APPENDIX 40
Memorandum by Health Promotion England
(PH 82A)
1. INTRODUCTION
1.1 Health Promotion England (HPE) was established
in April 2000 upon the closure of the Health Education Authority
(HEA) by the Health Education Authority (Abolition) Order 2000
(Statutory Instrument 2000 No. 604 attached). Under the abolition
order certain staff, property rights and liabilities were transferred
to the Lambeth, Southwark and Lewisham Health Authority (LSL)
to continue, as the new HPE, elements of the public education
work previously undertaken by the HEA. Thus HPE carries out a
defined programme of health promotion campaigns on behalf of the
Department of Health which includes work previously undertaken
by the HEA.
1.2 A Service Level Agreement (SLA) between
the Health Authority and the Department of Health (DH) sets out
the outputs and outcomes expected from HPE in return for an agreed
level of funding.
2. BACKGROUND
2.1 The HEA was established in 1987—as
a special health authority to replace the Health Education Council.
The HEA's functions included undertaking health education activity,
planning and carrying out campaigns; sponsoring research, publishing
material and providing a national centre of information and advice
on health and education in England. Funding was provided by DH
and the work programme was agreed jointly.
2.2 The DH contracted or commissioned the
HEA to undertake activity on public health education campaigns,
this included:—tobacco education, AIDS/HIV prevention, drugs,
nutrition, skin cancer prevention, mental health and immunisation.
2.3 The concept of evidence-based health
care and practice grew in the public health movement and government.
In July 1999, the Government published its white paper Saving
Lives: Our Healthier Nation. This signalled the replacement of
the HEA with the Health Development Agency (HDA) charged with
the study and dissemination of the evidence base for public health
interventions. This, combined with the publication of consolidated
ministerial priorities by the newly appointed Secretary of State
Alan Milburn in December, gave a clear message that the provision
of public health campaigns would be a central task for the Department
of Health, working closely with other government departments,
agencies such as the COPI, the newly created HPE and the voluntary
sector. The DH Communications Directorate is charged with developing
and managing national Communications Strategies for priority and
"must do" areas.
3. HPE: THE PRESENT
ARRANGEMENTS
In establishing the work programme for HPE,
discussions have taken place with DH policy and communications
leads. The resulting programmes of work vary widely from fully
integrated campaigns including advertising, press and PR, new
media, publishing, research and professional support (eg Immunisation)
through to basic level maintenance work, such as the reprinting
and distribution of existing print materials (eg Alcohol). These
discussions have occurred in a challenging arena, with multiple
changes taking place within DH and the NHS nationally and locally
in the context of the development and the implementation of the
NHS Plan.
3.2 In all HPE's programmes of work there
is a common link. Whether complex or simple, all our proposed
work programmes require liaison with those working in Health Promotion
and other relevant local professionals and the management of their
expectations. Former HEA programmes often involved sophisticated
formulae for field liaison which included: briefing days (roadshows),
database mailings, regular catalogues, flyers, newsletters, small
grants schemes, attendance at conferences and exhibitions, the
facilitation of reference or user groups, media training, telephone
support and other technical assistance. HPE are continuing to
adopt comprehensive field support strategies.
4. HPE WORK PROGRAMME
HPE has been initially contracted to work on
the following areas:
— Older People (Department of Trade
& Industry) falls campaign;
— And to provide and update a range
of other published health promotion resources produced by the
former HEA.
4.1 ALCOHOL
Alcohol consumption generally has fallen very
slightly, it continues to rise among the young. Drinking brings
with it many problems, not least 3,000 alcohol-related deaths
per year.
HPE promotes sensible drinking, especially targeting
young people and parents. Pending the launch of the National Alcohol
Strategy later in the year the work programme currently includes:
— The promotion of Drinkline (0800
917 8282), the free (except from some mobiles) alcohol helpline,
which provides support, advice and information.
— Provision of a portfolio of resources
for health specialists and the public.
— Support to the press and media on
alcohol issues.
— Provision of expert advice through
conferences and seminars including the British Nutrition Foundation
in September and a second paper on teenagers and alcohol to the
Drugs Education Forum in October 2000.
— Work with other key organisations
in the alcohol field including Alcohol Concern, The Portman Group,
WHO Phase IV Primary Care Project and the National Family and
Parenting Institute.
— Management of www.wrecked.co.uk a
site aimed at young people aged 14-16 years highlighting the dangers
of binge drinking and intoxication.
4.2 Children and Families
Having a baby is probably the major event in
any woman's life. Yet many women, particularly those from disadvantaged
groups, lack the knowledge to make this an enjoyable and as painless
an experience as possible and one that ensures the baby grows
up fit and healthy. Natal and peri-natal deaths are still at unacceptable
levels.
HPE aims to provide all new parents with authoritative
and independent information in forms that are acceptable to them
on all aspects of pregnancy and early years development.
— Since HPE was established, two reprints
of the flagship publications The Pregnancy Book Birth to Five
have been produced. A proposal, based on previous HEA research,
to merge the two books has been submitted to the DH and will be
considered at the Children's Programme Board shortly. The proposal
looks specifically at how to meet the needs of disadvantaged groups.
— Developing the new resource as a
website as well as in hard copy has been discussed with DH.
— HPE has also contributed to the Having
a baby life episode of UK online and is continuing to make
available a number of other specific titles in this area of child
health.
4.3 Drugs
11 per cent of 11-15 year olds (ONS, 1998) and
31 per cent of 16-19 year olds (BCS, 1998) had used drugs in the
last year.
Within this context, HPE works to support the
Government's ten-year strategy for tackling drugs misuse, Tackling
Drugs to Build a Better Britain (1998), specifically "to
support young people to resist drug misuse in order to achieve
their full potential in society".
The work programmes includes:
— The provision of information through
printed and new media resources for young people and parents including
a new site aimed at 14-16 year olds at www.d-2k.co.uk
— Press releases and feature/editorial
coverage of the issues in media outlets to promote the National
Drugs Helpline (0800 776600 and www.ndh.org.uk) as a sourse of
free, confidential information and advice and to encourage responsible
reporting of drugs issues
— Regular contact and the supply of
accurate information to provide support for professionals in the
field, to extend and enhance other government activity where appropriate
with a range of government and non-government agencies at national,
regional and local levels.
4.4 Immunisation
Cases of Meningococcal C have fallen by 90 per
cent among 15-17 year olds in England and Wales and by 82 per
cent in babies under a year old, from 32 in 1999 to 6 in 2000.
For more than ten years the Immunisation public
education campaign has been an integral part of the UK National
Childhood Immunisation Programme. This work is continuing within
HPE through the provision of resources and support for health
professionals. The work programme includes:
— A range of print and new media resources
containing up to date information on all childhood immunisations
including www.immunisation.org.uk
— Research to assess the impact of
the public education campaign
— Expert advice to Immunisation Co-ordinators
and other health professionals through factsheets and locally
organised seminars for professionals
— Promotions including Babies
TV advertising encouraging uptake of childhood immunisations
— Continuation of the successful Meningitis
C campaign aimed at under 18s and new freshers.
— Work with a number of local, national
and international organisations including Primary Care 2000, Advanced
Vaccinology Course (Annecy), and the Millennium conference in
Liege.
4.5 Sexual Health
Latest figures from the Public Health Laboratory
Service (Dec 2000) on sexually transmitted infections (STIs) show
a rapid increase in acute infections since 1995, with genital
chlamydia diagnoses rising by 76 per cent, gonorrhoea by 55 per
cent, syphilis by 54 per cent and genital warts by 20 per cent.
This suggests an increasing complacency over safer sex and lack
of awareness of the seriousness of many STIs including long-term
effects such as pelvic inflammatory disease, infertility or ectopic
pregnancy.
Pending the launch of the national sexual health
strategy later in the year, HPE will continue to:
— Run a safer sex TV campaign featuring
two cartoon characters called `Clem' and `Lydia'. The ad aims
to build awareness of safer sex including the dangers of chlamydia
amongst young men and women, emphasising that practising safer
sex makes sense.
— Run a TV filler about chlamydia broadcast
on ITV and BBC on a free-to-air basis. Both films offer further
information or advice, free and in confidence by calling the National
AIDS Helpline (0800 567123) or viewers can visit www.lovelife.uk.com.
— Provide information about HIV, other
sexually transmitted infections, and unintended pregnancy through
resources and a range of media
— Support various agencies and professionals
that work with young people to enable them to promote safer sex
— Promote the National AIDS Helpline
(0800 567123) which is a freephone service providing advice and
information about HIV, AIDS and sexual health/local services.
4.6 Older People (Department of Trade &
Industry) falls campaign
Every five hours an older person is killed as
a result of falling in the home and about 1,000 older people are
killed each year falling on their own stairs. Yet many accidents
can be prevented by simple, practical actions.
Avoiding slips, trips and broken hips is
a campaign to raise public and professional awareness of the risk
of falls in the home to older people. The work programme includes:
— The provision of free resources on
falls prevention and stair safety in the home including leaflets
(new Step up to Safety leaflet), posters, audiocassettes
and videos.
— Research into the needs of health
professionals working with older people.
— Building alliances with a broad range
of professionals who work closely with older people: pharmacists,
chiropodists, the ambulance service, community transport and housing
as well as health professionals from many different disciplines.
All have an interest in promoting independence in older people
and recognise that preventing falls in the home is one important
way.
— Developing a register for local activists
and anyone interested in learning about best practice and networking
with others working in falls prevention.
— Promoting the campaign website www.preventinghomefalls.gov.uk.
— Providing expert advice through conferences
and publications including Practice Nurse, British Geriatrics
Society, Health Advisory Services, Help the Aged, Community Transport
Association, Age Concern, Research into Ageing, Disabled Living
Foundation and Basic Skills Agency.
4.7 Marketing and Communications
4.7.1 In addition to the advertising, press
& PR, new media and alliance work already highlighted under
topic areas a number of corporate activities have also been undertaken.
These include: establishing an HPE website at www.hpe.org.uk including
an on-line catalogue, developing marketing materials, regular
mailings and newsletters to Health Promotion Units and a contact
database and contributing to a range of exhibitions, conferences
and events nationally and locally.
4.8 Publishing
4.8.1 A key focus in April 2000 was to transfer
the HEA publications list comprising nearly 500 titles into three
categories—HDA, HPE and DH. A fourth category—the
Food Standards Agency (FSA)—was added later in the year.
This necessitated a comprehensive review of all titles and a re-structuring
of the stock management system at the warehouse.
4.8.2 A seamless transition of service was
essential, as the prime concern of customers is continuity of
service and sufficient supply of stock. Without confidence in
these it is difficult to plan work at local level which relies
on nationally produced resources. Many Health Promotion Units
provide resources to a range of local health and other professionals.
4.8.3 Audits and reviews
HPE is currently auditing it's resource portfolio
(and selected DH titles) for appropriateness for people with learning
difficulties and other disadvantaged groups, with a view to ensuring
that all current and future titles meet DDA requirements and conform
to best practice standards with regard to meeting the needs of
vulnerable communities. Current distribution services are also
being reviewed to ensure effective and efficient delivery in the
future to all audiences, such as voluntary agencies, the police,
local authorities, HAZs and other organisations who now have a
stake in health promotion activity.
5. MANAGEMENT
ARRANGEMENTS
5.1 HPE works under a service level agreement
(SLA) with the Department of Health (DH) and other Government
departments. The work of the unit is approved through a management
steering group consisting of:
— DH Communication Director (Helen
McCallum—Chair).
— Senior Public Health Policy Team
(Professor Donald Nutbeam).
— DH Public Health branch leads.
— DH Communications Deputy Director
and SLA Manager (Wyn Roberts and David Horton).
— LSL Deputy Director of Public Health
(Dr Alan Maryon Davis).
— HPE General Manager (Geof Webb).
5.2 HPE is managed through Lambeth, Southwark
& Lewisham Health Authority (LSL).
6. THE FUTURE
6.1 HPE was initially contracted to 31 March
2001. Business planning discussions are currently taking place
within DH regarding HPE's future role in delivering government
health promotion activities.
6.2 A number of options are being considered
to assess how HPE can best add value to: the health related work
of government and particularly to cross government initiatives;
the work of other national agencies and; meeting local needs and
priorities in order to strengthen the delivery of national programmes.
15 January 2001
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