Wiltshire's Joint Health and Wellbeing Strategy
Contents
Our vision
People in Wiltshire are empowered to live full, healthy and enriched lives.
The four key themes of Wiltshire's Health and Wellbeing Strategy
In everything we do, we consider the impact of the action on social mobility and ask how we can help to tackle the disparities in opportunities, experience, access and health outcomes that exist within Wiltshire. We focus on the factors that have the greatest influence on people's health, such as ensuring good and secure homes and jobs.
Case for change
Whilst a significant proportion of our population are healthy; good health isn't just about the treatment of illness. It is the food we eat, the relationships we maintain, the environments in which we live and work and the opportunities we have to thrive. Supporting people to remain healthy, independent and well is a crucial feature of this strategy. To make the biggest changes in people's health and wellbeing, we need to focus on the social and environmental factors impacting on people's lives. Addressing these wider determinants of health - such as housing, unemployment, homelessness, education, social isolation, transport and community safety - alongside recognition of the rurality of much of Wiltshire, is critical for improving social mobility and tackling inequalities.
Achieving change
We will:
- promote health in all policies - including housing, employment and planning. This will include the development of sustainable communities, whole life housing and walkable neighbourhoods. The review of Wiltshire's Local Plan and Local Transport Plan is an important opportunity to deliver this.
- support healthy home settings - with action on fuel and food poverty, helping people to find stable well paid work and higher incomes, mental health and loneliness and by increasing digital inclusion
- give children and young people the best start in life - with a focus on the whole family, family learning, parenting advice, relationship support, the first 1000 days (early years), and community health services
- target outreach activity - identifying particular groups to improve health outcomes and access to services (identifying and then focusing on several of these each year) - work to tackle root causes, plan delivery and carry out evaluation.
- improve access through online services, community locations and mobile services as well as community diagnostic hubs.
We take a long-term view, focusing on what is right for Wiltshire and invest in prevention and early intervention to tackle problems before they get worse. We encourage personal resilience and have a whole life approach to planning and providing services for our residents alongside this, aimed at improving outcomes in population health and care.
Case for change
Evidence suggests 60% of what we do to prevent poor health and improve wellbeing relates to wider determinants of health i.e. the conditions in which people are born, grow, live, work and age. Unhealthy behaviours for example smoking, alcohol misuse, poor diet and lack of physical activity, are significant contributors to a large proportion of ill health and long-term health conditions such as cancers, cardiovascular disease, diabetes and dementia. We need a system that is fit for purpose, can manage the challenges of increasing demand, focuses on prevention, supports those with long-term conditions and their carers and helps our populations to improve their health outcomes.
Achieving change
We will:
- lay the foundations for good emotional wellbeing whilst young - by developing a coordinated approach and promoting a core offer in schools across Wiltshire relevant to the challenges young people face (including new challenges such as social media)
- empower individuals across the life course - in all schools, with working age adults and for the elderly - with advice focusing on healthy lifestyles, smoking cessation, alcohol and substance misuse
- perevent ill health - through increased uptake of screening, health checks and immunisations as well as ensuring the best use of antibiotics.
- enable a healthy workforce through targeted preventative activity
- adopt a proactive population health management approach - rolling this out to new areas (such as management of moderate frailty) each year to enable earlier detection and intervention
We ensure our dialogue with communities is open, transparent and inclusive, in the right place and at the right time so that the distinctive needs of local communities are met. We enable stronger and resilient communities and support broader social and economic development
Case for change
Population growth and management of long term conditions means our health and care system is under increasing pressure, particularly as it recovers from the pandemic. When people have the skills, knowledge and confidence to manage their own health and care, not only do they achieve better health outcomes, there is also the benefit of reduced healthcare costs and increased satisfaction with services. However, when individuals in a community feel isolated, this impacts their ability to remain resilient, which is a strong predictor for poor outcomes. Enabling communities to be stronger and more resilient allows local solutions for local problems, by working together with partner agencies and the voluntary sector to meet their health and wellbeing needs.
Achieving change
We will:
- support local community action - through initiatives such as neighbourhood collaboratives allied to the development of Primary Care Networks, community based programmes and social prescribing, the community mental health model, area board activity using community area JSNAs to inform local action planning and the allocation and bidding for wellbeing grants
- pilot community conversations - starting with neighbourhoods in Wiltshire that have significant deprivation and roll these out gradually across the county.
- consider the way in which we buy goods and services can deliver improved local job opportunities (acting as 'anchor' institutions) and other wider benefits (social value)
- embed Healthwatch Wiltshire and voluntary and community sector voices in relevant decision-making structures and ensure the public voice is heard with consultation results and co-production reflected in decision papers and relevant attendance at the Health and Wellbeing Board
We design and deliver our activities in partnership with service users, the voluntary, community and social enterprise (VCSE) sector, local communities and public sector partners. We collectively consider how to integrate our work, get maximum value for public sector spend and plan our use of the public sector estate together.
Case for change
Our current health and care system is under pressure and can be confusing for staff, patients, families and carers. As our populations get older and more people develop long-term health conditions, our system is becoming less able to cope with the changing needs and expectations of the people it serves. This is leading to higher demand for social care, carers and community health services and these pressures will continue to increase with a reduction in the working age population. The way we pay for health and care services can encourage high-end care in expensive settings, often reinforcing isolated working practices. We currently spend too much on services responding at the point of crisis and not enough on early intervention and preventative support that aims to keep people well for longer. Initial signs are that COVID has reinforced the investment in acute services and although there has been some staffing growth there are also challenges with increasing activity and productivity across the system to address the elective care backlog.
Achieving change
We will:
- provide integrated, personalised services at key stages in a person's life - this will include starting to complete later life planning with people in their early 60s (or before that in more deprived areas) so that we are preparing for when they are older, end of life care, and increasing the provision of personal budgets and coproduction of services
- boost 'out-of-hospital' care, encouraging a 'hospital without walls' model with improved digital and local access to consultants, and dissolving the divide between primary and community health services - through coordination of community multi-disciplinary teams, clustering services around primary care networks, and guaranteeing support to people in care homes
- enable frontline staff to work more closely together - planning our workforce needs together, developing case studies on front line cooperation, supporting shared records and IT and sharing estates wherever possible
- ensure carers benefit from greater recognition and support by improving how we identify unpaid carers
- improve join-up of services through community healthcare, primary, secondary and tertiary healthcare (including specialist services, for the armed forces and their families, pharmaceutical services and healthcare in the justice sector)
- drive improvement by delivering our vision through collective oversight of quality and performance, reconfiguration of clinical pathways, recommissioning of services and overseeing pooled budgets and joint teams together (through the Wiltshire Integrated Care Alliance). The ICA will bring together officers from the relevant organisations and report regularly to the Health and Wellbeing Board on progress against this strategy and its own transformation programme as well as the Better Care Plan
If you require more information, please contact executivebusinesssupport@wiltshire.gov.uk (opens new window)