Ambition, action, achievement

... is the alliterative phrase attached to a draft framework document fulfilling the community service commitments of the final Darzi report. Along with the quality framework itself, there are 6 guidance papers, one of which addresses the inequalities agenda (Transforming community services for health, wellbeing and reducing inequalities). HSJ has an in-depth review of the framework document.

The state we're in

The 2009 health profiles have been released. Providing a snapshot of health at county or local authority level, they help commissioners and providers to target their activity where it's most needed. Regional and SHA level profiles will be available later in the year. Key changes highlighted by Public Health Minister Gillian Merron include reduction in rates of early death from cancer, heart disease and stroke, as well as increases in general life expectancy and of children's access to PE in state schools.

Target practice

A focus on routine and manual smokers for stop smoking services will make a significant contribution to achieving PSA and health inequality targets, DoH guidance argues. The guidance also stresses the importance of partnerships with local authorities and the third sector and awareness of the wider context of tobacco control.

Social enterprise

The Social Enterprise Investment Fund is accepting applications again, the DoH has announced. The Fund, which was set up in 2007, provides financing and business support for not-for-profit enterprises in the health and social care sector. The promotional report, Transforming Health and Social Care, gives case studies from earlier beneficiaries, including a cardiovascular screening project, a keep fit programme and St Luke's Healthy Living Centre in Southend.

Our house

Growing up in social housing looks at the relationship between housing, family circumstances and later development. The report, produced by the Tenant Services Authority, along with the Joseph Rowntree Foundation, uses data from four studies, tracing samples of people born in 1946, 1958, 1970 and 2000, to examine the changing nature of social housing.

Decisions, decisions

How the healthcare system helps patients to make informed choices is the focus of a new policy paper from the Health Services Management Centre at the University of Birmingham . The paper evaluates a range of communication methods and raises some serious questions about the use of the internet, which the authors suggest is "emerging as the government’s key delivery route for information about health services". Those areas of the population who are least well served by healthcare services, the paper argues, are also less likely to be able to access or search effectively many of these information resources.

... more equal than others

The Department of Health's Single Equality Scheme statement for 2009-2012 sets out policy and measures by which the DoH and will fulfill its obligations under current equality legislation, including the health inequalities agenda.

Cancer screening

Affluence affects takeup of breast cancer screening, while it's ethnicity that appears to have more influence over cervical cancer screening uptake, a research report published in the BMJ suggests. Researchers at Oxford University's Cancer Epidemiology Unit used sociodemographic data from the Office of National Statistics (ONS) to look at uptake rates amongst women aged 40-74 from 2005 to 2007. Cancer Research UK and the National Cancer Intelligence Network have also produced a study on cancer incidence and survival by ethnic group.

Making it happen

A new Child Poverty Bill was introduced to the House of Commons on 11 June, following consultation earlier this year (Ending child poverty: making it happen). The Bill, which puts into a legal framwork the government's commitment to eradicate child poverty by 2020, is jointly sponsored by the Department for Children Schools and Families (DSCF), the Department for Work and Pensions (DWP) and the Treasury. As well as national level accountability, the Bill also creates an obligation on local authorities and their partners (including SHAs) to set out a local needs assessment and a joint local child poverty strategy and to consider the issue when developing Sustainable Communities Strategies. The latest issue of Community Care includes some case studies of local "innovation pilots" funded by DSCF.

Are you experienced?

National statistics on the self-reported experience of patients in black and minority ethnic (BME) groups were released on 10 June. The data, based on the National Patient Survey programme output, shows that people from BME groups were more likely to report a negative experience (or "less likely to report a positive experience," as the DoH press release puts it) than white patients. Differences were most marked in the primary care survey and least in the mental health survey.

Stub out smoking

This week Public Health Minister Gillian Merron announced that the 25 local authority areas with highest smoking prevalence will receive a share of £2.5 million to develop further stop smoking initiatives. These could include support for trading standards to enforce regulations on the sale and advertising of tobacco products or work with local revenue officers to combat ther illegal tobacco market as well as anti-smoking marketing activities.

... and statistics

The June issue of Health Statistics Quarterly from the Office of National Statistics provides some useful inequalities data (topics include adult female mortality, infant deaths and chronic illness).

Gypsy and Traveller Communities

Primary Care Contracting has issued a Primary Care Service Framework for gypsy and traveller communities, Public Health Update reports. The PCSF is designed to help PCTs "extend entitlement" to these traditionally hard to reach groups.

Rehab

Record numbers of young people were treated for drug problems last year, a Radio 1 news feature announced. The data provided by the National Treatment Agency suggests that the rise is simply in treatment levels rather than reflective of increased drug use. The NTA has also released a report identifying good practice in rehabilitation and detoxifiation centres.

Smoking Cessation Services

The latest issue of the Journal of Public Health includes a systematic review of strategies to enhance access of disadvantaged groups to smoking cessation programmes that makes quite bleak reading. The team of researchers considered 48 studies, around half from the UK, but found few that provided clear evidence of success, partly owing to a lack of reporting of socioeconomic data. However, the authors do note that NHS stop smoking services have managed to reach smokers living in disadvantaged areas. They also identify good practice, such as the use of "health equity audits" to interrogate client data and ensure that services are reaching disadvantaged groups. Meanwhile the Department of Health has announced a "new systems-based approach", modelled on the process used by stop smoking services in Yorkshire and Humberside.

What's bred in the bone

The foundations of adult disease can be laid by developmental and biological disruptions in early childhood, argue the authors of an article in The Journal of the American Medical Association, highlighted by Dr Buttery's Public Health BLOG. The article focuses on how neuroscience can inform the debate, but other articles in the issue, which has a child and adolescent health theme, look at futher health promotion and access to healthcare issues.

Safer Together
...is the theme of National Child Safety Week (22-28 June). The Child Accident Prevention Trust has put together an information pack for anyone working with children and young people and there's also a website.

Childhood Obesity

It's more likely that children from poorer communities in London will be obese than those from more affluent families, the London Health Observatory reported last week. The LHO's report consitutes the first detailed analysis of local level data from the National Child Measurement Programme (NCMP) for 2006-8. NCMP data was released earlier this month. The LHOs' director praised PCTs and local authorities for the quality of data recording, but noted that the figures constituted "a striking finding for both London’s most deprived and for black communities.” Risk of obesity was highest amongt children from the poorest boroughs, with with a range of 6% to 14% for children in reception year, and from 12% to 26% in year 6. Additionally, there was a significantly higher risk of obesity for children from black ethnic minority groups in both year groups than other ethnic groups. Overall, London's figures are higher than the national average, too. The National Obesity Observatory's May newsletter provides a useful survey of data on obesity and deprivation.