Decision details

Aidan Kirkpatrick, Consultant in Public Health and Alison Moore, Public Health Specialist, Lancashire County Council presented the report to the Board, which articulated the pressing need for the development of a Lancashire wide Healthy Hearts strategy. It  outlined the strategic intent and proposed key recommendations to the Health and Wellbeing Board, seeking  a mandate for this work and ensure system wide buy-in.

The Board was reminded that the report aligned with the recent commitment to prioritise Healthy Hearts and also with the Government's 'Levelling Up' agenda; that by 2030 the gap in Healthy Life Expectancy between local areas where it is highest and lowest would have narrowed and that by 2035 Healthy Life Expectancy would rise by five years. 

The latter policy intervention was particularly pertinent for Lancashire given not only the wide variations in both Life Expectancy and Healthy Life Expectancy across Lancashire; but also crucially the fact that when considering the expectancy gap between the most and least deprived quintiles of Lancashire, just over 24% of this gap was attributed to circulatory disease related mortality (ahead of all other causes of death).

The Board recognised that cardiovascular disease has a strong impact on life expectancy, and the Healthy Hearts Programme, based on a Best Practice Framework, will help address this.

The Board were informed that arrangements were underway for a workshop later in March to scope out how best to further develop the Healthy Hearts Strategy and associated work programmes.  This would help to build upon a range of emerging national targets related to cardiovascular disease.

Robin Ireland, Food Active was welcomed to the Board and supported discussion about the Healthy Weight Declaration (Appendix A) . Food Active is a North-West based charity and so far, across England, 26 Councils have adopted the Healthy Weight Declaration.  Lancashire County Council initially signed the Health Weight Declaration in 2017, however, during 2020 the 16 commitments as detailed in Appendix A were reviewed and refreshed.

The Board were also asked to note that an event was being planned towards the end of June 2022 around Healthy Weight to consider policies that can be adopted at district level.

Following the presentation, the following points were raised:

The Board was asked about emotional wellbeing  and mental health in young people, and whether there were any lessons to be learnt as the strategy is taken forward. The Board was informed that the plan was to start to explore across the teams where insight and learning could be sought from residents. To start the process, discussions have been taking place with teams across Lancashire and it is crucial to get the perception of the programme right.  Across the networks, they need to be directing residents to programmes that are already in place, working together to increase the numbers of participators and improve the quality of the programmes. It was also noted that there should be a family approach and have a variety of delivery to try and attract people to take part and to remove the stigma of the word 'weight' and make it fun.

A query was raised in terms of what is stopping people engaging with the services that are being offered to them, particularly when there are 65% of people in Lancashire who are overweight or obese.  The Board were referred back to the Foresight Obesity System Map, which shows the causes of overweight and obesity and the complexity of people's lives. The intention is to work on a whole systems approach and look at the different reasons why people may not be engaging, ie transport issues, community safety, drug and alcohol use, weather etc. that are being identified as a barrier in accessing a healthy lifestyle.

Adrian Leather, from Active Lancashire commented that the whole issue is about behaviour change and everybody is working on that agenda.  Three offers were made to support the Healthy Hearts offer, from Active Lancashire, which were:

i)  To provide data on areas in Lancashire where the focus is most needed on physical activity (who is active, who has the propensity to be active, age profiles) and also data on indications of what works around messaging and offers and working with local partners will join this area of work up.

ii)  To help on Business Health Matters around workplace health and wellbeing and health checks available and would like to see this referenced more during this piece of work on Healthy Hearts.  If it was to become a campaign, Active Lancashire would like to work with the Authority on targeting and developing the messaging and to focus on young people and adults.

iii)  Work on informing the policy on sustainable transport and resource applications ie upgrading pavements, prioritising routes which would support local cycling routes.

Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council commented that the intent behind the Healthy Hearts programme was to mobilise collective endeavours.  Planning is happening on three dimensions:

i)  Policy and creating a better environment (ie planning, transport).

ii)  Services for individuals (ie clinical, behaviour change or broader wellbeing programmes).

iii)  Mobilising communities and engaging them.

It was agreed that the Board would welcome the offer from Active Lancashire and link up with the work that was alluded to in the workplaces to enable a shared understanding and develop it with partners.  It was noted that this was the start of the journey and there was lots of learning to be taken forward following discussions at this meeting and also from Rossendale and the work they have carried out for their plan and the successful links they have made with their communities.

It was also noted that the role of the District Councils is crucial in this area of work and to utilise the Community Hubs model which has been in place throughout Covid and proved a better connection between communities and Local Authorities.

Data sharing was highlighted as a challenge for the NHS Health Checks programme, and was recognised as a generic challenge for many different services. If a service intervention is undertaken in a community setting, and that service is dependent upon follow up by NHS, particularly in primary care, then robust and safe data transfer is essential.  This remains a key challenge and discussions are taking place to provide solutions.  It was also noted that it was not only a technical issue, but a cultural issue Lancashire and South Cumbria wide.

Resolved:  That the Health and Wellbeing Board:

i)  Endorsed the strategic development of the proposed Healthy Hearts Programme.

ii)  Signed the Healthy Weight Declaration (Appendix A) pledging to tackle unhealthy   weight within Lancashire.

iii)  Supported the targets currently being developed for the emerging Healthy Hearts   Strategy.

iv)  Endorsed a joined up collaborative approach with the emerging Integrated Care   System Cardiovascular Disease Prevention Programme, to support cross   organisational leadership and delivery responsibilities.

v)  Agreed to receive future updates as this programme of work develops further.

vi)  Agreed the offers received from Active Lancashire and to work with partners to develop the Healthy Hearts offers for Lancashire.