Regional CVD prevention CVD Showcase, Liverpool, Sept 2010 Robin Ireland, Chief Executive, Heart of MerseyNICE public health guidance 25
What this presentation covers• Recommendations for regional CVD prevention programmes• Lessons for Heart of Mersey• Implications for local policies
What this presentation covers• Recommendations for regional CVD prevention programmes
CVD programmes: good practiceLocal and regional CVD prevention programmesshould:• comprise intense, multi-component interventions• target the whole population• complement initiatives for individuals at high risk• be sustainable for a minimum of 5 years• be allocated adequate time and resources.
CVD programmes: preparation• Find out about CVD prevalence and incidence locally• Identify groups that are disproportionately affected• Consider how policies related to food, tobacco control and physical activity may affect local prevalence• Gauge the community’s knowledge of CVD risk factors and their ability to make changes to reduce the risk
CVD programmes: development• Ensure the programme: - adopts a population-based approach - is underpinned by sound theory - helps address local targets - acts as an incentive for commissioning - tackles health inequalities - links to strategies targeting people at high risk of CVD.
CVD programmes: resources• Ensure the programme lasts a minimum of 5 years and is adequately staffed• Produce a long-term plan – and gain political commitment – for funding beyond the end of the research or evaluation period• Volunteers should be an additional – rather than a core – resource
CVD programmes: leadership• Identify senior figures within primary care trusts and local authorities to act as champions• Identify – and provide for training for – people to lead the CVD programme, including local people• Develop systems within local strategic partnerships and regional (or sub-regional) partnerships to agree shared priorities
CVD programmes: evaluation• Budget for and establish baseline measures before the CVD programme begins• Ensure evaluation is built in from the outset• Ensure appropriate methods are used to: - evaluate programme processes - capture health outcome measures or indicators
Prevention is cost effective! a life withoutExpenses palliative prevention care a life with prevention 20 30 40 50 60 70 80 90 at work maybe at work difference in mortalitySource: Kaiser Permanente / Hjalsted Age
Lessons for Heart of Mersey Health is created and maintained outside the health sector!
Lessons for Heart of Mersey• The importance of a population-based approach• Tackling health inequalities• Working in partnership and addressing local aims• Advocating for appropriate local policies to support healthier lifestylesRegional CVD prevention
Liverpool PCT Healthcare Procurement Unit Value of Local Partnerships Opportunities for Strategic Change New collaborations Health at the heart of everyone’s strategy and delivery Action Bringing together resources learning Collaborative feedback Action Building capacity for Health Influence policy and action Reach new set of organisations and people 15
Implications for local CVD prevention –Food and Nutrition policies •Improve the diet of children and young people •Tackle take-away food •Improve food procurement •Improve training for catering managers •Improve knowledge of local diets •Continue to advocate for appropriate national policies and regulation to support local food and nutrition policiesRegional CVD prevention
Implications for local CVD prevention –Tobacco control policies •Restrict the supply of tobacco and tobacco products to children and young people •Tackle illicit tobacco •Develop capacity to support smoke free policies in settings e.g. mental health organisations •Continue to advocate for appropriate national policies and regulation to support local tobacco control policiesRegional CVD prevention
Implications for local CVD prevention –Physical activity policies •The physical environment should encourage people to be physically active •Local transport plans should promote walking and cycling and active transport •Focus on the needs of children and young people •Encourage sports stadia and local clubs to be health promoting •Continue to advocate for appropriate national policies and regulation to support local policies promoting physical activityRegional CVD prevention
Costs and savings per 200,000 population High Low deprivation deprivationOver a 5 year period region regionNumber of CVD events (aged 40 yrs+) 16,270 14,140Current costs (£ million)* 75.10 65.20Cost of implementation (£ million) 0.236 0.236regional programme recommendationsSavings (£ million) 0.420 0.341arising from regional programme recommendations * Costs and savings related to CVD events in this table apply to a population aged 40 years and over.
A COMPREHENSIVE APPROACH TO CVD (NCD) PREVENTION AdvocacyDelivery Research AN INTEGRATED SERVICE