August 2012 - Public Health Association of New Zealand

Healthy skin –a public healthsuccess storyThose working in public health can often feel likethey’re “up against it”. The foresight of preventioncan be a struggle in an environment where thereare insufficient resources or too many policychallenges. So it’s great, every now and then, tocome across a story that helps us celebrate whatcan and has been successfully done in publichealth. Keeping Well’s ‘Healthy Skin in GreaterWellington’ initiative is just such a story.Keeping Well is the population health strategy forthe Wellington region and its implementation isled by Regional Public Health.By 2010, Wellington and Hutt Valley DHB data showedthat, for children under 14 years, 65.7 per 10,000 werebeing admitted to hospital with serious skin infections. Thiswas quite a shocking increase from 1996/7 figures of just15.4 per 10,000.What’s more, there were the usual ethnic and socialdisparities with the significant majority of children admittedcoming from Māori and Pacific families, and from thepoorer parts of greater Wellington.Alarmed by these increases, Regional Public Healthreviewed what it was doing about serious skin infectionsand organised an inter-disciplinary hui attendedby representatives from the DHBs, Primary HealthOrganisations and numerous health providers andgovernment agencies.Together they formed an initiative called Healthy Skinin Greater Wellington and developed a Roadmap forcombating the increasing burden and disparities of seriousskin infections among children.The Roadmap identified a number of required actionareas, but one of the most significant was ensuringa common approach to the prevention, assessment,management and treatment so that health professionalsacross the region were consistent in the treatment andadvice they provided.To achieve this more standardised approach Healthy Skinin Greater Wellington was supported by five resources,mainly focussed on children.The first resource, the Healthy Skin Tool, was originallyfor clinicians to use to educate their patients about skininfections, how they should be treated and how to avoidthem in future. However, it quickly also began to be usedmore widely by other community organisations highlightinga widespread recognition of the problem in the region.The Healthy Skin Tool uses pictures to feature fivedifferent stages of the development of a serious skininfection (using traffic light colours), from healthy to inneed of hospitalisation, and lists advice and guidelines fordealing with each stage.“One significant achievement is that thesame messages about skin health arestarting to be used by the health sector andthe wider community across the region.”The resource has been in circulation since November2011, and, based on feedback, an updated version isabout to be released.While it is too early to officially evaluate the success of thisresource alone, Barry Gall, a Senior Public Health Advisorat Regional Public Health, said the Healthy Skin Tool hadbeen very widely welcomed.“We’ve had people asking for the resource from all aroundthe country and, at the request of some stakeholders,we’ve adapted the tool for adult cellulitis.”The second resource is a set of protocols for healthprofessionals aimed at promoting evidence-basedpractice for the prevention, assessment, management andtreatment of skin infections in people of 25 years of ageand under.Endorsement for the final version is currently being6PHA News August 2012