Rapid Health and Equality Impact Assessment (HEqIA)of Mersey Care NHS Trust’s Outline Business Case for Mental Health and Learning Disability Services

The aim of this assessment is to look at the health and equality impacts of Mersey Care's Outline Business Case which aims to: Establish home treatment as the norm; Refocusing in-patient services around patients who are acutely ill with shorter lengths of stay; Developing a local Psychiatric intensive Care in-patient Unit (PICU); Strengthen community and primary care services. The results of this Health and Equality Impact Assessment will be used to feed the Outline Business Cas

An overview of the history and work of Liverpool Public Health Observatory, and its impact on policy and services

Liverpool Public Health Observatory (LPHO) was established in 1990 to provide intelligence to Merseyside Health Authorities (later Primary Care Trusts and now Local Authority Public Health Departments). The work programme for LPHO is now managed by the Cheshire and Merseyside Public Health Intelligence Network, on behalf of the Directors of Public Health. The Intelligence Network identify areas of work based on local priorities and those of the CHAMPS public health collaborative service1. A project lead, usually a member of local authority staff, is identified, and a working group is established – the working group provides expert input into the projects, and a steer to researchers in the University regarding scope and local requirements. Academic support for the projects is provided by the University of Liverpool. When reports are complete, they are uploaded to LPHO’s website, and disseminated widely via CHAMPS to relevant professionals, including relevant leads within the NHS and local authorities, and presented at relevant local, national and international conferences and events. Projects are now evaluated six months after they have been completed. This overview report provides a summary of some of the more recent reports that have been compiled by LPHO, including evaluation findings where these are available, and the impact that LPHO’s work has had on public health practice. An appendix which lists all LPHO’s publications is included at the end of this report for future reference

Dietetic helpers in the community: the Bolton Community Nutrition Assistants Project

Study objective: To explore the role of 'Community Nutrition Assistants' (CNAs) in helping to increase coverage, by increasing access to local community dietetic services, and to bring about positive changes in the determinants of healthy eating, within low income areas of Bolton, England. Study design: A descriptive evaluation of programme development and field-testing (1995-1997) in the community. Non-experimental design. Setting: community, less affluent neighbourhoods in Bolton, North West England. Subjects: 1272 people in total, individuals and members of community groups, recorded as CNA contacts during 2 discreet monitoring periods; an opportunistic or purposive sampling strategy was used; subjects were randomly selected for group interview (n=8) and telephone interviews (n=41) out of a traceable sample of contacts (n=94) over a randomly selected 1month collection period. Findings: compared with professional only service, CNAs efforts resulted in a fourfold increase in coverage of community nutrition services in the local community. CNAs demonstrated unique attributes, which positively influence their ability to work well with local people, but particularly those considered hard to reach. At least half the subjects interviewed reported positive behaviour changes such as changes to foods bought, cooking methods or foods eaten in the home. Conclusions: This study has shown some benefits in training local people to work alongside existing community dietitians. This may help to reduce inequalities in health, address barriers to healthy eating experienced by low income families, and improve cost effectiveness. Before expansion continues on an ad hoc basis further research is needed to test generalisability, to assess health outcomes, and to quantify the value of using local people. The findings here are useful in guiding further developments

Health Locus of Control and Assimilation of Cervical Cancer Information in Deaf Women

This study assessed the relationship between Deaf women's internal health locus of control (IHLC) and their cervical cancer knowledge acquisition and retention. A blind, randomized trial evaluated Deaf women's (N = 130) baseline cancer knowledge and knowledge gained and retained from an educational intervention, in relation to their IHLC. The Multidimensional Health Locus of Control scales measured baseline IHLC, and a cervical cancer knowledge survey evaluated baseline to post-intervention knowledge change. Women's IHLC did not significantly predict greater cervical cancer knowledge at baseline or over time. IHLC does not appear to be a characteristic that must be considered when creating Deaf women's cancer education programs

Hospital service areas – a new tool for health care planning in Switzerland

BACKGROUND: The description of patient travel patterns and variations in health care utilization may guide a sound health care planning process. In order to accurately describe these differences across regions with homogeneous populations, small area analysis (SAA) has proved as a valuable tool to create appropriate area models. This paper presents the methodology to create and characterize population-based hospital service areas (HSAs) for Switzerland. METHODS: We employed federal hospital discharge data to perform a patient origin study using small area analysis. Each of 605 residential regions was assigned to one of 215 hospital provider regions where the most frequent number of discharges took place. HSAs were characterized geographically, demographically, and through health utilization indices and rates that describe hospital use. We introduced novel planning variables extracted from the patient origin study and investigated relationships among health utilization indices and rates to understand patient travel patterns for hospital use. Results were visualized as maps in a geographic information system (GIS). RESULTS: We obtained 100 HSAs using a patient origin matrix containing over four million discharges. HSAs had diverse demographic and geographic characteristics. Urban HSAs had above average population sizes, while mountainous HSAs were scarcely populated but larger in size. We found higher localization of care in urban HSAs and in mountainous HSAs. Half of the Swiss population lives in service areas where 65% of hospital care is provided by local hospitals. CONCLUSION: Health utilization indices and rates demonstrated patient travel patterns that merit more detailed analyses in light of political, infrastructural and developmental determinants. HSAs and health utilization indices provide valuable information for health care planning. They will be used to study variation phenomena in Swiss health care

Developing emergency services in the community

SIGLEAvailable from British Library Document Supply Centre-DSC:4584.057(no 9) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Amphetamine, cocaine and crack use Prevalence, treatment and services; a report prepared for St. Helens and Knowsley Health

SIGLEAvailable from British Library Document Supply Centre-DSC:6206.080(40) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Dietetic helpers in the community: the Bolton Community Nutrition Assistants Project

Study objective: To explore the role of 'Community Nutrition Assistants' (CNAs) in helping to increase coverage, by increasing access to local community dietetic services, and to bring about positive changes in the determinants of healthy eating, within low income areas of Bolton, England. Study design: A descriptive evaluation of programme development and field-testing (1995-1997) in the community. Non-experimental design. Setting: community, less affluent neighbourhoods in Bolton, North West England. Subjects: 1272 people in total, individuals and members of community groups, recorded as CNA contacts during 2 discreet monitoring periods; an opportunistic or purposive sampling strategy was used; subjects were randomly selected for group interview (n=8) and telephone interviews (n=41) out of a traceable sample of contacts (n=94) over a randomly selected 1month collection period. Findings: compared with professional only service, CNAs efforts resulted in a fourfold increase in coverage of community nutrition services in the local community. CNAs demonstrated unique attributes, which positively influence their ability to work well with local people, but particularly those considered hard to reach. At least half the subjects interviewed reported positive behaviour changes such as changes to foods bought, cooking methods or foods eaten in the home. Conclusions: This study has shown some benefits in training local people to work alongside existing community dietitians. This may help to reduce inequalities in health, address barriers to healthy eating experienced by low income families, and improve cost effectiveness. Before expansion continues on an ad hoc basis further research is needed to test generalisability, to assess health outcomes, and to quantify the value of using local people. The findings here are useful in guiding further developments

Prevention Programmes Cost-Effectiveness Review: Physical activity

This is the first topic area covered by the cost effectiveness review series. A comprehensive review of the literature is presented on evidence of the cost effectiveness and potential cost savings of preventive programmes and projects relating to physical activity