The East Lothian Experience Support from the Start.

The East Lothian ExperienceThe East Lothian Experience

Support from the StartSupport from the Start

Ministerial Taskforce Report – Ministerial Taskforce Report – June 2008June 2008

““Scotland’s health is Scotland’s health is improving rapidly but it is improving rapidly but it is not improving fast enough not improving fast enough for the poorest sections of for the poorest sections of our society. Health our society. Health inequalities remain our inequalities remain our major challenge”major challenge”

2020thth century trends in life expectancy in Scotland and 16 other century trends in life expectancy in Scotland and 16 other Western European countriesWestern European countries

Life expectancy in years

30

40

50

60

70

80

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000

Scotland

The National ProgrammeThe National Programme

Health inequalities are Health Ministers’ top Health inequalities are Health Ministers’ top prioritypriority

Key priority areas of children’s very early Key priority areas of children’s very early years; the big killer diseases of years; the big killer diseases of cardiovascular disease and cancer; drugs cardiovascular disease and cancer; drugs and alcohol problems and links to violence; and alcohol problems and links to violence; mental health and wellbeingmental health and wellbeing

Eight test sites established to find new ways Eight test sites established to find new ways of working at a community partnership levelof working at a community partnership level

East Lothian Test Site

East LothianEast Lothian

One of 32 Scottish Unitary One of 32 Scottish Unitary CouncilsCouncils

Known as ‘Edinburgh’s Known as ‘Edinburgh’s garden’garden’

Fastest growing population in Fastest growing population in Scotland (90,155)Scotland (90,155)

A good place to live, bring up A good place to live, bring up families & retire to.families & retire to.

Lot of service pressures esp. Lot of service pressures esp. housing, and care services for housing, and care services for older people older people

Health is slightly above Scots Health is slightly above Scots averageaverage

Inequality is the issueInequality is the issue

Health Inequality in East LothianHealth Inequality in East Lothian

Breastfeeding Rates

64.5

46.8

22.9 22.5

34

0

10

20

30

40

50

60

70

North Berwick East Lothian Wallyford &Whitecraig

Prestopnans Tranent N

Percentages – source Community Health Profile 2004


Smoking during pregnanacy

16.9

24

31.930.9

32.1

0

5

10

15

20

25

30

35





Children in workless homes

7.2

12.6

24.2

21.7 21.7

0

5

10

15

20

25

30




Community Planning Partners can make a difference by focusing services on pathways that can reduce health inequality in the early years of life.

Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows the only way of of his head, behind Christopher Robin. It is, as far as he knows the only way of coming downstairs, but sometimes he feels that there really is another way, if coming downstairs, but sometimes he feels that there really is another way, if

only he could stop bumping for a moment and think of it. only he could stop bumping for a moment and think of it. And then he thinks that perhaps there isn’t.And then he thinks that perhaps there isn’t.

The Test Site approachThe Test Site approach

Consistent parenting, safe, nurturing early years, supportive education

Health behaviours

Opportunity to escape poverty. To have decent

housing, social networks, self esteem, control

Key Elements of ApproachKey Elements of Approach

LeadershipLeadership – strategic, service & – strategic, service & community championscommunity champions

LearningLearning – what works – what works Engage with Communities Engage with Communities Mainstream servicesMainstream services InnovationInnovation

ActivitiesActivities

Action learning setsAction learning sets Civic Conversations Civic Conversations – short term learning outcomes– short term learning outcomes

Development fundDevelopment fund Service mapping & redesign Service mapping & redesign – – medium term outcomesmedium term outcomes

Measuring and evaluating changeMeasuring and evaluating change

Action Learning SetsAction Learning Sets

Action Learning Sets are a small group of Action Learning Sets are a small group of individuals who support each other in individuals who support each other in learning and development in an area learning and development in an area where they have an interest and want to where they have an interest and want to expand their expertise. They consist of 5-expand their expertise. They consist of 5-8 people with a facilitator. Each set 8 people with a facilitator. Each set reflects a range of services but does not reflects a range of services but does not mix managers and practitioners. Service mix managers and practitioners. Service Champions participate.Champions participate.

Service ChampionsService Champions

An Equally Well Service Champion is an An Equally Well Service Champion is an individual, identified by senior managers individual, identified by senior managers who is able and willing to foster a learning who is able and willing to foster a learning environment within their areas in relation environment within their areas in relation to promoting Health Equality.to promoting Health Equality.


Communicating the vision and values of Communicating the vision and values of Support from the Start within their areaSupport from the Start within their area

Bringing the experience and knowledge of Bringing the experience and knowledge of their service area to an Action Learning their service area to an Action Learning SetSet

Supporting services to identify training and Supporting services to identify training and information needs related to Support from information needs related to Support from the Start and communicating these to the the Start and communicating these to the Project ManagerProject Manager


Contributing as appropriate to a Support Contributing as appropriate to a Support from the Start online learning logfrom the Start online learning log

Be willing to participate, as appropriate, in Be willing to participate, as appropriate, in the dissemination of the East Lothian Test the dissemination of the East Lothian Test Site experience to other authorities and Site experience to other authorities and agencies within Scotlandagencies within Scotland

Civic ConversationsCivic Conversations

How do we get communities, parents and How do we get communities, parents and children involved in key health children involved in key health improvement challenges for the early improvement challenges for the early years of life?years of life?

Do East Lothian services make it easy for Do East Lothian services make it easy for parents to be ‘good enough’ and can parents to be ‘good enough’ and can parents access the right support early parents access the right support early enough when they are finding it hard to enough when they are finding it hard to cope?cope?

Civic ConversationsCivic Conversations

How should we target support for children How should we target support for children and families that are at risk of poor health and families that are at risk of poor health so that those who need the most support so that those who need the most support get it when they need it?get it when they need it?

Does the physical space of our Does the physical space of our communities contribute to creating good communities contribute to creating good health in the early years and support health in the early years and support parents in raising healthy children safely?parents in raising healthy children safely?

Development FundDevelopment Fund

Initial Fund of £49000:- Initial Fund of £49000:- Applications for small development grants Applications for small development grants

can be made by the Service Champions. can be made by the Service Champions.

Projects mustProjects must• contribute to at least one target areacontribute to at least one target area• demonstrate potential for learningdemonstrate potential for learning• lessons from the work must be lessons from the work must be

communicated.communicated.

Community engagementCommunity engagement

Open ended dialogue with communities Open ended dialogue with communities about health in early yearsabout health in early years

Civic conversations for short term Civic conversations for short term outcomesoutcomes

How does it work –How does it work – Different in each communityDifferent in each community The Tranent experienceThe Tranent experience

Outputs

A healthier start to life for children in Prestonpans, Wallyford, Whitecraig, Tranent & Musselburgh

East.

We haves explored a diverse range of ways to involve communities, parents & children in key health improvement challenges

All relevant services have reviewed how they can make it easy for parents to be 'good enough', and how they help parents to access the right support, early enough when they are finding it hard to cope?

All services have reviewed how we target support for children and families that are at risk of poor health, and ask is it effective?

We have assessed the physical space of our communities and its contribution to creating good health in the early years and support for parents in raising healthy children safely

Reduce obesity levels among children in P1

Reduce pregnancies in under 16 years

Increase no. of children with no obvious caries experience in P1

Reduce smoking rates in pregnancy

Increase opportunity for involving parents and children

Increase number of HIAs on new developments

Improved outcomes for looked after children

Increase proportion of newborn children breastfed at 6 -8 weeks

Improved educational attainment

Improve emotional well being in early years

Review of Service pathways to identify - what works?what needs improved?what are the gaps?

NHS Services- Health Visitors- Midwifery Services- General practise- Health Promotion & public health services- CAMHS

ELC Services- Early Year services- Primary school P1–P3- Children’s social work- Community Services- Environment Services

Voluntary sectorChildren 1st

First StepCare Free KidsBarnardosOthers

Private Sector- Nurseries- Childminders

Integrated Children’s services Plan Joint Health Improvement Plan Equally Well Implementation Plan Early Years framework Getting it Right for every Child Curriculum For excellence Single Outcome Agreement Lothian Health Plan Support From the Start service development Fund

Developing Service pathways -Identifying interventions- Agreeing intervention- Implementing- Evaluating

Identify Service Champions to lead on learning process

Supporting learning Establish a local research & evaluation networkEstablish a local learning networkEstablish action learning sets for championsEstablish a web log

Assumptions & Risks

This model assumes that health inequality is best addressed by mainstream services combined with a vigorous community engagement strategy. It also

assumes that service providers and the target communities have a shared interest in improving health and addressing inequality and are willing to prioritise this

Logic Model For ‘Support from the Start’

Risk are: Recession. Time pressures on services limiting capacity for change. Prioritisation of health and social justice issues change before objectives can be realised. Barriers to working across agencies reduce capacity for change and shared learning.

Inputs Activities Participation Short-term outcomes (learning) Medium Term Outcome (Action)

Long-term outcomes

Finally…………….Finally…………….

……………………..but..but

this is to facilitate changethis is to facilitate change

If we keep on doing what we have always done then we will If we keep on doing what we have always done then we will not address the equity issues in our communitynot address the equity issues in our community

We will know we have succeeded when:-We will know we have succeeded when:-

Children and families are engaged with the Children and families are engaged with the key health improvement challengeskey health improvement challenges

Parents can access support for healthy Parents can access support for healthy living when they need itliving when they need it

Parents and children have good quality Parents and children have good quality child friendly environmentschild friendly environments

Those at most risk of poor health receive Those at most risk of poor health receive most supportmost support

More informationMore information

Web log

http://edubuzz.org/blogs/equallywell/

http://equallywell.ning.com/

The East Lothian Experience Support from the Start.

Documents

Transcript of The East Lothian Experience Support from the Start.