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Supporting Guidance Standard 1.1

Health and Care Standards

Supporting Guidance

Standard 1.1  Health Promotion, Protection and Improvement

 

What is the Standard about?

The systems and programmes that organisations need to have in place to play their part in protecting and improving the physical, mental health and wellbeing of their local population.  It is also about ensuring clear relationships and allocations of responsibilities between the various organisations with public health responsibilities, plus the responsibilities people have for their own and their family’s health and wellbeing.

 

Who is it for?

  • Health Boards working in partnership with other bodies and supported by Public Health Wales;
  • Public Health Wales, working in support of and in partnership with many stakeholders, including third sector
  • Providers of primary care services; and
  • Individuals – staff and citizens

 

In relation to the standard criteria (in bold) the following key questions need to be considered:

 People know and understand what care, support and opportunities are available, locally, regionally and nationally, including community support and support for people from protected groups.

  • How do you utilise local provision to support people in building resilience?
  • Is physical and mental health promotion, protection and improvement literature produced and published in relevant minority languages and alternative formats for people with sensory loss?
  • Are ‘take-up’ levels consistent with the Health Board’s local demographic data for age, disability, gender reassignment, race, religion/belief, sex and sexual orientation?  If gaps exist, what positive action is developed to improve engagement from these communities?
  • Are people and their families provided with appropriate advice and support to reduce their risk of dental and oral disease?  Most dental and oral diseases are preventable.

 

People are supported to engage, participate and feel valued in society.

  • How do you promote the Five Ways to Wellbeing for people and your staff?
  • How do you raise awareness and understanding of the needs of people with dementia?
  • How do you ensure people and carers living with dementia, cognitive impairment and sensory loss are being supported?
  • What measures do you take to avoid discrimination and stigma?

 

People are supported to be healthy, safe, and happy, and to lead an active life.

  • How do you promote healthy lifestyles and enable healthy choices?
  • How do staff promote and protect the physical, mental health and wellbeing of their service users?
  • Do you include highlighting the benefits to mental health of the Five Ways to Wellbeing?
  • Do you promote the ‘Add to your Life' Health Check for 50+?
  • Is the All Wales Obesity Pathway implemented across your health board?
  • Does your health board work collaboratively with the local authority and third sector to promote exercise for all and healthy lifestyle messages?
  • Does your health board provide appropriate information and actively encourage the eligible population to take up screening services?

 

Children have a good, healthy, safe and nurturing start in life.

  • Is the Healthy Child Wales Programme being implemented across your health board?
  • Are all new mothers given a copy of Bump, Baby and Beyond?
  • How are you promoting the availability and uptake of positive parenting programmes?
  • Are parents receiving lifestyle advice to take advantage of the ‘teachable moment’ – E.g.  for alcohol brief interventions?
  • How is full uptake of all immunisation programmes promoted to the diverse communities in your area?
  • Are the appropriate guidance, information and support available on antenatal and new born screening programmes across your health board?
  • How do you highlight the risk of postnatal depression and explain how to build resilience?

 

Carers of individuals who are unable to manage their own health and wellbeing are supported.

  • How do you facilitate early identification of carers to improve access by carers to the information and services that they need to help them to care, in order to protect their own mental and physical health?
  • How do you ensure that carers receive earlier and planned support, through local partnerships or joint commissioning involving the NHS, local authorities, the third sector and the private sector?
  • How do you involve carers in the decision making processes around care management and at a strategic level in service planning and delivery?
  • How do you ensure that carers’ issues are mainstreamed into the everyday working practices of NHS and other staff, to ensure that they work with carers in effective partnership?
  • Do you signpost carers supporting those who misuse substances to the Welsh drug and alcohol helpline, as they can provide carers and families with easily accessible information and signpost them to local agencies for support?
  • How do you ensure that young and young adult carers can exercise their UN Convention Rights in respect of social and wellbeing services?
  • Have you a shared understanding of ‘alternative care’, and how it can be used to achieve outcomes for carers and those they care for? (see section 6.7 of the Carers’ Strategy)
  • Does your organisation provide support for employees that have caring responsibilities?
  • How do you signpost to mental health helplines such as C.A.L.L and Samaritans when appropriate?

 

People are supported to make decisions about their health behaviour and wellbeing which impact on their health and the health and wellbeing of their children

  • Is Change4Life Wales actively promoted for staff and the public for supporting positive lifestyle change in the areas of healthy eating, physical activity and alcohol and for maintaining a healthy body weight?
  • Does your organisation promote the benefits of healthy lifestyles on mental health and wellbeing?
  • See smoking cessation questions in the section below
  • Does your health board provide appropriate accessible information and actively encourage the eligible population to take up screening services?

 

Breast feeding is promoted and supported.

  • Has your Health Board achieved UNICEF UK Baby Friendly accreditation of maternity and health visiting services?
  • If not, are actions in place to ensure this standard is met?
  • How are you ensuring all staff are aware of the Health Boards accreditation by the UNICEF UK Baby Friendly Initiative and what it means?
  • For those with neonatal services, are you working towards the UNICEF UK Baby Friendly Initiative Standards for Neonatal Care?
  • How do you consider the needs of all breastfed infants; new mothers and babies in maternity services; breastfeeding mothers and babies who may be in-patients in other parts of the service; breastfeeding mothers who are visiting hospital/health service sites?
  • How are you supporting members of staff returning to work after maternity leave who are breastfeeding mothers , e.g. through flexible working, breaks, facilities for expressing and storing breast milk.?
  • Is there an infant feeding strategy group that is responsible for monitoring rates and addressing inequalities in breastfeeding?

 

Smoking cessation and smoke free environments are promoted and supported.

  • How are you addressing the action from the Tobacco Control Delivery Plan that ‘NHS Wales Health Boards should prioritise smoking cessation for their staff, to aim for 35% of smoking staff accessing support per annum’?
  • Is this supported by in-house smoking cessation services?
  • Is smoking cessation included in all relevant care pathways? What is the referral mechanism?
  • Do you have voluntary bans in place on the use of e-cigarettes in enclosed and substantially enclosed premises; and tobacco and e-cigarettes in NHS grounds? How are they enforced?
  • Are ‘take-up’ levels consistent with the Health Board’s local demographic data for age, disability, gender reassignment, race, religion/belief, sex and sexual orientation?  If gaps exist, what positive action is developed to improve engagement from these communities?
  • How are you reviewing and updating your local Tobacco Control Plan?
  • Do you cross-reference with the Corporate Health Standard / Small Workplace Health Award?

 

People are supported to avoid harm to their health and wellbeing by making healthy choices and accepting opportunities to prevent ill health.

  • Has your organisation/service undertaken a co-production self assessment?  How are you addressing areas of weakness?
  • How do you support citizens to maintain and improve their health, wellbeing and independence?
  • How do you encourage self care and promote understanding of the risks of antibiotic misuse and over use?
  • Do you signpost to mental health helplines such as C.A.L.L and Samaritans when appropriate?
  • See questions relating to smoking cessation above
  • Does your health board provide appropriate information and actively encourage the eligible population to take up screening services?

 

There is active promotion of healthy and safe workplaces and communities.

  • How do you promote healthy and safe workplaces and supportive environments
  • Has the organisation achieved / maintained the Corporate Health Standard / Small Workplace Health Award, and at which level of award?
  • Has the NHS Wales Local Health Board / Trust achieved the Corporate Health Standard requirement in ‘Working Differently Working Together: Workforce and Organisational Development Framework’?
  • How do you encourage people and staff to sign to the Time to Change Wales pledge?

 

There is active promotion of the health and well being of staff.

  • How does the organisation promote and protect the physical and mental health and wellbeing of staff?
  • How do you promote healthy lifestyles and enable healthy choices?
  • What arrangements are in place for ensuring healthy food and drink options are provided and promoted to staff?
  • See questions relating to smoking cessation above

 

Systems, resources and plans are in place to identify and act upon significant public health issues so as to prevent and control communicable diseases and provide immunisation programmes; with effective programmes to screen and detect disease.

  • How do you identify and act upon public health issues?
  • How do you access public health advice?
    • To provide specialist public health advice and health intelligence to support the identification of public health issues and service planning
    • To deliver specific health improvement and health protection programmes to the local population
    • To support the development of healthy and safe workplaces; and
    • In relation to the control of communicable diseases and environmental hazards?
  • How do you identify and mitigate against risk in respect of this standard?
  • How do you ensure that the workforce can access training on health promotion, protection and improvement?
  • Do you have clear arrangements for monitoring health promotion, protection and improvement activities?
  • How do you prevent and control communicable diseases?
  • How do you provide effective immunisation programmes and support the delivery and improvement of immunisation services
  • How do you eliminate preventable healthcare associated infection and minimise the risk of transmission of community acquired infections?
  • Do you have effective programmes to screen, to prevent and to detect disease?
  • Do your screening programmes meet defined standards?
  • Are plans in place to offer routine vaccinations and catch up opportunities in line with the national immunisation schedule?

 

Needs assessment and public health advice informs service planning, policies and practices.

  • How do you ensure that needs assessment is aligned with equality impact assessment and public health advice informs service planning, policies and practice?
  • How do public health needs assessments and equality impact assessment inform service provision?

 

Health services have systems and processes in place that play their part in reducing inequalities and protect and improve the health and wellbeing of their local population.

  • Does your health board provide appropriate information and actively encourage the eligible population to take up screening services, particularly those in the most deprived groups and people with sensory loss?
  • Does you health board have systems in place to raise awareness and increase uptake of immunisation programmes in hard to reach groups?
  • How do you demonstrate a commitment to improved analysis and reporting of health inequalities in health promotion, primary and secondary care?
  • How do you demonstrate that tackling health inequalities is understood to be the responsibility of the whole organisation and all who work in it?
  • Do you have clear measurable objectives for reducing health inequalities?
  • Do you set out actions to counter the inverse care law in primary and secondary care and where necessary assess how resources will be reallocated to reflect need?
  • How do you demonstrate close working with the initiative such as Communities First, Flying Start, and Families First, to reduce broader inequalities and secure the greatest reduction in health inequalities, particularly through strengthening links with primary and community care services?
  • How do you identify local poverty goals and demonstrate how you will achieve these and the goals in the national tackling poverty programme?

 

Relationships and allocations of responsibilities between the various organisations with public health responsibilities are clear and acted upon. 

  • How do you work with all partners to reduce health inequalities and improve population health?
  • Can you show evidence of a deliberate shift to applying the principle of proportionate universalism (action that is universal, but proportionate to the level of disadvantage) for example in support for children and their families to ensure all children achieve a good level of health development at age 5 in line with Marmot guidance.

 

Legislation and Guidance

 

Good Practice Guides and Toolkits

 

Useful Contacts