Press release: New technology supports new mums to breastfeed

Almost three-quarters of women start breastfeeding when their child is born, however by 6 to 8 weeks this drops to just 44%. This makes breastfeeding rates in England among the lowest in the world.

A new survey of 1,000 mothers of young children commissioned by Public Health England (PHE) revealed that in hindsight, mothers wished they had been better prepared for breastfeeding. Before the birth of their first child, mums’ biggest priorities were:

• buying baby equipment (66%)
• preparing for labour (49%)
• buying baby clothes (40%)

However, post birth, nearly a quarter (24%) wished they had read about and were more prepared for breastfeeding and 1 in 4 (26%) of those who had given breast milk to their first child wished they had known that asking for help can make a real difference.

Evidence shows the right support helps mothers to breastfeed for longer. PHE’s programme Start4Life has created the Breastfeeding Friend to encourage parents to adopt healthy behaviours. It is available for free on a range of platforms, including Facebook Messenger, and now for the first time it will also be available as a skill for Amazon Alexa’s voice service.

Mothers can ask Alexa a variety of questions about breastfeeding and the answers will be provided tailored to the age of the baby. This means that they can get helpful advice even when their hands are full.

The survey also highlighted that almost a third (31%) of mothers also felt embarrassed about asking for help with breastfeeding from healthcare professionals. Many mothers can find breastfeeding challenging and often this may cause them to give up.

It also found that almost two thirds (64%) felt that access to 24 hours a day, 7 days a week breastfeeding support, such as a phoneline, website or chatbot, would make new mothers:

• more likely to have a positive experience of breastfeeding
• more likely to decide to try breastfeeding (59%)
• breastfeed for longer (58%)

PHE recommends exclusive breastfeeding for around the first 6 months. Breastfeeding boosts a baby’s ability to fight illness and infection, and babies who are not breastfed are more likely to get diarrhoea and chest infections. Breastfeeding also lowers a mother’s risk of breast cancer and may reduce the risk of ovarian cancer.

Viv Bennett, Chief Nurse at Public Health England said:

Breastfeeding, whilst natural, is something that mothers and babies learn together, and whilst learning, women may have questions and setbacks. PHE is working with health professionals to make sure women are not embarrassed and receive timely help. Health professionals do an excellent job of caring for new mothers, but they cannot be available 24 hours a day, 7 days a week, which is where our Breastfeeding Friend from Start4Life is designed to help. This tool, together with the range of support materials from Start4Life, can provide breastfeeding advice at any time of night or day and support mothers and their partners and families through challenges they may face.

These digital offerings will help guide new parents through their first weeks of breastfeeding and beyond, providing help at any time of the day or night, and aim to complement support and advice from health care professionals and breastfeeding specialists. The information provided by all the Start4Life services is NHS approved and both services are independent of Amazon and Facebook.

Dr Cheryll Adams CBE, Executive Director Institute of Health Visiting, says:

This innovative new service will enhance those already provided by health professionals. Whether a mother manages to establish breastfeeding is largely determinant on the support she receives in the first few days after birth. However, with such short hospital stays, professional support is not as widely available as it once was. To have this back up, which can be accessed from anywhere, will be hugely helpful and we expect health visitors to want to promote the service.

Justine Roberts, CEO and Founder of Mumsnet, says:

Breastfeeding is a hard-won skill for many women, and most mothers will experience a setback along the way, particularly in the first few weeks. We see from conversations on Mumsnet that mothers are looking for breastfeeding support 24 hours a day, 7 days a week, and in fact middle of the night crises when face-to-face help isn’t available can be the most profoundly lonely and difficult. These new round-the-clock digital services could provide help when mothers need it most.

More information, advice and tips on breastfeeding is available on the Start4Life website.

Background

1 - Once Breastfeeding Friend from Start4Life is enabled from the Alexa app, users can activate the skill on their Alexa by using the wake word ‘Alexa’ and asking for the ‘Breastfeeding Friend’. A ‘card’ will be sent to the user’s Alexa app showing some of the most common questions the Breastfeeding Friend can answer. Users can access quick tips or advice, and ask Alexa a variety of questions about breastfeeding. The answers will be provided tailored to the age of the baby. The 24 hours a day, 7 days a week Breastfeeding Friend from Start4Life aims to make it simple and easy for breastfeeding mums to ask for help if they are facing any breastfeeding difficulties.

2 - In addition to the Breastfeeding Friend from Start4Life there are many other ways that mothers can get breastfeeding support. The Start4Life website has a range of advice and resources which can help mothers continue breastfeeding. Mothers can also call a national helpline (0300 100 0212) provided by the Breastfeeding Network 365 days a year. Mothers can also get help through:

• friends and family
• their Midwifery team
• their health visitor
• local breastfeeding drop-in services

3 - The survey was conducted by Kantar Public from 26 January to 7 February 2018 with a nationally representative sample of 1005 mothers in England with children under the age of 4, on behalf of PHE. The data were weighted to population statistics based on age of mum, region and socio-economic group. Findings show:

• of those who ever gave breastmilk to their first child, younger mums were more likely than older mums to use online sources (42% of 18 to 34 years compared to 30% of 35 to 50 years) when researching or starting to breastfeed
• of mums who breastfed their first child, a quarter wished they’d known it can take a long time, but it’s quality time to spend with their baby (25%) and there is lots of help and support available from breastfeeding groups, other parents and online (24%)
• 1 in 4 (26%) mums felt using more online/digital tools and information would have helped them to be more prepared for becoming a mum
• in hindsight, mums wished their main priorities before the birth of their first child had been preparing for labour (33%), spending time with friends and family (26%), reading about and preparing for breastfeeding (24%) and preparing for night feeds (22%)

4 - Sometimes breastfeeding isn’t possible for a range of reasons. If this is the case, in terms of liquids babies should only be given infant formula milk for the first 12 months and no other types of milk.

5 - Start4Life’s Information Service for Parents and Start4Life website offers NHS information and advice for parents-to-be and parents of 0 to 5 year olds providing them with the advice they need to help get their child off to the best start in life.

6 - The Department of Health is also supporting Unicef UK to develop a neonatal infant feeding network to support sick and preterm babies.

7 - PHE exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services.

freuds

Email start4life@freuds.com

Telephone 020 3003 6399

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/new-technology-supports-new-mums-to-breastfeed
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Independent report: SACN statement on diet, cognitive impairment and dementia

This position statement by SACN provides an overview of the currently available evidence on nutrition and cognitive impairment and dementia (including Alzheimer’s disease) in adults. It considers evidence relevant to the prevention - not the treatment - of cognitive impairment or dementia.

The position statement concludes that:

• the evidence base in this area is very limited
• there is no evidence that specific nutrients or food supplements affect the risk of cognitive impairment or dementia
• there is some observational evidence that greater adherence to a Mediterranean dietary pattern may be associated with reduced risk of mild cognitive impairment and dementia

While there is no single Mediterranean diet, such diets tend to include higher intakes of vegetables, fruit, legumes, cereals, fish and monounsaturated fatty acids; lower intakes of saturated fat, dairy products and meat; and a moderate alcohol intake. Mediterranean type diets broadly align with current UK healthy eating recommendations as depicted in the Eatwell Guide (PHE, 2016).

You can find more information about SACN online.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/sacn-statement-on-diet-cognitive-impairment-and-dementia
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Research and analysis: Population surveillance using child development outcome indicators

All children between the ages of 2 to 2 and a half years are offered a development review by health visitors. The Ages and Stages Questionnaire (ASQ-3) is used as part of the review to give an objective measure of development, allowing comparisons which help to identify children who are not progressing as expected and supporting decisions on closer monitoring of progress or the targeting of services. The ASQ-3 looks at:

• communication
• physical skills
• problem-solving
• how a child is developing emotionally and socially

This data is collated by NHS Digital as part of the Community Services Data Set.

The study worked with data from 3 local services and found that data from the ASQ-3 might be used nationally to create useful indicators for local areas. These indicators would allow local areas to compare how children are developing with populations in other parts of England and to consider the impact of local early years services on child development outcomes.

The data could also inform the targeting of services towards children with the greatest need by showing how children from different social groups have different outcomes. The method proposed is efficient as it is based on existing data collection and reporting. It offers the opportunity to increase understanding and the evidence-base for the relationship between outcomes in early and later life.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/population-surveillance-using-child-development-outcome-indicators
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Guidance: Health matters: health and wellbeing community-centred approaches

Involving and empowering local communities, and particularly disadvantaged groups, is central to local and national strategies in England for both promoting health and wellbeing and reducing health inequalities. This edition of Health matters highlights some of the successful interventions that have been implemented across England.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/health-matters-health-and-wellbeing-community-centred-approaches
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Case study: Community development route to health improvement in Aylesbury

Summary

The programme uses a community development approach to health improvement providing a Healthy Living Centre (HLC) within the Walton Court and Southcourt communities of Aylesbury town in the Buckinghamshire county council area, alongside engagement in other key areas of deprivation across Buckinghamshire.

The overall programme includes a generic Skilled for Health (SfH) programme called English for Health and Wellbeing (SfHW), a Skilled for Health Maternity programme with Black and Ethnic Minority (BaME) women of childbearing age. It also includes a range of health improvement activities, for example, ‘simply walk’, chair-based exercise, youth hub and boxing club, and dementia activities such as silver singers and senior lunch clubs. These are underpinned by a range of community development and engagement approaches, including volunteering.

Background

The development of this centre was informed by previous engagement work with this community by the former Primary Care Trusts (PCTs), which identified specific needs around promoting health, developing skills for work and community development and supporting families.

The original service model had 3 focus areas:

• health promotion and improvement
• supporting and enabling people into learning and work
• community development

The purpose of the projects was to provide targeted health promotion initiatives for those in disadvantaged and vulnerable groups, mainly focused on people on low incomes, black and minority ethnic groups (BaME), older people, children and young people, people with emotional wellbeing issues and people living in isolated circumstances, in order to promote health and wellbeing and reduce inequalities.

It took a holistic view of health and offers services to users which cover not just lifestyle services, also, employment advice, reducing social isolation and volunteering.

What was involved?

The aims of the Community Development and Health Improvement programme include:

• to co-produce a range of health improvement projects based upon preventive and early health interventions that aim to enable individuals and communities to take responsibility for their own health
• to work in collaboration with the local statutory and voluntary sectors to enable and enhance community ownership, capacity, resilience and cohesion by building the confidence and skills of local people

The programme operates from a physical centre and offers a range of different community and health improvement programmes, a nursery, community café and the hire of a community centre, managed on behalf of the local housing trust.

It has also expanded since the original service model and now delivers projects in other geographical locations, for example, the SfH programme in High Wycombe and Chesham.

The community café operates partly as a key mechanism to enable engagement with the local community. The environment is informal and due to its location is not related to any other services. There is, therefore, no stigma attached to entering or using the venue. The café has also proved an effective way to engage users who otherwise would not easily engage with statutory services such as local authorities, the police or the NHS.

There is an Ofsted registered fully subscribed nursery on site, which offers crèche and other childcare options for those in the area and using the centre for any of its activities.

In 2014 the HLC conducted 15 local conversations with diverse interest groups within the broader community, partnered by The People’s Health Trust. The portfolio of projects and programmes delivered from the HLC are built around these priorities and focus on health, skills and employment, social and family problems. The delivery methodology of all these programmes is community engagement, recognition of community resources and joint problem solving.

Outcomes

An evaluation of the HLC entitled ‘Nourishing the Community: an evaluation of the added value of the HLC’ described the added benefits to the community:

General community

It provides a positive social space, use of a community building, food and drink, access to nursery provision, computer suite that is a tangible asset to the local community.

For individuals

Benefits have been critical, for example, removal from domestic violence and achieving stability in family relationships, volunteering and employment opportunities.

For partners

It has provided affordable room hire, administration and opportunity to develop a multi-issue approach across a community.

For commissioners

It has provided qualitative insight and feedback on community issues for more vulnerable communities and extended reach into new communities.

There are separate outcomes for each project delivered from the HLC. Some of the outcomes for the overarching health improvement and community development programme include:

• reducing social isolation, increased social connectedness, increased knowledge and awareness of health issues, changes in health behaviours, and better access to services
• increased capacity through additional volunteers, funding or shared resources
• more appropriate use of services, increased capacity to manage non-clinical need and raised awareness of community assets

As well as promoting uptake and widening access to services, community-centred approaches may increase health literacy and give individuals the confidence to engage in their health care. Engaged communities can provide supportive environments and positive social norms that help individuals gain motivation, confidence and skills to self-care.

What works well?

There are 4 main elements of advice for commissioning this via public health in a local authority setting:

• communicating the benefits of the programme especially with all the relevant stakeholders before and continuously throughout the project, including members
• demonstrating continuous year on year improvement with community and service user engagement
• demonstrating robust evaluation, tangible outcomes and quality of a range of health improvement programmes to secure sustainable resources in a time of reduced public funding
• setting clear and measurable outcomes for each year and building robust project management and leadership into all stages of the process

Next steps

The current contract commissioned by Buckinghamshire county council Public Health team, started on 1 January 2017 and is due to expire on 31 December 2019.

Further information

Public Health Leads

Angie Blackmore, Public Health Principal, Buckinghamshire County Council Tel: 01296 387472

Susie Cook, Public Health Practitioner (Advanced), Buckinghamshire county council Tel: 01296 387626

Healthy Living Centre Lead

Jan Webster, Chief Executive Officer, Healthy Living Centre Tel: 01296 334562

Website:

Details of the range of programmes and the centre facilities can be found on the Healthy Living Centre website.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/case-studies/community-development-route-to-health-improvement-in-aylesbury
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Case study: Asset-based community development in Northumberland

Summary

The public health team at Northumberland county council is taking a fresh approach to improving health outcomes in their population and reducing avoidable health inequalities. The focus is much more upstream and asset based with the ambition of achieving countywide, resilient, flourishing communities who have high levels of wellbeing.

It is collaborative and community focused and has involved listening to what local people say helps them to feel well and gives them a purpose in life. This insight is helping the team reshape the joint health and wellbeing strategy to address, within public health responsibilities, what really matters to local people and what will achieve the sustainable outcomes.

Background

Reducing health inequalities is a key priority for Northumberland. Working with communities to identify strengths and assets to work together is vital to successfully addressing these inequalities. This includes having autonomy, positive relationships, a purpose in life, and self-acceptance, all of which enable communities to flourish. Evidence from community-health interventions has shown that a contributory factor to health and wellbeing is being linked to a local community and reduced social isolation.

The team makes the best use of all the different types of resources available in Northumberland.

These resources include:

• the human resources (people)
• natural resources (place)
• energy, passion and expertise (approach)

Working in this way is not only in response to the substantial financial cuts facing public services but also is the right thing to do. This approach can lead to improved health behaviours, self-efficacy and empowerment, have positive impacts on housing, crime, and social capital, and yield a social return on investment. There is also increasing evidence it also reduces health and social care costs.

What was involved?

Using the concept of asset-based community development, Northumberland public health team has been working with communities to identify the communities’ own assets and resources. The focus of this work was in the north of the county as it had strong community anchors, is a rural area that does not have access to the broad range of services available in the more densely populated areas of the county. Also historically, much of the council’s efforts have been focused on the more deprived south-east area rather than the more rural north.

Northumberland public health started by having conversations with communities about what factors create health and wellbeing, rather than the more traditional approach of focusing on preventing the causes of ill health. This empowers and encourages communities to utilise what they already possess. This asset-based approach acknowledges that the expertise to improve health and wellbeing already exists in the community and the public health’s team’s role is to facilitate rather than ‘do’.

In September 2015, a ‘World Cafe’ event was held in Berwick for the local community to have a conversation about being well. This was organised by the members of the public health team, supported by the Berwick, Glendale and Seahouses Community Development Trusts.

The aim was to:

• meet people from the area and find out what was important
• identify local strengths and assets
• help people connect to support and resources

The event was well attended and people shared ideas about what was important for them. Micro-grants were suggested as a mechanism to encourage people and groups to initiate activities to support their own health and wellbeing.

Working together, the public health team and the 3 trusts developed the micro-grants concept. A key principle was that it should be simple and easily accessible to enable groups and individuals who hadn’t previously applied for funding to set up projects and activities. The partners worked together to create and adapt the processes to support this.

The grant size was kept small and the processes light to enable projects to take off without unmanageable administration or accountability. The high level of trust between the partners resulted in the trusts ensuring that the funding was focused on projects that had clear health benefits.

Projects have been wide ranging and include:

New Seahouses Seaside Amateur Drama Club

The grant was used to hire a room for rehearsals and props for the first event. The first play brought together from the community 100 people across a wide age range. The group has expanded; is now self sufficient, and is looking forward to putting on their second event.

Prior Park Residents Group

The grant was used for room hire and administration support for a new residents group in Berwick,

Bamburgh, Beadnell Skiff Building Project

The grant was used to raise funds to purchase a skiff kit and trailer; the skiff (a small flat-bottomed open boat) is now being built as part of a community project.

This approach has had the following outcomes:

• identified local strengths and assets
• established networks to increase involvement in decision making by local residents
• there are over 75 projects across the 3 community trust areas and initial monitoring suggests that 26 projects have together involved over 1,000 people in some positive activity in their community
• mapped against the 5 ways to wellbeing, 27% of the projects were linked to being active and 39% were linked to learning and 98% were linked to staying socially connected, promoting social and emotional wellbeing
• 38 out of 42 projects in Seahouses have continued and in Wooler, 40 schemes are continuing, some with additional funding from elsewhere or self-funded

What has worked well?

The approach focuses on the conditions that create good health and wellbeing such as:

• feeling connected
• doing things you’re good at
• building confidence and skills

rather than the negative factors which create ill health such as:

• excessive alcohol consumption
• smoking
• lack of physical activity
• poor diet

As the approach and the ideas came from the community they have been more likely to be sustained by the community.

The approach focuses on what’s strong rather than what’s wrong, and is built on the positives and the strengths within communities to improve health and wellbeing:

• by developing the assets already there, communities have offered resources, time, accommodation, equipment so much more can be delivered with lower overheads compared to a publicly funded service
• we have asked communities, what do you need and what would work here - tailoring the approach to the needs of the local area
• it has been contagious and travelled by word of mouth, people have told their friends and people have made friends as a result
• it has widened participation with people being involved who hadn’t previously and have got together to talk about and share things when they wouldn’t usually, for example sharing our heritage and skills
• it has been inter-generational, involving children in the nursery through to older people in their 80s
• it used micro-grants - small amounts with minimal bureaucracy; communities were pleased with this approach and told us that the small amounts felt low risk and reduced their fear of trying something new and it not working
• the micro-grants have provided seed funding for new ideas and new connections, for example, in Seahouses over 100 residents gathered together in community play and over 200 got together in Berwick for a family fun day
• as the approach and the ideas came from the community they are more likely to be sustained by the community
• after finding out if the idea would work, some groups have gone on to bid for further funding or after finding out something works and there is interest, they have self-funded
• using this approach has helped to build trust both between communities and with the council and will be a building block for future relationships and joint working

Next steps

We have gained a better understanding of existing assets in areas with high wellbeing and are currently sharing good examples across Northumberland. This will become easier as more relationships are built with local people.

Half of Northumberland residents agree that people pull together to improve the local area and it is hoped that this proportion will grow. The role of Northumberland county council’s public health team is now to facilitate change to make it easier to be healthy and to connect people with services and other partners.

The Northumberland Director of Public Health aims to continue to:

• challenge our thinking and move from a ‘deficit model’ to focusing on and maximising the strengths already in our communities
• build relationships with local communities to find and maintain local solutions to improve wellbeing
• harness the skills and passion for Northumberland in our own workforce so that they can be agents of change, to seize every opportunity and make every contact with people a health improving opportunity

The learning from north Northumberland has informed the public health team’s underpinning values and principles about how it will work in the future such as:

• being community-focused, community-driven and locality-based
• mobilising and building on existing assets
• supporting the devolvement of power
• helping to build and support partnerships and networks

This learning has informed the development of ‘A people and place-based approach to wellbeing in Northumberland’ which is being taken forward in the Health and Wellbeing Board’s joint health and wellbeing strategy and will inform our future funding strategy and bids for external funding.

Further information

For more information please contact: Liz Morgan, Director of Public Health, Northumberland county council.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/case-studies/asset-based-community-development-in-northumberland
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Case study: Auntie Pam’s peer volunteer scheme helps mums-to-be in Kirklees

Summary

Auntie Pam’s is a support service for mums-to-be in Kirklees. In setting up and running this with users we learnt how user-led service design and development can result in a cost effective service with many additional benefits to the community.

Background

Kirklees is between Manchester and Leeds with a population of approximately 400,000 living in a wide variety of communities, rural and suburban. The largest minority ethnic group is of South Asian origin, making up approximately 12% of the total population. There are increasing numbers of Eastern European and African migrants.

The project received national funding because of concerns about the high infant mortality rate in the area compared to national statistics. There was some feedback that women found it hard to successfully engage with or access services. Following a successful trial period, the local Public Health directorate funded the service for approximately 16,000 women of childbearing age and their families, with centres in Dewsbury and Huddersfield. It is now run by the local authority.

What was involved?

Auntie Pam’s helps mums-to-be and new mums with support for pregnancy, parenting and access to services.

Women across Kirklees were asked what they needed. Social marketing revealed it was important for them not to feel judged and that available services were often telling them how to parent. They preferred to be supported by “someone like them” for example, a mother who was familiar with their own situation (single parent, financial worries, economic background) and could relate to their needs.

As a result, it was decided to base the scheme around peer support with drop in access. Trained peer volunteers, who are all local mums, offer confidential one-to-one chats, a cuppa and a non-judgemental listening ear. Understanding the pressures that parents face, they offer continued support and signpost to other services when required. There is a chance to identify and talk through issues, prioritise needs, and find goals and solutions. Clients and volunteers are supported with “whole-life” approaches to social, economic and financial challenges.

A bespoke training package gave local volunteers training in motivational skills, behaviour change, loss and bereavement and other issues such as housing and benefits. This has led to Auntie Pam’s evolving into a skills programme as well as a support service.

Auntie Pam’s also runs a free ‘swap shop’/equipment store where families can borrow essentials like changing mats, buggies, cots, as well as accessing clothes for new born and older babies. Items can be swapped when outgrown.

Outcomes

Using the 6 outcomes areas listed below, we evaluated the service to assess how well it is continuing to meet the needs of those who stand to benefit from Auntie Pam’s involvement. It also looks to understand how clients and outcomes differ across time and the locations of the 2 centres.

• number of women who access the Auntie Pam’s service
• increased resilience to poor health behaviours and negative lifestyle circumstances
• improved emotional wellbeing, self-esteem and motivation
• number of women who successfully train as peer support volunteers
• improved and/or increased access to appropriate and timely services required by clients
• clients and volunteers involved in and influencing children’s and maternity services planning, development and delivery

Achievements

Auntie Pam’s has:

• had contact with approximately 2,000 clients over 8 years (in March 2018) via the drop-in centres, telephone enquiries, at the local post-natal ward or via other pregnancy support interventions
• trained volunteers who have learnt additional useful skills, gaining access to NVQs and going onto study midwifery degrees
• a minimum of 27 volunteers as the service continues to expand

The experiences of clients and volunteers is recorded as qualitative stories in a journey log.

Auntie Pam’s was awarded a national Local Government Chronicle community involvement award in 2016 and awarded the Duke of York Community Initiative Award in 2017.

What works well?

Social marketing helped to meet user needs and expectations. The volunteering approach allowed the service to develop in a cost efficient way and has substantial benefits to those receiving training.

Dee Haigh-Elmore, Public Health Kirklees council said:

“We are continually learning from service users and our volunteers, who have often been service users as well. An example of this is the way the initial project has evolved from a pilot focused on young mums with specific needs, to a wider group of people including older mums and some dads and to address a much broader set of needs such as housing or benefit issues.

“We have seen very positive outcomes because we have really bought into a user-led, total planning approach. It has been central to the project design and continued management, and is not a superficial aspect which is added on.”

The most important advice that we can give to others starting a similar project is that local services should be user-led and not service-driven to achieve the best results in a cost effective way.

Next steps

The service will continue with volunteering and service user feedback at its heart. This includes exploring more options away from drop in centres as these don’t work for everyone. Training and support to volunteers will also continue to develop. We plan to work across the council to develop user driven approaches more widely.

Further information

For more information please contact: Dee Haigh-Elmore, Public Health, Kirklees Council

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/case-studies/auntie-pams-peer-volunteer-scheme-helps-mums-to-be-in-kirklees
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Case study: Ways to Wellness Newcastle for people with long term conditions

Summary

Participating GP practices in Newcastle can refer patients to a Ways to Wellness link worker, trained in behaviour change methods, who then works with the person one-to-one to identify health and wellness goals that are meaningful to them. Eligible patients are between 40 and 74 years of age, with a diagnosis of 1 of 8 long term conditions such as diabetes or heart disease.

Background

The west of Newcastle upon Tyne, a population of 132,000, includes some of the most deprived areas in England. There is evidence that people in lower socio-economic groups tend to suffer proportionately more, and earlier in life, with long term conditions (LTCs), have poorer health outcomes and use more health service resources.

The aim of the project is to help people overcome barriers to managing their long term health conditions. Patients will manage their daily lives better, look forward to a healthier and longer life expectancy and will make less use of hospital services, their GP services and prescription drugs.

The project is the culmination of several years of work by different organisations in the west of Newcastle upon Tyne to pilot services to improve peoples’ health. It developed through the guidance of the steering group and through consultation with the community. GP practices in Newcastle West offered social prescribing in a small way for some years and wanted to provide this to more patients, in a more organised way.

The service is funded by a Social Impact Bond investment from Bridges Ventures. Newcastle Gateshead Clinical Commissioning Group (CCG), The Big Lottery Fund and the Cabinet Office.

What was involved?

Seventeen participating GP practices in the west of Newcastle can refer patients to a Ways to Wellness link worker, trained in behaviour change methods, who then works with the person one-to-one to identify health and wellness goals that are meaningful to them. The link workers connect the person, when indicated, to community and voluntary groups and resources in their area.

The shared decision-making process and supportive coaching relationship established with the link worker enables patients to be equal partners in managing their health. People are supported to develop sustainable healthy behaviours, and learn to self-manage their conditions confidently to live healthier and more fulfilling lives, while reducing their dependency on traditional health services.

Ways to Wellness is unique in a number of ways, including:

• scale of social prescribing (linking people with sources of support in the local community)
• integration with GP practices
• based within the community and voluntary sector
• social impact bond (SIB) investment funding (funding for improved social outcomes that result in public sector savings)
• outcome based contracting and commissioning
• development of a robust financial model and dedicated management information system
• funding focused on link worker capacity (rather than activities) to invest in one-to-one patient support
• establishment of a new organisation, Ways to Wellness, with a strong board of directors, to steer the pioneering work

There have been issues with getting training accredited and assessing skills and competencies

Outcomes

As this is a 7 year project, some of the expected outcomes are:

• improvements in patient self-management
• improvements in patient’s health compared with predictions
• reduction in hospital visits and bed days
• reduced visits to GPs
• reduced reliance on prescription drugs for some conditions (such as those for depression)

All link workers use the Well-being Star to support and measure patient’s progress. In Ways to Wellness’ first year (April 2015 to March 2016), over 1,100 patients were referred to the service, of which over 300 patients completed a second assessment of their wellbeing. Compared to when they started with Ways to Wellness, these patients, on average, have improved their wellbeing by 4 points on the Well-being Star, which is considered a significant improvement. The areas where patients reported the most significant improvements in wellbeing are:

• work, volunteering and other activities
• lifestyle
• feeling positive

Nearly 3 years into the project, there have been 4,000 patient referrals.

The longer term outcomes around savings to secondary care costs are yet to be realised.

What works well?

There have been some major factors contributing to the success of the project so far. These include:

• relationship building with key stakeholders including GPs, and community and voluntary sector which led to excellent referral rates from GPs to the project
• each of the 4 providers covering a geographical area and a cluster of practices has enhanced relationship building and generated shared learning between the providers
• the development of the dedicated management information system
• the commitment of the steering group to drive the programme

Some of the challenges faced included:

• negotiating the standard NHS contract which is not designed for an innovative outcomes based approach
• dealing with information governance issues / sharing of data
• political factors around persuading funders to get on board and working in partnership with voluntary and community sector

The most important factor to was to establish a group of strong willed, like-minded people with local influence and credibility who are prepared to push perceived boundaries.

Next steps

The project doesn’t complete until 2022 and the work is ongoing. The next step is to look at secondary care data trends.

Further information

For more information please contact:

• Chris Drinkwater, Chair, Ways to Wellness
• Dr Guy Pilkington, Assistant Chair, Newcastle Gateshead CCG
• Philippa Dodds, Delivery Project Lead (Newcastle), Newcastle Gateshead CCG

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Correspondence: Vaccine Update: issue 275, February 2018

The February issue features:

• sharing best practice for improving uptake in the Childhood Programme
• HPV for MSM phased national rollout
• shortage of pneumococcal polysaccharide vaccine (PPV23)
• publication of the revised PHE National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners
• vaccine coverage
• flu Vaccine Information and Availability 2017/18 for the children’s national immunisation programme
• flu vaccines available for the children’s programme
• MMR vaccine ordering restriction
• ViperaTab is changing presentation
• update on supply of Purified Protein Derivative PPD 10TU for Mantoux testing
• Good Friday and Easter Monday Bank Holidays
• Nimenrix pack size: Erratum and update
• vaccine supply for the non-routine programme

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Press release: Research reveals levels of inappropriate prescriptions in England

This implies that antibiotic prescribing nationally should be reduced by 10% by 2020, in accordance with the national ambition to cut levels of inappropriate prescribing in half. These data are published in 5 articles in a supplement to the Journal of Antimicrobial Chemotherapy.

Professor Paul Cosford, PHE Medical Director said:

Antibiotics are critical to modern medicine, saving millions of lives since the 1940s when they were first introduced. Using antibiotics when you don’t need them threatens their long term effectiveness and we all have a part to play to ensure they continue to help us, our families and communities in the future.

This publication highlights the role GPs can play and I urge all practices to look at ways they can reduce their inappropriate prescribing levels to help make sure the antibiotics that save lives today can save lives tomorrow.

Health Secretary, Jeremy Hunt said:

Drug-resistant infections are one of the biggest threats to modern medicine and inappropriate prescribing of antibiotics is only exacerbating this problem.

We are leading the world in our response. Since 2012, antibiotics prescribing in England is down by 5% and we’ve invested more than £615 million at home and abroad in research, development and surveillance. But we need to go further and faster otherwise we risk a world where superbugs kill more people a year than cancer and routine operations become too dangerous.

Antibiotics are important for treating serious bacterial infections, but their effectiveness is threatened by antibacterial resistance. Antibiotics are unique among drugs as the more they are used, the less effective they become and over time resistance develops. In response to this, the UK government set an ambition to reduce inappropriate antibiotic prescribing by 50% by 2020. This work seeks to quantify the amount of current antibiotic prescribing that is inappropriate.

The research found that the majority of antibiotic prescriptions in English primary care were for infections of the respiratory and urinary tracts. However, in almost a third of all prescriptions, no clinical reason was documented. Antibiotic prescribing rates varied substantially between GP practices, nonetheless, there is scope for all practices across the country to reduce their rates of prescribing.

For most conditions, substantially higher proportions of GP consultations resulted in an antibiotic prescription than is appropriate according to expert opinion. An antibiotic was prescribed in 41% of all uncomplicated acute cough consultations when experts advocated 10%, as well as:

• bronchitis (actual: 82% versus ideal: 13%)
• sore throat (actual: 59% versus ideal: 13%)
• rhinosinusitis (actual: 88% versus ideal: 11%)
• acute otitis media in 2 to 18 year olds (actual: 92% versus ideal: 17%)

This work demonstrates the existence of substantial inappropriate antibiotic prescribing and poor diagnostic coding in English primary care. Better diagnostic coding, more precise prescribing guidelines, and a deeper understanding of appropriate long-term uses of antibiotics would allow identification of further reduction potentials.

Read the supplement Appropriateness of antibiotic prescribing in English primary care.

Contact Daniel Luzer to request a copy of the journal supplement.

This work was resourced by Public Health England (PHE).

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8400

Out of hours telephone 020 8200 4400

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Press release: UK Public Health Rapid Support Team deploys to Nigeria

The UK Public Health Rapid Support Team (UK-PHRST), a joint run effort of Public Health England and the London School of Hygiene & Tropical Medicine, is deploying to Nigeria to help control an outbreak of Lassa fever.

Nigeria is currently experiencing an unusually severe epidemic of Lassa fever - a viral haemorrhagic illness that is normally present in the country but on a lower scale. The outbreak is most prevalent in the southern Nigerian states of Edo, Ondo and Ebonyi.

Given the size of the current outbreak and the risk of further spread locally, the government of Nigeria has requested support from the UK-PHRST team.

The UK-PHRST team deployment includes an expert in patient management, 2 epidemiologists (experts in tracking outbreaks) and a logistician.

The UK-PHRST will provide technical and analytical support for the public health response to control this outbreak, and will also assist with important research on Lassa fever that can provide insight for controlling the disease in the future.

The team will be working alongside the Nigerian Centre for Disease Control, the World Health Organisation (WHO), and other experts in outbreak control to support the Nigerian government’s response.

Professor Daniel Bausch, Director of the UK PHRST said:

The Lassa fever situation in Nigeria has been worsening and now requires an escalated level of response in order to help the Nigerian government slow transmission and save lives.

We are proud to be assisting the government of Nigeria by offering specialist support that will benefit the country both in the immediate and long term.

Public Health Minister Steve Brine MP, said:

Viruses like Lassa fever do not respect borders – and it is only right that we share our expertise with countries facing serious outbreaks around the world.

Our invaluable Rapid Support Team will provide help on the ground in Nigeria to manage the spread of the virus, and grow the country’s ability to protect itself from other dangerous diseases.

Humans usually become infected with Lassa virus from exposure to urine or faeces of infected rodents that are unique to Africa. The virus may also be spread between humans through direct contact with the blood, urine, faeces, or other bodily secretions of an infected person, though this tends to be less common. Typical symptoms include fever, sore throat, headache, abdominal pain and diarrhoea, with bleeding and shock in severe cases. The public health risk to the UK is low.

The UK PHRST is funded by the UK government. It continually monitors infectious diseases and other hazards globally, identifying situations where the deployment of specialist expertise could prevent these threats from turning into a global outbreak. It also conducts outbreak-related research and focuses on building in-country capacity to prevent outbreaks with overseas partners.

Background

For latest case numbers of Lassa Fever in Nigeria, please refer to the WHO: http://www.ncdc.gov.ng/reports/weekly.

UK-PHRST

UK-PHRST consists of public health experts, scientists, academics and clinicians ready to respond to urgent requests from countries around the world within 48 hours to support them in preventing local disease outbreaks from becoming global epidemics.

Informed by surveillance data, the UK-PHRST deploys on behalf of UK government in response to requests from low- and middle-income countries, as well as with the WHO and the Global Outbreak and Response Network (GOARN).

The UK PHRST has previously deployed members to Ethiopia (outbreak of Acute Watery Diarrhoea), Nigeria (Meningitis outbreak), Sierra Leone (cholera risk), Madagascar (plague outbreak) and Bangladesh (Diptheria outbreak).

The core team consists of:

• epidemiologists (experts in tracking and understanding disease transmission)
• microbiologists (diagnosing the cause of an outbreak)
• clinical researchers (developing the best patient management practices)
• social scientists (community engagement during outbreaks)
• data scientists (managing data and modelling outbreak trajectories)
• infection prevention and control experts (advising on preventing transmission)
• logisticians

The UK-PHRST consortium of research institutions includes the University of Oxford and King’s College London as academic partners.

Public Health England

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

London School of Hygiene & Tropical Medicine

The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The school is one of the highest-rated research institutions in the UK, is among the world’s leading schools in public and global health, and was named University of the Year in the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice.

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8038

Out of hours 020 8200 4400

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Research and analysis: Deaths associated with neurological conditions

These resources are about people who have died with a neurological condition recorded on their death certificate in England during the period of 2001 to 2014.

They are written for those commissioning or providing end of life care to help them make sure local services meet the needs of people dying with neurological conditions.

They investigate:

• the numbers and rates of deaths associated with neurological conditions and their recent trends
• the demographic characteristics of people dying with neurological conditions
• the underlying cause of death and association with the broad disease groups
• the place of death

Detailed analysis has been provided for 7 of the condition groups previously defined by the neurology intelligence network:

• epilepsy
• motor neurone disease and spinal muscular atrophy
• multiple sclerosis and inflammatory disorders
• neuromuscular diseases
• parkinsonism and other extrapyramidal disorders/tic disorders
• traumatic brain and spine injury
• tumours of the nervous system

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Collection: Weekly national flu reports

National influenza reports, tracking seasonal flu and other seasonal respiratory illnesses in the UK.

Reports from spring 2013 and earlier are available on the UK Government Web Archive.

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Guidance: Hepatitis A/Typhoid vaccine: patient group direction

This patient group direction (PGD) template supports the administration of HepA/Typhoid vaccine to individuals considered at risk of exposure to Salmonella enterica serovar typhi, (S. typhi) and/or hepatitis A virus, in accordance with recommendations from the National Travel Health Network and Centre (NaTHNaC) or in accordance with PHE hepatitis A temporary recommendations.

It is valid from 1 March 2018 to 29 February 2020.

Practitioners must not use this PGD template until it has been authorised in Section 2. This is a legal requirement (see Human Medicines Regulations 2012).

Practitioners should follow local policy and procedures to access authorised PGD documents. This PGD template should be used with reference to current national guidance, Green Book, and Summary of Product Characteristics for the vaccine.

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Guidance: Typhoid Vi vaccine: patient group direction

This patient group direction (PGD) template supports the administration of typhoid Vi polysaccharide vaccine to overseas travellers at risk of exposure to Salmonella enterica serovar typhi (S. typhi) in accordance with recommendations from the National Travel Health Network and Centre (NaTHNaC).

It is valid from 1 March 2018 to 29 February 2020.

Practitioners must not use this PGD template until it has been authorised in Section 2. This is a legal requirement (see Human Medicines Regulations 2012).

Practitioners should follow local policy and procedures to access authorised PGD documents. This PGD template should be used with reference to current national guidance, Green Book, and Summary of Product Characteristics for the vaccine.

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Promotional material: Cervical screening: HPV primary screening

HPV primary screening is used as the first test on cervical screening samples in some areas of England. Women invited for cervical screening in these areas will receive this leaflet along with the national invitation leaflet. HPV primary screening will gradually be introduced across the country.

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Research and analysis: Oral health survey report: children in Yorkshire and Humber 2015

This report uses data taken from the third National Dental Public Health Epidemiology Programme for England oral health survey of five-year-old children, 2015.

The report focuses on the findings for 5-year-old children in Yorkshire and the Humber at both a regional and lower tier local authority level.

It provides benchmarking data that can be used in joint strategic needs assessments and oral health needs assessments. The data can assist with planning, commissioning and evaluating oral health improvement programmes and dental services and support the monitoring and reporting of water fluoridation programmes.

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Official Statistics: NHS health check quarterly statistics: February 2018

This update contains data from 152 local authorities for October to December 2017 (quarter 3 for 2017 to 2018) and cumulative data from 1 April 2013 to 31 December 2017.

The cumulative data also includes amended statistics for:

• 10 local authorities for April to September 2017 (quarter 1 and 2 of 2017 to 2018)

For more information about NHS Health Check data contact PHE.enquiries@phe.gov.uk.

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Corporate report: PHE equality report: 2017

The equality duty is supported by 2 specific duties which require public bodies such as PHE to:

• publish information to show their compliance with the equality duty
• set and publish equality objectives at least every 4 years

The report set out how PHE responded to meeting these 2 specific duties.

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Research and analysis: High consequence infectious diseases: monthly summaries

Public Health England (PHE) produce a monthly report that provides detailed updates on known HCID events around the world. HCID’s are characterised by acute infectious illness, ability to spread person-to-person, high case-fatality rate, difficulty in rapid recognition and detection, lack of effective treatments and the need for coordination at the national level to appropriately respond. The purpose of this report is simply to raise awareness.

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Open consultation: Data-sharing MoU between NHS Digital and Home Office: call for evidence

Public Health England (PHE) is seeking evidence on the public health impact of the MoU on data sharing between NHS Digital, the Home Office and the Department of Health, particularly on the healthcare-seeking behaviour and health outcomes of the migrant population.

Evidence can be:

• peer-reviewed publications
• narrative accounts
• case studies
• more formal analyses using qualitative, quantitative or mixed methods

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Guidance: Falls prevention: cost-effective commissioning

The return on investment tool pulls together evidence on the effectiveness and associated costs for interventions aimed at preventing falls in older people living in the community. The flexible Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user. All interventions are aimed at those aged 65 and over.

The tool comes with an accompanying report, which details how the tool was constructed and presents the main results.

The second report summarises the findings from a literature review carried out to identify cost-effective interventions.

Local authorities and Clinical Commissioning Groups (CCGs) can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.

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Independent report: SACN annual report 2017

This report provides a summary of the work of SACN and its working groups and subgroup, along with details of members’ declarations of interest and their biographies.

The SACN home page provides more information on the committee.

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Corporate report: PHE Board meeting papers: February 2018

The agenda and papers available for the Public Health England (PHE) Board meeting of 14 February 2018.

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Guidance: Emerging infections: characteristics, epidemiology and global distribution

Many (60 to 80%) emerging infections are derived from an animal source. Infectious disease emergence can be viewed as a two-step process:

1. introduction of the agent into a new host population, followed by

2. establishment and further dissemination within the new host population

See timeline of disease emergence since 1997

See global map of disease emergence since 1997

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Collection: Emerging infections

Emerging infections have been appearing at an average rate of one per year globally.

See Timeline of Emerging Infections since 1997

See Global map of emerging infections since 1997

Human Animal Infections and Risk Surveillance group (HAIRS)

The HAIRS group is a multi-agency and cross-disciplinary horizon scanning group set up in 2004 in order to identify and assess emerging infectious risks to human health. Outputs include disease risk assessments and annual reports of topics discussed.

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Research and analysis: E-cigarettes and heated tobacco products: evidence review

Updated: Added a list of the report’s authors and a research citation to the executive summary.

In the government’s Tobacco Control Plan for England, Public Health England (PHE) was asked to update its 2015 evidence review on e-cigarettes and other novel nicotine delivery systems annually until the end of the current Parliament in 2022.

PHE commissioned a group of leading tobacco control researchers from the UK Centre for Tobacco and Alcohol Studies (UKCTAS) to produce this report, which underwent international peer review.

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Guidance: Alcohol and drug prevention, treatment and recovery: why invest?

This ‘Why invest?’ slide set is part of a collection of guidance and tools to assist local commissioners and providers to demonstrate the scale of harms caused by drug and alcohol misuse and make the case for investing in drug and alcohol treatment and interventions. The resources available include commissioning support packs, social return on investment and value for money tools, and evidence reviews.

Download the ‘Why invest?’ slides to use in your own presentations.

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Research and analysis: Legionnaires' disease monthly surveillance reports: 2018

This publication provides the 2018 reports. Legionnaires’ disease monthly surveillance reports for 2017 are also available.

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Research and analysis: Healthy Child Programme: rapid review on safeguarding

The Healthy Child Programme sets out the recommended framework of universal and progressive services for children and young people in England to promote their health and wellbeing.

The purpose of this rapid review is to update the evidence regarding safeguarding guidance, focusing on prevention and early intervention.

The review looks at relevant systematic review level evidence, supplemented with some primary impact evaluations in the areas of preventing or intervening early with:

• child abuse and neglect
• child sexual abuse and exploitation
• intimate partner violence
• female genital mutilation
• gang violence

View the presentation slides for the summary of the review.

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Research and analysis: Reported norovirus outbreaks (suspected and lab-confirmed) in hospitals: 2018

These data are collected through the hospital norovirus outbreak reporting scheme (HNORS).

For previous data see the archive of older reports.

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Research and analysis: Common gastrointestinal infections in England and Wales: laboratory reports in 2018

For 2017 and earlier previous years’ data, see: the 2017, 2015.

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Research and analysis: Foodborne illness in humans: general outbreaks in England and Wales in 2018

An outbreak is an incident in which two or more people, thought to have a common exposure, experience a similar illness or proven infection (at least one of them having been ill).

A general outbreak is an outbreak affecting members of more than one household or residents of an institution.

For previous data see the archive of older reports.

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Guidance: Homeless adults with complex needs: evidence review

Public Health England (PHE) South East has carried out an independent review of the literature on homelessness, looking particularly at people living or begging on the streets to support efforts to prevent and reduce homelessness and the adverse outcomes associated with this.

This review is aimed at local authorities and other stakeholders who are developing strategies and interventions to prevent homelessness and support adults with complex needs. It advises a system-wide, integrated approach to dealing with homelessness and identifies some tools and guidance which may be of use to local authorities in developing their work in this area.

PHE carried out this review for Portsmouth and Southampton city councils.

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Guidance: Rabies: administration of vaccine and immunoglobulin

This guidance from Public Health England’s Virus Reference Department is for health professionals whose patients require a course of post-exposure rabies vaccination with rabies immunoglobulin (RIG).

It provides critical information on the correct administration of RIG, and should remain with the product.

This document forms part of the PHE Rabies post-exposure prophylaxis: management guidelines.

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Press release: Local authorities should offer NHS Health Check to all eligible

Speaking at Public Health England ‘s Cardiovascular Disease (CVD) Prevention Conference today (Thursday 8 February 2018), Chief Executive Duncan Selbie has called on local authorities to ensure that all local residents eligible for a free NHS Health Check get an invite – to help tackle the one in four premature deaths in the country caused by CVD.

The NHS Health Check is free for all adults in England aged 40 to 74, who have not yet developed CVD. It’s one of the largest health prevention programmes in the world, helping to detect and prevent early signs of cardiovascular diseases such as high blood pressure, heart disease, kidney disease, type 2 diabetes and dementia.

CVD is a leading cause of disability and death in the UK, affecting around 7 million people and being responsible for 26% of all deaths in England – estimated to cost the NHS around £9 billion a year.

Duncan Selbie, chief executive of Public Health England, said:

Since 2013, over 6.1 million people have taken an NHS Health Check. The programme is a cornerstone in England for the prevention of conditions such as CVD, which causes one in four premature deaths and places a huge strain on individuals, families and our healthcare system. We also know that it is the same risk factors causing many cancers and other preventable illnesses, so this is a hugely important programme.

The NHS Health Check has had much success and has the potential to prevent many thousands of premature deaths and ill health in England, but there is still much to be done. Every local authority in the country is required by law to ensure that all eligible people in their area are offered a check every 5 years. We must work together to increase numbers taking up the offer, in particular targeting our efforts to those at greatest risk.

There is good evidence that the programme is successful in identifying those at high risk of cardiovascular disease, but we also need to follow up with effective care and support for them.

The Conference, with over 500 health professionals expected to attend, including GPs and NHS Health Check providers, will focus on a number of ways that CVD risk can be reduced, including:

• ensuring equity and reducing inequality through CVD prevention programmes highlighting the importance of health care professionals in delivering behaviour change messaging for CVD risk reduction
• learning from a range of international CVD prevention projects

PHE has also recently published two documents focusing on CVD prevention:

• Size of the Prize provides region-specific statistics on the opportunity to prevent many thousands of heart attacks and strokes by improving the follow-up care given to those found to be at risk following an NHS Health Check
• the stocktake and action plan sets out how to further improve the impact of the programme over the next 5 years

Background

1. PHE’s CVD Prevention Conference 2018 is taking place on 8 February at the Kia Oval, Surrey Cricket Club in London
2. View national comparison data on NHS Health Check uptake
3. The Heart Age Test is an innovative online tool to check your risk of having a heart attack or stroke - it tells you your heart age compared to your real age, explains why it’s important to know your blood pressure and cholesterol numbers and gives advice on how to reduce your heart age. The tool is a collaboration between PHE, NHS Choices, UCL and the British Heart Foundation.

About Public Health England

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook: www.facebook.com/PublicHealthEngland.

Public Health England press office

Email phe-pressoffice@phe.gov.uk

Telephone 020 7654 8400

Out of hours telephone 020 8200 4400

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Guidance: National minimum standards and core curriculum for immunisation training for registered healthcare practitioners

In order to ensure the ongoing delivery of a high quality, safe and effective immunisation programme that achieves high uptake, it is important that all practitioners involved in immunisation have a high level of knowledge and are confident in immunisation policy and procedures.

To gain this, they need to receive comprehensive foundation training, regular updates, supervision and support.

The aim of the national standards is to describe the training that should be given to all practitioners engaging in any aspect of immunisation so that they are able to confidently, competently and effectively promote and administer vaccinations.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/publications/national-minimum-standards-and-core-curriculum-for-immunisation-training-for-registered-healthcare-practitioners
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News story: PHE launches opioid treatment quality improvement programme

Opioid substitution treatment (OST) plays a fundamental role in supporting people to recover from drug dependence. But sustained recovery is hard to achieve when addiction is combined with a lack of personal and social resources. Long-term recovery often needs high-quality treatment and a range of other support, tailored to each person.

Clinical guidance, including the new Drug misuse and dependence: UK guidelines on clinical management, describes quality drug treatment. PHE is helping drug services implement the guidelines and improve treatment where it is not optimal.

The OST programme will support services to improve the quality of treatment so that people understand how their treatment works, comply with it and stick with it. That way they should get more from it and increase their chances of recovery. This will include a focus on using psychosocial interventions to support changes in behaviour. There is already a lot of good practice in this country, and the programme will aim to harness and build on that.

Among the issues that we plan to address, one is people continuing to use drugs, particularly heroin, while receiving treatment. Drug treatment monitoring data (NDTMS) and PHE’s drugs evidence review both found that people who continue to use illegal substances (especially heroin) while on substitution treatment are less likely to fully benefit from treatment and to reduce the wider harms caused by their drug use. Cutting down, rather than stopping drug use, is still a good result for many people and they still benefit from being in treatment. Pushing people too hard to stop all ‘use on top’ can drive them out of treatment or prevent them seeking help in the first place. The programme will develop resources to support services in getting this right.

The programme will also enhance wider recovery support for those in treatment by supporting services to help more in other aspects of their lives beyond drug use, such as employment, living arrangements, family relationships, trauma and abuse.

PHE will be making contact with providers and service user organisations shortly to gain their input and involvement.

from Public Health England - Activity on GOV.UK https://www.gov.uk/government/news/phe-launches-opioid-treatment-quality-improvement-programme
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