PURPOSE

This paper considers the current issues relating to the health and well being of Braunstone residents and proposes a strategic approach for tackling them. A concerted and sustained effort will be required to achieve long term results. It is proposed that these issues be reviewed on an annual basis.

CURRENT POSITION

Health fundamentally affects all aspects of our lives and can impact on the lives of our families and friends. Poor health is cited as the major barrier for 25% of those who were unemployed at the start of the NDC programme. Statistical evidence highlights five core issues:

• Conceiving early - Braunstone has the third highest conception rate amongst teenage women in the Leicester. Teenage mothers are less likely to finish their education, less likely to find a good job and more likely to bring up their child alone and in poverty. The infant mortality rate for babies born to teenage mothers is 60% higher than for older mothers. Between1995 and1999 the ratio of teenage pregnancies increased from 90.6 to 93.6 per 1,000 under 18 year olds. Reversing this trend is a major challenge.
• Starting badly - Statistical evidence suggests that babies with low birth weight are less likely to thrive physically and educationally and are more likely to suffer ill health earlier and more frequently. Low birth weight is associated with smoking during pregnancy. Since 1998 the percentage of low birth weights for Braunstone has reduced showing signs of improvement.
• Accessing services - At the start of the NDC programme 20% of respondents to the household survey found it difficult to get to their doctor. Take up of preventative treatments such as smear tests and immunisation is relatively low across the area. Resident surveys undertaken by the Sport Action Zone Team reveal low levels of participation in sport and physical activity compared to the city and national average.
• Suffering ill health - Currently more residents of Braunstone have limiting long term illness (16%) than of those of Leicester (13%) or nationally (12%). There is also some evidence of higher than average prescriptions for anti depressant drugs and high numbers of referrals to mental health services across the area. However, more accurate research in needed to ascertain the scale of the issue and the most effective way of addressing it.
• Dying younger - Braunstone residents have a higher standardised mortality ratio than for the Leicester by a factor of 73.4%. For residents under 75 years this ratio is over twice that of the City and nationally. Whilst there have been improvements in the number of deaths caused by heart diseases, the number of people dying of cancer have increased.

The accumulative impact of all of the above factors is that Braunstone residents die much younger than people elsewhere. This situation is unacceptable and must be addressed.

OPPORTUNITIES

It is accepted that the best way of improving health is improving access to primary care services. The new Braunstone Health and Social Care Centre scheduled to open early in 2005 provides a major opportunity to increase local access and improve local services. The estimated £250k annual income generated from the Centre will provide more opportunities for community development. In addition to the Braunstone Health and Social Care Centre there will also be two new primary care centres just outside of the NDA on the former Roxy Cinema site and at Westcotes. It is anticipated that within little more than two years 80% of residents will be able to access modern services. It is crucial that the key agencies work together to bring about a step change in the standard of services available to Braunstone residents and raise their understanding and practice in good health care.

EVIDENCE

The statistical sources used for the targets in this strategy may change as a result of new ward boundaries and new locations of the primary care centres. There is a commitment that equivalent statistics will be provided to ensure compatibility of evidence over time should changes be needed.

VISION

For Braunstone residents to live longer and healthier lives.

OUTCOMES

OBJECTIVES

Each of these outcomes is underpinned by a series of objectives that can be measured during the period of the delivery plan.

STRATEGIC FRAMEWORK

The following framework is proposed for tackling the core issues systematically:

• Partnership working - to align effort with key service providers especially the: PCT, BCA, DAATs, LCC, LIFT, LPT, Resolution, SAZ and Sure Start and establish strong links with the primary care centres.
• Action Research - to fill key knowledge gaps especially the incidence of mental illness and identify target areas/markets for those likely to be most receptive to intervention as well identifying the needs of those with acute psychosis.
• Teenage pregnancies - to increase awareness and understanding of the long term implications of young pregnancies and widen accessibility to preventive measures.
• Early years support - to enhance support for pre and primary school aged children and their parents through the Sure Start programme.
• Prevention - to provide incentives, intervention measures and effectively marketing of preventative actions to promote active life styles and immunisation programmes
• Service enhancement - to continuously assess the local mental and physical social and health care needs, identifying gaps and effective ways services for filling them.
• Integrated systems and services - to support the integration of mainstream people centred services as the basis for creating a modernised service focussed on the new Braunstone Health and Social Care Centre.
• Strategic projects - to identify viable projects capable of achieving significant results through their profile, community networks or geographic location.
• Opportunity orientated approach - to encourage innovation from local providers and 'sub communities' and evaluate its impact - sharing good practice and lessons learnt.

NEXT STEPS

The next phase in developing this strategy include:

• Action Plan - that will identify a lead agency, key milestones and resources for implementing each element of the strategic framework with the involvement of the key partners.
• Programme Review - BCA is already committed to funding a number of key projects that can help contribute to this strategy. It is important that the value of these projects is reviewed and remaining gaps identified that need to be filled to achieve the strategy objectives.
  Both the preparation of the Health Action Plan and the Programme Review will be complete by the end of the year.

BCA'S ROLE

The BCA has a key role in developing this strategy in:

• Leading and co-ordinating - to champion the need for good health care and encourage all of the partners to work collaboratively to bring about sustained improvement.
• Supporting partners - to assist the partner agencies especially the PCT, LCC and LPT improve provision and delivery of local services.
• Assessing Needs and consulting - to identify gaps and projects for filling them in consultation with the partner agencies and local community.

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