Walsall Health and Wellbeing Board Review

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1 Walsall Health and Wellbeing Board Review Partnering for success The HWB meets about every 6 weeks at the Walsall Council building. The public are welcome to attend the meetings and many do come along to hear what is being discussed. The strategic discussions and decisions of the HWB echo those taking place in a number of Local Authority (LA) NHS and partner Boards across Walsall to consider the many factors involved to improve the health and wellbeing of our residents across a number of areas of work. The Health and Wellbeing Board understands that it cannot achieve its aims in isolation and therefore it has formed alliances with a number of other key LA and NHS partner groups. The key groups are: Walsall Health and Wellbeing Board (HWB) brings together the NHS (through Walsall Clinical Commissioning Group), public health, adult social care and children s services, including elected representatives and Healthwatch Walsall. Together, we plan how best to meet the needs of our local population and tackle local inequalities in health. The ambition of the Board is: to improve the health and wellbeing of everyone in Walsall and reduce the inequalities by improving the outcomes of people in deprived communities and vulnerable groups faster than the average for the borough of Walsall Board/Groups with links to The Health & Wellbeing Board Health and Wellbeing Task and Finish Groups Strategic Advisory Group Joint Commissioning Committee Healthy Walsall Board Walsall Economic Board CCG Improving Outcomes Committee Health and Wellbeing Board Safer Walsall Partnership Youth Justice Management Board Public Health Programme Board Health Protection Forum Children & Young People s Partnership Safeguarding Children Board Safeguarding Adults Board HWB members need to know... All the members recognise that in order to do their job well, they need to be constantly learning. They need to know: what the job of the Health and Wellbeing Board is what their responsibilities, as members of the HWB, are what are the health and wellbeing needs of the people of Walsall What is already being done and what evidence do we have of the impact What are the barriers to success and what do we need to do to overcome them What else do we need to do What can we learn from similar areas of the country The members of the Health and Wellbeing Board all have differing personal and professional expertise and experience they can bring to the table knowledge, skills and understanding. As a result, the HWB work programme always contains a number of HWB development sessions to ensure that members are given the opportunity to learn from each other and invited experts. There were four development sessions in the last municipal year covering topics such as NHS and LA systems, the Better Care Fund, governance of the HWB and future horizon scanning. During 2014/15, the HWB members also took part in an independent evaluation undertaken by a representative from the Local Government Association which resulted in a number of recommendations that have been considered and acted upon. 1

2 Joint Strategic Needs Assessment 2014/15 As a result, over the course of the year, the HWB agreed to develop specialist Task and Finish Groups to focus on a issue for a time limited period to identify specific actions to overcome the barriers. This year the issues selected for the Task and Finish Groups were Alcohol and Healthy Weight, both of which are covered in more detail in the paragraphs overleaf. Walsall Health and Wellbeing Board s 19 Priorities The current Joint Strategic Needs Assessment (JSNA) document for Walsall Council and Walsall Clinical Commissioning Group was completed in December This in turn informs the development of the Health & Wellbeing Strategy (HWS) for Walsall. During 2014/15, the Walsall JSNA process has focussed on two main tasks: - Providing in-depth needs assessments to support the Task and Finish Groups of the Health and Wellbeing Board covering alcohol, and healthy weight. Identifying and filling gaps in the JSNA to support other ongoing work for example an Eye Health Needs Assessment. The Walsall JSNA process has also been strengthened in other ways. Each in-depth needs assessment for a particular topic has compulsory sections on gathering an evidence base that have required consultation with stakeholders, including the public. During 2014/15, a dedicated website for Walsall JSNA was developed. The website contains the core JSNA dataset, the deep dive needs assessments and the JSNA locality area partnership profiles. They can be found at; Health and Wellbeing Strategy (HWS) The 3 year Health and Wellbeing Strategy for Walsall was developed in 2013 and has an action plan that has been revisited each year. In 2014/15, the Health and Wellbeing Board (HWB) recognised 19 priorities within 8 themes that cover the human life cycle. They range from helping parents ensure children have the best start in life to reducing emergency admissions to hospital for over 75s. Other paragraphs in this review talk about ongoing work covering some of these priorities. Over the course of the year the HWB meetings receives progress updates on the 19 priorities. The Information provided is discussed, queried and challenged by members to identify any potential gaps, barriers to progress and to propose possible solutions. The HWB recognises that some priorities are particularly complex and at times expected outcomes have been difficult to achieve. In particular this has been the case where; the issue is a significant contributor to death, disability or service cost the issue impacts on a number of services within the Council and NHS as well as other partners the issue is recognised by partners as needing to be tackled urgently services at a local level could be reshaped Theme Wellbeing in Walsall Give every child the best start in life Enable all children and young people to maximise their capabilities and have control over their lives Money, Home, Job Creating and developing healthy and sustainable places and communities Improving health and wellbeing through healthy lifestyles: Making healthier choices easier Reducing the burden of preventable disease, disability and death Healthy ageing and independent living Priority 1. Promote emotional wellbeing and encourage people to be more self reliant 2. Help parents ensure children enjoy the best start in life 3. Reduce infant mortality 4. Reduce the gap in attainment between children from the least and the most deprived communities in Walsall 5. Provide education to improve parenting skills 6. Help children maintain a healthy weight 7. Ensure mental health services for children are fit for purpose 8. Provide support to vulnerable young adults so they can access jobs or training 9. Support businesses to provide healthy workplaces 10. Reduce child poverty and the impact on families of workless parents 11. Ensure the best possible welfare advice for those in need 12. Ensure staff of local service providers have knowledge and skills to improve the health of their service users 13. Ensure that we provide land and space for healthy living and that the health impacts of developments are properly assessed. 14. Encourage ways to involve local people and communities in efforts to improve 15. Reduce the harm caused by alcohol and drugs 16. Help people to find out how to improve their own health 17. Ensure employees are trained to give appropriate healthy lifestyles advice and know about available local support, thereby helping people improve their health 18. Reduce the life expectancy gap by improving the health of the poorest people, and men in particular 19. Reduce emergency admissions to hospital for over 75s and reduce the use of long-term residential care 2

3 Obesity Task and Finish group update In line with national trends, obesity remains a real challenge in the borough and Walsall s population remains increasingly overweight / obese. 24% of Walsall s Reception children were overweight or very overweight and 40% of Year 6 children are also overweight or very overweight in 2013/14 Almost 70% of the adult population is classed as overweight or obese. Obesity and physical inactivity is associated with many chronic diseases including; Diabetes Coronary heart disease Some cancers. Obesity is a significant and continuing threat to human health. It places a large burden on public resources and in terms of health care its costs and effects are numerous. It impacts on employers through lost productivity It Impacts on families due to the physical/ psychological burdens of having/ caring for someone with a long-term chronic disability. A healthy weight task and finish group has looked at innovative ways to tackle the problem. Its main actions have so far included: Re-design of the Healthy Schools Initiative to provide schools with a package of tailored support Supporting and equipping teachers with the skills, confidence and activity ideas to lead visits to green spaces including allotments Funding of a joint post with planning to improve the environment Implementation of a Workplace Wellbeing Charter. Protecting Vulnerable Children in Walsall Protecting children from harm is a priority for all agencies in Walsall and so a protocol to clarify roles and accountability has been agreed and signed between: Childrens and Young People s Partnership Board Health and Well-being Board Safeguarding Children Board. This means that each Board will ensure that they prioritise the safeguarding of children and young people in their work and hold each other to account in demonstrating that they do. This is done by each Board reporting to each other during the year - Their plans for the year and what they will do to improve safeguarding Their progress on delivering their plans. This will provide the opportunity for each Board to consider, and make suggestions on the performance and plans of the Boards with regard to safeguarding, and to identify data that needs to be included in the JSNA and key safeguarding issues that need to be incorporated in the refresh of the Health and Wellbeing Strategy. Further work is underway to include further boards in the protocol including: Safeguarding Adults Board Safer Walsall Local Policing and Crime Board Youth Justice Management Board. Managing 6 boards reporting to each other would be impossible so it is planned to set up each year a Walsall Safeguarding summit to allow members of each of the 6 boards to challenge and support each other s progress on improving safeguarding and also coordinate efforts to further improve safeguarding. The proposed process would be; 1. Each Board chair to present a report on progress (5 minutes) 2. Challenge discussions 30 minutes 3. User Voice what people in need of protection say 4. Agree areas for a. Individual boards to prioritise b. Collaborative priorities c. Including children and young people s voices to improve services. Health and Wellbeing Board Alcohol Plan The sensible and safe use of alcohol can play an important cultural and social role within our society. However the problematic use of alcohol can have significant negative impact for individuals, their families and communities if left unchallenged. The negative impacts can be seen across the range of priority areas of the Health and Well-being Strategy: family problems including babies being born with foetal alcohol syndrome, increased levels of family dysfunction and alcohol related domestic violence alcohol co-morbidity with mental health problems poor health and reduced life expectancy community safety challenges, increased alcohol related offending and fear of crime. The Health and Wellbeing Board has launched an Alcohol Action Plan to focus on: a preventative approach to raise awareness, particularly in schools, about the problems of alcohol misuse optimising opportunities for brief interventions and referrals into treatment at each stage in social care, health and criminal justice systems a partnership project focusing on intensive and coordinated support to the most complex cases e.g. frequent flyers presenting to the Hospital A&E Dept. coordinating the use of new Anti Social Behaviour tools and powers, trading standards, enforcement and licensing services to reduce alcohol related problems strengthening information sharing across agencies for better coordinated responses to individuals presenting with alcohol related problems. 3

4 Urgent and Emergency Care Vision and Strategy In 2014, the Clinical Commissioning Group (CCG) Governing Body completed a review of Urgent Care (UC) services in Walsall following a wide ranging consultation with members of the public and other stakeholders including the Health and Well Being Board. At its meeting in November 2014 the CCG s Governing Body took these views into account and agreed to the strategic direction of Urgent Care over the next 5-7 years as follows: To develop a town centre Urgent Care Centre Hub - A unified Urgent and Emergency Care System in one building to enable: people to walk into the service at any time of the day for urgent care or be brought to the service by ambulance if they have an emergency need 24/7. The new centre will benefit patients in the following ways: easy to access, providing the right care, in the right place, at the right time The new service will be based at Walsall Manor Hospital s A&E department and would be open 24 hours per day, 7 days per week for people who need urgent or emergency care Patients to go through one door and be directed to the most appropriate service. This could be expertise provided by a GP, a hospital doctor or a nurse who will all have fast access to diagnostics and can route patients through appropriate pathways of care. By bringing services together in one place we will be able to make it easier for patients to know where to go for help at any time of the day or night. We will improve the quality of care provided to patients, and services will be able to make the best use of staffing and diagnostics and community support services, so that patients receive the right care, in the right place and at the right time. In delivering this 5 year vision, the UC strategy will address the important issues of our public consultation including concerns regarding: accessing a GP out of hours how Walsall Healthcare Trust Emergency Department works alongside other health and social care services to ensure a joined up, patient-centred service public transport access car parking A review of Urgent Care access in the North of the Borough. Summary This strategic direction is consistent with national guidance and best practice and is supported by the CCG s Clinical Operational Group, the Improving Outcomes Board, and the Systems Resilience Group. In developing the strategy further, we will continue to take into account the views of local people and stakeholders, on the listening exercise and consultation conducted in early This will ensure that the patient voice is continually heard at the heart of our plans. Urgent Care planning priorities for 2015/16 Having agreed the vision the CCG is now working on delivery. Our priorities for this year are: 1. Completing an open tender process for the new service 2. Awarding the contract to the new service provider 3. Securing the new premises at the Saddlers Centre, Walsall town centre 4. Securing operational status of the service from 1 October 2016 initially from existing Walk In Centre site and then the new Saddlers site when available in early December Gain agreement on how the Urgent care providers including NHS 111 will work together to deliver an integrated service 6. Communications campaign around Urgent Care pathway and access Primary Care Co-commissioning In January 2015, all CCGs were given the opportunity to opt for one of three options for co-commissioning which were: fully delegated commissioning joint commissioning with NHS England Area Team Greater involvement. NHS Walsall CCG applied for and was granted joint commissioning responsibility with NHS England. This means patients and clinicians will now have more involvement in deciding how local primary care medical services are developed. Subsequently on 1 April 2015 the CCG received approval to jointly commission local GP services with NHS England. A Joint Commissioning Committee has already been set up with representatives from the CCG, NHS England, the Local Authority, Healthwatch Walsall and the Local Medical Committee to deliver this. This Committee also plays an important role in managing any potential conflicts of interest under the new joint arrangements. Meetings are held in public on a monthly basis at Walsall CCG s Head Office at Jubilee House and members of the public and wider stakeholders are encouraged to attend. information can be found on the CCG website 4

5 Public Health Transformation Fund The transfer of public health services from the NHS to the Local Authority has provided Walsall Council with an opportunity to commission more effective and seamless services which improve the health and wellbeing of the local community whilst also achieving greater value for money. Walsall Public Health recognises that whilst many beneficial health and wellbeing services are in place there is still more that can be done to improve health outcomes across Walsall. Services across the Council and wider partnerships will have ideas of how services can be significantly improved or enhanced but may not have the opportunity to develop these ideas without support or funding. The Public Health Transformation Fund has been specifically developed to offer this opportunity. The Public Health Transformation Fund provides a flexible financial investment with which to transform existing services and support innovative and pilot approaches to protecting, maintaining and improving the health and wellbeing of residents in Walsall. This investment may be either recurrent or time limited in nature. Public health services in Walsall have been working closely across Council Directorates and have invested in exciting and innovative approaches to the delivery of public health. The Transformation Fund is intended to: provide a dedicated funding stream which enables the Council and its partners to maximise public health gain from existing council services and to pilot innovative initiatives and activities which improve the health and wellbeing of the local population ensure that allocation of investment is made through a structured framework of good corporate governance and in accordance with the conditions of the ring fenced public health grant. The Transformation Fund aims to provide funding for projects which: Protect, maintain and improve the health and wellbeing of the local population Support the delivery of priority local health and wellbeing activities Facilitate collaborative and integrated approaches to population health and wellbeing Improve quality through targeting the right people with the right service in the right place and at the right time Gain better value for money by investing in prevention activities which reduce demand for council services in the long term. Projects sponsored by Walsall Public Health through the PH Transformation Fund Parenting Walsall Public Health is working with the Children s Directorate to transform parenting support across Walsall, and have invested 137k in parenting programmes as part of the Public Health Transformation. There is evidence to show that parenting programmes to reduce conduct disorder pay back 8 over 6 years for every 1 invested in Walsall this should translate to savings of 1,096,000 A*Stars In collaboration with the Economy and Environment Directorate, Walsall Public Health has invested 110k in the A* programme which encourages children to walk or cycle to school. There is evidence that getting one more child to walk or cycle to school could pay back as much as 768 or 539 respectively in health benefits, NHS costs, productivity gains and reductions in air pollution and congestion. The A* programme has already supported 1330 children in Walsall to complete training in cycling a potential payback of 717k in health benefits. Teenage Pregnancy Walsall Public Health is working with the Children s Directorate to transform teenage pregnancy prevention programmes in Walsall. Every pound spent on preventing teenage pregnancy saves 11 in healthcare costs. Walsall public health have invested 150k in teenage pregnancy services a potential saving of 1.65 million in health care costs in Walsall 5

6 What is a PNA? A Pharmacy Needs Assessment (PNA) looks at whether community pharmacies meet the needs of a local population. The PNA supports the Health and Wellbeing Board to develop plans to ensure the public can access appropriate services to meet their needs. Why are PNAs important? Community pharmacies are part of local health care and public health and affect NHS budgets. Therefore PNAs are very relevant when deciding if new pharmacies are needed, in response to applications by businesses. The public health strategy for England (2010) Healthy lives, healthy people, says: Community pharmacies are a valuable and trusted public health resource. With millions of contacts with the public each day, there is real potential to use community pharmacy teams more effectively to improve health and wellbeing and to reduce health inequalities. What does it cover? PNAs include pharmacies and the services they provide. These may include dispensing, providing advice on health, medicine reviews and local public health services, such as stop smoking, sexual health and support for drug users. The assessment also looks at other services, such as dispensing by GP surgeries, and services available in neighbouring HWB areas that might affect the need for the area. It should reflect the demographics of its local population, in different localities, and their needs. It should look at highlighting locality gaps that might be met by providing more pharmacy services, or opening more pharmacies. It should also take account of likely future needs. The PNA contains maps relating to the area and its pharmacies and must be aligned with other plans for local health and social care, including the Joint Strategic Needs Assessment (JSNA). How did we develop the PNA? The process for development of the PNA was overseen by Walsall Health and Wellbeing Board through the PNA Steering Group. The group was made up of representatives from Primary Care Contracting (NHSE), Public Health, Walsall Clinical Commissioning Group, Medicines Management and the Walsall Pharmaceutical Committee. The project plan for development contained the following steps: Identify local health needs, Health and Wellbeing Board and Clinical Commissioning Group priorities Identify current and potential pharmaceutical service provision Consider patient experience Healthwatch Walsall Pharmacy User Survey Map and synthesise data Consult with wider stakeholders (mandatory 60 day consultation) Seek final approval from Health and Wellbeing Board. Where can you find it? social_care/healthwellbeing.htm Better Care Fund The aim of the Better Care Fund is to join up health and social care services more effectively and thereby reduce duplication and enhance patient experience. This works in several different ways. Some older people have more than one health condition which makes them more likely to have to go to hospital because of deterioration in their health. If GPs, community nurses and social workers can share information in a confidential manner about patients, they can work together in a joined-up way and support them to remain at home. We want to ensure older people get the help they need, when they need it by having an identified worker who will act as a point of contact for the services in the system. In this way, workers can be on hand at short notice to provide support in the home. This way of working has already been tried out in Darlaston during the last year, where nearly 800 people with long term conditions were identified for this kind of support. This will be extended to other parts of the Borough during 2015/16. Use of specialised technology can support a person s independence by enabling them to monitor and self-manage their own long term conditions, for example conditions of the heart, diabetes, or dementia, in the comfort of their home. We want to support older people to remain at home by avoiding hospital admission wherever possible, and reducing the number of people who have to leave their own homes and enter a care home. Adaptations to the home can also make a real difference to whether an older person or couple can remain in their own home. It is also important to think of the carer in a family situation because carers have their own needs as well. When individuals do end up in hospital, it is important they remain there for only as long as they need medical treatment. If they can t go straight home, then it is important they can go somewhere that is safe and comfortable to complete their recovery so that they can then eventually go home. Nobody should have to go into a care home if they had been at home prior to going to hospital. The decision to leave the family home is an important step and should not be taken in a busy acute hospital before there has been time for recovery and rehabilitation that means they can go home again. Work has commenced to join up the case management of people being discharged from hospital more effectively during 2015/16, reducing the number of times people have to move within the hospital, and the number of readmissions. The Better Care Fund is focused on supporting older people to remain at home. The role of the Health and Well Being Board is to oversee these arrangements and ensure that good progress is made in reducing the number of people being admitted to hospital, or placed in a care home. This will in turn release funding for more investment in community services that support people to remain in their own homes. The real challenge will be the extent to which the health and social care system in Walsall can spend more time supporting people in their own homes than spending money on avoidable hospital admissions or unnecessary care home placements. 6

7 Walsall Clinical Commissioning Group Walsall Clinical Commissioning Group s (CCG) Operational Plan ( ) has been developed in the context of the CCG s strategic plan and local health care needs assessment. If the strategic plan is the What, the Operational Plan is the How. The objectives set out in the plan describe not only how strategic aims will be delivered but also how the CCG is acting on NHS Planning Guidance priorities. Our operational plan identifies 4 local priorities: Healthwatch Walsall Healthwatch Walsall (HWW) continues to be led by Assembly Members. It focuses on specific topics in order to provide feedback to social care commissioners / providers on ways in which commissioning or service provision can be improved. HWW has also worked with the Walsall NHS Trust to improve the content and detail of the Annual Quality Account. HWW s Service Watch questionnaire produced over 1200 completed responses from all over the borough and thanks to the success of our engagement programme and engagement grants scheme we were able to reach out to many traditionally hard to reach groups who provided a wealth of intelligence. HWW s first large scale piece of work focused on hospital discharge from the Manor Hospital and the final report is due to be published. HWW fed into the JSNA and Pharmaceutical Needs Assessment. Other work is continuing on GP Satisfaction, Accident & Emergency services and Obesity. HWW s Annual Report - due to be published shortly details many more achievements. HWW aims to build on last year s successful engagement programme and during the remainder of 2015 and into 2016 it has commissioned an even larger team to collect feedback from users. This research will help tackle inequalities in service provision for those harder to reach, or disengaged groups and in turn will be fed back to providers and commissioners. A second Borough wide Service Watch survey will also help HWW understand in more detail the patient and service user experience. HWW s refreshed website will have improved accessibility facilities and will provide a step change in the way we gather people s views and experiences. HWW is expanding its Enter & View activity to provide more service user experiences between formal inspections by the Care Quality Commission (CQC) or commissioners. HWW will also be working closely with the CQC on the planned inspection of Walsall Healthcare due to take place in the autumn. HWW will be publishing reports and recommendations from member led workstreams looking into Hospital Discharge, GP satisfaction, Obesity and Accident and Emergency services, and will also be focussing on Mental Health services as well as the implementation of the Better Care Fund and Co- Commissioning. Finally as HWW enters the 3rd year of its contract it looks forward to negotiating a new contract with the Council to ensure that the infrastructure, relationships and experience built up over the past 3 years can continue to be of benefit to Walsall people. 1. To reduce emergency admissions to hospital. In 2015/16 Urgent care will continue to be reviewed, transformed, and designed to produce better outcomes. 2. To improve service performance and quality particularly for Referral to Treatment times. 3. To improve mental health and wellbeing and parity of esteem 4. To provide the right care, in the right place, at the right time. In 2015/16 primary care capacity will be developed to support new models of delivery. If we are to realise the plan we will need partnerships with other organisations including the Local Authority, provider organisations and the voluntary sector. The Health and Wellbeing Board is therefore a pivotal forum where we will measure our contribution to the Borough s overarching health improvement plan. A key feature of our Plan is the Better Care Fund with its increased emphasis to work with partners to build a sustainable integrated health care system driven by joint commissioning. Other key local health priorities are infant mortality and diabetes. 7

8 Infant Mortality Task and Finish Group Infant mortality is a sensitive indicator of the overall health of a population, providing a measure of the wellbeing of infants, children and pregnant women. Walsall s infant mortality rate (6.8 per 1000 live births) is consistently higher than regional (5.4 per 1000 live births) and national rates (4.1 per 1000 live births), reflecting its high level of deprivation. Walsall has the highest levels of low birth weight babies both nationally and regionally at rates of 10.2 per Low birth weight babies are more likely to die in the first year of life and have a higher incidence of disability and other diseases than babies of normal birth weight. Teenage pregnancy rates in Walsall are dropping but continue to present a challenge. Both infant and perinatal mortality are strongly associated with deprivation, with infant mortality significantly higher in the most deprived areas of Walsall. Reducing health inequalities in infant mortality requires a combination of health interventions and actions on the wider social determinants of health. An audit into infant and perinatal deaths in Walsall completed in 2008 identified four key contributing factors, namely, smoking in pregnancy, maternal obesity, deprivation and consanguinity, which are in turn linked to prematurity and congenital abnormalities. A more recent audit of perinatal deaths in Walsall completed in 2014 developed key learning points for improvement of services for pregnant women and their babies. Priorities for action: In 2015/16, the Health and Wellbeing Board is leading a joint task and finish group with the Children and Young People s Partnership Board to review the current infant mortality work programme. Some of the key priorities within the infant mortality work programme include the following: Improving antenatal care through encouraging early booking for antenatal care, improved detection of intrauterine growth restriction (IUGR) and prompt detection and management of reduced foetal movements Reducing levels of maternal obesity and smoking in pregnancy through projects such as Maternal and Early Years Service, Smoke Free Homes, improving smoking cessation in pregnancy and working with ethnic communities to reduce the use of ethnic tobacco products Maintaining effective antenatal and newborn screening and immunisation programmes Reducing sudden unexpected death in infancy (SUDI) and improving breastfeeding initiation and continuation rates Targeting vulnerable groups through specialised programmes such as the Family Nurse Partnership Addressing social determinants such as reducing child poverty, improving housing and reducing overcrowding and reducing teenage conceptions, including repeat conceptions. Walsall has the 3rd highest rate of people diagnosed with Diabetes in England Diabetes continues to be a leading commissioning priority as the prevalence rate in Walsall is higher than the England average Diabetic projection in Walsall is likely to reach 10.9% of adults by 2030 if current trends continue Therefore an estimated 1,600 + cases of diabetes could be prevented in Walsall by if obesity in the borough is stabilised Walsall men from the South Asian communities and from the Black African/Caribbean community in the 35 to 54 age group account for the highest number of diabetics This means that 0.6% of the Walsall adult population has Diabetes, but it is yet to be diagnosed. Walsall Health and Wellbeing Board have agreed that Diabetes should be a key priority for a Task and Finish Group in 2015/16. To this end specialists and commissioners within Walsall Commissioning Group and other HWB partners will meet in a Diabetes Task and Finish Group so the issues can be considered effectively. The Health and Wellbeing Board recognises that the factors influencing the diabetes rate in Walsall are complex. Population demographics; high levels of deprivation, an increase in the elderly population and consequent lifestyles; all contribute to high levels of obesity in Walsall. However, on a positive note, there is evidence that lifestyle interventions can make a significant difference in the prevention and delay of Diabetes in others - and this is where the Task and Finish group will start. 8 Contact If you have any comments or feedback on the contents of this review then your views to or

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