Public Health Strategy for George Eliot Hospital Trust July 2012
The Public Health Strategy for George Eliot Hospital Trust Statement from Chief Executive It gives me great pleasure to present our first Public Health Strategy. At the George Eliot Hospital NHS Trust, our mission is to improve the health and wellbeing of our local communities by providing excellent services to meet their healthcare needs, as close to home as possible, through innovation and collaboration with professional health and social care partners. This strategy has evolved from our desire to do more than treat our patients, but also to protect and nurture their health and wellbeing, as well as that of their families/carers, our staff and the wider community that we serve. A significant proportion of our hospital admissions are related to patients with one or more chronic illnesses. Many chronic and life-shortening illnesses are preventable and are frequently caused by lifestyle issues such as smoking, alcohol, poor diet and lack of physical activity. In addition to the medical interventions and drug treatments we provide we recognise the importance of providing help and support to our patients to help them cope with their illness and improve their health for a better quality of life. We also recognise the importance of improving the advice, support and information we give to our patients, visitors and staff to help them avoid ill health. Our hospital, community, primary care and public health services all have significant opportunities to support this agenda. We aim to develop further as a health promoting organisation where consideration is given to our local environment and where healthy lifestyle choices become easier choices for everyone who works, visits and stays in our premises. We have produced this strategy to help us focus on, and plan, actions that will work towards preventing the illness rather than treating it. To achieve this vision a wide range of people, both internal and external, will need to be involved to ensure that the philosophy of a health promoting organisation is embedded into organisation structures and activities. We look forward to working together to address and improve local health priorities and health inequalities. Kevin McGee Chief Executive Contents George Eliot Hospital NHS Trust Public Health Strategy Page 2
Statement from Chief Executive 2 1. Background 4 2. What is Public Health? 4 3. Why does the Trust need a Public Health strategy? 4 4. Policy Context 5 5. Strategy Development 6 6. Where are we now? 6 7. Where do we want to be? 7 8. Next Steps 10 Page George Eliot Hospital NHS Trust Public Health Strategy Page 3
1. Background This strategy outlines how George Eliot Hospital NHS Trust is working to champion the health and wellbeing of its patients and their families, visitors, our staff, and the wider community. We plan to improve the support we give to our workforce to deliver positive health messages to the hundreds of people we encounter daily, and to further develop a healthy environment for our staff to work in. By taking a co-ordinated approach the entire organisation will be able reinforce consistent health-promoting messages in a health-promoting environment. The strategy incorporates current activity and seeks to develop this further within existing structures. 2. What is Public Health? Public Health is the science and art of preventing disease, prolonging life and promoting health through organised efforts in society. Ref: Sir Donald Acheson (1988) Public Health in England: the report of the Committee of Inquiry into the Future Development of the Public Health Function 3. Why Does the Trust Need a Public Health Strategy? To ensure executive support for public health activity To create opportunities for health promoting practice as part of the Trust s culture, underpinned by an ethos of reducing health inequalities To ensure the Trust is a healthy place to work To make a positive impact on the health of the wider community including (i.e. BME communities/learning disabilities/mental health etc) To improve partnership work with other organisations with similar public health aims To make an impact on the future health of the community by providing evidence-based public health interventions to service users (Making Every Contact Count) To work within the current health policy context To ensure information systems can measure public health activity To align with local Public Health priorities and direction to ensure optimum impact with health improvement, health protection and prevention approaches, using public health data to inform and guide targeted interventions George Eliot Hospital NHS Trust Public Health Strategy Page 4
4. Policy Context 4.1 National Policy The government has set out three national outcomes for the NHS, Social Care and Public Health. Several of the national indicators are shared between the 3 groups to ensure that joint action is undertaken where appropriate. Ref: draft Warwickshire Joint int Health and Wellbeing Strategy in March 2012 The Public Health Outcomes Framework for England 2013-2016 2013 2016 (January 2012, DH) sets out the following vision and outcomes: outcomes Vision - To improve and protect the nation s health and wellbeing, and improve the health of the poorest fastest. fastest Outcome 1 Outcome 2 Increased healthy life expectancy Reduced differences in life expectancy and healthy life expectancy between communities 4.2 Local Policy George Eliot Hospital NHS Trust Public Health Strategy Page 5
The Warwickshire Health and Wellbeing Board set out a draft Warwickshire Joint Health and Wellbeing Strategy in March 2012 with the following vision: In Warwickshire people will live longer, in better health and be supported to be independent for as long as possible. We will see the people of Warwickshire free from poverty, have a decent standard of living and no child will start their lives at a disadvantage or be left behind. We will see our communities aspiring to ever better achievements and to be more vibrant and supportive. The core principles of the strategy are: Keep people well and independent for as long as possible Ensure that the people of Warwickshire have a greater say in how services are provided Recognise that many public services have a direct impact on people s health and wellbeing and we will work with these services to improve and maximise this Help people to be cared for in their own home wherever possible Identify social problems or illness as early as possible to prevent situations getting worse Look for innovative ways to help people help themselves by using assistive technologies Integrate health, social care services and other public sector services wherever possible to improve the quality of care people receive Make sure people get the right care, in the right place, at the right time 5. Strategy Development This strategy was developed in the following way: a. Review of other Public Health strategies, particularly from other acute hospitals b. Review of national and local guidance/strategies for public health. c. Consideration of the Joint Strategic Needs Assessment (JSNA). d. Benchmarking against the WHO Health Promoting Hospitals standards (Ref: WHO, 2010, Implementing health promotion in hospitals: manual and self assessment forms) e. Development workshop 20 April 2012 attended by 22 members of staff across a range of departments/services (See Appendix 1 for the full workshop feedback). f. Consultation with staff by circulation of the draft strategy via an all user email with feedback incorporated into the final document. 6. Where are we now? Examples of Public Health activities that are already in place are: a. The Trust has a No Smoking Policy which means it is smokefree apart from minimal provision of designated smoking shelters for patients and visitors only. b. Patients, visitors and staff have access to stop smoking support. c. The Workforce Wellbeing group co-ordinates a range of activities to support healthier choices/activities for staff. d. A measured mile around the hospital site to encourage walking can be used by staff, patients and visitors. e. Some brief intervention training has taken place and a number of staff are raising lifestyle issues such as smoking and alcohol with patients and referring on to support services where appropriate. George Eliot Hospital NHS Trust Public Health Strategy Page 6
f. A philosophy of Making Every Contact Count is being developed so staff systematically raise lifestyle issues with patients, record activity and refer on to support services where appropriate. g. Staff from the local specialist alcohol agency on site at the hospital. h. Delivery of public health services through the Community Division Stop Smoking Services, TB service, Health Trainer Service. i. Various training communication, sickness absence, etc. j. Staff side support k. External employee assistance programme. l. Health checks m. Supporting policies/initiatives, eg. infection prevention, baby friendly, cycle scheme, substance misuse, etc. n. Delivery of health information sessions in the BME community o. Diabetes Department deliver advice sessions for people with diabetes who want to fast during the month of Ramadan. p. Delivery of Falls and Bone Health Strategy q. Delivery of End of Life Care/Liverpool Care Pathway It is recognised that this isn t a comprehensive list and one of the actions that this strategy recommends is the identification/collation of current public health activities. However, much more needs to be done to ensure that this work is developed, co-ordinated and measured in a systematic way. 7. Where do we want to be? 7.1 Strategic Vision For George Eliot Hospital NHS Trust to: 1. Have healthy premises/venues to work in and visit 2. Recognise and reduce health inequalities in the local population 3. Have a positive and increased impact on the health of the community it is part of 4. Develop partnership arrangements to promote and deliver a comprehensive range of value for money integrated services to protect and improve the health of the local community George Eliot Hospital NHS Trust Public Health Strategy Page 7
7.2 Overall Objectives 1. To collect baseline information to identify good practice and gaps in activity 2. To develop an action plan to ensure implementation of the strategy 3. To ensure patients/families/carers are systematically given brief interventions on lifestyle issues (Making Every Contact Count) 4. To integrate brief interventions (Making Every Contact Count) into patient pathways to ensure systematic delivery and recording. 5. To further develop healthy workplace activities 6. To collaborate with partners to contribute to the prevention of ill-health 7. To further develop as a good corporate citizen 8. To develop information systems to monitor public health activity to demonstrate the Trust s contribution as a key partner in delivering public health. 7.3 Outcomes The outcomes are grouped into 3 key areas for activity: a. Workplace our staff The benefits of improving staff health include improved productivity/performance, reduced absenteeism, improved staff morale and staff retention and providing role models in promoting healthy lifestyles in the community. b. Improving health patients and their families, visitors More people are living with chronic conditions and have reduced life expectancy/quality of life. The risk of certain diseases can be reduced with positive changes to lifestyle with support. There is the evidence that health professionals delivering brief interventions is effective. c. Corporate citizenship links with the wider community This recognises the NHS as having an impact on the wider community. For example, using corporate powers and resources in ways that benefit local communities, and as an employer, purchaser of goods and services, manager of transport, energy, waste and water, landholder and commissioner of building work and as influential neighbour. This will need to be considered within the context of financial considerations. The outcomes presented here will develop over time with the addition of new information from the gap analysis and as part of the work of the Strategy Steering Group that will be set up. George Eliot Hospital NHS Trust Public Health Strategy Page 8
7.4 Outcomes Workplace a. For the Workforce Wellbeing Group to be the main co-ordinating mechanism for workplace health activity. b. Further development of staff support. c. Develop mechanism to expedite and improve the lessons learnt from investigations. d. Support the improvement of listening skills for Managers to encourage 2-way communication with staff. e. Staff to be aware of this strategy and new staff to receive training on it as part of induction. f. Occupational Health Service to include a focus on prevention and early intervention approaches and be seen by staff as a Occupational Health and Wellness Service. g. Developing a green travel approach which encourages walking or cycling to work. h. Improved results in the annual staff survey in particular with regard to morale. i. Reduced sickness absence and supporting staff to be able to attend work on a regular basis. j. Improve the uptake of flu vaccinations among staff 7.5 Outcomes - Improving health patients and their families, visitors a. Delivery of brief interventions on lifestyle issues to patients and referral to support services where appropriate (Making Every Contact Count) to encourage patients to make improvements to their lifestyle. b. Systematically recording public health activity in patient records to monitor the Trust s contribution to overall public health activity in Warwickshire. c. Inclusion of health promotion activity (Making Every Contact Count, etc) in job descriptions to encourage this activity as standard practice. d. All letters and leaflets to have standard no smoking policy messages as well as information about stop smoking services to further encourage a culture of no smoking in Trust premises. 7.6. Outcomes - Corporate citizenship links with the wider community a. Reduce availability of junk food (foods with low nutritional value) in Trust premises and increase the availability of healthier food options. b. Improve recycling and use of green energy c. Champion sustainability through good corporate citizenship on transport, procurement, facilities management, employment and skills, community engagement and new buildings d. Fun day with a focus on healthy eating and physical activity George Eliot Hospital NHS Trust Public Health Strategy Page 9
8. Next Steps To take this strategy forward a Public Health Steering Group will be set up which will be responsible for monitoring an action plan that will be developed. Progress will be reported to the Trust Board, as well as to staff throughout the organisation. Jane Wright Public Health Manager Jane.wright@geh.nhs.uk, 07900 228980 Julie Whittaker Associate Director for Community Services July 2012 George Eliot Hospital NHS Trust Public Health Strategy Page 10
George Eliot Hospital NHS Trust Public Health Strategy Page 11