Salford Primary Care Trust – your leader for health IN Salford Friday 12 th December 2008 Salford Primary Care Trust Strategic Plan Overview and Scrutiny Committee

Leading the NHS in Salford Commissioner of services Partnerships Community services provider Review of the context for the Strategic Plan

The Strategic Plan 3-5 year planning document Articulates vision, aims, objectives, etc. Identifies priority areas for attention and investment PCT progress on priorities will be assessed.

Strategy development Understanding health needs – to support needs-led investment Review current investments Anticipating availability of resources Implementation Plan over next 5 years

An Introduction to health In Salford

There's a lot of variation in health…. Between Salford and rest of England & Wales: Salford

Deaths from Liver Disease (Women) Salford

And within Salford – eg local deaths

Health is closely linked to poverty

What memorable things have happened to you in the last three years?

The Life Expectancy gap between Salford and the rest of England & Wales is just that – 3 years Life Expectancy Shortfall on E&W average Life Expectancy Shortfall on E&W average Men Women How many memorable things are people missing for their 3 lost years?

And now the good news: People in Salford are already living longer And they will continue to live longer in the future BUT They may have additional years of ill health NOT good health

The Premier League of ill health in Salford Salford Premier League for Health (2006) DiseaseNumber of DeathsAbove E&W rate Heart Disease & Stroke84735% Cancer64726% Respiratory Disease36715% Digestive Diseases1466% Accidents733% Mental & Behavioural Disorders 693%

And the main causes are….. The “Lifestyle” Issues Smoking Alcohol Obesity

Smoking 550 deaths a year 30% of adults smoke Over 2,500 smokers need hospital treatment each year Costs more than £3m/year Cost to industry of smoking related ill health £9m Total Cost to Salford £53M

Alcohol One of worst performing areas in the country 6th highest rate of alcohol-related hospital admissions 40,400 people drink more than daily guideline 13,200 experiencing harm to health 4,200 dependent drinkers

Obesity 39,000 obese adults 68,000 overweight 5,500 Obese Children 5,700 Overweight Cost to local economy about £10m/yr Links to Heart Disease, Cancer, Diabetes etc

Mental health – a silent problem More mentally ill people drawing incapacity benefits than unemployed people on Jobseeker’s Allowance Nearly 1 in 10 people in Salford being treated for depression Anxiety and depression a big issue for elderly people Dementia and an ageing population

People can make a choice to change their Lifestyle BUT The environment needs to support the choice

GoalOutcome Measure To reduce health inequalitiesHealth Inequalities To increase life expectancyLife Expectancy To reduce the rate of teenage pregnancyUnder 18 conception rate* To reduce the number of people who smoke Smoking quitters To reduce the risk from hypertensionHypertension prevalence Reduce deaths from cancerCancer mortality rate To utilise patient experience in commissioning decisions Self reported experience of patients and users To reduce the impact of alcohol-related harm Rate of hospital admissions per 100,000 for alcohol related harm* To reduce the social and economic impact of mental health problems Out of work due to Mental Health problems To reduce obesity in all agesObesity

How to tackle these health issues? Identify initiatives Scope Scale Likely impact Plan implementation Direct resources

Current position Strategic Plan remains as ‘final draft’ World Class Commissioning assurance panel held Awaiting confirmation of the PCT’s financial allocation and affordability Initiatives developing Business Cases for proposed investment

Question: In which service area would you want to invest more money? Coronary Heart Disease services – out-patient services and in-patient interventions. Diagnostic services – more capacity. Smoking cessation support. Exercise 1

Question: From which service area would you want to disinvest? Coronary Heart Disease services – out-patient and in-patient services. Diagnostic services – more capacity. Smoking cessation support. Exercise 2

Question: From which service area would you want to disinvest? Coronary Heart Disease services – out-patient and in-patient services. Diagnostic services – more capacity. Smoking cessation support. Exercise 2