Vibrant and healthy communities with inclusive leisure, heritage and culture opportunities

Are we achieving our targets?

Green – 7; Amber – 2; Red – 5; M – 6

Are we getting better?

6

Improved performance

1

Stayed the same

7

Requires improvement

6

Further information is needed or the latest measure is unavailable

Analysis and issues

There is mixed performance across the Vibrant and Healthy communities key performance indicators, with one measure reporting declining and off-target performance, and two measures reporting Green but declining performance relating to self-reporting smokers, and engagement with libraries. One measure regarding the proportion of adults who are oversight or obese is in measurement as the national methodology has changed, and a new measure is proposed for 2019-2020 in Appendix Six.

The red indicator measures to the number of people who engage with museums, which stands at 122,937 compared to the year-end target of 130,873, and is declining compared to year-end performance in 2017-18 of 142,564.

Some of the reasons which account for this reduced footfall include:

  • Chester History and Heritage moved to the Grosvenor Museum and did not open until June 2018 and recorded fewer visitors than previous years;
  • Chester Castle opened for three days per week (14930) as opposed to six days per week in 2017/18 (19464) – leading to a reduction of 4500;
  • An exceptionally warm 2018 summer saw museum visitors reduce nationally. This may account for the drop in recorded visitors to our indoor site: Grosvenor Museum. 2017/18 – 78975 / 2018/19 – 73958.
  • Stretton Watermill recorded a reduction in visitors attributable in part to the damaged signage from the main road.
  • Lion Salt Works recorded fewer visitors although not as significant reduction as had been expected during post-opening years.

The Council is undertaking a programme during 2019, as work continues on finalising the new Development Plan. An essential aim of this project is to use the data and information collected to increase awareness and understanding of each of the Council’s museums users, acquire and develop tools to make contact with new audiences and track the Council’s progress marketing to these groups.

The measure regarding excess weight’s methodology has changed and alternative options to capture this data will be reviewed in the year-end refresh process. A new methodology is proposed for 19-20, necessitated by the fact that in 2016 the Active People Survey (the previous data capture method) was replaced by the Active Lives survey and a new excess weight indicator is required as Active Lives represents a change in survey methodology, both in terms of questions asked and the mode of response (from telephone to online or paper completion). Furthermore, no target will be set for 19/20 whilst this measure is baselined, as this is a new service and a new client group.

The rate of self-reported smokers has increased to 12.7% against the target of 13%, and therefore while the measure is Green and under-target, this represents a slight decline against figures at year-end 2017-18, and a reversion to near levels seen in 2016-17, when the measure reported at 13.1%.

1,850,721 people have engaged with libraries in the first half of 2018/19. This is significantly in excess of the target of 1,447,475, however it does represent a slight decline from 2017-18’s year-end performance, which included Storyhouse’s initial year, following its opening in May 2017.

  • 1,374,704 items of stock borrowed (580,167 Childrens books)
    • Increase of 18% at Hope Farm Library
    • Increase of 5% at Weaverham Library
  • 5,156 participated in the Summer Reading Challenge, highlights included:
    • Northwich Library had 773 participants in the Summer Reading Challenge (489 completed the challenge)
    • Upton Library had 493 participants in the Summer Reading Challenge (288 completed the challenge)
    • Blacon Library had 211 participants in the Summer Reading Challenge (109 completed the challenge)
  • 14,784 new members. In comparison with 17/18 including:
    • 8% increase at Northwich Library
    • 8% increase at Neston Library
    • 18% increase at Great Boughton Library
    • 11% increase at Lache Library
    • 12% increase at Sandiway Library
    • 12% increase at Upton Library
    • 8% increase at Wharton Library

Storyhouse (as part of above)

  • 212,942 items of stock borrowed (107,725 Childrens books)
  • 27,157 items of children’s stock borrowed during the Summer Reading Challenge (this was stock borrowed between the set dates of the SRC – not necessarily as a result of the SRC)
  • 540 participated in the Summer Reading Challenge (223 completed)
  • 3,107 new members

Wider Performance Indicators

In terms of the wider measures, there are five Green measures, two Amber and three Red indicators to report. The first red indicator is the number of people engaging with smoking cessation services who successfully quit smoking, measured at 4 weeks. The mid-year result is 193 against an end of year target of 1,330. This reflects a recognised national trend over recent years and the impact of e-cigarettes, which are now by far the most common method of quitting tobacco. This target is in-scoped to be refreshed, further information is available in Appendix Six.

There are also two Reds regarding the gap in life expectancy between the most and least affluent men and women. It should be noted this measure is reported with a time lag of two years. As of the latest available data at March 2019, this gap has grown from 9.4 years in Men in 2017-18, to 10.4 years in 2018-19, and from 8.8 years for women in 2017-18, to 9.1 years in 2018-19.

In 2014-16, improvements in male life expectancy stalled both locally and nationally. Data for 2015-17 indicates that male life expectancy in both Cheshire West and Chester increased slightly. Male life expectancy has generally increased in both deprived and affluent areas but not at equal rates. Provisional analysis of 2015-17 data however suggests that life expectancy in more deprived areas fell, while less deprived areas improved, causing the inequality gap to widen further. Coronary heart disease (CHD) has the biggest impact on male inequality in life expectancy. Mortality rates from CHD have reduced considerably but remain significantly high in more deprived areas compared to less deprived areas of CW&C. Despite reductions in the absolute gap, premature mortality rates are over 3 times higher in the most deprived areas compared to the least deprived areas. Key disease groups identified as contributing to the widening inequality gap are cancer, respiratory disease, liver disease and stroke. Initial analysis suggests that all of these conditions have seen premature mortality rates (death rates for people aged under 75) increase in the more deprived areas.

Female life expectancy has also stalled locally and nationally. In 2014-2016 female life expectancy in Cheshire West and Chester decreased for the first time since 2001-2003. The estimate stayed the same into 2015-17 at 82.8 years. The England estimate has also remained the same at 83.1 years.

Changes in female life expectancy have not been consistent within Cheshire West and Chester, the inequality gap has continued to widen between the most and least deprived areas. Key disease groups that have impact on female inequality are coronary heart disease (CHD) and cancer, particularly lung cancer. Chronic Obstructive Pulmonary Disease (COPD) is also contributing to the widening inequality gap with increases in mortality rates in more deprived areas.

A wide range of social, economic and environmental factors influences health and wellbeing. Some of these factors are the result of large-scale universal trends; others are due to individual behaviours. Factors such as income and education level, employment, the environment in which people live and relationships with others all have considerable impacts on life-spans. The Council has a major role to play in all these areas; life expectancy is not solely the responsibility of Public Health.

As Public Health’s focus is on prevention and early intervention, a number of strategies have been developed and key services commissioned, all of which have the potential to impact on life-expectancy. These are briefly outlined below. Cheshire West and Chester’s Health Improvement Strategy (2018-22) focuses on key areas of behaviour that impact on people’s longevity: smoking; healthy diets and being active; and substance misuse (drugs and alcohol). These behavioural factors impact significantly on the drivers of the inequality gap identified above. The action plans for each of these areas are currently being implemented.

The Children and Young People’s (0-19s) integrated service allows delivery of a truly inclusive service for 0 – 19 year olds and young people up to age 25 with special educational needs and disabilities. This service contributes to giving every child the best start in life – which the Council know impacts massively on health and wellbeing in later years. Additionally, the Integrated Wellbeing Service (smoking cessation; weight management; falls prevention; and getting more physically active) provides a targeted approach to support vulnerable, at risk population groups to stop smoking, be more active, and achieve a healthy weight goal. Finally, the new Substance Misuse Service went live on 1st April 2019 and Westminster Drug Project is the new provider. Priorities include increasing the number of people accessing specialist treatment for alcohol dependency, improving the support available for children and families affected by parental alcohol misuse and strengthening the digital offer for those who are concerned about their own drinking.

Furthermore, alcohol admissions to hospital has seen improving performance at 617 per 100,000 population in 2018-19, compared to 632 in 2017-18. This however remains above the target of 529. An extensive programme of work to reduce alcohol’s harm is underway, outlined in the ‘Actions’ section below.

Examples of green measures include high levels of physical activity in the borough, with almost 2.5 million residents using Brio Leisure venues by year-end, and the number of volunteers at museums, which has increased to 94 from mid-year performance of 66.

Actions

Key highlights of progress within 2018-19 regarding the initiated action milestones include:

  • The Cultural Strategy has identified a place–based approach that is aligned to the four regeneration and locality priority areas across the authority: Chester, Ellesmere Port, Mid-Cheshire and Rural Area and Market Towns
  • Chester Heritage and Visual Arts strategy:
    • CH&VA Strategy: one year on workshop held May 2018
    • Chester Castle temporary opening summer 2018 – programme of events and local artists installation of artworks
    • Visual Arts Commissions: FLOAT – final installation of Maelstrom due February 2019
    • Storyhouse digital commissioning programme – the second artwork commission will be launched in May 2019
    • Supporting emerging artists with professional development
    • Lead artists collaborated with design team to produce proposals for Archives/ History Centres
  • Winsford
  • Seven Sisters artwork, by Liam Hopkins installed in Winsford Town Park
  • Lead artist appointed for Winsford and project in its initial stages; steering group includes local arts organisation and members of local community
  • Northwich
  • Supported local initiative for Visual Arts Festival that took place in July 2018
  • NOW Northwich, an international street arts festival developed in partnership with Cheshire Dance and Deda, in October 2018
  • Ellesmere Port
    • Supporting ambitious capital development scheme for Whitby Hall, home to Action Transport Theatre
  • Cultural delivery across the borough:
    • Support for professional arts organisations:
      • Storyhouse; Action Transport Theatre; Cheshire Dance; Rural Touring Arts; Theatre in the Quarter
    • Slant – Cultural Destinations sub-regional partnership led by Marketing Cheshire.
    • Members of Local Cultural Education Partnership (LCEP)
    • Support the Cheshire West Voluntary Arts Network
  • Implement the actions supporting each priority area within the Eat Well Be Active Framework.
  • Membership of the Health and Wellbeing Board has been reviewed and Brio Leisure and ForHousing are now represented on the Board.
  • The Health Improvement Strategy, launched in 2018, is the delivery mechanism for the Health and Wellbeing Strategy (2015-2020). Multi-agency partnership action plans exist for the five priority areas within the Strategy, namely:
    • Eat Well Be Active (covered in Section A.6.1.2)
    • Tobacco Control
    • Alcohol
    • Drugs
    • Sexual health
  • An update on Alcohol Harm Reduction progress was presented to the Health and Wellbeing Board on 20th February 2019. Other current work underway to reduce alcohol related harm includes:
    • Establishment of a multi-agency Substance Misuse Partnership to oversee delivery of the strategy
    • Redesign of the Integrated Substance Misuse Treatment service. Westminster Drug Project is commissioned to deliver this service from April 2019. Priorities for the new service include increasing the number of people accessing specialist treatment for alcohol dependency, improving the support available for children and families affected by parental alcohol misuse and strengthening the digital offer for those who are concerned about their own drinking.
    • For the second year running, Chester City has been awarded ‘Purple Flag Status’ in recognition of strong partnership working to ensure a safe and healthy night-time economy in the city. Initiatives which aim to reduce alcohol harms carried out by the Purple Flag partnership include:
    • The provision of a ‘Safe Space’ which operates every Saturday night providing support and basic medical care for those who have become vulnerable as a result of alcohol. The initiative aims to reduce attendances at Accident & Emergency department as well as reducing pressure on services such as ambulance and police.
    • The Drink Less Enjoy More campaign, which works with bar staff and police to ensure that people who are already intoxicated do not get served with more alcohol. The campaign also aims to raise awareness that they risk a £1,000 fine if they attempt to purchase alcohol for someone who is already intoxicated.
    • Alcohol Concern have been running the ‘Blue Light Project’, and over 150 frontline staff from a wide range of agencies have received training in ways to encourage high impact, change resistant drinkers into specialist alcohol treatment and support
    • A borough wide ‘Making Every Contact Count’ (MECC) initiative has been started which will provide training to frontline staff to enable them to offer brief advice and signposting to residents on a wide range of lifestyle issues including alcohol. It is hoped that all council staff will undertake an online version of this training and face to face training will also be offered.
  • Drugs
    • A Substance Misuse Partnership Board is currently being established. It is intended for the inaugural meeting to take place in May 2019. This will oversee the alcohol and drugs elements of the Health Improvement Strategy. A new substance misuse service (drugs and alcohol) has been commissioned and started on 1st April 2019. The new provider is Westminster Drug Project (see above in Alcohol Harm Reduction section).
  • Sexual Health.
    • A new Sexual Health service has been commissioned, starting April 2019. The new provider is Virgin Care.
  • Implement the priority actions within the Physical Activity Growth Strategy with key partners:
    • Figures from May 2018 to March 2019 show that 24 primary schools and early year’s providers in west Cheshire are signed up to the Active Kids Pledge.
    • Figures from May 2018 to March 2019 show that 31 workplaces in west Cheshire have taken the Active Workplace Pledge. The Council signed up to the pledge in January 2019 and other partners from the Eat Well Be Active partnership group have also signed up including Cheshire CCG’s and Mersey Forest.
    • For Active Design a working group has been formed and has identified the Ellesmere Port Town centre Masterplan as a pilot area to trial Active Design principles and this has been fed into the Town Centre Masterplan Cabinet paper approved at February 2019 Cabinet. In line with NHS Transformation Plan, work collaboratively to ensure improvements in mental health services and support.
  • Public Health is leading on developing an all-age Mental Health Strategy for the borough. Public Health play an active role in the work of the Cheshire West and Chester-wide multi-agency Mental Health Partnership Board, which was set up to implement the NHS 5 Year Forward View for Mental Health.
  • Implement the actions from the agreed Dementia Strategy
    • The Dementia Strategy Group is continuing to progress key priorities identified for September 2018 to September 2019 are:
      • Development of a communications campaign;
      • Development of a Joint Strategic Needs Assessment
      • Improving dementia diagnosis.
  • Background work has been undertaken to inform the development of the communication campaign. The focus of the campaign is ‘diagnosing early and living better for longer’.
  • The Council are continuing to work closely with the NHS to support the improvement of dementia diagnosis rates. Encouraging people to seek help early and get an early diagnosis to live better for longer is also one of the key aims of the communications campaign.

An example of an action which has been re-phased relates to the Heritage Lottery Fund (HLF) bid for the Archives project, which was submitted June but was unsuccessful. The Council are in discussions with Heritage Lottery Fund about their new funding framework, and the project remains live.

Next Reporting Period

The following are examples of tasks and milestones expected to be completed in 2019-2020:

  • Implementation of actions relating to the Falls Strategy.
  • Implementation of actions supporting the priority areas within the Eat Well Be Active framework.
  • The ongoing development of a measure of natural capital and evaluating the significant benefits that green spaces provide to communities.