Matthew Ashton, Director of Public Health for Knowsley & Sefton, presented at the Liverpool City Region Health Summit on improving health and wellbeing in the region. He discussed how healthy populations are happier, more economically prosperous, and cost less for healthcare services. The presentation outlined priorities like giving every child the best start in life and creating a fair employment and standard of living for all. It recognized existing efforts across the NHS and local governments, but noted the complex challenges including acting at a large scale and pace with limited resources. Ashton proposed developing an LCR Health & Wellbeing Plan to tie together current activities, set shared ambitions and priorities, and put citizens at the heart of improving community health.
Matthew Ashton: Improving Health and Wellbeing in our Region
1. Improving Health and
Wellbeing in Our Region
Matthew Ashton, Director of Public Health,
Knowsley & Sefton
Liverpool City Region Health Summit
12TH OCTOBER 2016
2. Why is good health a good thing?
• Healthy people are happier people
and happier people are healthier
Happy
People
• Healthy populations are more
economically prosperous
populations, and vice versa.
Contribute
More
• Reduced expenditure on costly
services and increased productivity
Cost
Less
8. “It is not in the stars
to hold our destiny
but in ourselves”
William Shakespeare
9. Fair Society, Healthy Lives, 2008
• Give every child the best start in life
• Maximise capabilities and control over their
own lives
• Fair employment and good work for all
• Healthy standard of living for all
• Healthy and sustainable places and
communities
• Strengthen the role and impact of ill-health
prevention
10. Transforming health & wellbeing, 2013
• Best start in life
• Helping people find good jobs and stay in work
• Active and safer travel
• Warmer & safer homes
• Access to green and open spaces and the role of
leisure services
• Strong communities, wellbeing and readiness
• Public protection and regulatory services
• Health and spatial planning
11. Lots already happening…
• Case for change – adults
• Case for change – children & young people
• NHS Sustainability and Transformation Plans
(STP)
• Increased focus on prevention and early
intervention across the system
• Learning from other places e.g. Manchester
12. Barriers?
• Complex
– Health and wellbeing
– System and structures
– Acting at scale and pace
– Common language / narrative
– Resources?
• Doing nothing is not an option!
13.
14. LCR Health & Wellbeing Plan?
• Opportunity to improve health & wellbeing in LCR
• LCR plan, not an organisational plan!
• Ties all existing activity together
• Allows for ambition and priorities to be stated
• Owned by the system, collectively and
individually
• People / Citizens at the heart of everything we
do!
But recognition of the importance of good health isnt a new thing. Over two thousand years ago the roman philosopher and politician Cicero was talking about the welfare of the people being the supreme law. “salus populi suprema lex esto”, and this motto appears on a number of coat of arms up and down the country, including salford and lewisham.
And as cllr moorhead mentioned, the creation of the national health service (note, health, not national ill health service), was part of a series of measures designed to help the government actively support the health and wellbeing of its citizens. And of course, health and wellbeing has improved a lot over the last 70 years.
When nhs was formed, average national life expectancy for women was 71, and for men was 66. now its 83 and 79, so a significant increase.
However, as you know, life expectancy varies substantially according to deprivation. Average Life expectancy in merseyside is 2 to 3 years lower than national levels, and varies substantially within merseyside depending on where you live. For example, its 73 in bootle, and 14 miles up the road in ainsdale its 85. and obviously similar patterns exist in wirral, liverpool, halton, st helens, and knowsley.
healthy life expectancy is a different story, people now live longer, but not always in good health. Healthy life expectancy is only 59 for men, and 61 for women, meaning that on average people are living around 20 years in poor health. And how sure are we that this is always the best option for people, and what choice do people actually have in this?
Going forward, we will have more people living longer and in poor health, putting further pressure on our health and care system.
There are also other non traditional data sources which can give a good insight into levels of health and wellbeing. For example, Recent data on happiness from the governments wellbeing survey, has shown sefton to be the happiest place in merseyside, and knowsley having the biggest increase in happiness, with scores of 7.3 and 7.2 out of 10 respectively. However this is still below the national average of 7.5. And within these figures, approx 1 in 7 people scored their happiness levels as being between 0 and 4, some of the highest proportions giving a low score in the uk.
But what determines health outcomes? There is lots of research on this, that all say similar things, but for the purpose of illustration I will use harris roxas from 2014, which concluded that 10-25% of health outcomes were determined by genetics, 15-30% from health services, 20-40% from lifestyle factors, 5-15% from place and the environment, and 20-30% were as a result of education, employment, amount of money people have, and so on.
So clearly, a very complex picture, and the solutions therefore need to be a whole system approach.
Seeing as we are in knowsley, the home of shakespeare north, and with it being the 400th anniversary of his death, it feels like a quote may be appropriate. It is not in the stars to hold our destiny, but in ourselves. (from julius caesar).
And its also not as if we are starting from a blank piece of paper here. Loads of key policy statements over the last couple of years, including ….
Health and social care act 2012, care act 2014, 5 year forward view, mental health 5 year forward view, children and families act 2014, crisis care concordat, better care fund, and so on.
And we also have a good understanding of the evidence base, what works, what actually makes a difference to improve health and wellbeing
For example, Marmot review into health inequalities in 2008, 6 key policy objectives that would have the biggest impact on reducing health inequalities…
Kings fund, improving the publics health, 2013, gave 8 priority areas for local authorities and their partners to focus on…
As cllr moorhead said, we have the workforce, we have the data and the evidence, and we have the general public behind us. However…
