draft health and wellbeing strategy for milton keynes · • the milton keynes health and wellbeing...

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DRAFT Health and Wellbeing Strategyfor Milton Keynes

A 10 year strategy 2018 - 2028

DRAFT

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DRAFT Joint Health and Wellbeing Strategy for Milton Keynes

Lifelong Wellbeing For our safe, active, vibrant and caring community Our 10 year strategy for Milton Keynes

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Wellbeing First - Shift resources to focus on preventionClosing the Gap - reduce inequalities in life chancesOne MK - An integrated health and wellbeing system

For each section:

Why is this important?

What needs toimprove compared toelsewhere?

What are the local andnational policydrivers?

Plans

OurPassions

StartingWell

AgingWell

LivingWell

Priorities

Priorities

Priorities

ProgressIndicators

ProgressIndicators

ProgressIndicators

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1. Our vision

• Lifelong wellbeing for our safe, active, vibrant and caring community.

2. Our approach/passion

• Wellbeing first - Shift resources to focus on prevention and early intervention

• Closing the gap - reduce inequalities in life chances

• One MK - Ensure an integrated health and wellbeing system across Milton Keynes

3. The MK System Charter for working together effectively

The MK System Charter for working together effectively!

WE WILL:!•" Achieve positive outcomes for MK people !•" Keep focussing on our agreed priorities!•" Break through organisational boundaries

to do the best for MK !•" Focus on prevention and early

intervention to keep people healthy !•" Openly share our knowledge and

information to drive major change in MK !•" Involve local communities, vulnerable

people and service users to harness their expertise and experience !

•" Share our resources and take collective decisions about their most effective use!

BEHAVIOURS:!•" Seek success for MK!•" Recognise we are equal

partners!•" Have frequent personal

contact!•" Understand each other#s

organisations, services and perspectives!

•" Speak well of and respect each other and never undermine!

•" Speak up, resolve conflict, move on!

•" Act with integrity and keep all our promises!

•" Stick to our decisions!

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4. The Milton Keynes Health and Wellbeing Board – A place basedapproach

• The Milton Keynes Health and Wellbeing Board will lead a whole system approach in Milton Keynesin which all organisations work together towards shared priorities.

• The Board has agreed through the Joint Health and Wellbeing Strategy shared priorities and how toimprove health and wellbeing in Milton Keynes set out across the life course of Starting, Living andAgeing Well.

5. Areas of Focus for Milton Keynes from the Joint Strategic NeedsAssessment

5.1 Population and Place

• Encourage non-polluting and active forms of travel such as cycling and walking to improve healthand move towards low emission economy

• Focus on the solutions required to address the levels of insufficient housing to meet need, which iscontributing to homelessness

• Focus on prevention of violent behaviour with a focus on domestic abuse and sexual abuse

5.2 Children and Young People

• All services should identify vulnerable women and families and take appropriate action to ensuretheir wellbeing and improve outcomes

• Ensure early intervention and prevention to tackle the underlying risk factors for infant mortality

• All providers must tackle risky behaviours and adverse childhood experiences, by supportingparents and families to access support as early as possible

• Continue the review of children’s non-elective admission pathways for common conditions, toidentify opportunities for appropriate care and improved care management

• Schools and partners must work together to achieve good emotional, mental and physical health,wellbeing and resilience for all pupils, including the most vulnerable, through a whole schoolapproach

5.3 Adults and Older People

• Increase cancer symptom awareness to improve levels of early diagnosis

• Improve care management of diagnosed hypertensive patients to reduce onward risk of heartattack and stroke

• Ensure successful implementation of the Diabetes Prevention Programme for people at high risk oftype 2 diabetes

• Increase uptake of influenza vaccine in at risk groups

• Achieve “parity of esteem” between mental health and physical health services

• Assess the need for falls related training for staff across health and social care sectors, and deliverappropriate levels of training

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6. Starting Well6.1 Why this is important

• The first 1,001 days from conception to age 2 has an impact and influence on the rest of the lifecourse.

• Families are the most important influence on a child in the early years, and identifying thosefamilies who need help as early as possible opens opportunities to provide evidence – basedinterventions.

• Early interventions not only improve life chances for our children, but also reduce future costs asintervening early is more effective.

• Adverse childhood experiences include a range of risk factors that impact on a child includingparent’s substance misuse, low birthweight, poor parental mental health, social deprivation, abusein the home. They are one of the strongest predictors of poor health and social outcomes in adults.

• Over half of all mental illness starts before the age of 14 years and 75% has developed by the mid-twenties. Good emotional health and wellbeing amongst children and young people promoteshealthy behaviours, good attainment and help prevent behavioural and mental health problems.

• Strengthening children’s social and emotional skills and building resilience is key to promotinghealth and wellbeing.

• Children and young people need to be protected from inappropriate caring roles so that they canachieve their potential at school.

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6.2 Milton Keynes compared to other parts of the country:

• MK infant mortality rate of 5.3 deaths per 1,000 live births is significantly higher than the nationalaverage of 3.9 per 1,000.

• Our children have different experiences and chances depending on where in MK they live - 18.3%of children under 16 are living in poverty.

• MK children achieved an average of 59.9% for educational attainment which is significantly belowthe England state-funded schools average of 63.0%.

• 9.6% of 4-5 year old children and 19.0% of 10-11 year old pupils in MK were defined as obese –these outcomes are disproportionally higher in lower socio-demographic, socially disadvantagedgroups and in some ethnic groups.

• Rates of emergency admissions for in children in MK are significantly higher than the Englishaverage

• It is estimated that 9.6% of MK children aged 5-16 have a mental health problem.

• It is estimated that nearly half of all children are exposed to at least one adverse childhoodexperience, and 1 in 12 are exposed to four or more, this more likely to place children at risk ofabuse and/or neglect.

6.3 Key national and local policy drivers

To be informed during consultation

6.4 Priorities

• Promote wellbeing and keep women safe during pregnancy so that children have the best start inlife

• Make children and young people’s mental health and wellbeing a golden thread througheverything we do

• Make physical activity and eating well part of everyday life for children and young people

• Stop problems from escalating through better, more joined up earlier help

• Improve the life chances of children and young people with disabilities

• Stop all forms of abuse and the negative impact it has on children and young people

• Tackle the impact of low quality housing on children and young people

• Keep children and young people in the driving seat of change recognising their rights as expertsthrough experience

6.5 What will change?


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7. Living Well7.1 Why this is important

• Evidence shows that income, employment, education, housing quality and crime are stronglylinked to both physical and mental health.

• Healthy lifestyles, early diagnosis and control of conditions like blood pressure, diabetes and heartdisease improve the health and wellbeing of the population and the environments we live, workand play in can facilitate this.

• Tobacco is still the greatest single health risk and accounts for up to half of the life expectancy gapbetween deprived communities and the rest of the population.

• Reducing levels of smoking and alcohol misuse and improvements in diet and levels of physicalactivity will greatly reduce the burden of disease for individuals, their families and for society.Unhealthy behaviours cause 40% of premature mortality.

• People and communities that lack social support and social networks are less likely to experiencepositive mental health and wellbeing and to take care of themselves.

• Satisfaction with life is lower, and suicide rates are higher in middle age.


• MK residents are less well-established; fewer than 10% have lived here 10 years or more.

• More residents report living in overcrowded households and complain about unwanted noise. Ahigher proportion of households are homeless.

• The proportion of people reporting feeling satisfied with their lives is below the national average -it should be higher.

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• MK residents are less deprived but they are more likely to be overweight or obese, be admitted tohospital for some alcohol-related admissions, and, if HIV positive, to be diagnosed late. Uptake ofbowel cancer screening is below the national average.

• Most people in Milton Keynes enjoy a high quality of life but the proportion of residents living inadverse circumstances is higher.

• Carers report a lower quality of life (lowest 25% nationally in 2014/5), and greater social isolation,and fewer residents feel supported to manage their conditions.



7.4 Priorities

• Improve population mental wellbeing and resilience through raised awareness of the benefits ofgood mental wellbeing and services available to support people at times of mental distress

• Reduce the risk of heart disease, cancer and stroke by increasing healthy eating and exercise, andreducing smoking and alcohol consumption

• Improve detection and management (including self-management) of long term conditions such ashypertension, diabetes and HIV

• Strengthen the role of healthy living community pharmacist’s and improve access to advice andsupport in the community (social prescribing)

• People with autism are supported through early diagnosis, have access to high quality informationand the opportunity to have access to employment

• Make MK a good place to be a carer by supporting carers and giving them and those they care for avoice in care choices

• Reduce the number of rough sleepers and stem the rise in households in temporaryaccommodation

• Stop all forms of adult abuse and exploitation



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8. Ageing Well 8.1 Why this is important

• The population aged 85 and over in MK is predicted to increase by 86% from 4,300 in 2017 to 8,000in 2030.

• Health and social care must adapt to meet the needs of the growing numbers of older people byincreasing the capacity of services for diseases that increase in frequency with age, e.g. dementia,and for increasing numbers of people with multiple coexisting conditions. Existing and emergingtechnologies should be fully utilised to support this.

• Where individuals have a high level of need due to ill health it is essential that there is co-ordinatedcare across the NHS and social care system.

• Dementia increases sharply with age from about one in thirty at the age of 70, to one in five inthose over the age of 80. The number of people with dementia is expected to increase from 2,400in 2017 to 3,300 by 2025.

• Depression is the most common mental health need for older people and the prevalence rises withage, to as high as 40% among those living in care homes.

• The better health arising from adopting healthier behaviours and self-efficacy continues to beimportant in people at older age.

• Social isolation is a contributing factor to over 60% of preventable illness.

• Nearly a third of pensioners live alone. Lack of social support increases the risk of hospitaladmission, re-admission, and a longer stay in hospital.

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• There are more premature deaths from the common causes of death, especially lung disease; andadmissions for all smoking-related disease are higher. Significant health inequalities persistbetween the less deprived and more deprived areas of MK.

• The likelihood of hospital admission is higher, and emergency re-admissions are higher

• Hospital admissions from people with dementia are higher

• Reported health related quality of life among carers of people with dementia is lower

• Fewer residents at the end of their lives are supported to be able to die in the place they choose.



8.4 Priorities

• Increase earlier diagnosis of dementia by raising awareness and provide a range of good qualityservices for people living with dementia

• Promote choice and control for older people thereby helping them to live at home for as long asthey wish and are able to

• Support older people to stay healthy, maintain independence and receive the care they need in themost appropriate settings

• Develop high quality out of hospital services to reduce the need for hospital admission and getpeople home safely and quickly

• More people at the end of their lives are supported to be able to die in a place of their choice



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Milton Keynes CouncilCivic Offices1 Saxon Gate EastCentral Milton Keynes MK9 3EJ

November 2017

Available in audio, large print, braille and other languages

01908 253041

www.milton-keynes.gov.uk

draft health and wellbeing strategy for milton keynes · • the milton keynes health and wellbeing...

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