Key Interventions - The 'Big Wins'

The 2004 document National Standards, Local Action summarises NHS and wider interventions that will have the greatest impact in achieving the mortality targets:

“NHS interventions which will result in the largest reductions in death rates from heart disease and stroke by 2010 are the management of hypertension, high cholesterol and diabetes within primary care, both for those with established disease and at high risk. Positive effects will also be achieved by reductions in smoking, and in ‘call to needle times for thrombolysis”.

“NHS interventions which will result in the largest reductions in death rates from cancer by 2010 are earlier detection, shorter waiting times for diagnosis and treatment along the care pathway and optimal treatment and support for people diagnosed as having cancers... Reductions in smoking rates will also have a longer term impact”.

“Reducing mortality from suicide involves tackling risk factors for those with deteriorating mental health; Such factors include unemployment and social exclusion.”

A later document summarises key NHS interventions to support the achievement of the national health inequalities target.  Focusing on disadvantaged groups and areas, these are :

Life expectancy

• Ensuring that prevention and treatment services for cancer and Coronary Heart Disease (CHD) reach those in greatest need or with poorest health outcomes, including disadvantaged groups and ethnic groups with high prevalence. For CHD in particular reducing hypertension and increasing prescription of statins

 

• Increasing smoking cessation

 

• Reducing excess winter deaths, including by increasing influenza immunisation  

Infant Mortality

• Reducing smoking in pregnancy

 

• Improving nutrition in women of childbearing age

 

• Reducing teenage pregnancy

 

• Increasing breast-feeding initiation and duration rates

 

• Providing effective ante-natal care (including screening and immunisation) and promoting early ante-natal booking

 

• Improving the quality of midwifery, obstetric and neonatal services

 

• Effective education about ways to promote health, eg immunisation

 

• Provision of high quality family support (eg through health visitors)

All of these interventions need to be underpinned by the following principles:

• Improving access to, and quality of, services for currently under-served areas and groups, particularly primary care services

 

• Targeting service provision to ensure high quality services are delivered relevant to need

 

• Ensuring workforce are targeted more intensively at deprived areas and groups

 

• Ensuring services are culturally sensitive

 

• Improving translation, advocacy and interpretation services

 

• Ensuring availability of appropriately skilled public health practitioner workforce to undertake preventive work with disadvantaged groups 

Other NHS interventions

Other key NHS interventions to support narrowing of health inequalities more broadly include:

• Identification of local health inequalities, including improving data quality and collections to identify groups or areas with high health need/poor health outcomes

 

• Providing local leadership by developing and sustaining close partnership working, identifying a single set of local priorities and taking concerted action with partners to tackle health inequalities, including influencing community strategies

 

• Contributing to the development of the Local Strategic Partnership to realise its potential for health improvement and tackling inequalities

 

• Supporting Sure Start, contributing to regeneration and leading the development and delivery of the health domain of Local Neighbourhood Renewal Strategies in the most deprived areas.

 

• Making the NHS a power for regeneration to stimulate local economies and enhance the employability of disadvantaged groups, through its local employment and purchasing procedures and capital programmes.

Blackburn with Darwen Health and Wellbeing Strategy

In Blackburn with Darwen we have been working with partners on our priorities for action, to meet national and local targets for Health and Wellbeing.  These are encapsulated in our Health and Wellbeing Strategy; you can find out more by visiting www.healthandwellbeing.bwdpct.nhs.uk/