04a JSNA Appendix , item 5. PDF 6 MB - Lambeth Council

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LONDON BOROUGH OF LAMBETH
JOINT STRATEGIC NEEDS ASSESSMENT
Preliminary assessment
Version 4
Lambeth JSNA – Preliminary Assessment
Version 4
October 2008
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Version control
Title
Lambeth JSNA – Preliminary Assessment
Version: Version 4
Author
Lambeth PCT and London Borough of Lambeth
Publication Date: November 2008
Target Audience: PCT CEs, NHS Trust CEs, SHA CEs, Foundation Trust CEs ,
Medical Directors, Emergency Care Leads, Community and
voluntary sector, public.
Description:
Lambeth Joint Strategic Needs Assessment – Preliminary
Assessment to be published in November 2008 is the preamble to
the final JSNA to be document in June 2009.
Superseded version/docs: Version 1, 2 and 3
Action Required:
Approval from the JSNA steering group to publish the preliminary
assessment.
Contact Details:
Ruth Wallis – Director of Public health, Lambeth Primary Care
Trust, NHS.
Email - ruth.wallis@lambethpct.nhs.uk
Jo Cleary – Director of Adult and Social Services, London Borough
of Lambeth
Email - jcleary@lambeth.gov.uk
Phyllis Dunipace – Director of Children and young people services,
London Borough of Lambeth.
Email - pdunipace@lambeth.gov.uk
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Foreword
(Director of Children’s Services, Director of Adult and Community Services, Director of Public Health)
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Contents
No. Item Page No.
1. Introduction 5
2. Overview 13
3. Demographics 14
4. Health of Lambeth residents 32
5. Economic development 49
6. Children and young people 61
7. Community safety 77
8. Consultation with stakeholders 88
9. Review of needs assessments 94
10. Lambeth priorities 103
11. Sustainable community strategy priorities 118
Appendix I JSNA project plan 120
Appendix II Customer focus – Literature review 133
Appendix III Glossary 154
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1. Introduction
The concept of Joint Strategic Needs Assessment (JSNA) was introduced in the
Department of Health’s (DH) Commissioning Framework for Health and well-being
document published in March 2007. The Local Government and Public
Involvement in Health Act (2007) [Clause 116] places a duty on upper tier local
authorities and Primary Care Trusts (PCT) to undertake a Joint Strategic Needs
Assessment (JSNA). This provision came into force in April 2008. The Director of
Public Health, Director of Adult Social Services and Director of Children’s Services
are jointly expected to take a lead in producing a strategic needs assessment
through strong partnership.
The DH describes JSNA as ‘a systematic method for reviewing the health and wellbeing
needs of a population, leading to agreed commissioning priorities that will
improve health and well-being outcomes and reduce inequalities. The JSNA is
expected to “describe the future health care and well-being needs of local
population and the strategic direction of service delivery to help meet those needs”.
A key element of JSNA is that it should involve all the important stakeholders in
identifying needs and take appropriate actions to address those. The assessment
process is expected to make use of existing information, identify gaps, actively
engage stakeholders including patients and public for their views, understand local
service provision; and most importantly, the outputs or findings be translated into
actions for the commissioning and delivery of health and social care services,
health improvement and well-being programmes and interventions.
The World Class Commissioning competencies emphasise the role of JSNA in
driving the long term commissioning strategies of PCTs and their collaborative
work with community partners including public and patient engagement. The JSNA
is envisioned as a dynamic process periodically updated and is expected to
contribute immensely as a key tool to achieve a shift towards commissioning to
improve health and well-being outcomes and reduce inequalities.
This document reviews the demography and health profile of Lambeth residents
and attempts to identify the health inequalities in terms of the wider determinants of
health and well-being with due regard to the health and well-being outcomes. This
document will identify priorities based on the current health and well-being status of
Lambeth residents and review of existing needs assessments conducted. However
provision of recommendations will follow consultations with stakeholder, mapping
and understanding local services and review of evidence of effectiveness of
interventions.
At present like in other boroughs, Lambeth PCT and the London Borough of
Lambeth have set priorities which have been highlighted through the PCT’s
Commissioning Strategy Plan 2007-2012 and the council’s Sustainable Community
Strategy for 2008-2020. The JSNA will focus on prioritisation and joint
commissioning for the next three years and we foresee this process to be a
dynamic one where the outputs from the JSNA will inform the commissioning (and
joint commissioning) cycle continuously and regularly starting 2008-09 and
continuing for the next three years.
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National policies
The Department of Health’s (DH) Commissioning Framework for Health and wellbeing
document published in March 2007 set out the concept of JSNA. There are
three recent national documents that are most relevant to the development of this
Commissioning Strategy:
1. Our Health, Our Care, Our Say.
2. Choosing Health.
3. Commissioning for Health and Well-being.
All are available in full on the Department of Health website. In addition there
is a very wide range of guidance and technology appraisals from the National
Institute of Clinical Excellence (NICE).
Finally, this section briefly considers the national health targets set by the
Healthcare Commission against which PCT performance is measured.
Our Health, Our Care, Our Say
The White Paper on community services, ‘Our Health, Our Care, Our Say,’ emphasised
the importance of good commissioning in providing integrated services, building on good
local partnerships. The White Paper stated that NHS commissioners should commission
for ‘health and well-being’ to ensure that health improvement is at the heart of the
commissioning process. This 2006 White Paper aims to set a new direction for the
health and social care system, changing the way services are delivered so that
they are more ‘personalised’ and give people a ‘stronger voice so the they are the
major drivers of service improvement’.
It aims to achieve this by a focus on providing better, higher quality care,
providing an improved patient experience and providing better value for
money. In doing so, particular emphasis is placed on:
- Enabling better health and well-being.
- Better access to General Practice and community services.
- Support for people with longer-term needs.
- Delivering care and services closer to home.
The paper also highlights:
- The importance of Practice Based Commissioning as a way of driving
up quality, choice and value for money.
- Encouraging innovation by greater patient and user choices.
- Allowing different providers to compete for services.
Choosing Health – Making Healthy Choices Easier
This 2006 White Paper proposes improving health and health inequalities by
supporting people to make healthy lifestyle decisions. There is a particular
focus on protecting children and young people’s health. The paper has a
number of chapters outlining how this is to be achieved, encompassing:
- Children & Young People – starting on the right path.
- Local communities leading for health.
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- Health as a way of life.
- A health-promoting NHS.
- Work & health.
Commissioning Framework for Health & Well being
Central government has stated a clear intention to shift the focus of healthcare from
treating sick people towards prevention and supporting well-being, not least to enable NHS
funds to be spent on non- NHS services that have a preventive benefit for the NHS.
This 2007 Commissioning Framework is designed to help commissioners
achieve the overall objective of improving health and well-being, with the aim
of looking further than just physical health problems in promoting well-being,
to include issues such as social care, work and housing. The Framework
proposes the following key actions:
- A shift towards services that are personal, sensitive to individual need
and that maintain independence and dignity.
- A strategic reorientation towards promoting health and well being,
investing now to reduce future ill health costs.
- A stronger focus on commissioning service and interventions that will
achieve better health, across health and local government with
everyone working together to promote inclusion and tackle health
inequalities.
The aim is a move to look further than just physical health problems, to
promoting well-being, which includes social care, work and housing.
NICE Guidance
The National Institute of Clinical Excellence (NICE) produces a wide range of
well-researched clinical guidance and technology appraisals. The full details
of these are available on the NICE website. Lambeth PCT’s has found NICE
recommendations to be a very helpful tool in driving up quality and clinical
outcomes on a consistent basis across providers.
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Lambeth PCT Commissioning Strategy Plan – 2007-2012
The PCT has identified its commissioning priorities for the next five years.
The three historic priority areas mentioned under this paragraph have benefited
hugely from the focus they have received and there is widespread confidence in
the strategies that are currently in place to deliver improved outcomes and reduced
inequalities in both the short and long term. However, for each of these priorities,
there were particular areas that it was considered would benefit from further work
over the next five years:
Children & Young People - pre-natal to under 5s
Sexual Health - health promotion, prevention & screening
Long Term Conditions – co morbidities and acute conditions
There was strong consensus that there were three new priorities emerging that the
PCT would increasingly like to put more focus on in the next five years:
1. Staying Healthy
Focused specifically on increasing investment over the strategic period in
health promotion and prevention activity and in doing so on addressing
key health risk factors in Lambeth such as smoking, obesity, alcohol and
drug abuse.
2. Mental Health
The PCT is a clear outlier in terms of prevalence of serious mental illness
despite the fact it is also an outlier on how much it spends on mental
health services. It was considered that current care pathways are complex
and difficult for both users and professional to navigate through.
3. End of Life Care
This represents an area where there is significant scope for service
redesign and the development of more responsive and better quality
models of care with greater choice for patients.
The PCT has completed work to develop draft-commissioning intentions for each
for each of these six areas, plus the other key areas of commissioning work. In
addition the PCT has considered further the implications of implementing the
proposed commissioning intentions on primary and community services, as many
of the proposals include a focus on shifting services from hospital-based settings to
community-based settings.
In summary, in developing this 5 year Commissioning Strategy, Lambeth PCT has
identified these key areas of work over the next five years:
1. Children & Young People Current priorities to be
2. Sexual Health‘ phased out’ over
3. Long Term Conditions the next 3 years
4. Staying Healthy New local priorities
5. Mental Health to be ‘phased in’
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6. End of Life Care over the next 5 years
a) Planned Care
b) Unplanned Care Other key areas
c) Primary Care and Community Services areas for commissioning
d) Older People
e) Learning Disabilities
f) Physical Disabilities
g) Substance Misuse
h) Prison Health
Although the initial three priority areas are described as ‘phased out’ after three
years, this certainly does not mean work in these areas will cease after this time. It
simply highlights the PCT’s expectation that it will have developed comprehensive
and robust plans and strategies for these areas within this period. Therefore, by the
end of three years, the focus will move from planning to the on going
implementation of strategies that will improve services and outcomes in Children
and Young People, Sexual Health Long and Term Conditions.
The Lambeth JSNA will incorporate the needs assessment conducted to
understand the priorities in Lambeth while continuing the work on identifying unmet
needs of the population of Lambeth.
The PCT has also refreshed the Commissioning Strategy Plan for 2008/09 and
details are included in the recommendations section towards the end of the
document.
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Lambeth Sustainable Community Strategy – 2008-2020
The London Borough of Lambeth recently published its Sustainable Community Strategy
following work done to understand the ‘State of the Borough’ with the main focus emerging
as ‘Worklessness’. It’s a relatively new term which describes people who are out of work
but who want a job. It includes people claiming unemployment benefits, people not
currently working who are seeking employment and those who are economically inactive.
This strategic priority was based on evidence that employment and health – physical or
mental – have a close association as employment is one of the wider determinants of
health and well-being of an individual. If we’re genuinely committed to tackling
worklessness we have to first acknowledge the complex and inter-related issues which
come with it and understand that a sustainable community is one which focuses on the
economic, social and environmental wellbeing of its residents.
We know that worklessness is one of the key causes of crime, poverty and social
exclusion. These challenges often lead to lower than average skills/educational attainment,
poor health and poor living environments. Clearly there is a cycle in motion which can only
be addressed head-on and as a whole. This strategy encompasses an approach that looks
at individual as well as at community level.
It is believed that in Lambeth, tackling worklessness by increasing employment will:
• Provide greater financial resources so people can live healthier lives
• Reduce poverty through improved family incomes
• Break benefit dependency
• Facilitate workplace interaction of people from different communities which will
promote community cohesion
• Improve living standards which will reduce people’s incentive to commit some types
of crime
• Enable vulnerable communities to become economically active through targeted
support services/projects
• Allow access to better skills and education for all residents
• Facilitate better family support services for single parents to become economically
active
This strategy also sets out how we will tackle the wider economic, social and
environmental issues associated with worklessness to achieve a thriving and prosperous
borough. The strategy is devised using the following outcomes to create a sustainable
borough:
Economic Wellbeing
- Outcome 1: Lambeth is a great place to do business with higher levels of
investment and business growth
- Outcome 2: Greater wellbeing for households through higher numbers of residents
in employment
Social Wellbeing
- Outcome 3: Children and young people are on the path to success through the
provision of good quality education, training and jobs which reduces the risk of
exclusion and offending.
- Outcome 4: Empowered, safe and cohesive places where people have the
confidence to play active roles in their communities
- Outcome 5: Improved health and wellbeing of people which enables them to live
active and independent lives
- Outcome 6: Lower levels of poverty and social exclusion in Lambeth by helping
more of our socially excluded adults in employment, education and training
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Lambeth Local Area Agreement 2008-2011
London Borough of Lambeth is a diverse and multicultural borough which benefits from
integrated and cohesive communities. In recent years Lambeth has seen rapid
improvements to key services which have, in turn, helped to improve the quality of life for
all people in the borough. Throughout the life of our previous Community Strategy we saw
crime within the borough fall, educational attainment rise and more young people
accessing employment and training. These are just some of the success stories Lambeth
can be proud of. However, Lambeth First knows that many challenges remain and that
only by working together can the borough tackle the causes of the challenges faced by the
people living and working in our town centres and communities.
In the Sustainable Community Strategy (SCS) and its medium term action plan in the Local
Area Agreement (LAA), Lambeth First has recognised that the only way to tackle the
challenges facing our communities is to target the causes of problems rather than the
effects. Through the development of this strategy the partnership has recognised that the
overarching focus should be to tackle worklessness within the borough.
Worklessness lies at the heart of the causes of poverty and exclusion and these in turn are
linked to poor health, poor education standards, low aspirations, higher crime and weaker
communities that are less integrated and cohesive. Tackling the barriers to worklessness
will require improvements across a wide range of policy areas, including health and older
people, education, community safety, the local economy, creating strong communities and
improvements to the built environment.
The outlook for the borough is very optimistic in terms of our ability to delivery the
outcomes in the SCS and performance improvements against LAA indicators. The LSP
itself is significantly more focused on delivery than ever before and shows a real
commitment to achieving results together. This is manifested in the significant investment
of senior management and leadership time in the design of the SCS/LAA, in the
demonstrable ability to prioritise and in the new structures being established to manage
and monitor delivery.
There has been a marked improvement in the general level of confidence in statutory and
other service providers in the borough in recent months. The PCT recently topped an
IPSOS/MORI survey of patients’ recent experience of healthcare in their area. A key
voluntary sector provider, the Lambeth Voluntary Action Council (LVAC) has been
shortlisted for a grant of £500,000 to establish a volunteers centre. Meanwhile the Council
was awarded a 3-star rating by the Audit Commission in February this year and judged the
strongest improving borough in London. This included plaudits on our use of resources.
The Lambeth LAA indicators and target setting for the next three years has now been
finalised. 35 indicators plus 18 for children and young people were proposed and agreed.
through a lengthy process of negotiation within the partnership and with GOL (Government
office for London). A dedicated LAA Task and Finish group was established for a crosscutting
approach to selection of indicators that best reflect the partnership’s priorities as set
out in the SCS. This group was chaired by the Borough Commander, Sharon Rowe, and
made up of service leads from across the partnership. The first cut of indicators
emanating from this group generated a lot of discussion within GOL about how best to
reconcile central government’s needs in terms of achieving PSAs with local priorities. With
GOL’s support, the LSP board was able to agree a basket of indicators that was broadly
acceptable to, and supported by, GOL.
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In addition to the 35 national indicators the partnership is considering inclusion of a small
number of local indicators around parenting, volunteering, fuel poverty and
street/environmental cleanliness.
The Lambeth JSNA will aid in influencing the refresh of the Sustainable Community
Strategy and consequently the future LAAs.
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LAMBETH JOINT STRATEGIC NEEDS ASSESSMENT
Preliminary Assessment 2008
2. Overview
This Preliminary Assessment is the first step in the development of a JSNA for the
borough of Lambeth. The assessment is underpinned by a provisional framework
of Health and Wellbeing outcomes derived from those already defined within the
statutory frameworks for Every Child Matters, Supporting People and CSCI Adult
Social Care service provision. The information has been gathered through the
JSNA Primary dataset which includes analysis and interpretation of various
indicators.
In this first phase, available information on needs across Lambeth has been
mapped against this framework to illustrate the current status of each outcome in
the borough and to highlight any readily identified inequalities. Alignment with
national priorities as set out in the National Indicator set has been clarified through
provisional mapping of the indicators to the framework. Finally, capture of details of
related, local priority actions has begun to show how work already underway
through current strategies and plans is contributing to achievement of the
outcomes.
The next stage of investigative work will be driven by commissioners from across
the partnership. They will help to narrow the focus of the assessment by
recommending areas which merit detailed review of the effectiveness of existing
service provision. In parallel with this, assessment of market capacity (including
skills base) of the borough will take place to identify any capacity building or
workforce planning implications for future service delivery.
Further work on the provisional health and wellbeing outcome framework is already
underway to refine it in partnership with patients, service users and community and
voluntary organisations. Stakeholder engagement is simultaneously being taken
forward and it is hoped that the newly formed Lambeth LINk (Local Involvement
Nerwork) will help to take this aspect forward.
In view of the magnanimity of the task and provisional time table for delivery of
elements of JSNA, it has been identified that gap analysis is crucial to having
agreement of strategic recommendations jointly. This will require agreement on
methodology of the JSNA so that it can be applied to areas of need. The JSNA
methodology is being drafted which will offer a systematic method for reviewing the
issues related to health and well-being faced by the local population leading to
identification of met and unmet needs. This will then be applied to gap areas which
will inform the next refresh of the Sustainable Community Strategy, due for 2011.
The project plan sets out the provisional milestones to achieve this. It should be
noted that a JSNA is a dynamic process and will follow parallel to commissioning
cycles. The following chapters provide a profile of health and social care in
Lambeth.
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3. Demography of Lambeth
Demographics
Lambeth has the largest population compared to all the inner London boroughs. It
is also one of the densely populated areas in the country with the fifth highest
density in the UK. Lambeth has a highly mobile and ethnically diverse population.
Over 60% of Lambeth’s population are not of UK origin and over 150 languages
are spoken across the borough. The public health findings show that, on average,
the population of Lambeth has performed worse of several health indicators than
the rest of London or UK as a whole.
The estimated resident population of Lambeth is 271,950 (Office for National
Statistics, 2006 mid-year estimates (MYE)). The Greater London Authority (GLA)
2007 round interim projections (RIP) for population estimate for Lambeth for 2008
is 285,580. The general practice (GP) registered population in Lambeth is 361,680
(Apr, 2008) as seen in the graph below.
Lambeth Population estimates
400000
350000
361680
300000
271950
285580
250000
200000
ONS - MYE 2006
GLA 2007 RIP estimates
GP registered (Apr 2008)
150000
100000
50000
0
ONS - MYE
2006
GLA 2007 RIP
estimates
GP registered
(Apr 2008)
The population make up shows approximately 52% within the age group 20-44
years showing a high proportion of young employable adults within the borough as
seen in the population pyramid below. The population estimates are derived from
the GLA 2007 Round interim projections for Lambeth.
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Population - Mid Year Estimate 2007
20-44 age group = 52%
Age Bands
85+
80-84
75-79
70-74
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
Females
Males
15 12 9 6 3 0 3 6 9 12 15
percent
The Greater London Authority’s (GLA) Data Management and Analysis Group
(DMAG) released population projections for every local authority, borough and
district within the UK were used in calculations. The GLA 2007 demographic
projections use the structural results from the CLG (Communities and Local
Government) based household projections. GLA offers borough level projections
with inputs on fertility, future survival, migrations and uses updated estimates of
recently completed development, the latest local trends in fertility and mortality and
the latest data on migration affecting London. GLA incorporates ONS (Office for
National Statistics) estimates and ONS national labour force projections, for
population projection. The estimates projected by GLA have been used to
understand the demographic change in the Lambeth population over the next five
years and beyond.
The following graph compares the ONS, GLA and GP registered population in
different age-groups in Lambeth.
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number
Population of Lambeth Age-Specific
45,000
40,000
35,000
ONS GLA GP List
30,000
25,000
20,000
15,000
10,000
5,000
0
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
Source: National Statistics; GLA 2007Round Ward Population Projections
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85-Plus
Age
According to GLA 2007 round interim projections, the population in Lambeth is
expected to rise from 285,580 in 2007 to 295,505 by 2014 - a rise of 11,626 as
seen in the table and graph below.
Lambeth population projections (GLA)
Males Females Persons
2005 139420 141487 280907
2006 140204 142834 283038
2007 140336 143543 283879
2008 140924 144656 285580
2009 141533 145734 287267
2010 142157 146784 288941
2011 142790 147812 290602
2012 143465 148849 292314
2013 144100 149816 293915
2014 144739 150765 295505
Source: GLA 2007 RIP projections
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Lambeth Population Projection - Source: GLA 2007 RIP
350,000
300,000
250,000
200,000
150,000
100,000
Lambeth population estimates
Males
Lambeth population estimates
Females
Lambeth population estimates
GLA 2007 RIP projections
50,000
0
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Lambeth's population is ethnically diverse with the BME community accounting for
35% of the total population. Of this ethnically diverse population, black Caribbean
and black African communities form the majority accounting for 26% of the total
Black and Minority Ethnic (BME) population as shown in the graph below.
% Black and Minority Ethnic Communities in Lambeth
Population - 2007 estimates
12.0%
11.5%
10.0%
9.8%
% Population
8.0%
6.0%
4.0%
2.0%
4.7%
1.6%
0.9% 0.9% 1.1% 1.8%
2.7%
0.0%
Black Caribbean
Black African
Black Other
Indian
Pakistani
Bangladeshi
Chinese
Other Asian
Other
Ethnic background
Ethnic group projections from GLA suggest that the Black Caribbean group in
Lambeth is likely to decrease by 2% of the total population in the next 25 years,
compared to an increase in the Black African population by 15% and in the Asian
population by 26%. These projections are based on the Census ethnic complexity
of Lambeth’s communities and this pattern is not expected to change during the
period 2008-2033.
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Population Projection by Ethnicity, 2006 to 2021
40,000
35,000
Number of people
30,000
25,000
20,000
15,000
10,000
5,000
0
Black
Caribbean
Black
African
Black Other Indian Pakistani Bangladeshi Chinese Other Asian Other
2006 31,589 33,233 14,057 4,738 2,607 2,402 3,349 4,679 7,765
2026 29,239 38,354 16,138 4,521 2,784 2,940 3,969 6,009 11,060
Source:GLA 2005 Round Interim Ethnic Group Projections
GLA projections suggest Lambeth is to remain a young borough, with most
increases within ethnic groups occurring in the 0-19 and 20-44 year old age
ranges.
It should be noted that these are long-term projections on ethnicity and there are
social and political factors such as change in immigration laws, cultural balance;
that can influence change in the ethnicity within the population over a period of time
in any given area or region.
Lambeth is one of the most densely populated boroughs in the country with a
rapidly growing population that is projected to grow by 15% over the next 20 years.
In 2006, the density (measured in terms of people occupancy per square kilometre)
in Lambeth shows an increase compared with 2005 by 77 people per Sq. Km
almost similar to that of London.
People per Sq
Km
Area (Sq Km) MYE
England 130281 50,726,382 389
London 1572 7,512,372 4779
Lambeth 27 271,950 10072
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Population Density
People per square km
12000
10000
8000
6000
4000
2000
0
10072
4779
389
England London Lambeth
The 2007 Index of Multiple Deprivation (IMD) places Lambeth as the 5th
most deprived borough in London and 19th most deprived in England.
Poverty and social exclusion are some of the social challenges in the
borough.
15
10
5
0
-5
-10
-15
-20
-25
-30
-35
-40
Changes in Deprivation ranking Lambeth and
Comparable LAs
-35
-3
3
-13
-18
-5
8
Brent
Hackney
Haringey
Lambeth
Lewisham
Newham
Southwark
Local
authority
Score
2007 Rank
Score
2004 Rank Change Status
Brent 29.22 53 24.85 88 -35 Worsening
Hackney 46.10 2 42.90 5 -3 Worsening
Haringey 35.73 18 36.11 15 3 Improving
Lambeth 34.94 19 32.21 32 -13 Worsening
Lewisham 31.04 39 28.43 57 -18 Worsening
Newham 42.95 6 39.33 11 -5 Worsening
Southwark 33.33 26 34.74 18 8 Improving
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The above table describes the relative change in deprivation indices for the London
cosmopolitan boroughs. It is notable that Lambeth is now the 5th most deprived
borough in London. Lambeth has 177 super output areas (SOA’s) - with roughly
1,500 residents. In 2007, 26 (14.7%) of these were in the 10% most deprived in the
country compared to 20 (11.3%) in 2004. Overall the most deprived are the areas
of Coldharbour between, roughly, Railton Road and the Moorlands Estate; the
Crown Lane area of Knights Hill ward and the Angell Town Estate in Coldharbour.
Mobility
There is relatively high mobility within the Lambeth population compared to inner
London boroughs. There appears to be high mobility both in the internal as well as
international migration. Statistics show the net inflow of over 8.5% and a net
outflow of over 10%. Economic advantage and cosmopolitan nature of Lambeth
makes its population very mobile. It should be noted that this has a predominant
influence on measuring impact of health interventions on the local population over
a period of time.
Migration
12.0%
Internal Migration in Lambeth 2006-07 ONS publication
10.0%
8.0%
6.0%
4.0%
2.0%
0.0%
-2.0%
-4.0%
-6.0%
-8.0%
-10.0%
-12.0%
Wandsworth
Lambeth
Southwark
Newham
Haringey
Lewisham
Internal migration (Inflow and Outflow) in Lambeth expressed as a percentage of
population 2006-07
Camden
Westminster
Islington
Tower Hamlets
Hackney
Hammersmith and
Fulham
Kensington and
Chelsea
Internal migration % In
Internal migration % out
How many people live in Lambeth?
STATUS
• The latest mid-year population estimate (2006) from the Office for National
Statistics is almost 272,000 people. This gives Lambeth the second highest
population in Inner London, after Wandsworth (279,000), and 7th largest in
Greater London.
• The GLA 2007 population projections differ slightly, putting Lambeth’s
population at 285,580 in 2008.
• The population registered with GPs in Lambeth is 343,600 (Dec 2007). This
is likely to be an overcount of Lambeth residents since it includes people
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living in other boroughs but within the surgery catchment areas and people
who have moved but not informed their doctors.
PROJECTED CHANGES
• ONS project total Lambeth population as 279,500 by 2028, a 5% increase
on 2008.
• GLA figures project the total population in Lambeth by 2028 as 322,300
people. This is an increase of 12.9% on 2008.
What is the male/female ratio of people in Lambeth?
STATUS
• According to the 2001 census, the gender split in Lambeth of 49% male and
51% female reflects that of London and the country more broadly.
PROJECTED CHANGES
• There is no agreement on the predicted ratio. The GLA population
projections predict that the female population of the borough will increase to
52% by 2028 while the ONS projections show the opposite proportions (with
males representing 52% and females 48%).
What ages are the people of Lambeth?
STATUS
• Almost half (45%) of Lambeth’s population is aged between 20 and 39
years, compared with just over a third (36%) for London and three in ten
(28%) nationally 1 .
• Approximately one in five of Lambeth’s population are aged 19 or under
(59,711 or 21.9%). Of these, a third (19,455) are aged 0-4 years. (2006 Mid
Year Estimate)
• Lambeth has one of the highest teenage populations of the Inner London
boroughs (18,522 13-19 year olds).
• Older People aged 65 and over account for just 1 in 10 residents, a smaller
proportion than elsewhere.
PROJECTED CHANGES
• Both the GLA and ONS population projections predict a substantial increase
of around 50% in the number of 50-69 year olds by 2028.
• The ONS figures predict that by 2028, the 0-30 year old population will have
dropped below 2003 figures. The GLA figures also project a 5% drop in the
19-34 year old population by 2028.
• Moderate increases are projected in 5-16 age band, 45-49 age band, 70-74
age band (GLA figures only) and over 85 year olds.
What are their ethnic backgrounds?
STATUS
• According to the 2001 Census, a third (33%) of Lambeth's then population
were from ethnic minorities, the seventh highest proportion in the country.
• The borough has the second highest proportion of Black Caribbean
residents of any UK local authority (after Lewisham) and the fourth highest
proportion of Black African people (both 11%).
• Around six in ten residents have a white ethnic origin.
1 2001 Census
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• 10% of residents are from a mix of other ethnic groups, including 4% of
residents from Asian backgrounds.
• Unlike other London boroughs where it is the younger population who tend
to come from diverse backgrounds, Lambeth has an ethnically complex
older population. A third of those Lambeth residents born in the Republic of
Ireland and a third of those born in Jamaica are of pensionable age (34%
and 31% respectively).
PROJECTED CHANGES
• Projections from the GLA suggest that the Black Caribbean group in
Lambeth is likely to decrease by 2% of the total population in the next 25
years, compared with an increase in the Black African population by 15%
and in the Asian population by 26%.
• Although the whole black Caribbean population is projected to decrease
over time, Black Caribbeans aged over 60 years are projected to grow by a
third (34%) by 2025. Similarly, Black Africans aged over 60 are projected to
increase by 250%, though from a smaller baseline.
What languages do they speak?
STATUS
• Based on reports from schools, approximately 132 different languages are
spoken by families in the borough, with the most common languages after
English being Yoruba and Portuguese.
What are their faiths and beliefs?
STATUS
• There are fewer residents in Lambeth who identify themselves as religious
than nationally (71% compared with 82% nationally).
• 60% classify themselves as Christian, 5% as Muslim and 8% report
belonging to another faith or religion.
What are their sexual orientations?
STATUS
• The 2006 residents’ survey asked a question about sexuality for the first
time and found 3% of respondents identified themselves as lesbian, gay or
bi-sexual.
• This is likely to be an under representation since the LGBT matters report 2
commissioned by Lambeth Council looking at lesbian, gay and bi and transsexual
needs in the borough conservatively estimates that LGBT
communities represent 5% of London’s population, with higher
concentrations in inner-London areas like Lambeth.
Where do they live?
• Lambeth is one the most densely populated areas in the country with almost
all Super Output Areas in Lambeth having between 1,300 and 1,700
residents.
• The areas of highest population density are mostly in the central part of the
borough, in Brixton, Stockwell and Clapham. As expected, the areas with
the lowest population density include parks or open spaces.
2 The full report can be accessed at http://www.sigmaresearch.org.uk/files/report2006c.pdf
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How do they live?
• There are 118,454 households in the borough (Census 2001)
• In 2001, the percentage of lone parent households with dependent children
was above London and national averages (12.1% compared to 8.9% and
7.1% respectively).
• Households in Lambeth can be categorised using Mosiac data from
Experian:
Mosaic Type Mosaic Group Lambeth
Name
People living
in social
housing, with
uncertain
employment
in deprived
areas
Educated,
young single
people living
in areas of
transient
population
High density social
housing, mostly in
inner London, with
high levels of
diversity
Neighbourhoods
with transient
singles living in
multiply occupied
large old houses
Social tenants
Single house
sharers
Percentage
of Lambeth
Households
26%
21%
What areas have
high numbers of
these
households?
• Mursell and
South Lambeth
estates
• Stockwell Park
estate
• Mawby Brough
and Wyvill
Estates
• Streets around
Tulse Hill
Station
• Flaxman Road,
near
Loughborough
Junction
• Clapham Road
Educated, Economically Successful 16% • Fawnbrake
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young single
people living
in areas of
transient
population
Educated,
young single
people living
in areas of
transient
population
Close knit,
inner-city
town and
manufacturing
communities
successful singles,
many living in
privately rented
inner city flats
Young
professionals and
their families who
have gentrified
terraces in pre
1914 suburbs
Multi-cultural inner
city terraces
attracting second
generation settlers
from diverse
communities
singles
Young
professionals
and their
families
Multi-cultural
second
generation
11%
10%
Ave/ Brantwood
Rd in Herne Hill
• Clapham Rd/
South Island
Place in Oval
ward
• Telford Avenue/
Salford Rd in
Streatham Hill
• Gubyon
Avenue,
Dorchester
Drive in Herne
Hill
• Rosendale
Road in
Thurlow Park
ward
• Milkwood Road
In Herne Hill
ward
• Amesbury
Avenue/
Hailsham Drive
Career
professionals
living in
sought after
locations
Career
professionals
living in
sought after
locations
Financially
successful people
living in smart flats
in cosmopolitan
inner city locations
Highly educated
senior
professionals,
many working in
the media, politics
and law
Wealthy
senior
professionals
6%
• Dorchester
Drive/
Brantwood
Road in Herne
Hill
• Clapham Old
town
• Belevedere
road in Bishops
• Wards can also be analysed between Mosaic categories. The table shows
the percentage of households in each ward in each Mosaic category, with
town centre and borough comparators. Green shows high numbers in an
area, red low numbers.
North Lambeth Town
North
Bishop’s Oval Prince’s Vassall
Centre
Lambeth
Lambeth
Single house sharers 27.1 20.4 18.5 25.4 22.5 21.1
Successful singles 7.2 31.3 7.8 9.0 14.6 15.8
Young profs. & families 4.3 2.3 4.3 1.3 2.9 10.9
Social tenants 35.7 31.4 46.2 49.5 41.0 25.8
Wealthy senior profs. 13.8 7.3 8.9 2.0 7.5 6.0
Multi-cultural 2nd Gen. 1.6 2.8 1.8 7.8 3.6 10.0
Other 10.3 4.5 12.6 4.9 7.8 9.8
Brixton own Centre Brixton Cold -
Herne Tulse
Ferndale
Hill harbour
Hill Hill
Brixton Lambeth
Single house sharers 28.6 24.4 25.8 24.2 30.4 26.8 21.1
Successful singles 21.6 3.3 35.4 13.9 12.3 17.7 15.8
Young profs. & families 11.8 4.6 6.5 21.5 9.7 10.4 10.9
Social tenants 19.4 56.3 23.1 12.0 33.1 29.2 25.8
Wealthy senior profs. 0.5 0.1 0.7 5.4 1.2 1.4 6.0
Multi-cultural 2nd Gen. 12.9 6.6 5.2 11.6 6.6 8.4 10.0
Other 5.1 4.8 3.3 11.4 6.8 6.1 9.8
Clapham & Stockwell Claph. Claph. Larkhall Stock- Thorn- Claph & Lambeth
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Town Centre Commn Town well ton Stock
Single house sharers 9.1 17.8 19.9 18.3 8.5 15.4 21.1
Successful singles 25.5 26.2 21.2 7.7 11.3 18.7 15.8
Young profs. & families 14.3 13.3 7.7 6.4 21.6 12.0 10.9
Social tenants 13.3 18.5 40.8 54.4 42.4 34.3 25.8
Wealthy senior profs. 29.7 12.9 3.8 6.3 2.4 10.7 6.0
Multi-cultural 2nd Gen. 1.2 8.3 4.2 2.5 4.9 4.3 10.0
Other 6.9 3.0 2.3 4.4 9.0 4.8 9.8
Streatham Town Centre St. Streat. Streat. Streat.
Streatham
Leonard. Hill South Wells
Lambeth
Single house sharers 19.5 25.0 12.4 19.0 19.5 21.1
Successful singles 25.6 16.8 1.9 22.5 17.5 15.8
Young profs. & families 18.0 16.5 7.0 20.5 16.0 10.9
Social tenants 0.6 10.1 2.5 13.4 7.0 25.8
Wealthy senior profs. 11.8 5.8 7.2 4.4 7.2 6.0
Multi-cultural 2nd Gen. 13.9 15.7 29.0 7.1 15.7 10.0
Other 10.7 10.1 40.0 13.1 17.0 9.8
Norwood Town Centre Gipsy Knight's Thurlow
Hill Hill Park
Norwood Lambeth
Single house sharers 21.5 16.8 24.6 20.7 21.1
Successful singles 6.8 4.6 9.4 6.8 15.8
Young profs. & families 5.5 13.0 23.0 13.7 10.9
Social tenants 18.6 14.5 7.2 13.6 25.8
Wealthy senior profs. 2.7 1.1 9.1 4.1 6.0
Multi-cultural 2nd Gen. 30.8 27.2 9.9 23.0 10.0
Other 14.1 22.7 16.8 18.1 9.8
Mosaic September 2007
How many people move into/out of the borough?
• It is difficult to be exact about the numbers of people moving in and out of
the borough. The latest data, from the 2006 ONS Mid-Year population
estimate is that total migration in 2006 was 22.4% of the population. This
means that 10.9% of the population lived somewhere else the year before,
and 11.5% moved out of the borough during the year.
• The largest group of new job-seeking immigrants between 2002 and 2006
were from Poland with 3,550 new National Insurance registrations for Polish
people living in Lambeth.
• The next two largest totals for new NI registration were for immigrants from
Australia (2,830) and Jamaica (1,750).
How many people have informal care responsibilities?
• It is estimated from the 2001 census that there are approximately 18,500
carers in Lambeth (7% of the resident population).
• Adult carers may be family, friends or neighbours, or may be partners within
marriage or civil partnerships. Some care for those with mental health
issues, physical or learning disabilities, whilst others have the additional
complication of caring for someone with a dual/complex diagnosis. Some
are parent carers caring for a child with a disability.
• There are a number of young carers aged under 16 living in the borough. In
2001 there were 483 carers aged 0-15 in Lambeth (37 of these were
providing 50+ hours of care per week).
• In 2001 there were 106 carers aged over 85 in the borough (44 of these
providing 50+ hours of care per week).
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• Many carers in Lambeth come from Black and Minority Ethnic (BME)
communities, with a disproportionate number coming from the Asian
communities.
• The majority of carers (68%) provide 1-19 hours of care per week. 13%
provide 20-49 hrs and the remaining 19% provide 50+ hrs each week.
• In 2001 over half of carers worked full or part-time. 782 carers combined
work with 50+ hours of care each week.
How many people are economically active?
• 76.2% of the population of Lambeth is economically active; this compares
with 75.1% for London and 78.6% nationally. 3
• The overall employment rate in Lambeth is 68.5%. This compares with the
London employment rate of 69.8% and a national figure of 74.3%.
• 18.7% of the economically inactive are neither in employment nor
unemployed and do not want a job; this compares with 18.0% for London
and 16.1% nationally. 4
• In May 2008, 3.6% of the resident working age population for Lambeth is
claiming Job Seekers Allowance (JSA), compared with 2.6% for London
and 2.2% nationally. At 63.10% of claimants, Lambeth is below the London
average (65.50%) for claiming up to 6 months JSA, but higher than London
averages for claimants over 6 up to 12 months and over 12 months. 5
• Lambeth has 9.6% of young people aged 16-18 not in education,
employment or training (NEET), compared with 9% for Southwark, 5.5% in
Wandsworth and just 0.8% above the London average. This is down from
15.3% in 2004. Projections show that just 8.6 % will not be in paid work or
preparing for it in Lambeth by 2009-10, closing the gap on the England
average. 6
How many people are claiming benefits?
• The percentage of working age people on out of work benefits is16.5%. In
the worst performing neighbourhoods this increases to 27.7% (Q2 2007).
• Just over a third (36%) 7 of children in Lambeth live in families on key
benefits compared with 28% in London. Lambeth ranks as the 11th highest
rate for this nationally and 27th out of the 33 London boroughs.
• The number of people claiming incapacity benefits represents
approximately 7.1% of the working age population (London 6.1% and
nationally 7.2%).
• The number of people claiming lone parent benefits represents
approximately 4.0% of the total working age population (compared with
London 3.1% and nationally 2.0%).
3 NOMIS Official Labour Market Statistics (Oct 2006 – Sep 2007). Percentages are for those of working age
(16-59/64). Economically active are people who are either in employment or unemployed.
4 People who are neither in employment nor unemployed includes, for example, all those who were looking
after a home or retired. Also people wanting a job, these are those not in employment who want a job but are
not classed as unemployed because they have either not sought work in the last four weeks or are not
available to start work.
5 The Jobseeker's Allowance (JSA) is payable to people under pensionable age who are available for, and
actively seeking, work of at least 40 hours a week.
6 London Borough of Lambeth. CYPS Performance Digest Report. March 2008
7 Government Office for London /DWP August 2008, based on 5% sample.
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How is Lambeth ranked on deprivation measures?
• Lambeth as a whole is slightly more deprived than Inner London, and
considerably more deprived than England as a whole.
• It is ranked overall the 19 th most deprived local authority district in England,
compared with 23 rd in 2004.
• North Lambeth is the most deprived town centre with all wards other than
Bishops wholly in the 30% most deprived in the country.
• Coldharbour is the most deprived ward in the borough with 60% of its area
classified in the 10% most deprived nationally.
How do the people of Lambeth rate their own health and well-being?
• Just over three quarters of Lambeth residents rate their own health as good
or very good. This rises to 89% among private renters (compared with 71%
among council tenants), 90% among 18-34 year olds and 86% among AB
residents and full time workers. Health ratings are unsurprisingly lower
among people with long-term limiting illness (27%) and older people (55%).
Black Caribbean residents (69%) are less positive about their health.
• In 2001 only 55% of Carers assessed their own health as “Good”.
Which groups of people within Lambeth could be considered to be
vulnerable?
• The main groups of people in the borough who could be considered to be
vulnerable are:
older people with support needs including the frail elderly
people with a long-term limiting illness
people with mental health problems including mentally disordered
offenders
people with learning disabilities
people with physical disabilities or sensory impairments.
people with substance misuse (drug and/or alcohol) problems
carers
women at risk of domestic violence
homeless people
rough sleepers
travellers
offenders/people at risk of offending
people with HIV/AIDS
refugees and asylum seekers
• The groups of children and young people who are vulnerable to doing less
well against some or all of the national outcomes include:
Looked After Children
young people leaving care
young people at risk of harm
young carers
children with special educational needs or disabilities
children who are very mobile, e.g. traveller and refugee children
children from different faith groups
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some BME children and young people
young people at risk of offending and misusing substances
teenage parents
children from low income families.
Older people
• Lambeth has a relatively lower number of older people compared with other
areas though this is expected to change with the numbers of those aged
over 85 expected to increase (see age projections above).
• More older people are helped to live at home in Lambeth than compared
with both London and England (107 per 1,000 population in 2006/07
compared with 91 in England).
People with a long-term limiting illness
• In 2001 there were 36,763 residents who classified themselves as having a
long-term limiting illness (14%) of the following ages:
0-15 2,334
16-44 10,766
45-59 8,376
60-64 3,324
65-74 5,824
75+ 6,141
Total 36,765
• This is a smaller proportion of adults living with long-term illness than is
seen across England (21%).
People with mental health problems
• Lambeth has a higher prevalence of mental health needs than other
comparative areas of London 8 .
• 4,169 people are currently recorded with severe and enduring mental health
needs under the Care Programme Approach (CPA).
• An estimated 37,000 people are engaged with primary care for treatment for
varying degrees of anxiety and depression.
• There are disproportionately high numbers of people with mental health
needs within ethnic minority communities, particularly African Caribbean
males.
• The proportion of people with Severe Mental illness and dual diagnosis of
substance misuse is very high at 50%.
People with learning disabilities
• In Sept 2007 there were 863 adults on the Lambeth register for people with
learning disability.
• In Sept 2007 ethnic minorities made up 19% of people with learning
disabilities aged 50-59 years, but 60% of those aged 20-29 years and 70%
of the 0-9 age group.
People with physical disabilities or sensory impairments
• There is not yet a detailed picture of the number of Lambeth residents with
physical disabilities or sensory impairments.
8 Bexley, Bromley, Greenwich, Lewisham, Southwark.
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People with substance misuse problems
• The Home Office estimates 5,029 Problematic Drug Users (PDUs) of
opiates and/or crack cocaine in Lambeth (estimate based on 2004/05 data).
The total number of Problematic Drug Users PDUs known to treatment in
2006/07 was 1,991.
• 2,033 drug users accessed treatment during 2007/08. 149 of these (7.3%)
were aged 17 or under. 79% of individuals were retained in structured
treatment for more than 12 weeks.
• 72% of adult drug users in treatment in Lambeth are male (28% female).
• The proportion of BME clients in treatment is not significantly different from
the proportions in Lambeth’s overall resident population.
• 13% of those accessing treatment for the first time in 2007/08 had a dual
diagnosis of mental health problems alongside their substance misuse
issues.
• CHAIN data for Lambeth shows that 88% of all rough-sleepers have alcohol
and/or drug support needs. This is notably higher than the proportion across
other London boroughs. 9
• It is estimated that 23-24% of Lambeth’s population drink excessively and
that Lambeth has a higher rate of alcohol related hospital admissions than
London and England. The largest single categories of hospital admissions
are for alcohol related disorder and then liver disease. 10
• The general profile for an excessive drinker in Lambeth is that of a white
male.
Carers
• It is estimated from the 2001 census that there are approximately 18,500
carers in Lambeth (7% of the resident population).
• There are a number of young carers aged under 16 living in the borough. In
2001 there were 483 carers aged 0-15 in Lambeth (37 of these were
providing 50+ hours of care per week).
Women at risk from domestic violence
• Research suggests that 13% of women experience domestic violence at
some point in their lives.
• The National Domestic Violence helpline received 322 calls from Lambeth
women between Jan and June 2005. This was the highest rate of any
London borough and 100 more calls than the second highest borough.
• The Gaia Domestic Violence refuge centre supported 626 Lambeth women
between May 2006 and March 2008.
Homeless people
• The number of households accepted as being homeless has been
successfully reduced from 1,651 to 735 over the last 5 years.
• There are currently 2,100 people waiting for an offer in Temporary
Accommodation.
• Lambeth has one of the highest rates of teenage homelessness, with
figures that are above London and national averages.
Rough sleepers
• There are approximately 13 people sleeping rough in Lambeth on any one
night.
9 CHAIN (2007)
10 Alcohol Needs Assessment 2006/07
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• CHAIN data for Lambeth shows that 88% of all rough-sleepers have alcohol
and/or drug support needs. This is notably higher than the proportion across
other London boroughs. 11
Travellers
• The GLA estimates 42 Travellers in Lambeth based on estimated national
population apportioned to Lambeth on basis of population.
Offenders/people at risk of offending
• An estimated 1500 Lambeth residents are received into London prisons a
year. 12 The probation caseload is around 2500 (60% custody, 40%
community).
• There are higher proportions of BME offenders from Lambeth than the
London average (25% British White vs. 37% average and 33% Black
Caribbean vs. 15% average). 3
• Of Lambeth offenders who had an Offender Assessment completed (267),
the average need score was 8 th highest of the 32 London boroughs (City of
London excluded). The rank order of criminogenic needs for Lambeth is
very similar to the London average, though Lambeth has a higher % of its
offenders with a need in most areas and within employment, training and
education. It has one of the lowest scores for alcohol with only 18%
(average 24%) of its offenders assessed as having an alcohol need linked
to their offending. 3
People with HIV/AIDS
• The HIV and AIDS reporting system (HARS) assesses national prevalence
at 801 patients diagnosed and receiving care per 100,000 of population.
Refugees and asylum seekers
• The GLA estimates 105 asylum seekers, calculated as an apportionment to
Lambeth of national applications for asylum on the basis of population size.
Looked after children
• There were 525 looked after children (LAC) in Lambeth in 2007/08. The
number of LAC exceeds London and national averages but has reduced
from 660 in 2005/06.
Young people leaving care
•
Young people at risk of harm
• At 31 March 2007 there were 62 children aged 4 and under and 113
children aged 5-15 on the child protection register (CPR). 13 By 2007/08
there were 245 in total. The numbers of children on the CPR exceed
London and national averages.
Children with special educational needs or disabilities
• 27% of pupils have some form of special educational need.
• Data from the ICOUNT Disability Register in 2007 shows that there were
621 registered children with disabilities and a further 324 who are thought to
be eligible for the Register. Estimates by the PCT, however, suggest that
11 CHAIN (2007)
12 London Area Office LISAR (initial screening and referral) data 2007
13 London Borough of Lambeth. Childcare Sufficiency Assessment. 2007
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there are approximately 1,000 children under 5 with a disability or SEN.
There are also 5,390 children aged over 5 who have been seen by a health
professional in relation to a disability or SEN.
Teenage parents
•
On which issues does Lambeth differ significantly from the national
average? (as reported in the 2001 census)
• The Census Area Classifications categorise Lambeth as London
Cosmopolitan, similar to Southwark, Lewisham, Hackney, Islington,
Haringey and Brent. The classification is generated using census variables.
• Census variables with a proportion in Lambeth far below the national
average are:
People aged between 45 and 64
Pensioners who live alone
Households with two adults and no dependent children
People who live in a detached house
People who live in a two car household
People who provide unpaid care
Women who work part-time
People who work in manufacturing.
People who work in the wholesale or retail trades
• Census variables with a proportion in Lambeth far above the national
average are:
Children aged four or under
People aged between 25 and 44
People who identify themselves as Black African, Black Caribbean or
Other Black
People who were not born in the United Kingdom
People who are not living in a couple and are separated, widowed or
divorced
People who live alone but who are not Pensioners
People who live in lone parent households
People who rent their accommodation privately
People who live in flats
Average no of people per room
People with a higher education qualification
People who take public transport to work
People who are students
People who are unemployed
Men who work part-time.
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4. Health of Lambeth residents?
Overview
• Just over three quarters of Lambeth residents rate their own health as good or very
good. This rises to 89% among private renters (compared with 71% among council
tenants), 90% among 18-34 year olds and 86% among AB residents and full time
workers. Health ratings are unsurprisingly lower among people with long-term
limiting illness (27%) and older people (55%). Black Caribbean residents (69%) are
less positive about their health.
• In general, the health of people in Lambeth is significantly poorer compared with
the England average
• Life expectancy in males and females is lower and deaths from smoking and
premature deaths from circulatory diseases and cancer are higher than the rest of
England.
• Lambeth is amongst the most deprived areas nationally and the average
deprivation in all wards is higher than the average deprivation in all England wards.
• Smoking prevalence is high in Lambeth especially in deprived areas and in people
lower socio-economic group and in manual occupation. The deaths attributable to
smoking every year are also high in Lambeth compared to the national average.
• Lambeth has higher than average levels of physical activity probably resulting in
lower percentage of obesity in adults. However, obesity in 10-11 year olds is very
high with 1 in 4 children obese in that age group.
• The all age all cause mortality has fallen significantly in the past few years but it
remains above the England and London average.
• The rate of inequality between Lambeth residents and the England and Wales
average has reduced for women, with the cancer reduction particularly notable,
bringing Lambeth down to E&W averages. Further challenges remain in relation to
securing an equivalent improvement in men's health.
• Exponential projection using number of births in previous year, shows a growing
trend in births over the next five years.
• Birth weight (Awaiting returns from hospital (Acute and Community)
• Crude birth weight (Awaiting returns from hospital (Acute and Community)
• The infant mortality rate is 5.7 children per 1,000 live births. This is compared with
4.9 and 5 per 1,000 in London and England. 14 The infant mortality rate is reducing
and the inequality gap is getting narrower plans are to further reduce this gap
further over the next five years.
• The gap in the death rates from cardio-vascular diseases between men and
women is slightly worsening while the gap in deaths rates from cancer in men in
Lambeth and England is widening.
• Coronary heart disease remains the single and preventable cause of all deaths in
Lambeth followed by cerebro-vascular diseases (stroke), cancer and chronic lung
diseases.
• The top 10 causes of hospital admissions in Lambeth in 200708 were: Pregnancy
related conditions, Digestive disorders, Genito-Urinary system, Neoplasms, Injuries
and Poisonings, Circulatory diseases, Respiratory diseases, Musculoskeletal
disorders, Eye related, Nervous System. Overall there has been a fall in total
14 London Borough of Lambeth. Draft State of the Borough: The evidence base supporting the Sustainable
Community Strategy. 2008.
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admissions in 2007-08 over 2006-07 and admissions due to circulatory diseases
and skin have fallen in comparison to the total admissions in 2007-08.
• Lambeth has a higher incidence of mental illness than other cosmopolitan areas in
London. There were approximately 4500 people with severe and enduring mental
illness receiving treatment through a care programme approach via the integrated
mental health service in Lambeth.
STATUS
• In general, the health of people in Lambeth is significantly poorer than the
England average.
• Life expectancy in males and females is lower and deaths from smoking
and early deaths from heart disease, stroke and cancer are higher than the
rest of England.
• Just over three quarters of Lambeth residents rate their own health as good
or very good. This rises to 89% among private renters (compared with 71%
among council tenants), 90% among 18-34 year olds and 86% among AB
residents and full time workers. Health ratings are unsurprisingly lower
among people with long-term limiting illness (27%) and older people (55%).
Black Caribbean residents (69%) are less positive about their health.
Life expectancy
• A baby boy born in Lambeth during 2004-06 could on average expect to live
75.1 years and a baby girl could expect to live to 80.1 years 15 . Ten years
ago these figures were 71.3 and 78.1 years respectively, so life expectancy
has lengthened and gap between the sexes has narrowed. However, a baby
boy in Lambeth lives 2.2 years less and a baby girl 1.5 years less than the
equivalent babies in England and Wales where males live to 77.3 years,
and females to 81.6 years on average.
Birth rate
• Exponential projection using the number of births in the previous year
shows a growing trend in births over the next five years.
• Birth weight / Crude birth weight (awaiting returns from hospital (Acute and
Community))
Mortality rate
• The infant mortality rate is 5.8 children per 1,000 live births. 1 This compares
with 4.9 and 5 per 1,000 in London and England. 16 The infant mortality rate
is reducing and the inequality gap is getting narrower with plans in place to
further reduce this gap over the next five years.
• The all age all cause mortality rate in Lambeth has fallen significantly in the
past few years but it remains above the England and London average.
• Coronary heart disease remains the single most preventable cause of all
deaths in Lambeth followed by cerebro-vascular diseases (stroke), cancer
and chronic lung diseases.
• The rate of health inequality between Lambeth residents and the England
and Wales average has reduced for women, with the cancer reduction
particularly notable, bringing Lambeth down to E&W averages. Further
challenges remain in relation to securing an equivalent improvement in
men's health.
15 Department of Health area profile 24 June 2008.
16 London Borough of Lambeth. State of the Borough: The evidence base supporting the Sustainable
Community Strategy. 2008.
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• The gap in the death rates between men and women from cardio-vascular
diseases is slightly worsening while the gap in deaths rates from cancer in
men in Lambeth and England is widening.
Hospital admissions
• The top 10 causes of hospital admissions in Lambeth in 200708 were:
Pregnancy related conditions
Digestive disorders
Genito-Urinary system
Neoplasms
Injuries and Poisonings
Circulatory diseases
Respiratory diseases
Musculoskeletal disorders
Eye related
Nervous System.
• Overall there has been a fall in total hospital admissions in 2007-08 over
2006-07 and admissions due to circulatory diseases and skin have fallen in
comparison to the total admissions in 2007-08.
• Diabetes – The case-detected prevalence of diabetes in Lambeth (2.95%) is
lower than the national average (3.6%) and detection in primary care is
good with up to 90% cases detected and registered. However the
prevalence models provided by the APHO (Association of Public health
observatories) shows a prevalence of 3.8% meaning around 1% of diabetics
are still undetected in the population.
• Circulatory: CHD – The case detected prevalence of CHD (Coronary Heart
disease) in Lambeth is approximately 1.4% however the modelled
prevalence is around 3% meaning there are over 5000 cases in Lambeth
with CHD and who need to be on the CHD register in primary care and who
need to be on preventative medication.
• Circulatory: Stroke – Although the prevalence of stroke is lower in Lambeth
the directly standardised mortality rate from stroke although declining is still
higher than the England average.
• Cancer: Cancer is the third main cause of death in Lambeth and the
incidence of cancer in Lambeth for males is higher than the England
average while it is similar for females.
• Cancer: by site (analysis is being done)
• The POPPI (Projecting Older People Population Information) system
estimates approximately 11,044 people aged 65 and over with a limiting
long-term illness in Lambeth. Projections show a reduction in 2010 through
2015 followed by a rise of approximately 5-7% in 2020 through 2025.
• Infectious: hospital-acquired infections – the rate of health care acquired or
hospital acquired infections is lower than the London and national average
in Lambeth.
• Dental: decay – Approximately 9% of 12 year olds, 28% of 5 year olds in
Lambeth have active dental decay which is lower than the national average.
• Aural
• Optical
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• Trauma: falls – The mortality rate (directly standardised rate) from
accidental falls is almost twice that of the London average when measured
on a three rolling average. The rate in males is more than 2.5 times that of
the female rate.
• Musculo-skeletal: arthritis
• Musculo-skeletal: osteoporosis
• Pharmaceutical
NATIONAL PRIORITIES
Reference Indicator
NI 137 Healthy life expectancy at age 65
NI 120 All-age all-cause mortality rate
NI 119 Self-reported measure of people’s overall health and wellbeing
Are they physically healthy?
STATUS
Limiting long-term illness
• The POPPI (Projecting Older People Population Information) system
estimates approximately 11,044 people aged 65 and over with a limiting
long-term illness in Lambeth. Projections show a reduction in 2010 through
2015 followed by a rise of approximately 5-7% in 2020 through 2025.
Diabetes
• The case-detected prevalence of diabetes in Lambeth (2.95%) is lower than
the national average (3.6%) and detection in primary care is good with up to
90% cases detected and registered. However the prevalence models
provided by the APHO (Association of Public Health Observatories) show a
prevalence of 3.8% meaning around 1% of diabetics are still undetected in
the population.
Circulatory: Coronary Heart Disease (CHD)
• The case detected prevalence of CHD in Lambeth is approximately 1.4%.
However the modelled prevalence is around 3% meaning there are over
5,000 cases in Lambeth with CHD who need to be on the CHD register in
primary care and who need to be on preventative medication.
• 31 Lambeth residents were admitted to hospital with an acute myocardial
infarction (heart attack) between April and December 07; this would equate
to 41 people over 12 months.
• 73 people were admitted to hospital with heart failure during the same
period (equating to 97 people over 12 months).
Circulatory: Stroke
• Stroke is the third most common cause of death in England and Wales,
after heart disease and cancer (The Stroke Association).
• Although the prevalence of stroke is lower in Lambeth and although the
directly standardised mortality rate from stroke is declining, it is still higher
than the England average.
• From April to December 07, 120 Lambeth residents suffered a stroke and
were admitted to hospital, this equates to 160 people annually.
Cancer: General
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• Cancer is the third main cause of death in Lambeth and the incidence of
cancer for males in Lambeth is higher than the England average; it remains
similar for females.
Cancer: by site
• (awaiting analysis)
Infectious: hospital-acquired infections
• The rate of health care-acquired or hospital-acquired infections in Lambeth
is lower than the London and national average.
Infectious: respiratory
• The rate of new cases of tuberculosis in Lambeth is significantly higher than
the England average but in line with the London average.
Preventative: Immunisations
• In Lambeth, rates of immunisation among children are amongst the lowest
in the country, with primary immunisations at two years of age in Lambeth at
approximately 82%, compared with 88% across London and 94% in
England.
• Immunisation take-up has turned a corner as resistance to the MMR jab has
abated. However, the London Assembly in 2003 found that take-up of the
first and second MMR together by a child’s fifth birthday remained at less
than half in Lambeth (48%), Greenwich (33%), Bromley (47%), and
Lewisham (47%). These poor take-up statistics compare with over 70% in
Harrow and Havering.
Dental: decay
• Approximately 9% of 12 year olds and 28% of 5 year olds in Lambeth have
active dental decay; these rates are in line with the average for London.
Trauma: falls
• Approximately one third of the population aged 65 yrs and over fall each
year. This means approximately 6,900 people in Lambeth. Falls are the
commonest cause of injury and accident-related death in this age group. 5-
10% sustain a fracture.
• It is estimated that one in two women and one in five men will suffer a
fracture after the age of 50.
• According to the National Osteoporosis Society, one year after an
osteoporotic fracture, the majority of patients are not prescribed any
pharmaceutical agents for the prevention of a further fracture. This is
despite the fact that drug treatments have been shown to reduce the risk of
fractures by up to 50%.
• The mortality rate (directly standardised rate) from accidental falls in
Lambeth is almost twice that of the London average when measured on a
three year rolling average. The rate in males is more than 2.5 times that of
the female rate.
• POPPI (Projecting Older People Population Information) estimates that by
2008 approximately 475 hospital admissions in Lambeth of people over 65
each year will be as a result of a fall.
SIGNIFICANT INEQUALITIES IDENTIFIED
• Although people aged over 65 comprise 8.75% of the population, they
account for 12% of A&E attendances and 19% of SELDOC calls.
• African-Caribbean and South Asian people are at least five times more
likely to have diabetes than the white population (Diabetes UK).
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NATIONAL PRIORITIES
Reference
Indicator
NI 121 Mortality rate from all circulatory diseases at ages under 75
NI 122 Mortality rate from all cancers at ages under 75
Diabetes: Modelled and/or recorded prevalence implications (e.g. Life
expectancy)
CHD mortality
CHD Modelled and/or recorded prevalence
Hospital admission rate for MI
Admissions for cardiac revascularisation
Stroke mortality
Hospital admission rate for Stroke
Cancer registrations
COPD Modelled and/or recorded prevalence
COPD mortality
TB notifications
%DMFT in 5-yr olds
Hospital admissions for fractured neck of femur
Admissions for hip and knee replacement
Aural
Optical
Musculo-skeletal: arthritis
Musculo-skeletal: osteoporosis
Pharmaceutical
CURRENT RELEVANT STRATEGIC PRIORITIES
• Long term conditions (copy from LPCT CSP)
• End of life care(copy from LPCT CSP)
• Sexual health(copy from LPCT CSP)
• Mental health(copy from LPCT CSP)
Do they enjoy good mental health?
STATUS
• Lambeth has a higher incidence of mental illness than other cosmopolitan
areas in London. There were approximately 4,500 people with severe and
enduring mental illness receiving treatment through a care programme
approach via the integrated mental health service in Lambeth.
Emotional health
• Lambeth schoolchildren listed exams (57%), friendships (41%) and getting
into trouble (43%) as the 3 things they worried about the most (Tell Us 2
survey 2007).
Dementia
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• In Lambeth over 1500 people are estimated to have dementia and are this
number is projected to rise to 1700 by 2025. Of these, it is predicted that up
to 700 individuals may not be in contact with mental health services.
Typically the BME community have a higher prevalence of early onset
dementia (6.1% compared to 2.2% for rest).
• POPPI (Projecting Older People Population Information) estimates that by
2008 there will be 1,598 over 65s in Lambeth predicted to have dementia, of
which 1,358 (84%) will be over 75.
• The NICE Clinical Guideline on Dementia gives a prevalence of 30% for
those over the age of 85 developing dementia. This would mean an
increase from 908 in 2001 to 1032 in 2010 in the over 85s.
Depression
• It is predicted that 1 in 6 individuals in Lambeth suffer from depression.
Suicide
• The mortality rate (standardised mortality ratio) from suicides and
undetermined injuries is declining in Lambeth but is still higher than the
national average.
SIGNIFICANT INEQUALITIES IDENTIFIED
• The BME community have a higher prevalence of early onset dementia
(6.1% compared with 2.2% for rest).
NATIONAL PRIORITIES
Reference
NI 50
NI 51
NI 58
Indicator
Emotional health of children
Effectiveness of child and adolescent mental health (CAMHs) services
Emotional and behavioural health of looked after children
CURRENT RELEVANT STRATEGIC PRIORITIES
• Mental health (copy from LPCT CSP)
Are they sexually healthy?
STATUS
Teenage pregnancy
• From the baseline year of 1998, Lambeth's teenage conception rate rose
year on year, peaking in 2003.
• However, data for 2004 and 2005 demonstrates a decline in the conception
rate. Data for 2005 shows Lambeth’s under-18 conception rate was 84.1 per
1,000 girls aged 15-17. This compares with the 2003 rate (103.3 per 1,000)
and 2004 rate (85.2 per 1,000) and represents a reduction of 6.6%. from the
1998 baseline The 2005 rate compares with 46 per 1,000 for London and
41.3 per 1,000 for England.
• The latest provisional data for quarter one in 2006 shows a further decline.
In addition to this, the difference between Lambeth’s conception rate and
the national average has narrowed from nearly two and a half times in 2003,
to nearly twice in 2005. Based on a review of 2006 data, early indications
from the Government Office for London (GOL) are that Lambeth is no longer
an accelerated borough under the review process.
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GUM services
•
HIV/AIDS
•
Contraception
• 20% of General Practitioner (GP) practices have achieved “Young People
Friendly” status regarding facilitating access to preventative and treatment
services for sexually transmitted infections.
Abortion
• The legal abortion rate for under 18s in Lambeth in 2006 was much higher
than average with 44 terminations per 1,000 of the population compared
with 24 in London and 18 in England.
Maternity services
•
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference
NI 112
NI 113
NI 126
Indicator
Under 18 conception rate
Prevalence of Chlamydia in under 25 year olds
Early access for women to maternity services
Under 18 Repeat conceptions
Under 16 conceptions
Under 16 Repeat conceptions
KC60 GUM STI data, particularly gonorrhoea
Offer of an appointment at a GUM service within 48 hours
New diagnoses of HIV/AIDS
Late diagnosis of HIV
Long acting reversible contraception methods as a % of all contraception
Access to NHS funded abortions before 10 weeks gestation
CURRENT RELEVANT STRATEGIC PRIORITIES
• Sexual health (copy from LPCT CSP)
Do they have healthy lifestyles?
STATUS
• The CACI Health ACORN profiles for 2006 show Lambeth as the 4 th worst
borough in London for unhealthy lifestyles.
• 97% of Lambeth schools are participating in the National Healthy Schools
Programme with 58% of our schools achieving the Healthy Schools status
as at December 2006. 50% of those schools accredited with HSS are taking
part in the extended healthy schools model as part of the LAA stretch target.
• From our consultations and survey results, however, we know that local
children and young people want more access to out of school leisure and
sporting activities as well as more general information about healthy
lifestyles, including healthy eating, drugs, alcohol, and local facilities.
Diet and Obesity
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• It is estimated that 30.3% of Lambeth adults eat a healthy diet. This is in line
with the average for London and above the national average of 26.3%. 17
• The level of obesity in Lambeth adults (18.6%) is lower than the England
average (23.6%), probably as a result of the higher than average levels of
physical activity in Lambeth. However obesity in children aged 10-11 is high
with up to 1 in 4 obese.
• 13.3% of children at reception level are obese in Lambeth compared with
11% in London, and 9.9% in England. 18
Breastfeeding
• The average rate of breastfeeding is 90.9%, although rates fall significantly
after hospital discharge. These rates are higher than the national and
London averages. 1
Hypertension
• Uncontrolled hypertension increases the risk of heart disease, diabetes,
stroke and vascular dementia. In December 2007 30,948 Lambeth residents
were on the hypertension register, and of these, 12,795 (41%) were
uncontrolled.
• The prevalence of hypertension in Lambeth is approximately 9.9%
compared with the modelled prevalence of 19.9% which means there could
be up to 34,000 individuals in Lambeth who have hypertension but have not
been detected and who are not being treated. However these estimates
have to be used with caution and detection and treatment of hypertension is
monitored through primary care.
Exercise
• Sports participation levels are the 4 th highest in London and the UK. 19
• The number of visits to Lambeth leisure centres during 2007-08 was 2.19
per head of the population. 20
• 81% of residents live within 5 mins. of a public open space (see map
below).
• 25.6 % of adults regularly participate in a minimum of 30 minutes of
moderate intensity exercise at least 3 times a week. 21
• Of the 48,900 men aged 30-44 in Lambeth, 2.6% participate 3 x week, 2.2%
participate 1-2 x week, 3.5% are inactive 22
• Lambeth has: 30,980 people aged 60+ 11% participate 3 x week, 7%
participate 1-2 x week, 76% are inactive. 8
• Of the 52,759 people on low incomes in Lambeth, 18% participate 3 x week,
11% participate 1-2 x week and 63% are inactive.
17 Modelled estimate from Health Survey for England.
18 London Borough of Lambeth. State of the Borough: The evidence base supporting the Sustainable
Community Strategy. 2008.
19 Sports England Active People Survey
20 ECCS Performance Digest 2007-08
21 Sports England Survey 2005-06.
http://www.sportengland.org/061206_active_people_london_region_factsheet_embargo_7_dec(2).p
df
22 Office for National Statistics (2007). Quinary age groups and sex for local authorities in the United
Kingdom;estimated resident population Mid-2006 Population Estimates (T 09).
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• Of the 95,726 people from black and minority ethnic communities in
Lambeth, 1.9% participate 3x week, 1.9% participate 1-2x week and 5.2%
are inactive. 8
• 100% of schools are signed up to the Schools Sports Partnership
Programme with 86% offering a minimum of at least 2 hours of good quality
Physical Education (PE) and sports.
• 82% of school pupils participate in at least 2 hours of high quality PE and
out of hours school sport in a typical week; this is lower than both the
London and England averages. 5
• 33 % of pupils were involved in inter school sports competitions during the
academic year compared with 35% nationally. 23
• 25% of Lambeth pupils participate in one or more community sports, dance
or multi skill clubs linked to school, in line with the national average.
• 59% of young people who responded to the Residents’ survey 2007 said
they used sports and leisure facilities.
• 2.6% of adults volunteer to support sport for a minimum of 1 hour per week.
5
• 5% of Lambeth pupils are actively involved in sports volunteering and
leadership compared with 12% nationally.
• 120 people participated in the 2005-06 ACTIVEwalks programme in the
borough, 96% of participants enjoy and regularly attend these sessions.
Health plans
• The Healthy Lifestyles team referred 743 patients onto the exercise referral
scheme were referred last 2007/08. Since 2004 participation has increased
from 150 to 800, with 50% being from BME groups.
• 67 children followed the ‘Mind, Exercise, Nutrition Do it’ programme in 2007.
Feedback from the families demonstrated that 80% were successful in
achieving their aims.
• 19 out of 54 Lambeth GP surgeries have signed up to provide a specialist,
enhanced service to patients with Learning Disabilities. These surgeries
carry out yearly health checks and draw up Health Action Plans (HAPs) with
the patients to address any specific health needs. There are currently 110
patients with HAPs.
• 85.5% of all schools in Lambeth have a School Travel Plan in place,
resulting in significant shifts with walking to schools increasing by 9%, car
driving decreasing by 7% and cycling increasing by 7%.
Smoking
• Smoking prevalence is high in Lambeth especially in deprived areas and in
people in lower socio-economic groups and in manual occupations. The
deaths attributable to smoking every year are also high in Lambeth
compared with the national average. However, the numbers of mothers
known to be smoking during pregnancy is lower than both the London and
England averages. 24
• Between April 2005 and March 2007 approximately 1,841 people reported
quitting smoking, with an expected success rate of around 50%. Whilst
encouraging, this should be balanced against the countervailing increases
in young people taking up smoking.
23 DfCSF (2007). 2006/7 School Sport Survey Research Report DISF-RW024.
24 Department of Health area profile 24 June 2008.
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SIGNIFICANT INEQUALITIES IDENTIFIED
• The African-Caribbean and Indian older people population is predicted to
increase over the years and these groups are at a higher risk of having
hypertension.
• 71.2% of people with disabilities compared with 40.3% of people without
impairments are inactive. 25
• Prevalence of obesity among children aged 2-10 is higher and has grown
from 9.9% in 1995 to 13.7% by 2003. 26
• 63.1% of people from the lowest socio-economic group compared with
34.1% from the highest socio-economic group are inactive. 8.
• 51.8% of people from Black and Minority Ethnic cultures compared with
40.4% white groups are inactive.
• 34.6% of males aged 30-44 compared with 19.2% males aged 16-29 are
inactive.
• 76% of older people 60+ compared to 39% people aged 16-59 are inactive.
• 25% of Lambeth’s children responding to the TellUs2 Survey cited lack of
parental consent as one of the main reasons for them not being involved in
activities such as sports and recreational activities. This compares with 11%
nationally.
• Not being able to participate in out of school leisure and recreation because
of carers’ concerns about their safety is also a key issue for children looked
after (LAC) (raised in the Young London Matters consultation 2007).
NATIONAL PRIORITIES
Reference
NI 52
NI 53
NI 55
Indicator
Take up of school lunches
Prevalence of breast-feeding at 6-8 weeks from birth
Obesity among primary school age children in Reception
NI 56 Obesity among primary school age children in Year 6
NI 8
NI 57
NI 123
Adult participation in sport and active recreation
Children and young people’s participation in high quality PE and sport
Stopping smoking
Obesity Modelled and/or recorded prevalence
Hypertension Modelled and/or recorded prevalence
Modelled and/or recorded drinking behaviour
Reducing underage sales of alcohol
CURRENT RELEVANT STRATEGIC PRIORITIES
• The North Lambeth and Southwark Sport Action Zone is one of the original
12 Sport Action Zones established to empower and support local
communities to develop sustainable and inclusive sport and physical activity
in areas of high deprivation. It has encouraged sports among young people
through local partnerships. Higher levels of participation are observed in
northern Lambeth where the Sport Action Zone has been most active.
25 Lambeth Needs Assessment for Physical Activity, March 2008
26 London Borough of Lambeth. Draft Parenting and Family Support Strategy 2008-11. 2008.
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Overview of green spaces and Council leisure facilities in Lambeth
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Overview of the main exercise providers and programmes in Lambeth
Do they choose not to abuse alcohol or illegal drugs?
STATUS
Illegal Drugs
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• The Home Office estimates 5,029 Problematic Drug Users (PDUs) of
opiates and/or crack cocaine in Lambeth (estimate based on 2004/05 data).
The total number of Problematic Drug Users PDUs known to treatment in
2006/07 was 1,991. If the Home Office estimate of 5,029 is correct, that
would mean that there are 3,038 PDUs who are treatment naïve (have not
engaged with treatment since 2004/5).
• During 2006/07, 894 clients entered treatment and 603 were discharged.
• 2,033 drug users accessed treatment during 2007/08. 149 of these (7.3%)
were aged 17 or under. 79% of individuals were retained in structured
treatment for more than 12 weeks.
• 72% of adult drug users in treatment in Lambeth are male (28% female).
• 59% of adult drug users in treatment in Lambeth are white; 26% are Black
which includes 10% Black Caribbean.
• The age profile of adult drug users in treatment in Lambeth puts 8% aged
20-24; 26% aged 25-34; 41% aged 35-44% and 16% aged 45-54. 2% are
aged 18-19 and a further 4% are aged 55+.
• National data has shown that clients who are retained in treatment for
longer than 12 weeks (84 days) have achieved significantly better
outcomes. In 2006/7, 74% of Lambeth clients were retained for more than
12 weeks. This was 2% higher than the London average. This figure rose to
77% for Lambeth DIP clients. Furthermore, only 3% of Lambeth clients were
“triaged only” (i.e. received a triage assessment, but did not engage in
treatment), compared with the London average of 7%.
• The proportion of Lambeth clients receiving treatment outside the borough
has significantly reduced from 10% to 5%.
• The proportion of BME clients in treatment is not significantly different from
the proportions in Lambeth’s overall resident population.
• 61% of individuals were discharged from structured treatment in a planned
way in 2007/08.
• 31% of referrals for treatment were self-referrals. One in seven of all
referrals are self-referrals entering through SLaM Stockwell CDT.
• Slightly less than a fifth of all clients were referred from the Criminal Justice
system in 2007/08; this is a similar proportion to last year.
• 13% of those accessing treatment for the first time in 2007/08 had a dual
diagnosis of mental health problems alongside their substance misuse
issues.
• The number of young people aged 15-17 who used drugs in the last year is
estimated at 2,210. 27
• 46 out of 85 schools have achieved the National Healthy Schools Status for
drug education with a further 10 working towards it.
• CHAIN data for Lambeth shows that 88% of all rough-sleepers have alcohol
and/or drug support needs. This is notably higher than the proportion across
other London boroughs. 28
• Preliminary statistics from the Aftercare Team show that most carers
engaging with treatment services are affected by their dependents’ polydrug
use (including alcohol), with only 6% affected by alcohol only. Nine out
27 London Borough of Lambeth. Draft Needs Assessment for Young People’s Specialist Substance Misuse Treatment.
2007.
28 CHAIN (2007)
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Alcohol
of ten carers were females (88%), and seven of ten (71%) were direct
relatives (the remaining as partners or friends).
• It is estimated that 23-24% of Lambeth’s population drink excessively and
that Lambeth has a higher rate of alcohol related hospital admissions than
London and England. The largest single categories of hospital admissions
are for alcohol related disorder and then liver disease. 29
• The public perception of drunk and rowdy behaviour in Lambeth is
consistent with London in general with 37% seeing it as a very or fairly big
problem (against 39% inner London and 40% London-wide). 6 out of 10
people did not see it as a very big problem at all (Residents’ survey 2007).
• The general profile for an excessive drinker in Lambeth is that of a white
male.
• Most drink drivers in Lambeth are male aged over 26 years. Almost 60% of
arrests take place between midnight and 0700 hours in the morning with
39% of those arrested coming from outside the borough. It is assumed,
though not known, that a large number of drink drivers would have been
socialising in the borough.
• Only 27% of Lambeth schoolchildren admit to having drunk an alcoholic
drink, significantly lower than the national average of 48%. However, 17%
preferred not to say, higher than the national average of 10%. (Tell Us 2
survey 2007).
• 46% of Lambeth schoolchildren would like more/better information on
alcohol (against 27% nationally) and 39% would like equivalent information
on drugs (31% nationally). (Tell Us 2 survey).
SIGNIFICANT INEQUALITIES IDENTIFIED
Illegal Drugs
• The proportion of young adults in treatment in Lambeth in 2006/07 was
lower than the London average (16%). However, these clients were retained
successfully (80%) compared with the borough retention rate for all ages
(74%) and the London retention rate for young adults (68%).
• 95% of young people engaged with the Youth Offending Service reported
as using illicit drugs.
• PDUs using crack cocaine are far less likely to engage in treatment, and
clients using both crack cocaine and heroin are far less likely to be retained
in treatment for more than 12 weeks.
• Mandatory drug testing is carried out on all those arrested for so-called drug
related “trigger offences”. Of those testing positive from April-Nov 2007,
89% were male and 58% were from BME communities including 21%
recorded as British Caribbean. 42% were categorised as White. The high
proportion of BME positive testers illustrates an over-representation within
this group and is significantly different from the borough’s overall BME
population.
• The age profile of those testing positive highlights that 91% are aged
between 18 and 44 with 18 to 24 yr olds representing the largest proportion
at 21%.
Alcohol
29 Alcohol Needs Assessment 2006/07
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• Alcohol related ambulance call outs are geographically aligned to wards
with strong night time economies where levels of alcohol and violent crime
are high. Alphabetically these are Bishops, Clapham Town, Coldharbour,
Oval and Princes.
NATIONAL PRIORITIES
Reference
NI 39
NI 40
NI 115
Indicator
Rate of hospital admissions per 100,000 for Alcohol-related harm
Number of drug users recorded as being in effective treatment
Substance misuse by young people
CURRENT RELEVANT STRATEGIC PRIORITIES
• Reduce the harm caused by problematic drug use and Alcohol consumption
(Safer Lambeth strategic plan 2008)
Department of Health Area Profile for Lambeth
Health Profiles for every local authority and region across England were published
on 24 June 2008 by the Department of Health and the Association of Public Health
Observatories.
The Profiles use key health indicators to capture a picture of the nation's health
down to local level.
The summary chart for Lambeth is included below.
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5. Economic development - Are they economically secure?
Are they economically active where possible?
STATUS
Individuals
• 76.2% of the population of Lambeth is economically active; this compares
with 75.1% for London and 78.6% nationally. 30
• 23.8% of the population of Lambeth is economically inactive, this compares
with 24.9% for London and 21.4% nationally.
• 18.7% of the economically inactive are neither in employment nor
unemployed and do not want a job; this compares with 18.0% for London
and 16.1% nationally. 31
• The overall employment rate in Lambeth is 68.5%. This compares with the
London employment rate of 69.8% and a national figure of 74.3%.
• The unemployment rate in Lambeth is 9.5% of the economically active
population compared with 6.9% for London and 5.3% nationally.
• In 2006-07, 66.9% of supervised juveniles in Lambeth were in full-time
education, employment or training (EET), compared with 70.3% in our
Nearest Neighbour (NN) group and 70.2% nationally 32 . In 2007-08 this has
improved to 68.9%, compared with 73.5% for our NN and 70.3% nationally.
• Lambeth has 9.6% of young people aged 16-18 not in education,
employment or training (NEET), compared with 9% for Southwark, 5.5% in
Wandsworth and just 0.8% above the London average. This is down from
15.3% in 2004. Projections show that just 8.6 % will not be in paid work or
preparing for it in Lambeth by 2009-10, closing the gap on the England
average. 33
• The Lambeth Year 11 Annual Activity survey 2007 of 1,783 pupils showed
that 90.4% remained in education, compared with 87% in 2006. 1.7% are in
full-time training, compared to 1.4% in 2006. 1.8% are in full-time
employment, compared to 1.4% in 2006.
• When asked which things would do most to make their life better, 19% of
Lambeth schoolchildren indicated that they would like more help to plan for
their future, compared with 17% who gave this response nationally.
• 16% of young people have made use of Connexions in the last 12 months.
64% said they had used the Connexions in their local area (Residents
Survey 2007).
30 NOMIS Official Labour Market Statistics (Oct 2006 – Sep 2007). Percentages are for those of working age
(16-59/64). Economically active are people who are either in employment or unemployed.
31 People who are neither in employment nor unemployed includes, for example, all those who were looking
after a home or retired. Also people wanting a job, these are those not in employment who want a job but are
not classed as unemployed because they have either not sought work in the last four weeks or are not
available to start work.
32 NN = nearest neighbour group consists of a comparable group of local authorities; Southwark, Hackney,
Islington, Haringey, Lewisham, Hammersmith and Fulham, Tower Hamlets & City of London, Greenwich,
Brent.
33 London Borough of Lambeth. CYPS Performance Digest Report. March 2008
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• In May 2008, 3.6% of the resident working age population for Lambeth is
claiming Job Seekers Allowance (JSA), compared with 2.6% for London and
2.2% nationally. At 63.10% of claimants, Lambeth is below the London
average (65.50%) for claiming up to 6 months JSA, but higher than London
averages for claimants over 6 up to 12 months and over 12 months. 34
• 88% of people using mental health services in Lambeth are unemployed.
• The number of adults with learning disabilities in employment was 2.3% in
2007/08.
• Over 53% (9,132) of working age people who said that they were carers in
the 2001 Census worked full or part time. 782 combined work with 50+
hours of caring each week.
• In common with other London boroughs, childcare is a barrier to
employment. In Lambeth, a large majority of people use relatives for
childcare, and those that pay, pay an average of £85 per week, compared
with the national median average of £23 per week.
Business
• LABS 2007 35 cites Lambeth’s economy as contributing 0.53% of total British
economic output and it is ranked 29 th out of 408 Local Authorities in terms of
size and its economy 36 .
• In 2007, there were around 10,000 businesses in Lambeth; but more than
three-quarters of these had fewer than five employees (Association of
British Insurers 2007).
• The 2007 Lambeth Economic Digest showed that 99.65% of businesses in
the borough are Small or Medium Enterprises (SMEs). However, in the
north of the borough there is a cluster of large firms, 48 of which employ
more than 200 employees; among these are the national headquarters of
IBM, Shell, and the ITV network.
• North Lambeth currently accommodates 61,500 jobs, almost 45% of the
borough’s total. 37
• Lambeth businesses comprise 38 :
SMEs 99.65%
Family owned 50.04%
Social Enterprises 12.38%
Ethnic minority owned businesses 40.62%
• The biggest contribution of businesses is from Real estate, renting and
business activities sector. There are higher concentrations of other
community services, hotel and restaurant sector, publishing sector,
education, health and social work sector and construction sector compared
with London. 39
34 The Jobseeker's Allowance (JSA) is payable to people under pensionable age who are available for, and
actively seeking, work of at least 40 hours a week.
35 Lambeth Businesses (LABS), Source: LABS; Annual Business Inquiry (ABI) 2007
36 Regeneration Delivery Plan 2007/08; Building a Better Lambeth.
37 Economic Development Strategy 2007-2010
38 From LABS boosted analysis, 2007
39 Lambeth Economic Digest 2008.
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• The business sectors with lower concentrations compared with London are
business and professional services, banking and finance, wholesale and
retail and transport and communications.
• At the start of 2007, there were 7,870 VAT registered businesses. The VAT
registration rate during 2006 was 44 per 10,000 working age population.
985 new registrations were made during 2006 and 600 businesses deregistered
in the same period.
SIGNIFICANT INEQUALITIES IDENTIFIED
• The BME employment rate is 50.9% 40 and there has been a 2% decrease in
the non white JSA claimant rate form March 2008 to April 2008.
• 61% of 19 year old care leavers known to Connexions are in education,
employment or training (EET).
• 12.9% of 16-19 year olds with learning difficulties or disabilities were NEET
in December 2007. This is a significant decrease of 29% from December
2006. 74.5% were in EET.
• Currently, 45% of teenage mothers are in EET. This represents an increase
of 22% on 2006 figures.
• The numbers of young offenders in full-time EET has increased by 6%
during the last two years to above 76%, which is higher than the average for
London, and the national average.
• Lambeth has extraordinary levels of social exclusion e.g. 96%
unemployment rates for people using community mental health teams. 41
Growing professional awareness of vocational possibilities for patients with
severe mental illness should mean that many patients could return to
competitive employment and return to mainstream society.
• There is evidence of documentation relating to vocational needs in only
18% of out-patients; 8% in patients of community mental health teams; and
39% in acute wards; 8% of patients were engaged in work schemes; 10% of
patients were in education; and 9% were engaged in vocational
interventions with their care coordinator; the latter was less likely if the
patient was from a Black or minority ethnic group. 42
• The more care that people provide, the less likely they are to be
economically active. In a national survey 87% of working age Carers who
care 20+ hours per week said that they would like to return to work, but four
out of five of them felt that it would be difficult or impossible for them to do
so.
NATIONAL PRIORITIES
Reference
NI 151
NI 144
NI 146
NI 150
NI 117
NI 45
Indicator
Overall Employment rate (working-age)
Offenders under probation supervision in employment at the end of their
order or licence
Adults with learning disabilities in employment
Adults in contact with secondary mental health services in employment
16-18 year olds who are not in education, training or employment (NEET)
Young offenders engagement in suitable education, employment or training
40 NOMIS/ APS October 2006 – September 2007.(data prior to his period has to be re-weighted)
41 Vocational and social inclusion service proposal, Mark Bertram, SLaM
42 Bertram & Howard, Occupational care planning for service users. Psychiatric Bulletin (2006), 30, 48-51
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NI 7
NI 171
NI 172
NI 182
NI 183
Environment for a thriving 3 rd sector
New business registration rate
Percentage of small businesses in an area showing employment growth
Satisfaction of business with local authority regulatory services
Impact of local authority trading standards services on the fair trading
environment
CURRENT RELEVANT STRATEGIC PRIORITIES
• Increase the number of young people in education, employment and
training, developing skills for adulthood. (Lambeth Children and Young People’s
Plan 2 2007-10)
• The Sustainable Communities Strategy contains identifies
worklessness priorities supported by indicators within the Local Area
Agreement.
• The Lambeth Employment and Skills Plan have agreed a target this
year of an employment rate of 70% by 2012.
• The Economic Development Strategy has a central objective of
creating training and employment ‘pathways’ for people to realise
their talents and take advantage of employment opportunities
alongside demand side objectives to support employer engagement
through initiatives such as the ‘Employer of First Choice’ programme.
The EDS offers an underpinning framework for the future rollout of
projects and interventions.
• Support Carers so that they can work, or continue with their education
or training (Carers Strategy 2008)
Do they possess valuable skills and qualifications?
STATUS
• The average point score per student in post 16 education has increased
from 547.6 in 2006 to 578.4 in 2007. Although these point scores are below
inner London and national figures the increase is larger than both inner
London and national increases.
• 39.5 43 % of the Working age population in Lambeth is qualified to at least
Level 4 or higher.
• 51.2% of the Working age population in Lambeth is qualified to at least
Level 3 or higher.
• 61.4% of the Working age population in Lambeth is qualified to at least
Level 2 or higher.
• The LABS report reveals that the top three biggest problems facing
Lambeth businesses are availability of appropriately skilled employees, size
of current premises and cost of labour.
• Lambeth residents are employed by sector as follows:
Manufacturing 2.7%
Construction 2.7%
Services 94.0%
43 NOMIS: ONS Annual Population Survey, Jan 2006 – Dec 2006.
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• Lambeth residents are employed in the service industry sectors as follows 44 :
Public administration, education & health 35.6%
Finance, IT and other business activity 28.5%
Distribution, hotels and restaurants 16.3%
Other services 8.2%
Tourism 7.2%
Transport & Communications 5.4%
SIGNIFICANT INEQUALITIES IDENTIFIED
• Lambeth has much higher percentages of residents who have no
qualifications than both London and nationally and it appears that the gap is
growing. 21.3% 45 of working age residents in Lambeth have no
qualifications compared with 13.9% for London and 13.8% nationally. The
difference Jan– Dec 2005 was 5.4% higher compared with London but for
Jan– Dec 2006 the difference was 7.4% higher than the London
percentage. 46
• The lack of the appropriate skills is a barrier to employment. Less than 50%
of adults with low or no qualifications are in work. 47
• Conversely, Lambeth has consistently had higher levels of residents
qualified to NVQ 4 and above compared with London and national
averages. For the period Jan– Dec 2006 the NVQ4 qualification level in
Lambeth was 4.9% higher than London and 12.1% higher than the national
average.
NATIONAL PRIORITIES
Reference
NI 161
NI 162
NI 163
NI 164
NI 165
NI 174
Indicator
Number of Level 1 qualifications in literacy (including ESOL) achieved
Number of Entry Level qualifications in numeracy achieved
Proportion of population aged 19-64 for males and 19-59 for females
qualified to at least Level 2 or higher
Proportion of population aged 19-64 for males and 19-59 for females
qualified to at least Level 3 or higher
Proportion of population aged 19-64 for males and 19-59 for females
qualified to at least Level 4 or higher
Skills gaps in the current workforce reported by employers
CURRENT RELEVANT STRATEGIC PRIORITIES
• Support Carers so that they can work, or continue with their education or
training (Carers Strategy 2008)
44 NOMIS: ONS annual business inquiry employee analysis (2006)
45 NOMIS APS, Data for Jan 2006 –Dec 2006
46 Lambeth Economic Digest
47 Lambeth Economic Development Strategy 2007-2010
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Do they enjoy access to sufficient income?
STATUS
• Average gross weekly earnings of employees in Lambeth is £537.3 48 , this
compares to £558.9 and £613.3 for neighbouring boroughs of Southwark
and Wandsworth respectively and the London average of £553.3.
• The 2001 Census showed that one-quarter (17,000 out of 67,000) of
Lambeth’s under-19s live in areas of income deprivation. 49
• 51% of Inner London children live in poverty 50 compared with 41% across
London and 28% nationwide. Borough level figures are not available but
Lambeth can be expected to exceed the Inner London figure. 51
• 23% of Lambeth residents surveyed (2007), felt the housing benefits service
was good or excellent compared with 21% across London and 22%
nationally. 20% of respondents said they actually used the service
compared with 13% for London and 18% nationally.
• The percentage of working age people on out of work benefits is16.5%. In
the worst performing neighbourhoods this increases to 27.7% (Q2 2007).
• Just over a third (36%) 52 of children in Lambeth live in families on key
benefits compared with 28% in London. Lambeth ranks as the 11th highest
rate for this nationally and 27th out of the 33 London boroughs.
• The number of people claiming incapacity benefits represents
approximately 7.1% of the working age population (London 6.1% and
nationally 7.2%). The number of people claiming incapacity benefits
allowance has fallen by 3%, a reduction of 390 claimants between
November 2006 and November 07.
• The number of people claiming lone parent benefits represents
approximately 4.0% of the total working age population (compared with
London 3.1% and nationally 2.0%). The total number of people claiming
lone parent benefits has decreased by 13% over the period November 2003
to 2007.
• 38% of secondary school pupils are eligible for free school meals, which is
the fifth highest proportion in England.
• The proportion of primary school pupils eligible for free school meals is
37.4%, which is the eighth highest proportion of primary school pupils
across England. 53
• Lambeth has the highest take-up nationally of the childcare element of
working family tax credit at 27% (compared with 11% for England).
SIGNIFICANT INEQUALITIES IDENTIFIED
• Vassall and Coldharbour wards display the highest working age benefit
claim rates within Lambeth with approximately 25% of the total working age
population claiming some form of working age benefit (i.e. incapacity
48 ONS annual survey of hours and earnings - resident analysis [2007]
49 This is the number of children and young people living in 10% most deprived Super Output Areas by Income
deprivation affecting children.
50 Households living in poverty subsist on an income 60% below the median household income. Calculation of
poverty rates control for geographic variations in house prices.
51 London Child Poverty Commission.
52 Government Office for London /DWP August 2008, based on 5% sample.
53 London Borough of Lambeth. Draft State of the Borough: The evidence base supporting the Sustainable
Community Strategy. 2008.
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benefit, job seekers allowance, lone parent benefits). (Based on DWP Ward
Count May 2007/working aged population).
• In Vassall ward, there was a 2% reduction in the number of people claiming
working age benefit . from February 2008 to May 2008.
• In Coldharbour ward, there was a 3% reduction for the same period.
• The Households Below Average Income data 2004/5 (DWP) showed that
21% of children nationally are from families on out of work benefits. Within
London there are 105 local wards where the percentage of children on
benefits is at least twice the national average. Lambeth had 2 wards
(Coldharbour, 48.2% and Tulse Hill, 43.85%). Southwark had 5 wards,
Wandsworth and Lewisham also had 2 wards. 54
NATIONAL PRIORITIES
Reference
NI 166
NI 152
NI 153
NI 173
NI 181
NI 116
NI 118
NI 180
Indicator
Median earnings of employees in the area
Working age people on out of work benefits
Working age people claiming out-of-work benefits in worst performing
neighbourhoods
Flows on to incapacity benefits from employment
Time taken to process Housing Benefit/Council Tax Benefit new
claims and change events
Proportion of children in poverty
Take up of formal childcare by low-income working families
The number of changes of circumstances which affect customers’
HB/CTB entitlement within the year.
Proportion of Older People in poverty
CURRENT RELEVANT STRATEGIC PRIORITIES
•
Do they live in decent homes?
STATUS
• The mix of housing stock in Lambeth is fairly typical of an inner London
borough with 37% owner-occupied properties, 38% social housing and 25%
privately rented.
• There is very high demand for housing in Lambeth reflected in an average
house price of £356k (Land Registry Dec 2007), almost double the national
average.
• Private renting in Lambeth is also expensive costing an average of £230 per
week for a 2 bedroom property, compared with less than £80 per week for a
social let (Housing needs survey 2007).
• Lambeth is estimated to have 5.16% of households in fuel poverty 55 ; this
compares with a London average of 5.4%.
54 http://www.jrf.org.uk/child-poverty/documents/London.doc
55 A household is defined as being in Fuel Poverty (full income) if, in order to maintain a satisfactory heating
regime, it needs to spend more than 10% of its income on all household fuel use.
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• Approximately 16,000 households are currently registered on the general
needs waiting list. Of these households only 30 (excluding sheltered) were
allocated social housing in 2007/08. 85% of all new social lettings are to
homeless households in temporary accommodation.
• There are currently 2,100 people waiting for an offer in Temporary
Accommodation.
• Through a successful homelessness prevention strategy, the number of
households accepted as being homeless has been successfully reduced
from 1,651 to 735 over the last 5 years.
• There are approximately 13 people sleeping rough in Lambeth on any one
night.
• Around 10% of households living in rented accommodation (both social and
private) are overcrowded. This compares with only 1.2% of owner-occupied
households.
• There are an estimated 28,000 or 22% of all households in the borough
under-occupying their homes (using the criteria of having more than one
spare bedroom).
• 1.8% of private sector properties are vacant for over six months.
• It is estimated that 4,881 additional affordable housing units would need to
be built each year if all affordable needs were to be met. This is an increase
on the 2002 survey estimate of 3,050 per annum. This rise is due both to a
decreased level of supply compared with 2002 and an increasing level of
need due to the significant rise in house prices over and above the ability of
households to afford them (Housing Needs Assessment 2007).
• Lambeth secured the second highest allocation of NAHP funding for the
2006/08 programme in London and successfully delivered 872 new units of
affordable housing between 2005-07.
• From April 2008 the Council has put in place a Choice Based Lettings
scheme with the aim of improving choice for people in housing need. People
looking for a home act directly by registering their interest in any advertised
council or housing association homes in Lambeth for which they are eligible.
Because of the severe shortage of social housing to rent in Lambeth, the
bidder in the greatest need is then invited to view the property.
• There is a government target that all social housing should meet the Decent
Homes Standard by 2010. For a home to be decent it needs to:
meet the current statutory minimum for housing
be in a reasonable state of repair
have reasonably modern facilities and services
provide a reasonable degree of thermal comfort.
• 66% of council homes and 88% of RSL homes meet the Decent Homes
standard. 11% of Private Sector properties are deemed unfit for purpose
(2004 Private Sector Stock Conditions Survey).
• 62% of tenants are satisfied with the landlord services provided by Lambeth
(2006 Tenant Satisfaction Survey). However, the housing management
service provided by Lambeth Council will shortly be transferred to an Arms
Length Management Organisation (ALMO), Lambeth Living.
• 18% of residents surveyed in 2007 rated our council housing as good to
excellent, compared with the London-wide figure of 21%. 18% also rated
our housing as poor to very poor, in line with the inner-London average.
SIGNIFICANT INEQUALITIES IDENTIFIED
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• With an average house price of £356k (Land Registry Dec 2007) almost
double the national average, residents on average incomes of £31k are
struggling to get onto the property ladder.
• Those from BME communities are over represented in social housing,
homelessness and over-crowding statistics.
• BME Households are likely to be larger than White households and more
likely to live in the social and private rented sectors. Black African
households represent the largest ethnic group in Lambeth that suffer from
high levels of overcrowding. Whilst there is not a sizeable Asian community
in the borough, proportionally the second ethnic group suffering from high
levels of overcrowding are Asian households.
• 73% of those placed in Temporary Accommodation over the year ending
Dec 2007 were of Black, Asian and Minority Ethnic backgrounds.
• Single, pregnant women and families with children combine to make up
75% of the 2,100 people currently awaiting an offer in Temporary
Accommodation. The average number of weeks spent by these households
in shared hostel accommodation in Lambeth is 11.2 weeks (2006/07)
(London median figure of 12.2 weeks) and in shared bed and breakfast
accommodation is 1.8 weeks (London median of 2.4 weeks).
• There are significantly high levels of homelessness among 16-17 year olds
with approximately 104 currently in Temporary Accommodation, above
London and national averages.
• Households with two adults without children (totalling 43%) are in greater
need of affordable housing compared with other household compositions.
• Older People tend to live in properties that are under occupied when
compared with other household types, but are reluctant to move into smaller
accommodation. This group is least likely to be in housing need.
• There are high levels of worklessness associated with those living in social
housing with 60% of social tenants being in receipt of housing benefit.
• 12% of residents in private sector properties move for work-related reasons;
this drops to only 0.1% of those in social housing.
• Receipt of incapacity benefit can be used as an indicator to demonstrate
correlation between health deprivation and social housing. In Lambeth there
are higher levels of incapacity benefits concentrated within social housing
estates. Lambeth has a high rate of Incapacity Benefit claimants within the
Brixton wards of Coldharbour and Vassall. These wards are among the
most deprived areas in London and also have higher levels of worklessness
and social housing than other wards in the borough.
NATIONAL PRIORITIES
Reference
NI 158
NI 160
NI 155
NI 154
NI 156
NI 157
NI 159
Indicator
% non-decent council homes
Local Authority Tenants’ satisfaction with landlord services
Number of affordable homes delivered (gross)
Net additional homes provided
Number of households living in Temporary Accommodation
Processing of planning applications
Supply of ready to develop housing sites
NI 170 Previously developed land that has been vacant or derelict for more than 5
years
NI 187
Tackling fuel poverty - % of people receiving income based benefits living in
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NI 46
homes with a low energy efficiency rating
Young offenders access to suitable accommodation
CURRENT RELEVANT STRATEGIC PRIORITIES
• Increase the supply of dwellings in the borough (Housing Strategy 2008)
• Improve the condition of existing stock (Housing Strategy 2008)
• Improve access to housing (Housing Strategy 2008)
• Mixed, sustainable communities (Housing Strategy 2008)
• Worklessness (Housing Strategy 2008)
• Empowering tenants (Housing Strategy 2008)
Do they enjoy easy access to transport?
STATUS
• 50.9% of households in Lambeth have no access to a car, one of the
highest proportions in the country (see map below) (Census 2001).
• Lambeth has the highest proportion of population who travel to work by
public transport: 58.6% compared with 14.1% nationally.
• 69% of Lambeth residents rate local public transport as good or excellent
compared with 66% of inner-London residents and 61% of Londoners
overall (Residents’ survey 2007).
• 64% of young people in Lambeth rate local public transport as good or
excellent compared with 63% of young inner-London residents and 57% of
young Londoners overall (Residents’ survey 2007).
SIGNIFICANT INEQUALITIES IDENTIFIED
• Residents in the south of the Borough face a number of difficulties in trying
to undertake local trips or access central London by public transport. They
are generally restricted to using buses which are slow due to a lack of
priority measures. In addition, since they are mainly focused on north-south
radial routes, they do not adequately serve some of the housing estates
(see map below).
NATIONAL PRIORITIES
Reference
NI 176
NI 177
NI 178
NI 167
NI 168
NI 169
Indicator
Working age people with access to employment by public transport (and
other specified modes)
Local bus and light rail passenger journeys originating in the authority area
Bus services running on time
Congestion – average journey time per mile during the morning peak
Principal roads where maintenance should be considered
Non-principal classified roads where maintenance should be considered
CURRENT RELEVANT STRATEGIC PRIORITIES
• The Lambeth Transport Local Implementation Plan sets out how Lambeth
will deliver the London Mayor's Transport Strategy and forms the basis for
future funding bids for projects until 2011. Included action areas: Road
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Safety, Parking and Enforcement, School Travel Plan Strategy, Cycling
Action Plan, Strategic Environmental Assessment.
OVERVIEW OF CAR ACCESS WITHIN LAMBETH
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OVERVIEW OF PUBLIC TRANSPORT WITHIN LAMBETH
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6. CYP - Do they enjoy and achieve in their lives?
Do the children and young people of Lambeth attend and enjoy high-quality
pre-school childcare, school and college?
STATUS
• 83% of Lambeth school children view themselves positively as learners and
try their best at school compared with 81% London-wide (TellUs2 Survey
2007).
• 55% of Lambeth school children enjoy school always or most of the time
compared with 58% for London (TellUs2 Survey 2007).
• Lambeth children would welcome more help with their studies from families
and friends, somewhere quieter at home to do homework, more help from
teachers and less noisy and disruptive classes (TellUs2 Survey 2007).
• Attendance levels at primary schools stand at 94.5% overall in Lambeth, a
0.8% improvement. Primary attendance levels are below the national
average of 94.8% for 2006-07.
• Attendance levels at secondary schools stand at 92.5% overall in Lambeth,
a 0.3% improvement. Secondary attendance levels are 0.3% above the
national average of 92.2% for 2006-07.
• Lambeth has a higher permanent exclusion rate in secondary schools of
0.36% of school population compared with London (0.32%) and England
(0.24%) respectively.
• Population projections from the GLA and analysis of current school rolls
indicate that there will be a shortfall in both primary and secondary school
places across Lambeth by 2015. The GLA’s projection for primary school
places indicate that 17 forms of entry will needed by 2017 to meet the
demand.
• A Primary School Places Expansion Project has been initiated to examine
options for addressing the projected shortfall in primary places. It is working
alongside the creation of a Primary Estate Master Plan which, by October
2008 will have produced a strategy for the expansion of Lambeth’s primary
estate to meet the rising demand for primary school places.
• Lambeth was the first London Council to start construction of secondary
schools under the Building Schools for the Future (BSF) Programme in
January 2007. By 2013, the Lambeth BSF programme will have created an
additional 2,370 secondary school places, including a new 180 place
school.
• 40% of Lambeth primary schools are now offering the full core of extended
services, exceeding the national target by 33%.
• Only 1 primary school currently requires special measures. Prior to this
judgement, no Lambeth schools had been in the category of concern for the
previous five years.
• 75% of schools inspected were judged as Good or Outstanding by
OFSTED.
• Lambeth’s value-added measure improved this year from 100.3 to 100.6.
• 67% of Lambeth primary schools achieved a positive value added score for
Key Stages 1 and 2.
• 11 schools are in the top 5 percent of schools in the country in terms of
value-added.
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• 80% of Looked After Children were offered their first choice secondary
school.
• In 2006 80% of children leaving care went onto further education. 56
• Data on the supply of childcare in Lambeth suggests that the number of
children per place for under 5s in Lambeth is better than the national
average. For instance, there are 2.0 children per place (across private,
voluntary and independent (PVI) group settings, childminders and
maintained provision) in Lambeth, compared to between 4.2 and 4.52
nationally.
• 53% of childcare providers were judged good or better for Nursery
Education in inspections in March 08, increased from 42% in March 07.
• In 2007, 8% of residents said they used the nursery education (under 5’s).
24% of those asked thought the local nursery education was good to
excellent compared with 29% for inner London.
• During 2006-07, 60% of integrated early years settings had a leader
qualified to NVQ level 4 or above.
• 26 Children’s Centres covering all wards in Lambeth are now in place. All
Children’s Centres offer the following core services:
On-site childcare or information and access to childcare in the local
area
Information on parenting, drop-in groups and opportunities to access
parenting support and education
Antenatal and postnatal services, child health services and
information on health issues
Information about employment, education and training
Information at points of transition, including information sessions
around the time of the birth of their child, and on entry to primary
school, which as part of the extended services programme will be
offering sessions for mothers and fathers as their child starts school.
• The percentage of full day care providers participating in the Childcare
Affordability Programme (CAP) increased from 31% to 52% in the first three
quarters of 2007/08.
• The percentage of flexible childcare providers participating in the Childcare
Affordability Programme (CAP) increased from 45% to 47% in first three
quarters of 2007/08.
SIGNIFICANT INEQUALITIES IDENTIFIED
• On average, over half (52%) of year six primary school pupils move on to
secondary schools outside the borough.
• There is an over-representation of BME children and young people amongst
those who are permanently excluded from school.
NATIONAL PRIORITIES
Reference
NI 85
NI 86
NI 87
Indicator
Post-16 participation in physical sciences (A level Physics, Chemistry and
Maths)
Secondary schools judged as having good or outstanding standards of
behaviour
Secondary school persistent absence rate
56 Lambeth Children and Young People’s Plan 2 2007-2010, CYPSP Version 5.5 July 2007.
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NI 88
NI 89
NI 90
NI 91
NI 106
NI 109
NI 114
Percentage of schools providing access to extended services
Reduction of number of schools judged as requiring special measures and
improvement in time taken to come out of the category
Take up of 14-19 learning diplomas
Participation of 17 year olds in education or training
Young people from low income backgrounds progressing to higher
education
Delivery of Sure Start Children’s Centres
Rate of permanent exclusions from school
CURRENT RELEVANT STRATEGIC PRIORITIES
• Increase access to quality local school places and good quality
childcare places (Lambeth Children and Young People’s Plan 2 2007-10)
Do the children and young people of Lambeth achieve national educational
standards?
STATUS
• Those Lambeth school children who complete their GCSEs are doing far
better than previously. Between 1996 and 2006 the gap between Lambeth
students and those in England gaining 5 or more A-C grades reduced from
a 20% point lag to 4% points behind the national average score. 56% of
Lambeth students gained five or more A*-C GCSE passes in 2007
compared with 62% nationally.
• Reading and mathematics at KS1 showed an improvement of 2% and 1%
respectively.
• KS2 results increased 1% to 71% in mathematics while science was up 2%
to 85%.
• Mathematics and science results at KS3 both improved by one percentage
point.
• At both Key Stage 2 (KS2) and at Key Stage 4 (KS4), the achievement gap
between young people who are eligible for free school meals and those who
are not is less than both the London and England gaps for English, Maths
and Science.
• 30% of children met the Foundation Stage Profile criteria to achieve the
points score target compared with 46% nationally. (The target is at least 78
points across the Foundation Stage Profile with at least 6 points in Personal,
Social and Emotional Development, and Communication, Language and
Literacy).
• 53.7% of young people leaving care achieve one or more GCSE A*-G
grades, an increase of 8.7%.
SIGNIFICANT INEQUALITIES IDENTIFIED
• Only 60% of Lambeth students achieved a Level 2 qualification by age 19 in
2006 compared with 71% of London and England students.
• The performance of Caribbean pupils is improving at a slower rate than in
Lambeth overall. The gap between Caribbean pupils and the average
widened at KS1 by 3 percentage points, at KS1 by 2 points and at KS3 by 4
percentage points.
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• For each Key Stage and for GCSE, Portuguese children are the lowest
achieving group with performance being especially low in reading and
writing at KS1, and in English at KS1. However, they have made the
greatest gains since 2001 of 11% at KS2, of 36% at KS 3 and 25% at
GCSE.
NATIONAL PRIORITIES
Reference
NI 72
Indicator
Achievement of at least 78 points across the Early Years Foundation Stage with at
least 6 in each of the scales in Personal Social and Emotional Development and
Communications, Language and Literacy
NI 73 Achievement at level 4 or above in both English and Maths at Key Stage 2
NI 74 Achievement at level 5 or above in both English and Maths at Key Stage 3
NI 75
NI 76
NI 77
NI 78
Achievement of 5 or more A*- C grades at GCSE or equivalent including English and
Maths
Reduction in number of schools where fewer than 65% of pupils achieve level 4 or
above in both English and Maths at KS2
Reduction in number of schools where fewer than 50% of pupils achieve level 5 or
above in both English and Maths at KS3
Reduction in number of schools where fewer than 30% of pupils achieve 5 or more A*-
C grades at GCSE and equivalent including GCSEs in English and Maths
NI 79 Achievement of a Level 2 qualification by the age of 19
NI 80 Achievement of a Level 3 qualification by the age of 19
NI 81 Inequality gap in the achievement of a Level 3 qualification by the age of 19
NI 82 Inequality gap in the achievement of a Level 2 qualification by the age of 19
NI 83 Achievement at level 5 or above in Science at Key Stage 3
NI 84
NI 92
Achievement of 2 or more A*- C grades in Science GCSEs or equivalent
Narrowing the gap between the lowest achieving 20% in the Early Years Foundation
Stage Profile and the rest
NI 93 Progression by 2 levels in English between Key Stage 1 and Key Stage 2
NI 94 Progression by 2 levels in Maths between Key Stage 1 and Key Stage 2
NI 95 Progression by 2 levels in English between Key Stage 2 and Key Stage 3
NI 96 Progression by 2 levels in Maths between Key Stage 2 and Key Stage 3
NI 97 Progression by 2 levels in English between Key Stage 3 and Key Stage 4
NI 98 Progression by 2 levels in Maths between Key Stage 3 and Key Stage 4
NI 99 Looked after children reaching level 4 in English at Key Stage 2
NI 100 Looked after children reaching level 4 in mathematics at Key Stage 2
NI 101 Looked after children achieving 5 A*-C GCSEs (or equivalent) at Key Stage 4
(including English and mathematics)
NI 102
NI 104
NI 105
NI 107
NI 108
Achievement gap between pupils eligible for free school meals and their peers
achieving the expected level at Key Stages 2 and 4
The Special Educational Need (SEN)/ non-SEN gap – achieving Key Stage 2 English
and Maths threshold
The Special Educational Needs (SEN)/non-SEN gap – achieving 5 A*- C GCSE
including English and Maths
Key Stage 2 attainment for Black and minority ethnic groups
Key Stage 4 attainment for Black and minority ethnic groups
CURRENT RELEVANT STRATEGIC PRIORITIES
• Raise attainment levels for all pupils and achieve floor targets to
enable pupils to achieve their full potential (Lambeth Children and Young
People’s Plan 2 2007-10)
• Narrow the achievement gaps for specific groups (Lambeth Children and
Young People’s Plan 2 2007-10)
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Do the people of Lambeth participate in recreational, social and
developmental activities?
STATUS
Leisure
• 34% of adult residents use the sport and leisure facilities in Lambeth,
compared with 43% inner London average. However, only 32% of residents
rated these facilities good to excellent compared with 41% inner London
average and 25% rated them poor against inner London 18% (Residents’
survey 2007).
• 67% of adult residents make use of the parks and open spaces in Lambeth,
compared with 74% inner London average. 64% of residents rated them of
a good/excellent standard.
• 75% of young people in Lambeth have used their local sports or leisure
facilities within the last 12 months. However, only 44% of young people
rated these facilities good to excellent compared with 62% inner London
average and 25% rated them poor against inner London 12%. Main reasons
given for not using local facilities were “better facilities elsewhere” ( 25%) or
simply “none in my local area” (43%) (Residents’ survey 2007).
• 31% of young people in Lambeth have used their local adventure
playgrounds within the last 12 months and 28% have used local youth clubs
and centres.
• The percentage of young people aged 13-19 reached by publicly funded
youth services is 24.6%, increased from 13.5% last year.
• There are now 47 FTE youth workers in Lambeth, an increase of 10. This
means an improved ratio of 1FTE youth worker per 553 young people aged
13-19, down from 1,935.2 last year.
• There is concern among both adults and young people about the availability
and quality of activities available for young people. Only 10% of adults rated
the existing provision of activities for teenagers as good/excellent (against
14% inner London average) and 43% listed additional provision as a key
priority for giving children a better start in life. Among young people
themselves, 31% felt available activities were good/excellent but 35% rated
them as poor (Residents’ survey 2007).
Cultural
• 19% of adult residents enjoy the arts and cultural services activities in
Lambeth and while 28% of residents rate them as good/excellent, 20% of
residents rate them as poor (Residents’ survey 2007).
• The 2006- 07 Satisfaction survey for Cultural Services showed:
38% satisfied with Sports & Leisure activities
57% satisfied with Libraries
32% satisfied with Museums and galleries
31% satisfied with theatres and concert halls
76% satisfied with parks and open spaces.
• 15,294 children and young people participated in the arts across the
borough for a minimum of 3 hours, compared with 13,861 last year. 36% of
young people consider available arts and cultural activities to be good
(against 41% inner London average) (Residents’ survey 2007).
Informal or life-long learning
• In March 2008 14% of the Lambeth population were active library book
borrowers.
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• During 2007-2008 there was a total average of 398 visits recorded to
Lambeth libraries each month and an average of 69,000 items issued each
month.
• During 2007-08 our library home visitors provided for 345 individual
customers and 40 venues including residential homes.
• 54% of adult residents use Lambeth libraries (against 64% inner London
average) and 50% rate them as good/excellent facilities (66% inner London
average) (Residents’ survey 2007).
• Encouragingly, 92% of young people have used their local library in the last
12 months though only 59% rate them as good/excellent (73% inner London
average) (Residents’ survey 2007).
• 6,388 people attended the life-long learning courses in 2006-07. 70% of
these were female and 73% were from BME groups. Of the total, 17% of
people were learners with learning difficulties/disabilities. The highest
numbers of attendees were from Coldharbour and Stockwell wards. Most
learners were aged 25-39yrs (39%) and 40 – 59yrs (32%).
• 8% of adult residents attend evening classes or other adult education in
Lambeth but 28% of adult residents consider the adult education provision
available to be good/excellent (35% inner London average) (Residents’
survey 2007).
• Following their life-long learning course, attendees planned to:
Do further studies (65%)
Find a job (14%)
Help their children with their learning (7%)
Use their new skills through volunteering (14%).
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference
NI 9
NI 10
NI 11
NI 199
Indicator
Use of public libraries
Visits to museums or galleries
Engagement in the arts
Children and young people’s satisfaction with parks and play areas
Social capital
CURRENT RELEVANT STRATEGIC PRIORITIES
• Increase opportunities for all young people to participate in out-ofschool
activities (Lambeth Children and Young People’s Plan 2 2007-10)
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Do they live in strong, cohesive and respectful communities?
STATUS
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• 83% of adult residents definitely agreed or tended to agree that people from
different backgrounds get on well together in Lambeth (Residents’ survey
2007).
• However, 50% of adult residents felt that “people not treating other people
with respect or consideration” was a very or fairly big problem in Lambeth.
• 34% of Lambeth residents perceive a “high” level of ASB within Lambeth.
• The highest proportion of recorded ASB incidents were categorised as
“Disregard for Community/Personal wellbeing” 57
• Main concerns relating to ASB highlighted by adults in the Residents’
survey 2007 were “parents not taking responsibility for their children” (52%
rated this a very/fairly big problem), “teenagers hanging around on the
streets” (50%), and “people using or dealing drugs” (50%).
• Overall, 70% of adult residents of Lambeth are very or fairly satisfied with
Lambeth as a place to live (Residents’ survey 2007).
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference
NI 1
NI 2
NI 5
NI 17
NI 22
NI 23
NI 35
Indicator
% of people who believe people from different backgrounds get on
well together in their local area
% of people who feel that they belong to their neighbourhood
Overall / general satisfaction with local area
Perceptions of anti-social behaviour
Perceptions of parents taking responsibility for the behaviour of their
children in the area
Perceptions that people in the area treat one another with respect
and consideration
Building resilience to violent extremism
CURRENT RELEVANT STRATEGIC PRIORITIES
• Support more active and respectful communities (Safer Lambeth strategic plan
2008)
• Facilitate the development of an independent, borough-wide Multi-Faith
Forum (Lambeth Communities First strategy 2007-10)
• Work with interested parties and groups to prepare a Together as One plan
(Lambeth Communities First strategy 2007-10)
• Contribute to the defining and piloting of neighbourhood working in Lambeth
(Lambeth Communities First strategy 2007-10)
Do they enjoy informed access to a broad range of support services,
personalised to their needs and abilities?
STATUS
• 81% of initial requests for social care support made by residents aged 18 or
over are progressed through to a completed assessment within the 28 day
57 Comprising: Rowdy behaviour (shouting, swearing, fighting, drunken behaviour, hooliganism), Noise,
Nuisance behaviour (including fireworks, urinating in public, arson, throwing missiles, climbing on buildings,
impeding access, games in restricted/inappropriate areas, misuse of air guns, letting down tyres), Hoax calls,
Animal related issues.
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statutory time limit (NI 132 2007/08). This is a new baseline for this
information.
• The care support services for 94% of residents aged 65 and over are in
place within the statutory time limit of 28 days from their completed
assessment (PAF D56 2007/08). This is in line with the inner London
average of 94%.
• 13% of carers received a specific carer’s service (PAF C62 2007/08). This
is above the inner London average of 10.8% for 2006/07.
• 17 care service users have their own individual support budgets through the
In Control pilot scheme allowing them to seek and buy alternatives to
traditional care services.
• 239 people aged 18 or over received direct payments in 2007-08. This
equates to 127.13 people per 100,000 population. The inner London
average for 2006/07 was 115 people per 100,000 population.
• The level of delayed transfers of care per 100,000 population aged 65 and
over is 21.2 (PAF D41 2007/08). There is considerable variation between
councils with values ranging from 4 to 55 in 2006/07.
• 84% items of equipment and minor adaptations were delivered within 7
working days (PAF D54 2007/08) This falls below the inner London average
of 90% for 2006/07.
• 48% of users of the adult social services provision in Lambeth rate the
services good/excellent and 53% of users of children/family social services
rate them good/excellent (Residents’ survey 2007).
• 61% of residents rate local health services good/excellent (up from 47% in
2003 and 58% in 2005) However, positive ratings are lowest among middle
class residents (AB 56%, C1 54%), those who work full or part-time (56%
and 55% respectively), Black Caribbean (55%), residents of Norwood (56%)
and of Streatham (52%).
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference Indicator
NI 140
NI 132
NI 133
NI 54
NI 127
NI 128
NI 130
NI 131
NI 134
NI 103
NI 135
NI 175
Fair treatment by local services
Timeliness of social care assessment (all adults)
Timeliness of social care packages following assessment
Services for disabled children
Self reported experience of social care users
User reported measure of respect and dignity in their treatment
Social Care clients receiving Self Directed Support per 100,000 population
Delayed transfers of care
The number of emergency bed days per head of weighted population
Special Educational Needs – statements issued within 26 weeks
Carers receiving needs assessment or review and a specific carer’s service,
or advice and information
Access to services and facilities by public transport, walking and cycling
CURRENT RELEVANT STRATEGIC PRIORITIES
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• 84% items of equipment and minor adaptations were delivered within 7
working days (PAF D54 2007/08) This falls below the inner London average
of 90% for 2006/07.
Can they live their lives in the way they choose?
STATUS
• 4,370 people aged 18 or over are supported to continue to live in their own
homes within Lambeth (NI 136). This equates to 2,315 adults per 100,000
population (weighted using the Relative Needs Formulae). This is a new
baseline for this information.
• 488 adults aged 18 or over received a provision of intensive home care
services which enabled them to remain at home, or go home following
hospital treatment or a period spent in a residential home. This equates to
20.74 per 1,000 population aged 65 or over. The inner London average for
2006/07 was 25.6.
• There were a total of 1,386 service users aged 18 and over in
permanent/temporary residential and nursing care in 2007/08 and of those
48% were placed outside the borough.
• 26 adults aged 18-64 were admitted on a permanent basis to
residential/nursing care during 2007/08. This equates to 1.8 per 10,000
population and puts Lambeth below the inner London average 2006/07 of
2.0.
• There were 176 older people permanently admitted to residential/nursing
care during 2007/08 and this equates to 74.8 per 10,000 population. This is
above the inner London average 2006/07 of 72.7 per 10,000 population.
• A total of 28 adults with learning disabilities were in an adult placement
during 2007/08 and of those 68% were placed outside of the borough.
• 98% of vulnerable people using Supporting People service users have been
supported to establish and maintain independent living in 2007/08.
• 76% of vulnerable people using Supporting People service users have
moved on in a planned way from temporary living arrangements during
2007/08. These 848 planned moves are an increase on the 674 planned
moves in 2006/07 and also above the target 769 planned moves for
2007/08.
SIGNIFICANT INEQUALITIES IDENTIFIED
• 51% of Offenders and People at risk of offending using Supporting People
services have moved on in a planned way from temporary living
arrangements during 2007/08. This rate is significantly below the planned
target of 75%.
• 59% of Rough Sleepers using Supporting People services have moved on
in a planned way from temporary living arrangements during 2007/08, below
the planned target of 66%.
NATIONAL PRIORITIES
Reference
NI 136
NI 139
NI 124
Indicator
People supported to live independently through social services (all adults)
The extent to which older people receive the support they need to live
independently at home
People with a long-term condition supported to be independent and in
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NI 125
NI 129
NI 141
NI 142
NI 138
control of their condition
Achieving independence for older people through rehabilitation/intermediate
care
End of life care – access to appropriate care enabling people to be able to
choose to die at home
Percentage of vulnerable people achieving independent living
Percentage of vulnerable people who are supported to maintain
independent living
Satisfaction of people over 65 with both home and neighbourhood
CURRENT RELEVANT STRATEGIC PRIORITIES
•
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Can they make a positive contribution?
Do they engage in decision making, confident that they can express their
needs and choices and be heard?
STATUS
• 1,000 people attended 3 People First Expos in 2008, 60% of whom had not
attended a local, formal meeting before.
• 49% of adults responding to the Residents’ survey 2007 felt that the council
listens to their concerns (against 53% across inner London) and 47% felt
they were involved in decision making (in line with 46% inner London). Both
these figures have dropped slightly since 2005 when 53% felt listened to
and 51% felt involved in decision making.
• 70% of adult residents feel that they are kept informed about what the
council is doing; this compares with 64% across London. However, only
35% are satisfied with the opportunities to participate in local decision
making.
• 48% of adult residents agree that they can actually influence decisions
made which affect their local area, higher than across both London 46% and
inner London 43%. However, only 20% of adults had actually taken part in
any consultative survey or meeting in the last 12 months.
• Young people in Lambeth feel less well informed with only 43% of young
people feeling they are kept up-to-date with what the council are doing (in
line with 41% across London).
• 40% of young people feel that the Council does listen to them and 35% feel
involved in the decision-making process, higher than the London average of
29%. 8% of young people aged 11-17 years in Lambeth have written to their
local Councillor, which is 5 points higher than across London.
• Young people in Lambeth (50%) are more likely to have voted in a school
election than young people nationally (43%). (Tell Us2 Survey 2007).
• 30% of young people aged 11-17 years have been a member of their school
council, six percentage points higher than the London average (Residents’
survey 2007).
• 46% of Lambeth schoolchildren in years 8 & 10 feel that their views are
listened to in the running of the school compared with 53% nationally (Tell
Us2 Survey 2007).
• Young people in Lambeth are more likely to have been involved in a school
council or parliament (17% against 14% nationally) with overall 10% fewer
reporting that they had not been engaged in decision making processes at
all compared with the national figures.
• There has been high involvement of Looked After Children in the decisionmaking
process through engagement in Corporate Parenting and
consultation groups. The participation of LAC in reviews has also improved
from 85% to 96%.
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
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Reference
NI 4
Indicator
% of people who feel they can influence decisions in their locality
CURRENT RELEVANT STRATEGIC PRIORITIES
• Increase opportunities for children, young people and their families’ voices
and views to be heard, enabling them to make a positive contribution to their
community (Lambeth Children and Young People’s Plan 2 2007-10)
• Develop a capacity building plan to support Friend of groups to develop their
role and influence over parks and green spaces service design and delivery.
(Lambeth Communities First strategy 2007-10)
Do they contribute to the wellbeing of their community?
STATUS
• There are currently 2,426 active 3 rd Sector organisations recorded on the
council’s GIFTs database operating within Lambeth.
• The council’s GIFTs database records 467 residents who have attended
local, community meetings and have expressed a wish to play an active part
in community life.
• 24% of adult respondents have volunteered in the last 12 months, 58% of
these within the Lambeth area. 81% of these volunteers contributed 5 hours
or fewer of their time each week. This is a new baseline from the Residents’
Survey 2007.
• One in five (21%) young people aged 11-17 years have volunteered (seven
points higher than across London), and one in ten (10%) have been a peer
educator (Residents’ Survey 2007).
• The council has devolved assets to community groups who are using them
to operate new and improved services for wider community benefit. Recent
examples include the transfer of Raleigh Hall to the Black Cultural Archives
and the transfer of Woodlawns to the Streatham Derby and Joan Club.
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference
NI 3
NI 6
NI 110
Indicator
Civic participation in the local area
Participation in regular volunteering
Young people’s participation in positive activities
CURRENT RELEVANT STRATEGIC PRIORITIES
• Develop a pilot Local Leadership Programme targeted at people who need
to work within a community and neighbourhood setting. (Lambeth Communities
First strategy 2007-10)
Are they law-abiding and avoid causing harm to others?
STATUS
• During 2006-07 there were 468 first time entrants to the youth justice
system in Lambeth.
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• In the latest available performance Lambeth has the seventh lowest rate of
re-offending of the 32 London boroughs as measured by the Youth Justice
Board and is within the top 30% of YOTs nationally.
• A reduction of above 20% in young people entering the criminal justice
system has been achieved in 2007/08, with the majority of these from BME
communities. This was against an LAA target to reduce the number of
young people entering the criminal justice system by 3%, with an additional
1% for young people from BME groups.
• Lambeth’s rate of youth re-offending has reduced from 63% recidivism in to
57% in 2005. The average for our Nearest Neighbour group in 2005 was
also 57%; this compared with the England and Wales average of 64%.
• A reduction of over 60% has been achieved in the frequency of re-offending
of young BME people subject to the Intensive Supervision and Surveillance
Programme against an LAA target of 10%.
SIGNIFICANT INEQUALITIES IDENTIFIED
• 75% of young people in the youth justice system come from BME
communities. 58
NATIONAL PRIORITIES
Reference
NI 18
NI 19
NI 30
NI 31
Indicator
Adult re-offending rates for those under probation supervision
Rate of proven re-offending by young offenders
Re-offending rate of prolific and priority offenders
Deleted
NI 111 First time entrants to the Youth Justice System aged 10-17
CURRENT RELEVANT STRATEGIC PRIORITIES
• Prevent young people from drifting into crime, in particular young black and
minority ethnic (BME) boys (Lambeth Children and Young People’s Plan 2 2007-10)
Do they live sustainably and try to minimise their impact on the
environment?
STATUS
• In 2006/07 Lambeth had the 3 rd lowest weight of household waste collection
compared with out nearest neighbours with 351.6 kg/head. The average of
the nearest neighbours group was 428.7 kg/head. 59
• Of the London authorities which send their waste to landfill in 2006/07,
Lambeth sends 84.7%, Hammersmith & Fulham 82.5%, Kensington &
Chelsea 81.9% and Wandsworth 79.2%.
• At the end of 2007/08, Lambeth reached the target of 25% of household
refuse being recycled or composted.
• 75% of our adult residents use the recycling facilities provided (in line with
78% across inner London) with 63% of residents rating these recycling
58 London Borough of Lambeth. Draft Parenting and Family Support Strategy 2008-11. 2008.
59 Hammersmith and Fulham, Haringey, Wandsworth, Hackney, Tower Hamlets, Ealing, Croydon, Brent,
Southwark, Islington, Waltham Forest, Newham, Greenwich, Lewisham, Hounslow.
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facilities good to excellent (64% inner London). 55% of young people in the
borough think the recycling facilities are good to excellent (54% inner
London).
• Local street and environmental cleanliness for 2007/08 was measured at
18.7% for litter & detritus, 6% for graffiti and 0.5% for flyposting. The lower
the figure, the cleaner the environment therefore the 2006/07 figures show a
slight improvement from 25%, 6% and 1% respectively. Compared with our
London nearest neighbour group, Lambeth is below the average of 23.90%
for litter & detritus and above the average of 10.24% for graffiti and 2.27%
for flyposting.
• Lambeth had a total 12,530 incidents of fly-tipping in 2007/08. The summer
months see a higher number of incidents than the winter months.
• 85.5% of all schools in Lambeth have a School Travel Plan in place,
resulting in significant shifts with walking to schools increasing by 9%, car
driving decreasing by 7% and cycling increasing by 7%.
• The 2007/08 mode of transport by school survey results showed that 9.5%
of children travelled by car, 0.5% car shared, 19.7% used public transport
43.6% walked, 0.8% cycled and 2.1% other.
• 58.6% of the resident population of Lambeth travel to work by public
transport (2001); this compares with nearest neighbours Wandsworth
56.2%, Southwark 52.6% and Lewisham 51.4%.
• Lambeth’s Energy Efficiency - Average Standard Assessment Procedure
Rating was 65 compared with the Nearest Neighbours group average of 69
and the top quartile of 70. (Based on a scale from 1 to 120 and on the
annual energy costs for space and water heating).
• There are currently 32 active 3 rd sector organisations recorded on the
council’s GIFTs database which list a specific environmental or
sustainability focus to their activities.
• Lambeth has two parks with a Green Flag Award (Milkwood and Vauxhall
Parks) and two further candidates for the award in 2008 (Ruskin Park and
St Paul’s Churchyard). In order to retain the award the council must ensure
that the public space is managed, maintained and developed to meet the
community’s needs and engages with all its users through appropriate
consultation.
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
Reference
NI 191
NI 192
NI 186
NI 195
NI 196
NI 197
NI 198
NI 185
NI 188
Indicator
Residual household waste per household
Percentage of household waste sent for reuse, recycling and composting
Per capita reduction in CO2 emissions in the LA area
Improved street and environmental cleanliness (levels of litter, detritus,
graffiti and fly-posting)
Improved street and environmental cleanliness – fly tipping
Improved Local Biodiversity – proportion of Local Sites where positive
conservation management has been or is being implemented
Children travelling to school – mode of transport usually used
CO2 reduction from Local Authority operations
Planning to Adapt to Climate Change
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NI 189
NI 190
NI 193
Flood (and coastal erosion) risk management
Achievement in meeting standards for the control system for animal health
Percentage of municipal waste landfilled
CURRENT RELEVANT STRATEGIC PRIORITIES
•
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7. Are they safe?
a. Are they safe from maltreatment, neglect, violence and sexual
exploitation?
STATUS
• Considerable progress has been made in safeguarding vulnerable adults
from abuse in Lambeth through improved awareness, reporting and
investigation. This is reflected in an annual upward trend in reported abuse,
from 126 alerts in 2005/06 to in excess of 300 in 2007/08.
• 93% of Lambeth school children felt very or quite safe from being hurt by
other people at home compared with 95% of children nationally (Tell Us 2
survey 2007).
• 87% of Lambeth school children felt very or quite safe from being hurt by
other people while in school compared with 85% of children nationally (Tell
Us 2 survey 2007).
• At 31 March 2007 there were 62 children aged 4 and under and 113
children aged 5-15 on the child protection register (CPR). 60 By 2007/08
there were 245 in total. The numbers of children on the CPR exceed
London and national averages.
• Re-registrations on the CPR were reduced from 12.5% in 2006/07 to 10.1%
in 2007/8, indicating effective intervention.
• There were 525 looked after children (LAC) in Lambeth in 2007/08. The
number of LAC exceeds London and national averages but has reduced
from 660 in 2005/06.
• The number of actions on registration on safety for new childcare providers
has significantly reduced from 59% in March 07 to 16.9% in March 08 and
on child protection from 17.9% in March 07 to 12% in March 08.
SIGNIFICANT INEQUALITIES IDENTIFIED
• Over 70% of LAC are from BME communities.
• 74.31% of children and young people on the CPR at 31 March 2008 were
from BME communities. 61
NATIONAL PRIORITIES
Reference
NI 70
NI 68
NI 59
NI 60
NI 64
NI 65
NI 66
Indicator
Hospital admissions caused by unintentional and deliberate injuries to
children and young people
Percentage of referrals to children’s social care going on to initial
assessment
Percentage of initial assessments for children’s social care carried out within
7 working days of referral
Percentage of core assessments for children’s social care that were carried
out within 35 working days of their commencement.
Child protection plans lasting 2 yrs or more
Percentage of children becoming the subject of Child Protection Plan for a
second or subsequent time
Percentage of looked after children cases which were reviewed within
required timescales
60 London Borough of Lambeth. Childcare Sufficiency Assessment. 2007
61 CPR3 Statutory Return 07/08
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NI 67
Percentage of child protection cases which were reviewed within required
timescales
CURRENT RELEVANT STRATEGIC PRIORITIES
• Improve support to families who have identified additional needs and where
there is a responsibility to safeguard children and young people (Lambeth
Children and Young People’s Plan 2 2007-10)
b. Are they safe from accidental injury and death?
STATUS
• Accidents and unintentional injuries are the third main cause of premature
mortality in Lambeth.
• In 2005-06, Lambeth had the highest number of adults killed or seriously
injured on our roads compared with our NN group with 162 accidents,
compared with the average of 112.
• Figures for people killed and seriously injured on the roads (adults and
children) are steadily decreasing in line with DfT targets and the Mayor’s
enhanced targets. However, there remain two areas of particular concern,
where casualty figures have remained constant or only decreased by a
small amount: cyclists and motorbike riders. This is in common with other
London boroughs.
• There are now 69% fewer serious child road accidents in Lambeth than 10
years ago. This reduction has exceeded both the national (50%) and
London (60%) targets.
• Lambeth had the 3 rd lowest figure of 7 children killed or seriously injured in
2005-06, amongst our NN group, the average being 11.
• There were 161 recorded arson incidents in 2005-06, 5 th lowest within the
NN group, with the average incidents across the group being 189.
• There were a total of 436 new service users aged 65 and over that received
one or more items of Telecare equipment during 2007/08.
• In 2005-06, 87.5% of all food businesses were contacted. Of these, 100% of
those classed as ‘high risk’ premises were deemed compliant with food
hygiene law. For medium and low risk premises, they were 93.4% and
90.2% compliant respectively. 62
• In 2006, Lambeth had 235 reported incidences of food poisoning compared
with the London average of 201. 63
• In 2007-08 there was a total weight of 1,079 kg of sex/drugs hazardous
waste collected.
• Road traffic continues to be the primary cause of air pollution in London with
over 90% of all air pollution caused by road vehicles. Vehicle pollutants of
greatest concern are Nitrogen Dioxide, Fine Particles (PM10), Carbon
Monoxide and Volatile Organic Compounds such as Benzene and 1, 3-
Butadiene. Ozone is also a pollutant of some concern.
• Lambeth is not currently meeting the Government Air Quality standards for
Nitrogen Dioxide and PM10 and the whole borough has been declared an
Air Quality Management area in common with other central London
boroughs.
62 BVPI returns for 2006-07
63 Food Poisoning Notification Received by the HPA
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SIGNIFICANT INEQUALITIES IDENTIFIED
• Hospital admission for Serious Unintentional Injury for 0-4 year olds was
98.8 per 100,000 in 2003-04. The London figure was 93.4, and in England
and Wales it was 90.24. 64
• In 2006, high and very high levels 65 of PM10 pollution were recorded at
Christchurch Road, Vauxhall Cross and Loughborough Junction. Vauxhall
Cross was the worst within the borough with 86 days recorded very high
levels of PM10.
NATIONAL PRIORITIES
Reference
NI 47
NI 48
NI 49
NI 184
NI 194
Indicator
People killed or seriously injured in road traffic accidents
Children killed or seriously injured in road traffic accidents
Number of primary fires and related fatalities and non-fatal casualties
(excluding precautionary checks)
Food establishments in the area which are broadly compliant with food
hygiene law
Air quality - % reduction in NOx and primary PM10 emissions through local
authority’s estate and operations
CURRENT RELEVANT STRATEGIC PRIORITIES
• Lambeth will seek a genuine reduction in danger for all road users by
identifying and controlling the principle sources of threat. (Lambeth Road Safety
Plan, based around the Mayors casualty reduction targets for 2010, part of the wider
Transport Local Implementation Plan 2005 - 2011).
c. Are they safe from bullying and discrimination?
STATUS
• 69% of Lambeth school children say that they had never been bullied in
school in the past 4 weeks compared with 70% in England as a whole (Tell
Us 2 survey 2007).
• All Lambeth schools have anti-bullying strategies in place.
• 30 primary schools and 4 secondary schools have developed a peer
mediation service to tackle bullying.
• 54% of Lambeth school children felt their schools dealt very well with
bullying compared with 57% of children nationally (Tell Us 2 survey 2007).
• 8% of Lambeth school children say that they had been bullied most days in
school in the past 4 weeks compared with 5% in England as a whole (Tell
Us 2 survey 2007).
SIGNIFICANT INEQUALITIES IDENTIFIED
•
NATIONAL PRIORITIES
64 Lambeth PCT. Health Risks in Lambeth: Annual Report of the Director of Public Health. 2006.
65 ‘High’ = Significant effects may be noticed by sensitive individuals and action to avoid or reduce these
effects may be needed (e.g. reducing exposure by spending less time in polluted areas outdoors). Asthmatics
will find that their 'reliever' inhaler is likely to reverse the effects on the lung. ‘Very high’ = the effects on
sensitive individuals described for 'High' levels of pollution may worsen.
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Reference
NI 69
Indicator
Children who have experienced bullying
CURRENT RELEVANT STRATEGIC PRIORITIES
• Supporting young people (Safer Lambeth strategic plan 2008)
• Support more active and respectful communities (Safer Lambeth strategic plan
2008)
d. Are they safe from crime and anti-social behaviour?
STATUS
Perceptions
• Crime overwhelmingly remains the number one priority of Lambeth
residents with almost two thirds (61%) of adult respondents highlighting it as
their main concern in the Residents’ survey 2007. This compares with 62%
Inner London average and 54% across London as a whole.
• 43% of adult residents thought that policing in the Lambeth area was good
or excellent; this compares with 47% across inner London (Residents’
survey 2007).
• In common with the rest of London, the top 4 concerns of young people in
Lambeth are crime, bad behaviour, bullying and drug users or drug pushers
(Lambeth Residents’ Survey 2007). 59% of young people put crime as one
of their top 3 issues of personal concern. 32% of young people included bad
behaviour in their top 3.
• 80% of adult residents felt “Very/Fairly safe” in the area where they live
during the day but that dropped to 45% after dark. (Lambeth Residents’
Survey 2007) This compares with Inner London (average of 78% by day;
46% after dark) and London (average of 79% by day, 46% after dark).
• 75% of young people felt “Very/Fairly safe” in the area where they live
during the day but that dropped to 31% after dark. This compares with Inner
London (average of 68% by day; 35% after dark) and London (average of
70% by day, 36% after dark) (Lambeth Residents’ Survey 2007).
• 71% of Lambeth school children feel very safe or quite safe from being hurt
by other people around their local area compared with 74% of children
nationally (Tell Us 2 survey 2007).
• 50% of adult respondents to the Residents’ survey 2007 felt that “teenagers
hanging around on the streets” was a very or fairly big problem.
• 50% of adult respondents to the Residents’ survey 2007 felt that people
using or dealing drugs was a very or fairly big problem compared with 41%
across Inner London.
• “Groups of Youths”, “People around the area” and “the reputation of the
area” are the main reasons influencing how safe people in the community
feel (Fear of Crime and Victimisation survey 2007).
Crime
• Lambeth is a high crime area with continuing levels of serious crime and
offending above the national average. Lambeth ranks 12 th out of the top 40
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high crime partnership areas in England 66 and within the top 3 high crime
boroughs in London.
• Since April 2005, success in reducing crime has been measured using a
basket of British Crime Survey (BCS) comparator crimes PSA1 67 . Lambeth
is within the 3 top high crime boroughs in London on its level of PSA1 crime
but has achieved a 30% reduction in the 3 years to 2007/08. This abovetarget
reduction was the 3rd highest percentage decrease in the
Metropolitan Police Service (MPS) area over that period.
• In comparison with the neighbouring boroughs of Wandsworth and
Southwark in 2006/07, Lambeth has the highest cost of estimated crime of
all 3 boroughs at £310.5m. However, of the 3 boroughs Lambeth has
enjoyed the greatest reductions in cost over the 3 year period to 2006/07
(£42m reduction).
• Although murder accounts for a very small percentage of Total Notifiable
Offences (TNOs), Lambeth is currently ranked highest on a count basis of
the 31 London boroughs. Lambeth had 23 murders in 2007/08, up from 15
in 2006/07.
• Lambeth has the highest levels in its CRDP family 68 of robbery (both
personal and business) but has seen an encouraging 15% reduction in
personal robbery since 2003/04.
• Lambeth has the highest level of recorded rape offences in its CRDP family
but has seen a very significant 23.5% reduction in recorded offences in
2006/07 when compared with 2002/03.
• A 19% decrease was achieved in Grievous Bodily Harm (GBH) offences in
2007/08 compared with the previous year. Lambeth is currently ranked 4 th
highest of the London boroughs on a count basis for GBH.
• Lambeth saw a decrease of 6.8% in Gun-enabled crime in 2007/08 when
compared with the previous year. The borough is ranked second highest of
the CRDP family on a count basis.
• Drug and alcohol misuse are seen as the key ‘drivers’ that lie behind much
crime and fear of crime in the borough. More residents in Lambeth see
drugs as a significant problem than the London average and drugs appear
to be easily available, particularly in open, street based markets such as
Brixton. More than 70% of arrests in Brixton are for possession or supply of
cannabis. The links between drugs and violent and acquisitive crime is well
established and 48% of arrests in Lambeth in 2006/7 were for drug related
offences.
• A quarter of Lambeth’s population is estimated to drink excessively and it is
thought that the borough has higher levels of alcohol related hospital
admissions than the average for London or England 69 . Links between
alcohol and domestic violence are well known, though links with other
violent crime types in Lambeth is less clear. It is likely that alcohol can
exacerbate incidents of violent crime such as stranger violence, mugging
rape and MPS believe that robbery victims in entertainment and transport
66 The areas with the highest rates of recorded crime per head of population plus the highest crime levels
(each being given equal weight) as measured using the BCS comparator in 2003/04.
67 PSA1 consists of Robbery of Personal Property, Burglary dwelling, Theft of motor vehicle, Theft from motor
vehicle, Motor vehicle interference & tampering, Theft person – snatch, Theft person – pick pocket, BCS
wounding, BCS criminal damage, BCS common assault, Theft of pedal cycle.
68 CRDP family comprise Brent, Camden, Greenwich, Hackney, Hammersmith and Fulham, Haringey,
Hounslow, Islington, Lewisham, Southwark, Tower Hamlets, Waltham Forest, Wandsworth.
69 Lambeth Alcohol Needs Assessment 2006/07
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hubs at night are more likely to be drunk. TfL and BTP also link alcohol to
violent crime on transport networks, generally at night.
• Youth offending is higher in Lambeth than the London or national average.
The borough has a higher rate of first time entrants to the youth justice
system and young people tend to be involved in more serious types of
offending – 12% of convictions result in custodial sentences in Lambeth
compared to only 8% in London and 6% nationally. There is significant overrepresentation
in the youth justice system of BME males, 76% of the youth
offending population in 2006/07.
• The involvement of young people in serious violent offending is increasing
across London and this is mirrored in Lambeth. For example, the average
ages of both suspects and victims in Operation Trident 70 investigated
shootings has dropped significantly in the past four years – from 24yrs three
years ago to 19yrs now. Five young people age 18 or under were murdered
in Lambeth in 2007/8.
• The 2007 MPS survey found 27 youth gangs in Lambeth out of 171 in
London.
• As with other crime types, reported Hate crimes have been falling in recent
years. Lambeth has seen a decrease of 13% in Racial incidents in 2007/08
compared with the previous year. There has also been a decrease of 21%
in Homophobic incidents in 2007/8 compared with the previous year.
• The National Domestic Violence helpline received 322 calls from Lambeth
women between Jan and June 2005. This was the highest rate of any
London borough and 100 more calls than the second highest borough.
• The Gaia Domestic Violence refuge centre supported 626 Lambeth women
between May 2006 and March 2008. 47.3% of these clients were selfreferrals.
• 37.1% of clients using the Gaia centre between May 2006 and March 2008
were aged 18-29. A further 42.8% were aged 30-44.
• Where the information was available for Gaia centre clients between May
2006 and March 2008, 15.3% of clients had a substance misuse need, 35%
had a mental health need, 19.7% had a disability and 44% had a suicidal
tendency.
• 40.1% of the perpetrators of domestic violence on women using the Gaia
centre between May 2006 and March 2008 were current spouses or
partners. 46.2% of perpetrators were ex-spouses or ex-partners.
• During 2006/07, 24.7% of domestic violence crimes were repeat offences.
• 30% of people surveyed reported that they had been a victim of crime within
Lambeth in the last 12 months and 20% had been victimised more than
once. Of those who had been victims of crime, only 57% had reported it to
the police (Fear of Crime and Victimisation survey 2007).
Anti-social behaviour
• The reported incidence of Anti Social Behaviour (ASB) in Lambeth is
recorded by the MPS according to the National Standard for Incident
Recording (NSIR) categories as follows:
Substance Misuse
Malicious / Nuisance
Communications
Abandoned Vehicle Vehicle Nuisance /
Inappropriate
Vehicle use
70 This is an ongoing MPS-wide operation preventing and investigating shootings in London.
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Rowdy /
Inconsiderate
Behaviour
Rowdy / Nuisance
Neighbours
Hate Incident
Street Drinking Noise Nuisance Prostitution Related
Activity
Possess / Sale / Use
of Fireworks
Animal Problems
Hoax call to
Emergency Services
Trespass
Begging / Vagrancy
Environmental
damage / littering
• The MPS are not the only recording agency in Lambeth, but currently
provide the most comprehensive data set for analysis. However, there
is a recognized deficit in environmental content due to under reporting
of these incidents to the Police.
• A combined baseline total of 26,664 ASB incidents were recorded in
2006/07 across Lambeth. This is a combined total of data on ASB
type incidents held by the Police, Park Rangers, Local Authority Noise
statistics, British Transport Police and Housing (Housemark) data.
• Most reported incidents of ASB were reported in Coldharbour (1st)
and Bishops (2nd) wards. These two wards stand out, especially
when compared with Tulse Hill (3rd) which had only approximately
half the count of Coldharbour.
• Rowdy / Inconsiderate behaviour is the highest reported type of
incident in all 21 wards.
• There are more reported incidents in the northern half of the borough
in comparison with the south.
• Although no long-term trend data is yet available, when considered in
overview there appears to be peak of ASB offences in the summer
months (July-August) with a further spike in October (coinciding with
Bonfire night) followed by a drop from November through the winter.
• 24% of adults avoid using the bus due to anti-social or violent young
people. 27% avoid using it because of behaviours classified as
disorder.
• In 2007-08, there were 992 complaints made about noise during the
day time and a further 4,221 complaints received regarding noise at
night time.
SIGNIFICANT INEQUALITIES IDENTIFIED
Perceptions
• 51% of young people aged 11 to 17 felt that not enough was being to
protect young people in the borough. This is up from 47% in 2005 and
higher than both the London (42%) and inner London (50%) averages.
(Lambeth residents’ survey 2007).
Crime
• Young people (aged 10-17 inclusive) accounted for only 15% of all
persons accused of Notifiable Offences (in comparison with adults) in
2006/07.
• MPS research of robbery of personal property showed that 56% of
suspects were aged 16-20 years with those aged 11-15 years
accounting for 22%.The victims of robbery are also most likely to be
aged 15-19.
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• The peak age of both victims and perpetrators involved in Tridentrelated
gang and group violent offending in London fell from 24 years
in 2004 to 19 years in 2006.
• Of those surveyed who reported being victims of crime to the Police in
the last 12 months, 44% were aged 16-19 years old and 42% were
Asian (Fear of Crime and Victimisation survey 2007).
• Women victims of crime in the last 12 months were found to be
slightly more likely to report the crime to the Police. Black and mixed
groups were least likely to report being a victim of crime as well as
those who had disabilities (Fear of Crime and Victimisation survey
2007).
• Victims of property crime and disorder were most likely to report crime
where as only 59% reported violent crime and 33% reported hate
crime (Fear of Crime and Victimisation survey 2007).
Anti-social behaviour
• 14 out of 21 wards record substance misuse as the second most
prolific issue (after rowdy behaviour). The 14 wards are
(alphabetically) Brixton Hill, Clapham Common, Coldharbour,
Ferndale, Gipsy Hill, Herne Hill, Knights Hill, Larkhall, Oval, Princes,
Stockwell, Thornton, Tulse Hill and Vassall.
• 6 out of 21 wards record street drinking as the second most prolific
issue (after rowdy behaviour). The 6 wards are (alphabetically)
Bishops, Clapham Town, St Leonards, Streatham Hill, Streatham
Wells and Thurlow Park.
• 93% of all fireworks incidents are reported during October and
November, in the run up to and around bonfire night. Tulse Hill ward
had the highest count of firework reports, followed by Coldharbour.
• Over 50% of all “Prostitution Related Activity” (NSIR definition) occurs
in Tulse Hill ward.
• There is a significant increase in the level of Low Level Disorder
offences committed by/perpetrated on young people coinciding with
the end of the school day.
NATIONAL PRIORITIES
Reference
NI 15
NI 16
NI 20
NI 28
NI 29
NI 26
NI 33
NI 32
NI 34
NI 36
NI 37
NI 38
Indicator
Serious violent crime rate
Serious acquisitive crime rate
Assault with injury crime rate
Serious knife crime rate
Gun crime rate
Specialist support to victims of a serious sexual offence
Arson incidents
Repeat incidents of domestic violence
Domestic violence - murder
Protection against terrorist attack
Awareness of civil protection arrangements in the local area
Drug-related (Class A) offending rate
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NI 27
NI 21
NI 24
NI 25
NI 41
NI 42
Understanding of local concerns about anti-social behaviour and crime by
the local council and police
Dealing with local concerns about anti-social behaviour and crime by the
local council and police
Satisfaction with the way the police and local council dealt with anti-social
behaviour
Satisfaction of different groups with the way the police and local council
dealt with anti-social behaviour
Perceptions of drunk or rowdy behaviour as a problem
Perceptions of drug use or drug dealing as a problem
CURRENT RELEVANT STRATEGIC PRIORITIES
• Reduce serious and violent crime (Safer Lambeth strategic plan 2008)
• Support more active and respectful communities (Safer Lambeth strategic plan
2008)
• Supporting young people (Safer Lambeth strategic plan 2008)
e. Do they have stability and are they cared for?
STATUS
• 7,643 adults in Lambeth of all age groups over 18 received social care
support services from the council during 2007/08. Of these, 6,217 are
supported to live at home and 1,426 are supported in residential or nursing
care homes.
• The numbers of adult clients of all age groups receiving services during
2007/08 were as follows:
Aged 18-64 Aged 65+
Physical disabilities 1,390 4,341
Mental Health 727 232
Learning Disabilities 660 45
Substance Misuse 116 15
Vulnerable People 30 87
TOTAL 2,923 4,720
• 5,095 vulnerable people receive services from Lambeth Supporting People
as follows:
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Number of
service users
% of service
users
Older People with support needs 2,200 43.18%
People with mental health problems 428 8.4%
Single Homeless with support needs 423 8.3%
Young People at risk 280 5.5%
Rough Sleepers 241 4.73%
People with alcohol problems 192 3.77%
Offenders/People at risk of offending 146 2.87%
Adults with learning disabilities 121 2.37%
Women at risk of domestic violence 116 2.28%
Teenage parents 78 1.53%
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Frail elderly 58 1.14%
People with HIV/AIDS 52 1.02%
Refugees 31 0.61%
Mentally disordered offenders 21 0.41%
People with drug problems 12 0.24%
Total 5,095 100%
• 75% of vulnerable people receiving Supporting People services are
Lambeth residents, above the London average of 70%. In 2007/08, 6% of
referrals originated from LB Southwark and 4% from LB Westminster. The
highest proportion of referrals from outside Lambeth under the London
cross-authority protocols are for Rough sleepers and Women at risk of
Domestic Violence.
• Lambeth provided 64 domestic violence refuge beds in 2007/08; this
equates to 2.6 per 10,000 population, more than twice the London target of
1.20 per 10,000 population.
• The following groups of vulnerable children and young people access
council services:
Looked After Children
Children at risk of harm
Young carers
Children with special educational needs or disabilities
Children who are very mobile, e.g. traveller and refugee children
Children from different faith groups
Some BME children and young people
Young people at risk of offending and misusing substances
Teenage parents
Children from low income families.
• The long-term stability of LAC has improved with the number of LAC with 3
or more placement moves reduced from 15.4% to 12.6% in 2007/08.
• 83% of looked after children and young people in Lambeth are placed in
foster care or family placements. The percentage of 10-15 year olds in
residential accommodation has reduced from 16.5% to 6.6%.
• The adoption rates of LAC have improved from 4.1% in 2006/07 to 6.1% in
2007/08.
• There are currently 5 young people over the age of 18 whose SEN require
ongoing accommodation and support. A further 26 young care leavers over
the age of 21 who are in higher education also receive continued support.
• 160 Personal Education Plans (PEP) were completed between April 2006
and March 2007 for a school age cohort of 385 LAC, which equates to 42%.
• The number of existing childcare providers judged good or outstanding in
Ofsted inspections on Staying Safe rose from 38.7% in March 2007 to 44%
in March 08.
• Each year approximately 550 young people appear in court for a range of
offences and 14% are sentenced to custody, mostly for less than one
year. 71
71 London Borough of Lambeth. Draft State of the Borough Report: The evidence base supporting the
Sustainable Community Strategy. 2008
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SIGNIFICANT INEQUALITIES IDENTIFIED
• Lambeth falls within the ‘bottom 10’ priority hotspot areas with lowest
performance for Adults with Learning Disabilities in Settled Accommodation.
Lambeth has 57%, Wandsworth 61%, Lewisham 63%, compared with the
England overall figure of 73% in 2005/06. 72
NATIONAL PRIORITIES
Reference Indicator
NI 145
NI 149
NI 61
NI 62
NI 63
NI 71
NI 147
NI 43
NI 44
NI 143
Adults with learning disabilities in settled accommodation
Adults in contact with secondary mental health services in settled
accommodation
Timeliness of placements of looked after children for adoption following an
agency decision that the child should be placed for adoption
Stability of placements of looked after children: number of placements
Stability of placements of looked after children: length of placement
Children who have run away from home/care overnight
Care leavers in suitable accommodation
Young people within the Youth Justice System receiving a conviction in court
who are sentenced to custody
Ethnic composition of offenders on Youth Justice System disposals
Offenders under probation supervision living in settled and suitable
accommodation at the end of their order or licence
CURRENT RELEVANT STRATEGIC PRIORITIES
• Improve transition arrangements for vulnerable young people, in particular
Looked After children and Children with Disabilities (Lambeth Children and Young
People’s Plan 2 2007-10)
72 www.cabinetoffice.gov.uk/social_exclusion_task_force/psa
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8. Consultation with stakeholders
Citizen’s forum – Commissioning Strategy Plan – Lambeth PCT
The PCT organized a citizen’s forum to discuss it’s objectives and get an
agreement on the priorities identified and objectives or goals set, through the fiveyear
Commissioning Strategy Plan 2007-2012. The main aim of this workshop was
to ensure that views of Lambeth residents influence the PCT’s strategic plans
including defining priorities and visions for services as well as ensuring particular
services meet users’ needs. PCT groups who are helping develop the
Commissioning Strategy Plan, were asked to take carefully consider intelligence on
public and user views, and to ensure that this is taken into account when defining
PCT commissioning priorities, intentions and delivery plans.
The PCT has a great wealth of information on public, patient and user views on
healthcare delivery. Much of this information came from direct involvement on a
particular subject or service and was either very local or service-specific in nature.
This available information was used in addition to the responses received through
this citizen’s forum.
This citizen’s forum focused on overall commissioning models and priorities across
a range of services and client groups. The questions included in this survey gave
intelligence that is Lambeth-specific and very local in nature and therefore highly
applicable to our services.
Methodology
Lambeth PCT commissioned OPM to organise a Citizen’s Forum for Lambeth
residents. This was to give a sample of the local population an opportunity to
engage in some detail on the content of the CSP.
One hundred and sixteen residents were recruited on-street for the event,
according to a sample specification designed to reflect the local demographics of
the borough. To ensure the desired mix on the day, potential participants were
asked to complete a recruitment questionnaire, with questions relating to their
occupation, household composition, age, ethnicity and quality of health.
A further 30 participants were recruited from various hard-to-reach groups. This
ensured that groups such as older people, specific patient groups, minority ethnic
groups and young parents were represented. These participants were recruited
through Lambeth-based community and voluntary sector bodies and organisations,
which identified and invited suitable service-users on our behalf. It should also be
noted that both recruitment phases were limited to English speakers.
105 people attended the event. 79 of these were drawn from the on-street
recruitment and the remaining 26 were service users or representatives from the
selected hard-to-reach groups. An incentive of £65 was offered to all participants.
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A great deal of useful feedback on the draft CSP was received as part of the preconsultation
process. This was considered very relevant to the full consultation and
therefore those responses have been incorporated into this report’s findings.
Identifying Stakeholders
A CSP Communications & Engagement Strategy was developed and relevant
stakeholders were identified by the following groups:
Health and social care partners
Representatives
Influencers
Patients & carers
Community
Internal, including independent practitioners and PBC consortia
‘Hard to Reach’ groups (identified by information Public Health)
A variety of different methods were used to engage with these groups.
Engagement
The methods used to involve stakeholders and the public in the consultation
process included:
- Sending consultation documents out and inviting comments
- Meetings
- Media press release
- Use of PCT website
- Internal communication
Hard to reach groups: In addition, the PCT made specific efforts to engage with
‘hard to reach’ groups using public health expertise to identify which groups were
priority targets for the consultation process i.e. those that had not been adequately
engaged by other aspects of the consultation process and who would be affected
by the CSP proposals. Hard to reach groups included refugees, homeless,
disabled (both children and adults), housebound Older Adults.
Consultation feedback
Throughout the consultation, target audiences were given four routes for submitting
feedback:
Email
Website online questionnaire
Post
Direct feedback to PCT staff at consultation meetings, including formal
meetings, forums or focus groups
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In addition, the Citizen’s Forum and ‘hard to reach’ focus groups hosted by OPM
also provided valuable feedback on the contents of the CSP.
Main findings
1. A strong and very widespread level support for the contents of the CSP. Its
strategic goals, themes and the priority areas were backed and welcomed by
the vast majority of respondents; many said these were congruent with their
own priorities or areas of work.
2. A great deal of support for including Staying Healthy and Mental Health as
priorities.
3. There was concern about the ‘phasing out’ of priorities over time – particularly
Children and Young People.
4. There is a perception that the PCT could do more to communicate better with
both the public and stakeholders on an ongoing basis.
5. Many respondents queried whether patient and public involvement to ensure
services are responsive had been given enough emphasis in the document.
6. It was felt that dentistry had not received the attention and emphasis it required
in the CSP.
7. Children with disabilities were highlighted by respondents as a particular area of
concern that was not adequately addressed by the CSP.
8. Respondents consistently emphasised the importance of working closely with
the council to achieve these improvements, coupled with a perception that
current joint working is poor.
9. In addition, there was a great deal of re-emphasis on the importance of working
with and placing services within schools in order to achieve the objectives
described for the Staying Healthy and Children and Young People’s strategies.
It is therefore suggested these issues need to be expanded in the next iteration
of the CSP.
10. The lack of close working with the voluntary sector was also highlighted as a
concern by some – and one that should be addressed further in the CSP.
11. The difficulty of accessing both primary and secondary care services (both GP
and hospitals) was an issue that recurred in feedback.
Actions
After reviewing the findings, several actions were suggested as a consequence of
consultation. Detailed feedback received was collated and categorised and then
shared with relevant leads in the various directorates. This will allow them to
incorporate specific ideas and feedback into their own plans and implementation
processes.
Conclusions
Overall, the Consultation on the Commissioning Strategy Plan (alongside
Healthcare for London) is one the largest consultation exercises the PCT has ever
engaged in. This has generally proven to be extremely successful and has yielded
very useful feedback and supported engagement with local stakeholders and
residents. However, it should also be acknowledged that this has required strong
senior leadership and some financial investment to be successful.
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The main finding of the consultation is that there is strong and widespread support
for the main contents of the Commissioning Strategy Plan. Hence, it reaffirms that
the internal PCT planning processes have been robust and responsive to what is
known about public and user priorities. This should give the organisation
confidence developing and implementing the proposals of the CSP over the next
few years.
The challenge going forward for the PCT is to ensure that the detailed feedback
received meaningfully impacts and informs how commissioning intentions are
framed and implemented. Moreover, the lessons learned from this consultation
exercise should be used to inform future public involvement work. Specifically, the
PCT needs to develop a stronger framework for engaging in an ongoing dialogue
with the local public, other stakeholders and hard to reach groups on issues
relating to the PCT and its strategic plans.
In addition, the health and social care Voluntary and Community sector forum will
be focussing on the work related to consultation with the voluntary sector
representatives to identify any gaps that need to be addressed to achieve better
health and well-being outcomes especially for vulnerable groups. This forum is
made up of over 200 voluntary organisations, both funded and unfunded groups,
small local organisations working with Lambeth’s residents. It is co-chaired by two
representatives from the voluntary sector and two from the statutory sector.
Customer focus programme – Literature review.
Summary of a recently conducted review by the Research and Policy division of
LBL, drawn from a variety of sources detailing service satisfaction is enclosed
below.
This literature review has drawn on a variety of sources detailing service
satisfaction and citizens’ perceptions of their customer experience in Lambeth.
These have included the 2007 residents’ survey, BVPI surveys and qualitative
research carried out with residents. A full list of sources is listed in the bibliography.
This review only contains data that was made available and is by no means
exhaustive.
Based on the customer service data available, well-performing services include
parks and open spaces, nursery education, recycling and public transport. Services
where the customer experience needs improving are council housing, parking,
leisure and sports facilities and planning.
Communications at Lambeth are improving and 70% of residents believe Lambeth
are good at keeping them informed which is better than London. People’s preferred
channels of communication are Lambeth Life, information provided by the council
and the website. Service users prefer to get information relevant to their specific
service use through direct letters and would like to be better informed about what
services they are entitled to and how to access them.
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People are keen to hear how services are performing and whether they are
keeping their promises. They would like to see balanced, realistic reporting (not just
good news) that shows how money is being spent to tackle important local issues.
Most people contact the council by telephone (70%) followed by face to face
contact at 13%. Face to face contact increases to 34% for housing tenants. Whilst
happy to use it as a source of information, people have less faith in using the
internet for interactive contact.
It is getting easier to get through to Lambeth on the phone, phones are answered
promptly and staff are perceived to be polite and helpful. However, customers
across service areas are less satisfied with the resolution of their problems. It can
be difficult to speak to the correct person and there is perceived to be a lack of
joined-up working between front and back office staff. Prompt resolution of
problems is an important area of customer service to be addressed.
Half (48%) of Lambeth residents currently feel that they can influence local
decisions which is higher than the London average (43%). There is an appetite
among Lambeth residents to be involved in local decision making with 40% keen to
be involved regardless and 52% dependant on the issue. One in five (20%)
residents have taken part in consultation, an increase from 16% in 2005, but there
is a need for consultation to be meaningful and for honest feedback that shows
how people’s views have been taken into account.
Recommendations for further research
- At Lambeth Council, we currently have a weak understanding about how
Lambeth residents view the services offered by partnership organisations:
What do people think of their customer experience of Job Centre Plus,
Metropolitan and community police services, health services, the voluntary
and community sector and fire services within the borough? How well do
council services link up with partnership services? How can these services
complement each other and work better together?
- Research has shown that there are two groups of people accessing services
within Lambeth. One group uses a lot of services and require detailed
contact specific to their needs. They like to contact us by phone or in
person. The other group use very few services and may potentially want
less contact. Research could be carried out to determine whether this is the
case and how customer service can best be structured to meet the needs of
heavy and light users of local services.
- There is currently little information available on the views of business users.
It would be interesting to understand their views on the services they use
and how they could be improved.
- Although people see the internet as an important source of information,
there appears to be barriers to using technology interactively for contacting
services, making payments and resolving problems. Further work could
investigate the barriers to interactive contact via the internet.
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The entire review is enclosed as an appendix.
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9. Review of needs assessments
Health Needs assessments are a primary source of identifying gaps in services for
health and service improvement. Lambeth PCT conducts needs assessment
routinely to influence commissioning decisions. A proforma was created and used
for reviewing health needs that are completed in health and social care as part of
the Joint Strategic Needs Assessments. The following health needs assessments
were reviewed: Alcohol, Physical Activity, children and young people, older people,
teenage pregnancy, sexual health.
Summary of findings and recommendations where provided by the needs
assessments are as follows:
Alcohol
Summary of needs
Met Epidemiology
Unmet
• Male predominance in deaths due to alcohol fallen from 87% to 56% (2001-5)
Service access
• ARP (Alcohol Recovery Project) and acute services believed to be high quality
when accessible
Epidemiology
• Rising mortality in females from alcohol; projected to exceed males
• Underestimation of extent of problem in A+E and ambulance, as ICD-10 coding
not used
Service access
• Low self-referral to services (3% in Lambeth vs. 36% nationally) and poor links
between acute and rehabilitation services
• 67% in-patient referral below target of 80%
• 61 and under have less knowledge than nationally (0.5% vs. 78% nationally)
• Alcohol services at maximum capacity, poor accessibility, not culturally specific,
not holistic
• Poor use of community strategies and integrated care pathway
Summary of recommendations
Medical care
• Screening and brief interventions in community/primary settings, complex care should be
referred to specialist centres. Development and use of integrated care pathways
• Ensure quality of care through use of standards such as DANOS/NOS
Service provision and configuration
• Need to increase capacity, community based specialist outreach services, shared care with
primary care.
• Ensure accessibility and targeting of specific groups (BAME, young people, women etc)
Health promotion
• Need for media and marketing strategy in both health and non-health centres
Information, monitoring and performance management
• Need to improve A+E and ambulance coding. Data needs to be collected on alcohol
attributable appointments in primary care setting
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Licensing and community approaches
• Extension of existing licensing process and health promotion strategies
Summary of implementation plan
• Use Models of care for alcohol misusers (MoCAM) guidance as framework for commissioning
• Increase capacity through community based specialist outreach services, increase
accessibility through more walk-in centres and out of hours services
• Develop programmes and services to target specific groups
• Develop media and marketing strategy (e.g. leaflets, posters) and target health and nonhealth
settings, including alcohol service directory
• Data collection and analysis of A+E and ambulance use, primary care appointments and
alcohol services use attributable to alcohol. Analysis along integrated care pathway
• Extend “Safer Socialising” scheme with incorporation of general health promotion e.g. Night
Club Health interventions
• Use the Licensing process to ensure use by local businesses.
Children and young people
Summary of needs
Met Antenatal-infancy
• Higher breastfeeding rate than nationally
• Maternal smoking rate equivalent to nationally
Age 1-5
• Lower tooth decay than nationally
• Increase in number of nursery places between 1997 and 2004
Age 5-15
• Lower level obesity than nationally
Unmet • High number of children living in poverty
Antenatal-infancy
• Lower immunisation coverage than nationally, lower than 95% target
• Significantly low birth rates in Tulse Hill, Coldharbour and Vassall wards
Age 5-15
• Significantly raised under-15 mortality rate
Age 16-19
• Higher teenage pregnancy rate than nationally
Children with disabilities
• Disability register not up to date
Children and adolescent’s mental health
• Children whose 1 st language is not English may not be known to housing/family
support/health services and often have higher mental health needs
• Children in care homes and looked after children have poorer outcomes
• Higher prevalence mental health problems in boys and white children
• Unmet need for treatment of conduct disorders, psychotic disorders, eating
disorders (? Incomplete data)
Summary of recommendations
Antenatal-infancy
• Antenatal Care: Ensure mobility within borough and between boroughs, chase
addresses, universal electronic record keeping, improve communication between
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professionals
• Domestic Violence: increase capacity, implement guidelines (DH) and develop
maternity liaison committee
• Improve interpretation services
• Improve parent support (e.g. from specialist Health Visitor), improve specialist training and
increase capacity in health visiting, especially infant mental health
• Make care pathway more flexible for vulnerable groups
Age 1-5
• Upgrade IT systems and improve information exchange and communication
• CAMHS to involve parents more and carry out earlier interventions
• Joint commissioning, pooled budgets
• Immunisation – improve funding for Coordinators, educate parents and professionals
• Accidents – develop multiagency forum
• Nutrition – develop group to take forward general nutrition issues and target specific groups
Age 5-15
• Develop school and non-school settings and reach children/families that don’t attend
• Effective joint commissioning (PCT and LBL in particular)
• Nutrition –encompass physical activity, restrict fast-food and similar outlets near schools
• Safeguard needs of children from emerging communities
Age 16-19
• Risky Behaviour: involve young people in development and monitoring of services, integrate
adolescent services
• Adolescent services: focus on cultural change and challenging values, co-ordinate transition
and family support
• Effective joint commissioning (PCT and LBL in particular)
• Healthy lifestyles: Behaviour and education, more voluntary sector investment and input
Children with disabilities
• Make use of Sure Start and Children Centres for early intervention
• Effective joint commissioning (e.g. Looked after children & Children with disabilities),
• Make use of key worker for transition
• Make use of health visitor support for families with complex needs
• Share and validate data
Children and adolescent’s mental health
• Improve staff cultural sensitivity and awareness
• Implement wide multi-agency working to target “risky behaviours” in CYP
• Promote emotional well-being, using positive language. Improve the confidence of the local
population in accessing services
• Agree inter-agency protocols and pathways, clarify communication (tier 1 to 4) and agree a
shared vision
• Expand tier 1 (universal) training e.g. health visitors and pre-school day-care
• Improve understanding of what is available to CYP and parents with mental health/behaviour
issues and how to access such resources
• Integrate prevention services into comprehensive CAMHS
• Intervene early and provide family support
• Ensure smooth transition to adult mental health services
Summary of implementation plan
Antenatal-infancy
• Antenatal care: CYPSP, Commissioning Group and TPPPB to ensure improved record
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keeping, use of electronic record and improved access to primary care
• Domestic violence (DV): CYPSP to implement DH guidelines, develop maternity liason
committee (MLC) and increase DV capacity
• Access: PCT shared services aim to reduce waiting times and increase access
• Mental health: CAMHS and NHS commissioning and NHS Provider Group to increase
capacity in health visiting and improve training, improve parent support and raise awareness
of parental mental health issues
• Care pathway: CYPSP, NHS Provider and Commissioning to map care pathway and
increase its flexibility
Age 1-5
• IT: NHS Commissioning to upgrade to RIO system
• Partnership: CYPSP to develop joint commissioning and pooled budget
• Health: NHS Commissioning, Provider group and Immunisation group to mainstream funding,
set up helpline, improve and disseminate education resources regarding immunisation.
Expand remit of TOILS obesity group. Implement vision screening and oral health policies
• Vulnerable children: Joint commissioning
Age 5-15
• School/non-school setting: breakfast clubs, parent education (re: smoking, chronic disease,
literacy), improved Health School, deliver counselling and therapy
• Nutrition: involve Youth Council and CYP Forum to regulate fast food outlets, promote
healthy eating interventions, increase sports facilities, target hard to reach children
• Joint commissioning
• Safeguarding Board to protect vulnerable children from emerging communities
Age 16-19
• User involvement: CYPSP to map use and identify gaps
• Promoting healthy lifestyles: Encourage more voluntary sector involvement, target at-risk
groups
• Risky Behaviour: Sexual Health Strategy Group to improve access to integrated services
• Adolescent services: Child and young person centred transition policy
• Joint commissioning
Children with disabilities
• Transition: develop key worker role
• Common data set
• Access: CYPSP to improve Sure Start and Children Centres resources
• Early intervention and Support: CYPSP to improve health visiting and Common Assessment
Framework
Children and adolescent’s mental health
• Access: CAMHS to develop single directory of services available and how to access
• CAMHS to promote emotional well-being and cultural sensitivity and develop multiagency
“risky behaviours” interventions and forum. Inter-agency working
• Training: CAMHS Commissioning Group to increase tier 1 (universal) training
Teenage pregnancy
Summary of needs
Met Services
• Low GUM clinic waiting times
• Services more user friendly following Modernisation Initiative
• Good links with public health
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Unmet
• Good peer SRE education (SHARES service), good community involvement
where available
Services
• Low uptake of EHC from Sexual Health Services (SHS). Lower number of
accredited pharmacists than neighbouring boroughs
• Lower uptake of LARC than neighbouring boroughs
• SRE education does not meet demands. However half of secondary school age
Lambeth children educated outside borough, so SRE provision unknown
Specific groups
• Boys, young men and fathers are not adequately targeted
• BME groups, asylum seekers, looked after children and care leavers, single
parent children, children at special schools, children living on housing estates,
children with drug alcohol and mental health issues are not adequately targeted
• Emotional support, raising self-esteem, tackling family issues not adequately done
Summary of recommendations
• TPPPB should work with other partnerships e.g. Crime and Disorder Reduction Partnership,
have more senior representation and widened membership and mainsteam TP funding
• Develop a borough wide comprehensive media, marketing and communications strategy to
include health promotion, the community and the “night-time economy”.
• Development of SRE
• Increase capacity of SHS by service redesign and increased investment. Greater
prescribing of LARC, improved uptake of Emergency Contraception and condoms in
these settings.
• Recruit performance specialist to monitor and evaluate services
Summary of implementation plan
• Use of life course based approach to TP to map whole care pathway
• Appointment of director level members to TPPPB board and widening of membership
to include community paediatricians and involve young people’s views
• TPPPB to ensure implementation of Local Implementation Grant (LIG) to protect
funding of Sure Start Plus
• Set up of finance and governance group
• Creation of information sub-group to monitor and evaluate services and to report to
TPPPB. Development of common dataset
• Consider use of small grants scheme to engage with community and voluntary sector
• Formation of partnerships to link with smoking in pregnancy, breastfeeding and
mental health (e.g. Mental Health Promotion Strategy in PCT). Work with Extended
Schools, Children’s Centres and Children’s Services
• Broaden scope of Speakeasy programme to help communication between children and
parents
• Encourage schools to aim for Healthy School Status, involve School Nurses and
Health Visitors to improve SRE. Consider starting SRE in primary school
• Use Locally Enhanced Services in GP contract to increase LARC prescription and new
pharmacy contract to expand EHC provision. Improve signposting and advertising of
abortion services
• Development of borough-wide comprehensive marketing, media and communications
strategy with involvement of PCT and Borough Communications teams
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Physical activity
Summary of needs
Met Children aged 1-14 years
Follow national guidelines for physical activity better than national average
Girls and Young Women
Unmet
Lower levels of inactivity in 16-24 year old girls than nationally
Middle aged men (30-44)
Initiation of North Lambeth and Southwark Sport Action Zone (SAZ)
Older people (60+)
Targeted and safe areas for exercise (e.g. active walks, SLIPS, Age Concern Festival,
Sheltered Housing Scheme Pilot, Fit as a Fiddle project, Ageing Well project)
Increased sports participation in over 55s in England
BAME community
Lower levels of inactivity in BAME community than nationally
People on low income
Initiation of North Lambeth and Southwark SAZ
Disabled people
Lower levels of inactivity in disabled group than nationally
Children aged 1-14 years
Continued increase and projected increase in prevalence of obesity
Girls and Young Women
Highest teenage pregnancy rate in Europe, resulting in higher inactivity
Middle aged men (30-44)
Higher inactivity than nationally
Older people (60+)
Higher inactivity than nationally
BAME community
None of Sport England’s 19 segments are driven by ethnicity, resulting in poor local
provision for BAME groups
People on low income
Higher inactivity than nationally, poor provision of sports facilities in several wards
Disabled people
Few and sparsely distributed locations in Lambeth with provision for disabled persons
Summary of recommendations
Children aged 1-14 years
• London Borough of Lambeth to take lead, bringing together various strategies
• Strategic marketing
• Provision of wide range of activities, strengthen volunteer and club base
• Extend exercise referral, continue MEND scheme
Girls and Young women
• Trail blazing projects (e.g. Recruiting Mothers and Daughters Together), multi- agency Alive
and Active programmes
• Define and dedicate lead agency and dedicated resource for girls and young women.
Establish Girls and Young Women’s Physical Activity Focus/Steering Group
Middle aged men (30-44)
• Early recruitment to physical activity.
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• PCT to lead initiatives. Integration with initiatives such as SAZ, family orientated exercise
Older people (60+)
• Agree on an agency to lead strategic development of physicial activity for this age group:
Borough Council, PCT, Age Concern
• Continue with Age Concern Communities for Health- Healthy Ageing Project
BAME community
• Interventions should reflect population demographics
• Consider results of Sport & Physical Activity Action Plan for Black, Asian and Ethnic Minority
Communities in London
People on low income
• Extend North Lambeth and Southwark SAZ
Disabled people
• Local strategic planning linked with regional Inclusive and Active plan
• Encourage participation, volunteering, increase opportunities
Summary of implementation plan
• Communication and translation of health benefits message to policy makers, investment and
service managers and community leaders
• Development of multi agency Strategic Framework for Physical Activity and Sport
• Employ Partnership Manager to establish effective CSPAN
• Build pathways using practical examples/Trail Blazer projects for children and young people
• Lead sub-groups, ensure priority given to each group through CSPAN. Highest priority for
young people, older people, disabled people, low income groups. Secondary priority for
middle aged males and young girls and women. Integrated approach to BAME
• Shared delivery of health promotion and targeted exercise delivery
• Identify low participation and deficiencies, tactical targeting
• Building Schools for the Future programme to enhance provision of sport facilities
• Invest in volunteers and workforce development
• Sustained long term investment
• Incorporation of social marketing (findings of five Pro-Active Sport and Physical Activity
Partnerships) into Strategic Framework for Physical Activity and Sport in Lambeth
Prisons needs assessment
Summary of needs
Met Service provision
Unmet
• Good range of services provided and involvement of specialist services, new
provision of art and drama therapy Nov 2007
• 1:1 smoking cessation advice available
Health problems
• Good identification of patients with diabetes, coronary heart disease, epilepsy
Substance misuse
• Integrated drug treatment service
Service provision
• Lack of electronic data and unlinked data systems, resulting in incomplete
information on prisoner and difficulty linking with community health systems
• Primary health care service separate from and unlinked to GP service
• Variation in staff-prisoner relationship in prison medical services
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• Prisoners sometimes use nicotine patches to supplement cigarette use
Health problems
• Under-diagnosis of hypertension and smoking cessation intervention
• No cardiovascular risk assessments done
• Prison Health Performance Indicator for Hepatitis B vaccination not met
Mental health
• Low uptake of referrals to outreach team- poor management of common mental
disorders
• Insufficient time in nurse-led mental health outreach service for interventions
• Only 1/3 of prisoners referred to mental health services attend- possible causes
are release from prison, simultaneous activities, lack of communication regarding
appointment, shortage of prison officers
• Long waiting times to access acute mental health services (24% wait more than 3
months), resulting in treatment of acutely unwell patients under common law in
prison
Self-harm/suicide/attempted suicide
• Self harm under Safer in Custody directorate with poor link with medical services
Substance misuse
• Drugs smuggled into prison and injection of controlled drugs occurs in prison
• Higher than expected for Brixton Prison number of prisoners on drug
detoxification programme
• Less drug testing than nationally
Sexual health
• Condoms only available on request
Health promotion
• Health promotion plan 2005 not fully implemented. Lack of health promotion
leaflets, health promotion induction varies. Less material than nationally
Physiotherapy
• Only one gym open or 2 available
Complaints
• Recorded but not always acted on. Often reported to perpetrator
Dental
• Long waiting times to see dentist: median 33 days, up to 454 days
Summary of recommendations
Service provision
• Screen all patients for mental illness, chronic diseases, controlled substances by person with
appropriate training
• Ensure one electronic record with linked database
• Integrate primary healthcare wing with GP service
• Training for all staff on primary mental health care and common medical emergencies
Health problems
• Urgently consider harm reduction measures e.g. needle exchange, disinfectant tablets, free
condom availability for prevention/reduction HIV/Hep B and C
• Follow guidance for Hepatitis B vaccination
• Address dental waiting list proactively
Mental health
• Prioritise management of self harm with mental health lead, strategy and evidence based
implementation plan
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• Audit suicide deaths against best practice guidance
• Increase counselling and cognitive behavioural therapies for management of common mental
illnesses
• Discussion about pan-London diversion of prisoners with acute mental illness to NHS facility
Substance misuse
• Regular and mandatory drug testing
Health promotion
• Enhance health promotion, including peer education, self-help, smoking cessation advice,
information on mental health symptoms, self harm, substance misuse, Hepatitis B and C and
TB.
• Seek innovative opportunities for exercise
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10. Lambeth priorities
Prioritisation
Why do we prioritise in Public Health?
The growing pressure to meet the 2010 target has placed a strong emphasis on an
area approach. This has emphasised a drive to target spearhead areas to reduce
health inequalities resulting in a limited scope of action at local level in
disadvantaged areas.
PCTs are required to commission health services to “improve health and well being
“of the population subject to an available budget. Therefore decisions on how best
to allocate available resources need to be taken. However improving well being of
the population is too broad criteria for the available resources. History has shown
that the demand for care will always exceed the capacity of available resources
despite the improvement of knowledge; technology and socio-economic status.
With the labour government priority has been given to reducing health inequalities
whilst keeping within budget, which requires that PCT select interventions which
bring the maximum benefit for the given resources. So the question is: Which
package of services is likely to bring the highest reduction of health inequalities,
reducing the gap in health status between socio-economic population groups?
The need to prioritisation has been a powerful force in narrowing the scope of
action and potential interventions. However, considerations should be accorded to
the fact that prioritising interventions in minority areas that experience most health
inequalities may not always be a cost-effective option. This features in the action to
prioritise interventions so that benefits are maximised within available resources.
NHS is run on public money and at times difficult decisions are made in terms of
prioritising investment to focus on reducing the overall burden of disease that is
likely to affect quality of life and healthy life expectancy in the long term, while
giving due consideration to health inequalities.
How do we prioritise in Public Health?
Public health agenda is dominated by two key objectives - Protection of health and
Preventing diseases in the local population. Cost-effective interventions that ensure
maximum benefits within available resources with an aim to reduce health
inequalities is the main outcome of prioritisation.
Cost-effectiveness
Efficiency refers to a service having results (improvement of the health condition)
without wasting time, effort or resources ), therefore leading to saving or “added
value.” In the NHS, choice of intervention is based on cost effectiveness so long as
there is evidence to support it. At PCT level the challenge is to adapt to local needs
and find out the most cost-efficient way to deliver a service which is known to be
effective. Ensuring that those in needs access the service and that those who
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accessed the service all benefit of it, increases cost-efficiency or added value of
the services.
The prioritisation process produces a list of potential interventions aiming at
reducing or preventing health inequalities by ensuring that resources are
distributed according to needs.
There are several drivers that inform and affect public health priority setting. While
there may be different approaches to priority setting, this process is largely driven
by National priorities set through the Operating framework by the DH where
providers need to explicitly plan for delivery especially in terms of following:
• Cleanliness and healthcare-associated infections
• Improving access
• Keeping adults and children well, improving their health and reducing
health inequalities
• Experience, satisfaction and engagement
• Emergency preparedness
The Healthcare Commission’s annual health check drives improvements in
healthcare for patients by monitoring progress of work towards meeting targets
through the set of indicators included in the National and Local indicator set. A new
approach within the Operating Framework 2008-09 for planning and managing
priorities both nationally and locally are ‘vital signs’. ‘Vital signs’ can be used to
develop local operational plans to deliver against national priorities and inform
decisions on local targets.
There has been a shift in approach to improving local services delivered by the
NHS, local authorities and public services. The focus has shifted from nationally set
targets driving service improvements to a focus on improved outcomes that matter
for individuals and local communities, which respond to the local context. Integral
to this is partnership working across health and social care and between local and
regional organisations. The advent of local area agreements (LAA) and the recent
requirement for PCTs and Local Authorities to conduct a Joint Strategic Needs
Assessment will be changing the way we prioritise in public health.
Local Area Agreements (LAA) and Joint Strategic Needs Assessment (JSNA)
LAAs deliver prioritisation and co-ordination at a local level and provide a platform
for local leadership. LAAs are an agreement between the public and the local
authority/NHS.
They set out the priorities for a local area agreed between central government and
a local area (the local authority and Local Strategic Partnership) and other key
partners at the local level.
The Local Government and Public Involvement in Health Act (2007) [Clause 116]
places a duty on upper tier local authorities and Primary Care Trusts (PCTs) to
undertake a Joint Strategic Needs Assessment (JSNA). This provision has come
into force since April 2008. The Director of Public Health, Director of Adult Social
Services and Director of Children’s Services are jointly expected to take a lead in
producing a strategic needs assessment through strong partnership. (Details in
Chapter 6)
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The following describes the process of priority setting in light of JSNA and LAA.
JSNA
Primary
Care Trust
Local
Authority
LSP
(Local Strategic
Partnership)
Priorities
PCT
Commissioning
Priorities
Local Area
Agreement
-Mental Health
-Long term conditions
- Sexual health
-Children & Young People
-End of Life care
-Staying healthy
-Healthier Communities &
Older people
-Economic Development
-Children & Young People
-Community Safety
-Active Communities
The following chart elicits the hierarchy that exists in terms of bureaucracy at present.
Central
Government
Department
of Health
Govt Office
For London
(Monitoring)
Communities
& Local
Government
NHS
PCT
Local
Authority
Monitored by
-Health Care Commission
-Audit Commission
Monitored through
-CAA-Comprehensive
Area Assessment
-APA Annual
Performance Assessment
-CSCI – Commission for
Social Care Inspection
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What are the PH priorities?
Main public health priorities:
- Improve life expectancy (LE)
- Reduce infant mortality.
- Reduce premature mortality (deaths under 75 years) from heart disease.
- Reduce premature mortality (deaths under 75 years) from cancer.
Additional priorities
In addition to LE and reducing premature deaths from circulatory diseases and
cancer, following are PH priorities with regard to prevention, detection & treatment:
Obesity
Smoking
Alcohol
Cancer Screening
CVD risk
assessment
Hypertension
CHD
Diabetes
Mental health
Sexual health
(TP & HIV)
Smoking, obesity, alcohol and substance misuse have a direct co-relation with
circulatory disease and cancer while hypertension, diabetes contribute to the
development of circulatory diseases leading to reduction in the healthy life
expectancy. Mental health has a direct correlation with physical health and is
identified as a priority in Lambeth.
Early intervention provides effective outcomes in the long-term and importance to
prevention and early detection and treatment have been highlighted through the
Staying healthy work stream developed in the PCT following the five year
Commissioning Strategy Plan.
‘Hiten’s Red Box’ (figure below) used traditionally by the PCT, states the areas of
high burden and low burden depending on performance and also states whether
they are worsening or improving.
High Burden
Hiten’s red box: update 2006/7
Cardiovascular disease mortality
(slower improvement compared for
nationally)
Cancer mortality
Teenage conceptions
Mortality from infectious and
parasitic disease
Healthy living issues (smoking,
obesity, poor diet, low physical
activity, alcohol, drug use)
Chronic liver disease deaths &
morbidity
Chronic renal disease morbidity
Hypertensive disorders
HIV prevalence
STIs prevalence
Severe mental illness morbidity
Diabetes mortality & morbidity
Low Burden
Infant mortality
Immunisation uptake
All cause mortality in girls under 15
years
Drug misuse
All cause mortality in boys under
15 years
Mortality from gastric, peptic and
duodenal ulcers
Improving
Worsening
What are Lambeth PCT’s Commissioning Priorities?
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Lambeth PCT’s Commissioning Strategy Plan (CSP) refresh –
October 2008
The PCT’s CSP has been developed following use of extensive information
sources including the JSNA primary dataset, the Public Health statistical bulletin,
the Annual Public Health report 2007/08 amongst others.
The summary of the PCT’s CSP refreshed this year is as follows:
The PCT held a workshop in June 2007 to review what the PCT’s commissioning
priorities should be for the next five years. The objective was to consider all the
information from our strategic drivers, outlined in Section 2, (such as Public Health
data and patient and users’ views), in the context of achieving the PCT’s vision and
strategic goals, to determine where the PCT’s efforts should be focussed in the
next five years.
The Workshop drew from a wide range of expertise, including:
1. The PCT Board
2. The PCT Professional Executive Committee
3. Lambeth Practice Based Commissioning Consortia Leads
4. Lambeth Local Authority Colleagues
5. PCT Commissioners
6. PCT Public Health Consultants
7. PCT Quality and Professional Development Leads
8. Primary Care and Community Services Leads
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The comprehensive discussion and analysis at this workshop led to a very clear
consensus at this meeting that this 5 year commissioning strategy should focus
on the following six priorities:
These were chosen because they are all areas:
• Of high local need and inequality
• That reflected information on public and user concerns
• Where there is clear evidence on effective interventions / models of care
that the PCT could implement to improve health outcomes
• Where the PCT felt it could do more in terms of its commissioning to secure
service change and improvement
The PCT’s Public Consultation on the 5 year Commissioning Strategy plan showed
very strong support from local public, users and stakeholders for this choice of 6
priority areas.
The six outcome measures then PCT has identified for WCC assurance are shown
in the table below:
Priority area Outcome Rationale
Long Term
Conditions
Hypertension – the
proportion of patients
with hypertension, CHD,
stroke and diabetes
whose blood pressure is
controlled at 150/90.
Fit to PCT vision and goals and HfL
themes.
Hypertension management a key
Lambeth risk factor - success in
delivering outcome will have a major
impact on improving health and
inequalities and significant population
impact also.
Lambeth detection rates lower than
national average.
Measurable and deliverable but
challenging.
Effective hypertension management
beings patients in to the heath care
system, but also promotes self care,
early intervention to avoid
deterioration and improved health
and well being.
Children and Maternity - Percentage Fit to PCT vision and goals and HfL
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Young People of women booked by 12
weeks
Sexual Health
Mental Health
Staying Healthy
Sexually Transmitted
Disease – the
percentage of the 15-24
population screened for
Chlamydia.
Early intervention and
Treatment – to increase
access to psychological
therapies.
Smoking - to achieve
targets for smoking
quitters per 100,000
population.
End of Life Care Choice – the percentage
of [people who die in the
place of their choosing.
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themes.
Improves access to population group
fundamental to delivering parenting
and early years strategies.
Linked to overall improved outcomes
– low birth rate, ethnic inequalities.
Low levels of performance currently
(40~% achievement) – scope for
significant improvement.
Measurable.
Fit to PCT vision and goals.
Prevalence of STIs, including
Chlamydia high – with ethnic
inequalities also.
Facilitates access to high risk
population groups and hard to reach
younger populations – links therefore
to prevention of other STIs, including
HIV, teenage pregnancy.
Evidence of cost effectiveness.
Service model and redesign in place
to support delivery.
Measurable.
Fit to PCT vision and goals and a
major priority area within the PCT’s
mental health strategy.
Areas of current service gap and
inequality – implementation of talking
therapies review from October 2008 –
identification as an outcome will
enable assessment of progress and
impact.
Fit to PCT vision and goals and HfL
themes.
High prevalence with significant health
impact. Significant inequality in
smoking rates between Lambeth and
nationally.
Current performance against targets is
challenging, although services
comprehensive – need to explore
more innovative approaches.
Measurable.
Fit to PCT vision and goals and HfL
themes.
Current performance (nationally and
locally) poor – scope for significant
improvement.
Will require service development and
redesign – supported by Guy’s and St
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Thomas’ Charity and Marie Curie
initiatives.
Inequalities issues – need to ensure
consistent focus across cancer and all
end of life care.
Further work, utilising the same baseline data and information as above has also
been carried out to identify the final two outcome measures. These are as follows:
Priority area Outcome Rationale
Long Term
Conditions
Alcohol or
Patient
Experience or
Flu Vaccines
Diabetes blood sugar
levels
An outcome related either
to alcohol or patient
experience.
Fit to PCT vision and goals and HfL
themes.
Lambeth detection rates low.
Effective management will improve
health outcomes and deterioration of
morbidity for diabetic patients.
Diabetes represents the PCT’s
biggest opportunity for shift to out of
hospital care (emergency
admissions high and hospital check
ups). .
Measurable.
Further work is required to confirm
the PCT’s final outcome measure.
The PCT is keen to include an
outcome related to responsiveness
of care, linked to its CSP strategic
goal. However it wishes to consider
further whether the DH measures will
provide the optimal outcome for
measuring progress in delivering this
goal and WCC.
Similarly the PCT is keen to include
an outcome related to alcohol, as
this is an area of significant need
and a key risk factor for the
population. Again however it wishes
to consider further whether the DH
measures will provide the optimal
outcome for measuring progress in
delivering this goal and WCC.
A further alternative is to include an
outcome measure on flu vaccination.
The above outcomes have been identified following a workshop at which all the
proposed outcomes were discussed and assessed. The workshop included the
PCT’s Board, PEC and Management Team, Practice Based Commissioners, PCT
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public health and commissioning leads, and representatives from key external
stakeholders. Over the next few weeks the PCT will carry out the following further
work on its 10 outcomes, to ensure a final sub mission in line with final CSP/WCC
deadlines.
Staying healthy
1.1. Initiative Outcome Indicators
1. To have completed the first pro-active vascular risk screening of the eligible
population (40-74 years)
2. To increase the % of practices with validated registers of patients without
symptoms of cardiovascular disease with an absolute risk of CVD events
greater than 20% over the next 10 year
3. To reduce smoking prevalence in line with the national targets
4. To increase the range of options available to support increasing physical
activity in adults with a CVD risk of greater than 20% over the next 10 years
and those just below 20% risk
5. Increase the number/% of patients assessed using the FAST tool (for
alcohol consumption). To increase the range of settings in which FAST is
used across care settings, with the specific aim of extending its use within
and beyond general practice
6. To increase the number of settings actively promoting the mental health and
well-being of pre-school and primary age children using evidenced
interventions to an agreed standard
7. To reduce the percentage of Lambeth adults and children classified as
obese, though the effective implementation of the PCT’s obesity strategy
8. To increase the percentage of Lambeth residents classified as suffering
from mental health and well being issue using evidenced interventions to an
agreed standard
9. To increase the proportion of PCT spend on health promotion/prevention
year on year.
Mental health
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Initiative Outcome Indicators
1. Increased access to psychological therapies in line with IAPT: increase in
no's of people seen
2. Percentage of adults in contact with secondary MH services in employment:
VSC8: N1 150
3. Percentage of adults in contact with mental health services in settled
accommodation: VSC06
2- 4: Psychosis: Delivery of 200 new cases by early intervention team
4. High percentage of people with SMI accessing physical health care checks
(QOF)
5. Proportion of older people diagnosed with dementia
Children and young people
Initiative Outcome Indicators
The approach taken to establishing outcomes for birth is to consider outcomes
along the care pathway, from maternity to adolescents. In addition outcomes have
been defined for two cross cutting client groups: children and adolescents with
mental health issues, and children with disabilities.
1. Maternity - % women booking by 12 weeks - Optimising the health of
mother and infant and reducing health inequalities – investment is already
underway which will deliver increased capacity in the Healthy Start teams,
which include health visitors. In order for women to gain access to key
advice and screening it is essential that they access maternity services in a
timely way. This will give them access to advice on diet, smoking, antenatal
screening, mental health screening, domestic violence screening etc all
factors which influence the health of the mother and unborn child.
2. Infancy and early years – Immunisation rates by 2 nd and 5 th birthday for MMR
- Infancy and early years - To have a completed schedule of childhood
immunisations, focusing on MMR at age 2 and 5 – immunisation rates in
Lambeth continue to below national averages. There is a strong evidencebase
surrounding immunisations preventing ill health in infancy and early
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years.
3. School aged children – No. of Lambeth schools achieving advanced Healthy
Schools status - To attain 50 of Lambeth schools reaching advanced Healthy
Schools status – Good progress has been made in attaining Healthy Schools
status in Lambeth, however the advanced program will give the opportunity
to give additional focus on emotional well being, substance misuse and
sexual health. It is proposed to broaden the programme to do some targeted
work on obesity, in addition to any national initiatives.
4. Adolescents – No. of services awarded You’re Welcome Status - Improve
youth engagement in health services – there is a high incidence of ill health
linked to risky behaviours in Lambeth including, sexual health and substance
misuse. Engagement of young people in health services, would promote
improved prevention and treatment.
5. Child and Adolescent Mental Health – Young people and their parent’s
satisfactions with CAMHS – ‘Value Added’ measure of the Strengths and
Difficulties Questionnaire (SDQ) - To maximise young people and their
parents satisfaction with CAMHS – to date significance focus on CAMHS has
been on ensuring the right processes/services are in place eg 24 hour
access. Patient satisfaction is being used nationally as a proxy measure for
outcomes rather than process. One of the key priorities identified in the
CAMHS strategy is to ensure that a systematic method of obtaining patient
feedback is developed in order to improve both the commissioning and the
provision of services.
6. Children with disabilities – National Survey, by Borough, of parents of
children with disabilities - To maximise young people and their parents
satisfaction with services for children with disabilities – There is anecdotal
evidence that the number of children with disabilities is increasing. A health
needs assessment is currently underway which will allow us to better under
stand the issue. Additional investment has already been made with LBL on
increased school nurse capacity in special schools, and the Aiming High
agenda will specifically increase provision of short breaks for children with
disabilities and their families.
Long term conditions
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Initiative Outcome Indicators
1. HbA1c of 7.5 or less (in the last 15 months for diabetic patients) for 70% of
diabetic patients by 2013
2. To increase the proportion of patients with hypertension, CHD, stroke and
diabetes whose blood pressure is controlled at 150/90
3. To increase in the percentage of stroke admissions given a brain scan within
24 hours
4. Increase the percentage of patients with COPD for whom diagnosis has
been confirmed by spirometry
5. A personalised care plan for all patients with a long term condition, starting
with patients at highest risk of admission
Sexual health
Initiative Outcome Indicators
The following key outcomes and quality improvements are planned through the
implementation of the sexual health strategy:
1. GUM 48 hr appointment wait
2. 17% 15-24 year olds screened for chlamydia (as a proxy for
prevalence
3. Increase in community service uptake by (a) young people
under 25 and (b) by men
4. Increased uptake of long-acting reversible contraception
(LARC)
5. Transfer of services from hospital to community settings.
6. Improved patient experience
End of life care
Initiative Outcome Indicators
1. More people to be able to express a choice of place of death - Most people
given a choice would prefer to die at home (this definition includes forms of
residential care i.e. care homes). Often however the wishes of people
coming to the end of their life are not discussed or documented and
therefore robust care planning to enable the wishes of the patient are often
not in place or happen towards the very end of life. The use of the Preferred
Priorities for Care (PPC) document and the monitoring of the use of the PPC
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will ensure that we are able to record, communicate and carry out the
patient’s wishes.
2. More people dying in the place of their choice - To maximise the number of
people who die in the place of their choice and to ensure they receive
excellent end of life care where ever that is. While most people express a
wish to die at home it is essential that good end of life care is available in all
settings.
3. Access to care at home - Most people would prefer to die at home as long as
high quality care can be assured and as long as they do not place too great
a burden on their family and friends. The Gold Standards Framework (GSF)
is now being used by 64% of Lambeth GP practices and there has been an
increase in the number of people receiving fully funded palliative continuing
care. However patients, carers and referrers report that access to health
and social care support and practical help is variable, is not always available
24/7 and in an emergency and can lead to carer burnout.
4. End of life care in care homes - Of the 14 care homes in Lambeth, 5 have
been involved in some way with implementing the GSF and 2 of those are
progressing to full accreditation. The PCT will be working with other
stakeholders to explore additional ways of incentivising care homes to
implement both the GSF and Liverpool Care Pathway (LCP). End of life
care for people with dementia has been highlighted as a priority area as part
of both the MCCP and Modernisation Initiative.
5. Acute care - A 3 year project is underway at GSTT to roll out the LCP across
the trust and so far 17 wards have implanted it. Work undertaken as part of
the MCDC programme has highlighted discharge planning as an area that
needs further work.
6. Access to bereavement services - The PCTs baseline review of EOLC
services completed early in 2008 identified a gap in bereavement services.
Work is underway with the national charity Cruse to develop a local Lambeth
bereavement service.
Planned care
Initiative Outcome Indicators
1. Reduction in cancer mortality
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2. Proportion of eligible population offered appropriate screening e.g. breast,
cervical and bowel (TBA)
3. Continued implementation of improved outcome guidance
4. Shift in outpatient attendances to community settings for defined conditions
and improved patient reported outcomes
5. Case management offered to 90% of patients identified as at risk of
admission (approximately 1600 patients)
Unplanned care
Initiative Outcome Indicators
1. To increase access to walk-in urgent care services
2. To increase access to routine and urgent care services outside the ‘normal’
working week.
3. To increase capacity in urgent care responses in primary care and
community services.
4. To reduce the need for urgent / emergency care.
5. To regionalise major trauma services in London (working with Healthcare for
London ) and to develop a Sector based trauma networks.
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Sustainable community strategy priorities: To realise our long-term term vision, Lambeth First has identified key priority areas for the next
three years. These are set out in our Local Area Agreement, which was approved in June 2008. See Appendix 1 for further details.
Vision
Lambeth is a diverse, dynamic and enterprising borough at the heart of London
Sustainability Economic Well-Being Social Well-Being Environmental Well-
Being
Universal Issues
Sustainable
Community
Strategy 2020
Outcomes
Lambeth is a great place
to do business with higher
levels of investment and
business growth
Greater wellbeing for
households through higher
numbers of residents in
employment
Children and young people are
on the path to success through
the provision of good quality
education, training and jobs
which reduces the risk of
exclusion and offending
Community Cohesion, Equalities, Sustainability and Culture
Empowered, safe and cohesive places where people have the confidence
to play active roles in their communities
Improved health and
wellbeing of people which
enables them to live
active and independent
lives
Lower levels of poverty and
social exclusion in Lambeth by
helping more of our socially
excluded adults in employment,
education and training
Mixed and sustainable
communities with an
increased supply of new
homes, improved existing
dwellings and a high
quality physical
environment
Lambeth Local
Area Agreement
Priority Areas for
Improvement
2008 - 2011
Increasing the overall
employment rate
Increasing VAT
registration rate for new
companies
Increasing the number of
working age people with a
Level 2 qualification or higher
Increasing the number of 19
year olds with Level 2
qualifications
Reducing the number of 16-
18 year olds not in education,
employment or training
Increasing migrants English
language skills and
knowledge
Reducing working age people
claiming out of work benefits
Improving the emotional health
of children
Reducing obesity in primary
school children
Improving the stability of
placements for looked after
children
Reducing the under 18
conception rate
Reducing the gap in
achievement between pupils
eligible for free school meals and
their peers at Key Stage 2 and 4
Reducing the rate of permanent
exclusions from school
Increasing the percentage of people who feel they can influence
decisions in their locality
Increasing overall satisfaction with the local area
Building resilience to violent extremism within Lambeth
Increasing young people’s participation in positive activities
Increasing take-up of formal childcare for low income working families
Reducing serious violent crime
Reducing serious acquisitive crime
Tackling perceptions about drug use and drug dealing
Tackling concerns about anti-social behaviour and crime by the local
council and police
Reducing mortality rates
from all circulatory
diseases for people under
75
Increasing the number of
clients receiving selfdirected
support
Increasing the number of
vulnerable people living
independently
Increasing carers needs
assessments undertaken
Reducing the proportion of
children in poverty
Increasing the number of adults
with learning disabilities in
employment
Increasing the number of adults
in contact with secondary mental
health services in employment
Increasing young offenders
engagement in suitable
education, employment or
training
Increasing offenders under
probation supervision in
employment at the end of their
order or licence
Increasing the number of
affordable homes
delivered (gross)
Reducing the number of
households living in
temporary
accommodation
Reducing per capita CO2
emissions in the local
authority area
Improving street and
environmental cleanliness
(levels of graffiti, litter,
detritus and fly posting)
(local PI)
Reducing the percentage
of non-decent homes
(local PI)
Our new way of
working
Increasing the numbers of volunteers registering (local PI)
Neighbourhood Working – Where appropriate we will deliver services at the neighbourhood level
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Chapter 6. Recommendations
The next phase of work as a part of the JSNA will be to identify gaps in terms of
understanding current service provision in health and social care to achieve the
desired health and well-being outcomes and to reduce inequalities.
To ensure the above, it is important that there is a good understanding of
currently provided service and evidence of their efficacy. In addition, a review of
evidence to determine cost-effective interventions will complement provision of
strategic recommendations in terms of commissioning or decommissioning of
service across the health and social care remit.
The areas of work identified are further consultation with stakeholders including
the community and voluntary sector, mapping local services specifically those
where there are unmet needs in the population, understand market capacity for
effective commissioning or decommissioning of services and local impact
assessment of proposed recommendations.
Appendix
I. JSNA Project Plan.
II. Customer focus – Literature review.
III. Glossary
IV. References documents
a. Lambeth - State of the Borough report.
b. Lambeth PCT Commissioning Strategy Plan.
c. Lambeth Annual Public Health Report.
d. Lambeth Public Health Statistical Bulletin.
e. Lambeth Sustainable Community Strategy.
f. Lambeth Local Area Agreement.
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Appendix 1
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LAMBETH
JOINT STRATEGIC NEEDS
ASSESSMENT
(JSNA)
PROJECT PLAN
Version 3.
Jun 30, 2008
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JSNA Project Plan
Overview of Project
Background
The concept of Joint Strategic Needs Assessment (JSNA) was introduced in the
Department of Health’s (DH) Commissioning Framework for Health and wellbeing
document published in March 2007. The Local Government and Public
Involvement in Health Act (2007) [Clause 116] places a duty on upper tier local
authorities and Primary Care Trusts (PCT) to undertake a Joint Strategic Needs
Assessment (JSNA). This provision came into force in April 2008. The Director
of Public Health, Director of Adult Social Services and Director of Children’s
Services are jointly expected to take a lead in producing a strategic needs
assessment through strong partnership.
The DH describes JSNA as ‘a systematic method for reviewing the health and
well-being needs of a population, leading to agreed commissioning priorities that
will improve health and well-being outcomes and reduce inequalities.
The JSNA is expected to “describe the future health care and well-being needs of
local population and the strategic direction of service delivery to help meet those
needs”. A key element of JSNA is that it should involve all the important
stakeholders in identifying needs and take appropriate actions to address those.
The assessment process is expected to make use of existing information, identify
gaps, actively engage stakeholders including patients and public for their views,
understand local service provision; and most importantly, the outputs or findings
be translated into actions for the commissioning and delivery of health and social
care services, health improvement and well-being programmes and
interventions.
The World Class Commissioning competencies emphasise the role of JSNA in
driving the long term commissioning strategies of PCTs and their collaborative
work with community partners including public and patient engagement. The
JSNA is envisioned as a dynamic process periodically updated and is expected
to contribute immensely as a key tool to achieve a shift towards commissioning
to improve health and well-being outcomes and reduce inequalities.
Aims and Objectives
Aim
To understand the current and future health and well-being needs of the
population; over both short term (3-5 years) to inform Local Area Agreements
(LAA), and the longer term (5-10 years) to inform strategic planning and
commissioning.
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Objectives:
• To develop a process for conducting the Joint Strategic Needs
Assessment.
To form a steering group and working group.
To agree governance arrangements for the JSNA process
To agree communication strategy to ensure adequate
internal and external communication
To list partners and stakeholders to be engaged in
development of JSNA.
To agree resource requirements.
• To design methods to develop the Lambeth Joint Strategic Needs
Assessment.
To agree the scope of work.
To develop a joint outcomes framework that can be used to
describe the health and wellbeing needs and inequalities
across Lambeth.
To develop and/or agree a prioritisation methodology to
identify strategic priorities and offer strategic
recommendations for service planning and improvement
following the needs assessment.
- To ensure that the output from the JSNA is disseminated to all
stakeholders and used in future commissioning.
To consult with the public on the final JSNA
To disseminate the findings to key stakeholders within the
LBL and Lambeth PCT.
Overall Approach
The Department of Health guidance on Joint Strategic Needs Assessment states
that the JSNA will provide a framework to examine all the factors that impact on
health and well-being of local communities including employment, education,
housing and environmental factors. To achieve this, it is proposed that a core
dataset be formed which will signpost users to a range of existing data from data
sources to assist in the JSNA process. Regarding engagement with
stakeholders, Strong and Prosperous communities emphasises that citizens and
communities know what they want from services and what needs to be done. It is
within the remit of this project to use patient and user experience and build on the
duties to consult and involve the stakeholders through LINKs and other such
networks.
The JSNA work is expected to deliver the following as a minimum:
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• Achieve a shift towards commissioning to improve health and well-being
outcomes and reduce inequalities.
• Identify priorities and offer strategic recommendations for service planning
and improvement.
• Provide evidence about the population on which services are planned to
address health inequalities;
• Identify gaps in equitable distribution of services;
• Create cross-sectoral partnership working and develope creative and
effective interventions;
• Engage with the populations and enable them to contribute to targeted
service planning and resource allocation;
Important factors to ensure objectives are delivered are:
• Joint working, partnerships and collaboration of PCT and various local
authority directorates and range of stakeholders.
• Agreeing scope of work in terms of deliverables.
• Availability and access to range of information related to health, and wider
determinants of health and well-being as well as on services currently
provided within the borough.
Project Outputs
The JSNA will be presented as a working document which will include the
following as a minimum:
1. A joint health and well-being outcomes framework.
2. Analysis of primary and secondary data to illustrate the health and wellbeing
status of local communities.
3. A profile of the population with regard to inequalities and inequities in the
context of wider determinants of health and well-being such as
environment, economy, transport, housing etc.
4. Map of local statutory services as well as voluntary services contributing to
improved health and well-being outcomes.
5. Consultation with stakeholders and gap analysis.
6. Review of evidence of effectiveness of interventions to provide
recommendations for cost-effective use of resources while reducing
inequity and inequalities.
The presentation of information in the JSNA will be discussed with the
commissioners and approach or methods agreed through a series of workshops.
The JSNA working draft structure will be agreed jointly with the commissioners
and other stakeholders. There are three possible suggestions on presentation of
information in the JSNA:
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1. A population-based approach where information related to various indicators
including the wider-determinants will be detailed for children and young people,
Adults and older people separately.
2. An outcomes based approach will see presentation of information by
outcomes to be achieved.
3. A service or specialty specific approach such as mental health, sexual health,
housing, environment etc.
Project Outcomes
• Agreeing methodology and process for JSNA and its cyclical review
locally.
• Prioritisation based on identified needs.
• Strategic recommendations to inform commissioning cycles within the
PCT and Local Authority.
• Feedback to the local community and stakeholders.
• Informing the development and/or refresh of the local Community
Strategy, PCT Commissioning strategy plan, PCT Local Delivery Plan,
Children and Young People’s Plan, PBC Commissioning plans,
Community regeneration strategies, Housing strategies, Community
Safety Strategy, Carer’s strategies, Workforce planning strategies and
other key strategies..
Stakeholder Analysis
Stakeholder
Local National health service (PCT)
- General Practitioners & allied
staff.
- District nurses.
- Family planning providers.
- Health promotion teams.
- Patient Advice and Liaison
Service (PALS)
- Community pharmacists.
Interest / stake
Statutory organisation
Local Authority
- Neighbourhood services
- Social care staff
Statutory organisation
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- Environmental officers
- Housing leads
- Community safety leads
- Economic development leads
- Schools
Community and Voluntary sector
Private providers
Voluntary sector
representation
Risk Analysis
Risk
Probability
(1-5)
Severity
(1-5)
Score
(P x
S)
Action to
Prevent/Manage Risk
Staffing 3 4 12 Agree resources to fund
additional staffing
requirements.
Organisational 2 4 8 Effective engagement of
partners and good
governance arrangements.
Technical 2 4 8 Ensure accessibility and
availability of sources of
information and analytical
expertise.
Related to external
partners
3 4 12 Communication strategy to
be developed.
Legal 2 5 10 Ensure robust
methodology in conducting
the JSNA and consultation
with legal advisors where
need arises.
Standards
Name of standard or
specification
Standards for better
health – Public health
Version
Governance 5b
Patient Focus
D8,9&10
Public Health
Notes
Healthcare organisations promote, protect
and demonstrably improve the health of the
community served, and narrow health
inequalities.
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C22a,c
D13a,b&d Core
standard C22a
and c
Healthcare organisations identify and act
upon significant pubic health problems and
health inequality issues, with primary care
trusts taking the leading role;
Technical Development
The JSNA will be a dynamic process with cyclical updates to specific pieces of
work such as population health and service related information that will include
various indicators (outcome indicators, health indicators, performance indicators).
The technical development will be led jointly by lead Directors from Lambeth PCT
and the local Authority – London Borough of Lambeth.
Project Management and Resources
Project Partners
No. Partner Roles
1. Lambeth Primary Care Trust (Local
NHS)
Joint Lead partner
2. London Borough of Lambeth
- Adult and Social Service
- Children’s Service
Joint Lead partner
3. The community and voluntary sector
(represented through the Lambeth
Voluntary Action Council – LVAC)
Partner
Project Management
The Local Strategic Partnership with have the overarching responsibility to
deliver the JSNA while the JSNA Steering Group will provide support and will
steer the JSNA Working Group’s progress of work.
The JSNA Working Group will be working closely with representatives from the
various theme boards such as the Children and young people theme board;
Healthier communities and older people board; Economic development and
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enterprise and Community safety board. Following is the proposed governance
arrangement chart followed by the composition of the JSNA Steering Group and
the JSNA Working Group.
The output of JSNA will be fed through the newly formed cross-cutting
commissioning group as described in the following chart:
Joint Strategic Needs Assessment – Governance
Health & Social
Care
Partnership
Children &
Young People
Partnership
Housing
Partnership
Metropolitan
Police
Cross Cutting
Commissioning
Group
Lambeth
PCT
Local Strategic
Partnership
Lambeth
Cabinet
Joint Strategic
Needs Assessment
Steering Group
Joint Strategic
Needs Assessment
Working Group
Children &
Young People
Transformation
Board
Safer &
Stronger
Communities
Transformation
Board
Adults &
Community
Services
DLT
Strategy &
Corporate
Services
DLT
Inform
Governance
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JSNA Steering Group membership
Role Name Title
Programme Sponsor
Jo Cleary
Ruth Wallis
Phyllis Dunipace
Executive Director – ACS
Director of Public Health
Executive Director – CYPS
Strategic Commissioning Helen Charlesworth-May Divisional Director, Strategy and
Commissioning, ACS
Technology
Transformation
& Mary Cotterell
Business Transformation Manager – STT
Policy & Performance Sophia Looney Divisional Director - Policy, Equalities &
Performance
Commissioning
Performance
&
Doreen Redwood Divisional Director Strategy &
Performance, CYPS
Regeneration & Housing Paul Cooper Assistant Director
Programme Manager Kate Hargreaves
Local Area Agreement
Senior Transformation Manager
Active Communities John Kerridge Assistant Director Area Services
Community Safety Simon Harding Assistant Director Community Safety
Project consultant lead Hiten Dodhia
(PCT)
Public Health Consultant
Project Sub-lead Ash More Lead on JSNA from PCT
Project Manager Christian Fleming Lead on JSNA from Lambeth
Metropolitan Police TBA TBA
The JSNA Working Group membership
Ash More Public Health Specialist PCT
Tarek Iskander AD Strategy and Commissioning PCT
Sarah Yandell Health and Social Care Officer LVAC
Christian Fleming Head of Performance and Workforce LBL
Development, ACS
Kevin Dillon Head of Policy, CYPS LBL
John Kerridge Asst Director Area Services LBL
Ann Skinner Head of Supporting people LBL
Ruth Staff Performance Manager, ECCS LBL
Megan Jones DAAT Manager, Community Safety LBL
Tom Tyson Policy manager, Regen. & Housing LBL
Geoff Wade Partnership development and Improvement, LBL
Community safety
Charlie Conyers Business & Housing Options Development LBL
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Manager, Regen. & Housing
Sushma Maharaj Data Analyst, Corporate Regeneration
Georges Sen- Research analyst, Quality Performance and
Gupta Research
Theron Newman Finance manager, ACS policy
LBL
LBL
LBL
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Project timetable with provisional dates
Process
Establishing
Steering Group
Task Initiation date Completion
date
Establishing Working
Group
Agreeing
Governance
arrangements
Resource allocation
(Staffing and
administrative
support)
JSNA elements
Developing preliminary
outcomes framework
Demographic and
health profile -
Overview
Inequalities in terms of
wider determinants
(housing, environment,
economics, etc)
Review of needs
assessments complete
and review scope of
those underway
Consultation with
public and patients
(Stakeholder
consultation)
Oct 2007 Oct 2007 Oct 2007
Nov 2007 Nov 2007 Nov 2007
Jan 2008 Mar 2008 Apr 2008
Nov 2007 In progress May 2008
Jan 2008 Jun 2008 Jun 2008
Jan 2007 In progress Sep 2008
Jan 2007 In progress Sep 2008
Apr 2008 In progress Sep 2008
Apr 2008
In progress Dec 2008
Map of local services To be started n/a Sep - Dec 2008
Review of evidence of
effectiveness of
interventions
1.1.1. Output
Prioritisation in terms
of health and wellbeing
needs of the
population
To be
started; Pan
London
approach
also being
considered
n/a
Target date Jun 2008
status
Sep 2008 – Mar
2009
To be started n/a Jan-Mar 2009
Strategic To be started Mar-Jun 2009
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recommendations
Lambeth JSNA –
Preliminary
assessment (first
draft)
Lambeth JSNA –
Full assessment
(first draft)
n/a = Not applicable
Apr 2008 Sep 2008
Apr 2008 In progress June 2009
Programme Support
The JSNA work relies heavily on engagement of all partners/stakeholders
including patient and public engagement. The JSNA project also relies on good
governance arrangements and effective communication strategy for both internal
communication and external communication especially related to dissemination
of findings.
Intellectual Property Rights
The JSNA will be owned jointly by the Lambeth PCT and London Borough of
Lambeth through the Local Strategic Partnership; and; the Director of Public
Health, Director of Adult and Social Service and Director of Children Services will
be the official sponsors of the project.
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Appendix II
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Customer Focus
Programme
Literature Review
September 2008
Produced by Philippa Hughes
Research and Consultation Team
Quality, Performance and Research
020 7926 2680
phughes@lambeth.gov.uk
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Executive Summary
This literature review has drawn on a variety of sources detailing service
satisfaction and citizens’ perceptions of their customer experience in Lambeth.
These have included the 2007 residents’ survey, BVPI surveys and qualitative
research carried out with residents. A full list of sources is listed in the
bibliography. This review only contains data that was made available and is by
no means exhaustive.
Based on the customer service data available, well-performing services include
parks and open spaces, nursery education, recycling and public transport.
Services where the customer experience needs improving are council housing,
parking, leisure and sports facilities and planning.
Communications at Lambeth are improving and 70% of residents believe
Lambeth are good at keeping them informed which is better than London.
People’s preferred channels of communication are Lambeth Life, information
provided by the council and the website. Service users prefer to get information
relevant to their specific service use through direct letters and would like to be
better informed about what services they are entitled to and how to access them.
People are keen to hear how services are performing and whether they are
keeping their promises. They would like to see balanced, realistic reporting (not
just good news) that shows how money is being spent to tackle important local
issues.
Most people contact the council by telephone (70%) followed by face to face
contact at 13%. Face to face contact increases to 34% for housing tenants.
Whilst happy to use it as a source of information, people have less faith in using
the internet for interactive contact.
It is getting easier to get through to Lambeth on the phone, phones are answered
promptly and staff are perceived to be polite and helpful. However, customers
across service areas are less satisfied with the resolution of their problems. It can
be difficult to speak to the correct person and there is perceived to be a lack of
joined-up working between front and back office staff. Prompt resolution of
problems is an important area of customer service to be addressed.
Half (48%) of Lambeth residents currently feel that they can influence local
decisions which is higher than the London average (43%). There is an appetite
among Lambeth residents to be involved in local decision making with 40% keen
to be involved regardless and 52% dependant on the issue. One in five (20%)
residents have taken part in consultation, an increase from 16% in 2005, but
there is a need for consultation to be meaningful and for honest feedback that
shows how people’s views have been taken into account.
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Recommendations for further research
- At Lambeth Council, we currently have a weak understanding about how
Lambeth residents view the services offered by partnership organisations:
What do people think of their customer experience of Job Centre Plus,
Metropolitan and community police services, health services, the voluntary
and community sector and fire services within the borough? How well do
council services link up with partnership services? How can these services
complement each other and work better together?
- Research has shown that there are two groups of people accessing
services within Lambeth. One group uses a lot of services and require
detailed contact specific to their needs. They like to contact us by phone
or in person. The other group use very few services and may potentially
want less contact. Research could be carried out to determine whether
this is the case and how customer service can best be structured to meet
the needs of heavy and light users of local services.
- There is currently little information available on the views of business
users. It would be interesting to understand their views on the services
they use and how they could be improved.
- Although people see the internet as an important source of information,
there appears to be barriers to using technology interactively for
contacting services, making payments and resolving problems. Further
work could investigate the barriers to interactive contact via the internet.
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Introduction
What is the Citizens’ Focus Programme?
Lambeth Council and its partners want to improve Customer Services and are
committed to developing a shared Customer Focus Programme (CFP) which will
achieve this. There is also a desire to link customer services to our ambitions for
engaging our communities and improving democratic participation as stated in
the corporate plan
Objectives of the strategy
• It will be a strategy for the whole council – not just the customer services
functions
• It will embrace all of our partners – becoming a strategy for Lambeth
public services not simply Lambeth council services – and therefore it will
be located within the LSP rather than the council
• It will respond to the new national agenda for reducing avoidable contact
and personalising services which means it may impact on both the design
and delivery of our services
• It will move beyond seeing people as customers of individual or groups of
services, and address them as citizens with broader rights and interests. It
will therefore look at how we can use our customer services infrastructure
to further our community engagement and democratic objectives. This
may mean we should talk in terms of a citizens’ services strategy.
Research underpinning the Customer Focus Programme
There is a need to identify what we already know about our citizens; what are
their views are about the services offered by the council and partnership
organisations? What are they currently happy with and where do they feel
improvements are needed?
This literature review is part of a four stage research project which will answer
these questions and underpin the development of the CFP. The CFP research
project covers:
1. Literature review.
2. Mosaic analysis of 2007 residents’ survey results.
3. Staff workshops with customer-facing staff
4. Complaints analysis
This literature review will be complemented by analysis of the Lambeth 2007
residents’ survey results by Mosaic categories of respondents. Staff workshops
will also be run with customer-facing staff and complaints will be analysed to
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identify key issues. This initial research will be combined to enable any gaps in
knowledge to be identified. New research will then be commissioned to address
these gaps.
Scope of literature review
There is a wealth of information available about the council and partnership
performance. This report aims to draw together satisfaction data from across all
services with a view to identify key strengths as well as areas for improvement. It
also aims to identify gaps and areas for future research. It is important to
remember that this review focuses on the perceptions of Lambeth’s citizens and
so may not reflect actual service delivery and only contains data that was made
available. It is by no means exhaustive. If you have further data that you would
like included, please contact the Research and Consultation team on 020 7926
2680 or consultation@lambeth.gov.uk
Key findings
How important is customer service?
When compared against issues such as tackling crime and antisocial behaviour,
customer services are rated as less of a spending priority by Lambeth residents.
However, we know from Ipsos MORI research that customer service is a key
driver of overall satisfaction.
Research conducted as part of the 2008/09 budget consultation found that any
customer service cost savings that can be implemented without too much impact
on service delivery would be welcomed by Lambeth residents, including taking a
slightly longer time to answer phones and reducing opening hours of call centres
in less busy times. However, people are against cost saving measures that they
feel will impact on the quality of service delivery. Voice recognition software was
not welcomed and people were critical of any move to relocate the Lambeth
service centre outside of the borough to save costs 73 .
73 Your Lambeth, your money, your opinion. Budget consultation 2008.
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Service delivery
The table below shows the percentage of users who rated services as good to
excellent in the 2007 residents’ survey with the exception of the planning data
which is drawn from the 2006 BVPI survey.
High rated services
Parks and open spaces 71%
Nursery education 70%
Recycling facilities 69%
Public transport 69%
Libraries 69%
Primary education 68%
Low rated services
Activities for young people
31/10% 74
Council housing 33%
Road repairs 35%
Parking 42%
Leisure and sports 42%
Planning 75 43%
Parks and open spaces (+13), street lighting (+8), housing benefit (+5) and public
transport (+4) have all improved since 2005 while planning (-10) 76 refuse
collection (-6) and policing (-5) are perceived to have gotten worse.
Although perceptions of libraries have improved over time in the 2006 BVPI
survey we recorded the lowest score of any borough across London.
Interestingly, more recent and reliable data from the 2007 residents’ survey
shows that libraries are perceived highly by residents who do use them (69%).
There are occasions where service specific data can tell a different story to the
residents’ survey. Four in ten (43%) residents rated the policing in their area as
good to excellent in the residents’ survey, compared to 72% who were very or
fairly satisfied with the way their local area is policed in a 2007 metropolitan
police survey (MPS) 77 . Similarly, the 2006 tenants’ satisfaction survey shows
62% of tenants are very or fairly satisfied with the service, compared with only
33% who rate it as good or excellent in the residents’ survey.
The four main problems identified by respondents to the 2007 MPS survey were
vandalism, graffiti and other deliberate damage to property or vehicles, teenagers
hanging around on the streets, people being drunk or rowdy in public places and
rubbish or litter lying around.
Activities for young people rate the lowest with only 10% of adults and 31% of
young people rating them as good or excellent. So any improvements that can be
74 31% = young people’s view, 10% = adults view.
75 Planning data is taken from the Planning BVPI survey 2006.
76 Planning data is taken from the Planning BVPI survey 2006.
77 Mps public confidence report 2006- 07.
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made to customer services elements would be welcomed and may impact on
perceptions of these services overall.
Residents are also less satisfied with the financial management of the council.
The budget consultation found that only 30% of residents believe that the council
provides good value for money for the council tax they pay and only 17% believe
that Lambeth has good financial management. Satisfaction with these measures
has decreased since 2005 78 . This ties in with the picture painted by the residents’
survey which shows that although Lambeth has maintained its ratings, it
underperforms inner London on five of the six key measures of corporate
performance - Providing good value for money for council tax paid (8 points
lower), doing a good job (8 points lower), being efficient and well run (6 pints
lower), making the area a better place to live (6 points lower) and doing a better
job than one year ago (5 points lower).
Satisfaction with the service offered by the planning service is also decreasing
with satisfaction having dropped ten percentage points between 2003 and 2006.
Six in ten applicants are pleased with the explanation provided for the planning
decision, but 37% believe that the information provided about the progress of
their application has gotten worse, and 46% believe that their application was
dealt with less promptly. These aspects of customer service should be prioritised
for improvement 79 .
The 2007 residents’ survey shows that 61% of Lambeth residents rate local
health services as good or excellent. Research conducted by Lambeth PCT
about GP practices in 2006 80 shows that patients are largely satisfied with and
were complimentary about reception teams, clinicians and the standard of
healthcare that they receive. Patients were less satisfied with the ease of booking
appointments and the length of time they have to wait in the surgery before being
seen (53%), the lowest satisfaction score. Access to a doctor on the phone for
advice remains an issue for many people and has the second lowest level of
satisfaction at 59%. These findings suggest that, across the PCT, patients are
generally less satisfied than they were in 2005, but are in line with 2004 figures.
In 2008 the national survey of local health services surveyed people over the age
of 16 who are registered with a GP. Lambeth is in the best scoring 20% of trusts
for receiving answers from the doctor that patients could understand (scoring
89/100), being kept informed about how long they would have to wait to see a
doctor (34/100), receiving information regarding any potential side effects their
medicine may have (76/100) and receiving copies of letters sent between their
GP and a specialist (62/100). However, Lambeth is in the lowest scoring 20% of
trusts for the length of time patients have to wait to see a doctor (79/100), being
78 Your Lambeth, your money, your opinion. Budget consultation 2008.
79 BVPI Planning Survey 2006.
80 Lambeth PCT General Practice Assessment questionnaire 2006.
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treated with respect by their doctor (95/100) and not receiving enough support to
manage a long term condition (53/100) 81 .
Given resource constraints, it is not possible to improve service delivery and
customer service across all services concurrently. Therefore the CFP should
initially focus on improving the customer service experience of low rated services
– activities for young people, planning, council housing, parking and road repairs.
Contact
The contact people have with the council and its partners has an important
influence on their perceptions of these organisations.
The 2005 residents’ survey showed that just under half of residents (47%) had
contacted the council in the previous 12 months. The most popular reason for
contacting the council was to make a complaint (39%), to apply to use a service
(33%) and to ask for advice or information (32%). The main complaints residents
make are about housing (24%), parking (15%) refuse collection/ recycling (13%)
and council tax (12%) 82 .
Telephone is by far the most popular way to contact the council, in 2005, 69%
used the phone to make a complaint and 74% for other contact. Only 13% of
Lambeth residents reported using face to face contact with the council 83 , but this
is a more popular method for housing tenants (37%) 84 and for people to contact
their local police (40%) 85 .
In 2005 written correspondence including email, accounted for a small
percentage of contact (15%). However, access to the internet in Lambeth is
increasing with just under one in four residents (24%) having no access at all in
2007, a fall of 8% since 2005 86 . Older people and more deprived residents are
less likely to have access or the skills and confidence to use it 87 .
Qualitative research conducted in 2005 shows that while people will use the
internet to find information about the council, there is a reluctance to use this
method for issues where either a response is required or a transaction is needed
to take place. Many people perceive the council to be inefficient and believe their
transaction will not be handled correctly or they will not receive a reply. They
81 National survey of local health services 2008. Healthcare Commission.
82 2005 Residents survey.
83 2005 residents survey
84 STATUS tenants survey 2007
85 mruk Metropolitan Police Survey 2006/07.
86 2007 Residents survey
87 Understanding our residents focus groups 2005.
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would rather speak or visit someone in person 88 . It would be interesting to
explore the extent to which these perceptions are still held given the significant
rise in internet penetration.
Satisfaction with customer services has improved since the opening of the
Lambeth Service Centre which provides the first point of contact for all phone
queries and Lambeth Contact, the first joint service centre for walk-in queries.
Users of both of these are generally satisfied with the service provided.
Customers believed that the phone is answered promptly, it is easy to navigate
the system and the staff are friendly and polite 89 . There is however, a conflict
between satisfaction with resolution of problems. Users of the joint service centre
believed that the staff there were able to successfully resolve their problem
(92%) 90 ; compared with 59% of Lambeth Service Centre users who stated their
problem was not resolved at all 91 .
Prompt resolution of problems or queries was the most important priority for
residents when contacting the council or partners, yet across the majority of
service areas where we have data including housing, LSC customers, council
tax, benefits and Adult and Community Services, the final resolution of a problem
was the area that most people were dissatisfied with. Issues that were perceived
to contribute to the lack of resolution include a lack of joined up working between
front line and back office staff and people not being sure who is the correct
person to contact to resolve a problem.
This lack of prompt resolution of problems needs to be addressed by the Citizens
Focus Programme.
In 2006/07, 10% of borough residents said that they had let the police know their
views on policing, crime or anti-social behaviour compared with less than 0.5% in
2005/06. The most common way that people contacted the police was through
an informal chat with a local officer 92 .
Southwark carried out research in 2007 into the national ‘tell us once’ project.
This aims to enable customers to notify government once of a birth, death or
change of address and overall make contact easier. Overall 72% of respondents
believe that such a service would be helpful compared to only 8% who feel it
wouldn’t be. People see the main benefits as saving them time (18%), saving
them having the same conversations with different organisations (15%) and
being sure that all the relevant parties were informed (14%). However, people do
have concerns about who would have access to their personal information
88 Understanding our residents focus groups 2005.
89 Lambeth Service Centre Customer Satisfaction Survey 2007.
90 Lambeth Contact User Satisfaction Survey 2007.
91 Lambeth Service Centre Customer Satisfaction Survey 2007.
92 MPS public confidence report 2006/07.
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(25%), that their personal data may not be securely stored (17%) and that the
service might not be reliable (16%) 93 .
Communication
IDeA/ MORI research shows that how well informed people are shapes their
opinion of the council and partners and drives overall satisfaction. Therefore in
considering a Customer Focus Programme, it is important to think about how we
communicate with our residents.
The 2007 residents’ survey shows that 70% of Lambeth residents believe that
the council keeps residents informed. This is 6 percentage points higher than the
rest of London at 64% and represents continuous improvement from 2003. This
contrasts with the picture from the BVPI survey which recorded a decline in
satisfaction between 2003/04 and 2005/06 which likely reflects its methodology.
People feel most informed about how to pay bills to the council (88%) and how
and where to register to vote (86%). In contrast around three in four feel
uninformed about what the council is doing to tackle antisocial behaviour in the
local area (80%), whether the council is delivering on its promises (75%) and
how well the council is performing (74%) 94 .
Most people find out information about Lambeth via information provided by the
council (39%). The next most popular methods are local media (19%), the
council website/ internet (17%) and word of mouth (11%) 95 .
Based on research findings, the main source of information provided by the council is
Lambeth Life, a fortnightly newspaper distributed to all homes in the borough. The
publication changed format in January 2008 from a monthly magazine to a fortnightly
newspaper. In October 2007 in its previous format, distribution was good and
satisfaction was fairly high. Three quarters (77%) had received a copy through their door
in the last three months. Of these 74% of people read some or all of it and 65% rated it
as good or excellent 96 . Research is planned to evaluate the success of the new format.
Regardless of format, qualitative research conducted in 2006 found people want to hear
balanced, realistic reporting about how the council is performing, how it spends council
tax money and whether it is keeping its promises. There should be less focus on good
news with people concerned that this is simply council propaganda. The key issue for
residents was that Lambeth Life should demonstrate openness and honesty about what
the Council does to address problems, with whom, and over what timescales 97 .
93
94 BVPI survey 2006.
95 BVPI survey 2006.
96 Lambeth Residents Survey 2007
97 Lambeth Life Research report. December 2006.
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The Lambeth Youth Council consultation project asked young people how they would
like to be kept informed by the council. The top choice was through newsletters or youth
magazines, chosen by 36% of primary school and 37% of secondary school children.
The second most popular choice was through a website chosen by 34% of primary and
36% of secondary children 98 .
Service users, especially within housing and ACS like to get written information
about the services they use and feel that it is important that they are notified
clearly and with notice about any changes 99 .
The Metropolitan Police Service report shows that Lambeth police are good at
keeping people informed. 56% of borough residents said that they felt very or
fairly well informed about what the police in their area had been doing over the
previous year. This is significantly higher than the rest of London at 47% and has
improved when compared to 44% of people in Lambeth in 2005/06 100 . The main
sources of receiving information are local newspapers, television, radio and
national newspapers. Less well disseminated is information about Lambeth Safer
Neighbourhood Teams with only 19% of residents having received information.
However, this is the same percentage as the rest of London. However, the 2007
resident’s survey shows that only 37% feel informed about what is being done to
tackle antisocial behaviour.
Participation
The 2007 Lambeth residents’ survey shows that a third (35%) are satisfied with
opportunities for participation in local decision making compared to 20% who are
dissatisfied. This is in line with the 2006 BVPI survey which shows 31% satisfied
and 26% dissatisfied. Satisfaction is significantly higher in North Lambeth and
Brixton at 48% and 43% respectively and significantly lower in Streatham at 23%.
Just under half (48%) of Lambeth residents feel that they can influence decisions
affecting their local area.
One in five Lambeth residents (20%) had taken part in a consultation in the last
12 months, an increase from 16% in 2005. 101 . There is an appetite for
involvement in Lambeth with 40% of people wanting to be more involved in the
decisions made and 52% wanting to be involved depending on the issue 102 .
However, people strongly believe that consultation needs to be meaningful and
want to see positive action happening from their views. It is vital that honest
feedback is given to participants about the outcomes of consultation and people
98 Lambeth Council Youth Consultation project. April 2007.
99 STATUS tenants survey and ACS satisfaction reports.
100 Source: mruk Metropolitan Police Service Public Attitude Survey 2006/07. June 2007.
101 Lambeth 2007 residents’ survey. January 2008.
102 BVPI survey 2006.
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are shown what has happened as a result of their involvement. This is a key part
of the community engagement strategy – Lambeth Together.
Priorities for particular groups
Different groups within Lambeth have different needs, prioities, and perceptions
of services. It is important to understand the requirements of our diverse
communities in order that we can meet their needs.
Young people
Most of the Council’s services are rated in line with the London-wide average by
young Lambeth residents, with the exception of leisure and sports facilities (-13)
and libraries (-6) which received lower ratings. Lambeth achieved a higher rating
for local health services (+9) among young people.
In 2007, 43% of young people in Lambeth believe that the council keeps them
informed about what is happening. This is similar to 2005 and in line with the rest
of London.
Two in five young people believe that the council listens to the concerns of young
people and 35% believe that young people are involved in decision making.
These are similar results to 2005 and across London. However, younger
residents are less likely to have participated in consultations and surveys than
adults, and fewer report reading Lambeth Life 103 .
Older people
Older residents in Lambeth tend to be more positive on a range of measures.
They are more likely to think the council is doing a good job. Despite the fact they
are more concerned about council tax they rate council tax collection more
positively than average. They also rate a number of other services more
positively including street lighting, refuse collection, recycling and public
transport.
Disabled people
Disabled people are more negative about parking, parks, leisure and arts and
cultural facilities in the borough.
General satisfaction among users of adult and community services is high with
70% of service users with a physical or sensory disability, 63% of home shopping
service users, 84% of elderly home care service users and 78% of home care
service users satisfied with the overall service they receive. The overwhelming
reason that people gave for being satisfied was getting on well with their carer
and their carer doing their job properly 104 .
103 Lambeth 2007 residents’ survey. January 2007.
104 Variety of ACS documents.
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Half of service users with a physical or sensory disability (49%) did not think they
were provided sufficient information by Lambeth in relation to services available
at home compared with 38% who did. People were happy with the leaflets they
received as they were easy to understand and found the staff approachable and
responsive. The biggest complaint was that service users felt that they were not
aware of what services they may be entitled to and how the system works to find
out. Service users also felt that Lambeth was not proactive enough in
communicating with them about changes to their service or their entitlements.
There are also problems with staff answering the phone unable to answer their
enquiry and getting passed around several people before finding someone who
can help. There is also a lack of joined up information and support when people
come out of hospital. Again there is confusion over who should be phoned and
how to get through to the appropriate person.
Seven in ten (70%) of elderly home care users say that they are always or
usually kept informed about changes in their care. There appear to be
discrepancies between the information given by the different home care provider
companies with only one in five (21%) of Care UK users informed compared to
43% of Keratome users.
In 2007, 71% of service users with a physical or sensory disability stated that
they had contacted the council or the care provider about their service; one in
five interviewees (18%) stated that they found it easy or fairly easy to contact
ACS. However, a larger proportion of service users, just under a third (31%)
reported that they found it difficult or fairly difficult. Some respondents were
frustrated following a number of attempts to contact relevant personnel had
failed, staff were unable to deal with their enquiry and there was a sense of being
passed from pillar to post. Half of the respondents did not know which team they
had contacted within ACS.
Information received on how to complain differed across services. 70% of hot
meals service users and elderly home care users and 60% of home shopping
service users said they knew how to complain compared with 35% of service
users with a physical or sensory disability.
Service users with a physical or sensory disability stated that their preferred
method of complaint is by phone.
Council tenants/ more deprived residents
For many tenants the Housing Department is the Council and their views of
Council performance are shaped largely by their experiences of the housing
service 105 .
105 Source: TNS Understanding our Residents. July 2005.
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Although council tenants are less likely to feel the council is doing a good job
they tend to be more positive than average about a range of local services
including nursery, primary, secondary and adult education, street cleaning and
parking. They are also more positive about non-council services like health and
policing. The unemployed are more likely than average to feel that the council
listens to them and council tenants are more likely to feel council staff are friendly
and polite. Council tenants are more satisfied with opportunities for involvement,
are positive about Lambeth Life and are more likely to feel informed about what
is being done to tackle anti-social behaviour. However, there are a number of
issues which need to be addressed with Lambeth’s more deprived residents.
They are more negative about refuse collection and council tax collection and are
less likely to recycle and use the borough’s parks.
Overall satisfaction with the landlord service provided by Lambeth is relatively
low with six in ten tenants (62%) satisfied. This places Lambeth 24 th across
London. However satisfaction is improving and Lambeth shows a strong, above
average rate of improvement (5%) in overall tenants’ satisfaction when compared
with the average for inner London boroughs, improving at 1% 106 . However in
contrast, the residents’ survey shows that users of council housing are less
satisfied in 2007 than 2005, with a decrease of twelve percentage points to 33%.
Repairs and maintenance was the most important service for 79% of Lambeth
tenants and it was used as an illustration of why the Council was seen by tenants
as slow, wasteful and inefficient. Criticisms of the repairs service fall into three
categories: Problems with reporting the problem, the speed of addressing the
problem and the quality of the work carried out to resolve the problem. One in
five comments received through the Lambeth Service Centre users’ survey was
regarding the need to improve the housing repairs service 107 . However
satisfaction levels with repairs in particular are improving showing an
improvement of nine percentage points from 2004 to 2006. The overall quality of
the home is the aspect of housing that tenants believe most needs to be
improved (90%).
Another factor that affects tenants’ satisfaction was the reduction in opening
hours and the closure of neighbourhood housing offices. Tenants complained
about difficulties in accessing their housing officers and of the attitude of some
housing officers 108 .
Seven in ten Lambeth council tenants (71%) believe that the council is good at
keeping them informed, the same proportion as 2005. Only just over one in ten
106 Source: STATUS Tenant Satisfaction Survey 2006.
107 Source: Lambeth Service Centre Customer Satisfaction Survey. Annual Summary Report
2006/07.
108 Source: TNS Understanding our Residents. July 2005.
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(12%) consider the landlord to be poor at keeping them informed. This is a slight
improvement on 2004 results rising from 68% 109 .
The most popular method of contacting Lambeth Housing is via the telephone and over
half (52%) select this as their favoured method. This is followed by nearly four in ten
(37%) who prefer contact in person at the housing office. When asked how they would
like to be contacted regarding their views on decisions affecting their home, three
quarters (75%) of Lambeth tenants state that they prefer to be contacted by letter. The
next most popular methods of contact are telephone at 34% and by home visit at 27% 110 .
Those tenants who had contacted Lambeth Housing in the 12 months prior to the survey
were asked to rate various aspects of their contact. Generally staff are considered to be
helpful and able to deal with problems, although nearly three in ten (29%) indicate staff
were difficult to get hold of. These perceptions may well have improved as a result of the
introduction of the LSC in March 2004. Tenants are less satisfied with the final outcome
of their query, with half (50%) expressing satisfaction compared to nearly four in ten
(38%) expressing dissatisfaction – a pattern consistent with other London Boroughs.
In line with other London boroughs, just under half of all council tenants are
satisfied with the opportunities for participation in decision making (49%).
Tenants do think that their views are taken into account with 49% thinking
Lambeth does so ‘a little’ and 25% ‘a lot.’ Improvements are needed however,
with 85% of tenants believing that taking their views into account needed
improvement. In terms of the avenues through which they could participate,
tenants thought that the format of tenants’ meetings was acceptable, although
were critical about the lack of positive outcomes. Those involved in tenants’
committees or the Tenants’ Council felt that they were time consuming and
unproductive 111 . Improving feedback to these groups about the outcome of their
participation is therefore vital.
Parents
Satisfaction levels are higher for nursery and primary education within Lambeth
with 70% and 68% of users rating them as good or excellent respectively.
Satisfaction decreases for the older education service providers with just over
half satisfied with secondary education (51%) and adult education (55%) within
the borough 112 . Only 22% of all residents think Lambeth secondary education is
good or excellent compared to 34% across London. Positively, satisfaction with
all types of education has improved since 2003 and fewer residents are
concerned about education than in 2005. A focus group with parents conducted
in 2005 found they were pleased with the nursery and primary schools that their
children attended, but became concerned when it was time for them to transfer to
secondary school. Five of the seven parents with children at primary school
stated that improvement to secondary schools in the borough was their top
109 STATUS Tenant Satisfaction Survey 2006.
110 STATUS Tenant Satisfaction Survey. 2006
111 STATUS Tenant Satisfaction Survey 2006.
112 Source: TNS Social Lambeth Residents Survey 2007/08. January 2008.
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priority for improvement. The main problems identified with secondary schools
included lack of choice, lack of communication with parents and schools being
unable to address the problems between pupils 113 .
More affluent residents
On the whole, residents from higher social backgrounds tend to be more satisfied
with the council, with more saying that the Council is doing a good job and rating
contact and engagement positively. In particular, they are more likely to feel the
council delivers value for money, more likely to feel informed, listened to and
involved in decision-making. In terms of specific services those from social class
AB are more positive about council tax collection and parks, and they are more
likely to recycle than others. However, this group are less likely to rate education
services positively and are more likely to identify education as a key concern.
They are also more likely to rate parking, road and pavement repairs, activities
for children and teenagers and leisure facilities poorly (despite the fact that they
actually use leisure services more). Little is known about how these ‘light’ users
of council services would prefer to contact and receive communication from the
council. Although the 2003 residents’ survey indicates that leaflets may be
popular for general communications, further research would be useful to explore
how best to serve the needs of this relatively large group.
New residents to the borough
Those who have lived in the borough for less than two years are more likely to
feel the council is doing a good job, they are also more positive about street
cleaning, street lighting and refuse collection. However, there are some specific
communications and engagement issues which need to be addressed. New
residents are less likely to feel involved in decision making, are less likely to feel
Lambeth council listens to its residents and feel less informed about what is
being done to tackle anti-social behaviour.
Long term residents
Residents who have lived in Lambeth for over five years are less positive about
the council 114 . This was echoed in the ‘understanding our customers’ focus
groups run in 2005 and the 2007 budget consultation where several long term
residents of the borough brought up the issue of trust. For them, reputation was
not just about performance, it was about whether they felt they could trust the
council or not 115 . In many cases this was based on experiences in the distant
past which continue to colour current perceptions.
Ethnic minority residents
The black Caribbean community are more concerned than average about jobs
and rate parks less positively, although they are more positive about adult
113 Source: Understanding our residents. July 2005.
114 Source: TNS Social Lambeth Residents Survey 2007/08. January 2008
115 Understanding our res
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education provision in the borough. In contrast, the black African community is
more positive than the Lambeth norm and tend to rate services well. In particular
street cleaning, nursery, primary and secondary education, libraries and parking
all received higher than average ratings 116 .
Small businesses
Small business owners are concerned about crime. Research carried out by the
Federation for Small Businesses (FSB) in 2004 showed that 57% of small
businesses in London had been a victim of crime in the previous 12 months 117 .
Many of these crimes are not reported to the police because small business
owners feel that ‘it would not achieve anything’ (40%), that the police are unlikely
to catch the perpetrators (27%) and because they do not want to make a claim
against their insurance (22%).Other concerns for small business owners are too
much legislation, red tape and regulations. Owners are dissatisfied with the
complexity (60%) volume (59%) and rate of change (56%) of legislation.
Legislation that was received least positively by owners was higher insurance
premiums and increases in National Insurance contributions 118 .
The FSB also calls for improvements to local government procurement
procedures to benefit small businesses. Suggestions include breaking down
contracts instead of aggregating them, so reducing the need to only purchase
from large suppliers. All contracts should be widely advertised regardless of their
value to encourage more participants to apply and there is a need to make it
easier to understand how to get on approved supplier lists and simplify pre
qualification paperwork.
Small businesses also want affordable town centre parking to enable people to
use their business. They believe there is also a need to standardise parking
across London borough’s provide more information about the offence on the
parking ticket and allow appeals and refunds against unfair tickets.
Recommendations for the CFP to address
• The priority services to focus on to improve the customer experience are:
- Council Housing especially the repairs service
- Parking
- Leisure and Sports facilities
- Planning especially the promptness of resolution and keeping people
informed with the progress of their application.
116 Lambeth residents’ survey 2007.
117 Federation of Small Businesses, Lifting the barriers survey 2004.
118 Federation of Small Businesses, Lifting the barriers survey 2004
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Other issues that the CFP should seek to improve:
• Resolution of problems and issues when people contact the council.
• The way complementary services work well together.
• Information about what services Lambeth and its partners offer and
people’s entitlement to them.
Gaps and further research
We currently have limited information about the following:
- Partnership data about how Lambeth residents view the services offered
by partner organisations. What do people think of their customer
experience of job centre plus, police, health services, voluntary and
community sector and fire service within the borough and how well do
council services link up with these organisations for people who need to
use multiple services? How can these services complement each other
and work better together?
- There are two distinct groups of people accessing services within
Lambeth. One uses a lot of services and want a lot of contact specific to
their needs. They like to contact us by phone or in person. The other
group use very few services and may potentially want less or easier
contact. Research should be carried out to determine whether this is the
case and how customer service can best be structured to meet their
needs.
- There is currently little information available on the views of business
users. It would be interesting to discover their views on the services they
use and how they could be improved.
- Although people see the internet as an important source of information,
there appears to be barriers to using technology interactively for
contacting services. Investigate the barriers to interactive contact via the
internet.
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APPENDIX III
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Glossary
A&E
ACS
AIDS
BME
C&YP
CAA
CAMHS
CHD
CLG
COPD
CPA
CSP
CVD
CYP
DASS
DH
E&W
GLA
GP
GPAQ
GSF
GST
GUM
GSF
HIV
IMD
JSNA
LBL
LTC
MH
MI
NHS
NICE
NSF
ONS
Accident & Emergency
Adult and Community Services
Acquired Immuno-deficiency syndrome
Black & Minority Ethnic
Children & Young People
Comprehensive area assessment
Child & Adolescent Mental Health Services
Coronary Heart Disease
Communities and Local Government
Chronic Obstructive Pulmonary Disease
Care Programme Approach
Commissioning Strategy Plan
Cardio Vascular Disease
Children and Young people
Director of Adult and Social Services
Department of Health
England & Wales
Greater London Authority
General Practitioner
General Practice Assessment Questionnaire
Gold Standards Framework
Guy’s & St Thomas’ NHS Foundation Trust
Genito Urinary Medicine
Gold Standards Framework
Human Immunodeficiency Virus
Index of multiple deprivation
Joint Strategic Needs Assessment
London Borough of Lambeth
Long Term Conditions
Mental Health
Myocardial Infarction
National Health Service
National Institute of Clinical Excellence
National Service Framework
Office for National statistics
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PCT
PEAT
PEC
POPPI
PR
QMAS
QOF
RSH
SCS
SH
SIPs
SLAM
SMI
STIs
TAC
YLL
YLD
Primary Care Trust
Physical Environment Assessment Team
Professional Executive Committee
Projecting Older People’s Population Information system
Public Relations
Quality Management Analysis System
Quality Outcome Framework
Reproductive Sexual Health
Sustainable Community Strategy
Sexual Health
Service Improvement Proformas
South London & Maudsley NHS Foundation Trust
Serious Mental Illness
Sexually Transmitted Infections
Team Around the Child
Years Life Lost
Years Lived with Disability
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