04a JSNA Appendix , item 5. PDF 6 MB - Lambeth Council
04a JSNA Appendix , item 5. PDF 6 MB - Lambeth Council
04a JSNA Appendix , item 5. PDF 6 MB - Lambeth Council
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DRAFT<br />
LONDON BOROUGH OF LA<strong>MB</strong>ETH<br />
JOINT STRATEGIC NEEDS ASSESSMENT<br />
Preliminary assessment<br />
Version 4<br />
<strong>Lambeth</strong> <strong>JSNA</strong> – Preliminary Assessment<br />
Version 4<br />
October 2008<br />
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DRAFT<br />
Version control<br />
Title<br />
<strong>Lambeth</strong> <strong>JSNA</strong> – Preliminary Assessment<br />
Version: Version 4<br />
Author<br />
<strong>Lambeth</strong> PCT and London Borough of <strong>Lambeth</strong><br />
Publication Date: November 2008<br />
Target Audience: PCT CEs, NHS Trust CEs, SHA CEs, Foundation Trust CEs ,<br />
Medical Directors, Emergency Care Leads, Community and<br />
voluntary sector, public.<br />
Description:<br />
<strong>Lambeth</strong> Joint Strategic Needs Assessment – Preliminary<br />
Assessment to be published in November 2008 is the preamble to<br />
the final <strong>JSNA</strong> to be document in June 2009.<br />
Superseded version/docs: Version 1, 2 and 3<br />
Action Required:<br />
Approval from the <strong>JSNA</strong> steering group to publish the preliminary<br />
assessment.<br />
Contact Details:<br />
Ruth Wallis – Director of Public health, <strong>Lambeth</strong> Primary Care<br />
Trust, NHS.<br />
Email - ruth.wallis@lambethpct.nhs.uk<br />
Jo Cleary – Director of Adult and Social Services, London Borough<br />
of <strong>Lambeth</strong><br />
Email - jcleary@lambeth.gov.uk<br />
Phyllis Dunipace – Director of Children and young people services,<br />
London Borough of <strong>Lambeth</strong>.<br />
Email - pdunipace@lambeth.gov.uk<br />
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Foreword<br />
(Director of Children’s Services, Director of Adult and Community Services, Director of Public Health)<br />
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Contents<br />
No. Item Page No.<br />
1. Introduction 5<br />
2. Overview 13<br />
3. Demographics 14<br />
4. Health of <strong>Lambeth</strong> residents 32<br />
<strong>5.</strong> Economic development 49<br />
6. Children and young people 61<br />
7. Community safety 77<br />
8. Consultation with stakeholders 88<br />
9. Review of needs assessments 94<br />
10. <strong>Lambeth</strong> priorities 103<br />
11. Sustainable community strategy priorities 118<br />
<strong>Appendix</strong> I <strong>JSNA</strong> project plan 120<br />
<strong>Appendix</strong> II Customer focus – Literature review 133<br />
<strong>Appendix</strong> III Glossary 154<br />
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1. Introduction<br />
The concept of Joint Strategic Needs Assessment (<strong>JSNA</strong>) was introduced in the<br />
Department of Health’s (DH) Commissioning Framework for Health and well-being<br />
document published in March 2007. The Local Government and Public<br />
Involvement in Health Act (2007) [Clause 116] places a duty on upper tier local<br />
authorities and Primary Care Trusts (PCT) to undertake a Joint Strategic Needs<br />
Assessment (<strong>JSNA</strong>). This provision came into force in April 2008. The Director of<br />
Public Health, Director of Adult Social Services and Director of Children’s Services<br />
are jointly expected to take a lead in producing a strategic needs assessment<br />
through strong partnership.<br />
The DH describes <strong>JSNA</strong> as ‘a systematic method for reviewing the health and wellbeing<br />
needs of a population, leading to agreed commissioning priorities that will<br />
improve health and well-being outcomes and reduce inequalities. The <strong>JSNA</strong> is<br />
expected to “describe the future health care and well-being needs of local<br />
population and the strategic direction of service delivery to help meet those needs”.<br />
A key element of <strong>JSNA</strong> is that it should involve all the important stakeholders in<br />
identifying needs and take appropriate actions to address those. The assessment<br />
process is expected to make use of existing information, identify gaps, actively<br />
engage stakeholders including patients and public for their views, understand local<br />
service provision; and most importantly, the outputs or findings be translated into<br />
actions for the commissioning and delivery of health and social care services,<br />
health improvement and well-being programmes and interventions.<br />
The World Class Commissioning competencies emphasise the role of <strong>JSNA</strong> in<br />
driving the long term commissioning strategies of PCTs and their collaborative<br />
work with community partners including public and patient engagement. The <strong>JSNA</strong><br />
is envisioned as a dynamic process periodically updated and is expected to<br />
contribute immensely as a key tool to achieve a shift towards commissioning to<br />
improve health and well-being outcomes and reduce inequalities.<br />
This document reviews the demography and health profile of <strong>Lambeth</strong> residents<br />
and attempts to identify the health inequalities in terms of the wider determinants of<br />
health and well-being with due regard to the health and well-being outcomes. This<br />
document will identify priorities based on the current health and well-being status of<br />
<strong>Lambeth</strong> residents and review of existing needs assessments conducted. However<br />
provision of recommendations will follow consultations with stakeholder, mapping<br />
and understanding local services and review of evidence of effectiveness of<br />
interventions.<br />
At present like in other boroughs, <strong>Lambeth</strong> PCT and the London Borough of<br />
<strong>Lambeth</strong> have set priorities which have been highlighted through the PCT’s<br />
Commissioning Strategy Plan 2007-2012 and the council’s Sustainable Community<br />
Strategy for 2008-2020. The <strong>JSNA</strong> will focus on prioritisation and joint<br />
commissioning for the next three years and we foresee this process to be a<br />
dynamic one where the outputs from the <strong>JSNA</strong> will inform the commissioning (and<br />
joint commissioning) cycle continuously and regularly starting 2008-09 and<br />
continuing for the next three years.<br />
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National policies<br />
The Department of Health’s (DH) Commissioning Framework for Health and wellbeing<br />
document published in March 2007 set out the concept of <strong>JSNA</strong>. There are<br />
three recent national documents that are most relevant to the development of this<br />
Commissioning Strategy:<br />
1. Our Health, Our Care, Our Say.<br />
2. Choosing Health.<br />
3. Commissioning for Health and Well-being.<br />
All are available in full on the Department of Health website. In addition there<br />
is a very wide range of guidance and technology appraisals from the National<br />
Institute of Clinical Excellence (NICE).<br />
Finally, this section briefly considers the national health targets set by the<br />
Healthcare Commission against which PCT performance is measured.<br />
Our Health, Our Care, Our Say<br />
The White Paper on community services, ‘Our Health, Our Care, Our Say,’ emphasised<br />
the importance of good commissioning in providing integrated services, building on good<br />
local partnerships. The White Paper stated that NHS commissioners should commission<br />
for ‘health and well-being’ to ensure that health improvement is at the heart of the<br />
commissioning process. This 2006 White Paper aims to set a new direction for the<br />
health and social care system, changing the way services are delivered so that<br />
they are more ‘personalised’ and give people a ‘stronger voice so the they are the<br />
major drivers of service improvement’.<br />
It aims to achieve this by a focus on providing better, higher quality care,<br />
providing an improved patient experience and providing better value for<br />
money. In doing so, particular emphasis is placed on:<br />
- Enabling better health and well-being.<br />
- Better access to General Practice and community services.<br />
- Support for people with longer-term needs.<br />
- Delivering care and services closer to home.<br />
The paper also highlights:<br />
- The importance of Practice Based Commissioning as a way of driving<br />
up quality, choice and value for money.<br />
- Encouraging innovation by greater patient and user choices.<br />
- Allowing different providers to compete for services.<br />
Choosing Health – Making Healthy Choices Easier<br />
This 2006 White Paper proposes improving health and health inequalities by<br />
supporting people to make healthy lifestyle decisions. There is a particular<br />
focus on protecting children and young people’s health. The paper has a<br />
number of chapters outlining how this is to be achieved, encompassing:<br />
- Children & Young People – starting on the right path.<br />
- Local communities leading for health.<br />
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- Health as a way of life.<br />
- A health-promoting NHS.<br />
- Work & health.<br />
Commissioning Framework for Health & Well being<br />
Central government has stated a clear intention to shift the focus of healthcare from<br />
treating sick people towards prevention and supporting well-being, not least to enable NHS<br />
funds to be spent on non- NHS services that have a preventive benefit for the NHS.<br />
This 2007 Commissioning Framework is designed to help commissioners<br />
achieve the overall objective of improving health and well-being, with the aim<br />
of looking further than just physical health problems in promoting well-being,<br />
to include issues such as social care, work and housing. The Framework<br />
proposes the following key actions:<br />
- A shift towards services that are personal, sensitive to individual need<br />
and that maintain independence and dignity.<br />
- A strategic reorientation towards promoting health and well being,<br />
investing now to reduce future ill health costs.<br />
- A stronger focus on commissioning service and interventions that will<br />
achieve better health, across health and local government with<br />
everyone working together to promote inclusion and tackle health<br />
inequalities.<br />
The aim is a move to look further than just physical health problems, to<br />
promoting well-being, which includes social care, work and housing.<br />
NICE Guidance<br />
The National Institute of Clinical Excellence (NICE) produces a wide range of<br />
well-researched clinical guidance and technology appraisals. The full details<br />
of these are available on the NICE website. <strong>Lambeth</strong> PCT’s has found NICE<br />
recommendations to be a very helpful tool in driving up quality and clinical<br />
outcomes on a consistent basis across providers.<br />
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<strong>Lambeth</strong> PCT Commissioning Strategy Plan – 2007-2012<br />
The PCT has identified its commissioning priorities for the next five years.<br />
The three historic priority areas mentioned under this paragraph have benefited<br />
hugely from the focus they have received and there is widespread confidence in<br />
the strategies that are currently in place to deliver improved outcomes and reduced<br />
inequalities in both the short and long term. However, for each of these priorities,<br />
there were particular areas that it was considered would benefit from further work<br />
over the next five years:<br />
Children & Young People - pre-natal to under 5s<br />
Sexual Health - health promotion, prevention & screening<br />
Long Term Conditions – co morbidities and acute conditions<br />
There was strong consensus that there were three new priorities emerging that the<br />
PCT would increasingly like to put more focus on in the next five years:<br />
1. Staying Healthy<br />
Focused specifically on increasing investment over the strategic period in<br />
health promotion and prevention activity and in doing so on addressing<br />
key health risk factors in <strong>Lambeth</strong> such as smoking, obesity, alcohol and<br />
drug abuse.<br />
2. Mental Health<br />
The PCT is a clear outlier in terms of prevalence of serious mental illness<br />
despite the fact it is also an outlier on how much it spends on mental<br />
health services. It was considered that current care pathways are complex<br />
and difficult for both users and professional to navigate through.<br />
3. End of Life Care<br />
This represents an area where there is significant scope for service<br />
redesign and the development of more responsive and better quality<br />
models of care with greater choice for patients.<br />
The PCT has completed work to develop draft-commissioning intentions for each<br />
for each of these six areas, plus the other key areas of commissioning work. In<br />
addition the PCT has considered further the implications of implementing the<br />
proposed commissioning intentions on primary and community services, as many<br />
of the proposals include a focus on shifting services from hospital-based settings to<br />
community-based settings.<br />
In summary, in developing this 5 year Commissioning Strategy, <strong>Lambeth</strong> PCT has<br />
identified these key areas of work over the next five years:<br />
1. Children & Young People Current priorities to be<br />
2. Sexual Health‘ phased out’ over<br />
3. Long Term Conditions the next 3 years<br />
4. Staying Healthy New local priorities<br />
<strong>5.</strong> Mental Health to be ‘phased in’<br />
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6. End of Life Care over the next 5 years<br />
a) Planned Care<br />
b) Unplanned Care Other key areas<br />
c) Primary Care and Community Services areas for commissioning<br />
d) Older People<br />
e) Learning Disabilities<br />
f) Physical Disabilities<br />
g) Substance Misuse<br />
h) Prison Health<br />
Although the initial three priority areas are described as ‘phased out’ after three<br />
years, this certainly does not mean work in these areas will cease after this time. It<br />
simply highlights the PCT’s expectation that it will have developed comprehensive<br />
and robust plans and strategies for these areas within this period. Therefore, by the<br />
end of three years, the focus will move from planning to the on going<br />
implementation of strategies that will improve services and outcomes in Children<br />
and Young People, Sexual Health Long and Term Conditions.<br />
The <strong>Lambeth</strong> <strong>JSNA</strong> will incorporate the needs assessment conducted to<br />
understand the priorities in <strong>Lambeth</strong> while continuing the work on identifying unmet<br />
needs of the population of <strong>Lambeth</strong>.<br />
The PCT has also refreshed the Commissioning Strategy Plan for 2008/09 and<br />
details are included in the recommendations section towards the end of the<br />
document.<br />
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<strong>Lambeth</strong> Sustainable Community Strategy – 2008-2020<br />
The London Borough of <strong>Lambeth</strong> recently published its Sustainable Community Strategy<br />
following work done to understand the ‘State of the Borough’ with the main focus emerging<br />
as ‘Worklessness’. It’s a relatively new term which describes people who are out of work<br />
but who want a job. It includes people claiming unemployment benefits, people not<br />
currently working who are seeking employment and those who are economically inactive.<br />
This strategic priority was based on evidence that employment and health – physical or<br />
mental – have a close association as employment is one of the wider determinants of<br />
health and well-being of an individual. If we’re genuinely committed to tackling<br />
worklessness we have to first acknowledge the complex and inter-related issues which<br />
come with it and understand that a sustainable community is one which focuses on the<br />
economic, social and environmental wellbeing of its residents.<br />
We know that worklessness is one of the key causes of crime, poverty and social<br />
exclusion. These challenges often lead to lower than average skills/educational attainment,<br />
poor health and poor living environments. Clearly there is a cycle in motion which can only<br />
be addressed head-on and as a whole. This strategy encompasses an approach that looks<br />
at individual as well as at community level.<br />
It is believed that in <strong>Lambeth</strong>, tackling worklessness by increasing employment will:<br />
• Provide greater financial resources so people can live healthier lives<br />
• Reduce poverty through improved family incomes<br />
• Break benefit dependency<br />
• Facilitate workplace interaction of people from different communities which will<br />
promote community cohesion<br />
• Improve living standards which will reduce people’s incentive to commit some types<br />
of crime<br />
• Enable vulnerable communities to become economically active through targeted<br />
support services/projects<br />
• Allow access to better skills and education for all residents<br />
• Facilitate better family support services for single parents to become economically<br />
active<br />
This strategy also sets out how we will tackle the wider economic, social and<br />
environmental issues associated with worklessness to achieve a thriving and prosperous<br />
borough. The strategy is devised using the following outcomes to create a sustainable<br />
borough:<br />
Economic Wellbeing<br />
- Outcome 1: <strong>Lambeth</strong> is a great place to do business with higher levels of<br />
investment and business growth<br />
- Outcome 2: Greater wellbeing for households through higher numbers of residents<br />
in employment<br />
Social Wellbeing<br />
- Outcome 3: Children and young people are on the path to success through the<br />
provision of good quality education, training and jobs which reduces the risk of<br />
exclusion and offending.<br />
- Outcome 4: Empowered, safe and cohesive places where people have the<br />
confidence to play active roles in their communities<br />
- Outcome 5: Improved health and wellbeing of people which enables them to live<br />
active and independent lives<br />
- Outcome 6: Lower levels of poverty and social exclusion in <strong>Lambeth</strong> by helping<br />
more of our socially excluded adults in employment, education and training<br />
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<strong>Lambeth</strong> Local Area Agreement 2008-2011<br />
London Borough of <strong>Lambeth</strong> is a diverse and multicultural borough which benefits from<br />
integrated and cohesive communities. In recent years <strong>Lambeth</strong> has seen rapid<br />
improvements to key services which have, in turn, helped to improve the quality of life for<br />
all people in the borough. Throughout the life of our previous Community Strategy we saw<br />
crime within the borough fall, educational attainment rise and more young people<br />
accessing employment and training. These are just some of the success stories <strong>Lambeth</strong><br />
can be proud of. However, <strong>Lambeth</strong> First knows that many challenges remain and that<br />
only by working together can the borough tackle the causes of the challenges faced by the<br />
people living and working in our town centres and communities.<br />
In the Sustainable Community Strategy (SCS) and its medium term action plan in the Local<br />
Area Agreement (LAA), <strong>Lambeth</strong> First has recognised that the only way to tackle the<br />
challenges facing our communities is to target the causes of problems rather than the<br />
effects. Through the development of this strategy the partnership has recognised that the<br />
overarching focus should be to tackle worklessness within the borough.<br />
Worklessness lies at the heart of the causes of poverty and exclusion and these in turn are<br />
linked to poor health, poor education standards, low aspirations, higher crime and weaker<br />
communities that are less integrated and cohesive. Tackling the barriers to worklessness<br />
will require improvements across a wide range of policy areas, including health and older<br />
people, education, community safety, the local economy, creating strong communities and<br />
improvements to the built environment.<br />
The outlook for the borough is very optimistic in terms of our ability to delivery the<br />
outcomes in the SCS and performance improvements against LAA indicators. The LSP<br />
itself is significantly more focused on delivery than ever before and shows a real<br />
commitment to achieving results together. This is manifested in the significant investment<br />
of senior management and leadership time in the design of the SCS/LAA, in the<br />
demonstrable ability to prioritise and in the new structures being established to manage<br />
and monitor delivery.<br />
There has been a marked improvement in the general level of confidence in statutory and<br />
other service providers in the borough in recent months. The PCT recently topped an<br />
IPSOS/MORI survey of patients’ recent experience of healthcare in their area. A key<br />
voluntary sector provider, the <strong>Lambeth</strong> Voluntary Action <strong>Council</strong> (LVAC) has been<br />
shortlisted for a grant of £500,000 to establish a volunteers centre. Meanwhile the <strong>Council</strong><br />
was awarded a 3-star rating by the Audit Commission in February this year and judged the<br />
strongest improving borough in London. This included plaudits on our use of resources.<br />
The <strong>Lambeth</strong> LAA indicators and target setting for the next three years has now been<br />
finalised. 35 indicators plus 18 for children and young people were proposed and agreed.<br />
through a lengthy process of negotiation within the partnership and with GOL (Government<br />
office for London). A dedicated LAA Task and Finish group was established for a crosscutting<br />
approach to selection of indicators that best reflect the partnership’s priorities as set<br />
out in the SCS. This group was chaired by the Borough Commander, Sharon Rowe, and<br />
made up of service leads from across the partnership. The first cut of indicators<br />
emanating from this group generated a lot of discussion within GOL about how best to<br />
reconcile central government’s needs in terms of achieving PSAs with local priorities. With<br />
GOL’s support, the LSP board was able to agree a basket of indicators that was broadly<br />
acceptable to, and supported by, GOL.<br />
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In addition to the 35 national indicators the partnership is considering inclusion of a small<br />
number of local indicators around parenting, volunteering, fuel poverty and<br />
street/environmental cleanliness.<br />
The <strong>Lambeth</strong> <strong>JSNA</strong> will aid in influencing the refresh of the Sustainable Community<br />
Strategy and consequently the future LAAs.<br />
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LA<strong>MB</strong>ETH JOINT STRATEGIC NEEDS ASSESSMENT<br />
Preliminary Assessment 2008<br />
2. Overview<br />
This Preliminary Assessment is the first step in the development of a <strong>JSNA</strong> for the<br />
borough of <strong>Lambeth</strong>. The assessment is underpinned by a provisional framework<br />
of Health and Wellbeing outcomes derived from those already defined within the<br />
statutory frameworks for Every Child Matters, Supporting People and CSCI Adult<br />
Social Care service provision. The information has been gathered through the<br />
<strong>JSNA</strong> Primary dataset which includes analysis and interpretation of various<br />
indicators.<br />
In this first phase, available information on needs across <strong>Lambeth</strong> has been<br />
mapped against this framework to illustrate the current status of each outcome in<br />
the borough and to highlight any readily identified inequalities. Alignment with<br />
national priorities as set out in the National Indicator set has been clarified through<br />
provisional mapping of the indicators to the framework. Finally, capture of details of<br />
related, local priority actions has begun to show how work already underway<br />
through current strategies and plans is contributing to achievement of the<br />
outcomes.<br />
The next stage of investigative work will be driven by commissioners from across<br />
the partnership. They will help to narrow the focus of the assessment by<br />
recommending areas which merit detailed review of the effectiveness of existing<br />
service provision. In parallel with this, assessment of market capacity (including<br />
skills base) of the borough will take place to identify any capacity building or<br />
workforce planning implications for future service delivery.<br />
Further work on the provisional health and wellbeing outcome framework is already<br />
underway to refine it in partnership with patients, service users and community and<br />
voluntary organisations. Stakeholder engagement is simultaneously being taken<br />
forward and it is hoped that the newly formed <strong>Lambeth</strong> LINk (Local Involvement<br />
Nerwork) will help to take this aspect forward.<br />
In view of the magnanimity of the task and provisional time table for delivery of<br />
elements of <strong>JSNA</strong>, it has been identified that gap analysis is crucial to having<br />
agreement of strategic recommendations jointly. This will require agreement on<br />
methodology of the <strong>JSNA</strong> so that it can be applied to areas of need. The <strong>JSNA</strong><br />
methodology is being drafted which will offer a systematic method for reviewing the<br />
issues related to health and well-being faced by the local population leading to<br />
identification of met and unmet needs. This will then be applied to gap areas which<br />
will inform the next refresh of the Sustainable Community Strategy, due for 2011.<br />
The project plan sets out the provisional milestones to achieve this. It should be<br />
noted that a <strong>JSNA</strong> is a dynamic process and will follow parallel to commissioning<br />
cycles. The following chapters provide a profile of health and social care in<br />
<strong>Lambeth</strong>.<br />
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3. Demography of <strong>Lambeth</strong><br />
Demographics<br />
<strong>Lambeth</strong> has the largest population compared to all the inner London boroughs. It<br />
is also one of the densely populated areas in the country with the fifth highest<br />
density in the UK. <strong>Lambeth</strong> has a highly mobile and ethnically diverse population.<br />
Over 60% of <strong>Lambeth</strong>’s population are not of UK origin and over 150 languages<br />
are spoken across the borough. The public health findings show that, on average,<br />
the population of <strong>Lambeth</strong> has performed worse of several health indicators than<br />
the rest of London or UK as a whole.<br />
The estimated resident population of <strong>Lambeth</strong> is 271,950 (Office for National<br />
Statistics, 2006 mid-year estimates (MYE)). The Greater London Authority (GLA)<br />
2007 round interim projections (RIP) for population estimate for <strong>Lambeth</strong> for 2008<br />
is 285,580. The general practice (GP) registered population in <strong>Lambeth</strong> is 361,680<br />
(Apr, 2008) as seen in the graph below.<br />
<strong>Lambeth</strong> Population estimates<br />
400000<br />
350000<br />
361680<br />
300000<br />
271950<br />
285580<br />
250000<br />
200000<br />
ONS - MYE 2006<br />
GLA 2007 RIP estimates<br />
GP registered (Apr 2008)<br />
150000<br />
100000<br />
50000<br />
0<br />
ONS - MYE<br />
2006<br />
GLA 2007 RIP<br />
estimates<br />
GP registered<br />
(Apr 2008)<br />
The population make up shows approximately 52% within the age group 20-44<br />
years showing a high proportion of young employable adults within the borough as<br />
seen in the population pyramid below. The population estimates are derived from<br />
the GLA 2007 Round interim projections for <strong>Lambeth</strong>.<br />
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Population - Mid Year Estimate 2007<br />
20-44 age group = 52%<br />
Age Bands<br />
85+<br />
80-84<br />
75-79<br />
70-74<br />
65-69<br />
60-64<br />
55-59<br />
50-54<br />
45-49<br />
40-44<br />
35-39<br />
30-34<br />
25-29<br />
20-24<br />
15-19<br />
10-14<br />
5-9<br />
0-4<br />
Females<br />
Males<br />
15 12 9 6 3 0 3 6 9 12 15<br />
percent<br />
The Greater London Authority’s (GLA) Data Management and Analysis Group<br />
(DMAG) released population projections for every local authority, borough and<br />
district within the UK were used in calculations. The GLA 2007 demographic<br />
projections use the structural results from the CLG (Communities and Local<br />
Government) based household projections. GLA offers borough level projections<br />
with inputs on fertility, future survival, migrations and uses updated estimates of<br />
recently completed development, the latest local trends in fertility and mortality and<br />
the latest data on migration affecting London. GLA incorporates ONS (Office for<br />
National Statistics) estimates and ONS national labour force projections, for<br />
population projection. The estimates projected by GLA have been used to<br />
understand the demographic change in the <strong>Lambeth</strong> population over the next five<br />
years and beyond.<br />
The following graph compares the ONS, GLA and GP registered population in<br />
different age-groups in <strong>Lambeth</strong>.<br />
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number<br />
Population of <strong>Lambeth</strong> Age-Specific<br />
45,000<br />
40,000<br />
35,000<br />
ONS GLA GP List<br />
30,000<br />
25,000<br />
20,000<br />
15,000<br />
10,000<br />
5,000<br />
0<br />
0-4<br />
5-9<br />
10-14<br />
15-19<br />
20-24<br />
25-29<br />
30-34<br />
35-39<br />
40-44<br />
Source: National Statistics; GLA 2007Round Ward Population Projections<br />
45-49<br />
50-54<br />
55-59<br />
60-64<br />
65-69<br />
70-74<br />
75-79<br />
80-84<br />
85-Plus<br />
Age<br />
According to GLA 2007 round interim projections, the population in <strong>Lambeth</strong> is<br />
expected to rise from 285,580 in 2007 to 295,505 by 2014 - a rise of 11,626 as<br />
seen in the table and graph below.<br />
<strong>Lambeth</strong> population projections (GLA)<br />
Males Females Persons<br />
2005 139420 141487 280907<br />
2006 140204 142834 283038<br />
2007 140336 143543 283879<br />
2008 140924 144656 285580<br />
2009 141533 145734 287267<br />
2010 142157 146784 288941<br />
2011 142790 147812 290602<br />
2012 143465 148849 292314<br />
2013 144100 149816 293915<br />
2014 144739 150765 295505<br />
Source: GLA 2007 RIP projections<br />
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<strong>Lambeth</strong> Population Projection - Source: GLA 2007 RIP<br />
350,000<br />
300,000<br />
250,000<br />
200,000<br />
150,000<br />
100,000<br />
<strong>Lambeth</strong> population estimates<br />
Males<br />
<strong>Lambeth</strong> population estimates<br />
Females<br />
<strong>Lambeth</strong> population estimates<br />
GLA 2007 RIP projections<br />
50,000<br />
0<br />
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014<br />
<strong>Lambeth</strong>'s population is ethnically diverse with the BME community accounting for<br />
35% of the total population. Of this ethnically diverse population, black Caribbean<br />
and black African communities form the majority accounting for 26% of the total<br />
Black and Minority Ethnic (BME) population as shown in the graph below.<br />
% Black and Minority Ethnic Communities in <strong>Lambeth</strong><br />
Population - 2007 estimates<br />
12.0%<br />
11.5%<br />
10.0%<br />
9.8%<br />
% Population<br />
8.0%<br />
6.0%<br />
4.0%<br />
2.0%<br />
4.7%<br />
1.6%<br />
0.9% 0.9% 1.1% 1.8%<br />
2.7%<br />
0.0%<br />
Black Caribbean<br />
Black African<br />
Black Other<br />
Indian<br />
Pakistani<br />
Bangladeshi<br />
Chinese<br />
Other Asian<br />
Other<br />
Ethnic background<br />
Ethnic group projections from GLA suggest that the Black Caribbean group in<br />
<strong>Lambeth</strong> is likely to decrease by 2% of the total population in the next 25 years,<br />
compared to an increase in the Black African population by 15% and in the Asian<br />
population by 26%. These projections are based on the Census ethnic complexity<br />
of <strong>Lambeth</strong>’s communities and this pattern is not expected to change during the<br />
period 2008-2033.<br />
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Population Projection by Ethnicity, 2006 to 2021<br />
40,000<br />
35,000<br />
Number of people<br />
30,000<br />
25,000<br />
20,000<br />
15,000<br />
10,000<br />
5,000<br />
0<br />
Black<br />
Caribbean<br />
Black<br />
African<br />
Black Other Indian Pakistani Bangladeshi Chinese Other Asian Other<br />
2006 31,589 33,233 14,057 4,738 2,607 2,402 3,349 4,679 7,765<br />
2026 29,239 38,354 16,138 4,521 2,784 2,940 3,969 6,009 11,060<br />
Source:GLA 2005 Round Interim Ethnic Group Projections<br />
GLA projections suggest <strong>Lambeth</strong> is to remain a young borough, with most<br />
increases within ethnic groups occurring in the 0-19 and 20-44 year old age<br />
ranges.<br />
It should be noted that these are long-term projections on ethnicity and there are<br />
social and political factors such as change in immigration laws, cultural balance;<br />
that can influence change in the ethnicity within the population over a period of time<br />
in any given area or region.<br />
<strong>Lambeth</strong> is one of the most densely populated boroughs in the country with a<br />
rapidly growing population that is projected to grow by 15% over the next 20 years.<br />
In 2006, the density (measured in terms of people occupancy per square kilometre)<br />
in <strong>Lambeth</strong> shows an increase compared with 2005 by 77 people per Sq. Km<br />
almost similar to that of London.<br />
People per Sq<br />
Km<br />
Area (Sq Km) MYE<br />
England 130281 50,726,382 389<br />
London 1572 7,512,372 4779<br />
<strong>Lambeth</strong> 27 271,950 10072<br />
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Population Density<br />
People per square km<br />
12000<br />
10000<br />
8000<br />
6000<br />
4000<br />
2000<br />
0<br />
10072<br />
4779<br />
389<br />
England London <strong>Lambeth</strong><br />
The 2007 Index of Multiple Deprivation (IMD) places <strong>Lambeth</strong> as the 5th<br />
most deprived borough in London and 19th most deprived in England.<br />
Poverty and social exclusion are some of the social challenges in the<br />
borough.<br />
15<br />
10<br />
5<br />
0<br />
-5<br />
-10<br />
-15<br />
-20<br />
-25<br />
-30<br />
-35<br />
-40<br />
Changes in Deprivation ranking <strong>Lambeth</strong> and<br />
Comparable LAs<br />
-35<br />
-3<br />
3<br />
-13<br />
-18<br />
-5<br />
8<br />
Brent<br />
Hackney<br />
Haringey<br />
<strong>Lambeth</strong><br />
Lewisham<br />
Newham<br />
Southwark<br />
Local<br />
authority<br />
Score<br />
2007 Rank<br />
Score<br />
2004 Rank Change Status<br />
Brent 29.22 53 24.85 88 -35 Worsening<br />
Hackney 46.10 2 42.90 5 -3 Worsening<br />
Haringey 3<strong>5.</strong>73 18 36.11 15 3 Improving<br />
<strong>Lambeth</strong> 34.94 19 32.21 32 -13 Worsening<br />
Lewisham 31.04 39 28.43 57 -18 Worsening<br />
Newham 42.95 6 39.33 11 -5 Worsening<br />
Southwark 33.33 26 34.74 18 8 Improving<br />
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The above table describes the relative change in deprivation indices for the London<br />
cosmopolitan boroughs. It is notable that <strong>Lambeth</strong> is now the 5th most deprived<br />
borough in London. <strong>Lambeth</strong> has 177 super output areas (SOA’s) - with roughly<br />
1,500 residents. In 2007, 26 (14.7%) of these were in the 10% most deprived in the<br />
country compared to 20 (11.3%) in 2004. Overall the most deprived are the areas<br />
of Coldharbour between, roughly, Railton Road and the Moorlands Estate; the<br />
Crown Lane area of Knights Hill ward and the Angell Town Estate in Coldharbour.<br />
Mobility<br />
There is relatively high mobility within the <strong>Lambeth</strong> population compared to inner<br />
London boroughs. There appears to be high mobility both in the internal as well as<br />
international migration. Statistics show the net inflow of over 8.5% and a net<br />
outflow of over 10%. Economic advantage and cosmopolitan nature of <strong>Lambeth</strong><br />
makes its population very mobile. It should be noted that this has a predominant<br />
influence on measuring impact of health interventions on the local population over<br />
a period of time.<br />
Migration<br />
12.0%<br />
Internal Migration in <strong>Lambeth</strong> 2006-07 ONS publication<br />
10.0%<br />
8.0%<br />
6.0%<br />
4.0%<br />
2.0%<br />
0.0%<br />
-2.0%<br />
-4.0%<br />
-6.0%<br />
-8.0%<br />
-10.0%<br />
-12.0%<br />
Wandsworth<br />
<strong>Lambeth</strong><br />
Southwark<br />
Newham<br />
Haringey<br />
Lewisham<br />
Internal migration (Inflow and Outflow) in <strong>Lambeth</strong> expressed as a percentage of<br />
population 2006-07<br />
Camden<br />
Westminster<br />
Islington<br />
Tower Hamlets<br />
Hackney<br />
Hammersmith and<br />
Fulham<br />
Kensington and<br />
Chelsea<br />
Internal migration % In<br />
Internal migration % out<br />
How many people live in <strong>Lambeth</strong>?<br />
STATUS<br />
• The latest mid-year population estimate (2006) from the Office for National<br />
Statistics is almost 272,000 people. This gives <strong>Lambeth</strong> the second highest<br />
population in Inner London, after Wandsworth (279,000), and 7th largest in<br />
Greater London.<br />
• The GLA 2007 population projections differ slightly, putting <strong>Lambeth</strong>’s<br />
population at 285,580 in 2008.<br />
• The population registered with GPs in <strong>Lambeth</strong> is 343,600 (Dec 2007). This<br />
is likely to be an overcount of <strong>Lambeth</strong> residents since it includes people<br />
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living in other boroughs but within the surgery catchment areas and people<br />
who have moved but not informed their doctors.<br />
PROJECTED CHANGES<br />
• ONS project total <strong>Lambeth</strong> population as 279,500 by 2028, a 5% increase<br />
on 2008.<br />
• GLA figures project the total population in <strong>Lambeth</strong> by 2028 as 322,300<br />
people. This is an increase of 12.9% on 2008.<br />
What is the male/female ratio of people in <strong>Lambeth</strong>?<br />
STATUS<br />
• According to the 2001 census, the gender split in <strong>Lambeth</strong> of 49% male and<br />
51% female reflects that of London and the country more broadly.<br />
PROJECTED CHANGES<br />
• There is no agreement on the predicted ratio. The GLA population<br />
projections predict that the female population of the borough will increase to<br />
52% by 2028 while the ONS projections show the opposite proportions (with<br />
males representing 52% and females 48%).<br />
What ages are the people of <strong>Lambeth</strong>?<br />
STATUS<br />
• Almost half (45%) of <strong>Lambeth</strong>’s population is aged between 20 and 39<br />
years, compared with just over a third (36%) for London and three in ten<br />
(28%) nationally 1 .<br />
• Approximately one in five of <strong>Lambeth</strong>’s population are aged 19 or under<br />
(59,711 or 21.9%). Of these, a third (19,455) are aged 0-4 years. (2006 Mid<br />
Year Estimate)<br />
• <strong>Lambeth</strong> has one of the highest teenage populations of the Inner London<br />
boroughs (18,522 13-19 year olds).<br />
• Older People aged 65 and over account for just 1 in 10 residents, a smaller<br />
proportion than elsewhere.<br />
PROJECTED CHANGES<br />
• Both the GLA and ONS population projections predict a substantial increase<br />
of around 50% in the number of 50-69 year olds by 2028.<br />
• The ONS figures predict that by 2028, the 0-30 year old population will have<br />
dropped below 2003 figures. The GLA figures also project a 5% drop in the<br />
19-34 year old population by 2028.<br />
• Moderate increases are projected in 5-16 age band, 45-49 age band, 70-74<br />
age band (GLA figures only) and over 85 year olds.<br />
What are their ethnic backgrounds?<br />
STATUS<br />
• According to the 2001 Census, a third (33%) of <strong>Lambeth</strong>'s then population<br />
were from ethnic minorities, the seventh highest proportion in the country.<br />
• The borough has the second highest proportion of Black Caribbean<br />
residents of any UK local authority (after Lewisham) and the fourth highest<br />
proportion of Black African people (both 11%).<br />
• Around six in ten residents have a white ethnic origin.<br />
1 2001 Census<br />
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• 10% of residents are from a mix of other ethnic groups, including 4% of<br />
residents from Asian backgrounds.<br />
• Unlike other London boroughs where it is the younger population who tend<br />
to come from diverse backgrounds, <strong>Lambeth</strong> has an ethnically complex<br />
older population. A third of those <strong>Lambeth</strong> residents born in the Republic of<br />
Ireland and a third of those born in Jamaica are of pensionable age (34%<br />
and 31% respectively).<br />
PROJECTED CHANGES<br />
• Projections from the GLA suggest that the Black Caribbean group in<br />
<strong>Lambeth</strong> is likely to decrease by 2% of the total population in the next 25<br />
years, compared with an increase in the Black African population by 15%<br />
and in the Asian population by 26%.<br />
• Although the whole black Caribbean population is projected to decrease<br />
over time, Black Caribbeans aged over 60 years are projected to grow by a<br />
third (34%) by 202<strong>5.</strong> Similarly, Black Africans aged over 60 are projected to<br />
increase by 250%, though from a smaller baseline.<br />
What languages do they speak?<br />
STATUS<br />
• Based on reports from schools, approximately 132 different languages are<br />
spoken by families in the borough, with the most common languages after<br />
English being Yoruba and Portuguese.<br />
What are their faiths and beliefs?<br />
STATUS<br />
• There are fewer residents in <strong>Lambeth</strong> who identify themselves as religious<br />
than nationally (71% compared with 82% nationally).<br />
• 60% classify themselves as Christian, 5% as Muslim and 8% report<br />
belonging to another faith or religion.<br />
What are their sexual orientations?<br />
STATUS<br />
• The 2006 residents’ survey asked a question about sexuality for the first<br />
time and found 3% of respondents identified themselves as lesbian, gay or<br />
bi-sexual.<br />
• This is likely to be an under representation since the LGBT matters report 2<br />
commissioned by <strong>Lambeth</strong> <strong>Council</strong> looking at lesbian, gay and bi and transsexual<br />
needs in the borough conservatively estimates that LGBT<br />
communities represent 5% of London’s population, with higher<br />
concentrations in inner-London areas like <strong>Lambeth</strong>.<br />
Where do they live?<br />
• <strong>Lambeth</strong> is one the most densely populated areas in the country with almost<br />
all Super Output Areas in <strong>Lambeth</strong> having between 1,300 and 1,700<br />
residents.<br />
• The areas of highest population density are mostly in the central part of the<br />
borough, in Brixton, Stockwell and Clapham. As expected, the areas with<br />
the lowest population density include parks or open spaces.<br />
2 The full report can be accessed at http://www.sigmaresearch.org.uk/files/report2006c.pdf<br />
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How do they live?<br />
• There are 118,454 households in the borough (Census 2001)<br />
• In 2001, the percentage of lone parent households with dependent children<br />
was above London and national averages (12.1% compared to 8.9% and<br />
7.1% respectively).<br />
• Households in <strong>Lambeth</strong> can be categorised using Mosiac data from<br />
Experian:<br />
Mosaic Type Mosaic Group <strong>Lambeth</strong><br />
Name<br />
People living<br />
in social<br />
housing, with<br />
uncertain<br />
employment<br />
in deprived<br />
areas<br />
Educated,<br />
young single<br />
people living<br />
in areas of<br />
transient<br />
population<br />
High density social<br />
housing, mostly in<br />
inner London, with<br />
high levels of<br />
diversity<br />
Neighbourhoods<br />
with transient<br />
singles living in<br />
multiply occupied<br />
large old houses<br />
Social tenants<br />
Single house<br />
sharers<br />
Percentage<br />
of <strong>Lambeth</strong><br />
Households<br />
26%<br />
21%<br />
What areas have<br />
high numbers of<br />
these<br />
households?<br />
• Mursell and<br />
South <strong>Lambeth</strong><br />
estates<br />
• Stockwell Park<br />
estate<br />
• Mawby Brough<br />
and Wyvill<br />
Estates<br />
• Streets around<br />
Tulse Hill<br />
Station<br />
• Flaxman Road,<br />
near<br />
Loughborough<br />
Junction<br />
• Clapham Road<br />
Educated, Economically Successful 16% • Fawnbrake<br />
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young single<br />
people living<br />
in areas of<br />
transient<br />
population<br />
Educated,<br />
young single<br />
people living<br />
in areas of<br />
transient<br />
population<br />
Close knit,<br />
inner-city<br />
town and<br />
manufacturing<br />
communities<br />
successful singles,<br />
many living in<br />
privately rented<br />
inner city flats<br />
Young<br />
professionals and<br />
their families who<br />
have gentrified<br />
terraces in pre<br />
1914 suburbs<br />
Multi-cultural inner<br />
city terraces<br />
attracting second<br />
generation settlers<br />
from diverse<br />
communities<br />
singles<br />
Young<br />
professionals<br />
and their<br />
families<br />
Multi-cultural<br />
second<br />
generation<br />
11%<br />
10%<br />
Ave/ Brantwood<br />
Rd in Herne Hill<br />
• Clapham Rd/<br />
South Island<br />
Place in Oval<br />
ward<br />
• Telford Avenue/<br />
Salford Rd in<br />
Streatham Hill<br />
• Gubyon<br />
Avenue,<br />
Dorchester<br />
Drive in Herne<br />
Hill<br />
• Rosendale<br />
Road in<br />
Thurlow Park<br />
ward<br />
• Milkwood Road<br />
In Herne Hill<br />
ward<br />
• Amesbury<br />
Avenue/<br />
Hailsham Drive<br />
Career<br />
professionals<br />
living in<br />
sought after<br />
locations<br />
Career<br />
professionals<br />
living in<br />
sought after<br />
locations<br />
Financially<br />
successful people<br />
living in smart flats<br />
in cosmopolitan<br />
inner city locations<br />
Highly educated<br />
senior<br />
professionals,<br />
many working in<br />
the media, politics<br />
and law<br />
Wealthy<br />
senior<br />
professionals<br />
6%<br />
• Dorchester<br />
Drive/<br />
Brantwood<br />
Road in Herne<br />
Hill<br />
• Clapham Old<br />
town<br />
• Belevedere<br />
road in Bishops<br />
• Wards can also be analysed between Mosaic categories. The table shows<br />
the percentage of households in each ward in each Mosaic category, with<br />
town centre and borough comparators. Green shows high numbers in an<br />
area, red low numbers.<br />
North <strong>Lambeth</strong> Town<br />
North<br />
Bishop’s Oval Prince’s Vassall<br />
Centre<br />
<strong>Lambeth</strong><br />
<strong>Lambeth</strong><br />
Single house sharers 27.1 20.4 18.5 2<strong>5.</strong>4 22.5 21.1<br />
Successful singles 7.2 31.3 7.8 9.0 14.6 1<strong>5.</strong>8<br />
Young profs. & families 4.3 2.3 4.3 1.3 2.9 10.9<br />
Social tenants 3<strong>5.</strong>7 31.4 46.2 49.5 41.0 2<strong>5.</strong>8<br />
Wealthy senior profs. 13.8 7.3 8.9 2.0 7.5 6.0<br />
Multi-cultural 2nd Gen. 1.6 2.8 1.8 7.8 3.6 10.0<br />
Other 10.3 4.5 12.6 4.9 7.8 9.8<br />
Brixton own Centre Brixton Cold -<br />
Herne Tulse<br />
Ferndale<br />
Hill harbour<br />
Hill Hill<br />
Brixton <strong>Lambeth</strong><br />
Single house sharers 28.6 24.4 2<strong>5.</strong>8 24.2 30.4 26.8 21.1<br />
Successful singles 21.6 3.3 3<strong>5.</strong>4 13.9 12.3 17.7 1<strong>5.</strong>8<br />
Young profs. & families 11.8 4.6 6.5 21.5 9.7 10.4 10.9<br />
Social tenants 19.4 56.3 23.1 12.0 33.1 29.2 2<strong>5.</strong>8<br />
Wealthy senior profs. 0.5 0.1 0.7 <strong>5.</strong>4 1.2 1.4 6.0<br />
Multi-cultural 2nd Gen. 12.9 6.6 <strong>5.</strong>2 11.6 6.6 8.4 10.0<br />
Other <strong>5.</strong>1 4.8 3.3 11.4 6.8 6.1 9.8<br />
Clapham & Stockwell Claph. Claph. Larkhall Stock- Thorn- Claph & <strong>Lambeth</strong><br />
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Town Centre Commn Town well ton Stock<br />
Single house sharers 9.1 17.8 19.9 18.3 8.5 1<strong>5.</strong>4 21.1<br />
Successful singles 2<strong>5.</strong>5 26.2 21.2 7.7 11.3 18.7 1<strong>5.</strong>8<br />
Young profs. & families 14.3 13.3 7.7 6.4 21.6 12.0 10.9<br />
Social tenants 13.3 18.5 40.8 54.4 42.4 34.3 2<strong>5.</strong>8<br />
Wealthy senior profs. 29.7 12.9 3.8 6.3 2.4 10.7 6.0<br />
Multi-cultural 2nd Gen. 1.2 8.3 4.2 2.5 4.9 4.3 10.0<br />
Other 6.9 3.0 2.3 4.4 9.0 4.8 9.8<br />
Streatham Town Centre St. Streat. Streat. Streat.<br />
Streatham<br />
Leonard. Hill South Wells<br />
<strong>Lambeth</strong><br />
Single house sharers 19.5 2<strong>5.</strong>0 12.4 19.0 19.5 21.1<br />
Successful singles 2<strong>5.</strong>6 16.8 1.9 22.5 17.5 1<strong>5.</strong>8<br />
Young profs. & families 18.0 16.5 7.0 20.5 16.0 10.9<br />
Social tenants 0.6 10.1 2.5 13.4 7.0 2<strong>5.</strong>8<br />
Wealthy senior profs. 11.8 <strong>5.</strong>8 7.2 4.4 7.2 6.0<br />
Multi-cultural 2nd Gen. 13.9 1<strong>5.</strong>7 29.0 7.1 1<strong>5.</strong>7 10.0<br />
Other 10.7 10.1 40.0 13.1 17.0 9.8<br />
Norwood Town Centre Gipsy Knight's Thurlow<br />
Hill Hill Park<br />
Norwood <strong>Lambeth</strong><br />
Single house sharers 21.5 16.8 24.6 20.7 21.1<br />
Successful singles 6.8 4.6 9.4 6.8 1<strong>5.</strong>8<br />
Young profs. & families <strong>5.</strong>5 13.0 23.0 13.7 10.9<br />
Social tenants 18.6 14.5 7.2 13.6 2<strong>5.</strong>8<br />
Wealthy senior profs. 2.7 1.1 9.1 4.1 6.0<br />
Multi-cultural 2nd Gen. 30.8 27.2 9.9 23.0 10.0<br />
Other 14.1 22.7 16.8 18.1 9.8<br />
Mosaic September 2007<br />
How many people move into/out of the borough?<br />
• It is difficult to be exact about the numbers of people moving in and out of<br />
the borough. The latest data, from the 2006 ONS Mid-Year population<br />
estimate is that total migration in 2006 was 22.4% of the population. This<br />
means that 10.9% of the population lived somewhere else the year before,<br />
and 11.5% moved out of the borough during the year.<br />
• The largest group of new job-seeking immigrants between 2002 and 2006<br />
were from Poland with 3,550 new National Insurance registrations for Polish<br />
people living in <strong>Lambeth</strong>.<br />
• The next two largest totals for new NI registration were for immigrants from<br />
Australia (2,830) and Jamaica (1,750).<br />
How many people have informal care responsibilities?<br />
• It is estimated from the 2001 census that there are approximately 18,500<br />
carers in <strong>Lambeth</strong> (7% of the resident population).<br />
• Adult carers may be family, friends or neighbours, or may be partners within<br />
marriage or civil partnerships. Some care for those with mental health<br />
issues, physical or learning disabilities, whilst others have the additional<br />
complication of caring for someone with a dual/complex diagnosis. Some<br />
are parent carers caring for a child with a disability.<br />
• There are a number of young carers aged under 16 living in the borough. In<br />
2001 there were 483 carers aged 0-15 in <strong>Lambeth</strong> (37 of these were<br />
providing 50+ hours of care per week).<br />
• In 2001 there were 106 carers aged over 85 in the borough (44 of these<br />
providing 50+ hours of care per week).<br />
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• Many carers in <strong>Lambeth</strong> come from Black and Minority Ethnic (BME)<br />
communities, with a disproportionate number coming from the Asian<br />
communities.<br />
• The majority of carers (68%) provide 1-19 hours of care per week. 13%<br />
provide 20-49 hrs and the remaining 19% provide 50+ hrs each week.<br />
• In 2001 over half of carers worked full or part-time. 782 carers combined<br />
work with 50+ hours of care each week.<br />
How many people are economically active?<br />
• 76.2% of the population of <strong>Lambeth</strong> is economically active; this compares<br />
with 7<strong>5.</strong>1% for London and 78.6% nationally. 3<br />
• The overall employment rate in <strong>Lambeth</strong> is 68.5%. This compares with the<br />
London employment rate of 69.8% and a national figure of 74.3%.<br />
• 18.7% of the economically inactive are neither in employment nor<br />
unemployed and do not want a job; this compares with 18.0% for London<br />
and 16.1% nationally. 4<br />
• In May 2008, 3.6% of the resident working age population for <strong>Lambeth</strong> is<br />
claiming Job Seekers Allowance (JSA), compared with 2.6% for London<br />
and 2.2% nationally. At 63.10% of claimants, <strong>Lambeth</strong> is below the London<br />
average (6<strong>5.</strong>50%) for claiming up to 6 months JSA, but higher than London<br />
averages for claimants over 6 up to 12 months and over 12 months. 5<br />
• <strong>Lambeth</strong> has 9.6% of young people aged 16-18 not in education,<br />
employment or training (NEET), compared with 9% for Southwark, <strong>5.</strong>5% in<br />
Wandsworth and just 0.8% above the London average. This is down from<br />
1<strong>5.</strong>3% in 2004. Projections show that just 8.6 % will not be in paid work or<br />
preparing for it in <strong>Lambeth</strong> by 2009-10, closing the gap on the England<br />
average. 6<br />
How many people are claiming benefits?<br />
• The percentage of working age people on out of work benefits is16.5%. In<br />
the worst performing neighbourhoods this increases to 27.7% (Q2 2007).<br />
• Just over a third (36%) 7 of children in <strong>Lambeth</strong> live in families on key<br />
benefits compared with 28% in London. <strong>Lambeth</strong> ranks as the 11th highest<br />
rate for this nationally and 27th out of the 33 London boroughs.<br />
• The number of people claiming incapacity benefits represents<br />
approximately 7.1% of the working age population (London 6.1% and<br />
nationally 7.2%).<br />
• The number of people claiming lone parent benefits represents<br />
approximately 4.0% of the total working age population (compared with<br />
London 3.1% and nationally 2.0%).<br />
3 NOMIS Official Labour Market Statistics (Oct 2006 – Sep 2007). Percentages are for those of working age<br />
(16-59/64). Economically active are people who are either in employment or unemployed.<br />
4 People who are neither in employment nor unemployed includes, for example, all those who were looking<br />
after a home or retired. Also people wanting a job, these are those not in employment who want a job but are<br />
not classed as unemployed because they have either not sought work in the last four weeks or are not<br />
available to start work.<br />
5 The Jobseeker's Allowance (JSA) is payable to people under pensionable age who are available for, and<br />
actively seeking, work of at least 40 hours a week.<br />
6 London Borough of <strong>Lambeth</strong>. CYPS Performance Digest Report. March 2008<br />
7 Government Office for London /DWP August 2008, based on 5% sample.<br />
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How is <strong>Lambeth</strong> ranked on deprivation measures?<br />
• <strong>Lambeth</strong> as a whole is slightly more deprived than Inner London, and<br />
considerably more deprived than England as a whole.<br />
• It is ranked overall the 19 th most deprived local authority district in England,<br />
compared with 23 rd in 2004.<br />
• North <strong>Lambeth</strong> is the most deprived town centre with all wards other than<br />
Bishops wholly in the 30% most deprived in the country.<br />
• Coldharbour is the most deprived ward in the borough with 60% of its area<br />
classified in the 10% most deprived nationally.<br />
How do the people of <strong>Lambeth</strong> rate their own health and well-being?<br />
• Just over three quarters of <strong>Lambeth</strong> residents rate their own health as good<br />
or very good. This rises to 89% among private renters (compared with 71%<br />
among council tenants), 90% among 18-34 year olds and 86% among AB<br />
residents and full time workers. Health ratings are unsurprisingly lower<br />
among people with long-term limiting illness (27%) and older people (55%).<br />
Black Caribbean residents (69%) are less positive about their health.<br />
• In 2001 only 55% of Carers assessed their own health as “Good”.<br />
Which groups of people within <strong>Lambeth</strong> could be considered to be<br />
vulnerable?<br />
• The main groups of people in the borough who could be considered to be<br />
vulnerable are:<br />
older people with support needs including the frail elderly<br />
people with a long-term limiting illness<br />
people with mental health problems including mentally disordered<br />
offenders<br />
people with learning disabilities<br />
people with physical disabilities or sensory impairments.<br />
people with substance misuse (drug and/or alcohol) problems<br />
carers<br />
women at risk of domestic violence<br />
homeless people<br />
rough sleepers<br />
travellers<br />
offenders/people at risk of offending<br />
people with HIV/AIDS<br />
refugees and asylum seekers<br />
• The groups of children and young people who are vulnerable to doing less<br />
well against some or all of the national outcomes include:<br />
Looked After Children<br />
young people leaving care<br />
young people at risk of harm<br />
young carers<br />
children with special educational needs or disabilities<br />
children who are very mobile, e.g. traveller and refugee children<br />
children from different faith groups<br />
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some BME children and young people<br />
young people at risk of offending and misusing substances<br />
teenage parents<br />
children from low income families.<br />
Older people<br />
• <strong>Lambeth</strong> has a relatively lower number of older people compared with other<br />
areas though this is expected to change with the numbers of those aged<br />
over 85 expected to increase (see age projections above).<br />
• More older people are helped to live at home in <strong>Lambeth</strong> than compared<br />
with both London and England (107 per 1,000 population in 2006/07<br />
compared with 91 in England).<br />
People with a long-term limiting illness<br />
• In 2001 there were 36,763 residents who classified themselves as having a<br />
long-term limiting illness (14%) of the following ages:<br />
0-15 2,334<br />
16-44 10,766<br />
45-59 8,376<br />
60-64 3,324<br />
65-74 5,824<br />
75+ 6,141<br />
Total 36,765<br />
• This is a smaller proportion of adults living with long-term illness than is<br />
seen across England (21%).<br />
People with mental health problems<br />
• <strong>Lambeth</strong> has a higher prevalence of mental health needs than other<br />
comparative areas of London 8 .<br />
• 4,169 people are currently recorded with severe and enduring mental health<br />
needs under the Care Programme Approach (CPA).<br />
• An estimated 37,000 people are engaged with primary care for treatment for<br />
varying degrees of anxiety and depression.<br />
• There are disproportionately high numbers of people with mental health<br />
needs within ethnic minority communities, particularly African Caribbean<br />
males.<br />
• The proportion of people with Severe Mental illness and dual diagnosis of<br />
substance misuse is very high at 50%.<br />
People with learning disabilities<br />
• In Sept 2007 there were 863 adults on the <strong>Lambeth</strong> register for people with<br />
learning disability.<br />
• In Sept 2007 ethnic minorities made up 19% of people with learning<br />
disabilities aged 50-59 years, but 60% of those aged 20-29 years and 70%<br />
of the 0-9 age group.<br />
People with physical disabilities or sensory impairments<br />
• There is not yet a detailed picture of the number of <strong>Lambeth</strong> residents with<br />
physical disabilities or sensory impairments.<br />
8 Bexley, Bromley, Greenwich, Lewisham, Southwark.<br />
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People with substance misuse problems<br />
• The Home Office estimates 5,029 Problematic Drug Users (PDUs) of<br />
opiates and/or crack cocaine in <strong>Lambeth</strong> (estimate based on 2004/05 data).<br />
The total number of Problematic Drug Users PDUs known to treatment in<br />
2006/07 was 1,991.<br />
• 2,033 drug users accessed treatment during 2007/08. 149 of these (7.3%)<br />
were aged 17 or under. 79% of individuals were retained in structured<br />
treatment for more than 12 weeks.<br />
• 72% of adult drug users in treatment in <strong>Lambeth</strong> are male (28% female).<br />
• The proportion of BME clients in treatment is not significantly different from<br />
the proportions in <strong>Lambeth</strong>’s overall resident population.<br />
• 13% of those accessing treatment for the first time in 2007/08 had a dual<br />
diagnosis of mental health problems alongside their substance misuse<br />
issues.<br />
• CHAIN data for <strong>Lambeth</strong> shows that 88% of all rough-sleepers have alcohol<br />
and/or drug support needs. This is notably higher than the proportion across<br />
other London boroughs. 9<br />
• It is estimated that 23-24% of <strong>Lambeth</strong>’s population drink excessively and<br />
that <strong>Lambeth</strong> has a higher rate of alcohol related hospital admissions than<br />
London and England. The largest single categories of hospital admissions<br />
are for alcohol related disorder and then liver disease. 10<br />
• The general profile for an excessive drinker in <strong>Lambeth</strong> is that of a white<br />
male.<br />
Carers<br />
• It is estimated from the 2001 census that there are approximately 18,500<br />
carers in <strong>Lambeth</strong> (7% of the resident population).<br />
• There are a number of young carers aged under 16 living in the borough. In<br />
2001 there were 483 carers aged 0-15 in <strong>Lambeth</strong> (37 of these were<br />
providing 50+ hours of care per week).<br />
Women at risk from domestic violence<br />
• Research suggests that 13% of women experience domestic violence at<br />
some point in their lives.<br />
• The National Domestic Violence helpline received 322 calls from <strong>Lambeth</strong><br />
women between Jan and June 200<strong>5.</strong> This was the highest rate of any<br />
London borough and 100 more calls than the second highest borough.<br />
• The Gaia Domestic Violence refuge centre supported 626 <strong>Lambeth</strong> women<br />
between May 2006 and March 2008.<br />
Homeless people<br />
• The number of households accepted as being homeless has been<br />
successfully reduced from 1,651 to 735 over the last 5 years.<br />
• There are currently 2,100 people waiting for an offer in Temporary<br />
Accommodation.<br />
• <strong>Lambeth</strong> has one of the highest rates of teenage homelessness, with<br />
figures that are above London and national averages.<br />
Rough sleepers<br />
• There are approximately 13 people sleeping rough in <strong>Lambeth</strong> on any one<br />
night.<br />
9 CHAIN (2007)<br />
10 Alcohol Needs Assessment 2006/07<br />
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• CHAIN data for <strong>Lambeth</strong> shows that 88% of all rough-sleepers have alcohol<br />
and/or drug support needs. This is notably higher than the proportion across<br />
other London boroughs. 11<br />
Travellers<br />
• The GLA estimates 42 Travellers in <strong>Lambeth</strong> based on estimated national<br />
population apportioned to <strong>Lambeth</strong> on basis of population.<br />
Offenders/people at risk of offending<br />
• An estimated 1500 <strong>Lambeth</strong> residents are received into London prisons a<br />
year. 12 The probation caseload is around 2500 (60% custody, 40%<br />
community).<br />
• There are higher proportions of BME offenders from <strong>Lambeth</strong> than the<br />
London average (25% British White vs. 37% average and 33% Black<br />
Caribbean vs. 15% average). 3<br />
• Of <strong>Lambeth</strong> offenders who had an Offender Assessment completed (267),<br />
the average need score was 8 th highest of the 32 London boroughs (City of<br />
London excluded). The rank order of criminogenic needs for <strong>Lambeth</strong> is<br />
very similar to the London average, though <strong>Lambeth</strong> has a higher % of its<br />
offenders with a need in most areas and within employment, training and<br />
education. It has one of the lowest scores for alcohol with only 18%<br />
(average 24%) of its offenders assessed as having an alcohol need linked<br />
to their offending. 3<br />
People with HIV/AIDS<br />
• The HIV and AIDS reporting system (HARS) assesses national prevalence<br />
at 801 patients diagnosed and receiving care per 100,000 of population.<br />
Refugees and asylum seekers<br />
• The GLA estimates 105 asylum seekers, calculated as an apportionment to<br />
<strong>Lambeth</strong> of national applications for asylum on the basis of population size.<br />
Looked after children<br />
• There were 525 looked after children (LAC) in <strong>Lambeth</strong> in 2007/08. The<br />
number of LAC exceeds London and national averages but has reduced<br />
from 660 in 2005/06.<br />
Young people leaving care<br />
•<br />
Young people at risk of harm<br />
• At 31 March 2007 there were 62 children aged 4 and under and 113<br />
children aged 5-15 on the child protection register (CPR). 13 By 2007/08<br />
there were 245 in total. The numbers of children on the CPR exceed<br />
London and national averages.<br />
Children with special educational needs or disabilities<br />
• 27% of pupils have some form of special educational need.<br />
• Data from the ICOUNT Disability Register in 2007 shows that there were<br />
621 registered children with disabilities and a further 324 who are thought to<br />
be eligible for the Register. Estimates by the PCT, however, suggest that<br />
11 CHAIN (2007)<br />
12 London Area Office LISAR (initial screening and referral) data 2007<br />
13 London Borough of <strong>Lambeth</strong>. Childcare Sufficiency Assessment. 2007<br />
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there are approximately 1,000 children under 5 with a disability or SEN.<br />
There are also 5,390 children aged over 5 who have been seen by a health<br />
professional in relation to a disability or SEN.<br />
Teenage parents<br />
•<br />
On which issues does <strong>Lambeth</strong> differ significantly from the national<br />
average? (as reported in the 2001 census)<br />
• The Census Area Classifications categorise <strong>Lambeth</strong> as London<br />
Cosmopolitan, similar to Southwark, Lewisham, Hackney, Islington,<br />
Haringey and Brent. The classification is generated using census variables.<br />
• Census variables with a proportion in <strong>Lambeth</strong> far below the national<br />
average are:<br />
People aged between 45 and 64<br />
Pensioners who live alone<br />
Households with two adults and no dependent children<br />
People who live in a detached house<br />
People who live in a two car household<br />
People who provide unpaid care<br />
Women who work part-time<br />
People who work in manufacturing.<br />
People who work in the wholesale or retail trades<br />
• Census variables with a proportion in <strong>Lambeth</strong> far above the national<br />
average are:<br />
Children aged four or under<br />
People aged between 25 and 44<br />
People who identify themselves as Black African, Black Caribbean or<br />
Other Black<br />
People who were not born in the United Kingdom<br />
People who are not living in a couple and are separated, widowed or<br />
divorced<br />
People who live alone but who are not Pensioners<br />
People who live in lone parent households<br />
People who rent their accommodation privately<br />
People who live in flats<br />
Average no of people per room<br />
People with a higher education qualification<br />
People who take public transport to work<br />
People who are students<br />
People who are unemployed<br />
Men who work part-time.<br />
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4. Health of <strong>Lambeth</strong> residents?<br />
Overview<br />
• Just over three quarters of <strong>Lambeth</strong> residents rate their own health as good or very<br />
good. This rises to 89% among private renters (compared with 71% among council<br />
tenants), 90% among 18-34 year olds and 86% among AB residents and full time<br />
workers. Health ratings are unsurprisingly lower among people with long-term<br />
limiting illness (27%) and older people (55%). Black Caribbean residents (69%) are<br />
less positive about their health.<br />
• In general, the health of people in <strong>Lambeth</strong> is significantly poorer compared with<br />
the England average<br />
• Life expectancy in males and females is lower and deaths from smoking and<br />
premature deaths from circulatory diseases and cancer are higher than the rest of<br />
England.<br />
• <strong>Lambeth</strong> is amongst the most deprived areas nationally and the average<br />
deprivation in all wards is higher than the average deprivation in all England wards.<br />
• Smoking prevalence is high in <strong>Lambeth</strong> especially in deprived areas and in people<br />
lower socio-economic group and in manual occupation. The deaths attributable to<br />
smoking every year are also high in <strong>Lambeth</strong> compared to the national average.<br />
• <strong>Lambeth</strong> has higher than average levels of physical activity probably resulting in<br />
lower percentage of obesity in adults. However, obesity in 10-11 year olds is very<br />
high with 1 in 4 children obese in that age group.<br />
• The all age all cause mortality has fallen significantly in the past few years but it<br />
remains above the England and London average.<br />
• The rate of inequality between <strong>Lambeth</strong> residents and the England and Wales<br />
average has reduced for women, with the cancer reduction particularly notable,<br />
bringing <strong>Lambeth</strong> down to E&W averages. Further challenges remain in relation to<br />
securing an equivalent improvement in men's health.<br />
• Exponential projection using number of births in previous year, shows a growing<br />
trend in births over the next five years.<br />
• Birth weight (Awaiting returns from hospital (Acute and Community)<br />
• Crude birth weight (Awaiting returns from hospital (Acute and Community)<br />
• The infant mortality rate is <strong>5.</strong>7 children per 1,000 live births. This is compared with<br />
4.9 and 5 per 1,000 in London and England. 14 The infant mortality rate is reducing<br />
and the inequality gap is getting narrower plans are to further reduce this gap<br />
further over the next five years.<br />
• The gap in the death rates from cardio-vascular diseases between men and<br />
women is slightly worsening while the gap in deaths rates from cancer in men in<br />
<strong>Lambeth</strong> and England is widening.<br />
• Coronary heart disease remains the single and preventable cause of all deaths in<br />
<strong>Lambeth</strong> followed by cerebro-vascular diseases (stroke), cancer and chronic lung<br />
diseases.<br />
• The top 10 causes of hospital admissions in <strong>Lambeth</strong> in 200708 were: Pregnancy<br />
related conditions, Digestive disorders, Genito-Urinary system, Neoplasms, Injuries<br />
and Poisonings, Circulatory diseases, Respiratory diseases, Musculoskeletal<br />
disorders, Eye related, Nervous System. Overall there has been a fall in total<br />
14 London Borough of <strong>Lambeth</strong>. Draft State of the Borough: The evidence base supporting the Sustainable<br />
Community Strategy. 2008.<br />
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admissions in 2007-08 over 2006-07 and admissions due to circulatory diseases<br />
and skin have fallen in comparison to the total admissions in 2007-08.<br />
• <strong>Lambeth</strong> has a higher incidence of mental illness than other cosmopolitan areas in<br />
London. There were approximately 4500 people with severe and enduring mental<br />
illness receiving treatment through a care programme approach via the integrated<br />
mental health service in <strong>Lambeth</strong>.<br />
STATUS<br />
• In general, the health of people in <strong>Lambeth</strong> is significantly poorer than the<br />
England average.<br />
• Life expectancy in males and females is lower and deaths from smoking<br />
and early deaths from heart disease, stroke and cancer are higher than the<br />
rest of England.<br />
• Just over three quarters of <strong>Lambeth</strong> residents rate their own health as good<br />
or very good. This rises to 89% among private renters (compared with 71%<br />
among council tenants), 90% among 18-34 year olds and 86% among AB<br />
residents and full time workers. Health ratings are unsurprisingly lower<br />
among people with long-term limiting illness (27%) and older people (55%).<br />
Black Caribbean residents (69%) are less positive about their health.<br />
Life expectancy<br />
• A baby boy born in <strong>Lambeth</strong> during 2004-06 could on average expect to live<br />
7<strong>5.</strong>1 years and a baby girl could expect to live to 80.1 years 15 . Ten years<br />
ago these figures were 71.3 and 78.1 years respectively, so life expectancy<br />
has lengthened and gap between the sexes has narrowed. However, a baby<br />
boy in <strong>Lambeth</strong> lives 2.2 years less and a baby girl 1.5 years less than the<br />
equivalent babies in England and Wales where males live to 77.3 years,<br />
and females to 81.6 years on average.<br />
Birth rate<br />
• Exponential projection using the number of births in the previous year<br />
shows a growing trend in births over the next five years.<br />
• Birth weight / Crude birth weight (awaiting returns from hospital (Acute and<br />
Community))<br />
Mortality rate<br />
• The infant mortality rate is <strong>5.</strong>8 children per 1,000 live births. 1 This compares<br />
with 4.9 and 5 per 1,000 in London and England. 16 The infant mortality rate<br />
is reducing and the inequality gap is getting narrower with plans in place to<br />
further reduce this gap over the next five years.<br />
• The all age all cause mortality rate in <strong>Lambeth</strong> has fallen significantly in the<br />
past few years but it remains above the England and London average.<br />
• Coronary heart disease remains the single most preventable cause of all<br />
deaths in <strong>Lambeth</strong> followed by cerebro-vascular diseases (stroke), cancer<br />
and chronic lung diseases.<br />
• The rate of health inequality between <strong>Lambeth</strong> residents and the England<br />
and Wales average has reduced for women, with the cancer reduction<br />
particularly notable, bringing <strong>Lambeth</strong> down to E&W averages. Further<br />
challenges remain in relation to securing an equivalent improvement in<br />
men's health.<br />
15 Department of Health area profile 24 June 2008.<br />
16 London Borough of <strong>Lambeth</strong>. State of the Borough: The evidence base supporting the Sustainable<br />
Community Strategy. 2008.<br />
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• The gap in the death rates between men and women from cardio-vascular<br />
diseases is slightly worsening while the gap in deaths rates from cancer in<br />
men in <strong>Lambeth</strong> and England is widening.<br />
Hospital admissions<br />
• The top 10 causes of hospital admissions in <strong>Lambeth</strong> in 200708 were:<br />
Pregnancy related conditions<br />
Digestive disorders<br />
Genito-Urinary system<br />
Neoplasms<br />
Injuries and Poisonings<br />
Circulatory diseases<br />
Respiratory diseases<br />
Musculoskeletal disorders<br />
Eye related<br />
Nervous System.<br />
• Overall there has been a fall in total hospital admissions in 2007-08 over<br />
2006-07 and admissions due to circulatory diseases and skin have fallen in<br />
comparison to the total admissions in 2007-08.<br />
• Diabetes – The case-detected prevalence of diabetes in <strong>Lambeth</strong> (2.95%) is<br />
lower than the national average (3.6%) and detection in primary care is<br />
good with up to 90% cases detected and registered. However the<br />
prevalence models provided by the APHO (Association of Public health<br />
observatories) shows a prevalence of 3.8% meaning around 1% of diabetics<br />
are still undetected in the population.<br />
• Circulatory: CHD – The case detected prevalence of CHD (Coronary Heart<br />
disease) in <strong>Lambeth</strong> is approximately 1.4% however the modelled<br />
prevalence is around 3% meaning there are over 5000 cases in <strong>Lambeth</strong><br />
with CHD and who need to be on the CHD register in primary care and who<br />
need to be on preventative medication.<br />
• Circulatory: Stroke – Although the prevalence of stroke is lower in <strong>Lambeth</strong><br />
the directly standardised mortality rate from stroke although declining is still<br />
higher than the England average.<br />
• Cancer: Cancer is the third main cause of death in <strong>Lambeth</strong> and the<br />
incidence of cancer in <strong>Lambeth</strong> for males is higher than the England<br />
average while it is similar for females.<br />
• Cancer: by site (analysis is being done)<br />
• The POPPI (Projecting Older People Population Information) system<br />
estimates approximately 11,044 people aged 65 and over with a limiting<br />
long-term illness in <strong>Lambeth</strong>. Projections show a reduction in 2010 through<br />
2015 followed by a rise of approximately 5-7% in 2020 through 202<strong>5.</strong><br />
• Infectious: hospital-acquired infections – the rate of health care acquired or<br />
hospital acquired infections is lower than the London and national average<br />
in <strong>Lambeth</strong>.<br />
• Dental: decay – Approximately 9% of 12 year olds, 28% of 5 year olds in<br />
<strong>Lambeth</strong> have active dental decay which is lower than the national average.<br />
• Aural<br />
• Optical<br />
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• Trauma: falls – The mortality rate (directly standardised rate) from<br />
accidental falls is almost twice that of the London average when measured<br />
on a three rolling average. The rate in males is more than 2.5 times that of<br />
the female rate.<br />
• Musculo-skeletal: arthritis<br />
• Musculo-skeletal: osteoporosis<br />
• Pharmaceutical<br />
NATIONAL PRIORITIES<br />
Reference Indicator<br />
NI 137 Healthy life expectancy at age 65<br />
NI 120 All-age all-cause mortality rate<br />
NI 119 Self-reported measure of people’s overall health and wellbeing<br />
Are they physically healthy?<br />
STATUS<br />
Limiting long-term illness<br />
• The POPPI (Projecting Older People Population Information) system<br />
estimates approximately 11,044 people aged 65 and over with a limiting<br />
long-term illness in <strong>Lambeth</strong>. Projections show a reduction in 2010 through<br />
2015 followed by a rise of approximately 5-7% in 2020 through 202<strong>5.</strong><br />
Diabetes<br />
• The case-detected prevalence of diabetes in <strong>Lambeth</strong> (2.95%) is lower than<br />
the national average (3.6%) and detection in primary care is good with up to<br />
90% cases detected and registered. However the prevalence models<br />
provided by the APHO (Association of Public Health Observatories) show a<br />
prevalence of 3.8% meaning around 1% of diabetics are still undetected in<br />
the population.<br />
Circulatory: Coronary Heart Disease (CHD)<br />
• The case detected prevalence of CHD in <strong>Lambeth</strong> is approximately 1.4%.<br />
However the modelled prevalence is around 3% meaning there are over<br />
5,000 cases in <strong>Lambeth</strong> with CHD who need to be on the CHD register in<br />
primary care and who need to be on preventative medication.<br />
• 31 <strong>Lambeth</strong> residents were admitted to hospital with an acute myocardial<br />
infarction (heart attack) between April and December 07; this would equate<br />
to 41 people over 12 months.<br />
• 73 people were admitted to hospital with heart failure during the same<br />
period (equating to 97 people over 12 months).<br />
Circulatory: Stroke<br />
• Stroke is the third most common cause of death in England and Wales,<br />
after heart disease and cancer (The Stroke Association).<br />
• Although the prevalence of stroke is lower in <strong>Lambeth</strong> and although the<br />
directly standardised mortality rate from stroke is declining, it is still higher<br />
than the England average.<br />
• From April to December 07, 120 <strong>Lambeth</strong> residents suffered a stroke and<br />
were admitted to hospital, this equates to 160 people annually.<br />
Cancer: General<br />
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• Cancer is the third main cause of death in <strong>Lambeth</strong> and the incidence of<br />
cancer for males in <strong>Lambeth</strong> is higher than the England average; it remains<br />
similar for females.<br />
Cancer: by site<br />
• (awaiting analysis)<br />
Infectious: hospital-acquired infections<br />
• The rate of health care-acquired or hospital-acquired infections in <strong>Lambeth</strong><br />
is lower than the London and national average.<br />
Infectious: respiratory<br />
• The rate of new cases of tuberculosis in <strong>Lambeth</strong> is significantly higher than<br />
the England average but in line with the London average.<br />
Preventative: Immunisations<br />
• In <strong>Lambeth</strong>, rates of immunisation among children are amongst the lowest<br />
in the country, with primary immunisations at two years of age in <strong>Lambeth</strong> at<br />
approximately 82%, compared with 88% across London and 94% in<br />
England.<br />
• Immunisation take-up has turned a corner as resistance to the MMR jab has<br />
abated. However, the London Assembly in 2003 found that take-up of the<br />
first and second MMR together by a child’s fifth birthday remained at less<br />
than half in <strong>Lambeth</strong> (48%), Greenwich (33%), Bromley (47%), and<br />
Lewisham (47%). These poor take-up statistics compare with over 70% in<br />
Harrow and Havering.<br />
Dental: decay<br />
• Approximately 9% of 12 year olds and 28% of 5 year olds in <strong>Lambeth</strong> have<br />
active dental decay; these rates are in line with the average for London.<br />
Trauma: falls<br />
• Approximately one third of the population aged 65 yrs and over fall each<br />
year. This means approximately 6,900 people in <strong>Lambeth</strong>. Falls are the<br />
commonest cause of injury and accident-related death in this age group. 5-<br />
10% sustain a fracture.<br />
• It is estimated that one in two women and one in five men will suffer a<br />
fracture after the age of 50.<br />
• According to the National Osteoporosis Society, one year after an<br />
osteoporotic fracture, the majority of patients are not prescribed any<br />
pharmaceutical agents for the prevention of a further fracture. This is<br />
despite the fact that drug treatments have been shown to reduce the risk of<br />
fractures by up to 50%.<br />
• The mortality rate (directly standardised rate) from accidental falls in<br />
<strong>Lambeth</strong> is almost twice that of the London average when measured on a<br />
three year rolling average. The rate in males is more than 2.5 times that of<br />
the female rate.<br />
• POPPI (Projecting Older People Population Information) estimates that by<br />
2008 approximately 475 hospital admissions in <strong>Lambeth</strong> of people over 65<br />
each year will be as a result of a fall.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Although people aged over 65 comprise 8.75% of the population, they<br />
account for 12% of A&E attendances and 19% of SELDOC calls.<br />
• African-Caribbean and South Asian people are at least five times more<br />
likely to have diabetes than the white population (Diabetes UK).<br />
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NATIONAL PRIORITIES<br />
Reference<br />
Indicator<br />
NI 121 Mortality rate from all circulatory diseases at ages under 75<br />
NI 122 Mortality rate from all cancers at ages under 75<br />
Diabetes: Modelled and/or recorded prevalence implications (e.g. Life<br />
expectancy)<br />
CHD mortality<br />
CHD Modelled and/or recorded prevalence<br />
Hospital admission rate for MI<br />
Admissions for cardiac revascularisation<br />
Stroke mortality<br />
Hospital admission rate for Stroke<br />
Cancer registrations<br />
COPD Modelled and/or recorded prevalence<br />
COPD mortality<br />
TB notifications<br />
%DMFT in 5-yr olds<br />
Hospital admissions for fractured neck of femur<br />
Admissions for hip and knee replacement<br />
Aural<br />
Optical<br />
Musculo-skeletal: arthritis<br />
Musculo-skeletal: osteoporosis<br />
Pharmaceutical<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Long term conditions (copy from LPCT CSP)<br />
• End of life care(copy from LPCT CSP)<br />
• Sexual health(copy from LPCT CSP)<br />
• Mental health(copy from LPCT CSP)<br />
Do they enjoy good mental health?<br />
STATUS<br />
• <strong>Lambeth</strong> has a higher incidence of mental illness than other cosmopolitan<br />
areas in London. There were approximately 4,500 people with severe and<br />
enduring mental illness receiving treatment through a care programme<br />
approach via the integrated mental health service in <strong>Lambeth</strong>.<br />
Emotional health<br />
• <strong>Lambeth</strong> schoolchildren listed exams (57%), friendships (41%) and getting<br />
into trouble (43%) as the 3 things they worried about the most (Tell Us 2<br />
survey 2007).<br />
Dementia<br />
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• In <strong>Lambeth</strong> over 1500 people are estimated to have dementia and are this<br />
number is projected to rise to 1700 by 202<strong>5.</strong> Of these, it is predicted that up<br />
to 700 individuals may not be in contact with mental health services.<br />
Typically the BME community have a higher prevalence of early onset<br />
dementia (6.1% compared to 2.2% for rest).<br />
• POPPI (Projecting Older People Population Information) estimates that by<br />
2008 there will be 1,598 over 65s in <strong>Lambeth</strong> predicted to have dementia, of<br />
which 1,358 (84%) will be over 7<strong>5.</strong><br />
• The NICE Clinical Guideline on Dementia gives a prevalence of 30% for<br />
those over the age of 85 developing dementia. This would mean an<br />
increase from 908 in 2001 to 1032 in 2010 in the over 85s.<br />
Depression<br />
• It is predicted that 1 in 6 individuals in <strong>Lambeth</strong> suffer from depression.<br />
Suicide<br />
• The mortality rate (standardised mortality ratio) from suicides and<br />
undetermined injuries is declining in <strong>Lambeth</strong> but is still higher than the<br />
national average.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• The BME community have a higher prevalence of early onset dementia<br />
(6.1% compared with 2.2% for rest).<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 50<br />
NI 51<br />
NI 58<br />
Indicator<br />
Emotional health of children<br />
Effectiveness of child and adolescent mental health (CAMHs) services<br />
Emotional and behavioural health of looked after children<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Mental health (copy from LPCT CSP)<br />
Are they sexually healthy?<br />
STATUS<br />
Teenage pregnancy<br />
• From the baseline year of 1998, <strong>Lambeth</strong>'s teenage conception rate rose<br />
year on year, peaking in 2003.<br />
• However, data for 2004 and 2005 demonstrates a decline in the conception<br />
rate. Data for 2005 shows <strong>Lambeth</strong>’s under-18 conception rate was 84.1 per<br />
1,000 girls aged 15-17. This compares with the 2003 rate (103.3 per 1,000)<br />
and 2004 rate (8<strong>5.</strong>2 per 1,000) and represents a reduction of 6.6%. from the<br />
1998 baseline The 2005 rate compares with 46 per 1,000 for London and<br />
41.3 per 1,000 for England.<br />
• The latest provisional data for quarter one in 2006 shows a further decline.<br />
In addition to this, the difference between <strong>Lambeth</strong>’s conception rate and<br />
the national average has narrowed from nearly two and a half times in 2003,<br />
to nearly twice in 200<strong>5.</strong> Based on a review of 2006 data, early indications<br />
from the Government Office for London (GOL) are that <strong>Lambeth</strong> is no longer<br />
an accelerated borough under the review process.<br />
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GUM services<br />
•<br />
HIV/AIDS<br />
•<br />
Contraception<br />
• 20% of General Practitioner (GP) practices have achieved “Young People<br />
Friendly” status regarding facilitating access to preventative and treatment<br />
services for sexually transmitted infections.<br />
Abortion<br />
• The legal abortion rate for under 18s in <strong>Lambeth</strong> in 2006 was much higher<br />
than average with 44 terminations per 1,000 of the population compared<br />
with 24 in London and 18 in England.<br />
Maternity services<br />
•<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 112<br />
NI 113<br />
NI 126<br />
Indicator<br />
Under 18 conception rate<br />
Prevalence of Chlamydia in under 25 year olds<br />
Early access for women to maternity services<br />
Under 18 Repeat conceptions<br />
Under 16 conceptions<br />
Under 16 Repeat conceptions<br />
KC60 GUM STI data, particularly gonorrhoea<br />
Offer of an appointment at a GUM service within 48 hours<br />
New diagnoses of HIV/AIDS<br />
Late diagnosis of HIV<br />
Long acting reversible contraception methods as a % of all contraception<br />
Access to NHS funded abortions before 10 weeks gestation<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Sexual health (copy from LPCT CSP)<br />
Do they have healthy lifestyles?<br />
STATUS<br />
• The CACI Health ACORN profiles for 2006 show <strong>Lambeth</strong> as the 4 th worst<br />
borough in London for unhealthy lifestyles.<br />
• 97% of <strong>Lambeth</strong> schools are participating in the National Healthy Schools<br />
Programme with 58% of our schools achieving the Healthy Schools status<br />
as at December 2006. 50% of those schools accredited with HSS are taking<br />
part in the extended healthy schools model as part of the LAA stretch target.<br />
• From our consultations and survey results, however, we know that local<br />
children and young people want more access to out of school leisure and<br />
sporting activities as well as more general information about healthy<br />
lifestyles, including healthy eating, drugs, alcohol, and local facilities.<br />
Diet and Obesity<br />
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• It is estimated that 30.3% of <strong>Lambeth</strong> adults eat a healthy diet. This is in line<br />
with the average for London and above the national average of 26.3%. 17<br />
• The level of obesity in <strong>Lambeth</strong> adults (18.6%) is lower than the England<br />
average (23.6%), probably as a result of the higher than average levels of<br />
physical activity in <strong>Lambeth</strong>. However obesity in children aged 10-11 is high<br />
with up to 1 in 4 obese.<br />
• 13.3% of children at reception level are obese in <strong>Lambeth</strong> compared with<br />
11% in London, and 9.9% in England. 18<br />
Breastfeeding<br />
• The average rate of breastfeeding is 90.9%, although rates fall significantly<br />
after hospital discharge. These rates are higher than the national and<br />
London averages. 1<br />
Hypertension<br />
• Uncontrolled hypertension increases the risk of heart disease, diabetes,<br />
stroke and vascular dementia. In December 2007 30,948 <strong>Lambeth</strong> residents<br />
were on the hypertension register, and of these, 12,795 (41%) were<br />
uncontrolled.<br />
• The prevalence of hypertension in <strong>Lambeth</strong> is approximately 9.9%<br />
compared with the modelled prevalence of 19.9% which means there could<br />
be up to 34,000 individuals in <strong>Lambeth</strong> who have hypertension but have not<br />
been detected and who are not being treated. However these estimates<br />
have to be used with caution and detection and treatment of hypertension is<br />
monitored through primary care.<br />
Exercise<br />
• Sports participation levels are the 4 th highest in London and the UK. 19<br />
• The number of visits to <strong>Lambeth</strong> leisure centres during 2007-08 was 2.19<br />
per head of the population. 20<br />
• 81% of residents live within 5 mins. of a public open space (see map<br />
below).<br />
• 2<strong>5.</strong>6 % of adults regularly participate in a minimum of 30 minutes of<br />
moderate intensity exercise at least 3 times a week. 21<br />
• Of the 48,900 men aged 30-44 in <strong>Lambeth</strong>, 2.6% participate 3 x week, 2.2%<br />
participate 1-2 x week, 3.5% are inactive 22<br />
• <strong>Lambeth</strong> has: 30,980 people aged 60+ 11% participate 3 x week, 7%<br />
participate 1-2 x week, 76% are inactive. 8<br />
• Of the 52,759 people on low incomes in <strong>Lambeth</strong>, 18% participate 3 x week,<br />
11% participate 1-2 x week and 63% are inactive.<br />
17 Modelled estimate from Health Survey for England.<br />
18 London Borough of <strong>Lambeth</strong>. State of the Borough: The evidence base supporting the Sustainable<br />
Community Strategy. 2008.<br />
19 Sports England Active People Survey<br />
20 ECCS Performance Digest 2007-08<br />
21 Sports England Survey 2005-06.<br />
http://www.sportengland.org/061206_active_people_london_region_factsheet_embargo_7_dec(2).p<br />
df<br />
22 Office for National Statistics (2007). Quinary age groups and sex for local authorities in the United<br />
Kingdom;estimated resident population Mid-2006 Population Estimates (T 09).<br />
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• Of the 95,726 people from black and minority ethnic communities in<br />
<strong>Lambeth</strong>, 1.9% participate 3x week, 1.9% participate 1-2x week and <strong>5.</strong>2%<br />
are inactive. 8<br />
• 100% of schools are signed up to the Schools Sports Partnership<br />
Programme with 86% offering a minimum of at least 2 hours of good quality<br />
Physical Education (PE) and sports.<br />
• 82% of school pupils participate in at least 2 hours of high quality PE and<br />
out of hours school sport in a typical week; this is lower than both the<br />
London and England averages. 5<br />
• 33 % of pupils were involved in inter school sports competitions during the<br />
academic year compared with 35% nationally. 23<br />
• 25% of <strong>Lambeth</strong> pupils participate in one or more community sports, dance<br />
or multi skill clubs linked to school, in line with the national average.<br />
• 59% of young people who responded to the Residents’ survey 2007 said<br />
they used sports and leisure facilities.<br />
• 2.6% of adults volunteer to support sport for a minimum of 1 hour per week.<br />
5<br />
• 5% of <strong>Lambeth</strong> pupils are actively involved in sports volunteering and<br />
leadership compared with 12% nationally.<br />
• 120 people participated in the 2005-06 ACTIVEwalks programme in the<br />
borough, 96% of participants enjoy and regularly attend these sessions.<br />
Health plans<br />
• The Healthy Lifestyles team referred 743 patients onto the exercise referral<br />
scheme were referred last 2007/08. Since 2004 participation has increased<br />
from 150 to 800, with 50% being from BME groups.<br />
• 67 children followed the ‘Mind, Exercise, Nutrition Do it’ programme in 2007.<br />
Feedback from the families demonstrated that 80% were successful in<br />
achieving their aims.<br />
• 19 out of 54 <strong>Lambeth</strong> GP surgeries have signed up to provide a specialist,<br />
enhanced service to patients with Learning Disabilities. These surgeries<br />
carry out yearly health checks and draw up Health Action Plans (HAPs) with<br />
the patients to address any specific health needs. There are currently 110<br />
patients with HAPs.<br />
• 8<strong>5.</strong>5% of all schools in <strong>Lambeth</strong> have a School Travel Plan in place,<br />
resulting in significant shifts with walking to schools increasing by 9%, car<br />
driving decreasing by 7% and cycling increasing by 7%.<br />
Smoking<br />
• Smoking prevalence is high in <strong>Lambeth</strong> especially in deprived areas and in<br />
people in lower socio-economic groups and in manual occupations. The<br />
deaths attributable to smoking every year are also high in <strong>Lambeth</strong><br />
compared with the national average. However, the numbers of mothers<br />
known to be smoking during pregnancy is lower than both the London and<br />
England averages. 24<br />
• Between April 2005 and March 2007 approximately 1,841 people reported<br />
quitting smoking, with an expected success rate of around 50%. Whilst<br />
encouraging, this should be balanced against the countervailing increases<br />
in young people taking up smoking.<br />
23 DfCSF (2007). 2006/7 School Sport Survey Research Report DISF-RW024.<br />
24 Department of Health area profile 24 June 2008.<br />
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SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• The African-Caribbean and Indian older people population is predicted to<br />
increase over the years and these groups are at a higher risk of having<br />
hypertension.<br />
• 71.2% of people with disabilities compared with 40.3% of people without<br />
impairments are inactive. 25<br />
• Prevalence of obesity among children aged 2-10 is higher and has grown<br />
from 9.9% in 1995 to 13.7% by 2003. 26<br />
• 63.1% of people from the lowest socio-economic group compared with<br />
34.1% from the highest socio-economic group are inactive. 8.<br />
• 51.8% of people from Black and Minority Ethnic cultures compared with<br />
40.4% white groups are inactive.<br />
• 34.6% of males aged 30-44 compared with 19.2% males aged 16-29 are<br />
inactive.<br />
• 76% of older people 60+ compared to 39% people aged 16-59 are inactive.<br />
• 25% of <strong>Lambeth</strong>’s children responding to the TellUs2 Survey cited lack of<br />
parental consent as one of the main reasons for them not being involved in<br />
activities such as sports and recreational activities. This compares with 11%<br />
nationally.<br />
• Not being able to participate in out of school leisure and recreation because<br />
of carers’ concerns about their safety is also a key issue for children looked<br />
after (LAC) (raised in the Young London Matters consultation 2007).<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 52<br />
NI 53<br />
NI 55<br />
Indicator<br />
Take up of school lunches<br />
Prevalence of breast-feeding at 6-8 weeks from birth<br />
Obesity among primary school age children in Reception<br />
NI 56 Obesity among primary school age children in Year 6<br />
NI 8<br />
NI 57<br />
NI 123<br />
Adult participation in sport and active recreation<br />
Children and young people’s participation in high quality PE and sport<br />
Stopping smoking<br />
Obesity Modelled and/or recorded prevalence<br />
Hypertension Modelled and/or recorded prevalence<br />
Modelled and/or recorded drinking behaviour<br />
Reducing underage sales of alcohol<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• The North <strong>Lambeth</strong> and Southwark Sport Action Zone is one of the original<br />
12 Sport Action Zones established to empower and support local<br />
communities to develop sustainable and inclusive sport and physical activity<br />
in areas of high deprivation. It has encouraged sports among young people<br />
through local partnerships. Higher levels of participation are observed in<br />
northern <strong>Lambeth</strong> where the Sport Action Zone has been most active.<br />
25 <strong>Lambeth</strong> Needs Assessment for Physical Activity, March 2008<br />
26 London Borough of <strong>Lambeth</strong>. Draft Parenting and Family Support Strategy 2008-11. 2008.<br />
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Overview of green spaces and <strong>Council</strong> leisure facilities in <strong>Lambeth</strong><br />
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Overview of the main exercise providers and programmes in <strong>Lambeth</strong><br />
Do they choose not to abuse alcohol or illegal drugs?<br />
STATUS<br />
Illegal Drugs<br />
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• The Home Office estimates 5,029 Problematic Drug Users (PDUs) of<br />
opiates and/or crack cocaine in <strong>Lambeth</strong> (estimate based on 2004/05 data).<br />
The total number of Problematic Drug Users PDUs known to treatment in<br />
2006/07 was 1,991. If the Home Office estimate of 5,029 is correct, that<br />
would mean that there are 3,038 PDUs who are treatment naïve (have not<br />
engaged with treatment since 2004/5).<br />
• During 2006/07, 894 clients entered treatment and 603 were discharged.<br />
• 2,033 drug users accessed treatment during 2007/08. 149 of these (7.3%)<br />
were aged 17 or under. 79% of individuals were retained in structured<br />
treatment for more than 12 weeks.<br />
• 72% of adult drug users in treatment in <strong>Lambeth</strong> are male (28% female).<br />
• 59% of adult drug users in treatment in <strong>Lambeth</strong> are white; 26% are Black<br />
which includes 10% Black Caribbean.<br />
• The age profile of adult drug users in treatment in <strong>Lambeth</strong> puts 8% aged<br />
20-24; 26% aged 25-34; 41% aged 35-44% and 16% aged 45-54. 2% are<br />
aged 18-19 and a further 4% are aged 55+.<br />
• National data has shown that clients who are retained in treatment for<br />
longer than 12 weeks (84 days) have achieved significantly better<br />
outcomes. In 2006/7, 74% of <strong>Lambeth</strong> clients were retained for more than<br />
12 weeks. This was 2% higher than the London average. This figure rose to<br />
77% for <strong>Lambeth</strong> DIP clients. Furthermore, only 3% of <strong>Lambeth</strong> clients were<br />
“triaged only” (i.e. received a triage assessment, but did not engage in<br />
treatment), compared with the London average of 7%.<br />
• The proportion of <strong>Lambeth</strong> clients receiving treatment outside the borough<br />
has significantly reduced from 10% to 5%.<br />
• The proportion of BME clients in treatment is not significantly different from<br />
the proportions in <strong>Lambeth</strong>’s overall resident population.<br />
• 61% of individuals were discharged from structured treatment in a planned<br />
way in 2007/08.<br />
• 31% of referrals for treatment were self-referrals. One in seven of all<br />
referrals are self-referrals entering through SLaM Stockwell CDT.<br />
• Slightly less than a fifth of all clients were referred from the Criminal Justice<br />
system in 2007/08; this is a similar proportion to last year.<br />
• 13% of those accessing treatment for the first time in 2007/08 had a dual<br />
diagnosis of mental health problems alongside their substance misuse<br />
issues.<br />
• The number of young people aged 15-17 who used drugs in the last year is<br />
estimated at 2,210. 27<br />
• 46 out of 85 schools have achieved the National Healthy Schools Status for<br />
drug education with a further 10 working towards it.<br />
• CHAIN data for <strong>Lambeth</strong> shows that 88% of all rough-sleepers have alcohol<br />
and/or drug support needs. This is notably higher than the proportion across<br />
other London boroughs. 28<br />
• Preliminary statistics from the Aftercare Team show that most carers<br />
engaging with treatment services are affected by their dependents’ polydrug<br />
use (including alcohol), with only 6% affected by alcohol only. Nine out<br />
27 London Borough of <strong>Lambeth</strong>. Draft Needs Assessment for Young People’s Specialist Substance Misuse Treatment.<br />
2007.<br />
28 CHAIN (2007)<br />
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Alcohol<br />
of ten carers were females (88%), and seven of ten (71%) were direct<br />
relatives (the remaining as partners or friends).<br />
• It is estimated that 23-24% of <strong>Lambeth</strong>’s population drink excessively and<br />
that <strong>Lambeth</strong> has a higher rate of alcohol related hospital admissions than<br />
London and England. The largest single categories of hospital admissions<br />
are for alcohol related disorder and then liver disease. 29<br />
• The public perception of drunk and rowdy behaviour in <strong>Lambeth</strong> is<br />
consistent with London in general with 37% seeing it as a very or fairly big<br />
problem (against 39% inner London and 40% London-wide). 6 out of 10<br />
people did not see it as a very big problem at all (Residents’ survey 2007).<br />
• The general profile for an excessive drinker in <strong>Lambeth</strong> is that of a white<br />
male.<br />
• Most drink drivers in <strong>Lambeth</strong> are male aged over 26 years. Almost 60% of<br />
arrests take place between midnight and 0700 hours in the morning with<br />
39% of those arrested coming from outside the borough. It is assumed,<br />
though not known, that a large number of drink drivers would have been<br />
socialising in the borough.<br />
• Only 27% of <strong>Lambeth</strong> schoolchildren admit to having drunk an alcoholic<br />
drink, significantly lower than the national average of 48%. However, 17%<br />
preferred not to say, higher than the national average of 10%. (Tell Us 2<br />
survey 2007).<br />
• 46% of <strong>Lambeth</strong> schoolchildren would like more/better information on<br />
alcohol (against 27% nationally) and 39% would like equivalent information<br />
on drugs (31% nationally). (Tell Us 2 survey).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
Illegal Drugs<br />
• The proportion of young adults in treatment in <strong>Lambeth</strong> in 2006/07 was<br />
lower than the London average (16%). However, these clients were retained<br />
successfully (80%) compared with the borough retention rate for all ages<br />
(74%) and the London retention rate for young adults (68%).<br />
• 95% of young people engaged with the Youth Offending Service reported<br />
as using illicit drugs.<br />
• PDUs using crack cocaine are far less likely to engage in treatment, and<br />
clients using both crack cocaine and heroin are far less likely to be retained<br />
in treatment for more than 12 weeks.<br />
• Mandatory drug testing is carried out on all those arrested for so-called drug<br />
related “trigger offences”. Of those testing positive from April-Nov 2007,<br />
89% were male and 58% were from BME communities including 21%<br />
recorded as British Caribbean. 42% were categorised as White. The high<br />
proportion of BME positive testers illustrates an over-representation within<br />
this group and is significantly different from the borough’s overall BME<br />
population.<br />
• The age profile of those testing positive highlights that 91% are aged<br />
between 18 and 44 with 18 to 24 yr olds representing the largest proportion<br />
at 21%.<br />
Alcohol<br />
29 Alcohol Needs Assessment 2006/07<br />
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• Alcohol related ambulance call outs are geographically aligned to wards<br />
with strong night time economies where levels of alcohol and violent crime<br />
are high. Alphabetically these are Bishops, Clapham Town, Coldharbour,<br />
Oval and Princes.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 39<br />
NI 40<br />
NI 115<br />
Indicator<br />
Rate of hospital admissions per 100,000 for Alcohol-related harm<br />
Number of drug users recorded as being in effective treatment<br />
Substance misuse by young people<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Reduce the harm caused by problematic drug use and Alcohol consumption<br />
(Safer <strong>Lambeth</strong> strategic plan 2008)<br />
Department of Health Area Profile for <strong>Lambeth</strong><br />
Health Profiles for every local authority and region across England were published<br />
on 24 June 2008 by the Department of Health and the Association of Public Health<br />
Observatories.<br />
The Profiles use key health indicators to capture a picture of the nation's health<br />
down to local level.<br />
The summary chart for <strong>Lambeth</strong> is included below.<br />
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<strong>5.</strong> Economic development - Are they economically secure?<br />
Are they economically active where possible?<br />
STATUS<br />
Individuals<br />
• 76.2% of the population of <strong>Lambeth</strong> is economically active; this compares<br />
with 7<strong>5.</strong>1% for London and 78.6% nationally. 30<br />
• 23.8% of the population of <strong>Lambeth</strong> is economically inactive, this compares<br />
with 24.9% for London and 21.4% nationally.<br />
• 18.7% of the economically inactive are neither in employment nor<br />
unemployed and do not want a job; this compares with 18.0% for London<br />
and 16.1% nationally. 31<br />
• The overall employment rate in <strong>Lambeth</strong> is 68.5%. This compares with the<br />
London employment rate of 69.8% and a national figure of 74.3%.<br />
• The unemployment rate in <strong>Lambeth</strong> is 9.5% of the economically active<br />
population compared with 6.9% for London and <strong>5.</strong>3% nationally.<br />
• In 2006-07, 66.9% of supervised juveniles in <strong>Lambeth</strong> were in full-time<br />
education, employment or training (EET), compared with 70.3% in our<br />
Nearest Neighbour (NN) group and 70.2% nationally 32 . In 2007-08 this has<br />
improved to 68.9%, compared with 73.5% for our NN and 70.3% nationally.<br />
• <strong>Lambeth</strong> has 9.6% of young people aged 16-18 not in education,<br />
employment or training (NEET), compared with 9% for Southwark, <strong>5.</strong>5% in<br />
Wandsworth and just 0.8% above the London average. This is down from<br />
1<strong>5.</strong>3% in 2004. Projections show that just 8.6 % will not be in paid work or<br />
preparing for it in <strong>Lambeth</strong> by 2009-10, closing the gap on the England<br />
average. 33<br />
• The <strong>Lambeth</strong> Year 11 Annual Activity survey 2007 of 1,783 pupils showed<br />
that 90.4% remained in education, compared with 87% in 2006. 1.7% are in<br />
full-time training, compared to 1.4% in 2006. 1.8% are in full-time<br />
employment, compared to 1.4% in 2006.<br />
• When asked which things would do most to make their life better, 19% of<br />
<strong>Lambeth</strong> schoolchildren indicated that they would like more help to plan for<br />
their future, compared with 17% who gave this response nationally.<br />
• 16% of young people have made use of Connexions in the last 12 months.<br />
64% said they had used the Connexions in their local area (Residents<br />
Survey 2007).<br />
30 NOMIS Official Labour Market Statistics (Oct 2006 – Sep 2007). Percentages are for those of working age<br />
(16-59/64). Economically active are people who are either in employment or unemployed.<br />
31 People who are neither in employment nor unemployed includes, for example, all those who were looking<br />
after a home or retired. Also people wanting a job, these are those not in employment who want a job but are<br />
not classed as unemployed because they have either not sought work in the last four weeks or are not<br />
available to start work.<br />
32 NN = nearest neighbour group consists of a comparable group of local authorities; Southwark, Hackney,<br />
Islington, Haringey, Lewisham, Hammersmith and Fulham, Tower Hamlets & City of London, Greenwich,<br />
Brent.<br />
33 London Borough of <strong>Lambeth</strong>. CYPS Performance Digest Report. March 2008<br />
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• In May 2008, 3.6% of the resident working age population for <strong>Lambeth</strong> is<br />
claiming Job Seekers Allowance (JSA), compared with 2.6% for London and<br />
2.2% nationally. At 63.10% of claimants, <strong>Lambeth</strong> is below the London<br />
average (6<strong>5.</strong>50%) for claiming up to 6 months JSA, but higher than London<br />
averages for claimants over 6 up to 12 months and over 12 months. 34<br />
• 88% of people using mental health services in <strong>Lambeth</strong> are unemployed.<br />
• The number of adults with learning disabilities in employment was 2.3% in<br />
2007/08.<br />
• Over 53% (9,132) of working age people who said that they were carers in<br />
the 2001 Census worked full or part time. 782 combined work with 50+<br />
hours of caring each week.<br />
• In common with other London boroughs, childcare is a barrier to<br />
employment. In <strong>Lambeth</strong>, a large majority of people use relatives for<br />
childcare, and those that pay, pay an average of £85 per week, compared<br />
with the national median average of £23 per week.<br />
Business<br />
• LABS 2007 35 cites <strong>Lambeth</strong>’s economy as contributing 0.53% of total British<br />
economic output and it is ranked 29 th out of 408 Local Authorities in terms of<br />
size and its economy 36 .<br />
• In 2007, there were around 10,000 businesses in <strong>Lambeth</strong>; but more than<br />
three-quarters of these had fewer than five employees (Association of<br />
British Insurers 2007).<br />
• The 2007 <strong>Lambeth</strong> Economic Digest showed that 99.65% of businesses in<br />
the borough are Small or Medium Enterprises (SMEs). However, in the<br />
north of the borough there is a cluster of large firms, 48 of which employ<br />
more than 200 employees; among these are the national headquarters of<br />
IBM, Shell, and the ITV network.<br />
• North <strong>Lambeth</strong> currently accommodates 61,500 jobs, almost 45% of the<br />
borough’s total. 37<br />
• <strong>Lambeth</strong> businesses comprise 38 :<br />
SMEs 99.65%<br />
Family owned 50.04%<br />
Social Enterprises 12.38%<br />
Ethnic minority owned businesses 40.62%<br />
• The biggest contribution of businesses is from Real estate, renting and<br />
business activities sector. There are higher concentrations of other<br />
community services, hotel and restaurant sector, publishing sector,<br />
education, health and social work sector and construction sector compared<br />
with London. 39<br />
34 The Jobseeker's Allowance (JSA) is payable to people under pensionable age who are available for, and<br />
actively seeking, work of at least 40 hours a week.<br />
35 <strong>Lambeth</strong> Businesses (LABS), Source: LABS; Annual Business Inquiry (ABI) 2007<br />
36 Regeneration Delivery Plan 2007/08; Building a Better <strong>Lambeth</strong>.<br />
37 Economic Development Strategy 2007-2010<br />
38 From LABS boosted analysis, 2007<br />
39 <strong>Lambeth</strong> Economic Digest 2008.<br />
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• The business sectors with lower concentrations compared with London are<br />
business and professional services, banking and finance, wholesale and<br />
retail and transport and communications.<br />
• At the start of 2007, there were 7,870 VAT registered businesses. The VAT<br />
registration rate during 2006 was 44 per 10,000 working age population.<br />
985 new registrations were made during 2006 and 600 businesses deregistered<br />
in the same period.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• The BME employment rate is 50.9% 40 and there has been a 2% decrease in<br />
the non white JSA claimant rate form March 2008 to April 2008.<br />
• 61% of 19 year old care leavers known to Connexions are in education,<br />
employment or training (EET).<br />
• 12.9% of 16-19 year olds with learning difficulties or disabilities were NEET<br />
in December 2007. This is a significant decrease of 29% from December<br />
2006. 74.5% were in EET.<br />
• Currently, 45% of teenage mothers are in EET. This represents an increase<br />
of 22% on 2006 figures.<br />
• The numbers of young offenders in full-time EET has increased by 6%<br />
during the last two years to above 76%, which is higher than the average for<br />
London, and the national average.<br />
• <strong>Lambeth</strong> has extraordinary levels of social exclusion e.g. 96%<br />
unemployment rates for people using community mental health teams. 41<br />
Growing professional awareness of vocational possibilities for patients with<br />
severe mental illness should mean that many patients could return to<br />
competitive employment and return to mainstream society.<br />
• There is evidence of documentation relating to vocational needs in only<br />
18% of out-patients; 8% in patients of community mental health teams; and<br />
39% in acute wards; 8% of patients were engaged in work schemes; 10% of<br />
patients were in education; and 9% were engaged in vocational<br />
interventions with their care coordinator; the latter was less likely if the<br />
patient was from a Black or minority ethnic group. 42<br />
• The more care that people provide, the less likely they are to be<br />
economically active. In a national survey 87% of working age Carers who<br />
care 20+ hours per week said that they would like to return to work, but four<br />
out of five of them felt that it would be difficult or impossible for them to do<br />
so.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 151<br />
NI 144<br />
NI 146<br />
NI 150<br />
NI 117<br />
NI 45<br />
Indicator<br />
Overall Employment rate (working-age)<br />
Offenders under probation supervision in employment at the end of their<br />
order or licence<br />
Adults with learning disabilities in employment<br />
Adults in contact with secondary mental health services in employment<br />
16-18 year olds who are not in education, training or employment (NEET)<br />
Young offenders engagement in suitable education, employment or training<br />
40 NOMIS/ APS October 2006 – September 2007.(data prior to his period has to be re-weighted)<br />
41 Vocational and social inclusion service proposal, Mark Bertram, SLaM<br />
42 Bertram & Howard, Occupational care planning for service users. Psychiatric Bulletin (2006), 30, 48-51<br />
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NI 7<br />
NI 171<br />
NI 172<br />
NI 182<br />
NI 183<br />
Environment for a thriving 3 rd sector<br />
New business registration rate<br />
Percentage of small businesses in an area showing employment growth<br />
Satisfaction of business with local authority regulatory services<br />
Impact of local authority trading standards services on the fair trading<br />
environment<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Increase the number of young people in education, employment and<br />
training, developing skills for adulthood. (<strong>Lambeth</strong> Children and Young People’s<br />
Plan 2 2007-10)<br />
• The Sustainable Communities Strategy contains identifies<br />
worklessness priorities supported by indicators within the Local Area<br />
Agreement.<br />
• The <strong>Lambeth</strong> Employment and Skills Plan have agreed a target this<br />
year of an employment rate of 70% by 2012.<br />
• The Economic Development Strategy has a central objective of<br />
creating training and employment ‘pathways’ for people to realise<br />
their talents and take advantage of employment opportunities<br />
alongside demand side objectives to support employer engagement<br />
through initiatives such as the ‘Employer of First Choice’ programme.<br />
The EDS offers an underpinning framework for the future rollout of<br />
projects and interventions.<br />
• Support Carers so that they can work, or continue with their education<br />
or training (Carers Strategy 2008)<br />
Do they possess valuable skills and qualifications?<br />
STATUS<br />
• The average point score per student in post 16 education has increased<br />
from 547.6 in 2006 to 578.4 in 2007. Although these point scores are below<br />
inner London and national figures the increase is larger than both inner<br />
London and national increases.<br />
• 39.5 43 % of the Working age population in <strong>Lambeth</strong> is qualified to at least<br />
Level 4 or higher.<br />
• 51.2% of the Working age population in <strong>Lambeth</strong> is qualified to at least<br />
Level 3 or higher.<br />
• 61.4% of the Working age population in <strong>Lambeth</strong> is qualified to at least<br />
Level 2 or higher.<br />
• The LABS report reveals that the top three biggest problems facing<br />
<strong>Lambeth</strong> businesses are availability of appropriately skilled employees, size<br />
of current premises and cost of labour.<br />
• <strong>Lambeth</strong> residents are employed by sector as follows:<br />
Manufacturing 2.7%<br />
Construction 2.7%<br />
Services 94.0%<br />
43 NOMIS: ONS Annual Population Survey, Jan 2006 – Dec 2006.<br />
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• <strong>Lambeth</strong> residents are employed in the service industry sectors as follows 44 :<br />
Public administration, education & health 3<strong>5.</strong>6%<br />
Finance, IT and other business activity 28.5%<br />
Distribution, hotels and restaurants 16.3%<br />
Other services 8.2%<br />
Tourism 7.2%<br />
Transport & Communications <strong>5.</strong>4%<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• <strong>Lambeth</strong> has much higher percentages of residents who have no<br />
qualifications than both London and nationally and it appears that the gap is<br />
growing. 21.3% 45 of working age residents in <strong>Lambeth</strong> have no<br />
qualifications compared with 13.9% for London and 13.8% nationally. The<br />
difference Jan– Dec 2005 was <strong>5.</strong>4% higher compared with London but for<br />
Jan– Dec 2006 the difference was 7.4% higher than the London<br />
percentage. 46<br />
• The lack of the appropriate skills is a barrier to employment. Less than 50%<br />
of adults with low or no qualifications are in work. 47<br />
• Conversely, <strong>Lambeth</strong> has consistently had higher levels of residents<br />
qualified to NVQ 4 and above compared with London and national<br />
averages. For the period Jan– Dec 2006 the NVQ4 qualification level in<br />
<strong>Lambeth</strong> was 4.9% higher than London and 12.1% higher than the national<br />
average.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 161<br />
NI 162<br />
NI 163<br />
NI 164<br />
NI 165<br />
NI 174<br />
Indicator<br />
Number of Level 1 qualifications in literacy (including ESOL) achieved<br />
Number of Entry Level qualifications in numeracy achieved<br />
Proportion of population aged 19-64 for males and 19-59 for females<br />
qualified to at least Level 2 or higher<br />
Proportion of population aged 19-64 for males and 19-59 for females<br />
qualified to at least Level 3 or higher<br />
Proportion of population aged 19-64 for males and 19-59 for females<br />
qualified to at least Level 4 or higher<br />
Skills gaps in the current workforce reported by employers<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Support Carers so that they can work, or continue with their education or<br />
training (Carers Strategy 2008)<br />
44 NOMIS: ONS annual business inquiry employee analysis (2006)<br />
45 NOMIS APS, Data for Jan 2006 –Dec 2006<br />
46 <strong>Lambeth</strong> Economic Digest<br />
47 <strong>Lambeth</strong> Economic Development Strategy 2007-2010<br />
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Do they enjoy access to sufficient income?<br />
STATUS<br />
• Average gross weekly earnings of employees in <strong>Lambeth</strong> is £537.3 48 , this<br />
compares to £558.9 and £613.3 for neighbouring boroughs of Southwark<br />
and Wandsworth respectively and the London average of £553.3.<br />
• The 2001 Census showed that one-quarter (17,000 out of 67,000) of<br />
<strong>Lambeth</strong>’s under-19s live in areas of income deprivation. 49<br />
• 51% of Inner London children live in poverty 50 compared with 41% across<br />
London and 28% nationwide. Borough level figures are not available but<br />
<strong>Lambeth</strong> can be expected to exceed the Inner London figure. 51<br />
• 23% of <strong>Lambeth</strong> residents surveyed (2007), felt the housing benefits service<br />
was good or excellent compared with 21% across London and 22%<br />
nationally. 20% of respondents said they actually used the service<br />
compared with 13% for London and 18% nationally.<br />
• The percentage of working age people on out of work benefits is16.5%. In<br />
the worst performing neighbourhoods this increases to 27.7% (Q2 2007).<br />
• Just over a third (36%) 52 of children in <strong>Lambeth</strong> live in families on key<br />
benefits compared with 28% in London. <strong>Lambeth</strong> ranks as the 11th highest<br />
rate for this nationally and 27th out of the 33 London boroughs.<br />
• The number of people claiming incapacity benefits represents<br />
approximately 7.1% of the working age population (London 6.1% and<br />
nationally 7.2%). The number of people claiming incapacity benefits<br />
allowance has fallen by 3%, a reduction of 390 claimants between<br />
November 2006 and November 07.<br />
• The number of people claiming lone parent benefits represents<br />
approximately 4.0% of the total working age population (compared with<br />
London 3.1% and nationally 2.0%). The total number of people claiming<br />
lone parent benefits has decreased by 13% over the period November 2003<br />
to 2007.<br />
• 38% of secondary school pupils are eligible for free school meals, which is<br />
the fifth highest proportion in England.<br />
• The proportion of primary school pupils eligible for free school meals is<br />
37.4%, which is the eighth highest proportion of primary school pupils<br />
across England. 53<br />
• <strong>Lambeth</strong> has the highest take-up nationally of the childcare element of<br />
working family tax credit at 27% (compared with 11% for England).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Vassall and Coldharbour wards display the highest working age benefit<br />
claim rates within <strong>Lambeth</strong> with approximately 25% of the total working age<br />
population claiming some form of working age benefit (i.e. incapacity<br />
48 ONS annual survey of hours and earnings - resident analysis [2007]<br />
49 This is the number of children and young people living in 10% most deprived Super Output Areas by Income<br />
deprivation affecting children.<br />
50 Households living in poverty subsist on an income 60% below the median household income. Calculation of<br />
poverty rates control for geographic variations in house prices.<br />
51 London Child Poverty Commission.<br />
52 Government Office for London /DWP August 2008, based on 5% sample.<br />
53 London Borough of <strong>Lambeth</strong>. Draft State of the Borough: The evidence base supporting the Sustainable<br />
Community Strategy. 2008.<br />
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benefit, job seekers allowance, lone parent benefits). (Based on DWP Ward<br />
Count May 2007/working aged population).<br />
• In Vassall ward, there was a 2% reduction in the number of people claiming<br />
working age benefit . from February 2008 to May 2008.<br />
• In Coldharbour ward, there was a 3% reduction for the same period.<br />
• The Households Below Average Income data 2004/5 (DWP) showed that<br />
21% of children nationally are from families on out of work benefits. Within<br />
London there are 105 local wards where the percentage of children on<br />
benefits is at least twice the national average. <strong>Lambeth</strong> had 2 wards<br />
(Coldharbour, 48.2% and Tulse Hill, 43.85%). Southwark had 5 wards,<br />
Wandsworth and Lewisham also had 2 wards. 54<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 166<br />
NI 152<br />
NI 153<br />
NI 173<br />
NI 181<br />
NI 116<br />
NI 118<br />
NI 180<br />
Indicator<br />
Median earnings of employees in the area<br />
Working age people on out of work benefits<br />
Working age people claiming out-of-work benefits in worst performing<br />
neighbourhoods<br />
Flows on to incapacity benefits from employment<br />
Time taken to process Housing Benefit/<strong>Council</strong> Tax Benefit new<br />
claims and change events<br />
Proportion of children in poverty<br />
Take up of formal childcare by low-income working families<br />
The number of changes of circumstances which affect customers’<br />
HB/CTB entitlement within the year.<br />
Proportion of Older People in poverty<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
•<br />
Do they live in decent homes?<br />
STATUS<br />
• The mix of housing stock in <strong>Lambeth</strong> is fairly typical of an inner London<br />
borough with 37% owner-occupied properties, 38% social housing and 25%<br />
privately rented.<br />
• There is very high demand for housing in <strong>Lambeth</strong> reflected in an average<br />
house price of £356k (Land Registry Dec 2007), almost double the national<br />
average.<br />
• Private renting in <strong>Lambeth</strong> is also expensive costing an average of £230 per<br />
week for a 2 bedroom property, compared with less than £80 per week for a<br />
social let (Housing needs survey 2007).<br />
• <strong>Lambeth</strong> is estimated to have <strong>5.</strong>16% of households in fuel poverty 55 ; this<br />
compares with a London average of <strong>5.</strong>4%.<br />
54 http://www.jrf.org.uk/child-poverty/documents/London.doc<br />
55 A household is defined as being in Fuel Poverty (full income) if, in order to maintain a satisfactory heating<br />
regime, it needs to spend more than 10% of its income on all household fuel use.<br />
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• Approximately 16,000 households are currently registered on the general<br />
needs waiting list. Of these households only 30 (excluding sheltered) were<br />
allocated social housing in 2007/08. 85% of all new social lettings are to<br />
homeless households in temporary accommodation.<br />
• There are currently 2,100 people waiting for an offer in Temporary<br />
Accommodation.<br />
• Through a successful homelessness prevention strategy, the number of<br />
households accepted as being homeless has been successfully reduced<br />
from 1,651 to 735 over the last 5 years.<br />
• There are approximately 13 people sleeping rough in <strong>Lambeth</strong> on any one<br />
night.<br />
• Around 10% of households living in rented accommodation (both social and<br />
private) are overcrowded. This compares with only 1.2% of owner-occupied<br />
households.<br />
• There are an estimated 28,000 or 22% of all households in the borough<br />
under-occupying their homes (using the criteria of having more than one<br />
spare bedroom).<br />
• 1.8% of private sector properties are vacant for over six months.<br />
• It is estimated that 4,881 additional affordable housing units would need to<br />
be built each year if all affordable needs were to be met. This is an increase<br />
on the 2002 survey estimate of 3,050 per annum. This rise is due both to a<br />
decreased level of supply compared with 2002 and an increasing level of<br />
need due to the significant rise in house prices over and above the ability of<br />
households to afford them (Housing Needs Assessment 2007).<br />
• <strong>Lambeth</strong> secured the second highest allocation of NAHP funding for the<br />
2006/08 programme in London and successfully delivered 872 new units of<br />
affordable housing between 2005-07.<br />
• From April 2008 the <strong>Council</strong> has put in place a Choice Based Lettings<br />
scheme with the aim of improving choice for people in housing need. People<br />
looking for a home act directly by registering their interest in any advertised<br />
council or housing association homes in <strong>Lambeth</strong> for which they are eligible.<br />
Because of the severe shortage of social housing to rent in <strong>Lambeth</strong>, the<br />
bidder in the greatest need is then invited to view the property.<br />
• There is a government target that all social housing should meet the Decent<br />
Homes Standard by 2010. For a home to be decent it needs to:<br />
meet the current statutory minimum for housing<br />
be in a reasonable state of repair<br />
have reasonably modern facilities and services<br />
provide a reasonable degree of thermal comfort.<br />
• 66% of council homes and 88% of RSL homes meet the Decent Homes<br />
standard. 11% of Private Sector properties are deemed unfit for purpose<br />
(2004 Private Sector Stock Conditions Survey).<br />
• 62% of tenants are satisfied with the landlord services provided by <strong>Lambeth</strong><br />
(2006 Tenant Satisfaction Survey). However, the housing management<br />
service provided by <strong>Lambeth</strong> <strong>Council</strong> will shortly be transferred to an Arms<br />
Length Management Organisation (ALMO), <strong>Lambeth</strong> Living.<br />
• 18% of residents surveyed in 2007 rated our council housing as good to<br />
excellent, compared with the London-wide figure of 21%. 18% also rated<br />
our housing as poor to very poor, in line with the inner-London average.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
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• With an average house price of £356k (Land Registry Dec 2007) almost<br />
double the national average, residents on average incomes of £31k are<br />
struggling to get onto the property ladder.<br />
• Those from BME communities are over represented in social housing,<br />
homelessness and over-crowding statistics.<br />
• BME Households are likely to be larger than White households and more<br />
likely to live in the social and private rented sectors. Black African<br />
households represent the largest ethnic group in <strong>Lambeth</strong> that suffer from<br />
high levels of overcrowding. Whilst there is not a sizeable Asian community<br />
in the borough, proportionally the second ethnic group suffering from high<br />
levels of overcrowding are Asian households.<br />
• 73% of those placed in Temporary Accommodation over the year ending<br />
Dec 2007 were of Black, Asian and Minority Ethnic backgrounds.<br />
• Single, pregnant women and families with children combine to make up<br />
75% of the 2,100 people currently awaiting an offer in Temporary<br />
Accommodation. The average number of weeks spent by these households<br />
in shared hostel accommodation in <strong>Lambeth</strong> is 11.2 weeks (2006/07)<br />
(London median figure of 12.2 weeks) and in shared bed and breakfast<br />
accommodation is 1.8 weeks (London median of 2.4 weeks).<br />
• There are significantly high levels of homelessness among 16-17 year olds<br />
with approximately 104 currently in Temporary Accommodation, above<br />
London and national averages.<br />
• Households with two adults without children (totalling 43%) are in greater<br />
need of affordable housing compared with other household compositions.<br />
• Older People tend to live in properties that are under occupied when<br />
compared with other household types, but are reluctant to move into smaller<br />
accommodation. This group is least likely to be in housing need.<br />
• There are high levels of worklessness associated with those living in social<br />
housing with 60% of social tenants being in receipt of housing benefit.<br />
• 12% of residents in private sector properties move for work-related reasons;<br />
this drops to only 0.1% of those in social housing.<br />
• Receipt of incapacity benefit can be used as an indicator to demonstrate<br />
correlation between health deprivation and social housing. In <strong>Lambeth</strong> there<br />
are higher levels of incapacity benefits concentrated within social housing<br />
estates. <strong>Lambeth</strong> has a high rate of Incapacity Benefit claimants within the<br />
Brixton wards of Coldharbour and Vassall. These wards are among the<br />
most deprived areas in London and also have higher levels of worklessness<br />
and social housing than other wards in the borough.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 158<br />
NI 160<br />
NI 155<br />
NI 154<br />
NI 156<br />
NI 157<br />
NI 159<br />
Indicator<br />
% non-decent council homes<br />
Local Authority Tenants’ satisfaction with landlord services<br />
Number of affordable homes delivered (gross)<br />
Net additional homes provided<br />
Number of households living in Temporary Accommodation<br />
Processing of planning applications<br />
Supply of ready to develop housing sites<br />
NI 170 Previously developed land that has been vacant or derelict for more than 5<br />
years<br />
NI 187<br />
Tackling fuel poverty - % of people receiving income based benefits living in<br />
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NI 46<br />
homes with a low energy efficiency rating<br />
Young offenders access to suitable accommodation<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Increase the supply of dwellings in the borough (Housing Strategy 2008)<br />
• Improve the condition of existing stock (Housing Strategy 2008)<br />
• Improve access to housing (Housing Strategy 2008)<br />
• Mixed, sustainable communities (Housing Strategy 2008)<br />
• Worklessness (Housing Strategy 2008)<br />
• Empowering tenants (Housing Strategy 2008)<br />
Do they enjoy easy access to transport?<br />
STATUS<br />
• 50.9% of households in <strong>Lambeth</strong> have no access to a car, one of the<br />
highest proportions in the country (see map below) (Census 2001).<br />
• <strong>Lambeth</strong> has the highest proportion of population who travel to work by<br />
public transport: 58.6% compared with 14.1% nationally.<br />
• 69% of <strong>Lambeth</strong> residents rate local public transport as good or excellent<br />
compared with 66% of inner-London residents and 61% of Londoners<br />
overall (Residents’ survey 2007).<br />
• 64% of young people in <strong>Lambeth</strong> rate local public transport as good or<br />
excellent compared with 63% of young inner-London residents and 57% of<br />
young Londoners overall (Residents’ survey 2007).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Residents in the south of the Borough face a number of difficulties in trying<br />
to undertake local trips or access central London by public transport. They<br />
are generally restricted to using buses which are slow due to a lack of<br />
priority measures. In addition, since they are mainly focused on north-south<br />
radial routes, they do not adequately serve some of the housing estates<br />
(see map below).<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 176<br />
NI 177<br />
NI 178<br />
NI 167<br />
NI 168<br />
NI 169<br />
Indicator<br />
Working age people with access to employment by public transport (and<br />
other specified modes)<br />
Local bus and light rail passenger journeys originating in the authority area<br />
Bus services running on time<br />
Congestion – average journey time per mile during the morning peak<br />
Principal roads where maintenance should be considered<br />
Non-principal classified roads where maintenance should be considered<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• The <strong>Lambeth</strong> Transport Local Implementation Plan sets out how <strong>Lambeth</strong><br />
will deliver the London Mayor's Transport Strategy and forms the basis for<br />
future funding bids for projects until 2011. Included action areas: Road<br />
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Safety, Parking and Enforcement, School Travel Plan Strategy, Cycling<br />
Action Plan, Strategic Environmental Assessment.<br />
OVERVIEW OF CAR ACCESS WITHIN LA<strong>MB</strong>ETH<br />
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6. CYP - Do they enjoy and achieve in their lives?<br />
Do the children and young people of <strong>Lambeth</strong> attend and enjoy high-quality<br />
pre-school childcare, school and college?<br />
STATUS<br />
• 83% of <strong>Lambeth</strong> school children view themselves positively as learners and<br />
try their best at school compared with 81% London-wide (TellUs2 Survey<br />
2007).<br />
• 55% of <strong>Lambeth</strong> school children enjoy school always or most of the time<br />
compared with 58% for London (TellUs2 Survey 2007).<br />
• <strong>Lambeth</strong> children would welcome more help with their studies from families<br />
and friends, somewhere quieter at home to do homework, more help from<br />
teachers and less noisy and disruptive classes (TellUs2 Survey 2007).<br />
• Attendance levels at primary schools stand at 94.5% overall in <strong>Lambeth</strong>, a<br />
0.8% improvement. Primary attendance levels are below the national<br />
average of 94.8% for 2006-07.<br />
• Attendance levels at secondary schools stand at 92.5% overall in <strong>Lambeth</strong>,<br />
a 0.3% improvement. Secondary attendance levels are 0.3% above the<br />
national average of 92.2% for 2006-07.<br />
• <strong>Lambeth</strong> has a higher permanent exclusion rate in secondary schools of<br />
0.36% of school population compared with London (0.32%) and England<br />
(0.24%) respectively.<br />
• Population projections from the GLA and analysis of current school rolls<br />
indicate that there will be a shortfall in both primary and secondary school<br />
places across <strong>Lambeth</strong> by 201<strong>5.</strong> The GLA’s projection for primary school<br />
places indicate that 17 forms of entry will needed by 2017 to meet the<br />
demand.<br />
• A Primary School Places Expansion Project has been initiated to examine<br />
options for addressing the projected shortfall in primary places. It is working<br />
alongside the creation of a Primary Estate Master Plan which, by October<br />
2008 will have produced a strategy for the expansion of <strong>Lambeth</strong>’s primary<br />
estate to meet the rising demand for primary school places.<br />
• <strong>Lambeth</strong> was the first London <strong>Council</strong> to start construction of secondary<br />
schools under the Building Schools for the Future (BSF) Programme in<br />
January 2007. By 2013, the <strong>Lambeth</strong> BSF programme will have created an<br />
additional 2,370 secondary school places, including a new 180 place<br />
school.<br />
• 40% of <strong>Lambeth</strong> primary schools are now offering the full core of extended<br />
services, exceeding the national target by 33%.<br />
• Only 1 primary school currently requires special measures. Prior to this<br />
judgement, no <strong>Lambeth</strong> schools had been in the category of concern for the<br />
previous five years.<br />
• 75% of schools inspected were judged as Good or Outstanding by<br />
OFSTED.<br />
• <strong>Lambeth</strong>’s value-added measure improved this year from 100.3 to 100.6.<br />
• 67% of <strong>Lambeth</strong> primary schools achieved a positive value added score for<br />
Key Stages 1 and 2.<br />
• 11 schools are in the top 5 percent of schools in the country in terms of<br />
value-added.<br />
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• 80% of Looked After Children were offered their first choice secondary<br />
school.<br />
• In 2006 80% of children leaving care went onto further education. 56<br />
• Data on the supply of childcare in <strong>Lambeth</strong> suggests that the number of<br />
children per place for under 5s in <strong>Lambeth</strong> is better than the national<br />
average. For instance, there are 2.0 children per place (across private,<br />
voluntary and independent (PVI) group settings, childminders and<br />
maintained provision) in <strong>Lambeth</strong>, compared to between 4.2 and 4.52<br />
nationally.<br />
• 53% of childcare providers were judged good or better for Nursery<br />
Education in inspections in March 08, increased from 42% in March 07.<br />
• In 2007, 8% of residents said they used the nursery education (under 5’s).<br />
24% of those asked thought the local nursery education was good to<br />
excellent compared with 29% for inner London.<br />
• During 2006-07, 60% of integrated early years settings had a leader<br />
qualified to NVQ level 4 or above.<br />
• 26 Children’s Centres covering all wards in <strong>Lambeth</strong> are now in place. All<br />
Children’s Centres offer the following core services:<br />
On-site childcare or information and access to childcare in the local<br />
area<br />
Information on parenting, drop-in groups and opportunities to access<br />
parenting support and education<br />
Antenatal and postnatal services, child health services and<br />
information on health issues<br />
<br />
<br />
Information about employment, education and training<br />
Information at points of transition, including information sessions<br />
around the time of the birth of their child, and on entry to primary<br />
school, which as part of the extended services programme will be<br />
offering sessions for mothers and fathers as their child starts school.<br />
• The percentage of full day care providers participating in the Childcare<br />
Affordability Programme (CAP) increased from 31% to 52% in the first three<br />
quarters of 2007/08.<br />
• The percentage of flexible childcare providers participating in the Childcare<br />
Affordability Programme (CAP) increased from 45% to 47% in first three<br />
quarters of 2007/08.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• On average, over half (52%) of year six primary school pupils move on to<br />
secondary schools outside the borough.<br />
• There is an over-representation of BME children and young people amongst<br />
those who are permanently excluded from school.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 85<br />
NI 86<br />
NI 87<br />
Indicator<br />
Post-16 participation in physical sciences (A level Physics, Chemistry and<br />
Maths)<br />
Secondary schools judged as having good or outstanding standards of<br />
behaviour<br />
Secondary school persistent absence rate<br />
56 <strong>Lambeth</strong> Children and Young People’s Plan 2 2007-2010, CYPSP Version <strong>5.</strong>5 July 2007.<br />
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NI 88<br />
NI 89<br />
NI 90<br />
NI 91<br />
NI 106<br />
NI 109<br />
NI 114<br />
Percentage of schools providing access to extended services<br />
Reduction of number of schools judged as requiring special measures and<br />
improvement in time taken to come out of the category<br />
Take up of 14-19 learning diplomas<br />
Participation of 17 year olds in education or training<br />
Young people from low income backgrounds progressing to higher<br />
education<br />
Delivery of Sure Start Children’s Centres<br />
Rate of permanent exclusions from school<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Increase access to quality local school places and good quality<br />
childcare places (<strong>Lambeth</strong> Children and Young People’s Plan 2 2007-10)<br />
Do the children and young people of <strong>Lambeth</strong> achieve national educational<br />
standards?<br />
STATUS<br />
• Those <strong>Lambeth</strong> school children who complete their GCSEs are doing far<br />
better than previously. Between 1996 and 2006 the gap between <strong>Lambeth</strong><br />
students and those in England gaining 5 or more A-C grades reduced from<br />
a 20% point lag to 4% points behind the national average score. 56% of<br />
<strong>Lambeth</strong> students gained five or more A*-C GCSE passes in 2007<br />
compared with 62% nationally.<br />
• Reading and mathematics at KS1 showed an improvement of 2% and 1%<br />
respectively.<br />
• KS2 results increased 1% to 71% in mathematics while science was up 2%<br />
to 85%.<br />
• Mathematics and science results at KS3 both improved by one percentage<br />
point.<br />
• At both Key Stage 2 (KS2) and at Key Stage 4 (KS4), the achievement gap<br />
between young people who are eligible for free school meals and those who<br />
are not is less than both the London and England gaps for English, Maths<br />
and Science.<br />
• 30% of children met the Foundation Stage Profile criteria to achieve the<br />
points score target compared with 46% nationally. (The target is at least 78<br />
points across the Foundation Stage Profile with at least 6 points in Personal,<br />
Social and Emotional Development, and Communication, Language and<br />
Literacy).<br />
• 53.7% of young people leaving care achieve one or more GCSE A*-G<br />
grades, an increase of 8.7%.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Only 60% of <strong>Lambeth</strong> students achieved a Level 2 qualification by age 19 in<br />
2006 compared with 71% of London and England students.<br />
• The performance of Caribbean pupils is improving at a slower rate than in<br />
<strong>Lambeth</strong> overall. The gap between Caribbean pupils and the average<br />
widened at KS1 by 3 percentage points, at KS1 by 2 points and at KS3 by 4<br />
percentage points.<br />
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• For each Key Stage and for GCSE, Portuguese children are the lowest<br />
achieving group with performance being especially low in reading and<br />
writing at KS1, and in English at KS1. However, they have made the<br />
greatest gains since 2001 of 11% at KS2, of 36% at KS 3 and 25% at<br />
GCSE.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 72<br />
Indicator<br />
Achievement of at least 78 points across the Early Years Foundation Stage with at<br />
least 6 in each of the scales in Personal Social and Emotional Development and<br />
Communications, Language and Literacy<br />
NI 73 Achievement at level 4 or above in both English and Maths at Key Stage 2<br />
NI 74 Achievement at level 5 or above in both English and Maths at Key Stage 3<br />
NI 75<br />
NI 76<br />
NI 77<br />
NI 78<br />
Achievement of 5 or more A*- C grades at GCSE or equivalent including English and<br />
Maths<br />
Reduction in number of schools where fewer than 65% of pupils achieve level 4 or<br />
above in both English and Maths at KS2<br />
Reduction in number of schools where fewer than 50% of pupils achieve level 5 or<br />
above in both English and Maths at KS3<br />
Reduction in number of schools where fewer than 30% of pupils achieve 5 or more A*-<br />
C grades at GCSE and equivalent including GCSEs in English and Maths<br />
NI 79 Achievement of a Level 2 qualification by the age of 19<br />
NI 80 Achievement of a Level 3 qualification by the age of 19<br />
NI 81 Inequality gap in the achievement of a Level 3 qualification by the age of 19<br />
NI 82 Inequality gap in the achievement of a Level 2 qualification by the age of 19<br />
NI 83 Achievement at level 5 or above in Science at Key Stage 3<br />
NI 84<br />
NI 92<br />
Achievement of 2 or more A*- C grades in Science GCSEs or equivalent<br />
Narrowing the gap between the lowest achieving 20% in the Early Years Foundation<br />
Stage Profile and the rest<br />
NI 93 Progression by 2 levels in English between Key Stage 1 and Key Stage 2<br />
NI 94 Progression by 2 levels in Maths between Key Stage 1 and Key Stage 2<br />
NI 95 Progression by 2 levels in English between Key Stage 2 and Key Stage 3<br />
NI 96 Progression by 2 levels in Maths between Key Stage 2 and Key Stage 3<br />
NI 97 Progression by 2 levels in English between Key Stage 3 and Key Stage 4<br />
NI 98 Progression by 2 levels in Maths between Key Stage 3 and Key Stage 4<br />
NI 99 Looked after children reaching level 4 in English at Key Stage 2<br />
NI 100 Looked after children reaching level 4 in mathematics at Key Stage 2<br />
NI 101 Looked after children achieving 5 A*-C GCSEs (or equivalent) at Key Stage 4<br />
(including English and mathematics)<br />
NI 102<br />
NI 104<br />
NI 105<br />
NI 107<br />
NI 108<br />
Achievement gap between pupils eligible for free school meals and their peers<br />
achieving the expected level at Key Stages 2 and 4<br />
The Special Educational Need (SEN)/ non-SEN gap – achieving Key Stage 2 English<br />
and Maths threshold<br />
The Special Educational Needs (SEN)/non-SEN gap – achieving 5 A*- C GCSE<br />
including English and Maths<br />
Key Stage 2 attainment for Black and minority ethnic groups<br />
Key Stage 4 attainment for Black and minority ethnic groups<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Raise attainment levels for all pupils and achieve floor targets to<br />
enable pupils to achieve their full potential (<strong>Lambeth</strong> Children and Young<br />
People’s Plan 2 2007-10)<br />
• Narrow the achievement gaps for specific groups (<strong>Lambeth</strong> Children and<br />
Young People’s Plan 2 2007-10)<br />
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Do the people of <strong>Lambeth</strong> participate in recreational, social and<br />
developmental activities?<br />
STATUS<br />
Leisure<br />
• 34% of adult residents use the sport and leisure facilities in <strong>Lambeth</strong>,<br />
compared with 43% inner London average. However, only 32% of residents<br />
rated these facilities good to excellent compared with 41% inner London<br />
average and 25% rated them poor against inner London 18% (Residents’<br />
survey 2007).<br />
• 67% of adult residents make use of the parks and open spaces in <strong>Lambeth</strong>,<br />
compared with 74% inner London average. 64% of residents rated them of<br />
a good/excellent standard.<br />
• 75% of young people in <strong>Lambeth</strong> have used their local sports or leisure<br />
facilities within the last 12 months. However, only 44% of young people<br />
rated these facilities good to excellent compared with 62% inner London<br />
average and 25% rated them poor against inner London 12%. Main reasons<br />
given for not using local facilities were “better facilities elsewhere” ( 25%) or<br />
simply “none in my local area” (43%) (Residents’ survey 2007).<br />
• 31% of young people in <strong>Lambeth</strong> have used their local adventure<br />
playgrounds within the last 12 months and 28% have used local youth clubs<br />
and centres.<br />
• The percentage of young people aged 13-19 reached by publicly funded<br />
youth services is 24.6%, increased from 13.5% last year.<br />
• There are now 47 FTE youth workers in <strong>Lambeth</strong>, an increase of 10. This<br />
means an improved ratio of 1FTE youth worker per 553 young people aged<br />
13-19, down from 1,93<strong>5.</strong>2 last year.<br />
• There is concern among both adults and young people about the availability<br />
and quality of activities available for young people. Only 10% of adults rated<br />
the existing provision of activities for teenagers as good/excellent (against<br />
14% inner London average) and 43% listed additional provision as a key<br />
priority for giving children a better start in life. Among young people<br />
themselves, 31% felt available activities were good/excellent but 35% rated<br />
them as poor (Residents’ survey 2007).<br />
Cultural<br />
• 19% of adult residents enjoy the arts and cultural services activities in<br />
<strong>Lambeth</strong> and while 28% of residents rate them as good/excellent, 20% of<br />
residents rate them as poor (Residents’ survey 2007).<br />
• The 2006- 07 Satisfaction survey for Cultural Services showed:<br />
38% satisfied with Sports & Leisure activities<br />
57% satisfied with Libraries<br />
32% satisfied with Museums and galleries<br />
31% satisfied with theatres and concert halls<br />
76% satisfied with parks and open spaces.<br />
• 15,294 children and young people participated in the arts across the<br />
borough for a minimum of 3 hours, compared with 13,861 last year. 36% of<br />
young people consider available arts and cultural activities to be good<br />
(against 41% inner London average) (Residents’ survey 2007).<br />
Informal or life-long learning<br />
• In March 2008 14% of the <strong>Lambeth</strong> population were active library book<br />
borrowers.<br />
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• During 2007-2008 there was a total average of 398 visits recorded to<br />
<strong>Lambeth</strong> libraries each month and an average of 69,000 <strong>item</strong>s issued each<br />
month.<br />
• During 2007-08 our library home visitors provided for 345 individual<br />
customers and 40 venues including residential homes.<br />
• 54% of adult residents use <strong>Lambeth</strong> libraries (against 64% inner London<br />
average) and 50% rate them as good/excellent facilities (66% inner London<br />
average) (Residents’ survey 2007).<br />
• Encouragingly, 92% of young people have used their local library in the last<br />
12 months though only 59% rate them as good/excellent (73% inner London<br />
average) (Residents’ survey 2007).<br />
• 6,388 people attended the life-long learning courses in 2006-07. 70% of<br />
these were female and 73% were from BME groups. Of the total, 17% of<br />
people were learners with learning difficulties/disabilities. The highest<br />
numbers of attendees were from Coldharbour and Stockwell wards. Most<br />
learners were aged 25-39yrs (39%) and 40 – 59yrs (32%).<br />
• 8% of adult residents attend evening classes or other adult education in<br />
<strong>Lambeth</strong> but 28% of adult residents consider the adult education provision<br />
available to be good/excellent (35% inner London average) (Residents’<br />
survey 2007).<br />
• Following their life-long learning course, attendees planned to:<br />
Do further studies (65%)<br />
Find a job (14%)<br />
Help their children with their learning (7%)<br />
Use their new skills through volunteering (14%).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 9<br />
NI 10<br />
NI 11<br />
NI 199<br />
Indicator<br />
Use of public libraries<br />
Visits to museums or galleries<br />
Engagement in the arts<br />
Children and young people’s satisfaction with parks and play areas<br />
Social capital<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Increase opportunities for all young people to participate in out-ofschool<br />
activities (<strong>Lambeth</strong> Children and Young People’s Plan 2 2007-10)<br />
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Do they live in strong, cohesive and respectful communities?<br />
STATUS<br />
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• 83% of adult residents definitely agreed or tended to agree that people from<br />
different backgrounds get on well together in <strong>Lambeth</strong> (Residents’ survey<br />
2007).<br />
• However, 50% of adult residents felt that “people not treating other people<br />
with respect or consideration” was a very or fairly big problem in <strong>Lambeth</strong>.<br />
• 34% of <strong>Lambeth</strong> residents perceive a “high” level of ASB within <strong>Lambeth</strong>.<br />
• The highest proportion of recorded ASB incidents were categorised as<br />
“Disregard for Community/Personal wellbeing” 57<br />
• Main concerns relating to ASB highlighted by adults in the Residents’<br />
survey 2007 were “parents not taking responsibility for their children” (52%<br />
rated this a very/fairly big problem), “teenagers hanging around on the<br />
streets” (50%), and “people using or dealing drugs” (50%).<br />
• Overall, 70% of adult residents of <strong>Lambeth</strong> are very or fairly satisfied with<br />
<strong>Lambeth</strong> as a place to live (Residents’ survey 2007).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 1<br />
NI 2<br />
NI 5<br />
NI 17<br />
NI 22<br />
NI 23<br />
NI 35<br />
Indicator<br />
% of people who believe people from different backgrounds get on<br />
well together in their local area<br />
% of people who feel that they belong to their neighbourhood<br />
Overall / general satisfaction with local area<br />
Perceptions of anti-social behaviour<br />
Perceptions of parents taking responsibility for the behaviour of their<br />
children in the area<br />
Perceptions that people in the area treat one another with respect<br />
and consideration<br />
Building resilience to violent extremism<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Support more active and respectful communities (Safer <strong>Lambeth</strong> strategic plan<br />
2008)<br />
• Facilitate the development of an independent, borough-wide Multi-Faith<br />
Forum (<strong>Lambeth</strong> Communities First strategy 2007-10)<br />
• Work with interested parties and groups to prepare a Together as One plan<br />
(<strong>Lambeth</strong> Communities First strategy 2007-10)<br />
• Contribute to the defining and piloting of neighbourhood working in <strong>Lambeth</strong><br />
(<strong>Lambeth</strong> Communities First strategy 2007-10)<br />
Do they enjoy informed access to a broad range of support services,<br />
personalised to their needs and abilities?<br />
STATUS<br />
• 81% of initial requests for social care support made by residents aged 18 or<br />
over are progressed through to a completed assessment within the 28 day<br />
57 Comprising: Rowdy behaviour (shouting, swearing, fighting, drunken behaviour, hooliganism), Noise,<br />
Nuisance behaviour (including fireworks, urinating in public, arson, throwing missiles, climbing on buildings,<br />
impeding access, games in restricted/inappropriate areas, misuse of air guns, letting down tyres), Hoax calls,<br />
Animal related issues.<br />
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statutory time limit (NI 132 2007/08). This is a new baseline for this<br />
information.<br />
• The care support services for 94% of residents aged 65 and over are in<br />
place within the statutory time limit of 28 days from their completed<br />
assessment (PAF D56 2007/08). This is in line with the inner London<br />
average of 94%.<br />
• 13% of carers received a specific carer’s service (PAF C62 2007/08). This<br />
is above the inner London average of 10.8% for 2006/07.<br />
• 17 care service users have their own individual support budgets through the<br />
In Control pilot scheme allowing them to seek and buy alternatives to<br />
traditional care services.<br />
• 239 people aged 18 or over received direct payments in 2007-08. This<br />
equates to 127.13 people per 100,000 population. The inner London<br />
average for 2006/07 was 115 people per 100,000 population.<br />
• The level of delayed transfers of care per 100,000 population aged 65 and<br />
over is 21.2 (PAF D41 2007/08). There is considerable variation between<br />
councils with values ranging from 4 to 55 in 2006/07.<br />
• 84% <strong>item</strong>s of equipment and minor adaptations were delivered within 7<br />
working days (PAF D54 2007/08) This falls below the inner London average<br />
of 90% for 2006/07.<br />
• 48% of users of the adult social services provision in <strong>Lambeth</strong> rate the<br />
services good/excellent and 53% of users of children/family social services<br />
rate them good/excellent (Residents’ survey 2007).<br />
• 61% of residents rate local health services good/excellent (up from 47% in<br />
2003 and 58% in 2005) However, positive ratings are lowest among middle<br />
class residents (AB 56%, C1 54%), those who work full or part-time (56%<br />
and 55% respectively), Black Caribbean (55%), residents of Norwood (56%)<br />
and of Streatham (52%).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference Indicator<br />
NI 140<br />
NI 132<br />
NI 133<br />
NI 54<br />
NI 127<br />
NI 128<br />
NI 130<br />
NI 131<br />
NI 134<br />
NI 103<br />
NI 135<br />
NI 175<br />
Fair treatment by local services<br />
Timeliness of social care assessment (all adults)<br />
Timeliness of social care packages following assessment<br />
Services for disabled children<br />
Self reported experience of social care users<br />
User reported measure of respect and dignity in their treatment<br />
Social Care clients receiving Self Directed Support per 100,000 population<br />
Delayed transfers of care<br />
The number of emergency bed days per head of weighted population<br />
Special Educational Needs – statements issued within 26 weeks<br />
Carers receiving needs assessment or review and a specific carer’s service,<br />
or advice and information<br />
Access to services and facilities by public transport, walking and cycling<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
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• 84% <strong>item</strong>s of equipment and minor adaptations were delivered within 7<br />
working days (PAF D54 2007/08) This falls below the inner London average<br />
of 90% for 2006/07.<br />
Can they live their lives in the way they choose?<br />
STATUS<br />
• 4,370 people aged 18 or over are supported to continue to live in their own<br />
homes within <strong>Lambeth</strong> (NI 136). This equates to 2,315 adults per 100,000<br />
population (weighted using the Relative Needs Formulae). This is a new<br />
baseline for this information.<br />
• 488 adults aged 18 or over received a provision of intensive home care<br />
services which enabled them to remain at home, or go home following<br />
hospital treatment or a period spent in a residential home. This equates to<br />
20.74 per 1,000 population aged 65 or over. The inner London average for<br />
2006/07 was 2<strong>5.</strong>6.<br />
• There were a total of 1,386 service users aged 18 and over in<br />
permanent/temporary residential and nursing care in 2007/08 and of those<br />
48% were placed outside the borough.<br />
• 26 adults aged 18-64 were admitted on a permanent basis to<br />
residential/nursing care during 2007/08. This equates to 1.8 per 10,000<br />
population and puts <strong>Lambeth</strong> below the inner London average 2006/07 of<br />
2.0.<br />
• There were 176 older people permanently admitted to residential/nursing<br />
care during 2007/08 and this equates to 74.8 per 10,000 population. This is<br />
above the inner London average 2006/07 of 72.7 per 10,000 population.<br />
• A total of 28 adults with learning disabilities were in an adult placement<br />
during 2007/08 and of those 68% were placed outside of the borough.<br />
• 98% of vulnerable people using Supporting People service users have been<br />
supported to establish and maintain independent living in 2007/08.<br />
• 76% of vulnerable people using Supporting People service users have<br />
moved on in a planned way from temporary living arrangements during<br />
2007/08. These 848 planned moves are an increase on the 674 planned<br />
moves in 2006/07 and also above the target 769 planned moves for<br />
2007/08.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• 51% of Offenders and People at risk of offending using Supporting People<br />
services have moved on in a planned way from temporary living<br />
arrangements during 2007/08. This rate is significantly below the planned<br />
target of 75%.<br />
• 59% of Rough Sleepers using Supporting People services have moved on<br />
in a planned way from temporary living arrangements during 2007/08, below<br />
the planned target of 66%.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 136<br />
NI 139<br />
NI 124<br />
Indicator<br />
People supported to live independently through social services (all adults)<br />
The extent to which older people receive the support they need to live<br />
independently at home<br />
People with a long-term condition supported to be independent and in<br />
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NI 125<br />
NI 129<br />
NI 141<br />
NI 142<br />
NI 138<br />
control of their condition<br />
Achieving independence for older people through rehabilitation/intermediate<br />
care<br />
End of life care – access to appropriate care enabling people to be able to<br />
choose to die at home<br />
Percentage of vulnerable people achieving independent living<br />
Percentage of vulnerable people who are supported to maintain<br />
independent living<br />
Satisfaction of people over 65 with both home and neighbourhood<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
•<br />
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Can they make a positive contribution?<br />
Do they engage in decision making, confident that they can express their<br />
needs and choices and be heard?<br />
STATUS<br />
• 1,000 people attended 3 People First Expos in 2008, 60% of whom had not<br />
attended a local, formal meeting before.<br />
• 49% of adults responding to the Residents’ survey 2007 felt that the council<br />
listens to their concerns (against 53% across inner London) and 47% felt<br />
they were involved in decision making (in line with 46% inner London). Both<br />
these figures have dropped slightly since 2005 when 53% felt listened to<br />
and 51% felt involved in decision making.<br />
• 70% of adult residents feel that they are kept informed about what the<br />
council is doing; this compares with 64% across London. However, only<br />
35% are satisfied with the opportunities to participate in local decision<br />
making.<br />
• 48% of adult residents agree that they can actually influence decisions<br />
made which affect their local area, higher than across both London 46% and<br />
inner London 43%. However, only 20% of adults had actually taken part in<br />
any consultative survey or meeting in the last 12 months.<br />
• Young people in <strong>Lambeth</strong> feel less well informed with only 43% of young<br />
people feeling they are kept up-to-date with what the council are doing (in<br />
line with 41% across London).<br />
• 40% of young people feel that the <strong>Council</strong> does listen to them and 35% feel<br />
involved in the decision-making process, higher than the London average of<br />
29%. 8% of young people aged 11-17 years in <strong>Lambeth</strong> have written to their<br />
local <strong>Council</strong>lor, which is 5 points higher than across London.<br />
• Young people in <strong>Lambeth</strong> (50%) are more likely to have voted in a school<br />
election than young people nationally (43%). (Tell Us2 Survey 2007).<br />
• 30% of young people aged 11-17 years have been a member of their school<br />
council, six percentage points higher than the London average (Residents’<br />
survey 2007).<br />
• 46% of <strong>Lambeth</strong> schoolchildren in years 8 & 10 feel that their views are<br />
listened to in the running of the school compared with 53% nationally (Tell<br />
Us2 Survey 2007).<br />
• Young people in <strong>Lambeth</strong> are more likely to have been involved in a school<br />
council or parliament (17% against 14% nationally) with overall 10% fewer<br />
reporting that they had not been engaged in decision making processes at<br />
all compared with the national figures.<br />
• There has been high involvement of Looked After Children in the decisionmaking<br />
process through engagement in Corporate Parenting and<br />
consultation groups. The participation of LAC in reviews has also improved<br />
from 85% to 96%.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
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Reference<br />
NI 4<br />
Indicator<br />
% of people who feel they can influence decisions in their locality<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Increase opportunities for children, young people and their families’ voices<br />
and views to be heard, enabling them to make a positive contribution to their<br />
community (<strong>Lambeth</strong> Children and Young People’s Plan 2 2007-10)<br />
• Develop a capacity building plan to support Friend of groups to develop their<br />
role and influence over parks and green spaces service design and delivery.<br />
(<strong>Lambeth</strong> Communities First strategy 2007-10)<br />
Do they contribute to the wellbeing of their community?<br />
STATUS<br />
• There are currently 2,426 active 3 rd Sector organisations recorded on the<br />
council’s GIFTs database operating within <strong>Lambeth</strong>.<br />
• The council’s GIFTs database records 467 residents who have attended<br />
local, community meetings and have expressed a wish to play an active part<br />
in community life.<br />
• 24% of adult respondents have volunteered in the last 12 months, 58% of<br />
these within the <strong>Lambeth</strong> area. 81% of these volunteers contributed 5 hours<br />
or fewer of their time each week. This is a new baseline from the Residents’<br />
Survey 2007.<br />
• One in five (21%) young people aged 11-17 years have volunteered (seven<br />
points higher than across London), and one in ten (10%) have been a peer<br />
educator (Residents’ Survey 2007).<br />
• The council has devolved assets to community groups who are using them<br />
to operate new and improved services for wider community benefit. Recent<br />
examples include the transfer of Raleigh Hall to the Black Cultural Archives<br />
and the transfer of Woodlawns to the Streatham Derby and Joan Club.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 3<br />
NI 6<br />
NI 110<br />
Indicator<br />
Civic participation in the local area<br />
Participation in regular volunteering<br />
Young people’s participation in positive activities<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Develop a pilot Local Leadership Programme targeted at people who need<br />
to work within a community and neighbourhood setting. (<strong>Lambeth</strong> Communities<br />
First strategy 2007-10)<br />
Are they law-abiding and avoid causing harm to others?<br />
STATUS<br />
• During 2006-07 there were 468 first time entrants to the youth justice<br />
system in <strong>Lambeth</strong>.<br />
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• In the latest available performance <strong>Lambeth</strong> has the seventh lowest rate of<br />
re-offending of the 32 London boroughs as measured by the Youth Justice<br />
Board and is within the top 30% of YOTs nationally.<br />
• A reduction of above 20% in young people entering the criminal justice<br />
system has been achieved in 2007/08, with the majority of these from BME<br />
communities. This was against an LAA target to reduce the number of<br />
young people entering the criminal justice system by 3%, with an additional<br />
1% for young people from BME groups.<br />
• <strong>Lambeth</strong>’s rate of youth re-offending has reduced from 63% recidivism in to<br />
57% in 200<strong>5.</strong> The average for our Nearest Neighbour group in 2005 was<br />
also 57%; this compared with the England and Wales average of 64%.<br />
• A reduction of over 60% has been achieved in the frequency of re-offending<br />
of young BME people subject to the Intensive Supervision and Surveillance<br />
Programme against an LAA target of 10%.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• 75% of young people in the youth justice system come from BME<br />
communities. 58<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 18<br />
NI 19<br />
NI 30<br />
NI 31<br />
Indicator<br />
Adult re-offending rates for those under probation supervision<br />
Rate of proven re-offending by young offenders<br />
Re-offending rate of prolific and priority offenders<br />
Deleted<br />
NI 111 First time entrants to the Youth Justice System aged 10-17<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Prevent young people from drifting into crime, in particular young black and<br />
minority ethnic (BME) boys (<strong>Lambeth</strong> Children and Young People’s Plan 2 2007-10)<br />
Do they live sustainably and try to minimise their impact on the<br />
environment?<br />
STATUS<br />
• In 2006/07 <strong>Lambeth</strong> had the 3 rd lowest weight of household waste collection<br />
compared with out nearest neighbours with 351.6 kg/head. The average of<br />
the nearest neighbours group was 428.7 kg/head. 59<br />
• Of the London authorities which send their waste to landfill in 2006/07,<br />
<strong>Lambeth</strong> sends 84.7%, Hammersmith & Fulham 82.5%, Kensington &<br />
Chelsea 81.9% and Wandsworth 79.2%.<br />
• At the end of 2007/08, <strong>Lambeth</strong> reached the target of 25% of household<br />
refuse being recycled or composted.<br />
• 75% of our adult residents use the recycling facilities provided (in line with<br />
78% across inner London) with 63% of residents rating these recycling<br />
58 London Borough of <strong>Lambeth</strong>. Draft Parenting and Family Support Strategy 2008-11. 2008.<br />
59 Hammersmith and Fulham, Haringey, Wandsworth, Hackney, Tower Hamlets, Ealing, Croydon, Brent,<br />
Southwark, Islington, Waltham Forest, Newham, Greenwich, Lewisham, Hounslow.<br />
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facilities good to excellent (64% inner London). 55% of young people in the<br />
borough think the recycling facilities are good to excellent (54% inner<br />
London).<br />
• Local street and environmental cleanliness for 2007/08 was measured at<br />
18.7% for litter & detritus, 6% for graffiti and 0.5% for flyposting. The lower<br />
the figure, the cleaner the environment therefore the 2006/07 figures show a<br />
slight improvement from 25%, 6% and 1% respectively. Compared with our<br />
London nearest neighbour group, <strong>Lambeth</strong> is below the average of 23.90%<br />
for litter & detritus and above the average of 10.24% for graffiti and 2.27%<br />
for flyposting.<br />
• <strong>Lambeth</strong> had a total 12,530 incidents of fly-tipping in 2007/08. The summer<br />
months see a higher number of incidents than the winter months.<br />
• 8<strong>5.</strong>5% of all schools in <strong>Lambeth</strong> have a School Travel Plan in place,<br />
resulting in significant shifts with walking to schools increasing by 9%, car<br />
driving decreasing by 7% and cycling increasing by 7%.<br />
• The 2007/08 mode of transport by school survey results showed that 9.5%<br />
of children travelled by car, 0.5% car shared, 19.7% used public transport<br />
43.6% walked, 0.8% cycled and 2.1% other.<br />
• 58.6% of the resident population of <strong>Lambeth</strong> travel to work by public<br />
transport (2001); this compares with nearest neighbours Wandsworth<br />
56.2%, Southwark 52.6% and Lewisham 51.4%.<br />
• <strong>Lambeth</strong>’s Energy Efficiency - Average Standard Assessment Procedure<br />
Rating was 65 compared with the Nearest Neighbours group average of 69<br />
and the top quartile of 70. (Based on a scale from 1 to 120 and on the<br />
annual energy costs for space and water heating).<br />
• There are currently 32 active 3 rd sector organisations recorded on the<br />
council’s GIFTs database which list a specific environmental or<br />
sustainability focus to their activities.<br />
• <strong>Lambeth</strong> has two parks with a Green Flag Award (Milkwood and Vauxhall<br />
Parks) and two further candidates for the award in 2008 (Ruskin Park and<br />
St Paul’s Churchyard). In order to retain the award the council must ensure<br />
that the public space is managed, maintained and developed to meet the<br />
community’s needs and engages with all its users through appropriate<br />
consultation.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 191<br />
NI 192<br />
NI 186<br />
NI 195<br />
NI 196<br />
NI 197<br />
NI 198<br />
NI 185<br />
NI 188<br />
Indicator<br />
Residual household waste per household<br />
Percentage of household waste sent for reuse, recycling and composting<br />
Per capita reduction in CO2 emissions in the LA area<br />
Improved street and environmental cleanliness (levels of litter, detritus,<br />
graffiti and fly-posting)<br />
Improved street and environmental cleanliness – fly tipping<br />
Improved Local Biodiversity – proportion of Local Sites where positive<br />
conservation management has been or is being implemented<br />
Children travelling to school – mode of transport usually used<br />
CO2 reduction from Local Authority operations<br />
Planning to Adapt to Climate Change<br />
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NI 189<br />
NI 190<br />
NI 193<br />
Flood (and coastal erosion) risk management<br />
Achievement in meeting standards for the control system for animal health<br />
Percentage of municipal waste landfilled<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
•<br />
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7. Are they safe?<br />
a. Are they safe from maltreatment, neglect, violence and sexual<br />
exploitation?<br />
STATUS<br />
• Considerable progress has been made in safeguarding vulnerable adults<br />
from abuse in <strong>Lambeth</strong> through improved awareness, reporting and<br />
investigation. This is reflected in an annual upward trend in reported abuse,<br />
from 126 alerts in 2005/06 to in excess of 300 in 2007/08.<br />
• 93% of <strong>Lambeth</strong> school children felt very or quite safe from being hurt by<br />
other people at home compared with 95% of children nationally (Tell Us 2<br />
survey 2007).<br />
• 87% of <strong>Lambeth</strong> school children felt very or quite safe from being hurt by<br />
other people while in school compared with 85% of children nationally (Tell<br />
Us 2 survey 2007).<br />
• At 31 March 2007 there were 62 children aged 4 and under and 113<br />
children aged 5-15 on the child protection register (CPR). 60 By 2007/08<br />
there were 245 in total. The numbers of children on the CPR exceed<br />
London and national averages.<br />
• Re-registrations on the CPR were reduced from 12.5% in 2006/07 to 10.1%<br />
in 2007/8, indicating effective intervention.<br />
• There were 525 looked after children (LAC) in <strong>Lambeth</strong> in 2007/08. The<br />
number of LAC exceeds London and national averages but has reduced<br />
from 660 in 2005/06.<br />
• The number of actions on registration on safety for new childcare providers<br />
has significantly reduced from 59% in March 07 to 16.9% in March 08 and<br />
on child protection from 17.9% in March 07 to 12% in March 08.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Over 70% of LAC are from BME communities.<br />
• 74.31% of children and young people on the CPR at 31 March 2008 were<br />
from BME communities. 61<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 70<br />
NI 68<br />
NI 59<br />
NI 60<br />
NI 64<br />
NI 65<br />
NI 66<br />
Indicator<br />
Hospital admissions caused by unintentional and deliberate injuries to<br />
children and young people<br />
Percentage of referrals to children’s social care going on to initial<br />
assessment<br />
Percentage of initial assessments for children’s social care carried out within<br />
7 working days of referral<br />
Percentage of core assessments for children’s social care that were carried<br />
out within 35 working days of their commencement.<br />
Child protection plans lasting 2 yrs or more<br />
Percentage of children becoming the subject of Child Protection Plan for a<br />
second or subsequent time<br />
Percentage of looked after children cases which were reviewed within<br />
required timescales<br />
60 London Borough of <strong>Lambeth</strong>. Childcare Sufficiency Assessment. 2007<br />
61 CPR3 Statutory Return 07/08<br />
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NI 67<br />
Percentage of child protection cases which were reviewed within required<br />
timescales<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Improve support to families who have identified additional needs and where<br />
there is a responsibility to safeguard children and young people (<strong>Lambeth</strong><br />
Children and Young People’s Plan 2 2007-10)<br />
b. Are they safe from accidental injury and death?<br />
STATUS<br />
• Accidents and unintentional injuries are the third main cause of premature<br />
mortality in <strong>Lambeth</strong>.<br />
• In 2005-06, <strong>Lambeth</strong> had the highest number of adults killed or seriously<br />
injured on our roads compared with our NN group with 162 accidents,<br />
compared with the average of 112.<br />
• Figures for people killed and seriously injured on the roads (adults and<br />
children) are steadily decreasing in line with DfT targets and the Mayor’s<br />
enhanced targets. However, there remain two areas of particular concern,<br />
where casualty figures have remained constant or only decreased by a<br />
small amount: cyclists and motorbike riders. This is in common with other<br />
London boroughs.<br />
• There are now 69% fewer serious child road accidents in <strong>Lambeth</strong> than 10<br />
years ago. This reduction has exceeded both the national (50%) and<br />
London (60%) targets.<br />
• <strong>Lambeth</strong> had the 3 rd lowest figure of 7 children killed or seriously injured in<br />
2005-06, amongst our NN group, the average being 11.<br />
• There were 161 recorded arson incidents in 2005-06, 5 th lowest within the<br />
NN group, with the average incidents across the group being 189.<br />
• There were a total of 436 new service users aged 65 and over that received<br />
one or more <strong>item</strong>s of Telecare equipment during 2007/08.<br />
• In 2005-06, 87.5% of all food businesses were contacted. Of these, 100% of<br />
those classed as ‘high risk’ premises were deemed compliant with food<br />
hygiene law. For medium and low risk premises, they were 93.4% and<br />
90.2% compliant respectively. 62<br />
• In 2006, <strong>Lambeth</strong> had 235 reported incidences of food poisoning compared<br />
with the London average of 201. 63<br />
• In 2007-08 there was a total weight of 1,079 kg of sex/drugs hazardous<br />
waste collected.<br />
• Road traffic continues to be the primary cause of air pollution in London with<br />
over 90% of all air pollution caused by road vehicles. Vehicle pollutants of<br />
greatest concern are Nitrogen Dioxide, Fine Particles (PM10), Carbon<br />
Monoxide and Volatile Organic Compounds such as Benzene and 1, 3-<br />
Butadiene. Ozone is also a pollutant of some concern.<br />
• <strong>Lambeth</strong> is not currently meeting the Government Air Quality standards for<br />
Nitrogen Dioxide and PM10 and the whole borough has been declared an<br />
Air Quality Management area in common with other central London<br />
boroughs.<br />
62 BVPI returns for 2006-07<br />
63 Food Poisoning Notification Received by the HPA<br />
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SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• Hospital admission for Serious Unintentional Injury for 0-4 year olds was<br />
98.8 per 100,000 in 2003-04. The London figure was 93.4, and in England<br />
and Wales it was 90.24. 64<br />
• In 2006, high and very high levels 65 of PM10 pollution were recorded at<br />
Christchurch Road, Vauxhall Cross and Loughborough Junction. Vauxhall<br />
Cross was the worst within the borough with 86 days recorded very high<br />
levels of PM10.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 47<br />
NI 48<br />
NI 49<br />
NI 184<br />
NI 194<br />
Indicator<br />
People killed or seriously injured in road traffic accidents<br />
Children killed or seriously injured in road traffic accidents<br />
Number of primary fires and related fatalities and non-fatal casualties<br />
(excluding precautionary checks)<br />
Food establishments in the area which are broadly compliant with food<br />
hygiene law<br />
Air quality - % reduction in NOx and primary PM10 emissions through local<br />
authority’s estate and operations<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• <strong>Lambeth</strong> will seek a genuine reduction in danger for all road users by<br />
identifying and controlling the principle sources of threat. (<strong>Lambeth</strong> Road Safety<br />
Plan, based around the Mayors casualty reduction targets for 2010, part of the wider<br />
Transport Local Implementation Plan 2005 - 2011).<br />
c. Are they safe from bullying and discrimination?<br />
STATUS<br />
• 69% of <strong>Lambeth</strong> school children say that they had never been bullied in<br />
school in the past 4 weeks compared with 70% in England as a whole (Tell<br />
Us 2 survey 2007).<br />
• All <strong>Lambeth</strong> schools have anti-bullying strategies in place.<br />
• 30 primary schools and 4 secondary schools have developed a peer<br />
mediation service to tackle bullying.<br />
• 54% of <strong>Lambeth</strong> school children felt their schools dealt very well with<br />
bullying compared with 57% of children nationally (Tell Us 2 survey 2007).<br />
• 8% of <strong>Lambeth</strong> school children say that they had been bullied most days in<br />
school in the past 4 weeks compared with 5% in England as a whole (Tell<br />
Us 2 survey 2007).<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
•<br />
NATIONAL PRIORITIES<br />
64 <strong>Lambeth</strong> PCT. Health Risks in <strong>Lambeth</strong>: Annual Report of the Director of Public Health. 2006.<br />
65 ‘High’ = Significant effects may be noticed by sensitive individuals and action to avoid or reduce these<br />
effects may be needed (e.g. reducing exposure by spending less time in polluted areas outdoors). Asthmatics<br />
will find that their 'reliever' inhaler is likely to reverse the effects on the lung. ‘Very high’ = the effects on<br />
sensitive individuals described for 'High' levels of pollution may worsen.<br />
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Reference<br />
NI 69<br />
Indicator<br />
Children who have experienced bullying<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Supporting young people (Safer <strong>Lambeth</strong> strategic plan 2008)<br />
• Support more active and respectful communities (Safer <strong>Lambeth</strong> strategic plan<br />
2008)<br />
d. Are they safe from crime and anti-social behaviour?<br />
STATUS<br />
Perceptions<br />
• Crime overwhelmingly remains the number one priority of <strong>Lambeth</strong><br />
residents with almost two thirds (61%) of adult respondents highlighting it as<br />
their main concern in the Residents’ survey 2007. This compares with 62%<br />
Inner London average and 54% across London as a whole.<br />
• 43% of adult residents thought that policing in the <strong>Lambeth</strong> area was good<br />
or excellent; this compares with 47% across inner London (Residents’<br />
survey 2007).<br />
• In common with the rest of London, the top 4 concerns of young people in<br />
<strong>Lambeth</strong> are crime, bad behaviour, bullying and drug users or drug pushers<br />
(<strong>Lambeth</strong> Residents’ Survey 2007). 59% of young people put crime as one<br />
of their top 3 issues of personal concern. 32% of young people included bad<br />
behaviour in their top 3.<br />
• 80% of adult residents felt “Very/Fairly safe” in the area where they live<br />
during the day but that dropped to 45% after dark. (<strong>Lambeth</strong> Residents’<br />
Survey 2007) This compares with Inner London (average of 78% by day;<br />
46% after dark) and London (average of 79% by day, 46% after dark).<br />
• 75% of young people felt “Very/Fairly safe” in the area where they live<br />
during the day but that dropped to 31% after dark. This compares with Inner<br />
London (average of 68% by day; 35% after dark) and London (average of<br />
70% by day, 36% after dark) (<strong>Lambeth</strong> Residents’ Survey 2007).<br />
• 71% of <strong>Lambeth</strong> school children feel very safe or quite safe from being hurt<br />
by other people around their local area compared with 74% of children<br />
nationally (Tell Us 2 survey 2007).<br />
• 50% of adult respondents to the Residents’ survey 2007 felt that “teenagers<br />
hanging around on the streets” was a very or fairly big problem.<br />
• 50% of adult respondents to the Residents’ survey 2007 felt that people<br />
using or dealing drugs was a very or fairly big problem compared with 41%<br />
across Inner London.<br />
• “Groups of Youths”, “People around the area” and “the reputation of the<br />
area” are the main reasons influencing how safe people in the community<br />
feel (Fear of Crime and Victimisation survey 2007).<br />
Crime<br />
• <strong>Lambeth</strong> is a high crime area with continuing levels of serious crime and<br />
offending above the national average. <strong>Lambeth</strong> ranks 12 th out of the top 40<br />
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high crime partnership areas in England 66 and within the top 3 high crime<br />
boroughs in London.<br />
• Since April 2005, success in reducing crime has been measured using a<br />
basket of British Crime Survey (BCS) comparator crimes PSA1 67 . <strong>Lambeth</strong><br />
is within the 3 top high crime boroughs in London on its level of PSA1 crime<br />
but has achieved a 30% reduction in the 3 years to 2007/08. This abovetarget<br />
reduction was the 3rd highest percentage decrease in the<br />
Metropolitan Police Service (MPS) area over that period.<br />
• In comparison with the neighbouring boroughs of Wandsworth and<br />
Southwark in 2006/07, <strong>Lambeth</strong> has the highest cost of estimated crime of<br />
all 3 boroughs at £310.5m. However, of the 3 boroughs <strong>Lambeth</strong> has<br />
enjoyed the greatest reductions in cost over the 3 year period to 2006/07<br />
(£42m reduction).<br />
• Although murder accounts for a very small percentage of Total Notifiable<br />
Offences (TNOs), <strong>Lambeth</strong> is currently ranked highest on a count basis of<br />
the 31 London boroughs. <strong>Lambeth</strong> had 23 murders in 2007/08, up from 15<br />
in 2006/07.<br />
• <strong>Lambeth</strong> has the highest levels in its CRDP family 68 of robbery (both<br />
personal and business) but has seen an encouraging 15% reduction in<br />
personal robbery since 2003/04.<br />
• <strong>Lambeth</strong> has the highest level of recorded rape offences in its CRDP family<br />
but has seen a very significant 23.5% reduction in recorded offences in<br />
2006/07 when compared with 2002/03.<br />
• A 19% decrease was achieved in Grievous Bodily Harm (GBH) offences in<br />
2007/08 compared with the previous year. <strong>Lambeth</strong> is currently ranked 4 th<br />
highest of the London boroughs on a count basis for GBH.<br />
• <strong>Lambeth</strong> saw a decrease of 6.8% in Gun-enabled crime in 2007/08 when<br />
compared with the previous year. The borough is ranked second highest of<br />
the CRDP family on a count basis.<br />
• Drug and alcohol misuse are seen as the key ‘drivers’ that lie behind much<br />
crime and fear of crime in the borough. More residents in <strong>Lambeth</strong> see<br />
drugs as a significant problem than the London average and drugs appear<br />
to be easily available, particularly in open, street based markets such as<br />
Brixton. More than 70% of arrests in Brixton are for possession or supply of<br />
cannabis. The links between drugs and violent and acquisitive crime is well<br />
established and 48% of arrests in <strong>Lambeth</strong> in 2006/7 were for drug related<br />
offences.<br />
• A quarter of <strong>Lambeth</strong>’s population is estimated to drink excessively and it is<br />
thought that the borough has higher levels of alcohol related hospital<br />
admissions than the average for London or England 69 . Links between<br />
alcohol and domestic violence are well known, though links with other<br />
violent crime types in <strong>Lambeth</strong> is less clear. It is likely that alcohol can<br />
exacerbate incidents of violent crime such as stranger violence, mugging<br />
rape and MPS believe that robbery victims in entertainment and transport<br />
66 The areas with the highest rates of recorded crime per head of population plus the highest crime levels<br />
(each being given equal weight) as measured using the BCS comparator in 2003/04.<br />
67 PSA1 consists of Robbery of Personal Property, Burglary dwelling, Theft of motor vehicle, Theft from motor<br />
vehicle, Motor vehicle interference & tampering, Theft person – snatch, Theft person – pick pocket, BCS<br />
wounding, BCS criminal damage, BCS common assault, Theft of pedal cycle.<br />
68 CRDP family comprise Brent, Camden, Greenwich, Hackney, Hammersmith and Fulham, Haringey,<br />
Hounslow, Islington, Lewisham, Southwark, Tower Hamlets, Waltham Forest, Wandsworth.<br />
69 <strong>Lambeth</strong> Alcohol Needs Assessment 2006/07<br />
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hubs at night are more likely to be drunk. TfL and BTP also link alcohol to<br />
violent crime on transport networks, generally at night.<br />
• Youth offending is higher in <strong>Lambeth</strong> than the London or national average.<br />
The borough has a higher rate of first time entrants to the youth justice<br />
system and young people tend to be involved in more serious types of<br />
offending – 12% of convictions result in custodial sentences in <strong>Lambeth</strong><br />
compared to only 8% in London and 6% nationally. There is significant overrepresentation<br />
in the youth justice system of BME males, 76% of the youth<br />
offending population in 2006/07.<br />
• The involvement of young people in serious violent offending is increasing<br />
across London and this is mirrored in <strong>Lambeth</strong>. For example, the average<br />
ages of both suspects and victims in Operation Trident 70 investigated<br />
shootings has dropped significantly in the past four years – from 24yrs three<br />
years ago to 19yrs now. Five young people age 18 or under were murdered<br />
in <strong>Lambeth</strong> in 2007/8.<br />
• The 2007 MPS survey found 27 youth gangs in <strong>Lambeth</strong> out of 171 in<br />
London.<br />
• As with other crime types, reported Hate crimes have been falling in recent<br />
years. <strong>Lambeth</strong> has seen a decrease of 13% in Racial incidents in 2007/08<br />
compared with the previous year. There has also been a decrease of 21%<br />
in Homophobic incidents in 2007/8 compared with the previous year.<br />
• The National Domestic Violence helpline received 322 calls from <strong>Lambeth</strong><br />
women between Jan and June 200<strong>5.</strong> This was the highest rate of any<br />
London borough and 100 more calls than the second highest borough.<br />
• The Gaia Domestic Violence refuge centre supported 626 <strong>Lambeth</strong> women<br />
between May 2006 and March 2008. 47.3% of these clients were selfreferrals.<br />
• 37.1% of clients using the Gaia centre between May 2006 and March 2008<br />
were aged 18-29. A further 42.8% were aged 30-44.<br />
• Where the information was available for Gaia centre clients between May<br />
2006 and March 2008, 1<strong>5.</strong>3% of clients had a substance misuse need, 35%<br />
had a mental health need, 19.7% had a disability and 44% had a suicidal<br />
tendency.<br />
• 40.1% of the perpetrators of domestic violence on women using the Gaia<br />
centre between May 2006 and March 2008 were current spouses or<br />
partners. 46.2% of perpetrators were ex-spouses or ex-partners.<br />
• During 2006/07, 24.7% of domestic violence crimes were repeat offences.<br />
• 30% of people surveyed reported that they had been a victim of crime within<br />
<strong>Lambeth</strong> in the last 12 months and 20% had been victimised more than<br />
once. Of those who had been victims of crime, only 57% had reported it to<br />
the police (Fear of Crime and Victimisation survey 2007).<br />
Anti-social behaviour<br />
• The reported incidence of Anti Social Behaviour (ASB) in <strong>Lambeth</strong> is<br />
recorded by the MPS according to the National Standard for Incident<br />
Recording (NSIR) categories as follows:<br />
Substance Misuse<br />
Malicious / Nuisance<br />
Communications<br />
Abandoned Vehicle Vehicle Nuisance /<br />
Inappropriate<br />
Vehicle use<br />
70 This is an ongoing MPS-wide operation preventing and investigating shootings in London.<br />
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Rowdy /<br />
Inconsiderate<br />
Behaviour<br />
Rowdy / Nuisance<br />
Neighbours<br />
Hate Incident<br />
Street Drinking Noise Nuisance Prostitution Related<br />
Activity<br />
Possess / Sale / Use<br />
of Fireworks<br />
Animal Problems<br />
Hoax call to<br />
Emergency Services<br />
Trespass<br />
Begging / Vagrancy<br />
Environmental<br />
damage / littering<br />
• The MPS are not the only recording agency in <strong>Lambeth</strong>, but currently<br />
provide the most comprehensive data set for analysis. However, there<br />
is a recognized deficit in environmental content due to under reporting<br />
of these incidents to the Police.<br />
• A combined baseline total of 26,664 ASB incidents were recorded in<br />
2006/07 across <strong>Lambeth</strong>. This is a combined total of data on ASB<br />
type incidents held by the Police, Park Rangers, Local Authority Noise<br />
statistics, British Transport Police and Housing (Housemark) data.<br />
• Most reported incidents of ASB were reported in Coldharbour (1st)<br />
and Bishops (2nd) wards. These two wards stand out, especially<br />
when compared with Tulse Hill (3rd) which had only approximately<br />
half the count of Coldharbour.<br />
• Rowdy / Inconsiderate behaviour is the highest reported type of<br />
incident in all 21 wards.<br />
• There are more reported incidents in the northern half of the borough<br />
in comparison with the south.<br />
• Although no long-term trend data is yet available, when considered in<br />
overview there appears to be peak of ASB offences in the summer<br />
months (July-August) with a further spike in October (coinciding with<br />
Bonfire night) followed by a drop from November through the winter.<br />
• 24% of adults avoid using the bus due to anti-social or violent young<br />
people. 27% avoid using it because of behaviours classified as<br />
disorder.<br />
• In 2007-08, there were 992 complaints made about noise during the<br />
day time and a further 4,221 complaints received regarding noise at<br />
night time.<br />
SIGNIFICANT INEQUALITIES IDENTIFIED<br />
Perceptions<br />
• 51% of young people aged 11 to 17 felt that not enough was being to<br />
protect young people in the borough. This is up from 47% in 2005 and<br />
higher than both the London (42%) and inner London (50%) averages.<br />
(<strong>Lambeth</strong> residents’ survey 2007).<br />
Crime<br />
• Young people (aged 10-17 inclusive) accounted for only 15% of all<br />
persons accused of Notifiable Offences (in comparison with adults) in<br />
2006/07.<br />
• MPS research of robbery of personal property showed that 56% of<br />
suspects were aged 16-20 years with those aged 11-15 years<br />
accounting for 22%.The victims of robbery are also most likely to be<br />
aged 15-19.<br />
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• The peak age of both victims and perpetrators involved in Tridentrelated<br />
gang and group violent offending in London fell from 24 years<br />
in 2004 to 19 years in 2006.<br />
• Of those surveyed who reported being victims of crime to the Police in<br />
the last 12 months, 44% were aged 16-19 years old and 42% were<br />
Asian (Fear of Crime and Victimisation survey 2007).<br />
• Women victims of crime in the last 12 months were found to be<br />
slightly more likely to report the crime to the Police. Black and mixed<br />
groups were least likely to report being a victim of crime as well as<br />
those who had disabilities (Fear of Crime and Victimisation survey<br />
2007).<br />
• Victims of property crime and disorder were most likely to report crime<br />
where as only 59% reported violent crime and 33% reported hate<br />
crime (Fear of Crime and Victimisation survey 2007).<br />
Anti-social behaviour<br />
• 14 out of 21 wards record substance misuse as the second most<br />
prolific issue (after rowdy behaviour). The 14 wards are<br />
(alphabetically) Brixton Hill, Clapham Common, Coldharbour,<br />
Ferndale, Gipsy Hill, Herne Hill, Knights Hill, Larkhall, Oval, Princes,<br />
Stockwell, Thornton, Tulse Hill and Vassall.<br />
• 6 out of 21 wards record street drinking as the second most prolific<br />
issue (after rowdy behaviour). The 6 wards are (alphabetically)<br />
Bishops, Clapham Town, St Leonards, Streatham Hill, Streatham<br />
Wells and Thurlow Park.<br />
• 93% of all fireworks incidents are reported during October and<br />
November, in the run up to and around bonfire night. Tulse Hill ward<br />
had the highest count of firework reports, followed by Coldharbour.<br />
• Over 50% of all “Prostitution Related Activity” (NSIR definition) occurs<br />
in Tulse Hill ward.<br />
• There is a significant increase in the level of Low Level Disorder<br />
offences committed by/perpetrated on young people coinciding with<br />
the end of the school day.<br />
NATIONAL PRIORITIES<br />
Reference<br />
NI 15<br />
NI 16<br />
NI 20<br />
NI 28<br />
NI 29<br />
NI 26<br />
NI 33<br />
NI 32<br />
NI 34<br />
NI 36<br />
NI 37<br />
NI 38<br />
Indicator<br />
Serious violent crime rate<br />
Serious acquisitive crime rate<br />
Assault with injury crime rate<br />
Serious knife crime rate<br />
Gun crime rate<br />
Specialist support to victims of a serious sexual offence<br />
Arson incidents<br />
Repeat incidents of domestic violence<br />
Domestic violence - murder<br />
Protection against terrorist attack<br />
Awareness of civil protection arrangements in the local area<br />
Drug-related (Class A) offending rate<br />
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NI 27<br />
NI 21<br />
NI 24<br />
NI 25<br />
NI 41<br />
NI 42<br />
Understanding of local concerns about anti-social behaviour and crime by<br />
the local council and police<br />
Dealing with local concerns about anti-social behaviour and crime by the<br />
local council and police<br />
Satisfaction with the way the police and local council dealt with anti-social<br />
behaviour<br />
Satisfaction of different groups with the way the police and local council<br />
dealt with anti-social behaviour<br />
Perceptions of drunk or rowdy behaviour as a problem<br />
Perceptions of drug use or drug dealing as a problem<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Reduce serious and violent crime (Safer <strong>Lambeth</strong> strategic plan 2008)<br />
• Support more active and respectful communities (Safer <strong>Lambeth</strong> strategic plan<br />
2008)<br />
• Supporting young people (Safer <strong>Lambeth</strong> strategic plan 2008)<br />
e. Do they have stability and are they cared for?<br />
STATUS<br />
• 7,643 adults in <strong>Lambeth</strong> of all age groups over 18 received social care<br />
support services from the council during 2007/08. Of these, 6,217 are<br />
supported to live at home and 1,426 are supported in residential or nursing<br />
care homes.<br />
• The numbers of adult clients of all age groups receiving services during<br />
2007/08 were as follows:<br />
Aged 18-64 Aged 65+<br />
Physical disabilities 1,390 4,341<br />
Mental Health 727 232<br />
Learning Disabilities 660 45<br />
Substance Misuse 116 15<br />
Vulnerable People 30 87<br />
TOTAL 2,923 4,720<br />
• 5,095 vulnerable people receive services from <strong>Lambeth</strong> Supporting People<br />
as follows:<br />
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Number of<br />
service users<br />
% of service<br />
users<br />
Older People with support needs 2,200 43.18%<br />
People with mental health problems 428 8.4%<br />
Single Homeless with support needs 423 8.3%<br />
Young People at risk 280 <strong>5.</strong>5%<br />
Rough Sleepers 241 4.73%<br />
People with alcohol problems 192 3.77%<br />
Offenders/People at risk of offending 146 2.87%<br />
Adults with learning disabilities 121 2.37%<br />
Women at risk of domestic violence 116 2.28%<br />
Teenage parents 78 1.53%<br />
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Frail elderly 58 1.14%<br />
People with HIV/AIDS 52 1.02%<br />
Refugees 31 0.61%<br />
Mentally disordered offenders 21 0.41%<br />
People with drug problems 12 0.24%<br />
Total 5,095 100%<br />
• 75% of vulnerable people receiving Supporting People services are<br />
<strong>Lambeth</strong> residents, above the London average of 70%. In 2007/08, 6% of<br />
referrals originated from LB Southwark and 4% from LB Westminster. The<br />
highest proportion of referrals from outside <strong>Lambeth</strong> under the London<br />
cross-authority protocols are for Rough sleepers and Women at risk of<br />
Domestic Violence.<br />
• <strong>Lambeth</strong> provided 64 domestic violence refuge beds in 2007/08; this<br />
equates to 2.6 per 10,000 population, more than twice the London target of<br />
1.20 per 10,000 population.<br />
• The following groups of vulnerable children and young people access<br />
council services:<br />
Looked After Children<br />
Children at risk of harm<br />
Young carers<br />
Children with special educational needs or disabilities<br />
Children who are very mobile, e.g. traveller and refugee children<br />
Children from different faith groups<br />
Some BME children and young people<br />
Young people at risk of offending and misusing substances<br />
Teenage parents<br />
Children from low income families.<br />
• The long-term stability of LAC has improved with the number of LAC with 3<br />
or more placement moves reduced from 1<strong>5.</strong>4% to 12.6% in 2007/08.<br />
• 83% of looked after children and young people in <strong>Lambeth</strong> are placed in<br />
foster care or family placements. The percentage of 10-15 year olds in<br />
residential accommodation has reduced from 16.5% to 6.6%.<br />
• The adoption rates of LAC have improved from 4.1% in 2006/07 to 6.1% in<br />
2007/08.<br />
• There are currently 5 young people over the age of 18 whose SEN require<br />
ongoing accommodation and support. A further 26 young care leavers over<br />
the age of 21 who are in higher education also receive continued support.<br />
• 160 Personal Education Plans (PEP) were completed between April 2006<br />
and March 2007 for a school age cohort of 385 LAC, which equates to 42%.<br />
• The number of existing childcare providers judged good or outstanding in<br />
Ofsted inspections on Staying Safe rose from 38.7% in March 2007 to 44%<br />
in March 08.<br />
• Each year approximately 550 young people appear in court for a range of<br />
offences and 14% are sentenced to custody, mostly for less than one<br />
year. 71<br />
71 London Borough of <strong>Lambeth</strong>. Draft State of the Borough Report: The evidence base supporting the<br />
Sustainable Community Strategy. 2008<br />
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SIGNIFICANT INEQUALITIES IDENTIFIED<br />
• <strong>Lambeth</strong> falls within the ‘bottom 10’ priority hotspot areas with lowest<br />
performance for Adults with Learning Disabilities in Settled Accommodation.<br />
<strong>Lambeth</strong> has 57%, Wandsworth 61%, Lewisham 63%, compared with the<br />
England overall figure of 73% in 2005/06. 72<br />
NATIONAL PRIORITIES<br />
Reference Indicator<br />
NI 145<br />
NI 149<br />
NI 61<br />
NI 62<br />
NI 63<br />
NI 71<br />
NI 147<br />
NI 43<br />
NI 44<br />
NI 143<br />
Adults with learning disabilities in settled accommodation<br />
Adults in contact with secondary mental health services in settled<br />
accommodation<br />
Timeliness of placements of looked after children for adoption following an<br />
agency decision that the child should be placed for adoption<br />
Stability of placements of looked after children: number of placements<br />
Stability of placements of looked after children: length of placement<br />
Children who have run away from home/care overnight<br />
Care leavers in suitable accommodation<br />
Young people within the Youth Justice System receiving a conviction in court<br />
who are sentenced to custody<br />
Ethnic composition of offenders on Youth Justice System disposals<br />
Offenders under probation supervision living in settled and suitable<br />
accommodation at the end of their order or licence<br />
CURRENT RELEVANT STRATEGIC PRIORITIES<br />
• Improve transition arrangements for vulnerable young people, in particular<br />
Looked After children and Children with Disabilities (<strong>Lambeth</strong> Children and Young<br />
People’s Plan 2 2007-10)<br />
72 www.cabinetoffice.gov.uk/social_exclusion_task_force/psa<br />
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8. Consultation with stakeholders<br />
Citizen’s forum – Commissioning Strategy Plan – <strong>Lambeth</strong> PCT<br />
The PCT organized a citizen’s forum to discuss it’s objectives and get an<br />
agreement on the priorities identified and objectives or goals set, through the fiveyear<br />
Commissioning Strategy Plan 2007-2012. The main aim of this workshop was<br />
to ensure that views of <strong>Lambeth</strong> residents influence the PCT’s strategic plans<br />
including defining priorities and visions for services as well as ensuring particular<br />
services meet users’ needs. PCT groups who are helping develop the<br />
Commissioning Strategy Plan, were asked to take carefully consider intelligence on<br />
public and user views, and to ensure that this is taken into account when defining<br />
PCT commissioning priorities, intentions and delivery plans.<br />
The PCT has a great wealth of information on public, patient and user views on<br />
healthcare delivery. Much of this information came from direct involvement on a<br />
particular subject or service and was either very local or service-specific in nature.<br />
This available information was used in addition to the responses received through<br />
this citizen’s forum.<br />
This citizen’s forum focused on overall commissioning models and priorities across<br />
a range of services and client groups. The questions included in this survey gave<br />
intelligence that is <strong>Lambeth</strong>-specific and very local in nature and therefore highly<br />
applicable to our services.<br />
Methodology<br />
<strong>Lambeth</strong> PCT commissioned OPM to organise a Citizen’s Forum for <strong>Lambeth</strong><br />
residents. This was to give a sample of the local population an opportunity to<br />
engage in some detail on the content of the CSP.<br />
One hundred and sixteen residents were recruited on-street for the event,<br />
according to a sample specification designed to reflect the local demographics of<br />
the borough. To ensure the desired mix on the day, potential participants were<br />
asked to complete a recruitment questionnaire, with questions relating to their<br />
occupation, household composition, age, ethnicity and quality of health.<br />
A further 30 participants were recruited from various hard-to-reach groups. This<br />
ensured that groups such as older people, specific patient groups, minority ethnic<br />
groups and young parents were represented. These participants were recruited<br />
through <strong>Lambeth</strong>-based community and voluntary sector bodies and organisations,<br />
which identified and invited suitable service-users on our behalf. It should also be<br />
noted that both recruitment phases were limited to English speakers.<br />
105 people attended the event. 79 of these were drawn from the on-street<br />
recruitment and the remaining 26 were service users or representatives from the<br />
selected hard-to-reach groups. An incentive of £65 was offered to all participants.<br />
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A great deal of useful feedback on the draft CSP was received as part of the preconsultation<br />
process. This was considered very relevant to the full consultation and<br />
therefore those responses have been incorporated into this report’s findings.<br />
Identifying Stakeholders<br />
A CSP Communications & Engagement Strategy was developed and relevant<br />
stakeholders were identified by the following groups:<br />
Health and social care partners<br />
Representatives<br />
Influencers<br />
Patients & carers<br />
Community<br />
Internal, including independent practitioners and PBC consortia<br />
‘Hard to Reach’ groups (identified by information Public Health)<br />
A variety of different methods were used to engage with these groups.<br />
Engagement<br />
The methods used to involve stakeholders and the public in the consultation<br />
process included:<br />
- Sending consultation documents out and inviting comments<br />
- Meetings<br />
- Media press release<br />
- Use of PCT website<br />
- Internal communication<br />
Hard to reach groups: In addition, the PCT made specific efforts to engage with<br />
‘hard to reach’ groups using public health expertise to identify which groups were<br />
priority targets for the consultation process i.e. those that had not been adequately<br />
engaged by other aspects of the consultation process and who would be affected<br />
by the CSP proposals. Hard to reach groups included refugees, homeless,<br />
disabled (both children and adults), housebound Older Adults.<br />
Consultation feedback<br />
Throughout the consultation, target audiences were given four routes for submitting<br />
feedback:<br />
Email<br />
Website online questionnaire<br />
Post<br />
Direct feedback to PCT staff at consultation meetings, including formal<br />
meetings, forums or focus groups<br />
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In addition, the Citizen’s Forum and ‘hard to reach’ focus groups hosted by OPM<br />
also provided valuable feedback on the contents of the CSP.<br />
Main findings<br />
1. A strong and very widespread level support for the contents of the CSP. Its<br />
strategic goals, themes and the priority areas were backed and welcomed by<br />
the vast majority of respondents; many said these were congruent with their<br />
own priorities or areas of work.<br />
2. A great deal of support for including Staying Healthy and Mental Health as<br />
priorities.<br />
3. There was concern about the ‘phasing out’ of priorities over time – particularly<br />
Children and Young People.<br />
4. There is a perception that the PCT could do more to communicate better with<br />
both the public and stakeholders on an ongoing basis.<br />
<strong>5.</strong> Many respondents queried whether patient and public involvement to ensure<br />
services are responsive had been given enough emphasis in the document.<br />
6. It was felt that dentistry had not received the attention and emphasis it required<br />
in the CSP.<br />
7. Children with disabilities were highlighted by respondents as a particular area of<br />
concern that was not adequately addressed by the CSP.<br />
8. Respondents consistently emphasised the importance of working closely with<br />
the council to achieve these improvements, coupled with a perception that<br />
current joint working is poor.<br />
9. In addition, there was a great deal of re-emphasis on the importance of working<br />
with and placing services within schools in order to achieve the objectives<br />
described for the Staying Healthy and Children and Young People’s strategies.<br />
It is therefore suggested these issues need to be expanded in the next iteration<br />
of the CSP.<br />
10. The lack of close working with the voluntary sector was also highlighted as a<br />
concern by some – and one that should be addressed further in the CSP.<br />
11. The difficulty of accessing both primary and secondary care services (both GP<br />
and hospitals) was an issue that recurred in feedback.<br />
Actions<br />
After reviewing the findings, several actions were suggested as a consequence of<br />
consultation. Detailed feedback received was collated and categorised and then<br />
shared with relevant leads in the various directorates. This will allow them to<br />
incorporate specific ideas and feedback into their own plans and implementation<br />
processes.<br />
Conclusions<br />
Overall, the Consultation on the Commissioning Strategy Plan (alongside<br />
Healthcare for London) is one the largest consultation exercises the PCT has ever<br />
engaged in. This has generally proven to be extremely successful and has yielded<br />
very useful feedback and supported engagement with local stakeholders and<br />
residents. However, it should also be acknowledged that this has required strong<br />
senior leadership and some financial investment to be successful.<br />
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The main finding of the consultation is that there is strong and widespread support<br />
for the main contents of the Commissioning Strategy Plan. Hence, it reaffirms that<br />
the internal PCT planning processes have been robust and responsive to what is<br />
known about public and user priorities. This should give the organisation<br />
confidence developing and implementing the proposals of the CSP over the next<br />
few years.<br />
The challenge going forward for the PCT is to ensure that the detailed feedback<br />
received meaningfully impacts and informs how commissioning intentions are<br />
framed and implemented. Moreover, the lessons learned from this consultation<br />
exercise should be used to inform future public involvement work. Specifically, the<br />
PCT needs to develop a stronger framework for engaging in an ongoing dialogue<br />
with the local public, other stakeholders and hard to reach groups on issues<br />
relating to the PCT and its strategic plans.<br />
In addition, the health and social care Voluntary and Community sector forum will<br />
be focussing on the work related to consultation with the voluntary sector<br />
representatives to identify any gaps that need to be addressed to achieve better<br />
health and well-being outcomes especially for vulnerable groups. This forum is<br />
made up of over 200 voluntary organisations, both funded and unfunded groups,<br />
small local organisations working with <strong>Lambeth</strong>’s residents. It is co-chaired by two<br />
representatives from the voluntary sector and two from the statutory sector.<br />
Customer focus programme – Literature review.<br />
Summary of a recently conducted review by the Research and Policy division of<br />
LBL, drawn from a variety of sources detailing service satisfaction is enclosed<br />
below.<br />
This literature review has drawn on a variety of sources detailing service<br />
satisfaction and citizens’ perceptions of their customer experience in <strong>Lambeth</strong>.<br />
These have included the 2007 residents’ survey, BVPI surveys and qualitative<br />
research carried out with residents. A full list of sources is listed in the bibliography.<br />
This review only contains data that was made available and is by no means<br />
exhaustive.<br />
Based on the customer service data available, well-performing services include<br />
parks and open spaces, nursery education, recycling and public transport. Services<br />
where the customer experience needs improving are council housing, parking,<br />
leisure and sports facilities and planning.<br />
Communications at <strong>Lambeth</strong> are improving and 70% of residents believe <strong>Lambeth</strong><br />
are good at keeping them informed which is better than London. People’s preferred<br />
channels of communication are <strong>Lambeth</strong> Life, information provided by the council<br />
and the website. Service users prefer to get information relevant to their specific<br />
service use through direct letters and would like to be better informed about what<br />
services they are entitled to and how to access them.<br />
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People are keen to hear how services are performing and whether they are<br />
keeping their promises. They would like to see balanced, realistic reporting (not just<br />
good news) that shows how money is being spent to tackle important local issues.<br />
Most people contact the council by telephone (70%) followed by face to face<br />
contact at 13%. Face to face contact increases to 34% for housing tenants. Whilst<br />
happy to use it as a source of information, people have less faith in using the<br />
internet for interactive contact.<br />
It is getting easier to get through to <strong>Lambeth</strong> on the phone, phones are answered<br />
promptly and staff are perceived to be polite and helpful. However, customers<br />
across service areas are less satisfied with the resolution of their problems. It can<br />
be difficult to speak to the correct person and there is perceived to be a lack of<br />
joined-up working between front and back office staff. Prompt resolution of<br />
problems is an important area of customer service to be addressed.<br />
Half (48%) of <strong>Lambeth</strong> residents currently feel that they can influence local<br />
decisions which is higher than the London average (43%). There is an appetite<br />
among <strong>Lambeth</strong> residents to be involved in local decision making with 40% keen to<br />
be involved regardless and 52% dependant on the issue. One in five (20%)<br />
residents have taken part in consultation, an increase from 16% in 2005, but there<br />
is a need for consultation to be meaningful and for honest feedback that shows<br />
how people’s views have been taken into account.<br />
Recommendations for further research<br />
- At <strong>Lambeth</strong> <strong>Council</strong>, we currently have a weak understanding about how<br />
<strong>Lambeth</strong> residents view the services offered by partnership organisations:<br />
What do people think of their customer experience of Job Centre Plus,<br />
Metropolitan and community police services, health services, the voluntary<br />
and community sector and fire services within the borough? How well do<br />
council services link up with partnership services? How can these services<br />
complement each other and work better together?<br />
- Research has shown that there are two groups of people accessing services<br />
within <strong>Lambeth</strong>. One group uses a lot of services and require detailed<br />
contact specific to their needs. They like to contact us by phone or in<br />
person. The other group use very few services and may potentially want<br />
less contact. Research could be carried out to determine whether this is the<br />
case and how customer service can best be structured to meet the needs of<br />
heavy and light users of local services.<br />
- There is currently little information available on the views of business users.<br />
It would be interesting to understand their views on the services they use<br />
and how they could be improved.<br />
- Although people see the internet as an important source of information,<br />
there appears to be barriers to using technology interactively for contacting<br />
services, making payments and resolving problems. Further work could<br />
investigate the barriers to interactive contact via the internet.<br />
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The entire review is enclosed as an appendix.<br />
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9. Review of needs assessments<br />
Health Needs assessments are a primary source of identifying gaps in services for<br />
health and service improvement. <strong>Lambeth</strong> PCT conducts needs assessment<br />
routinely to influence commissioning decisions. A proforma was created and used<br />
for reviewing health needs that are completed in health and social care as part of<br />
the Joint Strategic Needs Assessments. The following health needs assessments<br />
were reviewed: Alcohol, Physical Activity, children and young people, older people,<br />
teenage pregnancy, sexual health.<br />
Summary of findings and recommendations where provided by the needs<br />
assessments are as follows:<br />
Alcohol<br />
Summary of needs<br />
Met Epidemiology<br />
Unmet<br />
• Male predominance in deaths due to alcohol fallen from 87% to 56% (2001-5)<br />
Service access<br />
• ARP (Alcohol Recovery Project) and acute services believed to be high quality<br />
when accessible<br />
Epidemiology<br />
• Rising mortality in females from alcohol; projected to exceed males<br />
• Underestimation of extent of problem in A+E and ambulance, as ICD-10 coding<br />
not used<br />
Service access<br />
• Low self-referral to services (3% in <strong>Lambeth</strong> vs. 36% nationally) and poor links<br />
between acute and rehabilitation services<br />
• 67% in-patient referral below target of 80%<br />
• 61 and under have less knowledge than nationally (0.5% vs. 78% nationally)<br />
• Alcohol services at maximum capacity, poor accessibility, not culturally specific,<br />
not holistic<br />
• Poor use of community strategies and integrated care pathway<br />
Summary of recommendations<br />
Medical care<br />
• Screening and brief interventions in community/primary settings, complex care should be<br />
referred to specialist centres. Development and use of integrated care pathways<br />
• Ensure quality of care through use of standards such as DANOS/NOS<br />
Service provision and configuration<br />
• Need to increase capacity, community based specialist outreach services, shared care with<br />
primary care.<br />
• Ensure accessibility and targeting of specific groups (BAME, young people, women etc)<br />
Health promotion<br />
• Need for media and marketing strategy in both health and non-health centres<br />
Information, monitoring and performance management<br />
• Need to improve A+E and ambulance coding. Data needs to be collected on alcohol<br />
attributable appointments in primary care setting<br />
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Licensing and community approaches<br />
• Extension of existing licensing process and health promotion strategies<br />
Summary of implementation plan<br />
• Use Models of care for alcohol misusers (MoCAM) guidance as framework for commissioning<br />
• Increase capacity through community based specialist outreach services, increase<br />
accessibility through more walk-in centres and out of hours services<br />
• Develop programmes and services to target specific groups<br />
• Develop media and marketing strategy (e.g. leaflets, posters) and target health and nonhealth<br />
settings, including alcohol service directory<br />
• Data collection and analysis of A+E and ambulance use, primary care appointments and<br />
alcohol services use attributable to alcohol. Analysis along integrated care pathway<br />
• Extend “Safer Socialising” scheme with incorporation of general health promotion e.g. Night<br />
Club Health interventions<br />
• Use the Licensing process to ensure use by local businesses.<br />
Children and young people<br />
Summary of needs<br />
Met Antenatal-infancy<br />
• Higher breastfeeding rate than nationally<br />
• Maternal smoking rate equivalent to nationally<br />
Age 1-5<br />
• Lower tooth decay than nationally<br />
• Increase in number of nursery places between 1997 and 2004<br />
Age 5-15<br />
• Lower level obesity than nationally<br />
Unmet • High number of children living in poverty<br />
Antenatal-infancy<br />
• Lower immunisation coverage than nationally, lower than 95% target<br />
• Significantly low birth rates in Tulse Hill, Coldharbour and Vassall wards<br />
Age 5-15<br />
• Significantly raised under-15 mortality rate<br />
Age 16-19<br />
• Higher teenage pregnancy rate than nationally<br />
Children with disabilities<br />
• Disability register not up to date<br />
Children and adolescent’s mental health<br />
• Children whose 1 st language is not English may not be known to housing/family<br />
support/health services and often have higher mental health needs<br />
• Children in care homes and looked after children have poorer outcomes<br />
• Higher prevalence mental health problems in boys and white children<br />
• Unmet need for treatment of conduct disorders, psychotic disorders, eating<br />
disorders (? Incomplete data)<br />
Summary of recommendations<br />
Antenatal-infancy<br />
• Antenatal Care: Ensure mobility within borough and between boroughs, chase<br />
addresses, universal electronic record keeping, improve communication between<br />
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professionals<br />
• Domestic Violence: increase capacity, implement guidelines (DH) and develop<br />
maternity liaison committee<br />
• Improve interpretation services<br />
• Improve parent support (e.g. from specialist Health Visitor), improve specialist training and<br />
increase capacity in health visiting, especially infant mental health<br />
• Make care pathway more flexible for vulnerable groups<br />
Age 1-5<br />
• Upgrade IT systems and improve information exchange and communication<br />
• CAMHS to involve parents more and carry out earlier interventions<br />
• Joint commissioning, pooled budgets<br />
• Immunisation – improve funding for Coordinators, educate parents and professionals<br />
• Accidents – develop multiagency forum<br />
• Nutrition – develop group to take forward general nutrition issues and target specific groups<br />
Age 5-15<br />
• Develop school and non-school settings and reach children/families that don’t attend<br />
• Effective joint commissioning (PCT and LBL in particular)<br />
• Nutrition –encompass physical activity, restrict fast-food and similar outlets near schools<br />
• Safeguard needs of children from emerging communities<br />
Age 16-19<br />
• Risky Behaviour: involve young people in development and monitoring of services, integrate<br />
adolescent services<br />
• Adolescent services: focus on cultural change and challenging values, co-ordinate transition<br />
and family support<br />
• Effective joint commissioning (PCT and LBL in particular)<br />
• Healthy lifestyles: Behaviour and education, more voluntary sector investment and input<br />
Children with disabilities<br />
• Make use of Sure Start and Children Centres for early intervention<br />
• Effective joint commissioning (e.g. Looked after children & Children with disabilities),<br />
• Make use of key worker for transition<br />
• Make use of health visitor support for families with complex needs<br />
• Share and validate data<br />
Children and adolescent’s mental health<br />
• Improve staff cultural sensitivity and awareness<br />
• Implement wide multi-agency working to target “risky behaviours” in CYP<br />
• Promote emotional well-being, using positive language. Improve the confidence of the local<br />
population in accessing services<br />
• Agree inter-agency protocols and pathways, clarify communication (tier 1 to 4) and agree a<br />
shared vision<br />
• Expand tier 1 (universal) training e.g. health visitors and pre-school day-care<br />
• Improve understanding of what is available to CYP and parents with mental health/behaviour<br />
issues and how to access such resources<br />
• Integrate prevention services into comprehensive CAMHS<br />
• Intervene early and provide family support<br />
• Ensure smooth transition to adult mental health services<br />
Summary of implementation plan<br />
Antenatal-infancy<br />
• Antenatal care: CYPSP, Commissioning Group and TPPPB to ensure improved record<br />
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keeping, use of electronic record and improved access to primary care<br />
• Domestic violence (DV): CYPSP to implement DH guidelines, develop maternity liason<br />
committee (MLC) and increase DV capacity<br />
• Access: PCT shared services aim to reduce waiting times and increase access<br />
• Mental health: CAMHS and NHS commissioning and NHS Provider Group to increase<br />
capacity in health visiting and improve training, improve parent support and raise awareness<br />
of parental mental health issues<br />
• Care pathway: CYPSP, NHS Provider and Commissioning to map care pathway and<br />
increase its flexibility<br />
Age 1-5<br />
• IT: NHS Commissioning to upgrade to RIO system<br />
• Partnership: CYPSP to develop joint commissioning and pooled budget<br />
• Health: NHS Commissioning, Provider group and Immunisation group to mainstream funding,<br />
set up helpline, improve and disseminate education resources regarding immunisation.<br />
Expand remit of TOILS obesity group. Implement vision screening and oral health policies<br />
• Vulnerable children: Joint commissioning<br />
Age 5-15<br />
• School/non-school setting: breakfast clubs, parent education (re: smoking, chronic disease,<br />
literacy), improved Health School, deliver counselling and therapy<br />
• Nutrition: involve Youth <strong>Council</strong> and CYP Forum to regulate fast food outlets, promote<br />
healthy eating interventions, increase sports facilities, target hard to reach children<br />
• Joint commissioning<br />
• Safeguarding Board to protect vulnerable children from emerging communities<br />
Age 16-19<br />
• User involvement: CYPSP to map use and identify gaps<br />
• Promoting healthy lifestyles: Encourage more voluntary sector involvement, target at-risk<br />
groups<br />
• Risky Behaviour: Sexual Health Strategy Group to improve access to integrated services<br />
• Adolescent services: Child and young person centred transition policy<br />
• Joint commissioning<br />
Children with disabilities<br />
• Transition: develop key worker role<br />
• Common data set<br />
• Access: CYPSP to improve Sure Start and Children Centres resources<br />
• Early intervention and Support: CYPSP to improve health visiting and Common Assessment<br />
Framework<br />
Children and adolescent’s mental health<br />
• Access: CAMHS to develop single directory of services available and how to access<br />
• CAMHS to promote emotional well-being and cultural sensitivity and develop multiagency<br />
“risky behaviours” interventions and forum. Inter-agency working<br />
• Training: CAMHS Commissioning Group to increase tier 1 (universal) training<br />
Teenage pregnancy<br />
Summary of needs<br />
Met Services<br />
• Low GUM clinic waiting times<br />
• Services more user friendly following Modernisation Initiative<br />
• Good links with public health<br />
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Unmet<br />
• Good peer SRE education (SHARES service), good community involvement<br />
where available<br />
Services<br />
• Low uptake of EHC from Sexual Health Services (SHS). Lower number of<br />
accredited pharmacists than neighbouring boroughs<br />
• Lower uptake of LARC than neighbouring boroughs<br />
• SRE education does not meet demands. However half of secondary school age<br />
<strong>Lambeth</strong> children educated outside borough, so SRE provision unknown<br />
Specific groups<br />
• Boys, young men and fathers are not adequately targeted<br />
• BME groups, asylum seekers, looked after children and care leavers, single<br />
parent children, children at special schools, children living on housing estates,<br />
children with drug alcohol and mental health issues are not adequately targeted<br />
• Emotional support, raising self-esteem, tackling family issues not adequately done<br />
Summary of recommendations<br />
• TPPPB should work with other partnerships e.g. Crime and Disorder Reduction Partnership,<br />
have more senior representation and widened membership and mainsteam TP funding<br />
• Develop a borough wide comprehensive media, marketing and communications strategy to<br />
include health promotion, the community and the “night-time economy”.<br />
• Development of SRE<br />
• Increase capacity of SHS by service redesign and increased investment. Greater<br />
prescribing of LARC, improved uptake of Emergency Contraception and condoms in<br />
these settings.<br />
• Recruit performance specialist to monitor and evaluate services<br />
Summary of implementation plan<br />
• Use of life course based approach to TP to map whole care pathway<br />
• Appointment of director level members to TPPPB board and widening of membership<br />
to include community paediatricians and involve young people’s views<br />
• TPPPB to ensure implementation of Local Implementation Grant (LIG) to protect<br />
funding of Sure Start Plus<br />
• Set up of finance and governance group<br />
• Creation of information sub-group to monitor and evaluate services and to report to<br />
TPPPB. Development of common dataset<br />
• Consider use of small grants scheme to engage with community and voluntary sector<br />
• Formation of partnerships to link with smoking in pregnancy, breastfeeding and<br />
mental health (e.g. Mental Health Promotion Strategy in PCT). Work with Extended<br />
Schools, Children’s Centres and Children’s Services<br />
• Broaden scope of Speakeasy programme to help communication between children and<br />
parents<br />
• Encourage schools to aim for Healthy School Status, involve School Nurses and<br />
Health Visitors to improve SRE. Consider starting SRE in primary school<br />
• Use Locally Enhanced Services in GP contract to increase LARC prescription and new<br />
pharmacy contract to expand EHC provision. Improve signposting and advertising of<br />
abortion services<br />
• Development of borough-wide comprehensive marketing, media and communications<br />
strategy with involvement of PCT and Borough Communications teams<br />
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Physical activity<br />
Summary of needs<br />
Met Children aged 1-14 years<br />
Follow national guidelines for physical activity better than national average<br />
Girls and Young Women<br />
Unmet<br />
Lower levels of inactivity in 16-24 year old girls than nationally<br />
Middle aged men (30-44)<br />
Initiation of North <strong>Lambeth</strong> and Southwark Sport Action Zone (SAZ)<br />
Older people (60+)<br />
Targeted and safe areas for exercise (e.g. active walks, SLIPS, Age Concern Festival,<br />
Sheltered Housing Scheme Pilot, Fit as a Fiddle project, Ageing Well project)<br />
Increased sports participation in over 55s in England<br />
BAME community<br />
Lower levels of inactivity in BAME community than nationally<br />
People on low income<br />
Initiation of North <strong>Lambeth</strong> and Southwark SAZ<br />
Disabled people<br />
Lower levels of inactivity in disabled group than nationally<br />
Children aged 1-14 years<br />
Continued increase and projected increase in prevalence of obesity<br />
Girls and Young Women<br />
Highest teenage pregnancy rate in Europe, resulting in higher inactivity<br />
Middle aged men (30-44)<br />
Higher inactivity than nationally<br />
Older people (60+)<br />
Higher inactivity than nationally<br />
BAME community<br />
None of Sport England’s 19 segments are driven by ethnicity, resulting in poor local<br />
provision for BAME groups<br />
People on low income<br />
Higher inactivity than nationally, poor provision of sports facilities in several wards<br />
Disabled people<br />
Few and sparsely distributed locations in <strong>Lambeth</strong> with provision for disabled persons<br />
Summary of recommendations<br />
Children aged 1-14 years<br />
• London Borough of <strong>Lambeth</strong> to take lead, bringing together various strategies<br />
• Strategic marketing<br />
• Provision of wide range of activities, strengthen volunteer and club base<br />
• Extend exercise referral, continue MEND scheme<br />
Girls and Young women<br />
• Trail blazing projects (e.g. Recruiting Mothers and Daughters Together), multi- agency Alive<br />
and Active programmes<br />
• Define and dedicate lead agency and dedicated resource for girls and young women.<br />
Establish Girls and Young Women’s Physical Activity Focus/Steering Group<br />
Middle aged men (30-44)<br />
• Early recruitment to physical activity.<br />
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• PCT to lead initiatives. Integration with initiatives such as SAZ, family orientated exercise<br />
Older people (60+)<br />
• Agree on an agency to lead strategic development of physicial activity for this age group:<br />
Borough <strong>Council</strong>, PCT, Age Concern<br />
• Continue with Age Concern Communities for Health- Healthy Ageing Project<br />
BAME community<br />
• Interventions should reflect population demographics<br />
• Consider results of Sport & Physical Activity Action Plan for Black, Asian and Ethnic Minority<br />
Communities in London<br />
People on low income<br />
• Extend North <strong>Lambeth</strong> and Southwark SAZ<br />
Disabled people<br />
• Local strategic planning linked with regional Inclusive and Active plan<br />
• Encourage participation, volunteering, increase opportunities<br />
Summary of implementation plan<br />
• Communication and translation of health benefits message to policy makers, investment and<br />
service managers and community leaders<br />
• Development of multi agency Strategic Framework for Physical Activity and Sport<br />
• Employ Partnership Manager to establish effective CSPAN<br />
• Build pathways using practical examples/Trail Blazer projects for children and young people<br />
• Lead sub-groups, ensure priority given to each group through CSPAN. Highest priority for<br />
young people, older people, disabled people, low income groups. Secondary priority for<br />
middle aged males and young girls and women. Integrated approach to BAME<br />
• Shared delivery of health promotion and targeted exercise delivery<br />
• Identify low participation and deficiencies, tactical targeting<br />
• Building Schools for the Future programme to enhance provision of sport facilities<br />
• Invest in volunteers and workforce development<br />
• Sustained long term investment<br />
• Incorporation of social marketing (findings of five Pro-Active Sport and Physical Activity<br />
Partnerships) into Strategic Framework for Physical Activity and Sport in <strong>Lambeth</strong><br />
Prisons needs assessment<br />
Summary of needs<br />
Met Service provision<br />
Unmet<br />
• Good range of services provided and involvement of specialist services, new<br />
provision of art and drama therapy Nov 2007<br />
• 1:1 smoking cessation advice available<br />
Health problems<br />
• Good identification of patients with diabetes, coronary heart disease, epilepsy<br />
Substance misuse<br />
• Integrated drug treatment service<br />
Service provision<br />
• Lack of electronic data and unlinked data systems, resulting in incomplete<br />
information on prisoner and difficulty linking with community health systems<br />
• Primary health care service separate from and unlinked to GP service<br />
• Variation in staff-prisoner relationship in prison medical services<br />
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• Prisoners sometimes use nicotine patches to supplement cigarette use<br />
Health problems<br />
• Under-diagnosis of hypertension and smoking cessation intervention<br />
• No cardiovascular risk assessments done<br />
• Prison Health Performance Indicator for Hepatitis B vaccination not met<br />
Mental health<br />
• Low uptake of referrals to outreach team- poor management of common mental<br />
disorders<br />
• Insufficient time in nurse-led mental health outreach service for interventions<br />
• Only 1/3 of prisoners referred to mental health services attend- possible causes<br />
are release from prison, simultaneous activities, lack of communication regarding<br />
appointment, shortage of prison officers<br />
• Long waiting times to access acute mental health services (24% wait more than 3<br />
months), resulting in treatment of acutely unwell patients under common law in<br />
prison<br />
Self-harm/suicide/attempted suicide<br />
• Self harm under Safer in Custody directorate with poor link with medical services<br />
Substance misuse<br />
• Drugs smuggled into prison and injection of controlled drugs occurs in prison<br />
• Higher than expected for Brixton Prison number of prisoners on drug<br />
detoxification programme<br />
• Less drug testing than nationally<br />
Sexual health<br />
• Condoms only available on request<br />
Health promotion<br />
• Health promotion plan 2005 not fully implemented. Lack of health promotion<br />
leaflets, health promotion induction varies. Less material than nationally<br />
Physiotherapy<br />
• Only one gym open or 2 available<br />
Complaints<br />
• Recorded but not always acted on. Often reported to perpetrator<br />
Dental<br />
• Long waiting times to see dentist: median 33 days, up to 454 days<br />
Summary of recommendations<br />
Service provision<br />
• Screen all patients for mental illness, chronic diseases, controlled substances by person with<br />
appropriate training<br />
• Ensure one electronic record with linked database<br />
• Integrate primary healthcare wing with GP service<br />
• Training for all staff on primary mental health care and common medical emergencies<br />
Health problems<br />
• Urgently consider harm reduction measures e.g. needle exchange, disinfectant tablets, free<br />
condom availability for prevention/reduction HIV/Hep B and C<br />
• Follow guidance for Hepatitis B vaccination<br />
• Address dental waiting list proactively<br />
Mental health<br />
• Prioritise management of self harm with mental health lead, strategy and evidence based<br />
implementation plan<br />
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• Audit suicide deaths against best practice guidance<br />
• Increase counselling and cognitive behavioural therapies for management of common mental<br />
illnesses<br />
• Discussion about pan-London diversion of prisoners with acute mental illness to NHS facility<br />
Substance misuse<br />
• Regular and mandatory drug testing<br />
Health promotion<br />
• Enhance health promotion, including peer education, self-help, smoking cessation advice,<br />
information on mental health symptoms, self harm, substance misuse, Hepatitis B and C and<br />
TB.<br />
• Seek innovative opportunities for exercise<br />
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10. <strong>Lambeth</strong> priorities<br />
Prioritisation<br />
Why do we prioritise in Public Health?<br />
The growing pressure to meet the 2010 target has placed a strong emphasis on an<br />
area approach. This has emphasised a drive to target spearhead areas to reduce<br />
health inequalities resulting in a limited scope of action at local level in<br />
disadvantaged areas.<br />
PCTs are required to commission health services to “improve health and well being<br />
“of the population subject to an available budget. Therefore decisions on how best<br />
to allocate available resources need to be taken. However improving well being of<br />
the population is too broad criteria for the available resources. History has shown<br />
that the demand for care will always exceed the capacity of available resources<br />
despite the improvement of knowledge; technology and socio-economic status.<br />
With the labour government priority has been given to reducing health inequalities<br />
whilst keeping within budget, which requires that PCT select interventions which<br />
bring the maximum benefit for the given resources. So the question is: Which<br />
package of services is likely to bring the highest reduction of health inequalities,<br />
reducing the gap in health status between socio-economic population groups?<br />
The need to prioritisation has been a powerful force in narrowing the scope of<br />
action and potential interventions. However, considerations should be accorded to<br />
the fact that prioritising interventions in minority areas that experience most health<br />
inequalities may not always be a cost-effective option. This features in the action to<br />
prioritise interventions so that benefits are maximised within available resources.<br />
NHS is run on public money and at times difficult decisions are made in terms of<br />
prioritising investment to focus on reducing the overall burden of disease that is<br />
likely to affect quality of life and healthy life expectancy in the long term, while<br />
giving due consideration to health inequalities.<br />
How do we prioritise in Public Health?<br />
Public health agenda is dominated by two key objectives - Protection of health and<br />
Preventing diseases in the local population. Cost-effective interventions that ensure<br />
maximum benefits within available resources with an aim to reduce health<br />
inequalities is the main outcome of prioritisation.<br />
Cost-effectiveness<br />
Efficiency refers to a service having results (improvement of the health condition)<br />
without wasting time, effort or resources ), therefore leading to saving or “added<br />
value.” In the NHS, choice of intervention is based on cost effectiveness so long as<br />
there is evidence to support it. At PCT level the challenge is to adapt to local needs<br />
and find out the most cost-efficient way to deliver a service which is known to be<br />
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accessed the service all benefit of it, increases cost-efficiency or added value of<br />
the services.<br />
The prioritisation process produces a list of potential interventions aiming at<br />
reducing or preventing health inequalities by ensuring that resources are<br />
distributed according to needs.<br />
There are several drivers that inform and affect public health priority setting. While<br />
there may be different approaches to priority setting, this process is largely driven<br />
by National priorities set through the Operating framework by the DH where<br />
providers need to explicitly plan for delivery especially in terms of following:<br />
• Cleanliness and healthcare-associated infections<br />
• Improving access<br />
• Keeping adults and children well, improving their health and reducing<br />
health inequalities<br />
• Experience, satisfaction and engagement<br />
• Emergency preparedness<br />
The Healthcare Commission’s annual health check drives improvements in<br />
healthcare for patients by monitoring progress of work towards meeting targets<br />
through the set of indicators included in the National and Local indicator set. A new<br />
approach within the Operating Framework 2008-09 for planning and managing<br />
priorities both nationally and locally are ‘vital signs’. ‘Vital signs’ can be used to<br />
develop local operational plans to deliver against national priorities and inform<br />
decisions on local targets.<br />
There has been a shift in approach to improving local services delivered by the<br />
NHS, local authorities and public services. The focus has shifted from nationally set<br />
targets driving service improvements to a focus on improved outcomes that matter<br />
for individuals and local communities, which respond to the local context. Integral<br />
to this is partnership working across health and social care and between local and<br />
regional organisations. The advent of local area agreements (LAA) and the recent<br />
requirement for PCTs and Local Authorities to conduct a Joint Strategic Needs<br />
Assessment will be changing the way we prioritise in public health.<br />
Local Area Agreements (LAA) and Joint Strategic Needs Assessment (<strong>JSNA</strong>)<br />
LAAs deliver prioritisation and co-ordination at a local level and provide a platform<br />
for local leadership. LAAs are an agreement between the public and the local<br />
authority/NHS.<br />
They set out the priorities for a local area agreed between central government and<br />
a local area (the local authority and Local Strategic Partnership) and other key<br />
partners at the local level.<br />
The Local Government and Public Involvement in Health Act (2007) [Clause 116]<br />
places a duty on upper tier local authorities and Primary Care Trusts (PCTs) to<br />
undertake a Joint Strategic Needs Assessment (<strong>JSNA</strong>). This provision has come<br />
into force since April 2008. The Director of Public Health, Director of Adult Social<br />
Services and Director of Children’s Services are jointly expected to take a lead in<br />
producing a strategic needs assessment through strong partnership. (Details in<br />
Chapter 6)<br />
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The following describes the process of priority setting in light of <strong>JSNA</strong> and LAA.<br />
<strong>JSNA</strong><br />
Primary<br />
Care Trust<br />
Local<br />
Authority<br />
LSP<br />
(Local Strategic<br />
Partnership)<br />
Priorities<br />
PCT<br />
Commissioning<br />
Priorities<br />
Local Area<br />
Agreement<br />
-Mental Health<br />
-Long term conditions<br />
- Sexual health<br />
-Children & Young People<br />
-End of Life care<br />
-Staying healthy<br />
-Healthier Communities &<br />
Older people<br />
-Economic Development<br />
-Children & Young People<br />
-Community Safety<br />
-Active Communities<br />
The following chart elicits the hierarchy that exists in terms of bureaucracy at present.<br />
Central<br />
Government<br />
Department<br />
of Health<br />
Govt Office<br />
For London<br />
(Monitoring)<br />
Communities<br />
& Local<br />
Government<br />
NHS<br />
PCT<br />
Local<br />
Authority<br />
Monitored by<br />
-Health Care Commission<br />
-Audit Commission<br />
Monitored through<br />
-CAA-Comprehensive<br />
Area Assessment<br />
-APA Annual<br />
Performance Assessment<br />
-CSCI – Commission for<br />
Social Care Inspection<br />
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What are the PH priorities?<br />
Main public health priorities:<br />
- Improve life expectancy (LE)<br />
- Reduce infant mortality.<br />
- Reduce premature mortality (deaths under 75 years) from heart disease.<br />
- Reduce premature mortality (deaths under 75 years) from cancer.<br />
Additional priorities<br />
In addition to LE and reducing premature deaths from circulatory diseases and<br />
cancer, following are PH priorities with regard to prevention, detection & treatment:<br />
Obesity<br />
Smoking<br />
Alcohol<br />
Cancer Screening<br />
CVD risk<br />
assessment<br />
Hypertension<br />
CHD<br />
Diabetes<br />
Mental health<br />
Sexual health<br />
(TP & HIV)<br />
Smoking, obesity, alcohol and substance misuse have a direct co-relation with<br />
circulatory disease and cancer while hypertension, diabetes contribute to the<br />
development of circulatory diseases leading to reduction in the healthy life<br />
expectancy. Mental health has a direct correlation with physical health and is<br />
identified as a priority in <strong>Lambeth</strong>.<br />
Early intervention provides effective outcomes in the long-term and importance to<br />
prevention and early detection and treatment have been highlighted through the<br />
Staying healthy work stream developed in the PCT following the five year<br />
Commissioning Strategy Plan.<br />
‘Hiten’s Red Box’ (figure below) used traditionally by the PCT, states the areas of<br />
high burden and low burden depending on performance and also states whether<br />
they are worsening or improving.<br />
High Burden<br />
Hiten’s red box: update 2006/7<br />
Cardiovascular disease mortality<br />
(slower improvement compared for<br />
nationally)<br />
Cancer mortality<br />
Teenage conceptions<br />
Mortality from infectious and<br />
parasitic disease<br />
Healthy living issues (smoking,<br />
obesity, poor diet, low physical<br />
activity, alcohol, drug use)<br />
Chronic liver disease deaths &<br />
morbidity<br />
Chronic renal disease morbidity<br />
Hypertensive disorders<br />
HIV prevalence<br />
STIs prevalence<br />
Severe mental illness morbidity<br />
Diabetes mortality & morbidity<br />
Low Burden<br />
Infant mortality<br />
Immunisation uptake<br />
All cause mortality in girls under 15<br />
years<br />
Drug misuse<br />
All cause mortality in boys under<br />
15 years<br />
Mortality from gastric, peptic and<br />
duodenal ulcers<br />
Improving<br />
Worsening<br />
What are <strong>Lambeth</strong> PCT’s Commissioning Priorities?<br />
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<strong>Lambeth</strong> PCT’s Commissioning Strategy Plan (CSP) refresh –<br />
October 2008<br />
The PCT’s CSP has been developed following use of extensive information<br />
sources including the <strong>JSNA</strong> primary dataset, the Public Health statistical bulletin,<br />
the Annual Public Health report 2007/08 amongst others.<br />
The summary of the PCT’s CSP refreshed this year is as follows:<br />
The PCT held a workshop in June 2007 to review what the PCT’s commissioning<br />
priorities should be for the next five years. The objective was to consider all the<br />
information from our strategic drivers, outlined in Section 2, (such as Public Health<br />
data and patient and users’ views), in the context of achieving the PCT’s vision and<br />
strategic goals, to determine where the PCT’s efforts should be focussed in the<br />
next five years.<br />
The Workshop drew from a wide range of expertise, including:<br />
1. The PCT Board<br />
2. The PCT Professional Executive Committee<br />
3. <strong>Lambeth</strong> Practice Based Commissioning Consortia Leads<br />
4. <strong>Lambeth</strong> Local Authority Colleagues<br />
<strong>5.</strong> PCT Commissioners<br />
6. PCT Public Health Consultants<br />
7. PCT Quality and Professional Development Leads<br />
8. Primary Care and Community Services Leads<br />
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The comprehensive discussion and analysis at this workshop led to a very clear<br />
consensus at this meeting that this 5 year commissioning strategy should focus<br />
on the following six priorities:<br />
These were chosen because they are all areas:<br />
• Of high local need and inequality<br />
• That reflected information on public and user concerns<br />
• Where there is clear evidence on effective interventions / models of care<br />
that the PCT could implement to improve health outcomes<br />
• Where the PCT felt it could do more in terms of its commissioning to secure<br />
service change and improvement<br />
The PCT’s Public Consultation on the 5 year Commissioning Strategy plan showed<br />
very strong support from local public, users and stakeholders for this choice of 6<br />
priority areas.<br />
The six outcome measures then PCT has identified for WCC assurance are shown<br />
in the table below:<br />
Priority area Outcome Rationale<br />
Long Term<br />
Conditions<br />
Hypertension – the<br />
proportion of patients<br />
with hypertension, CHD,<br />
stroke and diabetes<br />
whose blood pressure is<br />
controlled at 150/90.<br />
Fit to PCT vision and goals and HfL<br />
themes.<br />
Hypertension management a key<br />
<strong>Lambeth</strong> risk factor - success in<br />
delivering outcome will have a major<br />
impact on improving health and<br />
inequalities and significant population<br />
impact also.<br />
<strong>Lambeth</strong> detection rates lower than<br />
national average.<br />
Measurable and deliverable but<br />
challenging.<br />
Effective hypertension management<br />
beings patients in to the heath care<br />
system, but also promotes self care,<br />
early intervention to avoid<br />
deterioration and improved health<br />
and well being.<br />
Children and Maternity - Percentage Fit to PCT vision and goals and HfL<br />
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Young People of women booked by 12<br />
weeks<br />
Sexual Health<br />
Mental Health<br />
Staying Healthy<br />
Sexually Transmitted<br />
Disease – the<br />
percentage of the 15-24<br />
population screened for<br />
Chlamydia.<br />
Early intervention and<br />
Treatment – to increase<br />
access to psychological<br />
therapies.<br />
Smoking - to achieve<br />
targets for smoking<br />
quitters per 100,000<br />
population.<br />
End of Life Care Choice – the percentage<br />
of [people who die in the<br />
place of their choosing.<br />
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themes.<br />
Improves access to population group<br />
fundamental to delivering parenting<br />
and early years strategies.<br />
Linked to overall improved outcomes<br />
– low birth rate, ethnic inequalities.<br />
Low levels of performance currently<br />
(40~% achievement) – scope for<br />
significant improvement.<br />
Measurable.<br />
Fit to PCT vision and goals.<br />
Prevalence of STIs, including<br />
Chlamydia high – with ethnic<br />
inequalities also.<br />
Facilitates access to high risk<br />
population groups and hard to reach<br />
younger populations – links therefore<br />
to prevention of other STIs, including<br />
HIV, teenage pregnancy.<br />
Evidence of cost effectiveness.<br />
Service model and redesign in place<br />
to support delivery.<br />
Measurable.<br />
Fit to PCT vision and goals and a<br />
major priority area within the PCT’s<br />
mental health strategy.<br />
Areas of current service gap and<br />
inequality – implementation of talking<br />
therapies review from October 2008 –<br />
identification as an outcome will<br />
enable assessment of progress and<br />
impact.<br />
Fit to PCT vision and goals and HfL<br />
themes.<br />
High prevalence with significant health<br />
impact. Significant inequality in<br />
smoking rates between <strong>Lambeth</strong> and<br />
nationally.<br />
Current performance against targets is<br />
challenging, although services<br />
comprehensive – need to explore<br />
more innovative approaches.<br />
Measurable.<br />
Fit to PCT vision and goals and HfL<br />
themes.<br />
Current performance (nationally and<br />
locally) poor – scope for significant<br />
improvement.<br />
Will require service development and<br />
redesign – supported by Guy’s and St<br />
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Thomas’ Charity and Marie Curie<br />
initiatives.<br />
Inequalities issues – need to ensure<br />
consistent focus across cancer and all<br />
end of life care.<br />
Further work, utilising the same baseline data and information as above has also<br />
been carried out to identify the final two outcome measures. These are as follows:<br />
Priority area Outcome Rationale<br />
Long Term<br />
Conditions<br />
Alcohol or<br />
Patient<br />
Experience or<br />
Flu Vaccines<br />
Diabetes blood sugar<br />
levels<br />
An outcome related either<br />
to alcohol or patient<br />
experience.<br />
Fit to PCT vision and goals and HfL<br />
themes.<br />
<strong>Lambeth</strong> detection rates low.<br />
Effective management will improve<br />
health outcomes and deterioration of<br />
morbidity for diabetic patients.<br />
Diabetes represents the PCT’s<br />
biggest opportunity for shift to out of<br />
hospital care (emergency<br />
admissions high and hospital check<br />
ups). .<br />
Measurable.<br />
Further work is required to confirm<br />
the PCT’s final outcome measure.<br />
The PCT is keen to include an<br />
outcome related to responsiveness<br />
of care, linked to its CSP strategic<br />
goal. However it wishes to consider<br />
further whether the DH measures will<br />
provide the optimal outcome for<br />
measuring progress in delivering this<br />
goal and WCC.<br />
Similarly the PCT is keen to include<br />
an outcome related to alcohol, as<br />
this is an area of significant need<br />
and a key risk factor for the<br />
population. Again however it wishes<br />
to consider further whether the DH<br />
measures will provide the optimal<br />
outcome for measuring progress in<br />
delivering this goal and WCC.<br />
A further alternative is to include an<br />
outcome measure on flu vaccination.<br />
The above outcomes have been identified following a workshop at which all the<br />
proposed outcomes were discussed and assessed. The workshop included the<br />
PCT’s Board, PEC and Management Team, Practice Based Commissioners, PCT<br />
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public health and commissioning leads, and representatives from key external<br />
stakeholders. Over the next few weeks the PCT will carry out the following further<br />
work on its 10 outcomes, to ensure a final sub mission in line with final CSP/WCC<br />
deadlines.<br />
Staying healthy<br />
1.1. Initiative Outcome Indicators<br />
1. To have completed the first pro-active vascular risk screening of the eligible<br />
population (40-74 years)<br />
2. To increase the % of practices with validated registers of patients without<br />
symptoms of cardiovascular disease with an absolute risk of CVD events<br />
greater than 20% over the next 10 year<br />
3. To reduce smoking prevalence in line with the national targets<br />
4. To increase the range of options available to support increasing physical<br />
activity in adults with a CVD risk of greater than 20% over the next 10 years<br />
and those just below 20% risk<br />
<strong>5.</strong> Increase the number/% of patients assessed using the FAST tool (for<br />
alcohol consumption). To increase the range of settings in which FAST is<br />
used across care settings, with the specific aim of extending its use within<br />
and beyond general practice<br />
6. To increase the number of settings actively promoting the mental health and<br />
well-being of pre-school and primary age children using evidenced<br />
interventions to an agreed standard<br />
7. To reduce the percentage of <strong>Lambeth</strong> adults and children classified as<br />
obese, though the effective implementation of the PCT’s obesity strategy<br />
8. To increase the percentage of <strong>Lambeth</strong> residents classified as suffering<br />
from mental health and well being issue using evidenced interventions to an<br />
agreed standard<br />
9. To increase the proportion of PCT spend on health promotion/prevention<br />
year on year.<br />
Mental health<br />
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Initiative Outcome Indicators<br />
1. Increased access to psychological therapies in line with IAPT: increase in<br />
no's of people seen<br />
2. Percentage of adults in contact with secondary MH services in employment:<br />
VSC8: N1 150<br />
3. Percentage of adults in contact with mental health services in settled<br />
accommodation: VSC06<br />
2- 4: Psychosis: Delivery of 200 new cases by early intervention team<br />
4. High percentage of people with SMI accessing physical health care checks<br />
(QOF)<br />
<strong>5.</strong> Proportion of older people diagnosed with dementia<br />
Children and young people<br />
Initiative Outcome Indicators<br />
The approach taken to establishing outcomes for birth is to consider outcomes<br />
along the care pathway, from maternity to adolescents. In addition outcomes have<br />
been defined for two cross cutting client groups: children and adolescents with<br />
mental health issues, and children with disabilities.<br />
1. Maternity - % women booking by 12 weeks - Optimising the health of<br />
mother and infant and reducing health inequalities – investment is already<br />
underway which will deliver increased capacity in the Healthy Start teams,<br />
which include health visitors. In order for women to gain access to key<br />
advice and screening it is essential that they access maternity services in a<br />
timely way. This will give them access to advice on diet, smoking, antenatal<br />
screening, mental health screening, domestic violence screening etc all<br />
factors which influence the health of the mother and unborn child.<br />
2. Infancy and early years – Immunisation rates by 2 nd and 5 th birthday for MMR<br />
- Infancy and early years - To have a completed schedule of childhood<br />
immunisations, focusing on MMR at age 2 and 5 – immunisation rates in<br />
<strong>Lambeth</strong> continue to below national averages. There is a strong evidencebase<br />
surrounding immunisations preventing ill health in infancy and early<br />
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years.<br />
3. School aged children – No. of <strong>Lambeth</strong> schools achieving advanced Healthy<br />
Schools status - To attain 50 of <strong>Lambeth</strong> schools reaching advanced Healthy<br />
Schools status – Good progress has been made in attaining Healthy Schools<br />
status in <strong>Lambeth</strong>, however the advanced program will give the opportunity<br />
to give additional focus on emotional well being, substance misuse and<br />
sexual health. It is proposed to broaden the programme to do some targeted<br />
work on obesity, in addition to any national initiatives.<br />
4. Adolescents – No. of services awarded You’re Welcome Status - Improve<br />
youth engagement in health services – there is a high incidence of ill health<br />
linked to risky behaviours in <strong>Lambeth</strong> including, sexual health and substance<br />
misuse. Engagement of young people in health services, would promote<br />
improved prevention and treatment.<br />
<strong>5.</strong> Child and Adolescent Mental Health – Young people and their parent’s<br />
satisfactions with CAMHS – ‘Value Added’ measure of the Strengths and<br />
Difficulties Questionnaire (SDQ) - To maximise young people and their<br />
parents satisfaction with CAMHS – to date significance focus on CAMHS has<br />
been on ensuring the right processes/services are in place eg 24 hour<br />
access. Patient satisfaction is being used nationally as a proxy measure for<br />
outcomes rather than process. One of the key priorities identified in the<br />
CAMHS strategy is to ensure that a systematic method of obtaining patient<br />
feedback is developed in order to improve both the commissioning and the<br />
provision of services.<br />
6. Children with disabilities – National Survey, by Borough, of parents of<br />
children with disabilities - To maximise young people and their parents<br />
satisfaction with services for children with disabilities – There is anecdotal<br />
evidence that the number of children with disabilities is increasing. A health<br />
needs assessment is currently underway which will allow us to better under<br />
stand the issue. Additional investment has already been made with LBL on<br />
increased school nurse capacity in special schools, and the Aiming High<br />
agenda will specifically increase provision of short breaks for children with<br />
disabilities and their families.<br />
Long term conditions<br />
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Initiative Outcome Indicators<br />
1. HbA1c of 7.5 or less (in the last 15 months for diabetic patients) for 70% of<br />
diabetic patients by 2013<br />
2. To increase the proportion of patients with hypertension, CHD, stroke and<br />
diabetes whose blood pressure is controlled at 150/90<br />
3. To increase in the percentage of stroke admissions given a brain scan within<br />
24 hours<br />
4. Increase the percentage of patients with COPD for whom diagnosis has<br />
been confirmed by spirometry<br />
<strong>5.</strong> A personalised care plan for all patients with a long term condition, starting<br />
with patients at highest risk of admission<br />
Sexual health<br />
Initiative Outcome Indicators<br />
The following key outcomes and quality improvements are planned through the<br />
implementation of the sexual health strategy:<br />
1. GUM 48 hr appointment wait<br />
2. 17% 15-24 year olds screened for chlamydia (as a proxy for<br />
prevalence<br />
3. Increase in community service uptake by (a) young people<br />
under 25 and (b) by men<br />
4. Increased uptake of long-acting reversible contraception<br />
(LARC)<br />
<strong>5.</strong> Transfer of services from hospital to community settings.<br />
6. Improved patient experience<br />
End of life care<br />
Initiative Outcome Indicators<br />
1. More people to be able to express a choice of place of death - Most people<br />
given a choice would prefer to die at home (this definition includes forms of<br />
residential care i.e. care homes). Often however the wishes of people<br />
coming to the end of their life are not discussed or documented and<br />
therefore robust care planning to enable the wishes of the patient are often<br />
not in place or happen towards the very end of life. The use of the Preferred<br />
Priorities for Care (PPC) document and the monitoring of the use of the PPC<br />
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will ensure that we are able to record, communicate and carry out the<br />
patient’s wishes.<br />
2. More people dying in the place of their choice - To maximise the number of<br />
people who die in the place of their choice and to ensure they receive<br />
excellent end of life care where ever that is. While most people express a<br />
wish to die at home it is essential that good end of life care is available in all<br />
settings.<br />
3. Access to care at home - Most people would prefer to die at home as long as<br />
high quality care can be assured and as long as they do not place too great<br />
a burden on their family and friends. The Gold Standards Framework (GSF)<br />
is now being used by 64% of <strong>Lambeth</strong> GP practices and there has been an<br />
increase in the number of people receiving fully funded palliative continuing<br />
care. However patients, carers and referrers report that access to health<br />
and social care support and practical help is variable, is not always available<br />
24/7 and in an emergency and can lead to carer burnout.<br />
4. End of life care in care homes - Of the 14 care homes in <strong>Lambeth</strong>, 5 have<br />
been involved in some way with implementing the GSF and 2 of those are<br />
progressing to full accreditation. The PCT will be working with other<br />
stakeholders to explore additional ways of incentivising care homes to<br />
implement both the GSF and Liverpool Care Pathway (LCP). End of life<br />
care for people with dementia has been highlighted as a priority area as part<br />
of both the MCCP and Modernisation Initiative.<br />
<strong>5.</strong> Acute care - A 3 year project is underway at GSTT to roll out the LCP across<br />
the trust and so far 17 wards have implanted it. Work undertaken as part of<br />
the MCDC programme has highlighted discharge planning as an area that<br />
needs further work.<br />
6. Access to bereavement services - The PCTs baseline review of EOLC<br />
services completed early in 2008 identified a gap in bereavement services.<br />
Work is underway with the national charity Cruse to develop a local <strong>Lambeth</strong><br />
bereavement service.<br />
Planned care<br />
Initiative Outcome Indicators<br />
1. Reduction in cancer mortality<br />
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2. Proportion of eligible population offered appropriate screening e.g. breast,<br />
cervical and bowel (TBA)<br />
3. Continued implementation of improved outcome guidance<br />
4. Shift in outpatient attendances to community settings for defined conditions<br />
and improved patient reported outcomes<br />
<strong>5.</strong> Case management offered to 90% of patients identified as at risk of<br />
admission (approximately 1600 patients)<br />
Unplanned care<br />
Initiative Outcome Indicators<br />
1. To increase access to walk-in urgent care services<br />
2. To increase access to routine and urgent care services outside the ‘normal’<br />
working week.<br />
3. To increase capacity in urgent care responses in primary care and<br />
community services.<br />
4. To reduce the need for urgent / emergency care.<br />
<strong>5.</strong> To regionalise major trauma services in London (working with Healthcare for<br />
London ) and to develop a Sector based trauma networks.<br />
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Sustainable community strategy priorities: To realise our long-term term vision, <strong>Lambeth</strong> First has identified key priority areas for the next<br />
three years. These are set out in our Local Area Agreement, which was approved in June 2008. See <strong>Appendix</strong> 1 for further details.<br />
Vision<br />
<strong>Lambeth</strong> is a diverse, dynamic and enterprising borough at the heart of London<br />
Sustainability Economic Well-Being Social Well-Being Environmental Well-<br />
Being<br />
Universal Issues<br />
Sustainable<br />
Community<br />
Strategy 2020<br />
Outcomes<br />
<strong>Lambeth</strong> is a great place<br />
to do business with higher<br />
levels of investment and<br />
business growth<br />
Greater wellbeing for<br />
households through higher<br />
numbers of residents in<br />
employment<br />
Children and young people are<br />
on the path to success through<br />
the provision of good quality<br />
education, training and jobs<br />
which reduces the risk of<br />
exclusion and offending<br />
Community Cohesion, Equalities, Sustainability and Culture<br />
Empowered, safe and cohesive places where people have the confidence<br />
to play active roles in their communities<br />
Improved health and<br />
wellbeing of people which<br />
enables them to live<br />
active and independent<br />
lives<br />
Lower levels of poverty and<br />
social exclusion in <strong>Lambeth</strong> by<br />
helping more of our socially<br />
excluded adults in employment,<br />
education and training<br />
Mixed and sustainable<br />
communities with an<br />
increased supply of new<br />
homes, improved existing<br />
dwellings and a high<br />
quality physical<br />
environment<br />
<strong>Lambeth</strong> Local<br />
Area Agreement<br />
Priority Areas for<br />
Improvement<br />
2008 - 2011<br />
Increasing the overall<br />
employment rate<br />
Increasing VAT<br />
registration rate for new<br />
companies<br />
Increasing the number of<br />
working age people with a<br />
Level 2 qualification or higher<br />
Increasing the number of 19<br />
year olds with Level 2<br />
qualifications<br />
Reducing the number of 16-<br />
18 year olds not in education,<br />
employment or training<br />
Increasing migrants English<br />
language skills and<br />
knowledge<br />
Reducing working age people<br />
claiming out of work benefits<br />
Improving the emotional health<br />
of children<br />
Reducing obesity in primary<br />
school children<br />
Improving the stability of<br />
placements for looked after<br />
children<br />
Reducing the under 18<br />
conception rate<br />
Reducing the gap in<br />
achievement between pupils<br />
eligible for free school meals and<br />
their peers at Key Stage 2 and 4<br />
Reducing the rate of permanent<br />
exclusions from school<br />
Increasing the percentage of people who feel they can influence<br />
decisions in their locality<br />
Increasing overall satisfaction with the local area<br />
Building resilience to violent extremism within <strong>Lambeth</strong><br />
Increasing young people’s participation in positive activities<br />
Increasing take-up of formal childcare for low income working families<br />
Reducing serious violent crime<br />
Reducing serious acquisitive crime<br />
Tackling perceptions about drug use and drug dealing<br />
Tackling concerns about anti-social behaviour and crime by the local<br />
council and police<br />
Reducing mortality rates<br />
from all circulatory<br />
diseases for people under<br />
75<br />
Increasing the number of<br />
clients receiving selfdirected<br />
support<br />
Increasing the number of<br />
vulnerable people living<br />
independently<br />
Increasing carers needs<br />
assessments undertaken<br />
Reducing the proportion of<br />
children in poverty<br />
Increasing the number of adults<br />
with learning disabilities in<br />
employment<br />
Increasing the number of adults<br />
in contact with secondary mental<br />
health services in employment<br />
Increasing young offenders<br />
engagement in suitable<br />
education, employment or<br />
training<br />
Increasing offenders under<br />
probation supervision in<br />
employment at the end of their<br />
order or licence<br />
Increasing the number of<br />
affordable homes<br />
delivered (gross)<br />
Reducing the number of<br />
households living in<br />
temporary<br />
accommodation<br />
Reducing per capita CO2<br />
emissions in the local<br />
authority area<br />
Improving street and<br />
environmental cleanliness<br />
(levels of graffiti, litter,<br />
detritus and fly posting)<br />
(local PI)<br />
Reducing the percentage<br />
of non-decent homes<br />
(local PI)<br />
Our new way of<br />
working<br />
Increasing the numbers of volunteers registering (local PI)<br />
Neighbourhood Working – Where appropriate we will deliver services at the neighbourhood level<br />
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Chapter 6. Recommendations<br />
The next phase of work as a part of the <strong>JSNA</strong> will be to identify gaps in terms of<br />
understanding current service provision in health and social care to achieve the<br />
desired health and well-being outcomes and to reduce inequalities.<br />
To ensure the above, it is important that there is a good understanding of<br />
currently provided service and evidence of their efficacy. In addition, a review of<br />
evidence to determine cost-effective interventions will complement provision of<br />
strategic recommendations in terms of commissioning or decommissioning of<br />
service across the health and social care remit.<br />
The areas of work identified are further consultation with stakeholders including<br />
the community and voluntary sector, mapping local services specifically those<br />
where there are unmet needs in the population, understand market capacity for<br />
effective commissioning or decommissioning of services and local impact<br />
assessment of proposed recommendations.<br />
<strong>Appendix</strong><br />
I. <strong>JSNA</strong> Project Plan.<br />
II. Customer focus – Literature review.<br />
III. Glossary<br />
IV. References documents<br />
a. <strong>Lambeth</strong> - State of the Borough report.<br />
b. <strong>Lambeth</strong> PCT Commissioning Strategy Plan.<br />
c. <strong>Lambeth</strong> Annual Public Health Report.<br />
d. <strong>Lambeth</strong> Public Health Statistical Bulletin.<br />
e. <strong>Lambeth</strong> Sustainable Community Strategy.<br />
f. <strong>Lambeth</strong> Local Area Agreement.<br />
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<strong>Appendix</strong> 1<br />
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LA<strong>MB</strong>ETH<br />
JOINT STRATEGIC NEEDS<br />
ASSESSMENT<br />
(<strong>JSNA</strong>)<br />
PROJECT PLAN<br />
Version 3.<br />
Jun 30, 2008<br />
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<strong>JSNA</strong> Project Plan<br />
Overview of Project<br />
Background<br />
The concept of Joint Strategic Needs Assessment (<strong>JSNA</strong>) was introduced in the<br />
Department of Health’s (DH) Commissioning Framework for Health and wellbeing<br />
document published in March 2007. The Local Government and Public<br />
Involvement in Health Act (2007) [Clause 116] places a duty on upper tier local<br />
authorities and Primary Care Trusts (PCT) to undertake a Joint Strategic Needs<br />
Assessment (<strong>JSNA</strong>). This provision came into force in April 2008. The Director<br />
of Public Health, Director of Adult Social Services and Director of Children’s<br />
Services are jointly expected to take a lead in producing a strategic needs<br />
assessment through strong partnership.<br />
The DH describes <strong>JSNA</strong> as ‘a systematic method for reviewing the health and<br />
well-being needs of a population, leading to agreed commissioning priorities that<br />
will improve health and well-being outcomes and reduce inequalities.<br />
The <strong>JSNA</strong> is expected to “describe the future health care and well-being needs of<br />
local population and the strategic direction of service delivery to help meet those<br />
needs”. A key element of <strong>JSNA</strong> is that it should involve all the important<br />
stakeholders in identifying needs and take appropriate actions to address those.<br />
The assessment process is expected to make use of existing information, identify<br />
gaps, actively engage stakeholders including patients and public for their views,<br />
understand local service provision; and most importantly, the outputs or findings<br />
be translated into actions for the commissioning and delivery of health and social<br />
care services, health improvement and well-being programmes and<br />
interventions.<br />
The World Class Commissioning competencies emphasise the role of <strong>JSNA</strong> in<br />
driving the long term commissioning strategies of PCTs and their collaborative<br />
work with community partners including public and patient engagement. The<br />
<strong>JSNA</strong> is envisioned as a dynamic process periodically updated and is expected<br />
to contribute immensely as a key tool to achieve a shift towards commissioning<br />
to improve health and well-being outcomes and reduce inequalities.<br />
Aims and Objectives<br />
Aim<br />
To understand the current and future health and well-being needs of the<br />
population; over both short term (3-5 years) to inform Local Area Agreements<br />
(LAA), and the longer term (5-10 years) to inform strategic planning and<br />
commissioning.<br />
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Objectives:<br />
• To develop a process for conducting the Joint Strategic Needs<br />
Assessment.<br />
To form a steering group and working group.<br />
To agree governance arrangements for the <strong>JSNA</strong> process<br />
To agree communication strategy to ensure adequate<br />
internal and external communication<br />
To list partners and stakeholders to be engaged in<br />
development of <strong>JSNA</strong>.<br />
To agree resource requirements.<br />
• To design methods to develop the <strong>Lambeth</strong> Joint Strategic Needs<br />
Assessment.<br />
To agree the scope of work.<br />
To develop a joint outcomes framework that can be used to<br />
describe the health and wellbeing needs and inequalities<br />
across <strong>Lambeth</strong>.<br />
To develop and/or agree a prioritisation methodology to<br />
identify strategic priorities and offer strategic<br />
recommendations for service planning and improvement<br />
following the needs assessment.<br />
- To ensure that the output from the <strong>JSNA</strong> is disseminated to all<br />
stakeholders and used in future commissioning.<br />
To consult with the public on the final <strong>JSNA</strong><br />
To disseminate the findings to key stakeholders within the<br />
LBL and <strong>Lambeth</strong> PCT.<br />
Overall Approach<br />
The Department of Health guidance on Joint Strategic Needs Assessment states<br />
that the <strong>JSNA</strong> will provide a framework to examine all the factors that impact on<br />
health and well-being of local communities including employment, education,<br />
housing and environmental factors. To achieve this, it is proposed that a core<br />
dataset be formed which will signpost users to a range of existing data from data<br />
sources to assist in the <strong>JSNA</strong> process. Regarding engagement with<br />
stakeholders, Strong and Prosperous communities emphasises that citizens and<br />
communities know what they want from services and what needs to be done. It is<br />
within the remit of this project to use patient and user experience and build on the<br />
duties to consult and involve the stakeholders through LINKs and other such<br />
networks.<br />
The <strong>JSNA</strong> work is expected to deliver the following as a minimum:<br />
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• Achieve a shift towards commissioning to improve health and well-being<br />
outcomes and reduce inequalities.<br />
• Identify priorities and offer strategic recommendations for service planning<br />
and improvement.<br />
• Provide evidence about the population on which services are planned to<br />
address health inequalities;<br />
• Identify gaps in equitable distribution of services;<br />
• Create cross-sectoral partnership working and develope creative and<br />
effective interventions;<br />
• Engage with the populations and enable them to contribute to targeted<br />
service planning and resource allocation;<br />
Important factors to ensure objectives are delivered are:<br />
• Joint working, partnerships and collaboration of PCT and various local<br />
authority directorates and range of stakeholders.<br />
• Agreeing scope of work in terms of deliverables.<br />
• Availability and access to range of information related to health, and wider<br />
determinants of health and well-being as well as on services currently<br />
provided within the borough.<br />
Project Outputs<br />
The <strong>JSNA</strong> will be presented as a working document which will include the<br />
following as a minimum:<br />
1. A joint health and well-being outcomes framework.<br />
2. Analysis of primary and secondary data to illustrate the health and wellbeing<br />
status of local communities.<br />
3. A profile of the population with regard to inequalities and inequities in the<br />
context of wider determinants of health and well-being such as<br />
environment, economy, transport, housing etc.<br />
4. Map of local statutory services as well as voluntary services contributing to<br />
improved health and well-being outcomes.<br />
<strong>5.</strong> Consultation with stakeholders and gap analysis.<br />
6. Review of evidence of effectiveness of interventions to provide<br />
recommendations for cost-effective use of resources while reducing<br />
inequity and inequalities.<br />
The presentation of information in the <strong>JSNA</strong> will be discussed with the<br />
commissioners and approach or methods agreed through a series of workshops.<br />
The <strong>JSNA</strong> working draft structure will be agreed jointly with the commissioners<br />
and other stakeholders. There are three possible suggestions on presentation of<br />
information in the <strong>JSNA</strong>:<br />
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1. A population-based approach where information related to various indicators<br />
including the wider-determinants will be detailed for children and young people,<br />
Adults and older people separately.<br />
2. An outcomes based approach will see presentation of information by<br />
outcomes to be achieved.<br />
3. A service or specialty specific approach such as mental health, sexual health,<br />
housing, environment etc.<br />
Project Outcomes<br />
• Agreeing methodology and process for <strong>JSNA</strong> and its cyclical review<br />
locally.<br />
• Prioritisation based on identified needs.<br />
• Strategic recommendations to inform commissioning cycles within the<br />
PCT and Local Authority.<br />
• Feedback to the local community and stakeholders.<br />
• Informing the development and/or refresh of the local Community<br />
Strategy, PCT Commissioning strategy plan, PCT Local Delivery Plan,<br />
Children and Young People’s Plan, PBC Commissioning plans,<br />
Community regeneration strategies, Housing strategies, Community<br />
Safety Strategy, Carer’s strategies, Workforce planning strategies and<br />
other key strategies..<br />
Stakeholder Analysis<br />
Stakeholder<br />
Local National health service (PCT)<br />
- General Practitioners & allied<br />
staff.<br />
- District nurses.<br />
- Family planning providers.<br />
- Health promotion teams.<br />
- Patient Advice and Liaison<br />
Service (PALS)<br />
- Community pharmacists.<br />
Interest / stake<br />
Statutory organisation<br />
Local Authority<br />
- Neighbourhood services<br />
- Social care staff<br />
Statutory organisation<br />
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- Environmental officers<br />
- Housing leads<br />
- Community safety leads<br />
- Economic development leads<br />
- Schools<br />
Community and Voluntary sector<br />
Private providers<br />
Voluntary sector<br />
representation<br />
Risk Analysis<br />
Risk<br />
Probability<br />
(1-5)<br />
Severity<br />
(1-5)<br />
Score<br />
(P x<br />
S)<br />
Action to<br />
Prevent/Manage Risk<br />
Staffing 3 4 12 Agree resources to fund<br />
additional staffing<br />
requirements.<br />
Organisational 2 4 8 Effective engagement of<br />
partners and good<br />
governance arrangements.<br />
Technical 2 4 8 Ensure accessibility and<br />
availability of sources of<br />
information and analytical<br />
expertise.<br />
Related to external<br />
partners<br />
3 4 12 Communication strategy to<br />
be developed.<br />
Legal 2 5 10 Ensure robust<br />
methodology in conducting<br />
the <strong>JSNA</strong> and consultation<br />
with legal advisors where<br />
need arises.<br />
Standards<br />
Name of standard or<br />
specification<br />
Standards for better<br />
health – Public health<br />
Version<br />
Governance 5b<br />
Patient Focus<br />
D8,9&10<br />
Public Health<br />
Notes<br />
Healthcare organisations promote, protect<br />
and demonstrably improve the health of the<br />
community served, and narrow health<br />
inequalities.<br />
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C22a,c<br />
D13a,b&d Core<br />
standard C22a<br />
and c<br />
Healthcare organisations identify and act<br />
upon significant pubic health problems and<br />
health inequality issues, with primary care<br />
trusts taking the leading role;<br />
Technical Development<br />
The <strong>JSNA</strong> will be a dynamic process with cyclical updates to specific pieces of<br />
work such as population health and service related information that will include<br />
various indicators (outcome indicators, health indicators, performance indicators).<br />
The technical development will be led jointly by lead Directors from <strong>Lambeth</strong> PCT<br />
and the local Authority – London Borough of <strong>Lambeth</strong>.<br />
Project Management and Resources<br />
Project Partners<br />
No. Partner Roles<br />
1. <strong>Lambeth</strong> Primary Care Trust (Local<br />
NHS)<br />
Joint Lead partner<br />
2. London Borough of <strong>Lambeth</strong><br />
- Adult and Social Service<br />
- Children’s Service<br />
Joint Lead partner<br />
3. The community and voluntary sector<br />
(represented through the <strong>Lambeth</strong><br />
Voluntary Action <strong>Council</strong> – LVAC)<br />
Partner<br />
Project Management<br />
The Local Strategic Partnership with have the overarching responsibility to<br />
deliver the <strong>JSNA</strong> while the <strong>JSNA</strong> Steering Group will provide support and will<br />
steer the <strong>JSNA</strong> Working Group’s progress of work.<br />
The <strong>JSNA</strong> Working Group will be working closely with representatives from the<br />
various theme boards such as the Children and young people theme board;<br />
Healthier communities and older people board; Economic development and<br />
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enterprise and Community safety board. Following is the proposed governance<br />
arrangement chart followed by the composition of the <strong>JSNA</strong> Steering Group and<br />
the <strong>JSNA</strong> Working Group.<br />
The output of <strong>JSNA</strong> will be fed through the newly formed cross-cutting<br />
commissioning group as described in the following chart:<br />
Joint Strategic Needs Assessment – Governance<br />
Health & Social<br />
Care<br />
Partnership<br />
Children &<br />
Young People<br />
Partnership<br />
Housing<br />
Partnership<br />
Metropolitan<br />
Police<br />
Cross Cutting<br />
Commissioning<br />
Group<br />
<strong>Lambeth</strong><br />
PCT<br />
Local Strategic<br />
Partnership<br />
<strong>Lambeth</strong><br />
Cabinet<br />
Joint Strategic<br />
Needs Assessment<br />
Steering Group<br />
Joint Strategic<br />
Needs Assessment<br />
Working Group<br />
Children &<br />
Young People<br />
Transformation<br />
Board<br />
Safer &<br />
Stronger<br />
Communities<br />
Transformation<br />
Board<br />
Adults &<br />
Community<br />
Services<br />
DLT<br />
Strategy &<br />
Corporate<br />
Services<br />
DLT<br />
Inform<br />
Governance<br />
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<strong>JSNA</strong> Steering Group membership<br />
Role Name Title<br />
Programme Sponsor<br />
Jo Cleary<br />
Ruth Wallis<br />
Phyllis Dunipace<br />
Executive Director – ACS<br />
Director of Public Health<br />
Executive Director – CYPS<br />
Strategic Commissioning Helen Charlesworth-May Divisional Director, Strategy and<br />
Commissioning, ACS<br />
Technology<br />
Transformation<br />
& Mary Cotterell<br />
Business Transformation Manager – STT<br />
Policy & Performance Sophia Looney Divisional Director - Policy, Equalities &<br />
Performance<br />
Commissioning<br />
Performance<br />
&<br />
Doreen Redwood Divisional Director Strategy &<br />
Performance, CYPS<br />
Regeneration & Housing Paul Cooper Assistant Director<br />
Programme Manager Kate Hargreaves<br />
Local Area Agreement<br />
Senior Transformation Manager<br />
Active Communities John Kerridge Assistant Director Area Services<br />
Community Safety Simon Harding Assistant Director Community Safety<br />
Project consultant lead Hiten Dodhia<br />
(PCT)<br />
Public Health Consultant<br />
Project Sub-lead Ash More Lead on <strong>JSNA</strong> from PCT<br />
Project Manager Christian Fleming Lead on <strong>JSNA</strong> from <strong>Lambeth</strong><br />
Metropolitan Police TBA TBA<br />
The <strong>JSNA</strong> Working Group membership<br />
Ash More Public Health Specialist PCT<br />
Tarek Iskander AD Strategy and Commissioning PCT<br />
Sarah Yandell Health and Social Care Officer LVAC<br />
Christian Fleming Head of Performance and Workforce LBL<br />
Development, ACS<br />
Kevin Dillon Head of Policy, CYPS LBL<br />
John Kerridge Asst Director Area Services LBL<br />
Ann Skinner Head of Supporting people LBL<br />
Ruth Staff Performance Manager, ECCS LBL<br />
Megan Jones DAAT Manager, Community Safety LBL<br />
Tom Tyson Policy manager, Regen. & Housing LBL<br />
Geoff Wade Partnership development and Improvement, LBL<br />
Community safety<br />
Charlie Conyers Business & Housing Options Development LBL<br />
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Manager, Regen. & Housing<br />
Sushma Maharaj Data Analyst, Corporate Regeneration<br />
Georges Sen- Research analyst, Quality Performance and<br />
Gupta Research<br />
Theron Newman Finance manager, ACS policy<br />
LBL<br />
LBL<br />
LBL<br />
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Project timetable with provisional dates<br />
Process<br />
Establishing<br />
Steering Group<br />
Task Initiation date Completion<br />
date<br />
Establishing Working<br />
Group<br />
Agreeing<br />
Governance<br />
arrangements<br />
Resource allocation<br />
(Staffing and<br />
administrative<br />
support)<br />
<strong>JSNA</strong> elements<br />
Developing preliminary<br />
outcomes framework<br />
Demographic and<br />
health profile -<br />
Overview<br />
Inequalities in terms of<br />
wider determinants<br />
(housing, environment,<br />
economics, etc)<br />
Review of needs<br />
assessments complete<br />
and review scope of<br />
those underway<br />
Consultation with<br />
public and patients<br />
(Stakeholder<br />
consultation)<br />
Oct 2007 Oct 2007 Oct 2007<br />
Nov 2007 Nov 2007 Nov 2007<br />
Jan 2008 Mar 2008 Apr 2008<br />
Nov 2007 In progress May 2008<br />
Jan 2008 Jun 2008 Jun 2008<br />
Jan 2007 In progress Sep 2008<br />
Jan 2007 In progress Sep 2008<br />
Apr 2008 In progress Sep 2008<br />
Apr 2008<br />
In progress Dec 2008<br />
Map of local services To be started n/a Sep - Dec 2008<br />
Review of evidence of<br />
effectiveness of<br />
interventions<br />
1.1.1. Output<br />
Prioritisation in terms<br />
of health and wellbeing<br />
needs of the<br />
population<br />
To be<br />
started; Pan<br />
London<br />
approach<br />
also being<br />
considered<br />
n/a<br />
Target date Jun 2008<br />
status<br />
Sep 2008 – Mar<br />
2009<br />
To be started n/a Jan-Mar 2009<br />
Strategic To be started Mar-Jun 2009<br />
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recommendations<br />
<strong>Lambeth</strong> <strong>JSNA</strong> –<br />
Preliminary<br />
assessment (first<br />
draft)<br />
<strong>Lambeth</strong> <strong>JSNA</strong> –<br />
Full assessment<br />
(first draft)<br />
n/a = Not applicable<br />
Apr 2008 Sep 2008<br />
Apr 2008 In progress June 2009<br />
Programme Support<br />
The <strong>JSNA</strong> work relies heavily on engagement of all partners/stakeholders<br />
including patient and public engagement. The <strong>JSNA</strong> project also relies on good<br />
governance arrangements and effective communication strategy for both internal<br />
communication and external communication especially related to dissemination<br />
of findings.<br />
Intellectual Property Rights<br />
The <strong>JSNA</strong> will be owned jointly by the <strong>Lambeth</strong> PCT and London Borough of<br />
<strong>Lambeth</strong> through the Local Strategic Partnership; and; the Director of Public<br />
Health, Director of Adult and Social Service and Director of Children Services will<br />
be the official sponsors of the project.<br />
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<strong>Appendix</strong> II<br />
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Customer Focus<br />
Programme<br />
Literature Review<br />
September 2008<br />
Produced by Philippa Hughes<br />
Research and Consultation Team<br />
Quality, Performance and Research<br />
020 7926 2680<br />
phughes@lambeth.gov.uk<br />
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Executive Summary<br />
This literature review has drawn on a variety of sources detailing service<br />
satisfaction and citizens’ perceptions of their customer experience in <strong>Lambeth</strong>.<br />
These have included the 2007 residents’ survey, BVPI surveys and qualitative<br />
research carried out with residents. A full list of sources is listed in the<br />
bibliography. This review only contains data that was made available and is by<br />
no means exhaustive.<br />
Based on the customer service data available, well-performing services include<br />
parks and open spaces, nursery education, recycling and public transport.<br />
Services where the customer experience needs improving are council housing,<br />
parking, leisure and sports facilities and planning.<br />
Communications at <strong>Lambeth</strong> are improving and 70% of residents believe<br />
<strong>Lambeth</strong> are good at keeping them informed which is better than London.<br />
People’s preferred channels of communication are <strong>Lambeth</strong> Life, information<br />
provided by the council and the website. Service users prefer to get information<br />
relevant to their specific service use through direct letters and would like to be<br />
better informed about what services they are entitled to and how to access them.<br />
People are keen to hear how services are performing and whether they are<br />
keeping their promises. They would like to see balanced, realistic reporting (not<br />
just good news) that shows how money is being spent to tackle important local<br />
issues.<br />
Most people contact the council by telephone (70%) followed by face to face<br />
contact at 13%. Face to face contact increases to 34% for housing tenants.<br />
Whilst happy to use it as a source of information, people have less faith in using<br />
the internet for interactive contact.<br />
It is getting easier to get through to <strong>Lambeth</strong> on the phone, phones are answered<br />
promptly and staff are perceived to be polite and helpful. However, customers<br />
across service areas are less satisfied with the resolution of their problems. It can<br />
be difficult to speak to the correct person and there is perceived to be a lack of<br />
joined-up working between front and back office staff. Prompt resolution of<br />
problems is an important area of customer service to be addressed.<br />
Half (48%) of <strong>Lambeth</strong> residents currently feel that they can influence local<br />
decisions which is higher than the London average (43%). There is an appetite<br />
among <strong>Lambeth</strong> residents to be involved in local decision making with 40% keen<br />
to be involved regardless and 52% dependant on the issue. One in five (20%)<br />
residents have taken part in consultation, an increase from 16% in 2005, but<br />
there is a need for consultation to be meaningful and for honest feedback that<br />
shows how people’s views have been taken into account.<br />
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Recommendations for further research<br />
- At <strong>Lambeth</strong> <strong>Council</strong>, we currently have a weak understanding about how<br />
<strong>Lambeth</strong> residents view the services offered by partnership organisations:<br />
What do people think of their customer experience of Job Centre Plus,<br />
Metropolitan and community police services, health services, the voluntary<br />
and community sector and fire services within the borough? How well do<br />
council services link up with partnership services? How can these services<br />
complement each other and work better together?<br />
- Research has shown that there are two groups of people accessing<br />
services within <strong>Lambeth</strong>. One group uses a lot of services and require<br />
detailed contact specific to their needs. They like to contact us by phone<br />
or in person. The other group use very few services and may potentially<br />
want less contact. Research could be carried out to determine whether<br />
this is the case and how customer service can best be structured to meet<br />
the needs of heavy and light users of local services.<br />
- There is currently little information available on the views of business<br />
users. It would be interesting to understand their views on the services<br />
they use and how they could be improved.<br />
- Although people see the internet as an important source of information,<br />
there appears to be barriers to using technology interactively for<br />
contacting services, making payments and resolving problems. Further<br />
work could investigate the barriers to interactive contact via the internet.<br />
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Introduction<br />
What is the Citizens’ Focus Programme?<br />
<strong>Lambeth</strong> <strong>Council</strong> and its partners want to improve Customer Services and are<br />
committed to developing a shared Customer Focus Programme (CFP) which will<br />
achieve this. There is also a desire to link customer services to our ambitions for<br />
engaging our communities and improving democratic participation as stated in<br />
the corporate plan<br />
Objectives of the strategy<br />
• It will be a strategy for the whole council – not just the customer services<br />
functions<br />
• It will embrace all of our partners – becoming a strategy for <strong>Lambeth</strong><br />
public services not simply <strong>Lambeth</strong> council services – and therefore it will<br />
be located within the LSP rather than the council<br />
• It will respond to the new national agenda for reducing avoidable contact<br />
and personalising services which means it may impact on both the design<br />
and delivery of our services<br />
• It will move beyond seeing people as customers of individual or groups of<br />
services, and address them as citizens with broader rights and interests. It<br />
will therefore look at how we can use our customer services infrastructure<br />
to further our community engagement and democratic objectives. This<br />
may mean we should talk in terms of a citizens’ services strategy.<br />
Research underpinning the Customer Focus Programme<br />
There is a need to identify what we already know about our citizens; what are<br />
their views are about the services offered by the council and partnership<br />
organisations? What are they currently happy with and where do they feel<br />
improvements are needed?<br />
This literature review is part of a four stage research project which will answer<br />
these questions and underpin the development of the CFP. The CFP research<br />
project covers:<br />
1. Literature review.<br />
2. Mosaic analysis of 2007 residents’ survey results.<br />
3. Staff workshops with customer-facing staff<br />
4. Complaints analysis<br />
This literature review will be complemented by analysis of the <strong>Lambeth</strong> 2007<br />
residents’ survey results by Mosaic categories of respondents. Staff workshops<br />
will also be run with customer-facing staff and complaints will be analysed to<br />
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identify key issues. This initial research will be combined to enable any gaps in<br />
knowledge to be identified. New research will then be commissioned to address<br />
these gaps.<br />
Scope of literature review<br />
There is a wealth of information available about the council and partnership<br />
performance. This report aims to draw together satisfaction data from across all<br />
services with a view to identify key strengths as well as areas for improvement. It<br />
also aims to identify gaps and areas for future research. It is important to<br />
remember that this review focuses on the perceptions of <strong>Lambeth</strong>’s citizens and<br />
so may not reflect actual service delivery and only contains data that was made<br />
available. It is by no means exhaustive. If you have further data that you would<br />
like included, please contact the Research and Consultation team on 020 7926<br />
2680 or consultation@lambeth.gov.uk<br />
Key findings<br />
How important is customer service?<br />
When compared against issues such as tackling crime and antisocial behaviour,<br />
customer services are rated as less of a spending priority by <strong>Lambeth</strong> residents.<br />
However, we know from Ipsos MORI research that customer service is a key<br />
driver of overall satisfaction.<br />
Research conducted as part of the 2008/09 budget consultation found that any<br />
customer service cost savings that can be implemented without too much impact<br />
on service delivery would be welcomed by <strong>Lambeth</strong> residents, including taking a<br />
slightly longer time to answer phones and reducing opening hours of call centres<br />
in less busy times. However, people are against cost saving measures that they<br />
feel will impact on the quality of service delivery. Voice recognition software was<br />
not welcomed and people were critical of any move to relocate the <strong>Lambeth</strong><br />
service centre outside of the borough to save costs 73 .<br />
73 Your <strong>Lambeth</strong>, your money, your opinion. Budget consultation 2008.<br />
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Service delivery<br />
The table below shows the percentage of users who rated services as good to<br />
excellent in the 2007 residents’ survey with the exception of the planning data<br />
which is drawn from the 2006 BVPI survey.<br />
High rated services<br />
Parks and open spaces 71%<br />
Nursery education 70%<br />
Recycling facilities 69%<br />
Public transport 69%<br />
Libraries 69%<br />
Primary education 68%<br />
Low rated services<br />
Activities for young people<br />
31/10% 74<br />
<strong>Council</strong> housing 33%<br />
Road repairs 35%<br />
Parking 42%<br />
Leisure and sports 42%<br />
Planning 75 43%<br />
Parks and open spaces (+13), street lighting (+8), housing benefit (+5) and public<br />
transport (+4) have all improved since 2005 while planning (-10) 76 refuse<br />
collection (-6) and policing (-5) are perceived to have gotten worse.<br />
Although perceptions of libraries have improved over time in the 2006 BVPI<br />
survey we recorded the lowest score of any borough across London.<br />
Interestingly, more recent and reliable data from the 2007 residents’ survey<br />
shows that libraries are perceived highly by residents who do use them (69%).<br />
There are occasions where service specific data can tell a different story to the<br />
residents’ survey. Four in ten (43%) residents rated the policing in their area as<br />
good to excellent in the residents’ survey, compared to 72% who were very or<br />
fairly satisfied with the way their local area is policed in a 2007 metropolitan<br />
police survey (MPS) 77 . Similarly, the 2006 tenants’ satisfaction survey shows<br />
62% of tenants are very or fairly satisfied with the service, compared with only<br />
33% who rate it as good or excellent in the residents’ survey.<br />
The four main problems identified by respondents to the 2007 MPS survey were<br />
vandalism, graffiti and other deliberate damage to property or vehicles, teenagers<br />
hanging around on the streets, people being drunk or rowdy in public places and<br />
rubbish or litter lying around.<br />
Activities for young people rate the lowest with only 10% of adults and 31% of<br />
young people rating them as good or excellent. So any improvements that can be<br />
74 31% = young people’s view, 10% = adults view.<br />
75 Planning data is taken from the Planning BVPI survey 2006.<br />
76 Planning data is taken from the Planning BVPI survey 2006.<br />
77 Mps public confidence report 2006- 07.<br />
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made to customer services elements would be welcomed and may impact on<br />
perceptions of these services overall.<br />
Residents are also less satisfied with the financial management of the council.<br />
The budget consultation found that only 30% of residents believe that the council<br />
provides good value for money for the council tax they pay and only 17% believe<br />
that <strong>Lambeth</strong> has good financial management. Satisfaction with these measures<br />
has decreased since 2005 78 . This ties in with the picture painted by the residents’<br />
survey which shows that although <strong>Lambeth</strong> has maintained its ratings, it<br />
underperforms inner London on five of the six key measures of corporate<br />
performance - Providing good value for money for council tax paid (8 points<br />
lower), doing a good job (8 points lower), being efficient and well run (6 pints<br />
lower), making the area a better place to live (6 points lower) and doing a better<br />
job than one year ago (5 points lower).<br />
Satisfaction with the service offered by the planning service is also decreasing<br />
with satisfaction having dropped ten percentage points between 2003 and 2006.<br />
Six in ten applicants are pleased with the explanation provided for the planning<br />
decision, but 37% believe that the information provided about the progress of<br />
their application has gotten worse, and 46% believe that their application was<br />
dealt with less promptly. These aspects of customer service should be prioritised<br />
for improvement 79 .<br />
The 2007 residents’ survey shows that 61% of <strong>Lambeth</strong> residents rate local<br />
health services as good or excellent. Research conducted by <strong>Lambeth</strong> PCT<br />
about GP practices in 2006 80 shows that patients are largely satisfied with and<br />
were complimentary about reception teams, clinicians and the standard of<br />
healthcare that they receive. Patients were less satisfied with the ease of booking<br />
appointments and the length of time they have to wait in the surgery before being<br />
seen (53%), the lowest satisfaction score. Access to a doctor on the phone for<br />
advice remains an issue for many people and has the second lowest level of<br />
satisfaction at 59%. These findings suggest that, across the PCT, patients are<br />
generally less satisfied than they were in 2005, but are in line with 2004 figures.<br />
In 2008 the national survey of local health services surveyed people over the age<br />
of 16 who are registered with a GP. <strong>Lambeth</strong> is in the best scoring 20% of trusts<br />
for receiving answers from the doctor that patients could understand (scoring<br />
89/100), being kept informed about how long they would have to wait to see a<br />
doctor (34/100), receiving information regarding any potential side effects their<br />
medicine may have (76/100) and receiving copies of letters sent between their<br />
GP and a specialist (62/100). However, <strong>Lambeth</strong> is in the lowest scoring 20% of<br />
trusts for the length of time patients have to wait to see a doctor (79/100), being<br />
78 Your <strong>Lambeth</strong>, your money, your opinion. Budget consultation 2008.<br />
79 BVPI Planning Survey 2006.<br />
80 <strong>Lambeth</strong> PCT General Practice Assessment questionnaire 2006.<br />
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treated with respect by their doctor (95/100) and not receiving enough support to<br />
manage a long term condition (53/100) 81 .<br />
Given resource constraints, it is not possible to improve service delivery and<br />
customer service across all services concurrently. Therefore the CFP should<br />
initially focus on improving the customer service experience of low rated services<br />
– activities for young people, planning, council housing, parking and road repairs.<br />
Contact<br />
The contact people have with the council and its partners has an important<br />
influence on their perceptions of these organisations.<br />
The 2005 residents’ survey showed that just under half of residents (47%) had<br />
contacted the council in the previous 12 months. The most popular reason for<br />
contacting the council was to make a complaint (39%), to apply to use a service<br />
(33%) and to ask for advice or information (32%). The main complaints residents<br />
make are about housing (24%), parking (15%) refuse collection/ recycling (13%)<br />
and council tax (12%) 82 .<br />
Telephone is by far the most popular way to contact the council, in 2005, 69%<br />
used the phone to make a complaint and 74% for other contact. Only 13% of<br />
<strong>Lambeth</strong> residents reported using face to face contact with the council 83 , but this<br />
is a more popular method for housing tenants (37%) 84 and for people to contact<br />
their local police (40%) 85 .<br />
In 2005 written correspondence including email, accounted for a small<br />
percentage of contact (15%). However, access to the internet in <strong>Lambeth</strong> is<br />
increasing with just under one in four residents (24%) having no access at all in<br />
2007, a fall of 8% since 2005 86 . Older people and more deprived residents are<br />
less likely to have access or the skills and confidence to use it 87 .<br />
Qualitative research conducted in 2005 shows that while people will use the<br />
internet to find information about the council, there is a reluctance to use this<br />
method for issues where either a response is required or a transaction is needed<br />
to take place. Many people perceive the council to be inefficient and believe their<br />
transaction will not be handled correctly or they will not receive a reply. They<br />
81 National survey of local health services 2008. Healthcare Commission.<br />
82 2005 Residents survey.<br />
83 2005 residents survey<br />
84 STATUS tenants survey 2007<br />
85 mruk Metropolitan Police Survey 2006/07.<br />
86 2007 Residents survey<br />
87 Understanding our residents focus groups 200<strong>5.</strong><br />
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would rather speak or visit someone in person 88 . It would be interesting to<br />
explore the extent to which these perceptions are still held given the significant<br />
rise in internet penetration.<br />
Satisfaction with customer services has improved since the opening of the<br />
<strong>Lambeth</strong> Service Centre which provides the first point of contact for all phone<br />
queries and <strong>Lambeth</strong> Contact, the first joint service centre for walk-in queries.<br />
Users of both of these are generally satisfied with the service provided.<br />
Customers believed that the phone is answered promptly, it is easy to navigate<br />
the system and the staff are friendly and polite 89 . There is however, a conflict<br />
between satisfaction with resolution of problems. Users of the joint service centre<br />
believed that the staff there were able to successfully resolve their problem<br />
(92%) 90 ; compared with 59% of <strong>Lambeth</strong> Service Centre users who stated their<br />
problem was not resolved at all 91 .<br />
Prompt resolution of problems or queries was the most important priority for<br />
residents when contacting the council or partners, yet across the majority of<br />
service areas where we have data including housing, LSC customers, council<br />
tax, benefits and Adult and Community Services, the final resolution of a problem<br />
was the area that most people were dissatisfied with. Issues that were perceived<br />
to contribute to the lack of resolution include a lack of joined up working between<br />
front line and back office staff and people not being sure who is the correct<br />
person to contact to resolve a problem.<br />
This lack of prompt resolution of problems needs to be addressed by the Citizens<br />
Focus Programme.<br />
In 2006/07, 10% of borough residents said that they had let the police know their<br />
views on policing, crime or anti-social behaviour compared with less than 0.5% in<br />
2005/06. The most common way that people contacted the police was through<br />
an informal chat with a local officer 92 .<br />
Southwark carried out research in 2007 into the national ‘tell us once’ project.<br />
This aims to enable customers to notify government once of a birth, death or<br />
change of address and overall make contact easier. Overall 72% of respondents<br />
believe that such a service would be helpful compared to only 8% who feel it<br />
wouldn’t be. People see the main benefits as saving them time (18%), saving<br />
them having the same conversations with different organisations (15%) and<br />
being sure that all the relevant parties were informed (14%). However, people do<br />
have concerns about who would have access to their personal information<br />
88 Understanding our residents focus groups 200<strong>5.</strong><br />
89 <strong>Lambeth</strong> Service Centre Customer Satisfaction Survey 2007.<br />
90 <strong>Lambeth</strong> Contact User Satisfaction Survey 2007.<br />
91 <strong>Lambeth</strong> Service Centre Customer Satisfaction Survey 2007.<br />
92 MPS public confidence report 2006/07.<br />
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(25%), that their personal data may not be securely stored (17%) and that the<br />
service might not be reliable (16%) 93 .<br />
Communication<br />
IDeA/ MORI research shows that how well informed people are shapes their<br />
opinion of the council and partners and drives overall satisfaction. Therefore in<br />
considering a Customer Focus Programme, it is important to think about how we<br />
communicate with our residents.<br />
The 2007 residents’ survey shows that 70% of <strong>Lambeth</strong> residents believe that<br />
the council keeps residents informed. This is 6 percentage points higher than the<br />
rest of London at 64% and represents continuous improvement from 2003. This<br />
contrasts with the picture from the BVPI survey which recorded a decline in<br />
satisfaction between 2003/04 and 2005/06 which likely reflects its methodology.<br />
People feel most informed about how to pay bills to the council (88%) and how<br />
and where to register to vote (86%). In contrast around three in four feel<br />
uninformed about what the council is doing to tackle antisocial behaviour in the<br />
local area (80%), whether the council is delivering on its promises (75%) and<br />
how well the council is performing (74%) 94 .<br />
Most people find out information about <strong>Lambeth</strong> via information provided by the<br />
council (39%). The next most popular methods are local media (19%), the<br />
council website/ internet (17%) and word of mouth (11%) 95 .<br />
Based on research findings, the main source of information provided by the council is<br />
<strong>Lambeth</strong> Life, a fortnightly newspaper distributed to all homes in the borough. The<br />
publication changed format in January 2008 from a monthly magazine to a fortnightly<br />
newspaper. In October 2007 in its previous format, distribution was good and<br />
satisfaction was fairly high. Three quarters (77%) had received a copy through their door<br />
in the last three months. Of these 74% of people read some or all of it and 65% rated it<br />
as good or excellent 96 . Research is planned to evaluate the success of the new format.<br />
Regardless of format, qualitative research conducted in 2006 found people want to hear<br />
balanced, realistic reporting about how the council is performing, how it spends council<br />
tax money and whether it is keeping its promises. There should be less focus on good<br />
news with people concerned that this is simply council propaganda. The key issue for<br />
residents was that <strong>Lambeth</strong> Life should demonstrate openness and honesty about what<br />
the <strong>Council</strong> does to address problems, with whom, and over what timescales 97 .<br />
93<br />
94 BVPI survey 2006.<br />
95 BVPI survey 2006.<br />
96 <strong>Lambeth</strong> Residents Survey 2007<br />
97 <strong>Lambeth</strong> Life Research report. December 2006.<br />
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The <strong>Lambeth</strong> Youth <strong>Council</strong> consultation project asked young people how they would<br />
like to be kept informed by the council. The top choice was through newsletters or youth<br />
magazines, chosen by 36% of primary school and 37% of secondary school children.<br />
The second most popular choice was through a website chosen by 34% of primary and<br />
36% of secondary children 98 .<br />
Service users, especially within housing and ACS like to get written information<br />
about the services they use and feel that it is important that they are notified<br />
clearly and with notice about any changes 99 .<br />
The Metropolitan Police Service report shows that <strong>Lambeth</strong> police are good at<br />
keeping people informed. 56% of borough residents said that they felt very or<br />
fairly well informed about what the police in their area had been doing over the<br />
previous year. This is significantly higher than the rest of London at 47% and has<br />
improved when compared to 44% of people in <strong>Lambeth</strong> in 2005/06 100 . The main<br />
sources of receiving information are local newspapers, television, radio and<br />
national newspapers. Less well disseminated is information about <strong>Lambeth</strong> Safer<br />
Neighbourhood Teams with only 19% of residents having received information.<br />
However, this is the same percentage as the rest of London. However, the 2007<br />
resident’s survey shows that only 37% feel informed about what is being done to<br />
tackle antisocial behaviour.<br />
Participation<br />
The 2007 <strong>Lambeth</strong> residents’ survey shows that a third (35%) are satisfied with<br />
opportunities for participation in local decision making compared to 20% who are<br />
dissatisfied. This is in line with the 2006 BVPI survey which shows 31% satisfied<br />
and 26% dissatisfied. Satisfaction is significantly higher in North <strong>Lambeth</strong> and<br />
Brixton at 48% and 43% respectively and significantly lower in Streatham at 23%.<br />
Just under half (48%) of <strong>Lambeth</strong> residents feel that they can influence decisions<br />
affecting their local area.<br />
One in five <strong>Lambeth</strong> residents (20%) had taken part in a consultation in the last<br />
12 months, an increase from 16% in 200<strong>5.</strong> 101 . There is an appetite for<br />
involvement in <strong>Lambeth</strong> with 40% of people wanting to be more involved in the<br />
decisions made and 52% wanting to be involved depending on the issue 102 .<br />
However, people strongly believe that consultation needs to be meaningful and<br />
want to see positive action happening from their views. It is vital that honest<br />
feedback is given to participants about the outcomes of consultation and people<br />
98 <strong>Lambeth</strong> <strong>Council</strong> Youth Consultation project. April 2007.<br />
99 STATUS tenants survey and ACS satisfaction reports.<br />
100 Source: mruk Metropolitan Police Service Public Attitude Survey 2006/07. June 2007.<br />
101 <strong>Lambeth</strong> 2007 residents’ survey. January 2008.<br />
102 BVPI survey 2006.<br />
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are shown what has happened as a result of their involvement. This is a key part<br />
of the community engagement strategy – <strong>Lambeth</strong> Together.<br />
Priorities for particular groups<br />
Different groups within <strong>Lambeth</strong> have different needs, prioities, and perceptions<br />
of services. It is important to understand the requirements of our diverse<br />
communities in order that we can meet their needs.<br />
Young people<br />
Most of the <strong>Council</strong>’s services are rated in line with the London-wide average by<br />
young <strong>Lambeth</strong> residents, with the exception of leisure and sports facilities (-13)<br />
and libraries (-6) which received lower ratings. <strong>Lambeth</strong> achieved a higher rating<br />
for local health services (+9) among young people.<br />
In 2007, 43% of young people in <strong>Lambeth</strong> believe that the council keeps them<br />
informed about what is happening. This is similar to 2005 and in line with the rest<br />
of London.<br />
Two in five young people believe that the council listens to the concerns of young<br />
people and 35% believe that young people are involved in decision making.<br />
These are similar results to 2005 and across London. However, younger<br />
residents are less likely to have participated in consultations and surveys than<br />
adults, and fewer report reading <strong>Lambeth</strong> Life 103 .<br />
Older people<br />
Older residents in <strong>Lambeth</strong> tend to be more positive on a range of measures.<br />
They are more likely to think the council is doing a good job. Despite the fact they<br />
are more concerned about council tax they rate council tax collection more<br />
positively than average. They also rate a number of other services more<br />
positively including street lighting, refuse collection, recycling and public<br />
transport.<br />
Disabled people<br />
Disabled people are more negative about parking, parks, leisure and arts and<br />
cultural facilities in the borough.<br />
General satisfaction among users of adult and community services is high with<br />
70% of service users with a physical or sensory disability, 63% of home shopping<br />
service users, 84% of elderly home care service users and 78% of home care<br />
service users satisfied with the overall service they receive. The overwhelming<br />
reason that people gave for being satisfied was getting on well with their carer<br />
and their carer doing their job properly 104 .<br />
103 <strong>Lambeth</strong> 2007 residents’ survey. January 2007.<br />
104 Variety of ACS documents.<br />
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Half of service users with a physical or sensory disability (49%) did not think they<br />
were provided sufficient information by <strong>Lambeth</strong> in relation to services available<br />
at home compared with 38% who did. People were happy with the leaflets they<br />
received as they were easy to understand and found the staff approachable and<br />
responsive. The biggest complaint was that service users felt that they were not<br />
aware of what services they may be entitled to and how the system works to find<br />
out. Service users also felt that <strong>Lambeth</strong> was not proactive enough in<br />
communicating with them about changes to their service or their entitlements.<br />
There are also problems with staff answering the phone unable to answer their<br />
enquiry and getting passed around several people before finding someone who<br />
can help. There is also a lack of joined up information and support when people<br />
come out of hospital. Again there is confusion over who should be phoned and<br />
how to get through to the appropriate person.<br />
Seven in ten (70%) of elderly home care users say that they are always or<br />
usually kept informed about changes in their care. There appear to be<br />
discrepancies between the information given by the different home care provider<br />
companies with only one in five (21%) of Care UK users informed compared to<br />
43% of Keratome users.<br />
In 2007, 71% of service users with a physical or sensory disability stated that<br />
they had contacted the council or the care provider about their service; one in<br />
five interviewees (18%) stated that they found it easy or fairly easy to contact<br />
ACS. However, a larger proportion of service users, just under a third (31%)<br />
reported that they found it difficult or fairly difficult. Some respondents were<br />
frustrated following a number of attempts to contact relevant personnel had<br />
failed, staff were unable to deal with their enquiry and there was a sense of being<br />
passed from pillar to post. Half of the respondents did not know which team they<br />
had contacted within ACS.<br />
Information received on how to complain differed across services. 70% of hot<br />
meals service users and elderly home care users and 60% of home shopping<br />
service users said they knew how to complain compared with 35% of service<br />
users with a physical or sensory disability.<br />
Service users with a physical or sensory disability stated that their preferred<br />
method of complaint is by phone.<br />
<strong>Council</strong> tenants/ more deprived residents<br />
For many tenants the Housing Department is the <strong>Council</strong> and their views of<br />
<strong>Council</strong> performance are shaped largely by their experiences of the housing<br />
service 105 .<br />
105 Source: TNS Understanding our Residents. July 200<strong>5.</strong><br />
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Although council tenants are less likely to feel the council is doing a good job<br />
they tend to be more positive than average about a range of local services<br />
including nursery, primary, secondary and adult education, street cleaning and<br />
parking. They are also more positive about non-council services like health and<br />
policing. The unemployed are more likely than average to feel that the council<br />
listens to them and council tenants are more likely to feel council staff are friendly<br />
and polite. <strong>Council</strong> tenants are more satisfied with opportunities for involvement,<br />
are positive about <strong>Lambeth</strong> Life and are more likely to feel informed about what<br />
is being done to tackle anti-social behaviour. However, there are a number of<br />
issues which need to be addressed with <strong>Lambeth</strong>’s more deprived residents.<br />
They are more negative about refuse collection and council tax collection and are<br />
less likely to recycle and use the borough’s parks.<br />
Overall satisfaction with the landlord service provided by <strong>Lambeth</strong> is relatively<br />
low with six in ten tenants (62%) satisfied. This places <strong>Lambeth</strong> 24 th across<br />
London. However satisfaction is improving and <strong>Lambeth</strong> shows a strong, above<br />
average rate of improvement (5%) in overall tenants’ satisfaction when compared<br />
with the average for inner London boroughs, improving at 1% 106 . However in<br />
contrast, the residents’ survey shows that users of council housing are less<br />
satisfied in 2007 than 2005, with a decrease of twelve percentage points to 33%.<br />
Repairs and maintenance was the most important service for 79% of <strong>Lambeth</strong><br />
tenants and it was used as an illustration of why the <strong>Council</strong> was seen by tenants<br />
as slow, wasteful and inefficient. Criticisms of the repairs service fall into three<br />
categories: Problems with reporting the problem, the speed of addressing the<br />
problem and the quality of the work carried out to resolve the problem. One in<br />
five comments received through the <strong>Lambeth</strong> Service Centre users’ survey was<br />
regarding the need to improve the housing repairs service 107 . However<br />
satisfaction levels with repairs in particular are improving showing an<br />
improvement of nine percentage points from 2004 to 2006. The overall quality of<br />
the home is the aspect of housing that tenants believe most needs to be<br />
improved (90%).<br />
Another factor that affects tenants’ satisfaction was the reduction in opening<br />
hours and the closure of neighbourhood housing offices. Tenants complained<br />
about difficulties in accessing their housing officers and of the attitude of some<br />
housing officers 108 .<br />
Seven in ten <strong>Lambeth</strong> council tenants (71%) believe that the council is good at<br />
keeping them informed, the same proportion as 200<strong>5.</strong> Only just over one in ten<br />
106 Source: STATUS Tenant Satisfaction Survey 2006.<br />
107 Source: <strong>Lambeth</strong> Service Centre Customer Satisfaction Survey. Annual Summary Report<br />
2006/07.<br />
108 Source: TNS Understanding our Residents. July 200<strong>5.</strong><br />
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(12%) consider the landlord to be poor at keeping them informed. This is a slight<br />
improvement on 2004 results rising from 68% 109 .<br />
The most popular method of contacting <strong>Lambeth</strong> Housing is via the telephone and over<br />
half (52%) select this as their favoured method. This is followed by nearly four in ten<br />
(37%) who prefer contact in person at the housing office. When asked how they would<br />
like to be contacted regarding their views on decisions affecting their home, three<br />
quarters (75%) of <strong>Lambeth</strong> tenants state that they prefer to be contacted by letter. The<br />
next most popular methods of contact are telephone at 34% and by home visit at 27% 110 .<br />
Those tenants who had contacted <strong>Lambeth</strong> Housing in the 12 months prior to the survey<br />
were asked to rate various aspects of their contact. Generally staff are considered to be<br />
helpful and able to deal with problems, although nearly three in ten (29%) indicate staff<br />
were difficult to get hold of. These perceptions may well have improved as a result of the<br />
introduction of the LSC in March 2004. Tenants are less satisfied with the final outcome<br />
of their query, with half (50%) expressing satisfaction compared to nearly four in ten<br />
(38%) expressing dissatisfaction – a pattern consistent with other London Boroughs.<br />
In line with other London boroughs, just under half of all council tenants are<br />
satisfied with the opportunities for participation in decision making (49%).<br />
Tenants do think that their views are taken into account with 49% thinking<br />
<strong>Lambeth</strong> does so ‘a little’ and 25% ‘a lot.’ Improvements are needed however,<br />
with 85% of tenants believing that taking their views into account needed<br />
improvement. In terms of the avenues through which they could participate,<br />
tenants thought that the format of tenants’ meetings was acceptable, although<br />
were critical about the lack of positive outcomes. Those involved in tenants’<br />
committees or the Tenants’ <strong>Council</strong> felt that they were time consuming and<br />
unproductive 111 . Improving feedback to these groups about the outcome of their<br />
participation is therefore vital.<br />
Parents<br />
Satisfaction levels are higher for nursery and primary education within <strong>Lambeth</strong><br />
with 70% and 68% of users rating them as good or excellent respectively.<br />
Satisfaction decreases for the older education service providers with just over<br />
half satisfied with secondary education (51%) and adult education (55%) within<br />
the borough 112 . Only 22% of all residents think <strong>Lambeth</strong> secondary education is<br />
good or excellent compared to 34% across London. Positively, satisfaction with<br />
all types of education has improved since 2003 and fewer residents are<br />
concerned about education than in 200<strong>5.</strong> A focus group with parents conducted<br />
in 2005 found they were pleased with the nursery and primary schools that their<br />
children attended, but became concerned when it was time for them to transfer to<br />
secondary school. Five of the seven parents with children at primary school<br />
stated that improvement to secondary schools in the borough was their top<br />
109 STATUS Tenant Satisfaction Survey 2006.<br />
110 STATUS Tenant Satisfaction Survey. 2006<br />
111 STATUS Tenant Satisfaction Survey 2006.<br />
112 Source: TNS Social <strong>Lambeth</strong> Residents Survey 2007/08. January 2008.<br />
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priority for improvement. The main problems identified with secondary schools<br />
included lack of choice, lack of communication with parents and schools being<br />
unable to address the problems between pupils 113 .<br />
More affluent residents<br />
On the whole, residents from higher social backgrounds tend to be more satisfied<br />
with the council, with more saying that the <strong>Council</strong> is doing a good job and rating<br />
contact and engagement positively. In particular, they are more likely to feel the<br />
council delivers value for money, more likely to feel informed, listened to and<br />
involved in decision-making. In terms of specific services those from social class<br />
AB are more positive about council tax collection and parks, and they are more<br />
likely to recycle than others. However, this group are less likely to rate education<br />
services positively and are more likely to identify education as a key concern.<br />
They are also more likely to rate parking, road and pavement repairs, activities<br />
for children and teenagers and leisure facilities poorly (despite the fact that they<br />
actually use leisure services more). Little is known about how these ‘light’ users<br />
of council services would prefer to contact and receive communication from the<br />
council. Although the 2003 residents’ survey indicates that leaflets may be<br />
popular for general communications, further research would be useful to explore<br />
how best to serve the needs of this relatively large group.<br />
New residents to the borough<br />
Those who have lived in the borough for less than two years are more likely to<br />
feel the council is doing a good job, they are also more positive about street<br />
cleaning, street lighting and refuse collection. However, there are some specific<br />
communications and engagement issues which need to be addressed. New<br />
residents are less likely to feel involved in decision making, are less likely to feel<br />
<strong>Lambeth</strong> council listens to its residents and feel less informed about what is<br />
being done to tackle anti-social behaviour.<br />
Long term residents<br />
Residents who have lived in <strong>Lambeth</strong> for over five years are less positive about<br />
the council 114 . This was echoed in the ‘understanding our customers’ focus<br />
groups run in 2005 and the 2007 budget consultation where several long term<br />
residents of the borough brought up the issue of trust. For them, reputation was<br />
not just about performance, it was about whether they felt they could trust the<br />
council or not 115 . In many cases this was based on experiences in the distant<br />
past which continue to colour current perceptions.<br />
Ethnic minority residents<br />
The black Caribbean community are more concerned than average about jobs<br />
and rate parks less positively, although they are more positive about adult<br />
113 Source: Understanding our residents. July 200<strong>5.</strong><br />
114 Source: TNS Social <strong>Lambeth</strong> Residents Survey 2007/08. January 2008<br />
115 Understanding our res<br />
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education provision in the borough. In contrast, the black African community is<br />
more positive than the <strong>Lambeth</strong> norm and tend to rate services well. In particular<br />
street cleaning, nursery, primary and secondary education, libraries and parking<br />
all received higher than average ratings 116 .<br />
Small businesses<br />
Small business owners are concerned about crime. Research carried out by the<br />
Federation for Small Businesses (FSB) in 2004 showed that 57% of small<br />
businesses in London had been a victim of crime in the previous 12 months 117 .<br />
Many of these crimes are not reported to the police because small business<br />
owners feel that ‘it would not achieve anything’ (40%), that the police are unlikely<br />
to catch the perpetrators (27%) and because they do not want to make a claim<br />
against their insurance (22%).Other concerns for small business owners are too<br />
much legislation, red tape and regulations. Owners are dissatisfied with the<br />
complexity (60%) volume (59%) and rate of change (56%) of legislation.<br />
Legislation that was received least positively by owners was higher insurance<br />
premiums and increases in National Insurance contributions 118 .<br />
The FSB also calls for improvements to local government procurement<br />
procedures to benefit small businesses. Suggestions include breaking down<br />
contracts instead of aggregating them, so reducing the need to only purchase<br />
from large suppliers. All contracts should be widely advertised regardless of their<br />
value to encourage more participants to apply and there is a need to make it<br />
easier to understand how to get on approved supplier lists and simplify pre<br />
qualification paperwork.<br />
Small businesses also want affordable town centre parking to enable people to<br />
use their business. They believe there is also a need to standardise parking<br />
across London borough’s provide more information about the offence on the<br />
parking ticket and allow appeals and refunds against unfair tickets.<br />
Recommendations for the CFP to address<br />
• The priority services to focus on to improve the customer experience are:<br />
- <strong>Council</strong> Housing especially the repairs service<br />
- Parking<br />
- Leisure and Sports facilities<br />
- Planning especially the promptness of resolution and keeping people<br />
informed with the progress of their application.<br />
116 <strong>Lambeth</strong> residents’ survey 2007.<br />
117 Federation of Small Businesses, Lifting the barriers survey 2004.<br />
118 Federation of Small Businesses, Lifting the barriers survey 2004<br />
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Other issues that the CFP should seek to improve:<br />
• Resolution of problems and issues when people contact the council.<br />
• The way complementary services work well together.<br />
• Information about what services <strong>Lambeth</strong> and its partners offer and<br />
people’s entitlement to them.<br />
Gaps and further research<br />
We currently have limited information about the following:<br />
- Partnership data about how <strong>Lambeth</strong> residents view the services offered<br />
by partner organisations. What do people think of their customer<br />
experience of job centre plus, police, health services, voluntary and<br />
community sector and fire service within the borough and how well do<br />
council services link up with these organisations for people who need to<br />
use multiple services? How can these services complement each other<br />
and work better together?<br />
- There are two distinct groups of people accessing services within<br />
<strong>Lambeth</strong>. One uses a lot of services and want a lot of contact specific to<br />
their needs. They like to contact us by phone or in person. The other<br />
group use very few services and may potentially want less or easier<br />
contact. Research should be carried out to determine whether this is the<br />
case and how customer service can best be structured to meet their<br />
needs.<br />
- There is currently little information available on the views of business<br />
users. It would be interesting to discover their views on the services they<br />
use and how they could be improved.<br />
- Although people see the internet as an important source of information,<br />
there appears to be barriers to using technology interactively for<br />
contacting services. Investigate the barriers to interactive contact via the<br />
internet.<br />
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APPENDIX III<br />
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Glossary<br />
A&E<br />
ACS<br />
AIDS<br />
BME<br />
C&YP<br />
CAA<br />
CAMHS<br />
CHD<br />
CLG<br />
COPD<br />
CPA<br />
CSP<br />
CVD<br />
CYP<br />
DASS<br />
DH<br />
E&W<br />
GLA<br />
GP<br />
GPAQ<br />
GSF<br />
GST<br />
GUM<br />
GSF<br />
HIV<br />
IMD<br />
<strong>JSNA</strong><br />
LBL<br />
LTC<br />
MH<br />
MI<br />
NHS<br />
NICE<br />
NSF<br />
ONS<br />
Accident & Emergency<br />
Adult and Community Services<br />
Acquired Immuno-deficiency syndrome<br />
Black & Minority Ethnic<br />
Children & Young People<br />
Comprehensive area assessment<br />
Child & Adolescent Mental Health Services<br />
Coronary Heart Disease<br />
Communities and Local Government<br />
Chronic Obstructive Pulmonary Disease<br />
Care Programme Approach<br />
Commissioning Strategy Plan<br />
Cardio Vascular Disease<br />
Children and Young people<br />
Director of Adult and Social Services<br />
Department of Health<br />
England & Wales<br />
Greater London Authority<br />
General Practitioner<br />
General Practice Assessment Questionnaire<br />
Gold Standards Framework<br />
Guy’s & St Thomas’ NHS Foundation Trust<br />
Genito Urinary Medicine<br />
Gold Standards Framework<br />
Human Immunodeficiency Virus<br />
Index of multiple deprivation<br />
Joint Strategic Needs Assessment<br />
London Borough of <strong>Lambeth</strong><br />
Long Term Conditions<br />
Mental Health<br />
Myocardial Infarction<br />
National Health Service<br />
National Institute of Clinical Excellence<br />
National Service Framework<br />
Office for National statistics<br />
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DRAFT<br />
PCT<br />
PEAT<br />
PEC<br />
POPPI<br />
PR<br />
QMAS<br />
QOF<br />
RSH<br />
SCS<br />
SH<br />
SIPs<br />
SLAM<br />
SMI<br />
STIs<br />
TAC<br />
YLL<br />
YLD<br />
Primary Care Trust<br />
Physical Environment Assessment Team<br />
Professional Executive Committee<br />
Projecting Older People’s Population Information system<br />
Public Relations<br />
Quality Management Analysis System<br />
Quality Outcome Framework<br />
Reproductive Sexual Health<br />
Sustainable Community Strategy<br />
Sexual Health<br />
Service Improvement Proformas<br />
South London & Maudsley NHS Foundation Trust<br />
Serious Mental Illness<br />
Sexually Transmitted Infections<br />
Team Around the Child<br />
Years Life Lost<br />
Years Lived with Disability<br />
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