NHS Herefordshire to tackle deep-rooted causes of ill health

NHS Herefordshire is to focus on removing health inequalities in the county, especially among the young, older people and vulnerable members of the community.

Clinicians, voluntary organisations and community groups attended a workshop and discussions (Thursday 21 January 2010) to agree a radical new strategy – called Healthy Herefordshire - to tackle the deep-rooted causes of ill health.

After widespread consultation, surveys, assessments and research, NHS Herefordshire has set out to stakeholders its understanding of the needs, views and wishes of local people. While the population as a whole lives longer than average and is comparatively healthy, nearly one in eight people have poorer quality of life, health and wellbeing.

NHS Herefordshire, working closely with Herefordshire Council and other partners, has set the challenge over the next four years of improving the health and life chances of two groups in particular. These are young people (affected by poverty, poor diet, lack of exercise, smoking, drinking and taking risks with sexual behaviour), and the increasingly ageing population (who need more care and support to live with dignity in their own homes, often in remote rural areas).

All this needs to be achieved against a background of financial constraints on public services, likely to be announced by government in the near future.

Ambitious targets include closing the gap between people’s health in deprived and affluent areas, as well as reducing premature deaths from cancer by 35 per cent, from heart disease by 50 per cent and from stroke by 40 per cent. The trust also wants to cut by half the levels of childhood obesity, road traffic deaths and alcohol-related hospital admissions, as well as increase by four fold the number of people who quit smoking.

“We need to achieve more, for more people, with fewer resources. So we have embarked upon a radical approach to how we plan, purchase and provide health and social care”, said Chris Bull, chief executive of NHS Herefordshire and Herefordshire Council.

“We have to streamline our administrative costs and concentrate on ensuring we have better quality services that provide a better experience for our customers and patients, and, above all, better outcomes for the people who need them most”.

“We have already laid many of the foundations needed to deliver our strategy successfully”, said Joanna Newton, chair of NHS Herefordshire, “and we are making progress on many of these targets.

“However, the primary care trust cannot do this alone, and to succeed we will need the continued close partnership working with the council, housing groups, the police, the voluntary sector and community groups to reverse the underlying causes leading to poor health and wellbeing”.

The new strategy says there is a firm commitment for goals and priorities that can be measured within the primary care trust, the council and with partners and providers of many health and care services. A new transition board is developing a new approach to how services can be provided and sustained for the future. And the way these services are designed and purchased is joined up around the needs of individual patients across the council and the trust.

However, the county is facing unprecedented demand to meet the needs of people with dementia, as numbers of people over 85 are forecast to double by 2026, and will need to improve access to services within local communities, especially in sparsely populated rural areas, so that care and support can be provided at or close to home. The aim is to maximise people’s independence by giving them more choice and control over their care.

Multiple deprivation and premature death in some communities, especially parts of Hereford, Leominster, Bromyard and, newly identified this year, in small rural pockets, is providing a fresh focus for resources.

The draft strategy for 2010 to 2014 will go to the primary care trust board later this month and, if accepted, will then go to the West Midlands Strategic Health Authority for approval. A copy of the strategy will be published on the primary care trust’s website www.herefordshire.nhs.uk