Priorities & Programmes

Priorities & Programmes

Joint Health and Wellbeing Strategy for Nottingham City (April 2022 – March 2025)

We know that people who face the biggest challenges also experience the poorest health. Working together we will provide the care our communities need to live longer and healthier lives.

The four priorities have been developed using local data and intelligence, including the views of people with lived experience and are areas we know we can do things differently to make a tangible difference to the health and wellbeing of Nottingham’s residents, by working together in partnership.

The Strategy sets out our shared vision, principles and priorities for action over the next three years to improve health and wellbeing, and reduce health inequalities across Nottingham City.

The Nottingham City Place-Base Partnership has been discharged responsibility for the oversight of the strategy and through this will ensure a partnership approach to delivery.

The Joint Health and Wellbeing Strategy for Nottingham City 2022 – 2025, will focus on four key priorities.

The four priorities

Eating and Moving for good health

Living with overweight or obesity increases the risks of diabetes, cardiovascular diseases, musculoskeletal conditions and some cancers. As well as people’s physical health, living with obesity can also have an impact on mental wellbeing and has been associated with anxiety and depression.

Living with overweight or obesity increases the risks of diabetes, cardiovascular diseases, musculoskeletal conditions and some cancers. As well as people’s physical health, living with obesity can also have an impact on mental wellbeing and has been associated with anxiety and depression.

For those not living with obesity, what we eat and how much we move are still important factors that influence our health and wellbeing. Furthermore, food shapes all our lives, our communities and our environment be it via the way we produce it, package it, transport it, or who we buy it from and eat it with. The increased awareness and interest in the role of food on climate change and our health as well as a growing consciousness about food poverty, present opportunities for change.

Everyone experiences multiple barriers and challenges to eating and moving for good health. These factors are complex and broad; for example: how easy it is to walk or cycle in the community; if we live surrounded by fast food shops; the skills we acquire as we grow up (e.g. cooking, physical literacy); or if we can afford to choose healthy food or afford to access sport equipment/facilities. We have built on previous childhood obesity workshops with health and care stakeholders, community organisations, schools and parents. We have identified five broad domains to be explored in order to provide structure to our whole system approach:

  • Food plan: Sustainable food, food poverty and the food environment
  • Physical activity, Leisure centres and Parks and Open Spaces
  • Schools and Nurseries
  • Community and voluntary sector
  • Healthy weight pathways

How will we know we have made a difference?

We will use the Public Health Outcomes Framework indicators on the proportion of Reception and Year 6 children who are living with overweight and obesity; and the proportion of adults living with overweight and obesity.

In addition, we will look at change in variables on diet quality such as the proportion of the adult population meeting the recommended ‘5-a-day’ on a ‘usual day’, and proportion of physically active children and young people, and adults.

We will work with partners to share local data and insight including service evaluations. It remains important to capture lived experience and while some changes will take time before they are ‘felt’ by individuals, others may have a more noticeable short-term impact. Open conversations with our residents; community organisations and wider stakeholders will also guide our learning.

Financial Wellbeing

Financial wellbeing means being able to meet current needs comfortably and having the financial resilience to maintain this in the future. It builds on the ideas of financial inclusion, access to services and financial capability.

A lack of financial wellbeing (‘money worries’) contributes to stress and poor mental wellbeing, and has a negative influence on our health behaviours and choices.

Research indicates there is an association between debt and mental health problems, and an association between living with long term ill-health and poverty.

We will be considering the enablers of financial wellbeing like access to services and support schemes, and tackling the barriers for financial wellbeing such as indebtedness and educational attainment. Areas for particular attention will include:

1. Crisis provision (foodbanks, emergency grants and loans)
2. Access to financial services (including credit unions)
3. Life course financial capability
4. Gambling and gambling related harm

How will we know we’ve made a difference?

We will use the Public Health Outcomes Framework indicators on income and earnings, employment, education and training and fuel poverty.

We will work with partners on sharing local data and insight on employment, income, and cost of living pressures.

Hearing the voice of our citizens through local services including welfare advice, foodbanks, and community engagement is really important. The Financial Resilience Partnership conduct an annual survey.

Severe Multiple Disadvantage

This work stream will focus on improving the experiences and outcomes of people living in Nottingham that are experiencing SMD.  We know that people experiencing SMD can feel services are difficult to access and that their care and support can feel fragmented or stigmatising.  We also know that people experiencing SMD can sometimes be frequent users of some services including emergency services, but their outcomes are still poorer than the general population.

Two hands holding each other with people in the background holding hands

As SMD is multi-faceted and complex, we need a system focused approach that brings together lived experience and a range of organisations within the voluntary and community sector with statutory organisations across health, social care, housing and criminal justice. 

We are fortunate in Nottingham City to have an existing strong partnership that can support the development of this much needed system approach. 

As a partnership we will:

  • Make sure we listen to the voices of people with lived experience and to frontline workers so that we can identify and address barriers to care and improve the support people receive.
  • Improve access to services, resolving problems through greater flexibility and making sure that staff know how to engage effectively with people that experience SMD.
  • Help services work more closely together, planning and delivering services around the person rather than expecting people to navigate what can be a very complex system.
  • Develop our understanding of the experience of SMD and how that impacts on people’s lives.

We will know if we have made a difference if:

  • People experiencing SMD feel involved in all aspects of their care and support and their experiences and voices influence the design and delivery of the care and support that they receive.
  • People experiencing SMD are be able to access the help and support they need at the right time and feel supported and not stigmatised by the help and support they receive.
  • Citizens with the greatest need are able to receive one to one support that will help them navigate services and achieve their goals and aspirations.
  • Staff working in all sectors feel better equipped and supported in working with citizens that are experiencing SMD.
  • There is more cross- organisational working between services so that citizens experiencing SMD don’t need to tell their story over and over again and don’t get lost in the system.
  • There is a greater focus on the outcomes for people that experience SMD, to include the citizen’s own goals and ambitions as well as wider outcomes relating to health and social care

Smoking and Tobacco control

For many people smoking is a chronic and relapsing addiction, which generally begins in childhood, and is not a lifestyle choice. Smoking is still the greatest cause of ill-health and early death in Nottingham City. Significantly reducing smoking prevalence will: improve health outcomes, support poverty reduction, deliver higher productivity, give babies and children a better start in life, reduce health and social care costs and cut crime by dealing with the illegal tobacco trade.

For many people smoking is a chronic and relapsing addiction, which generally begins in childhood, and is not a lifestyle choice. Smoking is still the greatest cause of ill-health and early death in Nottingham City. Significantly reducing smoking prevalence will: improve health outcomes, support poverty reduction, deliver higher productivity, give babies and children a better start in life, reduce health and social care costs and cut crime by dealing with the illegal tobacco trade.

Stub It Poster. Want to stop smoking but dont know where to start? www.ncgpa.org.uk/stub-it

Tobacco imposes a significant economic burden on society. In addition to the direct medical costs of treating tobacco-induced illnesses there are other indirect costs including loss of productivity, fire damage and environmental harm from cigarette litter and destructive farming practices. Each year it is estimated that smoking costs Nottingham about £137M; this includes £115M in lost productivity; £12M in healthcare costs; and £6.82M in costs to social care.

There are other costs of tobacco use too. Cigarettes and other smoking materials are one of the leading causes of fatal accidental fires in the home. Furthermore, cigarette butts make up a significant amount of litter items with the majority of cigarette filters being non-biodegradable and thus have a lasting environmental impact.

We will also consider Shisha; a tobacco-based product that is smoked through a water bowl. There are a number of health issues regarding shisha use. A common misconception is that smoking shisha is healthier than smoking cigarettes – there is a lack of understanding about the harm smoking shisha can cause.

Evidence suggests that there are significant levels of cannabis use among people who classify themselves as non-smokers and a significant proportion of tobacco smokers who also smoke cannabis weekly. Long term smokers of cannabis have an increased risk of many of the same diseases that tobacco smokers do. As such, we have decided to consider cannabis smoking within scope for this strategy.

If you are a Nottingham City resident and would like help to stop smoking. Contact the Stub-it team:
Web: ncgpa.org.uk/stub-it Tel: 0115 824 0583 (option 2)
Email: ncgpa.stubit@nhs.net

Our Programmes of work

Our programmes of work will feed into the four priorities highlighted in the health and wellbeing strategy:

As well as focusing on improving outcomes for citizens City PBP partners are:

• Developing the Integrated Care Partnership and establishing the PBP culture.
• Supporting our partners in recovery and restoration from Covid-19.

We know that accessing care and support is not always easy and that services in Nottingham are not as well joined up as they should be. We are committed to tackling this and are working with all of our partners, and beyond, to make sure that services talk to each other in a better way.

The Nottingham City PBP is part of the Nottingham and Nottinghamshire Integrated Care System (ICS).

We will work together to create happier, healthier communities
and reduce the gap in healthy life expectancy across
Nottingham City.

Hill illustration