Transforming PublicHealth Services

C O U N C I L

CITY

WOLVERHAMPTONOF

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About this Document

About this document

Public Health is about keepingpeople healthy and making sureeveryone has the same opportunitiesto live a healthy life.

In Wolverhampton, we haverecognised that traditional ways ofworking with people to deliver PublicHealth outcomes need to beimproved in line with what they havetold us in recent consultations andvia feedback through services. Thepurpose of this consultation is to askpeople about options for new waysof working to deliver Public Healthoutcomes which will in turn improvethe health and wellbeing of thepeople of Wolverhampton.

Public Health are mandated toprovide NHS Health Checks, HealthVisitors, Sexual Health Services,National Child MeasurementProgramme, Health Protectionassurance and providing advice forthe NHS, all these services will remain.

The City of Wolverhampton Council,Public Health Department, hasproduced this consultation documentto seek your opinion on how we canwork differently together.

This document will explain:

• why we need a new way ofworking

• what services are being reviewedand how we can work differently

• how you can get involved andhave your say

Public Health is at a point where wehave to change the way we work inorder to make a wider impact, thismeans looking at the services we buy(commission). We know fromevidence the things that most affecthealth are lifestyle choices and thefundamentals such as goodeducation having a job, decent

income, housing and theenvironment. Being unemployed forexample, can increase your risk ofdepression.

We also know that as digitaltechnology has advanced and theway in which people access advice,information and support haschanged over time.

Why we need to change

3Transforming Public Health Serviceswolverhampton.gov.uk

Why we need to change

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With less money from thegovernment and five years’ worth ofoutcome information since thetransfer of Public Health to the City ofWolverhampton Council, now is thetime to look at how we can workdifferently together. As Public Healthexperts, we want to work with otherparts of the council, NHS and thevoluntary and community sector tomake Public Health everyone’sbusiness. This means strengtheningour relationships with key partnersand working together to find ways ofimproving health for everyoneincluding better engagement andinvolvement with the public. We know this will take time to havean effect, but in the long term it willgreatly benefit the people that liveand work in Wolverhampton.

We have looked at how we spendour money and the outcomesachieved and we have the madefollowing changes:

• Reduced our Public Health staff costs

• Getting better value for money for services we must provide

We want to seek the views of thepublic, key partners andorganisations on how we can workmore effectively together and explorehow people access information,advice and support about thefollowing (see page 5).

Why we need to change

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4 City of Wolverhampton Council

Services being reviewed

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What services are being reviewedand how we can work

1 Support womento breastfeed

3Increase the number of children with ahealthy weight

5Improve young people’semotional and mentalwellbeing

2Reduce the number ofpeople who smoke

4Prevent healthcareacquired infection

differently

( )Communityand hospital

Services being reviewed

6 City of Wolverhampton Council wolverhampton.gov.uk

Breastfeeding provides long-term healthbenefits for mum and baby. Most mums stop

breastfeeding by 6-8 weeks after baby isborn. This low rate has stayed the same for

the past 7-8 years and we have not seen anyimprovement in parts of the city where breast

feeding rates are lowest. We know that the most important time to

support women to breastfeed is within the first ten days.

What we want to do:

Support womento breastfeed1

What we know

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Services being reviewed

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The breastfeeding peer supportservice aims to support women tobreastfeed, particularly those thatlive in the areas of our city wherebreastfeeding rates are lowest.This support has mainly beenoffered to women in the maternityunit during office hours, or by

telephone support and in somegroups in community venues.

This service is supported by anetwork of breastfeeding peersupport volunteers who work withmums when they need help withbreastfeeding.

• We want to help to normalisebreastfeeding inWolverhampton by:

• Promoting national and localcampaigns, resources, tools andproducts through our and ourpartner’s networks, social mediaand communication channels,including Start4Life

• We want to work better with GPs,midwives, health visitors, earlyyears, the voluntary sector andothers who have regular contactwith pregnant women and newmums who want to breastfeed

• We want to make women awareof all the support available tothem within their own homeduring the crucial first ten days,for example national telephone helplines; online videos and opportunities throughsocial media

• We want to work withcommissioners and otherproviders of breastfeedingsupport to continue the required training

Proposed ways of working

Current service

8 City of Wolverhampton Council wolverhampton.gov.uk

Services being reviewed

Over the last decade, nationally the number ofpeople smoking has significantly reduced and

positively this is the case locally.

However, the smoking rates in Wolverhamptonremains higher than the national average of 10%.

In a recent local survey, we asked current smokerswho want to quit what would help them.

The majority responded either; ‘nothing I can do iton my own, or ‘E-cigarettes’.

Fewer people than ever are using the local StopSmoking Services. Vaping or e-cigarettes are the

most popular method to quit. Our local survey tellsus that less young people than ever are

choosing to start smoking.

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What we know

What we want to do:

Reduce thenumber of peoplewho smoke

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Services being reviewed

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We currently commission GP andPharmacies to support people tostop smoking through counsellingand treatments. The current up-takeof this service is poor.

There are a number of projects inlocal schools that promote smokefree messages to young people and

parents, and educate around thedangers of second hand smokingand the effects of smoking. Thesmoke free school gates project hassupported smoke free children andenvironments by creating signs forschools and parks aimed at children,parents, carers and families.

Going forward we would like to:

• Work through school nurses andschools to support smoke freemessages

• Support schools to deliver asmoke free preventionprogramme through an evidencebased whole school approach

• Support secondary teachers todeliver PSHE curriculum topics toKS3 and KS4 pupils, with national‘Rise Above’ lesson plans co-created with teachers and videocontent developed with 11-16year olds

• Ensure professionals can havequality brief conversations tosupport people to stop smoking

• Make everyone aware of the self-help stop smoking tools andsupport available nationally(OneYou, NHS national quit line,NHS text support, NHS emailsupport programme, NHSSmokefree app, NHS online Chattool via Facebook messenger)

• Implement “Improve My Health”self-service pod in communityhubs

• Locally promote national stopsmoking campaigns and newdigital tools through our partners

Proposed ways of working

Current service

Services being reviewed

10 City of Wolverhampton Council wolverhampton.gov.uk

3What we want to do:

Increase the numberof children with ahealthy weight

1 in 4 children in Wolverhampton are alreadyoverweight or obese when they start school. Children whostart primary school overweight are not likely to become ahealthy weight before leaving. It is important for all children,

regardless of their weight, to eat healthily and meet therecommended levels of physical activity.

Having the best start in life which includes having strongrelationships, secure income, good nutrition and housing is the

foundation for preventing poor health in children.If healthy habits are established early in childhood as a family,

then they are far more likely to continue into adulthood.

The National Child Measurement Programme (NCMP) will continue to be provided by school nurses. Public Health wish to consult on how families can be supported following the identification

of child weight management issues.

What we know

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Services being reviewed

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The ‘5 Star Families’ programmeprovides healthy lifestyle advice tofamilies in a community venue over aten-week period. Children who aremeasured as overweight or obese inschool are invited to attend theprogramme with their family.

Only a quarter of families invited use this service.

The current prevention approachrunning in primary schools wouldcontinue and the School Nursingservices support healthy weight insecondary aged young people.

• Extend our reach and impact byworking more closely with staffgroups who already engage withpre-school age children to preventchildren becoming overweightbefore starting school

• Continue working with schools toproduce lesson plans that educatechildren in healthy eating and activity

• Provide self-help information andlinks to digital tools such as theChange4Life ‘Be Food Smart’ app,in the letter from school nurseswhen a child is measured as abovea healthy weight

• Locally promote national nutrition andphysical activity campaigns and toolsaimed at families with young children,through key partners working closestwith families e.g. children centres,nurseries, schools, NHS, voluntary andcommunity sector

• Support health visitors in ‘MakingEvery Contact Count’ and givingthem the expertise to advise familieson the resources and digital toolsavailable to keep children healthy

• Local action in line with the nationalSugar Reduction programme withindustry; for example, through ourlocal take-away planning activity

• Continue to improve the facilities forphysical activity in the environment

• Work together with secondaryschools to give children access toevidenced based self-help tools toachieve a healthy weight for examplethrough Public Health England ‘RiseAbove’ lesson plans

• Promoting whole school approachesto healthy lifestyles

Proposed ways of working

Current service

Reducing healthcare associated infections is a national priority with targets set by

the government. Good progress has been madeover the last decade in this area with significant

reductions in the number of infections.Wolverhampton is nationally recognised as an area of best practice for infection

prevention in nursing and care homes.

What we know

Services being reviewed

12 City of Wolverhampton Council wolverhampton.gov.uk

The service provides support for carehomes initiatives to reducehealthcare associated infections. Thisincludes audits, screening, treatment,training for staff and outbreakmanagement support.

It aims to reduce infections in theelderly population living in carehomes by treating infections earlyand prevent unnecessary admissionsto hospitals. The service does this byvisiting care homes and looking at

what they do; how they do it andproviding training for staff.

Signs of infections can be noted bythe GP, hospital or care home and iffound, this service offers support,advice and in some cases treatmentin the community.

As part of this service there is a postdischarge telephone nursing support for certain infections whenpeople leave the hospital and returnto the community.

Current service

What we want to do:

Prevent healthcareacquired infection4

Services being reviewed

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• Continue the excellent partnershipwork with the NHS and carehomes, who apply the policiescorrectly; complete reviews; dothe required training and use themanual - which helps themunderstand how to prevent aninfection spreading

• Work with the commissioners across the clinical commissioninggroup and the hospital toensure high quality services incare homes

• Continue to work with PublicHealth England (PHE) which is thenational co-ordinating advisorybody for infection and isresponsible for providing adviceand support to care homes inthe event of an outbreak ofinfectious diseases

• Identify elements of the servicethat could be sustained throughnew funding arrangements

• The hospital will have infectionprevention control if a resident is in hospital

• To continue to work with PrimaryCare so, when a resident isdischarged home, their GP willfollow hospital treatment adviceand work with the care home. It will then be the responsibility ofthe care home, using their trainingand manual, to make sure theinfection does not spread

• Explore training opportunities withour partners

• Explore making Infection Prevention everyone’s business i.e. Environmental Health, Adult Social Care

• Provision of assistance andsupport for the development ofsystems for the timely recognitionand control of infections

• Development and maintenance ofa digital platform for infectionprevention advice and intelligence

Proposed ways of working

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Services being reviewed

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5What we want to do:

Improve young people’semotional and mentalwellbeing

Having good mental wellbeing is as important as having good physical health. Mental wellbeing affects how we think, feel and act, and helps determine how

we handle stress and relate to others.

Local information tells us that mental wellbeingis an issue for young people.

Partners from the Clinical Commissioning Group, City of Wolverhampton Council and Headstart have

commissioned a new local service which will start in April 2018. It will offer young people and families a package of support towards

better emotional health and wellbeing.

What we know

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( )Communityand hospital

Services being reviewed

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The ‘Base 25’ service offers one toone free confidential counselling bytrained Counsellors to 11-25 yearolds. It aims to help young people towork through past and presentissues that are affecting them.Overall, service data shows that the service is well used inWolverhampton.

There is also the ‘Hospital Youth Link’service within the A&E departmentand Children’s Ward in the hospital.The service supports young peopleaged 11-18 who go into hospital witha mental health issue or who areinvolved in an assault / violence.

This approach tracks young peoplefrom the hospital to the community,signposting and working with key services.

• Continue to support andcollaborate with partners toimprove emotional health andwellbeing for example through theWolverhampton Child andAdolescent Mental HealthTransformational Board andHeadstart

• Promote good mental wellbeingusing the ‘Five Ways to Wellbeing’approach through our partner’scommunication channels

• Promote whole schoolapproaches to support staff andpupils with emotional health andwellbeing (EH&W)

• Locally promote national mentalhealth and wellbeing campaignsand evidence based digital toolsthrough our partners

• Work through schools to increaseawareness and provide youngpeople with the tools to buildresilience, using the Public HealthEngland digital platform ‘Rise Above’ lesson plans

• The City Council has developed aplan to work with local schools ona social and emotional mentalhealth offer for a consistentapproach in schools

Proposed ways of working

Current service

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WolverhamptonToday

wolverhampton.gov.uk 01902 551155

City of Wolverhampton Council, Civic Centre, St. Peter’s Square,

Wolverhampton WV1 1SH

@WolvesCouncil WolverhamptonToday

If you require this information in another format orlanguage please contact:

Email: customer.services@wolverhampton.gov.uk

Telephone: 01902 551155

How you can get involved andhave your say

This consultation will form part of on-going workthat we are undertaking and support us in thedecision-making process.

Your feedback on this consultation will help usmake sure we continue to provide

• services that support people• suitable alternative support to people where

there are identified gaps

We would be grateful if you could take the timeto read and complete our online survey onwww.wolverhampton.gov.uk/consultations

For furtherinformation pleasecontact Ravi Seehraon 01902 558657

or emailphcommissioning@wolverhampton.gov.uk

This consultationwill close at

noon on 19th February

2018