Basildon and Brentwood Prevention Strategy 2015-2020
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Basildon and Brentwood
Prevention Strategy
2015-2020
Basildon and Brentwood Prevention Strategy
1
Contents
1. Introduction ...........................................................................................................................................................................................7
2. Background................................................................................................................................................................................................8
The Purpose of Prevention .....................................................................................................................................................................9
3. Strategic Context ............................................................................................................................................................................... 10
3.1 National Strategic Context ....................................................................................................................................................... 10
The Care Act (2014) .............................................................................................................................................................................. 10
3.2 Essex County Council Strategic Context ............................................................................................................................... 12
Commissioning Strategies (All Outcomes) .................................................................................................................................. 12
Housing Strategy (in development) .............................................................................................................................................. 12
Assistive Technology (in development) ........................................................................................................................................ 12
Reablement ........................................................................................................................................................................................ 12
Physical Impairment Strategy (in development) ......................................................................................................................... 12
Older People’s Strategy ................................................................................................................................................................... 12
Carers’ Strategy ................................................................................................................................................................................. 12
Information, Advice & Guidance Strategy ................................................................................................................................... 12
Who Will Care? .................................................................................................................................................................................. 12
Essex 5 year health and care plan ................................................................................................................................................. 14
Market Position Statement .............................................................................................................................................................. 14
3.3 NHS Strategic Drivers................................................................................................................................................................ 14
3.4 District and Borough Council Strategic Drivers ........................................................................................................................ 15
4. Strategic Vision .................................................................................................................................................................................. 16
5. Local Current and Future Projected Need................................................................................................................................... 17
5.1 Introduction ...................................................................................................................................................................................... 17
5.2 Older People (OP). ......................................................................................................................................................................... 17
5.2.1 Adult Social Care Use by Older People .............................................................................................................................. 19
6. Primary Prevention ........................................................................................................................................................................... 22
6.1 Antenatal and Newborn Screening Programmes .................................................................................................................... 22
6.1.1 Introduction ..................................................................................................................................................................... 22
6.1.2 Future commissioning intentions ............................................................................................................................... 22
6.2 The 0-19 Healthy Child Programme........................................................................................................................................... 22
6.2.1 Introduction ..................................................................................................................................................................... 22
6.2.2 What works?.................................................................................................................................................................... 22
6.2.3 Future Commissioning Intentions ........................................................................................................................................ 24
6.3 Child Poverty.................................................................................................................................................................................... 25
6.4 Education and Lifelong Learning ................................................................................................................................................. 26
6.4.1 School Readiness ........................................................................................................................................................... 26
6.4.2 School Improvement .............................................................................................................................................................. 26
6.4.3 Children and Young People with Special Educational Needs and Disabilities (SEND)............................................. 27
6.5 Reducing Risk Behaviours in Children ....................................................................................................................................... 28
Basildon and Brentwood Prevention Strategy
2
6.5.1 Introduction ...................................................................................................................................................................... 28
6.5.2 What works? Evidence Base.......................................................................................................................................... 28
6.5.3 The situation in Essex ............................................................................................................................................................. 28
6.5.4 Future commissioning intentions ......................................................................................................................................... 29
6.6 Promoting Health Weight in Children and Adults ................................................................................................................... 29
6.6.1 Introduction .............................................................................................................................................................................. 29
6.6.2 What works? The evidence base on weight management. ........................................................................................... 29
6.6.3 The current situation in Basildon and Brentwood ............................................................................................................ 31
6.6.4 Future Commissioning Intentions ........................................................................................................................................ 32
6.7 Promoting Physical Activity ........................................................................................................................................................... 33
6.7.1 Introduction .............................................................................................................................................................................. 33
6.7.2 What works? The evidence base on promoting physical activity. ................................................................................ 33
6.7.3 The situation in Basildon and Brentwood .......................................................................................................................... 33
6.7.4 Future Commissioning Intentions ........................................................................................................................................ 34
6.8 Immunisation ................................................................................................................................................................................... 35
6.8.1 Introduction .............................................................................................................................................................................. 35
6.8.2 What works? Evidence base on immunisation ................................................................................................................ 35
6.8.3 The situation in Basildon and Brentwood .......................................................................................................................... 36
6.8.4 Future Commissioning Intentions ........................................................................................................................................ 37
6.9 Reducing the Prevalence of Smoking ................................................................................................................................... 38
6.9.1 Introduction ..................................................................................................................................................................... 38
6.9.2 What works? The evidence base on reducing smoking prevalence.................................................................. 38
6.9.3 The current situation in Basildon and Brentwood .................................................................................................... 38
6.9.4 Future Commissioning Intentions ........................................................................................................................................ 39
6.10 Alcohol harm minimisation and treatment ............................................................................................................................. 39
6.10.1 Introduction ............................................................................................................................................................................ 39
6.10.2 Evidence Base ........................................................................................................................................................................ 40
6.10.3 The situation in Essex ........................................................................................................................................................... 40
6.10.4 Future commissioning intentions....................................................................................................................................... 40
6.11 Strengthening Community Resilience ...................................................................................................................................... 41
6.12 Promoting Self-Care: Information, Advice and Guidance ................................................................................................... 45
6.12.1 Introduction ............................................................................................................................................................................ 45
6.12.2 What works? Evidence base on IAG and Self Care ...................................................................................................... 45
6.12.3 The current situation in Essex ............................................................................................................................................. 46
6.12.4 Commissioning Intentions ................................................................................................................................................... 46
7. Secondary Prevention........................................................................................................................................................................... 48
7.1 Health Checks .................................................................................................................................................................................. 48
7.1.1 Introduction .............................................................................................................................................................................. 48
7.1.2 What works? Evidence base on Health Checks ............................................................................................................... 48
7.1.3 The situation in Basildon and Brentwood .......................................................................................................................... 48
7.1.4 Commissioning Intentions ..................................................................................................................................................... 48
Basildon and Brentwood Prevention Strategy
3
7.2 Senior Health Checks ..................................................................................................................................................................... 49
7.2.1 Introduction .............................................................................................................................................................................. 49
7.2.2 What works? Evidence base on Senior Health Checks ................................................................................................... 49
7.2.3 The current situation in Basildon and Brentwood ............................................................................................................ 49
7.2.4 Commissioning Intentions ..................................................................................................................................................... 49
7.3 Prevention of strokes through case finding and treating undiagnosed hypertension and improving the clinical
management of circulatory disease................................................................................................................................................... 49
7.3.1 Introduction .............................................................................................................................................................................. 49
7.3.2 What works? Evidence Base on Stroke Prevention .......................................................................................................... 50
7.3.3 The situation in Basildon and Brentwood .......................................................................................................................... 50
7.3.4 Future Commissioning Intentions ........................................................................................................................................ 51
7.4 Prevention of Strokes in Patients with Atrial Fibrillation through effective anti-coagulation treatment. ..................... 51
7.4.1 Introduction .............................................................................................................................................................................. 51
7.4.2 Evidence Base .......................................................................................................................................................................... 51
7.4.3 The situation in Basildon and Brentwood .......................................................................................................................... 51
7.4.4 Commissioning intentions ..................................................................................................................................................... 52
7.5 Improving Mental Health through early intervention ............................................................................................................. 52
7.5.1 Introduction .............................................................................................................................................................................. 52
7.5.2 What works? Evidence base.................................................................................................................................................. 53
7.5.3 The situation in south Essex .................................................................................................................................................. 53
7.5.4 Future Commissioning Intentions ........................................................................................................................................ 53
7.6 Improving Housing and Homelessness Support...................................................................................................................... 54
7.6.1 Introduction .............................................................................................................................................................................. 54
7.7 Assistive Technology ...................................................................................................................................................................... 58
7.7.1 Introduction .............................................................................................................................................................................. 58
7.7.2 Evidence base .......................................................................................................................................................................... 58
7.7.3 The current situation in Essex ............................................................................................................................................... 59
7.7.4 Future Commissioning Intentions ........................................................................................................................................ 59
7.8 Support to Carers ........................................................................................................................................................................... 59
7.8.1 Introduction .............................................................................................................................................................................. 59
7.8.2 Evidence .................................................................................................................................................................................... 60
7.9 Improving Offender Health .......................................................................................................................................................... 61
7.9.1 Introduction .............................................................................................................................................................................. 61
8.1.1 Introduction .............................................................................................................................................................................. 64
8.1.2 What works? The evidence base on falls ........................................................................................................................... 64
8.1.3 The situation in Basildon and Brentwood .......................................................................................................................... 64
8.1.4 Commissioning Intentions ..................................................................................................................................................... 66
8.2.1 Introduction .............................................................................................................................................................................. 67
8.2.2 What works? Evidence base on continence ...................................................................................................................... 67
8.2.3 The situation in Essex ............................................................................................................................................................. 67
8.2.4 Commissioning Intentions ..................................................................................................................................................... 68
Basildon and Brentwood Prevention Strategy
4
8.3 Improve the Management of Stroke/TIA in Primary Care ..................................................................................................... 68
8.3.2 What works? Evidence Base on Stroke Management ..................................................................................................... 68
8.3.3 The situation in Basildon and Brentwood .......................................................................................................................... 68
8.3.4 Commissioning Intentions ..................................................................................................................................................... 70
8.4 Increase the provision of Stroke Early Supported Discharge (ESD) ..................................................................................... 70
8.4.1 Introduction .............................................................................................................................................................................. 70
8.4.2 Evidence Base .......................................................................................................................................................................... 71
8.4.3 The situation in Essex ............................................................................................................................................................. 71
8.4.4 Commissioning Intentions ..................................................................................................................................................... 71
8.5 Improve the Diagnosis and Management of COPD in Primary Care .................................................................................. 71
8.5.1 Introduction .............................................................................................................................................................................. 71
8.5.2 What works? Evidence base on Diagnosis and Management on COPD .................................................................... 71
8.5.3 The situation in Basildon and Brentwood .......................................................................................................................... 72
8.5.4 Commissioning Intentions ..................................................................................................................................................... 75
8.6 Commission integrated, preventative health and social care services aimed at frail elderly people ........................... 76
8.6.1 Introduction .............................................................................................................................................................................. 76
8.6.2 Evidence Base: Integrating health and social care ........................................................................................................... 76
8.6.3 The situation in Basildon and Brentwood .......................................................................................................................... 76
8.6.4 Commissioning Intentions ..................................................................................................................................................... 79
8.7 Reablement ...................................................................................................................................................................................... 79
8.7.1 Introduction .............................................................................................................................................................................. 79
8.7.2 Evidence Base .......................................................................................................................................................................... 80
8.7.3 The situation locally ................................................................................................................................................................ 80
8.7.4 Commissioning Intentions ..................................................................................................................................................... 81
8.8 Sensory Loss..................................................................................................................................................................................... 81
8.8.2 Evidence .................................................................................................................................................................................... 81
8.8.3 The current situation............................................................................................................................................................... 81
8.7.4 Future Commissioning Intentions ........................................................................................................................................ 81
8.9 Improving support to people with physical disabilities ........................................................................................................... 84
8.9.1 Background .............................................................................................................................................................................. 84
8.9.2 The situation in Essex ............................................................................................................................................................. 84
8.9.3 Future Commissioning Intentions ........................................................................................................................................ 85
8.10 Improving support to people with learning disabilities ........................................................................................................ 85
8.10.1 Background ............................................................................................................................................................................ 85
8.10.2 Evidence base ........................................................................................................................................................................ 86
8.11 Improve support and treatment of patients with more serious mental health problems to promote independence
and prevent relapse. ............................................................................................................................................................................. 87
8.11.1 Introduction ............................................................................................................................................................................ 87
8.11.2 The current situation in south Essex ................................................................................................................................. 87
8.12 Improving support to people with dementia ......................................................................................................................... 91
8.12.1 Introduction ............................................................................................................................................................................ 91
Basildon and Brentwood Prevention Strategy
5
8.12.2 What works? The evidence base on dementia ............................................................................................................. 91
8.12.3 The situation in Basildon and Brentwood ........................................................................................................................ 91
8.12.4 Future Commissioning Intentions ...................................................................................................................................... 94
9. Strategy Implementation and Monitoring ................................................................................................................................... 95
9.1 Workforce Planning ................................................................................................................................................................... 95
10 References ............................................................................................................................................................................................. 96
Basildon and Brentwood Prevention Strategy
6
1. Introduction
The Health and Social Care system both nationally and locally is under increasing pressure. The NHS has faced an
unprecedented and sustained slowdown in spending growth in recent years, and local government significant spending
cuts. Against this there is increasing demand for services both from an ageing chronically ill population, and through
the increasing expectations of individuals. In order to prevent the system from becoming unsustainable, both health and
social care will need to work in radically different ways than they did in the past.
One key solution is for health and local government, in partnership with the communities they serve to embrace and
deliver the prevention agenda. This requires a fundamental shift from reactive services that address ill health and care
needs once they have arisen, to proactive services that seek opportunities to intervene at the earliest possible stage and
throughout the life course of our population in order to empower individuals and communities to stay healthier for
longer. It requires a shift in thinking from ‘doing to’ to ‘doing with’ and it involves holistic integration of what are often
currently fragmented services around the individual.
There is a need to ensure that the support we provide for children, young people and their families across the County
represents the right support, for the right families at the right time and that we work with partners and communities to
develop the most effective model of intervention to make measurable improvements in outcomes for children in the
early years of their life which will then form a strong foundation for improved outcomes across the life course
The Care Act (2014) sets out a range of additional statutory duties for local authorities related to the prevention agenda.
It is critical to the vision in the Care Act that the care and support system works proactively to promote wellbeing and
independence, rather than simply waiting until people reach crisis point. As such it requires top tier local authorities to
work with key strategic partners to develop and agree a strategic approach to deliver the prevention agenda.
This strategy has been produced by Essex County Council in partnership with Basildon and Brentwood CCG, Basildon
Borough Council and Brentwood Borough Council. It sets out our thinking in terms of how to deliver The Prevention
Agenda across the services that we commission and provide. Where available, a critique of the published evidence and
local need is also discussed together with our commissioning intentions for the future.
Basildon and Brentwood Prevention Strategy
7
2. Background
‘Prevention’ can refer to a range of measures, services, facilities or other resources. There is no one definition for what
constitutes preventative activity; it can range from wide-scale whole population measures aimed at improving health, to
more targeted, individual interventions designed to improve the skills or functioning of one person or a particular group
of people. It can also include measures to lessen the impact of caring on a carer’s health and wellbeing.
“Prevention” is often broken down into three general approaches: primary, secondary and tertiary prevention which are
described below.
Primary Prevention: Measures to prevent ill health and promote wellbeing.
Primary prevention is defined as interventions, services, or resources aimed at individuals or populations who have no
current particular health or social care support needs. The aim of primary prevention is to help people avoid
developing needs for care and support by maintaining independence, good health and increased wellbeing.
Primary prevention measures are usually universal (i.e. available to all) which may include but are not limited to:
Provision of universal access to good quality information
Support for safer neighbourhoods
Health improvement interventions to promote healthy lifestyles and help people avoid or change health
damaging behaviour such as smoking or poor diet.
Schemes to reduce social isolation
Secondary Prevention: Measures to identify those at increased risk of poor health or wellbeing
and intervene early.
Secondary prevention refers to interventions or services aimed at individuals who have an increased risk of developing
needs, with the aim of helping to slow down further deterioration or preventing more serious ill health from developing.
In order to identify those individuals most likely to benefit from such targeted services, screening or case finding is
generally employed.
Examples of secondary prevention measures include:
Public health screening and case finding programmes that aim to identify disease early and intervene, for
example hypertension screening, health checks/senior health checks
Provision of housing, benefits and debt advice to those with existing mental health conditions to try and
prevent their mental health and social circumstances worsening.
Tertiary Prevention: Measures that delay or minimise the impact of existing health conditions
Tertiary prevention refers to interventions aimed at minimising the effect of disability or deterioration in people with
existing health conditions, complex care and support needs or caring responsibilities including supporting people to
regain skills and reduce need where possible. Local authorities must provide or arrange services, resources or facilities
that maximise independence for those who already have such needs. Tertiary prevention can also include helping
carers to continue to care by enabling them to have breaks from their caring responsibilities or developing mechanisms
to cope with the stress associated with caring.
Examples of tertiary prevention measures include:
Falls prevention programmes that provide interventions to older people who have already had a fall
Reablement programmes which focus on helping people to regain skills and capabilities after serious health
events such as stroke.
Personalised budgets that allow clients to purchase a range of services that maximise their independence
Basildon and Brentwood Prevention Strategy
8
The Purpose of Prevention
The course of someone’s journey through prevention services is not necessarily a straight line with a person moving
through the levels of preventative services in a successive way. For example, a person may still benefit from good quality
information (primary prevention) whilst they are in or being discharged from Intermediate Care (tertiary prevention).
Although broader in scope, the interventions identified in this strategy are in line with the approach underlying the
recent King’s Fund review of what works in avoiding hospital admissions: This includes bringing together different parts
of the health and social-care system, doing things we know are effective, stopping doing things we know are not
1
effective, and evaluating the outcomes of things we do not know about. The 2013 Essex Council Annual Public Health
2
Report builds on this by undertaking a comprehensive critique of published evidence relating to interventions that are
effective and ineffective in delivering system savings through reducing demand on unplanned health care and social
care services.
Figure 1 depicts a system-level overview of transitions between stages of dependence. These stages (general
population, low to moderate needs, substantial needs, complex needs) are depicted in boxes, with the flows into
and out of them depicted as the arrows joining them. The factors potentially affecting these flows are located at the top
part of the diagram (for factors potentially preventing flow towards reduced independence) and the bottom part of the
diagram (for factors potentially promoting regaining of independence).
Figure 1 System level overview of flows between different stages of dependency.
Source Lang, 2010a.
Basildon and Brentwood Prevention Strategy
9
3. Strategic Context
3.1 National Strategic Context
The Care Act (2014)
The Care Act (2014) sets out a range of additional statutory duties for local authorities including a number related to the
prevention agenda. It is critical to the vision in the Care Act that the care and support system works proactively to
promote wellbeing and independence, rather than simply waiting until people reach crisis point.
The Care Act places a duty on local authorities to provide or arrange for the provision of services, facilities or resources,
or take other steps, which it considers will—
(a) contribute towards preventing or delaying the development by adults in its area of needs for care and
support;
(b) contribute towards preventing or delaying the development by carers in its area of needs for support;
(c) reduce the needs for care and support of adults in its area;
(d) reduce the needs for support of carers in its area.
In particular, local authorities must consider how to identify “unmet need” – i.e. those people with needs which are not
currently being met, whether by the local authority or anyone else. Understanding unmet need will be crucial to
developing a longer-term approach to prevention that reflects the true needs of the local population.
In order to meet this challenge, the health and social care system will need to fundamentally change such that it
intervenes early to support individuals, and helps people to retain or regain their skills and confidence and prevents or
delays further deterioration wherever possible.
The Care Act specifies that a local authority’s responsibilities for prevention apply to all adults including:
Adults who do not have any current needs for care and support
Adults with needs for care and support, whether their needs are eligible and / or met by the local authority or
not
Carers, including those who may be about to undertake a caring role, or who do not currently have any needs
for support.
The Care Act mandates local authorities to undertake a number of prevention activities:
We MUST :
• Identify and understand current and future demand for preventative services (JSNA and ASC demand
management forecasts)
• Understand the supply of services, facilities and other resources already available that could support
prevention and be part of an overall local approach (Healthwatch Assets catalogue, Market position
statements and asset based elements of JSNA)
• Consider how to identify “unmet” need
• Promote diversity and quality in provision so that people have a choice of provider
• Ensure the integration of prevention with health and health-related services including housing
• Establish a service providing information and advice - including preventative services.
We SHOULD:
• Engage all providers to encourage innovation in supporting a preventative approach
• Consider how to align/integrate prevention approaches with local partners
st
• Consider the different opportunities for coming into contact with people including where the 1 contact is not
the local authority.
The Care Act Guidance also outlines situations or trigger points for the local authority to consider whether the provision
of a preventative service or some other step is appropriate. These include:
Basildon and Brentwood Prevention Strategy
10 initial contact through a customer services centre, whether by the person concerned or someone acting on
their behalf;
contact with a GP, community nurses, housing officers or other professionals which leads to a referral to the
local authority;
an assessment of needs or a carer’s assessment which identifies that the person would benefit from a
preventative service or other type of support available locally.
In addition approaches to identifying those people who may benefit from preventative support should consider how to
locate people in such circumstances, for example:
bereavement;
hospital admission and/or discharge;
people who have been recently admitted to or released from prison;
application for benefits such as Attendance Allowance, or Carer’s Allowance;
contact with/use of local support groups;
contact with/use of private care and support;
changes in housing.
Table 3.1 references chapters, sections and sub-sections within this strategy that meet the ‘must do’s’ and ‘should do’s’
in the Care Act (2014).
TABLE 3.1
We MUST : Where this can be seen in this strategy
• Identify and understand current and future demand for • Chapter 4
preventative services
• Understand the supply of services, facilities and other • ‘The current situation in Basildon and
resources already available that could support prevention Brentwood/Essex’ sub sections of
and be part of an overall local approach (Healthwatch Chapters 6,7 and 8.
Assets catalogue, Market position statements and asset
based elements of JSNA)
• Consider how to identify “unmet” need • Sections 6.1.4, 6.2.4, 6.3.4, 6.5.4, 6.6.4,
6.7.4, 7.1.4, 7.2.4, 7.3.3/4, 7.4.4, 7.5.4,
7.7.4, 7.8.4, 8.1.4, 8.2.4, 8.3.4, 8.5.4,
8.6.4, 8.8.4, 8.11.4, 8.12.4
• Promote diversity and quality in provision so that people • Sections 6.2.4, 6.3.2, 6.6.3/4, 6.7.3/4,
have a choice of provider 7.6.4, 7.8.4, 8.6.4, 8.11.3/4
• Ensure the integration of prevention with health and • Chapter 6, Primary Prevention
health-related services including housing • Sections 7.1, 7.2, 7.3, 7.4, 7.5, 7.6, 7.7,
8.1, 8.3, 8.6, 8.8, 8.11, 8.12
• Establish a service providing information and advice - • 6.7 Promoting Self Care; Information,
including preventative services. Advice and Guidance
We SHOULD:
• Engage all providers to encourage innovation in • Chapter 6, Primary Prevention
supporting a preventative approach • Chapter 7, Secondary Prevention
• Chapter 8 8, Tertiary Prevention
• Consider how to align/integrate prevention approaches • Chapter 6, Primary Prevention
with local partners • Chapter 7, Secondary Prevention
• Chapter 8, Tertiary Prevention
• Consider the different opportunities for coming into • Sections 6.1, 6.3, 6.4, 6.5, 6.7, 7.1, 7.2,
st
contact with people including where the 1 contact is not 7.3, 7.4, 7.5, 8.1, 8.2, 8.3, 8.4, 8.5, 8.6,
the local authority. 8.7, 8.8, 8.11, 8.12
Basildon and Brentwood Prevention Strategy
113.2 Essex County Council Strategic Context
Prevention is at the core of a large part of Essex County Council’s work. All our agreed Strategic Outcomes impact on
the prevention agenda with two of our corporate outcomes having particularly strong links to prevention:
People in Essex enjoy good health and wellbeing
People in Essex can live independently and exercise control over their lives
However, prevention is not just a public health or social care issue and links can be made to a number of other services
and ECC strategies including:
Commissioning Strategies (All Outcomes)
ECC is operating an outcomes based commissioning model. This has led to the development of commissioning
strategies based on each of the seven corporate outcomes.
Housing Strategy (in development)
Good quality housing can play a key role in a person’s wellbeing. The Care Act makes this link between wellbeing and
housing clearer by making housing a health related activity.
Assistive Technology (in development)
Assistive technology and equipment can enable people to remain in their own homes for longer offering a means for
them to undertake day to day tasks that they may otherwise be unable to do. It is therefore a vital preventative service.
Reablement
Reablement is referenced in the Care Act guidance as a preventative service. At Essex County Council we strongly
believe in the benefits of reablement and have increased the focus on this service in recent years, with it now forming a
key part of our adult social care offer.
Physical Impairment Strategy (in development)
Whilst our main commissioning approach has been based around outcomes, additional strategies have been developed
to emphasis the needs of particular groups. This targeting of services fits the definition of secondary and tertiary
prevention where services are focussed on risk groups.
Older People’s Strategy
As above this strategy has been developed to highlight the particular needs of this group. As older people are the
largest client group for adult social care in Essex, it will be vital that this prevention strategy reflects the needs of this
group.
Carers’ Strategy
Carers play a vital role in helping people remain in their own homes and keep a level of independence. Essex County
Council has acknowledged the role they play and outlines our commitment to supporting them in a Carers’ Strategy.
Information, Advice & Guidance Strategy
Information advice and guidance can provide an effective means of helping people access support away from formal
social care. By helping people find information on local services, support groups and other community initiatives near
them they can remain independent for longer without local authority intervention.
Prevention will also link to key partnership projects, building on existing work and shaping our actions in the future.
Who Will Care?
In January 2013, Essex partners tasked f five independent commissioners to answer the question: how will we care for
ourselves and our communities right now and in the future?
Basildon and Brentwood Prevention Strategy
12The commissioners, under the chairmanship of Sir Thomas Hughes-Hallett, developed five high impact solutions in their
September 2013 report ‘Who Will Care?’:
1. Agree a new understanding between the public sector and the people - the public sector needs to be up-
front and honest with us, clarifying the extent of the ‘care offer’ available to us
2. Prevent unnecessary crises in care - a new approach to change the focus of care from treating disease and
chronic conditions to supporting individuals earlier
3. Mobilise community resources
4. Use data and technology to the advantage of the people of Essex
5. Ensure clear leadership, vision and accountability
Children and Young People
Essex County Council is committed to improving outcomes for children, young people and their families.
Commissioning Strategies have been developed to enable these outcomes to be achieved and ECC is committed to
working with partners to ensure that there is a whole systems approach to support this.
Outcome One – Children in Essex get the best possible start in life
The Percentage of children ready for school
The Percentage of children achieving a good level of development by the age of five
Outcome Two – People in Essex enjoy good health and wellbeing
People in Essex have a healthy life expectancy
Prevalence of healthy lifestyles
Percentage of children achieving at school
Prevalence of mental health disorders among adults and children
Prevalence of teenage pregnancy
Outcome Three - People have aspirations and achieve their ambitions through education, training and lifelong learning
Percentage of children attending a good school
Percentage of children achieving at school
Early Years Review
In Autumn 2013 ECC led a whole system review of support for families in the early years - from pregnancy through to
children aged 5. This major piece of work afforded a unique opportunity to consider some key points that have
significant bearing on the way services for families with young children are commissioned including
How well are parents’/carers’ needs understood?
Are their needs met in ways that are accessible and empowering?
Overall does the system do well enough in growing confident, effective parenting, enabling parents /carers to
give children the best start in life?
Basildon and Brentwood Prevention Strategy
13As a result ECC have been able to gather intelligence that identifies opportunities for:
Innovation across the system, especially co-production with families
Removal of duplication of resources and roles
Determining what a common understanding and model of child development should look like
Skilling up the workforce to deliver new approaches
Developing a consistent offer at all the system ‘touch points’
Work is continuing to explore and test out how best a more integrated approach to increasing resilience amongst
families and improving the service offer made to them can be progressed.
Essex 5 year health and care plan
This plan focuses upon pan-Essex improvement interventions and pan-Essex enablers, and also provides an overview of
the financial impact of the plans of contributing organisations.
Whilst the primary unit of planning for 2014 – 2019 Five Year Plans is the CCG systems, it was agreed by Essex system
partners that there were also benefits from developing an over-arching Essex wide plan to enable us to deliver our
shared vision.
The Shared vision is:
‘By 2018 residents and local communities will have greater choice, control and responsibility for health and wellbeing
services. Life expectancy overall will have increased and the inequalities within and between our communities will have
reduced‘.
Market Position Statement
The Market Position Statement (MPS) has been produced to provide a better understanding for organisations about the
supply and demand of integrated care services in Essex in the medium and long term. It provides the market with key
messages about the Council’s approach, and emphasises the focus on prevention, personalisation and partnerships.
The Council wishes to see service offers from all parts of the market that are targeted at prevention and avoiding harm
to vulnerable people wherever possible. Market collaboration involving the Third Sector in solutions will be a priority for
our service offer moving forward.
3.3 NHS Strategic Drivers
NHS Basildon and Brentwood CCG’s Five Year plan contains a number of strategic actions supporting the prevention
agenda. These include:
• Integration of Health and Social care services around the patient through the Better Care Fund with an aim
that by 2019, only those patients with an appropriate medical need will be admitted to hospital.
• Providing a care coordination model to the frail elderly including a named accountable professional that will
coordinate care around the professional with a view to providing early intervention to reduce the risk of
unplanned care admissions.
• Delivering ‘Making Every Contact Count’ at practice level and commissioning providers to do the same.
• Developing a ‘Lifestyles Balanced Scorecard” for each GP practice with detailed recommendations for
improving the health of the practice’s population and tackling health inequalities
Basildon and Brentwood Prevention Strategy
14• Delivering a consistent high performance on health improvement programmes commissioned by ECC and
Public Health England including smoking cessation, health checks, immunisation and screening and sexual
health.
• Focusing coordinated commissioned programmes on populations facing high levels of deprivation including
Vange, Pitsea, St. Martins, Fryerns and Laindon Park
The South Essex CCGs in conjunction with ECC have developed an agreed a South Essex Joint Mental Health Strategy.
The strategy contains a number of key elements relating to the prevention agenda including improving primary care
and preventative mental health services, improving crisis response so that fewer people need in patient care, promoting
self-management and commissioning a recovery college.
3.4 District and Borough Council Strategic Drivers
*** TO FOLLOW
From these documents several themes emerge
Encouraging Healthy Lifestyles
Improving Education
Promoting independence and community resilience
Accommodation and suitable housing
Evidence based preventative clinical interventions
Targeting activities towards vulnerable groups
Empowering individuals
Improving employment
Reducing hospital admissions
Safeguarding
The Care Market, choice and sustainability
Basildon and Brentwood Prevention Strategy
15You can also read
