Dudley Strategy for Tackling Health Inequalities 2010-15

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8.3 TRANSFORMING COMMUNITY SERVICESIntroductionDudley Community Services provide a wide range of adult and children‟s services tothe population of Dudley. The core service specifications have been developed overmany years and are regularly reviewed to ensure they are able to respond todemographic changes identified within the Joint Strategic Needs Assessment (Littleand Moss, 2009) and other commissioning strategies. In 2009/10 the CommunityContract was agreed with commissioners and has been used by them to monitor theperformance of Dudley Community Services on activity and quality indicators. Thisreport endeavours to outline the key changes we have made to the way our servicesare managed and demonstrate how we believe we have positioned ourselves torespond to the agenda for Transforming Community Services and to support thecommissioners in addressing the priority needs of the resident population of DudleyBorough and reduce Health Inequalities.Vision and Values within Dudley Community Services.In 2009/10 we developed our own set of vision and value statements which built ofthose of Dudley PCT but reflected the “provider” function more clearly so that theyhad added relevance to our service areas. These have been updated for 2010/11 toreflect the Transforming Community Services agenda and have been distilled into 5mission statements;Box 1 Mission Statements1. To lead the safe transfer of DCS into one or more alternative organisationsunder the TCS agenda2. To work in partnership to develop integrated services which deliver a positivepatient experience, promote independence and improve health outcomes3. To deliver prevention and early intervention services that meet the needs of ourcommunities4. To provide first class community health services that people trust, in the rightsetting and at the right time5. To attract and retain an effective, diverse and flexible workforce enabling themto develop their skills and expertiseThese mission statements and supported by the nine strategic objectives shown inBox 2 and will be linked to the DCS business plans and those of the clinical businessunits. This helps us to ensure that prevention and early intervention are seen aseverybody‟s business and enables us to focus on this as we continue to transformcommunity services.Box 2 Strategic Objectives1. We will effectively lead DCS through an organisational change managementprogramme2. We will achieve clinical excellence3. We will contribute to the achievement of public health targets4. We will design and deliver patient centred care, develop new and existingservices to meet changing needs5. We will ensure the health and safety of our patients, staff and visitors185
6. We will manage our resources effectively7. We will attract and retain an effective, flexible workforce8. We will use technology to improve performance9. We will develop strong and effective partnership workingWhat have we done so far?In 2009/10 DCS responded to the Transforming Community Services agenda andundertook a full management restructure. This enabled us to develop 3 ClinicalBusiness units which focus on Children, Young People and their Families; Long TermConditions and End of Life Care; Acute Care and Rehabilitation. We believe this willhelp us support the commissioners in addressing their key priorities on Public Healthtargets, Unplanned Care and Long Term Conditions.We have focused the Health Visiting service on the pre-school children and aredeveloping effective transition from them to the School Health Advisor services. Thisincludes shared records which will improve continuity of care for children withadditional needs. Both Health Visitors and School Health Advisors have a significantpublic health role around prevention and early intervention for the registered GPpopulations, school populations and also for wider public health initiatives.The Community Health Nurses who provide services for the elderly have beenrealigned to the community nursing services which will enable them to furtherdevelop their role in addressing the needs of some of our most vulnerable patientsand this should support care closer to home, admission avoidance and effectivedischarge after a period in hospital. The community nursing teams have also beenreviewed and are working more effectively within their clusters.Dudley Community Services also played a key role in responding effectively to thePandemic in 2009. We provided immunisation services for patients and staff and alsomade significant contributions to the establishment and running of the Anti-ViralCollection Point.Actions to support the reduction of Health Inequalities.A virtual ward pilot is being run in a Practice in one of the most deprived areas of theBorough and if effective will be rolled out in the north of the Borough which willaddress a significant level of health needs for some of our most deprived populationsOur Nurse Consultant for Long Term Conditions undertook a review of frequentattendees at Emergency Departments. This showed a significant number who haddrug or alcohol issues and this work is being taken forward within the urgent carework streams to identify how the needs of these clients can be met. We are trainingall our Health Visitors in Breast Feeding to establish best practice.We will be training all staff to undertake Brief Interventions with clients. We havedeveloped an award winning service for children and adults from ethnic minoritygroups affected by Haemoglobinopathies.186
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2010FDudley Strategy forTackling He
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ENDORSEMENT OF THE 2010 - 2015HEALT
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CONTENTSFOREWORD………………
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Standardised Rate per 100,000 Popul
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There were three principles that un
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This work has been built on trustin
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ENSURE A HEALTHY STANDARD OF LIVING
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with, or at high risk of vascular d
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Tackling underage/illegal alcohol c
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2. VISION STATEMENTThe mission stat
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tackle health inequalities in the t
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These recommendations are addressed
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injustice and deprivation impact ne
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- Giving priority to pre and post-n
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Percentage of live and still births
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EYFS Median Scores by National Depr
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data which shows us locally what ac
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instability. Factors such as job se
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Proportion of population claiming J
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Data is available for those ALMPs f
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Labour market outcomes to date are
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achieved through transfer payments,
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% share of equivalised incomeA comp
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Figure 7 shows the income distribut
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Figure 9Proportion of the populatio
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Although temperature variations dur
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5. LEADERSHIP AND PARTNERSHIPDudley
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A Community Renewal team which coor
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6. COMMUNITY ENGAGEMENTCommunity En
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o DMBC sharing their community enga
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Transferring power to communitiesNI
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Secondary Prevention of CVDOptimum
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Ratio of obsevred vs. expected prev
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Performance variation cannot be exp
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Table 4: Range of performance gapDi
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Conclusions:The general conclusions
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7.2 ACUTE CARDIO-VASCULAR DISEASE (
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Timely ResponseApproximately 30% of
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IMD ScoreRevascularisation Ward Rat
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That an increase in access to diagn
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Establishing the level of health eq
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Timely ResponseTimely access to tre
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Continue implementation of current
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“reduce smoking during pregnancy
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Percentage who currently smokePerce
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1. Stop Smoking Service ProvisionDu
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Proportion of clients that have qui
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3. Communication and EducationDSSS
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The PCT, Acute Trust, Local Authori
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admissions. The following year Dudl
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Standardised Rate per 100,00 popula
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Netherton &WoodsideHalesowen NorthC
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women the Mosaic groups with signif
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numbers of alcohol related sexual o
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These include:Securing additional i
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The deprivation gap in invasive can
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Age standardised incidence rate rat
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One of the priorities of the Cancer
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Colorectal cancerProstate cancerThe
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and less radical treatment than you
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As more people than ever are surviv
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Page 144 and 145: 7.7 SEASONAL EXCESS DEATHSREDUCING
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Page 152 and 153: Percentage uptake of seasonal flu v
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Page 158 and 159: Standardised Rate per 100,000 popul
Page 162 and 163: PercentagePercentageFigure 7aMechan
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Page 166 and 167: Key findings from analysis of morta
Page 168 and 169: Standardised rate per 100,000 popul
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Page 176 and 177: Key findings from analysis of emerg
Page 178 and 179: Action plan updated in 2008 to rein
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Page 182 and 183: Further analysis shows that for hyp
Page 184 and 185: 8.2 SOCIAL CAREAdult Social CareSoc
Page 188 and 189: DCS has some key performance target
Page 190 and 191: 8.4 DEVELOPING THE ROLE OF THE VOLU
Page 192 and 193: at the heart of action to address c
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Page 196 and 197: capacity and confidence of individu
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Page 202 and 203: 9.1 DUDLEY HEALTH INEQUALITIES HIGH
Page 204 and 205: RECOMMENDATION ACTIVITY OUTCOMES LE
Page 210 and 211: Dudley Community Partnership (2005)
Page 212 and 213: Great Britain. Department of Health
Page 214 and 215: NHS Dudley and Dudley Metropolitan
Page 216 and 217: APPENDIX 1 - PERFORMANCE INDICATORS
Page 218 and 219: Indicator Dudley England Least Most
Page 220 and 221: APPENDIX 2 - DELIVERY PLANS FOR PRI
Page 222 and 223: PRIORITY AREA: TOBACCO CONTROLRECOM
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Page 226 and 227: Empower community members toraise a
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Page 230 and 231: Offender ManagementRECOMMENDATION A
Page 234 and 235: PRIORITY AREA: SEASONAL EXCESS DEAT
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APPENDIX 3 - HEALTH INEQUALITIES CH
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PRIORITY ACTIONENGAGEMENT- WORKFORC
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Dudley Strategy for Tackling Health Inequalities 2010-15

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