North East Lincolnshire Council

Public Health bulletin – 12 to 16 August 2019

Public Health Update

Starting and Developing Well

Children in the Care of the Nottinghamshire Councils Investigation Report

This report focuses on children in the care of Nottingham City Council and Nottinghamshire County Council. The report specifically considers the nature and extent of allegations of sexual abuse of children in the care of the Councils, the response of the Councils, Nottinghamshire Police and the Crown Prosecution Service to those allegations, and the steps taken to protect children in care in light of them.  The investigation found the most institutions referred to in the report failed children who were sexually abused whilst in the care of the Councils, to a greater or lesser extent. These included elected members, senior managers, frontline social work and residential staff and foster carers within both of the Councils, and Nottinghamshire Police.  The Chair and Panel recommendation that other local authorities should consider the issues identified in this report and take action as appropriate to their own circumstances. Councils should assess the potential risks posed by current and former residential care staff and foster carers directly provided by them in relation to the sexual abuse of children. Any concerns which arise should be referred to the appropriate body or process, including the Disclosure and Barring Service, the relevant regulatory body, the local authority designated officer (LADO), the fostering panel and the police.  Report


Children’s Voices: Children’s Experiences of Instability in the Care System

This paper attempts to measures stability in the care system by looking at how often children in care move home, school or social worker over a year. The data used examined the contributions from interviews with 22 children in England who are in care or care leavers. The interviewees were aged between 9 and 21. These interviews explored two themes – the impact that instability had on these children, in their own words, and their perspectives on the factors that make instability harder or easier to deal with.  The children shared a common need for stability in their lives. These are resilient but vulnerable children often living away from their families or without family at all. Frequently moving home, school and changing social worker is an unsettling and at times upsetting experience. All of these children wanted to live in a home where they felt loved and secure, to go to a good school where their needs and experiences were understood and catered for, and to build long-lasting and stable relationships with social workers. The paper explains that it is still too often the case that many children growing up in care do not receive the stability and certainty they deserve.  Paper


Early Help Resource Pack

‘Early help’ covers a broad range of services and support that are brought in before any formal interventions to help children, young people and families achieve good outcomes. This resource pack is designed to help all councillors to better understand their own local offer and how they can look at the role of evidence in developing and improving early help services. ‘Early intervention’ is the part of early help that provides support to children and young people who are identified as being at risk of poor outcomes, such as mental health problems, poor academic attainment or involvement in crime or antisocial behaviour. This support is more intensive than, or additional to, the help available through universal early help services, targeting specific issues to prevent problems occurring, or to tackle them head-on before they get worse.  Resource Pack


Living Well

Towards Mental Health Equality: A Manifesto for the Next Prime Minister

It is seven years since the Health and Social Care Act said the NHS would give mental health parity with physical health – setting out an ambition that mental health should always be treated with the same priority and value as physical health. Since this time, there is no doubt we have seen significant progress in mental health policy.  The manifesto sets out five areas that the next Prime Minister must address in order to improve the lives of people with mental health problems and promote the mental health of the nation. By addressing these areas, the new Prime Minister will lead the way towards mental health equality and bring us closer to the ambition of a fair deal for mental health.  Manifesto


Money and Mental Health: Annual Review 2018/19

The Money and Mental Health Policy Institute is now established as the go-to authority on the toxic link between financial difficulty and mental health problems — and how it can be broken. The Institute’s work in the past year has focused on three areas where they think they can make the greatest impact, they are effective Services, fair consumer markets and Sustainable incomes.  This Annual Review is an opportunity to reflect on their achievements and highlights some of their plans they have for the coming year.  Annual Review


Ageing Well 

Going the Extra Step: A Compendium of Best Practice in Dementia Care

The Housing Learning and Improvement Network used this year’s Dementia Action Week 2019 to gather and share examples of extra care schemes and other housing related community services supporting people with dementia to develop meaningful relationships.  These relationships can reduce social isolation and loneliness. The examples provided range from informal arrangements supported by staff or other residents to formal service provision.  This compendium brings those examples together in one place, along with further examples of best practice that we received during Dementia Action Week. Colleagues also told us about the fantastic work they were doing as Dementia Friendly organisations, and we have included a section of those examples as well.  Compendium


Healthy Places

Public Health, Prevention and Health Improvement

The public health function in local authorities sits within the context of council’s wider responsibilities to promote the economic, social and environmental wellbeing of their areas and there are specific statutory responsibilities for improving the public’s health. Therefore, Elected Members have a vital role in driving whole-system change – ensuring prevention is embedded in all council functions, and promoting collaboration with partners in the NHS, the wider public sector, the voluntary, community and social enterprise sector and the business sector. This publication offers practical support for members to know if their council is doing all it can to deliver on prevention.  This framework recognises the wide ranging scope of public health endeavours and activities with recognition of the wider public health functions, role of place and locally led nature of public health systems.  Report


What can the NHS do to prevent and reduce health inequalities?

This is quite an old paper, but it helps us understand how the NHS could reduce the consequences of inequalities in health for individual patients, and narrow social differences in life expectancy. The paper help to explain that the principal causes of inequalities in health lie outside the health service and that policies to prevent health inequalities must address the wider social determinants of health, starting in childhood. However, it is insufficient to focus on the prevention of future inequalities in health. It is also necessary to reduce existing inequalities in health, and to prevent them getting wider. In practice, these approaches are complementary.  The paper suggests that if we are serious about addressing health inequalities, general practices needs to work more effectively with other professions, services and organisations, using the intrinsic contact, coverage, and continuity of general practice as the hub of local health systems. In general, the NHS has too many hubs and not enough integrated working with patients at the centre. The intrinsic features of general practice make it the natural hub of care for most patients. We do not have a blueprint that can be ‘switched on’; there needs to be a change in direction and an agenda requiring a long-term commitment to joint working in general practice and primary care.  For example, policies to encourage self-help and self-management often imply that this is a minimal intervention, which quickly transforms patient behaviour. The reality is that reversing years of low expectations can be a long haul, ‘initially face to face, eventually side by side’. In a study of 3000 GP consultations in the west of Scotland, an essential ingredient was patient perception of practitioner empathy.5 While practitioner empathy was often reported by patients without enablement, patient enablement was never reported without practitioner empathy. ‘Co-production’ implies long-term relationships between patients and practitioners who know each other well, building knowledge and confidence from a succession of challenges and problems.  Paper


Extra Care Housing – The Heart of the Community in Porthmadog

The scheme aims to promote tenants’ health and wellbeing as well as their independence and a superb opportunity to benefit from an independent lifestyle in their own apartment within a safe and supportive environment, with the added benefit of having a flexible 24 hour care service on site. The report suggests that the benefits for the tenants include, tenants have their own tenancy and their own front door and are supported to maintain their independence, couples have an opportunity to stay together and have a variety of social and communal activities are available, in addition to a diverse levels of care and support needs and benefit from the flexible, tailored services that are available on site.  One of the key lessons learnt during this development of the scheme is one of strong partnership with the Local Authority, including regular liaison with the local council members, which was a key contributing factor to the success of the project. The building is quite confined and is located at the heart of local businesses and homes, therefore regular meetings were needed with all the neighbours before and during the building work – communication was key.  Report


Health for Wealth: Building a Healthier Northern Powerhouse for UK Productivity

There is a well-known productivity gap between the Northern Powerhouse and the rest of England of £4 per person – per-hour. There is also a substantial health gap between the Northern Powerhouse and the rest of England, with average life expectancy 2 years lower in the North. Given that both health and productivity are lower in the Northern Powerhouse, the NHSA commissioned this report to understand the impact of poor health on productivity and to explore the opportunities for improving UK productivity by unlocking inclusive, green, regional growth through health improvement. The report shows the importance of health and the NHS for productivity in the Northern Powerhouse.  So, as it develops its post-Brexit industrial strategy, central government should pay particular attention to the importance of improving health in the Northern Powerhouse as a route to increased wealth.  Although the findings demonstrate the scale of the health and economic challenges facing the Northern Powerhouse, they also provide a blueprint to overcome the problem: in order to improve UK productivity, we need to improve health in the North.  Report

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