Although a formal committee of Brighton & Hove City Council, the Health & Wellbeing Board has a remit which includes matters relating to NHS Sussex, the Local Safeguarding Boards for Children and Adults and Healthwatch.
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Title:
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Joint Health and Wellbeing Strategy – Starting Well update
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Date of Meeting:
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March 2024 |
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Report of:
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Alistair Hill, Director of Public Health |
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Contact:
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Caroline Vass Bernadette Alves
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Tel: 07968 049106 |
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Email:
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Caroline.vass@brighton-hove.gov.uk Bernadette.alves@brighton-hove.gov.uk
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Wards Affected:
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All |
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FOR GENERAL RELEASE
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Executive Summary
Health and Wellbeing Boards have a duty to prepare a Joint Health and Wellbeing Strategy to describe the vision and strategic aims to address the population needs identified in the Joint Strategic Needs Assessment (JSNA).
The Brighton & Hove Health and Wellbeing Strategy 2019-30 was approved by the Board in March 2019. It sets out the vision: ‘Everyone in Brighton & Hove will have the best opportunity to live a healthy, happy and fulfilling life’.
To deliver the ambition, the strategy identifies a number of outcomes for local people that are reflected under four key areas or themes in the Strategy known as the ‘Wells’: starting well, living well, ageing well, and dying well.
The Health and Wellbeing Board has chosen to receive updates on a specific strategy theme at each Board meeting. This will enable the Board to receive a richer picture of health and social care activity in Brighton & Hove relating to the specific ‘Well’.
This paper aims to provide the Board with an overview of the Starting Well strategy focus.
The Board will be asked to note the Starting Well update and services in place to deliver the strategic aims.
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Glossary of Terms JHWS - Joint Health and Wellbeing Strategy JSNA - Joint Strategic Needs Assessment |
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1. Decisions, recommendations and any options
1.1 That the Board notes the current status of the Joint Health and Wellbeing Strategy outcome measures and activity relating to Starting Well.
2. Relevant information
The Joint Health and Wellbeing Strategy
2.1 Health and Wellbeing Boards have a duty to prepare a Joint Health and Wellbeing Strategy (JHWS) to describe the vision and strategic aims to address the population needs identified in the Joint Strategic Needs Assessment (JSNA).
2.2 The Brighton & Hove JHWS was approved by the Health and Wellbeing Board in March 2019. It is a high-level strategy that sets out the vision of the Board for improving health and wellbeing and reducing health inequalities in Brighton & Hove.
2.3 The JHWS was developed by a panel nominated from the Health and Wellbeing Board and, in addition to Board representative, included representation from voluntary and community services, Brighton & Hove Chamber of Commerce, and the Brighton & Hove economic partnership. The views of local people and organisations were instrumental in developing the strategy.
2.4 The vision of the Board as set out in the JHWS is that: ‘Everyone in Brighton & Hove will have the best opportunity to live a healthy, happy and fulfilling life’.
2.5 The strategy details the challenges and health and wellbeing needs faced by the city: the growing population, and the predicted change to the age profile with greater proportion of older people.
2.6 It considers the health and wellbeing needs of the population and the corresponding health and care services and focuses on improving health and wellbeing outcomes for local residents across the key stages of life reflected as the four ‘Wells’: starting well, living well, ageing well, and dying well.
2.7 The strategy provides a bridge between local health and care services’ plans and strategies which will impact on health and wellbeing, where partners across the city understand that we all have a part to play in ensuring that everyone in Brighton & Hove has the best opportunity to live a healthy, happy and fulfilling life.
Development of the outcome measures
2.8 The Board agreed an initial set of outcome measures against which to monitor the delivery and impact of the strategy. These were updated in July 2021 with minor amendments in October 2022.
2.9 The criteria for inclusion as an outcome measure are:
· where they are population level outcomes (not system or process indicators)
· where Brighton & Hove performs poorly against defined comparators
· where there are significant inequalities within the city, and
· now also where the Covid-19 pandemic response is likely to have had a significant impact eg: physical activity.
2.10 The outcome measures are predominantly taken from: the Public Health Outcomes Framework; NHS Outcomes Framework; Adult Social Care Outcomes Framework; and Office for Health Improvement and Disparities (OHID) Wider Impacts of Covid-19 dashboard.
Monitoring the outcome measures
2.11 The outcome measures are ideally presented to reflect the status and trend of the measure i.e.: whether the trend is worsening or improving.
2.12 For this report it is not possible to reflect trends for all indicators. This is due to the re-basing of Office of National Statistics (ONS) mid-year population estimates following the 2021 Census. The current data points use the new ONS population estimates to provide current rates, but the historic population data has not yet been updated to enable comparable assessments over time. When the historic population data are updated trend data will be reinstated.
2.13 Trends are shown where the denominator is not based upon an ONS population figure, for example for flu immunisation where the denominator is those eligible for immunisation recorded on GP practice records. Where cohorts are sampled, for example adult social care survey data, then the denominator data will not be affected by the ONS changes and so these outcomes will continue to show trend data.
Outcomes measures update
2.14 At the Health and Wellbeing Board in November 2022, the Board opted to receive updates on the JHWS outcome measures at each Board meeting, rather than as a single annual update. This would take the form of focussing on one of the ‘Wells’ at each meeting.
2.15 The rationale for this was to enable the inclusion of a brief narrative of the specific ‘Well’ theme to provide a more integrated city-wide understanding of the outcomes and the actions in place. This will provide assurance to the Board that local programmes such as the Shared Delivery Plan and other local services are addressing the outcomes where there is the greatest need for improvement.
2.16 This report reflects the outcome measures and activity updates for the Strategy area ‘Starting Well’. The table at paragraph 2.18 below summarises the current status of Starting Well outcomes. The table of indicators identifies where they are significantly better than, worse than, or similar to England and compares Brighton and Hove performance with our ‘CIPFA’ neighbours (local authorities which are statistically similar in their characteristics to Brighton & Hove).
2.17 The Starting Well outcome measures (including the desired direction of travel) are:
· An increase in vaccination coverage for MMR vaccine: 2 doses at 5 years
· An increase in the percentage of children achieving a good level of development at 2 to and a half years
· An increase in the percentage of children achieving a good level of development at the end of school reception
· An increase in the percentage of children with free school meal status achieving a good level of development at the end of reception
· An increase in the average attainment 8 score (state funded schools) – ‘attainment 8’ measures the achievement of a pupil across 8 qualifications at the end of Key Stage 4 (aged 15-16 yrs)
· An increase in the average attainment 8 score of children in care
· A reduction in the Year six (10-11yrs) prevalence of children who are overweight
· An increase in the percentage of physically active children and young people (aged 5-16 years)
· A reduction in hospital admissions as a result of self-harm (10-24 years)
In addition to the national indicators, Brighton & Hove City Council undertake other local surveys to understand better the health and wellbeing of the population. One of these is the Safe and Well at School Survey (SAWSS) which is run every two years across all phases of school and college in the city. The latest survey was undertaken Nov/Dec 2023.
See over the page for a summary of overall trends