Increasing Employment Opportunities and Improving Workplace Health

Evidence Review 5 - Increasing employment opportunities and improving workplace health Briefing 5a - Workplace interventions to improve health and wellbeing Briefing 5b - Working with local employers to promote good quality work Briefing 5c - Increasing employment opportunities and retention for people with a long-term health condition or disability Briefing 5d - Increasing employment opportunities and retention for older people This set of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the role of employment opportunities and good quality work in improving health. These papers provide a summary of evidence on the effects of unemployment and poor working conditions on health and the unequal distribution of these effects. They then outlines the potential actions that can be taken in local areas around four specific topics: - Workplace interventions to improve health and well-being- Working with local employers to encourage, incentivise and enforce good quality work- Interventions to increase employment opportunities and retention for people with a long-term health condition or disability- Interventions to increase employment opportunities and retention for older people The full evidence review and four shorter summary briefings are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Benzodiazepines: Good Practice Guidelines for Clinicians

Benzodiazepines are one of the most widely used prescription medicinal products in the world. Benzodiazepines may be prescribed safely in the short-term and are a highly effective treatment for anxiety, insomnia and some forms of epilepsy and spasticity. Benzodiazepines are only indicated when the disorder is severe, disabling or subjecting the individual to extreme distress. Dependence is now recognised as a significant risk in patients receiving treatment for longer than one month and the practitioner has to be conscious of this when evaluating the relative benefits and risks of continued prescription. Download document here

Speech by Mr. Micheál Martin TD – Meeting The Challenges Of Cultural Diversity In The Irish Healthcare Sector

It gives me great pleasure to accept the invitation to address this conference on “Meeting the Challenges of Cultural Diversity in the Irish Healthcare Sector” which is being organised by the Irish Health Services Management Institute in partnership with the National Consultative Committee on Racism and Interculturalism. The conference provides an important opportunity to develop our knowledge and understanding of the issues surrounding cultural diversity in the health sector from the twin perspectives of patients and staff. Cultural diversity has over recent years become an increasingly visible aspect of Irish society bringing with it both opportunities and challenges. It holds out great possibilities for the enrichment of all who live in Ireland but it also challenges us to adapt creatively to the changes required to realise this potential and to ensure that the experience is a positive one for all concerned but particularly for those in the minority ethnic groups. In the last number of years in particular, the focus has tended to be on people coming to this country either as refugees, asylum seekers or economic migrants. Government figures estimate that as many as 340,000 immigrants are expected in the next six years. However ethnic and cultural diversity are not new phenomena in Ireland. Travellers have a long history as an indigenous minority group in Ireland with a strong culture and identity of their own. The changing experience and dynamics of their relationship with the wider society and its institutions over time can, I think, provide some valuable lessons for us as we seek to address the more numerous and complex issues of cultural diversity which have arisen for us in the last decade. Turning more specifically to the health sector which is the focus of this conference, culture and identity have particular relevance to health service policy and provision in that The first requirement is that we in the health service acknowledge cultural diversity and the differences in behaviours and in the less obvious areas of values and beliefs that this often implies. Only by acknowledging these differences in a respectful way and informing ourselves of them can we address them. Our equality legislation – The Employment Equality Act, 1998 and the Equal Status Act, 2000 – prohibits discrimination on nine grounds including race and membership of the Traveller community. The Equal Status Act prohibits discrimination on an individual basis in relation to the nine grounds while for groups it provides for the promotion of equality of opportunity. The Act applies to the provision of services including health services. I will speak first about cultural diversity in relation to the patient. In this respect it is worth mentioning that the recognition of cultural diversity and appropriate responses to it were issues which were strongly emphasised in the public consultation process which we held earlier this year in the context of developing National Anti-Poverty targets for the health sector and also our new national health strategy. Awareness and sensitivity training for staff is a key requirement for adapting to a culturally diverse patient population. The focus of this training should be the development of the knowledge and skills to provide services sensitive to cultural diversity. Such training can often be most effectively delivered in partnership with members of the minority groups themselves. I am aware that the Traveller community, for example, is involved in in-service training for health care workers. I am also aware that the National Consultative Committee on Racism and Interculturalism has been involved in training with the Eastern Regional Health Authority. We need to have more such initiatives. A step beyond the sensitivity training for existing staff is the training of members of the minority communities themselves as workers in our health services. Again the Traveller community has set an example in this area with its Primary Health Care Project for Travellers. The Primary Health Care for Travellers Project was established in 1994 as a joint partnership initiative with the Eastern Health Board and Pavee Point, with ongoing technical assistance being provided from the Department of Community Health and General Practice, Trinity College, Dublin. This project was the first of its kind in the country and has facilitated The project included a training course which concentrated on skills development, capacity building and the empowerment of Travellers. This confidence and skill allowed the Community Health Workers to go out and conduct a baseline survey to identify and articulate Travellers’ health needs. This was the first time that Travellers were involved in this process; in the past their needs were assumed. The results of the survey were fed back to the community and they prioritised their needs and suggested changes to the health services which would facilitate their access and utilisation. Ongoing monitoring and data collection demonstrates a big improvement in levels of satisfaction and uptake and ulitisation of health services by Travellers in the pilot area. This Primary Health Care for Travellers initiative is being replicated in three other areas around the country and funding has been approved for a further 9 new projects. This pilot project was the recipient of a WHO 50th anniversary commemorative award in 1998. The project is developing as a model of good practice which could inspire further initiatives of this type for other minority groups. Access to information has been identified in numerous consultative processes as a key factor in enabling people to take a proactive approach to managing their own health and that of their families and in facilitating their access to health services. Honouring our commitment to equity in these areas requires that information is provided in culturally appropriate formats. The National Health Promotion Strategy 2000-2005, for example, recognises that there exists within our society many groups with different requirements which need to be identified and accommodated when planning and implementing health promotion interventions. These groups include Travellers, refugees and asylum seekers, people with intellectual, physical or sensory disability and the gay and lesbian community. The Strategy acknowledges the challenge involved in being sensitive to the potential differences in patterns of poor health among these different groups. The Strategic aim is to promote the physical, mental and social well-being of individuals from these groups. The objective of the Strategy on these issues are: While our long term aim may be to mainstream responses so that our health services is truly multicultural, we must recognise the need at this point in time for very specific focused responses particularly for groups with poor health status such as Travellers and also for refugees and asylum seekers. In the case of refugees and asylum seekers examples of targeted services are screening for communicable diseases – offered on a voluntary basis – and psychological support services for those who have suffered trauma before coming here. The two approaches of targeting and mainstreaming are not mutually exclusive. A combination of both is required at this point in time but the balance between them must be kept under constant review in the light of changing needs. A major requirement if we are to meet the challenge of cultural diversity is an appropriate data and research base. I think it is important that we build up our information and research data base in partnership with the minority groups themselves. We must establish what the health needs of diverse groups are; we must monitor uptake of services and how well we are responding to needs and we must monitor outcomes and health status. We must also examine the impact of the policies in other sectors on the health of minority groups. The National Health Information Strategy, currently being developed, and the recently published National Strategy for Health Research – Making Knowledge Work for Health provide important frameworks within which we can improve our data and research base. A culturally diverse health sector workforce – challenges and opportunities The Irish health service can benefit greatly from successful international recruitment. There has been a strong non-national representation amongst the medical profession for more than 30 years. More recently there have been significant increases in other categories of health service workers from overseas. The Department recognises the enormous value that overseas recruitment brings over a wide range of services and supports the development of effective and appropriate recruitment strategies in partnership with health service employers. These changes have made cultural diversity an important issue for all health service organisations. Diversity in the workplace is primarily about creating a culture that seeks, respects, values and harnesses difference. This includes all the differences that when added together make each person unique. So instead of the focus being on particular groups, diversity is about all of us. Change is not about helping “them” to join “us” but about critically looking at “us” and rooting out all aspects of our culture that inappropriately exclude people and prevent us from being inclusive in the way we relate to employees, potential employees and clients of the health service. International recruitment benefits consumers, Irish employees and the overseas personnel alike. Regardless of whether they are employed by the health service, members of minority groups will be clients of our service and consequently we need to be flexible in order to accommodate different cultural needs. For staff, we recognise that coming from other cultures can be a difficult transition. Consequently health service employers have made strong efforts to assist them during this period. Many organisations provide induction courses, religious facilities (such as prayer rooms) and help in finding suitable accommodation. The Health Service Employers Agency (HSEA) is developing an equal opportunities/diversity strategy and action plans as well as training programmes to support their implementation, to ensure that all health service employment policies and practices promote the equality/diversity agenda to continue the development of a culturally diverse health service. The management of this new environment is extremely important for the health service as it offers an opportunity to go beyond set legal requirements and to strive for an acceptance and nurturing of cultural differences. Workforce cultural diversity affords us the opportunity to learn from the working practices and perspectives of others by allowing personnel to present their ideas and experience through teamwork, partnership structures and other appropriate fora, leading to further improvement in the services we provide. It is important to ensure that both personnel units and line managers communicate directly with their staff and demonstrate by their actions that they intend to create an inclusive work place which doesn´t demand that minority staff fit. Contented, valued employees who feel that there is a place for them in the organisation will deliver a high quality health service. Your conference here today has two laudable aims – to heighten awareness and assist health care staff to work effectively with their colleagues from different cultural backgrounds and to gain a greater understanding of the diverse needs of patients from minority ethnic backgrounds. There is a synergy in these aims and in the tasks to which they give rise in the management of our health service. The creative adaptations required for one have the potential to feed into the other. I would like to commend both organisations which are hosting this conference for their initiative in making this event happen, particularly at this time – Racism in the Workplace Week. I look forward very much to hearing the outcome of your deliberations. Thank you.

Director of Public Health Annual Report 2013

The fifth Director of Public Health Annual Report for Northern Ireland, launched on 16 June 2014, celebrates diversity in our population. Diversity is about people and how we value and appreciate those who are not like us. People differ in all sorts of ways which may not always be obvious or visible. These differences might include race and ethnicity, culture and belief, gender and sexuality, age and social status, ability, and use of health and social care services The report recognises the opportunities and challenges posed by population diversity and highlights some of the key programmes introduced to meet these needs.

Reducing the number of young people not in employment, education or training (NEET)

Evidence Review 3 - Reducing the number of young people not in employment, education or training (NEET) Briefing 3 - Reducing the number of young people not in employment, education or training (NEET) This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, examine how to help young people into employment, education or training. They describe the relationship between being NEET and health; inequalities in prevalence of being NEET; and the scale of the problem. The papers show that being NEET, particularly for prolonged periods, is associated with negative effects on health and a range of other outcomes. Furthermore, the chances of becoming NEET are not equally or randomly distributed throughout society – those who are relatively disadvantaged, from poor backgrounds, or who have had negative experiences at school are more likely to spend some time being NEET. The papers also propose actions that can be taken at a local level in order to reduce the proportion of young people who are NEET. There is good evidence on what works in order to enable and support young people to enter employment, education and training. Taking action to reduce NEET levels is both possible and necessary – both to ensure young people have opportunities, and also as an important way to improve public health and reduce inequalities. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

Dementia Care Services UK Market Briefing 2009

This brand new market briefing adds to the growing national debate on the future of dementia care services, making use of a unique and extensive L&B survey (2008) of over 6,000 care homes in the UK which provide care for people with dementia. It builds on the findings of the Alzheimer’s Society’s Dementia UK report (2007) and the national strategy for dementia Living Well with Dementia (2009) to identify market opportunities and provide essential guidance and information with regard to planning and developing new and existing services.Key issues, facts and figures highlighted in the report include:Dementia care is a multi-billion pound market in the UK and this market is set to grow considerably.��Dementia care in care homes dominates the sector in terms of current market value.��The use of dementia home care – though significantly smaller than the equivalent market in care homes – is set to rise markedly in the future.A significant proportion of residents for whom dementia is a known cause of admission are receiving care in settings which are not dedicated to dementia care.The new national dementia strategy for England, Living Well with Dementia should provide the strongest impetus yet for growth in the market for specialist dementia care.Growing awareness surrounding inappropriate use of anti-psychotic drugs on people with dementia in care homes may have a major operational impact on some homes if controls are increased and could substantially increase costs.Despite evidence of increasing dementia specialisation, there are, as yet, no organisations to emerge with full service dementia expertise and integrated care pathways.The supply of dedicated dementia services varies dramatically by region and locality, reflecting local and regional priorities and commissioning strategies.The design and layout of care homes for people with dementia is key and there is an increasing consensus around what constitutes best practice and ‘dementia friendly design’ .Care home fees for dementia are generally higher than fees for frail elderly residents.The report is essential reading for senior executives and managers within any organisation committed to, or considering involvement in, the dementia care sector, including for-profit, 'third sector' and public sector agencies.For further information, please contact:��Market ReportsTel.��020 7833 9123 orEmail��info@laingbuisson.co.uk��Download Full Brochure including Order Form��Download Contents and Tables�� Featured item on home page:��no��

Recognising diversity in Public Health NI

The fifth Director of Public Health Annual Report for Northern Ireland, launched on 16 June 2014, celebrates diversity in the population.��The report recognises the opportunities and challenges posed by population diversity and highlights some of the key programmes introduced to meet these needs.The presentation slides from key speakers from the launch event on 16 June 2014 and all parallel sessions will be��appended below.��Please note:��The PHA cannot be held responsible for any breach of copyright that may exist within individual presentations.Read more here>>

National Strategy for Higher Education 2030

Ireland’s higher education system has played a major role in the development of Irish society and the economy, and has an even more critical role to play in the coming decades as we seek to rebuild an innovative knowledge-based economy that will provide sustainable employment opportunities and good standards of living for all our citizens. Its role in enabling every citizen to realise their full potential and in generating new ideas through research are and will be the foundation for wider developments in society. The development of the higher education system in the years to 2030 will take place initially in an environment of severe constraints on public finances. Demand to invest in education to support job creation and innovation, and to help people back into employment is increasing. In the wider world, globalisation, technological advancement and innovation are defining economic development, people are much more mobile internationally as they seek out career opportunities, and competition for foreign direct investment remains intense.

National Strategy for Higher Education 2030 - Summary

Ireland’s higher education system has played a major role in the development of Irish society and the economy, and has an even more critical role to play in the coming decades as we seek to rebuild an innovative knowledge-based economy that will provide sustainable employment opportunities and good standards of living for all our citizens. Its role in enabling every citizen to realise their full potential and in generating new ideas through research are and will be the foundation for wider developments in society. The development of the higher education system in the years to 2030 will take place initially in an environment of severe constraints on public finances. Demand to invest in education to support job creation and innovation, and to help people back into employment is increasing. In the wider world, globalisation, technological advancement and innovation are defining economic development, people are much more mobile internationally as they seek out career opportunities, and competition for foreign direct investment remains intense.

Immunisation guidance notes for professionals (2015 edition)

Informed consent – which can be either written or oral (depending on local Trust policy) – must be obtained and recorded in the notes at the time of each immunisation, after the child’s fitness and suitability have been established. It is important that the person giving consent is fully informed about the vaccine at the time they give consent. Written material is available to assist in this, but is not a substitute for an opportunity to discuss the issues with a health professional. Consent is given by the person with parental responsibility; however, this person does not necessarily need to be present at the time the immunisation is given. Although the decision to immunise must be taken by the person with parental responsibility, they can arrange for someone else (eg grandparent or childminder) to bring the child to be immunised. You do not need consent in writing – if they have received all the relevant information and arranged for another person to bring the child, the circumstances indicate they have consented. A child under 16 years may give consent provided he or she understands fully the benefits and risks involved. If a competent child consents to treatment, a parent cannot override that consent. Obviously they should be encouraged to involve the person with parental responsibility in the decision. Legally, a parent can consent if a competent child refuses �