Boston's Health And Wellbeing Strategy 2017-2020 - Borough Of Boston

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APPENDIX ABoston’s Health andWellbeingStrategy 2017-20201

INTRODUCTIONWhile people are living longerit is often with poorer mentalwellbeing and increasingly complexhealth needs, many of which arepreventable.This strategy concentrates onearly intervention, self care andprevention of ill health. It focuses ona manageable number of key issueswhere a more joined-up approachcan make a real difference and is acontinuation of the work we havefocused on over the last three years.Examples of projects delivered byHealth and Wellbeing partners andlocal clubs over the last three yearsinclude: Launch of Boston park run andBoston Marathon Designation of 10 smokefree playareas Expansion of Boston health walksprogramme Development of Boston Body Hub Piloting of diabetes preventioncourses Launch of Boston DementiaAction Alliance and Memory Lanesessions Roll-out of Rogue Landlordinitiative Supporting FIT4YourFutureinitiative promoting financialconfidence Additional investment in playareas Creation of Lincolnshire’s firstCommunity Alcohol PartnershipAcute/urgent carePlannedsecondary carePrimary/ communitycareOUR FOCUSWellbeing / prevention /community-based projects2

HOW THISSTRATEGY HASBEEN DEVELOPEDHelp us spread the word and you couldbe in with a chance of winning a prize See overleaf for more detail e–virhtidskpdriveldenHamokedon’tsWe have developed this strategyusing national and local evidenceof health need, including theLincolnshire Joint Strategic NeedsAssessment and the Boston PublicHealth Profile. The content of thisstrategy has also been influencedthrough conversations with partnersvia the Boston Strategic HealthGroup and Boston Health andWellbeing Network.INFLUENCES ONHEALTH ANDWELLBEINGMany factors determine howhappy and healthy we will be. Thisstrategy recognises the importanceand interconnectedness of thosewider determinants. Our healthand wellbeing is influenced by avariety of factors including ourage, family history of illness, healthservices, loneliness, where we live,income and employment, education,planning, housing, access to qualitygreen space and air pollution.Behaviours such as diet, how muchexercise we do, and consumingtobacco, alcohol or drugs play amajor role in influencing health,mental well-being and the risk ofchronic conditions such as diabetesand heart disease.3

OUR PRIORITIES AND VISIONOur VisionThe table on page 9 illustrates linksto other key strategic documents.To enable the people of Boston tolive longer, be healthier and have abetter quality of life.Partnership working and crosscutting principlesPrioritiesOur strategy focuses on threepriorities: Work with partners to encouragehealthier lifestyles andbehaviours Collaborate with partners towork towards Boston becoming aDementia-Friendly Community Work with partners to improvelocal housing and financialconfidenceThere is a strong relationshipbetween the themes outlined in theJoint Health and Wellbeing Strategyfor Lincolnshire 2013-18 and ourstrategic priorities.4No single organisation can tacklethese complex problems alone.Partnership working is thereforeessential.The following key principles willguide our activity: A focus on individuals,communities or areas worstaffected by inequalities Recognition that mental wellbeing is essential to good health Ensuring services are developedwith both carers and those caredfor in mind Greater emphasis on socialprescribing (community referral)to improve well-being and reducereliance on clinical (medical)services.

PRIORITY 1:Encourage healthierlifestyles and behavioursTo make this happen we will: Encourage adults and children toWhy is this important?make healthier choices and avoid Living unhealthy lifestylesharmful behaviourincreases the risk of serious Improve leisure facilities andillnesses such as cancer, stroke,green spaces and encourageheart disease, diabetes, lungtheir use by the communitydisease and the onset of Provide a broader range ofdementiaopportunities for adults and It’s vital to get into healthy habitschildren to become more activeearly in life: Research shows thatand engaged in the arts.around 80% of obese adolescentswill become obese adultsHow will we know when we’re(Source: 2015 World Obesity, University of York)making a difference? 40% of all deaths in England More children and adults areare related to people’s lifestyleactivebehaviours Fewer children and adults are(Source: Public Health England 2016)overweight or obese Being active is beneficial for your Alcohol misuse and smoking hasmental health and wellbeingreduced(Source: Mental Health Foundation) Reduced prevalence of relatedhealth conditions such as type 2diabetesAlmost three-quarters of adults inBoston are overweight or obese(73.8%, 2013/15)Source: PHOFAlmost 1 in 3 adults in Bostonare inactive (31.5%, 2015)Source: Public Health OutcomesFramework (PHOF)Almost 4 in 10 childrenaged 10 to 11 years inBoston are overweight orobese (35.3%, 2015/16)Source: PHOFBoston 24.9%England 15.5%Almost 1 in 4 adults in Boston smokeSource: PHOF, 20165

PRIORITY 2:Work towards Bostonbecoming a DementiaFriendly CommunityWhy is this important? Recent statistics indicated that61,000 people died of dementialast year, making dementiathe leading cause of death inEngland and Wales (Source: PublicPolicy Exchange) 1 in 6 people over the age of 80have dementia, while the costto the UK is currently 26 billiona year and predicted costs areexpected to treble by 2040To make this happen we will: Increase awareness andunderstanding of dementia andspecifically focus on how toreduce stigma and discrimination Provide supportive and caringenvironments at a local level forthose with dementia and theircarers Support dementia preventionthrough the promotion ofhealthier lifestyles(Source: Public Policy Exchange)How will we know we’re making adifference? Improved diagnosis of dementia Achieve the national DementiaFriendly Community recognition(Source: Lincolnshire East CCG)status 1,009 people over 65 in Bostonwere living with dementia in 2015 People with dementia and theircarers are able to live well with(Source: Lincolnshire JSNA November 2016)dementia and feel part of their Simple lifestyle changes have thecommunitypotential to eliminate one in threedementia cases (The Lancet, July2017) Only 64.8% of the estimatednumber of people living withdementia in Lincolnshire Easthave been diagnosedTwo thirds of peoplewith dementia arewomen7.1% 8.5%2015 2030Projected cases ofdementia in peopleaged 65 and over inBoston(Source: Lincolnshire JSNANovember 2016)61 in 3 people whodie after the age of65 have dementia1 in 20 living withdementia are underthe age of 65

PRIORITY 3:Improve local housing andfinancial confidenceWhy is this important? People living in poor quality orovercrowded housing tend tohave poorer health, particularlyrespiratory conditions and mentalhealth Debt and household income areoften highlighted as the maindriver behind poor physical andmental health Despite lower wages in Boston,the proportion of income spenton rents is greater than theEngland averageTo make this happen we will: Improve housing standards,particularly in the private rentedsector Support vulnerable people whomay be at risk of becominghomeless Increase the supply and range ofaffordable and flexible housingoptions Work with partners to supportpeople to manage their finances,maximise income and buildfinancial confidenceHow will we know when we’remaking a difference? Fewer people are experiencingfuel poverty More affordable homes areavailable More homelessness cases areprevented Housing standards improve locally Local people are more confidentin the way they manage theirmoneyGross weekly pay in Boston(Source: Nomis, earnings by place ofresidence 2016)Boston 415GBaverage 541Almost 1 in 5 households in Boston are in fuel poverty(17%, 2014) (Source: BRE Stock Modelling Report)Disabled or long-termhealth conditionNot disabled/no healthproblems1 in 5 dwellings in Boston arecategorised as having serioushazards (20%, 2014)(Source: BRE Stock Modelling Report)Proportion of Boston users with adisability or long-term health condition(Source: Citizens Advice Mid Lincs, 2015/16)7

MEASURING OUR PROGRESSIn order to deliver our threepriorities, an action plan has beendeveloped incorporating shortterm outcome measures and trendindicators. This plan will help us tomeasure and track the progressof the strategy, recognising thateffecting real change takes time,particularly where behaviouralchange is involved.The strategy will be reviewed everythree years with progress monitoredby the Boston Strategic HealthGroup.8

Summary: Our strategy on a pageOur visionTo enable the people of Boston to live longer, be healthier and have a betterquality of life.OurprioritiesPRIORITY 1:Work with partners toencourage healthierlifestyles and behavioursOur priority actions Encourage adultsand children to makehealthier choicesand avoid harmfulbehaviour Improve leisurefacilities andgreen spaces andencourage their useby the community Provide abroader range ofopportunities foradults and children tobecome more activeand engaged in thearts.Principles PRIORITY 2:Collaborate with partnersto work towards Bostonbecoming a DementiaFriendly Community Increase awarenessand understandingof dementia andspecifically focus onhow to reduce stigmaand discrimination Provide supportiveand caringenvironments at alocal level for thosewith dementia andtheir carers Support dementiaprevention throughthe promotion ofhealthy lifestylesPRIORITY 3:Work with partners toimprove local housing andfinancial confidence Improve housingstandards,particularly in theprivate rented sector Support vulnerablepeople who may beat risk of becominghomeless Increase thesupply and rangeof affordable andflexible housingoptions Work with partnersto support peopleto manage theirfinances, maximiseincome and buildfinancial confidenceFocusing on individuals, communities or areas worst affected by inequailitiesRecognising that mental well-being is essential to good healthEnsuring services are tailored to both carers and those cared forSupporting social prescribing (community referral) to reduce reliance onmedical services

Strategic ContextImprove local housing andfinancial resiliencePromoting healthier lifestyles Improving the health and wellbeing of olderpeople Delivering high quality systematic care for majorcauses of ill health and disability Improving health and social outcomes forchildren and reduce inequalities Encourage healthier lifestylesand behavioursWork towards Bostonbecoming a dementia-friendlycommunityPrioritiesLincolnshire Joint Health & Wellbeing Strategy 2013-18 Tackling the social determinants of healthCouncil Plan 2016/17 – 2019/20Support the most vulnerable in our borough Provide affordable homesPlay a supporting role in meeting the widerhealth and well-being needs of our community by continuing to work closely with our partnersLincolnshire CCGs Draft Joint Operational Plan -2017/19Keeping people well and healthy Lincolnshire Sustainability & Transformation PlanProactive Care (prevention/self-care)

10Boston’s Health andWellbeingAction Plan 2017-2020Appendix A

Action Plan, 2017-20PriorityNational indicator(trend)Smoking prevalenceExcess weight in adults andchildren1. Work withpartners toencouragehealthierlifestyles andbehavioursProportion of physicallyactive and inactive adults(revised indicator)Average number portions offruit / veg (self-reported)Recorded diabetes% of police incidents whichare alcohol relatedAlcohol-related admissions tohospitalKey ActionsLeadorganisationLocal outcome measureEncourage adults andchildren to make healthychoices and avoid harmfulbehaviourEmbed key public healthmessages via Making EveryContact Count, One Youinitiatives and nationalcampaignsLCC (PH) MECC sessions hosted/numbersattended HAY quizzes and One You appsdownloadedOrganise community healthand wellbeing eventsLCC/BBC Number of events 2016/17 Target: 2(1) Estimated number of people involvedGreater education andenforcement of Smokefreelegislation to reduce exposureto second-hand smokeBBC/SLA Premises supported to meetregulations Schools engaged in smoking withchildren in cars projectImproved access to healthyfood when eating away fromthe homeBBC /LCC(PH)Support for allotments andcommunity gardensBBC/BTAC/Allotment Businesses engaged / awards given Feedback surveys from the businesses Site improvements 2016/17 Target:1(1)Key: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

AssociationsExplore opportunities toreintroduce communitycookery classes anddemonstrationsBostonMayflower/BBCDiabetes preventionprogrammeLECCGImplementation of the BostonCommunity AlcoholPartnership (CAP) action planLincolnshirePoliceReview Public SpacesProtection Order (drinking)BBCContinue to pilot workplacehealth initiativesLCC (PH) /Bakkavor Number of food demonstrations % of participants reporting positivechange % of participants reporting positivechange Number of incidents relating to alcoholmisuse Youth alcohol fuelled ASB Brief intervention training provided Absenteeism rateImprove our leisure facilitiesand green space toencourage their use by thecommunityFurther improvements to greenspaces and the public realm toencourage greater use ofoutdoor spaceEnhancement of leisure andsports facilities, including thedevelopment of ladies’ gym atGMLCBBC/BWT/BTAC/ParishCouncils/RSPBBBC/ ActiveLincolnshire Kilometres of new footpaths/cyclepaths New equipment and facilities installed New facilities or upgrade of existingfacilitiesKey: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

Provide a wider range ofopportunities for adults andchildren to become moreactiveSupport local CommunityHealth Walks to become selfsustainableSupport active travel optionswithin Boston TransportStrategy and encouragesimilar provision within majorplanning applicationsDevelop wider opportunities forpeople to engage in physicalactivity and the arts, includingdanceBBCLCC/BBCActiveLincolnshireArts NKLITCBBLBBC Health walks still in operation 6 months/ 1 year post decommissioning.2016/17 Target:12(12) Number of new walkers. 2016/17Target:40 Healthy walking throughput. 2016/17Target:8500 Measures included to promote walking& cycling External funding bids Participation levels New programmes developedKey: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

Priority2. Collaboratewith partnersto worktowardsBostonbecoming aDementiaFriendlyCommunityNational indicator(trend)Key ActionsSocial isolation: percentageof adult social care users whohave as much social contactas they would like (ASCOF1.18i)Increase awareness andunderstanding of dementia,focusing on reduced stigmaand discriminationCarer-reported quality of lifescore for people caring forsomeone with dementia(ASCOF)Dementia: emergencyadmissions aged 65 (ASCOF)LeadorganisationLocal outcome measureLCC (PH) Dementia Friends awareness sessions Attendances at Dementia FriendsSessionsWork towards DementiaFriendly Community (DFC)recognition for Boston,focusing on key sectorsBoston DAA Members of Boston DAA Achievement of DFC statusContinue developing theDementia PathwayLECCG Referrals into the DFSS Dementia care reviewed in the last 12months Dementia diagnosis rate (differencebetween the estimated and registeredprevalence of dementia)Encourage leisure and artsBoston DAAScope and deliver dementiaawareness events, includingsupporting DementiaAwareness WeekProvide supportive andcaring environments at alocal level for those livingwith dementia and theircarers Number of initiatives adopted e.g.dementia friendly swimmingKey: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

providers to become moredementia-friendlySupport dementiaprevention through thepromotion of healthierlifestylesBBC/AgeUK/BostonMayflower Work with partners to highlight ninerisk factors and to promote healthierlifestylesKey: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

PriorityNational indicator(trend)Statutory homelessness per1,000 householdsKey ActionsImprove housing standards,particularly in the privaterented sectorLeadorganisationBBC Number of properties improved.2016/17 Target: 100(112) Number of Disabled Facility GrantsapprovedBBC/Framework/P3 Number of homelessness casespreventedFuel poverty3. Work withpartners toimprove localhousing andfinancialresilienceLocal outcome measureTo continue to proactivelyenforce housing standardsincluding the licensing ofHMOs.To promote good practicethrough landlord newslettersand forums.In partnership with otherLincolnshire local authoritiesproduce and progress a newLincolnshire AffordableWarmth Strategy.Facilitate independent livingand safe homesSeek funding for fuel povertyinitiativesSupport vulnerable peoplewho are at risk of becominghomelessTo produce and deliver withother Lincolnshire localauthorities a new CountyHomelessness Strategy.Key: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

Prepare for the implications ofthe Homelessness ReductionAct 2017To increase the supply andrange of affordable andflexible housing optionsBBC/HousingAssociationsSeek funding and assistancefrom the Homes andCommunities Agency andother partners to support thedelivery of new affordablehousing in partnership withregistered providers andaccelerate the provision ofother high-quality new homesto meet the housing need inthe borough.Work with partners tosupport people to managetheir financesDevelop Boston SocialPrescribing pilot, incorporatingadvice on prescriptionCAML/BostonMayflower/LCVS Number of non-local authority ownedempty homes returned intooccupation as a result of action by thelocal authority. 2016/17 Target:60(80) Number of affordable homesdelivered. 2016/17 Target: 75(187) Income Maximisation: Annualised income secured % of clients better off financially Total debt dealt with by Citizens AdviceMid Lincs (Boston) Tenant savings (Mayflower) Number of pre-tenancy financialassessments (Mayflower) Number of entering employmentfollowing support package (Mayflower)Key: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

Financial inclusion advice forBBL area residentsMoney Matters project,supported by BBOSpecialist debt advice,supported by money adviceserviceIncome maximisation (Year 1),supported by LCCMoving into Volunteering andEmployment (MOVE) projectsupported by BBOExpand pre-tenancy financialassessments and support tothose individuals on thehousing registerKey: ASCOF Adult Social Care Outcomes Framework, BBC (EH) Boston Borough Council Environmental Health, BBL Boston Big Local, BBO Building Better Opportunities Big Lottery fund,BTAC Boston Town Area Committee, BWT Boston Woods Trust, CAML Citizens Advice Mid Lincs, CAP Community Alcohol Partnership, DAA Dementia Action Alliance, DFSS DementiaFamily Support Service, HAY ‘How Are You?’ One You self-assessment quiz, HMO Houses in Multiple Occupation, LCC (PH) Lincolnshire County Council (Public Health division), LECCG Lincolnshire East Clinical Commissioning Group, LITC Leisure in The Community, MECC Making Every Contact Count, QOL Quality of Life, SLA Smokefree Lincolnshire Alliance

Almost 1 in 3 adults in Boston are inactive (31.5%, 2015) Source: Public Health Outcomes Framework (PHOF) Almost three-quarters of adults in Boston are overweight or obese (73.8%, 2013/15) Source: PHOF Almost 4 in 10 children aged 10 to 11 years in Boston are overweight or obese (35.3%, 2015/16) Source: PHOF Almost 1 in 4 adults in Boston smoke

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