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Regional CVD prevention
           CVD Showcase, Liverpool, Sept 2010


             Robin Ireland, Chief Executive,
                    Heart of Mersey




NICE 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 practice
Local and regional CVD prevention programmes
should:

•   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
Lessons for Heart of Mersey
Prevention is cost effective!




                                               a life without
Expenses




                                                                                             palliative
                                                prevention
                                                                                             care
            a life with
            prevention




                         20            30         40        50       60          70       80        90
                                            at work              maybe at work   difference in
                                                                                   mortality
Source: 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 lifestyles




Regional CVD prevention
Working in regional and local
       partnerships:
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 policies



Regional 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 policies



Regional 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 activity



Regional CVD prevention
Costs and savings
                                     per 200,000 population

                                                           High          Low
                                                           deprivation   deprivation
Over a 5 year period                                       region        region

Number of CVD events (aged 40 yrs+)                        16,270        14,140

Current costs (£ million)*                                 75.10         65.20
Cost of implementation (£ million)
                                                            0.236         0.236
regional programme recommendations
Savings (£ million)
                                                            0.420         0.341
arising 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




                Advocacy




Delivery                             Research




             AN INTEGRATED SERVICE
Regional CVD prevention




Thank you
robin.ireland@heartofmersey.org.uk

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Regional cvd prevention sept 10

  • 1. Regional CVD prevention CVD Showcase, Liverpool, Sept 2010 Robin Ireland, Chief Executive, Heart of Mersey NICE public health guidance 25
  • 2. What this presentation covers • Recommendations for regional CVD prevention programmes • Lessons for Heart of Mersey • Implications for local policies
  • 3. What this presentation covers • Recommendations for regional CVD prevention programmes
  • 4. CVD programmes: good practice Local and regional CVD prevention programmes should: • 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.
  • 5. 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
  • 6. 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.
  • 7. 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
  • 8. 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
  • 9. 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
  • 10. Lessons for Heart of Mersey
  • 11. Prevention is cost effective! a life without Expenses palliative prevention care a life with prevention 20 30 40 50 60 70 80 90 at work maybe at work difference in mortality Source: Kaiser Permanente / Hjalsted Age
  • 12. Lessons for Heart of Mersey Health is created and maintained outside the health sector!
  • 13. 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 lifestyles Regional CVD prevention
  • 14. Working in regional and local partnerships:
  • 15. 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
  • 16. 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 policies Regional CVD prevention
  • 17. 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 policies Regional CVD prevention
  • 18. 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 activity Regional CVD prevention
  • 19. Costs and savings per 200,000 population High Low deprivation deprivation Over a 5 year period region region Number of CVD events (aged 40 yrs+) 16,270 14,140 Current costs (£ million)* 75.10 65.20 Cost of implementation (£ million) 0.236 0.236 regional programme recommendations Savings (£ million) 0.420 0.341 arising from regional programme recommendations * Costs and savings related to CVD events in this table apply to a population aged 40 years and over.
  • 20. A COMPREHENSIVE APPROACH TO CVD (NCD) PREVENTION Advocacy Delivery Research AN INTEGRATED SERVICE
  • 21. Regional CVD prevention Thank you robin.ireland@heartofmersey.org.uk