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MORAYS JOINT HEALTH IMPROVEMENT PLAN

By Howard Williams,2014-05-20 12:32
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31 Mar 2004The planning structure is at present focused around the Mental Health Framework Group, feeding into the Joint Community Care Planning

    Joint Health Improvement Plan

    2004-2007

    The Moray Collective‟s agreed Statement of Intent is:

‘The Moray Collective is required to establish arrangements to ensure all parts of health and social

    systems work in an integrated manner. It will do this by planning and prioritising across boundaries in a

    consistent manner to performance manage the system and achieve client/patient care to national

    standards. The Collective will seek to improve health, promote social inclusion and enhance the

    client/patient experience in Moray’.

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    INTRODUCTION ............................................................................................................................................. 5 THIS PLAN ....................................................................................................................................................... 5 A PROFILE OF MORAY ................................................................................................................................. 6 WHAT DOES THE EVIDENCE SHOW FOR MORAY? ............................................................................................. 7

    Older People ............................................................................................................................................... 7

    Rural Poverty .............................................................................................................................................. 7

    Coronary Heart Disease, Cancer and Stroke ................................................................................................ 7

    Mental Health .............................................................................................................................................. 7

    Accidents ..................................................................................................................................................... 7

    Drugs .......................................................................................................................................................... 8

    Drug Misuse in Young People ...................................................................................................................... 8

    Alcohol ........................................................................................................................................................ 8

    Food & Nutrition ......................................................................................................................................... 8

    Sexual Health .............................................................................................................................................. 8

    Oral Health ................................................................................................................................................. 8

    Physical Activity .......................................................................................................................................... 8

    Tobacco ....................................................................................................................................................... 8 THE VISION FOR MORAY ............................................................................................................................ 9 PLANS SUPPORTING HEALTH IMPROVEMENT IN MORAY .............................................................. 10

    WHY SHOULD HEALTH BE A PRIORITY FOR US ALL? ....................................................................... 11

    WHAT IS HEALTH? .................................................................................................................................... 11 WHO IS INVOLVED? .................................................................................................................................... 12 JOINT FUTURES .............................................................................................................................................. 13

    Vision, Principles and Values ..................................................................................................................... 13 TRANSLATING THE VISION INTO ACTION ........................................................................................... 14 PRIORITIES FOR ACTION .......................................................................................................................... 15 HEALTH IMPROVEMENT.................................................................................................................................. 15 HEALTH IMPROVEMENT STRATEGIC ACTIONS ................................................................................... 15

    COLLECTIVE PRIORITIES ................................................................................................................................. 19 CLINICAL PRIORITIES ..................................................................................................................................... 20

    Coronary Heart Disease and Stroke ........................................................................................................... 20

    Cancer....................................................................................................................................................... 21

    Mental Health ............................................................................................................................................ 22

    Older People ............................................................................................................................................. 25

    Delayed Discharges ................................................................................................................................... 26 KEY SERVICE OBJECTIVES .............................................................................................................................. 26 PLANNING FOR A PROGRESSIVE HEALTH SYSTEM ........................................................................... 28

    CAPITAL PROJECTS.................................................................................................................................... 30 PUBLIC INVOLVEMENT ............................................................................................................................. 33 STAFF CAPACITY, CAPABILITY AND COMMITMENT ........................................................................ 34

    HEALTH INTELLIGENCE AND E-HEALTH ............................................................................................. 35 PERFORMANCE ........................................................................................................................................... 35

    Action ........................................................................................................................................................ 36 RESOURCES .................................................................................................................................................. 36 DRAFT JHIP 25/08/03 2

     HEALTH & SOCIAL CARE - PLANNING MAPHEALTH & SOCIAL CARE - PLANNING MAPPLANNING GROUPS

     Community Planning Co-ordinatingNHS Grampian LocalMoray Community Plan GroupHealth PlanMike Moray Elaine B Local HousingMoray Joint Health ImprovementJoint Management GroupStrategyPlanBruce Archibald, Elaine B

    For Moray‟s Primary Care ServiceChildren/Children‟s ServiceBruce ArchibaldPlan PlanHealth Improvement ActionJoint Health Improvement PlanStrategy GroupMike M, Elaine B Community Care ActionBruce Archibald Plan

     Framework GroupMental Health Mgt Christie

    Older People Strategy GroupOlder PeopleSally Chisholm, Rieta Vilar

    Same as You Group Anne SleeLearning Disability

    Physical & SensoryCharles McKerron, Lesley Graham

    Carers ForumCarers StrategyCaroline Brain

    Moray DAATDrug & AlcoholTish Carter

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INTRODUCTION

This is a time of unprecedented opportunity for a conscious and co-ordinated drive for health

    improvement in Scotland. Local Authorities and NHS Boards have the prime potential, with

    Community Planning partners, to lead this drive, with a new, sustained emphasis on tackling

    the range of factors which influence the health of the population as a whole and contribute to

    the inequalities in health. Crucially this involves working with partner agencies and the public

    to understand and maximise their contributions to securing population health improvement.

The Scottish Executive view health improvement planning as integral to the Community

    Planning process and have therefore given the responsibility for developing health

    improvement plans to Community Planning Partnerships. In addition, the Scottish Executive‟s

    over-arching Social Justice Policy sets out a programme to tackle poverty and injustice. At its

    heart is the commitment to build strong and inclusive communities and reduce health

    inequalities. The Social Justice Targets provides us with a number of challenges to improve

    the health of the most disadvantaged of our citizens.

This Plan

Draws on the work of the Joint Health Implementation Strategy Group and seeks to capture

    the key strategic priorities setting down the approaches and methods to be taken to address

    them.

    The diagram on page 3, sets this plan within the familt of joint plans within Moray, it carries

    foward the social and health care thenes of the Community Plan and informs the more specific

    action plans for communtiy care and health improvementand will operate from January 2004

    to December 2007.

The development of a Joint Health Improvement Plan gives us the opportunity to review our

    current work, both core and targeted, in terms of its potential for health improvement and

    secure the commitment and enthusiasm of partner organisations and networks. It also gives

    us the opportunity to agree the priority areas for further work or a different approach, and

    identify any areas where we should disengage and work with individual and communities to

    agree joint priorities for future work. We need a framework to help us assess what we are

    currently doing and to decide what else we should do.

The Plan will

    ? Set the scene for building healthy

    communities in Moray and outlines national

    and local priorities for improving health and

    the role that partners can play.

    ? Identify what has been achieved so far and in

    setting key areas of activity gives a

    framework for action over the next three

    years.

    ? Include Action Plans that will be developed

    during 2003 and beyond with partners with

    detailed targets, monitoring and who will be

    involved in taking the actions forward.

Improving people‟s health does not happen quickly. It requires a long-term and sustained

    approach. Shared objectives and genuine partnership working will enable our local priorities

    to be developed and implemented successfully.

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A PROFILE OF MORAY

    Moray is an attractive place to live. It includes fishing villages in the north such as Buckie and Lossiemouth; the agriculturally rich Laich of Moray and the main town of Elgin; the Spey Valley, home to world renowned food processors such as Walkers and Baxters; and the highlands of the south which form part of the Cairngorm mountain range.

    70 percent of the Moray is open countryside with a further 25 percent made up of woodlands. The area to the south around Tomintoul will form part of the Cairngorms National Park proposed by the Government.

    Most people (almost 60%) live in the main towns of Elgin, Buckie, Forres, Keith and Lossiemouth. The overall population density is low at 38 persons per square kilometre (compared to 66 in Scotland). There is a clear difference between the populated, rich agricultural land in the Laich of Moray along the northern coast and the sparsely populated upland areas to the south. The population of around 86,000 is expected to increase gradually to 89,000 over the period to 2011.

    Just over 40,000 residents are economically active in Moray and unemployment levels are low. 21,200 of those are employed in the service industry. However, according to the New Earnings Survey 2001, Moray has the lowest gross average weekly earnings in Scotland at ?327.80 per week for full time employees. In comparison with our neighbours, the average weekly earning is ?476.80 for Aberdeen, ?370.10 for Aberdeenshire and ?374.50 for Highland. Despite the low earnings over half (55.3%) of households are owner occupied which is higher than for Scotland (52.1%).

    Only 12% of families are lone parent families, which is below the Scottish average of 15.9%. 17% of the population have connections with the two large RAF bases in Lossiemouth and Kinloss. 95% of the population is white with a range of the other ethnic groups making up the remaining 5%. 82% of the population was born in Scotland.

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What Does The Evidence Show For Moray?

Moray’s Population

    The population of Moray is 86,940. This is projected to increase by 1% by 2012. Unusually, there are more young people and more older people in Moray than the Scottish average. The global trend of an ageing population, is also reflected in Moray and by 2012 the population of those aged over 75 is projected to increase by 25%, which will have implications for health

    and care provision for that age group.

Older People

    Significant demographic changes, specifically with age distribution, are predicted for Moray ? Children under 15 will decrease by 18% (16026 to 13150) compared with City decrease by

    22% and Shire decrease by 15%

    ? People aged 65 and over will increase by 12% (14006 to 15719) compared with City

    increase by 4% and Shire increase by 25%

    ? People aged 75 and over will increase by 18% (6151 to 7275) compared with City increase

    by 9% and Shire increase by 21%

    ? People aged 85 and over will increase by 31% (1440 to 1880) compared with City increase

    by 19% and Shire increase by 36%

Generally

    ? People over 65 account for c16% of UK population but just over one third of spending on

    HCHS

    ? Evidence that over 65s will use health services more (additional 1 consultation pa per GP)

    through growing intolerance of minor disorders and by being proactive in managing

    individual health.

Rural Poverty

    As stated earlier Moray has the lowest gross average weekly earnings in Scotland. Coupled with high transport costs, fewer employment opportunities and other rural issues, a low wage economy has a negative impact on peoples‟ lifestyles in Moray. Moray is an area of some affluence, but also has communities of deprivation, particularly in rural settings.

Coronary Heart Disease, Cancer and Stroke

     In 1999, 588 people died in Moray from either Coronary Heart Disease, Cancer or Stroke, which accounts for almost two thirds of all deaths in the area. Since 1995, more people are dying in Moray from these illnesses, and a higher rate than in Grampian and Scotland as a whole.

Mental Health

    In 1999, Moray had the highest rate of admissions to mental health hospital in Grampian. 181 people were admitted to a psychiatric unit, a ratio of 2 people per 1000 population. Poor mental health can also relate to poor physical health.

    Accidents Road traffic accidents are high in Moray. During 1997-99, a total of 560 accidents involving injury occurred in Moray, resulting in 815 casualties and fatalities. 28 people were killed; 144 people were seriously injured; 643 people were slightly injured. 116 of these casualties were children in Moray, 17 of whom were either killed or seriously injured. Children, older people, pedestrians, cyclists, motorcyclists and young drivers have been identified as being particularly vulnerable to being injured in road accidents in Moray. Accidents involving young drivers (aged 17-25) accounted for 37% of road accidents in Moray, resulting in 243 casualties. Over 70% of these were male drivers.

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Drugs

    In 1999, Grampian had the second highest number of drug related deaths in Scotland (42 deaths), behind Greater Glasgow (112 deaths). 34% of drug users in Moray were aged between 15 and 24 and 35% were aged between 25 and 29 inclusive. The number of injecting drug users living in Moray in 1999 is approximately 30 to 80.

Drug Misuse in Young People

    Fewer young people in Moray had been offered drugs (40%) compared with 45% in 1995 which suggests that the number of drug users is decreasing. Only 25% of those surveyed had actually taken a drug compared with 30% in 1995.

    Alcohol In 1998, 19% of Moray adults were drinking more than the recommended levels of alcohol. Men drank considerably more alcohol 1-2 days a week (32%) or 3-5 days a week (17%) than women (24% and 9%).

Food & Nutrition

    A high percentage of men (33%) in Moray eat an unhealthy diet, compared with 17% of women. 47% of women eat a very healthy diet. Older people in Moray tend to have a healthier diet than younger people.

Sexual Health

    In 1999 there were 6 pregnancies for every 1000 young women aged 13-15. The rate has not improved over the previous five years. For 16-19 year olds, the number of pregnancies has decreased by 20% since 1995. In 1999 there were 52 pregnancies for every 1000 young women aged 16 to 19, compared with 65 in 1997. A drop in service opened in June 2002 in Moray to address these and other lifestyle issues for young people.

    Oral Health Moray is the only naturally fluoridated area in Scotland, and has 87% of 5 year olds with no dental decay compared to 36% in other areas. A national target was set for 2000 stating that 60% of 5 year olds should have no cavities, fillings or extractions. Moray is short of this target by 4.7%. There is a severe shortage of dentists in Moray that needs to be addressed to achieve optimum health in this area.

Physical Activity

    Regular physical activity is defined as taking exercise, sport, or heavy work 2-3 times a week or walking for at least 20 minutes on four or more consecutive days a week. More than half of Moray‟s adult population (55%) take no physical activity or less that the average, as defined above. 45% are physically active on a regular basis. School sports co-ordinators are to be appointed for every secondary school in Moray and Scotland to increase school sports. Children in Moray exercise less than the Grampian average.

    Tobacco 29% of adults in Moray are smokers. Smoking is the largest single cause of premature death in Scotland, responsible for 1 in every 6 deaths. in 1999, 25% of pregnant women smoked.

    Well-Being As for other areas of Grampian, Moray residents found the health of others (35%), stress (35%), and family (31%) as the most common issues which caused problems in their lives. 14% of people in Moray felt finding a job caused problems in their lives.

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THE VISION FOR MORAY

The people of Moray deserve the best health possible. To make our contribution to this, we

    need to realise our vision of an integrated health system, working together to ensure that we:

Develop services to maximise opportunities for health gain

     Sponsor and support the promotion of health

     Influence and work effectively across all agencies to improve the wider determinants of

    health.

The shared vision for Moray which has been brought together in the Moray Community Plan,

    produced in 2001, is -

    “to increase the quality of life for all sections of the community and to develop the well-being of communities within Moray

    Overarching Theme Overarching Theme Overarching Theme

    Community Social Inclusion Sustainable

    Involvement Development

    Strategic Theme Strategic Theme Strategic Theme Strategic Theme Strategic Theme

    Involving the Providing Encouraging Encouraging Responding community quality co-safe, healthy economic positively to

    ordiated and caring development sustainable

    services communties development

Whilst all of the above aspirations impact on health, the Community Plan theme of developing

    safe, healthy and caring communities provides a focus for health and health improvement. It

    is therefore through this theme that the joint health improvement plan will be developed and

    driven.

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PLANS SUPPORTING HEALTH IMPROVEMENT IN MORAY

There are many important initiatives already making a positive impact on health and much

    good joint working in evidence. A number of the health issues identified in this document are

    being ably dealt with by other planning processes and groups. For example, home safety and

    accident reduction issues are being taken forward by the Community Safety Partnership and

    its sub groups. We have to ensure that the health improvement agenda appropriately

    influences and shapes these other initiatives. There are already strong links and work is

    ongoing to develop shared objectives and actions with the potential for many future joint

    initiatives. The Joint Health Improvement Plan is interrelated with many planning processes

    that include:

Further details of joint actions within these plans and with those in JHIP will be added prior to

    completion of Final Draft

    ? The Moray Children’s Services Plan ? Moray Social Inclusion Partnership

    2002 Initiative

    ? Moray LHCC Summary Action Plan ? The Moray Community Economic

    Development Strategy 2001/2

    ? The Moray Framework for Mental Health ? Moray Local Housing Strategy

    1998-2004

     ? Moray Community Care Strategic Plan ? Network Plans eg Cancer

     ? Moray Strategy for Safer Communities ? Moray Community Learning Strategy

     ? Joint Futures ? Moray Strategy for Services for Older

    People ? Agenda 21

    ? Moray Carers Strategy ? Domestic Abuse Forum Action Plan

    ? Moray Homelessness Strategy ? Local Health Plan

? Moray Drug and Alcohol Action Team

    Strategy

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