Strengthen the role and impact of ill health prevention - Print version

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This priority focuses on:

  1. Prioritising prevention to tackle the causes of health-related problems to reduce the impact of ill-health on people’s lives, their families, and communities.
  2. Empowering people to take action to improve health and wellbeing for themselves and others and providing effective, timely and appropriate support where needed.
  3. Co-ordinating services, working together to design services which take account of the complexity of people’s lives and their overlapping health and social needs.
  4. Coventry and Warwickshire’s Integrated Care (ICS) priorities: prioritising prevention and improving future health outcomes through tackling health inequalities and improving access to health and care services.

Background

The Marmot Review summarised the importance the impact of addressing inequalities in health in later life and investing in the early years to preventing ill health later in life.

Coventry’s Health and Wellbeing Strategy and the Coventry & Warwickshire Integrated Care Partnership Inequalities Strategic Plan highlight the importance of taking a ‘population health’ approach to reduce inequalities in health as well as improving health overall.

The Core20PLUS5 is a national NHS England approach to inform action to reduce healthcare inequalities at both national and system level. The approach focuses on the most deprived 20% of the national population as identified by the national Index of Multiple Deprivation (IMD), priority groups identified locally (in Coventry these are transient communities and working-aged people on long-term sickness), and five clinical priorities (maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension). There is also an additional Core20PLUS5 for children and young people with five clinical priorities of asthma, diabetes, epilepsy, oral health and mental Health.

What we know

There are a number of programmes of work and interventions that support the strengthen the role and impact of ill-health prevention recommendation. These include:

  1. Programmes which promote healthy behaviours and lifestyles across the system to maximise impact and tackle barriers to healthy lifestyle, including mental well-being, diet, exercise, smoking and drugs and alcohol.
  2. Programmes which ensure we are doing all we can to reduce suicides.
  3. Domestic abuse programmes offering a range of interventions and programmes for the ‘whole family’ including victims, children and young people and perpetrators.
  4. An integrated health and care system with seamless local services in Coventry.

Legislation, Government guidance that support the strengthen the role and impact of ill-health prevention recommendation:

Links to service developments and strategies to support this recommendation:

Indicators

The indicators below will tell us how we are progressing:

  • Low wellbeing in adults
  • Support for adults’ mental health
  • Adults/children obese
  • Life expectancy female/ male

Services and activities

Delivery partners

  • Coventry City Council Ecology Team 
  • Coventry City Council Parks Team
  • Coventry City Council Planning Team
  • Coventry City Council Public Health Team
  • Coventry and Warwickshire Integrated Care System 
  • Family Health and Lifestyles service
  • Healthy Lifestyles Service

How we will measure progress

  • Self-reported perceptions, opinions, lifestyles, and behaviours
  • Self-reported wellbeing
  • Smoking prevalence
  • National Child Measurement Programme measures
  • Childhood immunisation rates
  • West Midlands Fire Service information

Case Study 1 - The Health Justice Partnership

Coventry and Warwickshire ICB, Central England Law Centre, Coventry Independent Advice Services, Coventry University and Health Organisations

As a Marmot city, Coventry delivers programmes of work aligned to the Marmot Principle strengthen the role and impact of ill health prevention. An example of this is the Health Justice Partnership (HJP), which was funded with a higher allocation to areas with greater deprivation.

What our organisation did

Central England Law Centre, proposed to develop a health justice partnership approach, starting in a PCN in a deprived area of Coventry, and then taking the learning from that project to develop further partnership in Coventry and North Warwickshire. The aims were to improve health outcomes for the relevant patients and reduce demands on GPs for non-clinical issues. The initial partnership was established with a Primary Care Network (PCN). The programme supports people from a range of ethnicities, reflecting the population of Coventry. Most patients supported by the HJP are from core20 areas (the poorest areas in the city) and other vulnerable groups such as homeless people, migrants, and refugees; with issues that relate to housing, benefits, or financial hardship. There were many cases of complex needs where patients had mental health issues, substance misuse, or a history of violence.

Central England Law Centre is planning on developing a third Health Justice Partnership with a primary care network in Nuneaton and Bedworth. They are also working with the PCN to find further evidence of the benefits of the HJP support and are also developing recommendations for future activity to maximise the effectiveness of this partnership approach.

Successes

Only a few months into the project and with a full evaluation planned at completion, the Health Justice Partnership is already starting to demonstrate some positive outcomes for people experiencing inequalities. The total predicted income gains for Coventry residents are currently at £620,000 per annum, and more data is being gathered to understand the ongoing impact on the demand for healthcare services.

Homelessness was ended or prevented for 4 patients, and 6 patients were supported to gain limited capacity for work-related activities status, saving approximately 48 GP appointments annually as patients no longer require sick notes.

Service user feedback included:

  • 37% of patients surveyed said visits to their GP had decreased since support from HJB
  • 73% of patients surveyed have not gone back to their GP regarding social welfare issues since the HJP intervention
  • 94.7% of patients surveyed advised that the HJP support had a positive impact on their physical or mental health

Find out more by visiting the Health Justice Partnership website [https://www.happyhealthylives.uk/download/clientfiles/files/HJP%20case%20study.pdf]

View a print version  [https://www.coventry.gov.uk/marmot-monitoring-tool/ten-years-marmot-city/print]

Case Study 2 - CV Life: Building social connections, confidence and physical activity for people in care homes and retired living schemes.

The Coventry Moves project was commissioned by Coventry City Council to get the city moving again following the COVID-19 pandemic.

Coventry Moves is a collaboration of partner organisations that deliver a wide variety of activities aimed at encouraging people to get up and active and have some fun. Resources for this project were targeted at people living in care homes and retired living schemes; with the aim to support social connections, improve mental health, and take part in physical activity. The Coventry Moves project is aligned to enabling adults to maximise capabilities and have control over their lives and strengthen the role and impact of ill health prevention Marmot Principles.

The CV Life community development teams initiated foyer and doorstep conversations to begin rebuilding connections and confidence. Through listening to the needs and interests of the residents, a range of activities were delivered within the communal lounges in the settings and community. Community connectors were identified through their initial involvement and informal committees were formed to support the longevity of activities. Activities were intentionally varied to appeal to engage a wide range of residents, these included:

  • Flower arranging
  • Reminiscence sessions
  • Dancing
  • Local day trips
  • Coach trips to the beach
  • Walking sports
  • Sporting Memories Community activities
  • Competitive quizzes
  • Seated exercise classes

A photographs of residents at the beach. One has a walking stick and one has a walking frame.

Successes:

CV Life has established long-term partnerships working in 12 care homes and retired living schemes. Care home managers have reported an increase in the physical activity and capability of residents, alongside a reduction in falls resulting in a reduction in emergency calls for ambulances.

The Sporting Memories project provided the opportunity to hear from sporting figures in an informal setting and supported building a strong social network for men, including those with dementia. Attendees found positive connections listening to others reflect on their shared interests.

Social networks have widened with people making connections between different residences. Friendships and relationships have emerged because of these social activities, building confidence, health and well-being.

CV Life leisure centres have implemented adapted programming making leisure activities more accessible and inclusive for people with disabilities or other needs.

 

A photograph taken of elderly residents and Coventry Moves

CV Life leisure centres have implemented adapted programming making leisure activities more accessible and inclusive for people with disabilities or other needs.

Service user feedback

“When Dad is at Sporting Memories it’s like we get a piece of him back. When he’s there he listens along to stories, nods his head in recognition and laughs at the jokes. It’s wonderful to see. Not only has it given us and him a sense of purpose, we’re also creating new memories, which is something I never thought I’d say again. We thought we’d lost that opportunity. There isn’t much hope or positivity when someone you love has this awful condition, but Sporting Memories has been a chink of light at the end of what’s been a very dark tunnel.”

Case Study 3 - West Midlands Fire Service

West Midlands Fire Service (WMFS) is a Marmot Partner. WMFS was presented with an award by Sir Michael Marmot in 2015 for their work with partners to reduce health inequalities.

WMFS have embedded the Marmot approach in their work. For example, the service:

  • Implement Marmot approach training as part of their onboarding of new staff.
  • Deliver engagement activities with children and young people as part of their prevention offer, to ‘enable all children, young people, and adults to maximise their capabilities and have control over their lives’, and ‘strengthen the role and impact of ill health prevention’ Marmot Principles.
  • Undertake ‘safe and well’ visits to advise and educate on safety at home, and identify and increase support to more vulnerable residents, taking a proportionate universalism approach; an important part of WMFS.
  • Conducted a ‘safe and well’ risk prioritisation trial, using risk scoring data to inform prioritisation of services. Actions from safe and well referrals enabled those of high risk to be identified quickly – those at most risk were contacted within seven days of a referral in most cases, and where possible, a shorter time frame than this.

An additional level of case support is also available for residents with more complex needs.

Successes

Early indications from the ‘safe and well’ risk prioritisation trial are that wait times for safe and well visits are reducing.

Visit the West Midlands Fire Service  [https://www.wmfs.net/]website for more information.

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