CWMS Review & Redesign Numbers entering service (Sept 06 March 10) 104. Numbers entering service (April 10 March 11) % completers / 74% reduce or maintain BMI. Needs analysis undertaken 28% top 10% deprivation. Improved referral mechanisms. Improved data collection & analysis. Maintenance programme developed. Exit routes developed. Focus on family & tracking of parental improvements.

17 Challenges Effectively evidencing success. Ensuring the correct provision / mix of services by identifying and addressing gaps in service provision. Establishing integrated pathways and working practices. Ensuring proactive engagement with stakeholders, including children, young people and families. Ensuring that services are outcomes-focused, evidence based and needs-led. Ensuring that all stakeholders understand that health is everyone s business.

18 With thanks Martin Ashton Service Manager: Commissioning for Health Improvement Wigan Council CYPS / NHS Ashton, Leigh & Wigan T: M: m.ashton@wigan.gov.uk