(Attachment: 3)Report - 8 pages (45K/bytes) - Fenland District Council

Update on external partnership from the Sustainable Community Strategy
Helping people live healthy, independent lives
Theme Explanation Strategic Theme
Partnership
Helping people
live healthy,
independent lives
Health and well-being is a
fundamental basis of quality of life.
Health and independence in later
years is particularly important in
Fenland because of its age profile
Fenland Health and
Social Well-being
partnership
Strategic Context
The Health and Wellbeing Partnership is one of Fenland’s Sustainable
Community Strategy (SCS) themed partnerships and is accountable to the
Fenland Strategic Partnership (FSP), to which it reports progress on achieving
outcomes on a quarterly basis.
Each year the Partnership completes an assessment of priorities through
analysis of health statistics, consideration of emerging issues, consultation and
engagement with the Fenland community.
The areas of work identified (priorities) provide focus for the Partnership’s
contribution to the SCS action plan for the following year.
An example of the partners that contribute to the work of the Health and Social
Wellbeing Partnership include Fenland District Council officers and Councillors,
NHS Cambridgeshire, Cambridgeshire County Council, Cambridgeshire
Community Services, Citizens Advice Bureau (CAB), and Age UK amongst
others.
The Partnership meets 4 times a year to utilise the knowledge and resources
provided by this multi-agency theme group to direct and support work to improve
the health and wellbeing of Fenland’s communities.
The strategic context in which the partnership works is changing with the
introduction of GP Consortia to replace the Primary Care Trust from April 2012.
Cambridgeshire is a pathfinder area for GP Consortia and arrangements across
Fenland are in the process of being completed. Another potential change through
the NHS White Paper will be to transfer the responsibility for public health to the
County Council. Health and Well Being Boards will also be set up to deliver a
health care strategy across Cambridgeshire and oversee the commissioning
arrangements of GPs in the area. At present, the statutory legislation does not
specify that District Councils will be members of the Health and Well Being Board
despite the key public health obligations within which it fulfils. However, in
Cambridgeshire the development of the Health and Well Being Board includes
District Councils.

The purpose of this Partnership is:
• To provide strategic leadership across all agencies in Fenland to
coordinate work that addresses health and wellbeing objectives.
• To take responsibility for the delivery of the health and wellbeing projects
identified within the Fenland SCS.
• To inform the commissioning of operational work to specialist ‘task and
finish’ groups who are accountable to the health and social being
partnership for successful delivery.
• To influence key strategies and stakeholders through informing them of
health needs in Fenland and mainstreaming these needs into the
activities of stakeholder organisations.
• To identify opportunities to bring additional resources to Fenland to
support health improvement activities.
• To incorporate views and feedback raised by the community through
channels such as the Community Fairs and Neighbourhood Forums.
• To promote the work of the Partnership to partners, staff and the
community through communication mechanisms.
The Health and Wellbeing Partnership’s (HWB) three priorities are:
1. Providing people with opportunities and encouragement to live a healthy
lifestyle
2. Shaping future health provision in Fenland through improving access to
information and services
3. Maintaining independent living
Progress in delivering each priority
Priority 1: Providing people with opportunities and encouragement to live a
healthy lifestyle
Evidence Base:
There is an established evidence base regarding lifestyle choices in Fenland. In
particular, the Joint Strategic Needs Assessment for Cambridgeshire (JSNA)
details there are high levels of smoking, obesity, teenage pregnancy and low
levels of exercise and healthy eating in Fenland compared to Cambridgeshire,
east of England and national averages.
Smoking:
• Approximately 27% of adults who live in Fenland smoke, which is the highest
estimated figure in the County (Cambridgeshire average is 22%), and higher
than the national average of 25.8%.
• Two of the top five wards for estimated smoking prevalence in
Cambridgeshire are in Fenland - Waterlees at 40% and Kingsmoor at 36%.

• Smoking is implicated in 4 in every 7 deaths in the over 65s in Fenland. There
are benefits from stopping smoking at any age, but they are greater the
earlier cessation takes place.
Obesity and Exercise:
• The JSNA states that Fenland has the highest proportion of obese adults at
29%, which is significantly higher than the national average of 22%.
• Of the 123 wards in Cambridgeshire, Fenland has the top 18 wards with the
highest estimated prevalence of obese adults.
• The Fenland Annual Health Report also states that 14% of Fenland children
are obese compared to a national figure of 10%.
• The JSNA states that only 21.7% of residents in Fenland consume five or
more portions of fruit and vegetables in a day compared to the 23.7% national
average.
• In relation to exercise, the JSNA reports that Fenland has the highest level of
zero participation in moderate intensity activity across the county and
compared to other districts in the East and England averages.
Teenage pregnancy:
In Cambridgeshire about 1 in 35 girls aged 15-17 become pregnant each year,
with the highest teenage pregnancy rates in Fenland and Cambridge City.
The Children’s JSNA states that the 5 wards in which teenage pregnancy is
highest in the county are in Fenland.
Teenage pregnancy rates are declining across Cambridgeshire and Fenland,
with the rate at its lowest in Fenland for 20 years.
Drug and alcohol abuse:
• On average there are over 4,500 alcohol related hospital admissions a year,
with statistically significantly high rates in Fenland and Cambridge City
compared to the Cambridgeshire average.
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Sub Priority 1.1 Smoking Cessation
Aim: The aim of this project is to promote smoking cessation activities and
reduce the prevalence of smoking in vulnerable groups.
Progress: The three individual projects outlined below have targeted sections of
the community where smoking is at its highest. All three projects have been
aided through the appointment of a dedicated Smoking Cessation Advisor
working with community groups in the Waterlees area. A weekly clinic is held at
the Oasis Centre which has recently been extended as the clinics are generally
full each week.

Access to smoking cessation services is important, therefore, staff from across
partner organisations have undergone training to be able to promote and refer
members of the public to the service. This includes 30 Children’s Centre staff,
and FDC staff from the Leisure Centres, and Housing Options team.
This sub-priority involves three specific projects:
1.1.1 To reduce smoking within the Family Nurse Partnership (FNP)
caseload of teenage parents in Wisbech
Family nurses in Wisbech have been trained by CamQuit to enable them to
effectively educate and refer teenage parents who are smokers to smoking
cessation services. Increased promotion of the project is planned and Health
Trainers have offered to help with this project. The target for this project is to
reduce the number of teenage mothers who smoke by 50%.
1.1.2 To reduce smoking prevalence in homeless families
Members of the Fenland District Council Housing Options team have been
trained by CamQuit to enable them to effectively refer residents who present
themselves as homeless to smoking cessation services. Marketing materials for
the scheme have been produced which are displayed in community locations and
contact with other partners who may come into contact with homeless people
with a smoking habit is being explored.
1.1.3 To promote Smoking Cessation in local businesses
A new Tobacco Control Co-ordinator is leading work on this project. Members of
the Fenland District Council Environmental Health team have been trained by
CamQuit to enable them to effectively refer residents to smoking cessation
services. Proactive introduction calls to sign up and engage local businesses
have been conducted and marketing and promotional materials have been
produced and information sessions held.
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Sub Priority 1.2 Obesity levels in children and young people
Aim: The aim of this project is to reduce the number of year 6 children who are
obese.
Progress: Only 1 school out of those 10 written to in October 2010 returned an
expression of interest in the SmallSteps4Life programme. In light of lack of
partnership staff resource to support wide project implementation the decision
was made to proceed and pilot within 1 school. This will also help to steer the
type and level of support that may be required to roll out the project. The project
is being taken forward with Elm Primary School in partnership with the Healthy
Schools Programme. Support is being provided to ensure that the project is fully
evaluated by NHS Cambridgeshire.

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Sub Priority 1.3 Obesity levels in adults
Aim: The aim of this project is to reduce the number of adults who are
overweight and obese and reduce the number of deaths arising from obesity.
Progress: A package of projects has been designed to reduce obesity levels in
adults. This package includes use of the Mobile Gym and Support Vehicle, GP
Referral project and use of British Heart Foundation (BHF) funded lifestyle coach.
The Mobile Gym team has been touring the district and is deployed 4 days per
week encouraging people to use the gym to improve health and exercise rates.
The Mobile Gym Support Vehicle has been undertaking health assessments with
the public providing healthy lifestyle advice and signposting to health services. To
date 1,680 health assessments have been completed. The Mobile Gym team has
referred 20 high risk clients to GP’s based on lifestyle check results and 3
individuals to Camquit. Many people have been referred to Council leisure
centres by their doctor for a tailored programme of exercise to improve health
and well being. There have been 236 exercise referrals to date with a 60%
completion rate.
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Sub Priority 1.4 Adult participation in regular exercise
Aim: To reduce adult obesity, increase participation in regular exercise and
increase life expectancy.
Progress: A BHF Lifestyle Coach has been deployed providing specialist
exercise classes for members of the community recovering from cardiovascular
treatment. The Health @ Work scheme trial has been initiated with a large
employer of Eastern European people. Capital improvement of the leisure
centres is underway to increase the capacity and attractiveness of exercise to the
community. Research for a Traveller specific Healthy Lifestyle DVD is underway
with the travelling community. The Mobile Gym has recently amended its
timetable in line with customer feedback/business case to maximise usage. 55
Mobile Gym users have been encouraged to transfer to a leisure centre, and the
total number of visits to the gym is 1,830 and the gym has 331 members
registered.
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Sub Priority 1.5 Sexual health and teenage pregnancy
Aim: To reduce teenage pregnancy rates and sexually transmitted infections
(STIs). To increase the number of young people accessing services.

Progress: Weekly sexual health clinics are held at Thomas Clarkson Community
College in Wisbech and the College of West Anglia (Wisbech campus), Neale
Wade Community College in March and Cromwell Community College in
Chatteris. Student and staff feedback from the colleges so far has been positive,
and increasing numbers of students access the services each week. The project
has ongoing support from the Chlamydia Screening Programme and voluntary
sector groups who assist with screening and C-Card (condom distribution).
A consultant-led clinic service will now be provided at Wisbech (North Cambs)
Hospital from April 2011.
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Sub Priority 1.6 Drug and alcohol abuse
Aim: To reduce drug and alcohol-related injuries and illness.
Progress: A project scoping document was developed and shared with the
Wisbech Community Alcohol Partnership (CAP) with a view to piloting improved
services integration, in Wisbech initially, with the potential to expand into March
by creating a second CAP. This project has stalled due to staffing issues.
PRIORITY 2: Shaping future health provision in Fenland through improving
access to information and services
Evidence Base: Priority 2
The Joint Strategic Needs Assessment for Cambridgeshire (2008)
Access to services:
• Although a high proportion of the population have access to some type of
private transport, approximately 20% of households do not have any access
to a private vehicle, and so are reliant on the provision of public transport.
• Four in ten pensioners do not have access to a car or van.
• For those residents living in the more remote villages, public transport is an
issue, with poor availability of services and a very limited number of bus
routes.
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Sub Priority 2.1 Access to services
Aim: To improve access to services and information.
Progress: Analysis of current access routes to hospitals and GP surgeries via
public transport have been mapped to provide an evidence base for discussion
with service and transport providers to improve access to health services in the
four Fenland market towns. This analysis had shown that many people, in

particular those in receipt of free bus passes, are not within 400 metres of a bus
stop. Furthermore, current bus routes do not travel to key health service
locations. Through the use of this evidence the Health and Social Wellbeing
partnership and Fenland District Council were invited to assist Cambridgeshire
County Council’s Health and Adult Social Care Scrutiny Committee regarding
Doddington Hospital and wider transport issues. This has now inspired partners
to work proactively together to solve these issues. Targeted marketing has been
undertaken using the map based evidence to ensure local residents who do not
live within 400 metres of a bus service are aware of the community transport
services available.
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Sub Priority 2.2 Transport links to healthcare
Aim: More efficient use of existing bus and community transport services to
improve access to healthcare.
Progress: Complimenting work the project set out at 2.1, further work has been
undertaken in relation to access to healthcare. This has been completed by
gathering data regarding travel arrangements to GP and hospital visits. A
questionnaire will be placed in all Fenland surgeries and hospitals to obtain
patient feedback on methods of travel to healthcare appointments. This evidence
will assist with future planning for healthcare and transport. The questionnaire is
now complete and will be made available for the public to complete in GP
Surgeries and hospitals in Fenland from April – July 2011. CCC, NHS and FDC
now include the full range of co-ordinated transport information for Fenland on
their websites. The information from the questionnaire will help to inform the
future dial a ride pilot project for Doddington Hospital and will assist the new GP
Clusters with transport decision making. During March 2011 NHS
Cambridgeshire will be making new criteria available to GP surgeries for
assessing whether patients are eligible for patient transport.
PRIORITY 3: Maintaining independent living
Evidence Base: Priority 3
The Joint Strategic Needs Assessment for Cambridgeshire (2008)
Keeping Active:
• 19% of Fenland’s population is over the age of 65 and 9% over 75.
• Fenland has a higher proportion of ‘all pensioner’ households (13%) than the
national average (9%). Fenland also has the highest proportion of one-person
pensioner households in Cambridgeshire as over 15% of households consist
of one pensioner living alone.
• Frailty in older people will place more demands for care at home. Currently
there are estimated to be 13,900 elderly people in Cambridgeshire who are

physically or mentally frail or both. Between 2006 and 2011, numbers of
elderly frail people are predicted to rise from 2,650 to 2,930 in Fenland.
Winter Warmth:
• There are over 13,000 households in Cambridgeshire in fuel poverty. Five
areas in Cambridge City, two in Huntingdonshire and one in Fenland are in
the worst 10% in England.
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Sub Priority 3.1 Maintain independent living (Keeping Active)
Aim: To increase support for vulnerable residents to enable them to safely
remain in their home and reduce the risk of accidents and falls. To develop &
target physical activity provision for older, frail, long term conditions for those that
are unable to access hospital provision.
Progress: A Falls Prevention class for Fenland has been developed and is about
to be launched. Roddons Housing Association have agreed to train all their
sheltered housing staff, who will then run sessions which are also open to the
wider community. Funding from the Stroke Heart Foundation has been received
for an exercise after stroke project. In total 8 members of staff are being trained.
Discussions have commenced with the Clinical Exercise Specialist Falls
Prevention Service CCS regarding the development of a programme of physical
activity for older people. A project plan for this priority is currently in development.
A pilot PSI class has been set up for 12 weeks and will begin at the George
Campbell Leisure Centre in March 2011.
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Sub Priority 3.2 Maintain independent living (Winter Warmth Project)
Aim: To meet accommodation needs of frail elderly residents by helping them
access home heat resources.
Progress: An information pack “brown bag” was developed for distribution in GP
practices at “flu clinics” and these were distributed to practices and a total of
10,000 were given out at flu clinics. Work is currently being undertaken with the
Home Shield Project (a county-wide project co-ordinated by Age UK and
Cambridgeshire County Council) which intends to roll out training to health staff
to help identify vulnerable people in need of services.