Joint Commissioning Plan of the Health and Social Care Board and the Public Health Agency: 2010-2011

Legislation enacted on 1 April 2009 created a new Commissioning system with the establishment of a region-wide Health and Social Care Board, including 5 Local Commissioning Groups (LCGs), and a Public Health Agency. In line with Departmental direction and guidance the objectives of the new commissioning arrangements were to: - Approach the future delivery of Health and Social Care from a region-wide perspective focused on outcomes. - Ensure local sensitivity through the creation of five Local Commissioning Groups reflective of their areas. - Give appropriate weight to the public health agenda to ensure that commissioning reflects the drive to reduce health inequalities in our society and works in partnership with others to improve health and wellbeing. In this regard the legislation signalled a new way forward which would first be expressed in a Commissioning Plan for 2010/11 and beyond. This plan outlines how the Health and Social Care Board and the Public Health Agency are approaching that task. It is our aim that this plan is straightforward and written in a manner which will encourage public engagement and understanding. We wish to show clearly how the commissioning task is to be approached and to signal the decisions necessary to ensure the maintenance of a health and social care system in Northern Ireland which responds to the population it serves.

Making Chronic Conditions Count: 5. Chronic Airflow Obstruction

Chronic conditions are responsible for a significant proportion of early deaths. They reduce qualityof life in many of the adults living with them, represent substantial financial costs to patients andthe health and social care system, and cause a significant loss of productivity to the economy.This report contains estimates and forecasts of the population prevalence of chronic airflowobstruction, and it shows how it varies across the island and what change is expected between2007, 2015 and 2020.

Making Chronic Conditions Count: 1. Diabetes

Chronic conditions are responsible for a significant proportion of early deaths. They reduce quality of life in many of the adults living with them, represent substantial financial costs to patients and the health and social care system, and cause a significant loss of productivity to the economy. This report contains estimates and forecasts of the population prevalence of diabetes, and it shows how it varies across the island and what change is expected between 2007, 2015 and 2020.

Making Chronic Conditions Count: 2. Coronary Heart Disease (Angina and Heart Attack)

Chronic conditions are responsible for a significant proportion of early deaths. They reduce quality of life in many of the adults living with them, represent substantial financial costs to patients and the health and social care system, and cause a significant loss of productivity to the economy. This report contains estimates and forecasts of the population prevalence of coronary heart disease (angina and heart attack), and it shows how it varies across the island and what change is expected between 2007, 2015 and 2020.

Making Chronic Conditions Count: 3. Hypertension

Chronic conditions are responsible for a significant proportion of early deaths. They reduce quality of life in many of the adults living with them, represent substantial financial costs to patients and the health and social care system, and cause a significant loss of productivity to the economy. This report contains estimates and forecasts of the population prevalence of hypertension and shows how it varies across the island and what change is expected between 2007, 2015 and 2020.

Making Chronic Conditions Count: 4. Stroke

Chronic conditions are responsible for a significant proportion of early deaths. They reduce quality of life in many of the adults living with them, represent substantial financial costs to patients and the health and social care system, and cause a significant loss of productivity to the economy. This report contains estimates and forecasts of the population prevalence of stroke, and it shows how it varies across the island and what change is expected between 2007, 2015 and 2020.

Chronic Airflow Obstruction Briefing

The Chronic Conditions Hub is a website that brings together information on chronic health conditions. It allows you to easily access, manage and share relevant information resources. The Chronic Conditions Hub includes the Institute of Public Health in Ireland’s (IPH) estimates and forecasts of the number of people living with chronic conditions. On the Chronic Conditions Hub you will find: - A Briefing for each condition - Detailed technical documentation - Detailed national and sub-national data that can be downloaded or explored using online data tools - A prevalence tool that allows you to calculate prevalence figures for your population data Chronic airflow obstruction (CAO) is a chronic lung condition that interferes with normal breathing. For the purpose of this briefing, CAO includes chronic obstructive pulmonary disease (COPD), chronic bronchitis and emphysema. CAO is responsible for a substantial amount of early deaths, reduced quality of life and significant costs to the health and social care system and to the economy. The World Health Organization estimates that COPD is the fourth leading cause of death worldwide and predicts that it will soon become the third leading cause of death.

Musculoskeletal Conditions Briefing

Musculoskeletal conditions (MSCs) are a group of diseases that affect the body’s bones, joints, muscles and the tissues that connect them. Common MSCs include back pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and spinal disorders. MSCs are the most common cause of severe long term pain and physical disability in developed countries. They significantly affect the psychosocial wellbeing of individuals as well as their families and carers. They are responsible for substantial costs to the health and social care system and the economy. They are a leading cause of absence from work and lost productivity at work. MSCs comprise a diverse group of conditions. Some have a specific medical diagnosis (eg rheumatoid arthritis) but others have no clear medical diagnosis (eg back pain). Risk factors for the development and progression of MSCs include age, sex, family history, obesity, physical inactivity, injury and biomechanical occupational health issues.

Musculoskeletal Conditions Briefing: Technical Documentation

Musculoskeletal conditions (MSCs) are a group of diseases that affect the body’s bones, joints, muscles and the tissues that connect them. Common MSCs include back pain, rheumatoid arthritis, osteoarthritis, osteoporosis, and spinal disorders. MSCs are the most common cause of severe long term pain and physical disability in developed countries. They significantly affect the psychosocial wellbeing of individuals as well as their families and carers. They are responsible for substantial costs to the health and social care system and the economy. They are a leading cause of absence from work and lost productivity at work. MSCs comprise a diverse group of conditions. Some have a specific medical diagnosis (eg rheumatoid arthritis) but others have no clear medical diagnosis (eg back pain). Risk factors for the development and progression of MSCs include age, sex, family history, obesity, physical inactivity, injury and biomechanical occupational health issues. This document details the methods used to calculate the estimates and forecasts.

Obesity - an acknowledged public health challenge

As we face a difficult economic climate, in which inequalities may worsen, the PHA faces many challenges in its efforts to improve the health of the population. One such challenge is the issue of obesity. Recently, in the Draft Programme for Government and, again today, in anticipation of the publication of the Consultation on the Review of Health and Social Care Services in Northern Ireland, the specific issue of obesity has been highlighted in the media.The PHA is committed to playing a lead role in tackling this major health issue and has been systematically examining the evidence of best practice and effectiveness to ensure that investment and working in partnership will bring clear benefits. A welcome consequence of any success would be a reduction in the impact of the physical, and emotional costs of obesity related ill-health to individuals - and the financial costs to an overstretched healthcare system.A multi-facetted approach to tackling obesity is required for Northern Ireland. This will mean working across government departments, looking at relevant legislation, taxation, food standards and labelling, as well as supporting a raft of programmes within education, workplace, and at the local community level."The prevalence of overweight and obesity has risen dramatically in recent years in Northern Ireland and is now the norm to be overweight, rather than the exception. The Northern Ireland Health and Social Wellbeing Survey (2010-11) indicated that 36% of adults are overweight and a further 23% are obese; this means that approximately 3 in 5 adults in Northern Ireland carry excess weight. A similar proportion of males and females were obese (23%) however males were more likely to be overweight (44%) than females (30%).Data from the Northern Ireland Health and Wellbeing Survey (2010-11) reported that 27% of children aged 2-15 years are obese or overweight. The findings presented here are based on the guidelines put forward by the International Obesity Task Force. Using this approach, 8% of children were assessed as obese, with similar results for boys (8%) and girls (9%). Obesity has serious implications for health and wellbeing and is associated with an increased risk of heart disease and stroke, type 2 diabetes, some cancers, respiratory problems and joint pain.Evidence indicates that being obese can reduce life expectancy by up to 9 years; and it can impact on emotional and psychological well-being and self-esteem, especially among young people.Obesity also impacts on wider society through economic costs, loss of productivity and increased demands on our health and social care system. It is estimated that obesity in Northern Ireland is resulting in 260,000 working days lost each year with a cost to the local economy of £500 million.The good news is that the intentional loss of significant weight (approx 10kg) in overweight and obese adults has been shown to confer significant health benefits, decreased morbidity and may also reduce obesity-related mortality.Key programmes and interventions are undertaken by the PHA in order to prevent and reduce overweight and obesity. The programmes/interventions are supported by significant ongoing work at local level. Examples include:the promotion of breastfeeding; local programmes to increase awareness of good nutrition and develop cooking skills, for example 'Cook It!'; promotion of more active lifestyles, for example, Walking for Health' and 'Teenage Kicks'; development of community allotment schemes; programmes for primary school children, for example Skip2bfit and Eat, Taste and Grow; and sports and other recreation, for example 'Active Belfast'. The PHA's multi media campaign 'It all adds up!' to encourage children to become more active and understand the importance of keeping fit, in a fun and exciting way, ran until October 2011. It encouraged parents and carers to go to the website www.getalifegetactive.com and download the PHA logbook It all adds up! to plan activities as a family. The logbook helped children and parents plan and keep track of their participation in physical activity at school, home and in the community. PHA is currently developing a public information campaign and other supportive work to increase public awareness of obesity as well as to provide advice and support for those who want to make real changes. The campaign development is well underway and is anticipated for launch in late Spring 2012. Like many common health problems, people living in disadvantaged circumstances suffer most and the PHA is committed to tackling this aspect of health inequality. The good news is that even a modest weight loss, of 1-1 Â_ stones, can help to reduce the risk of many of the health problems resulting from being overweight or obese. Information on losing weight through healthier eating and being more active can be found on the PHA websites - www.enjoyhealthyeating.info and www.getalifegetactive.com . These websites provide help and advice for anyone who wants to improve their eating habits and fitness levels, by making small, sustainable, healthy changes to their lifestyle. The PHA leaflet, Small changes, big benefits is also available to download from the PHA website, 'Publications' section.

Personal and Public Involvement Consultation Scheme (PDF 149KB)

The current structure of the health and social care system in Northern Ireland has its origins in the Review of Public Administration (RPA) which was initiated by the Northern Ireland Executive in June 2002. The purpose of RPA was to review Northern Ireland’s system of public administration with a view to putting in place a modern, citizen-centred, accountable and high quality system of public administration. The structure was designed to be more streamlined and accountable and aimed at maximising resources for front-line services and ensuring that people have access to high quality health and social care. Another key feature is the placement of public health and wellbeing firmly at the centre of the system, with a greater emphasis on prevention and support for vulnerable people to live independently in the community for as long as possible.  

Health And Social Care Inequalities Monitoring System: First Update Bulletin 2004 (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the first annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years åÊ

Health and Social Care Inequalities Monitoring System (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the firståÊ annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years. åÊ åÊ

Health Inequalities: NI Health % Social Care Inequalities Monitoring System - Regional 2014

Key Points: Health outcomes are generally worse in the most deprived areas in Northern Ireland when compared both with those witnessed in the region generally and in the least deprived areas. Large differences (health inequality gaps) continue to exist for a number of different health measures. åá Males in the 20% most deprived areas could expect, on average, to live 4.3 fewer years than the NI average and 7.3 fewer years than those in the 20% least deprived areas.åá Female life expectancy in the most deprived areas was 2.6 years less than the regional average and 4.3 years less than that in the least deprived areas.åá The overall death rate for males as measured by the All Age All Cause Mortality (AAACM) rate was a fifth higher in the most deprived areas (1,567 deaths per 100,000 population) than the NI average (1,304 deaths per 100,000 population), and 44% higher than in the least deprived areas (1,090 deaths per 100,000 population).åá The overall death rate for females (AAACM) in the most deprived areas (1,093 deaths per 100,000 population) was 17% higher than regionally (935 deaths per 100,000 population), and a third higher than in the least deprived areas (829 deaths per 100,000 population).åá The suicide rate in the most deprived areas (30.7 deaths per 100,000 population) was three times that in the least deprived areas (10.1 deaths per 100,000 population). All HSCIMS reports are published on the Departmental website at: http://www.dhsspsni.gov.uk/index/statistics/health-inequalities.htm

NI health and social care inequalities monitoring system (HSCIMS) - health inequalities in Northern Ireland: key facts 2015

This key facts publication provides an interim update to the NI health & social care inequalities monitoring system (HSCIMS) regional reports which are published every other year. It presents a summary of the latest position and inequality gaps between the most deprived areas and both the least deprived areas and the NI average in addition to a regional comparison with rural areas for a range of health outcomes included within the HSCIMS series, in addition to the health survey Northern Ireland (HSNI).