Meeting documents

Health Scrutiny Sub-Committee (DCC)
Monday 4 April 2005


            Meeting: Health Scrutiny Sub-Committee (County Hall, Durham - Council Chamber - 04/04/2005 10:00:00 AM)

                  Item: A10 Delivering 'Choosing Health'


         


Health Scrutiny Sub-Committee

4th April 2005

Delivering ‘Choosing Health
Report of Head of Overview and Scrutiny


Purpose of Report


1. To provide information about the Department of Health’s latest paper outlining how it expects ‘Choosing Health’ to be delivered nationally, regionally and locally. This report is partly based on a briefing provided by the Democratic Health Network.

Background

2. The Government’s White Paper, ‘Choosing Health: Making Healthier Choices Easier’ was published in November 2004. It sets out how the Government will make it easier for people to make healthier choices by offering them practical health to adopt healthier lifestyles.

3. The Government sees health improvement being found in people’s own ambition to live healthier lives and is under-pinned by three key principles:-

  • Informed choice for all.
  • Personalisation of support to make healthy choices.
  • Working in partnership to make health everyone’s business.
4. The document refers back not only to the Choosing Health white paper, but also to the Government’s Cross Cutting Spending Review on Health Inequalities . It re-emphasises the recognition in that document of the vital importance of co-delivery between local government and the NHS. The paper outlines current strategies and action and proposals for future action in relation to the six main priorities of the white paper, which are:
  • Tackling health inequalities.
  • Reducing the numbers of people who smoke.
  • Tackling obesity.
  • Improving sexual health.
  • Improving mental health and well-being.
  • Reducing harm and encouraging sensible drinking.
5. In addition, it is emphasised that the Government intends to take action across all departments on:-
  • helping children and young people to lead healthy lives,
  • promoting healthy and active life amongst older people.
6. The paper points out that local and central government have already agreed “shared priorities” where local government can make a real difference to communities and contribute to the Government’s national priorities.

Making it happen: nationally, locally and regionally

7. The section of the document under this heading provides a summary of the different partnerships, strategies, bodies and mechanisms at national, regional and local level which will be used to deliver the action identified under the white paper’s umbrella. At the local level, the document points out that local authorities and primary care trusts (PCTs) “share a responsibility” to improve health and well-being by:-
  • leading community partnerships,
  • delivering on national priorities and targets,
  • identifying local needs and achieving local targets,
  • commissioning and delivering services.
8. It also stresses that local authorities have a responsibility to ensure that effective local planning mechanisms are set up to drive improvements in health and well-being, for example, local strategic partnerships (LSPs), emerging children’s trust arrangements, crime and disorder reduction partnerships (CDRPs), drug and alcohol teams (DATs) and “Pathways to Work”. Much is also made of the potential of Local Area Agreements (LAAs) as “an important new planning process which brings health inequalities and health outcomes to the forefront of local community planning”.

9. Some more detail is given of new initiatives that were mentioned in the white paper, but it is still rather unclear what they will do. They are:
  • a network of “Health Champions” starting in local government “able to provide advice and support to new services”,
  • “people with experience and skills to provide consultancy, advice and peer review” to be recruited by the Improvement and Development Agency,
  • a new programme, Communities for Health, to pilot “new approaches to local action” in at least 12 areas from April 2005.
Delivery summaries

10 The first annex to the document summarises under each priority area:-
  • economic arguments for taking action,
  • “big wins”, ie key interventions and best practice held to be most likely to improve health,
  • the framework for cross-government action to improve health, including national and local targets, supporting strategies and measures of success,
  • Evidence of ‘big wins’.
11. Much of this annex refers to activity that is already under way, but as with the summary of delivery mechanisms referred to in the previous section, it is interesting to read an overview of action that cuts across government departments and policy areas, which clearly recognises that factors such as employment, education and housing are likely to make a significant contribution to health targets in the priority areas.

Delivery tables

12. The second annex to the document is the one that will be of most practical use to those engaged in improving health and tackling health inequalities on the ground. It references the Choosing Health commitments in considerable detail and outlines the “big wins” under the priority they relate to most closely. For each commitment, national, regional or local actions are suggested alongside the organization or body heading their implementation and their main delivery partners. Those responsible for monitoring and reporting on delivery are also listed.

13. It is not possible to summarise the delivery tables in a useful way. Much of the work in the delivery tables is already under way, but there are some apparently new initiatives. The following list give a flavour of some of these, but is not by any means comprehensive:-
  • revised guidance on health and neighbourhood renewal to be published early 2005,
  • an annual award scheme for local health champions,
  • a comprehensive and integrated prevention framework across all the areas covered by the National Service Frameworks,
  • development of a tool to assess local health and well-being that will help PCTs and local authorities jointly plan services and check on progress in reducing inequalities,
  • a new induction programme for all NHS staff,
  • from 2006, NHS Stop Smoking Services to be offered on the new “choose and book” system,
  • legislation to create new powers to ban retailers from selling tobacco products if they repeatedly flout the law, supported by a “communications programme for local authority enforcement”,
  • a comprehensive “care pathway” for obesity, providing a model for prevention and treatment,
  • tackling obesity to be included in the Quality and Outcomes Framework for GPs,
  • the Healthy Schools programme to target deprived schools, with a possible extension to nursery education,
  • more investment in school meals and better food in general in schools,
  • introduction and evaluation of chlamydia screening in retail pharmacies,
  • new models of physical healthcare for people with mental health problems,
  • from 2006, NHS-accredited health trainers giving support “to people who want it”,
  • private sector companies to develop new approaches to supporting “self-care for chronic conditions” linked to personal health plans,
  • a new healthy business assessment to be incorporated into the Investors in People standard,
  • by 2010, each PCT to have at least one qualified school nurse working with groups of primary schools,
  • health assessment to be built into all future legislation by including health as a component in regulatory impact assessment.
Recommendation

This report is for information.



Contact: Ian Mackenzie Tel: 0191 383 3506







Attachments


 Delivering 'Choosing Health' - 4 April.doc