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Explicating the role of partnerships in
changing the health and well-being of
local communities: a profile of
neighbourhood renewal activity focused
on promoting health and well-being in
Salford and the north west region and the
north east of England
Howarth, ML, Warne, T, Cook, G, Dawson, P and Elliott, D
Title Explicating the role of partnerships in changing the health and well-being
of local communities: a profile of neighbourhood renewal activity focused
on promoting health and well-being in Salford and the north west region
and the north east of England
Authors Howarth, ML, Warne, T, Cook, G, Dawson, P and Elliott, D
Type Monograph
URL This version is available at: http://usir.salford.ac.uk/id/eprint/15729/
Published Date 2009
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URBANregeneration
making a difference
Explicating the role of partnerships in
changing the health and well-being
of local communities:
A profile of Neighbourhood Renewal Activity Focused on Promoting
Health and Well-being in Salford and the North West Region and the
North East of England
Volume 2: 2009
Authors: Michelle Howarth & Tony Warne: Salford Centre for Nursing, Midwifey and Collaborative Research
University of Salford
Glenda Cook, Pam Dawson and Denise Elliott: School of Health,
Community and Education Studies, Northumbria UniversityUrban Regeneration: Making a Difference
Contents
Project Context 2
Chapter 1 A profile of Neighbourhood Renewal Activity Focused on 4
Promoting Health and Well-being in Salford and the North
West Region
1.1 Introduction 4
1.2 Aims of the Scoping Exercise 4
1.3 The Extent of Deprivation in the UK 6
1.4 The North West Health Context. 6
1.5 North West Indicators of Deprivation in Health and Well-being 7
1.6 Evidence of Neighbourhood Renewal in the North West. 8
1.7 Summary 9
1.8 Focus on Salford. 10
1.9 Regeneration Activity in Salford 11
1.10 Salford’s Neighbourhood Renewal Context. 13
1.11 References 16
1.12 Websites 16
Chapter 2 A Profile of Neighbourhood Renewal Activity Focused on 18
Promoting Health and Well-being in the North East Region
2.1 Introduction 18
2.2. Aims of the Scoping Exercise 18
2.3 Search strategy 18
2.4 The North East and its population 20
2.5 The Extent of Deprivation in the North East 20
2.6 The Health Context of the North East 21
2.7 Long-term health and well-being goals for the North East 21
2.8 Regeneration partnerships in the North East 22
2.9 Summary 26
2.10 References 27
2.11 Web sites 27
Chapter 3 Profile Summary of North West and North East England 28
Neighbourhood Renewal Activity: promoting health and
well-being
2.1 Introduction 28Urban Regeneration: Making a Difference
The Project Context
Introduction One university led on each theme, Effective cross-sector working is
but every university will contribute to fundamental to the challenge of
This scoping and mapping report is
each theme. The themes were: Crime, meeting the needs of vulnerable
one of three outputs from a project:
Community Cohesion, Health and populations and working towards the
Explicating the role of partnerships in
well-being and Enterprise. inclusion of marginalised groups.
changing the health and well-being
(http://regennorth.co.uk ) Universities have a key role to play in
of local communities , one of a
this process, yet this form of
number of projects in a larger Higher
knowledge transfer is only in its
Education Funding Council Strategic Health and Well-Being Theme
infancy, with huge potential for
Development Fund project ( HEFCE ) The North of England has some of development.
entitled: Urban Regeneration: Making the worst health profiles in the UK,
a Difference. This was a collaborative with startling inequalities in the
venture between Manchester The NHS and local authorities are
health experience of different
Metropolitan University, Northumbria heavily dependent on the higher
population groups as defined by
University, University of Salford and education sector as a source of
geographical and social group.
University of Central Lancashire. professionally qualified people and as
Relative proportions of deaths from
Bradford University was an affiliated a resource for further professional
cancer, heart disease and stroke in
partner. development and research and
particular, have been rising in recent
evaluation. This is complemented by
years. Rates of long-standing physical
practical, action-research in a number
This overarching project had two and mental health are also high
of HEIs, which is focused on the
aims: compared with other parts of the
needs of communities of practice.
country.
• To address key urban regeneration
challenges in the North of England
The Health theme identified 4
through inter-disciplinary These patterns are manifestations of
important areas which link health to
collaboration between the partner the degree of well-being in the
regeneration:
universities and practitioner community, which is affected by a
organisations, particularly in the wide range of factors, including • Health, employment and well-
public and voluntary sectors, and to housing, poverty, transport, being, including the social and
enhance their collective impact on employment etc, covering the whole economic dimensions of
society spectrum of regeneration issues. regeneration;
• To build a long term strategic Availability for work is a natural • Ageing and disability, including the
alliance between core university consequence of health and well- health and social care dimensions
partners while developing a being, with some parts of the North of regeneration;
distinctive form of knowledge having amongst the highest figures of
transfer (KT), which is both teaching worklessness in the UK.
• Enabling environments, including
and research-driven, in order to the physical and cultural
meet the needs of organisations Whilst the public sector is the dimensions of regeneration;
and professionals in business and mainstream provider of support, • Public health and primary care,
the community through the National Health Service including health inequalities.
and local authorities, the non-
In addition, a core focus across all of
Four thematic areas were identified, statutory sector plays a vital
the projects will be on increasing the
which reflect important issues in the complementary role and is critical to
skill and knowledge level of those
regeneration of the North of England sustaining the welfare of some of the
working in health and well-being
and map on to the breadth and most vulnerable communities and
regeneration.
depth of expertise amongst the sections of the population. This
From (http://regennorth.co.uk)
university partners and an existing includes charities and not-for-profit
firm base of collaboration with organisations such as housing
external organisations. associations. It is a diverse and
fragmented sector with an ability to
be highly responsive to new ideas.
2Urban Regeneration: Making a Difference
The Project: Explicating the role Conclusion
of partnerships in changing the The project was in itself a recognition
health and well-being of local of the need for partnership working
communities between Universities in order to
maximise the value of shared
It is clear that concepts of partnership knowledge and experience in
and collaboration underpin the addressing a common aim. It was also
successful implementation of urban an opportunity to engage with local
regeneration initiatives. What is less communities in urban regeneration
clear is how partnership working areas to identify their needs and
impacts upon the health and experiences in relation to their health
well-being aspects of urban and well-being and also determine a
regeneration. Evaluations of way in which effective partnership
outcomes are limited, and little working could be assured.
comprehensive information is
available as to the extent of any such
activities across the North West and
North East regions. This project
sought to examine the issues in
relation to these and to develop a
framework for supporting the analysis
of effective partnership working.
Key aims of the project
There were four main aims of the
project:
1. A scoping and mapping exercise to
develop a profile of community
health and well-being needs and
associated neighbourhood renewal
activity in Salford and the
northwest, and in Newcastle and
the northeast
2. A review of the literature and
development of a conceptual
framework for partnership
evaluation
3. Evaluation of the framework in
action through a series of case
studies of partnership working in
designated urban regeneration
areas
4.Determine the key factors in
effective partnership working
3Urban Regeneration: Making a Difference
Chapter 1 A profile of Neighbourhood
Renewal Activity Focused on Promoting
Health and Well-being in Salford and the
North West Region
Michelle Howarth and Tony Each of these contained various data Initially, a modest amount of evidence
Warne with one common denominator, that was located simply using terms such
of satisfying the needs of the as urban regeneration or
1.1 Introduction
community health and well being. For neighbourhood renewal. However,
Changes in policy following the example, the Index of Multiple two sites were located which
implementation of the White papers Deprivation, developed by the Office provided relevant information about
Saving Lives (DH 1999) and Our of the Deputy Prime Minister (2004) the progress and processes of
Healthier Nation (DH 1998) ushered details seven Domains of deprivation Regeneration. The Neighbourhood
in new ways of raising public health which include income deprivation, Renewal Data Site (NRD) provided
awareness and improving the health employment deprivation, health access to databases on the extent of
and well being of communities. deprivation and disability, education, regeneration monitoring, priority
Coupled with the later Wanless skills and training deprivation, setting and performance
Report (DH 2002) which argued that barriers to housing and services, management at a neighbourhood
the health of the nation needed to living environment deprivation and level. A full range of information was
improve through sustainable action at crime. These domains represent the available which detailed datasets and
both national and local levels, it is not Governments beliefs about the key information about neighbourhood
surprising that local regeneration regeneration areas which have been renewal issues. These sites do not
initiatives concerning health and targeted through a far-reaching range however, provide any insight into the
well-being have been placed at the of initiatives and illustrate the extent actual partnership working being
vanguard of community and public of problems faced by communities undertaken to achieve the outcomes.
health development. The focus of and urban regeneration programmes. The NRD site was designed to help
public health has now moved toward local partnerships target and monitor
The North West has some of the most
a community ‘hands on’ approach local programmes and is
rural areas in England and yet is also
predicated on partnership working predominantly used by those
witness to much extensive
between the NHS, local authorities preparing the Local Area Agreements,
regeneration in some of the most
and independent agencies. Thus, the Local Strategic Partnership (LSP)
deprived areas of the UK. A range of
emphasis of regeneration is to work coordinators and those who work at
National statistical databases have
collegially with the community rather a neighbourhood level. Other sites
been used to source health and social
than imposing some ideologically which provide information on the
care data about the health and
driven nationally set objectives in development of regeneration include
well-being of the North West (see
providing innovative ways of the British Urban Regeneration
table 1). The National Office for
addressing the health and well-being Association. The association was
statistics, Cancer sites and the British
needs of the population. officially formed in 1990 to “provide
Heart Foundation has provided some
a forum for the exchange of ideas,
of the figures about the state of the
experience and information for the
North West. Collectively, these facts
1.2 Aims of the Scoping Exercise emerging regeneration sector”.
present a sobering picture of the
The aim of this scoping exercise is to North West, most notably around the
describe the North West in terms of Neighbourhood Renewal (NR) areas
its location, aspects of deprivation already funded. It is not surprising
and health and well-being needs. therefore that much energy has been
Critically, the different partnership given over to the regeneration of
arrangements arising from the these areas. Indeed, some of the
plethora of agencies involved, make figures from the National Indices of
searching for sources of evidence Deprivation (2004) reveal a consistent
problematic. The ensuing wave of message about the extent of
community development programmes deprivation and health inequalities in
followed by the Neighbourhood the 17 areas identified in the North
renewal initiative resulted in an array West.
of different, often disparate websites,
policies and papers.
4Urban Regeneration: Making a Difference
The Neighbourhood Renewal Unit Through the NRU and government
(NRU) was also accessed as a main funding a wide range of initiatives
search site because of its responsibility were established to ascertain local
for overseeing the neighbourhood needs and to pilot new ways to fight
renewal strategy. It is part of the deprivation in the poorest and most
Department for Communities and deprived communities. The
Local Government (DCLG) and works Neighbourhood Renewal Unit site
with government offices and was therefore used as the main
neighbourhood renewal teams, to gateway to much of the information
monitor and support local strategic contained in this report about local
partnerships. regeneration initiatives. The site
details the extent of activity for all 17
sites across the North West.
Table 1. Web Sites Searched
Bolton, Salford & Trafford Mental Health Trust North West Public Health Observatory Health and
http://www.bstmht.nhs.uk/default.aspx (accessed 1st August Lifestyle Trends in England assessment tool
2007). http://www.nwph.net/lifestyles/ (accessed 1st August 2007)
British Heart Foundation Statistics Database North West Development Agency Regional Intelligence
www.heartstats.org Unit http://www.nwriu.co.uk/aboutus/2307.aspx
Cancer Research UK NW Public Health Information Portal
http://www.cancerresearchuk.org/ http://www.nwph.net/default.aspx
Community Health Action Partnership (CHAP) NW Public Health Observatory
http://www.chalk-ndc.info/index/doing/ndc-health/chap.htm http://www.nwph.net/nwpho/default.aspx
(accessed 1st August 2007)
Salford County Council
Community Health Profiles www.salford.gov.uk/council/
http://www.communityhealthprofiles.info/
(accessed 1st August 2007) Salford PCT
http://www.salford-pct.nhs.uk/
Department of Health
www.dh.gov.uk The 2001 National Census
http://www.statistics.gov.uk/census/
Neighbourhood Renewal Unit
http://www.neighbourhood.gov.uk/ The World Health Organisation
(accessed 1st August 2007) http://www.euro.who.int/
New Deal for Communities accessed through the
NRU site at http://www.neighbourhood.gov.uk/
5Urban Regeneration: Making a Difference
1.3 The Extent of Deprivation in Similar concerns about life expectancy
the UK in the North West were also Table 2: Long-term goals for
highlighted in the NWDA Action for the North West
In 2000, the Office of the Deputy
Sustainability Report which remarks
Prime Minister (ODPM) commissioned A healthy, safe and socially responsible
that the “average life expectancy for
the Social Disadvantage Research region where all people have access to
men and women in the region
Centre (SDRC) at the Department of necessities and are enabled to improve
continues to be below that of
Social Policy and Social Research at their quality of life
England and Wales and the North
the University of Oxford to update
West shares the worst life expectancy A distinctive, clean and tree rich
the Indices of Deprivation 2000 (ID
of the regions… further the North region which safeguards its wildlife,
2000) for England. The 2004 report
East. Manchester has the lowest male habitats and landscapes and acts to
builds on previous work undertaken
life expectancy at birth of any local limit the local impacts of climate
in 2002 and “rehearses the
authority in England (pg 48)”. change
conceptualisation underpinning the
model of multiple deprivation used In relation to health deprivation, the A region that uses its resources wisely,
and outlines the indicators and IMD (2004) defined health makes full use of renewable
domains that go to make up the ID deprivation as being “unexpected alternatives, produces minimal waste
2004”. Each domain indices is deaths or levels of ill health”. The and conserves its historic environment
considered in the geographical North West had the largest
A thriving, prosperous and attractive
contexts of the UK. This was helpful percentage of most deprived Super
region of high employment with the
in identifying the regions worst Output Area’s (SOP’s) in England
necessary infrastructure to support it
affected by deprivation particularly in (more than any other region):
and which uses land efficiently
relation to the North West. “Severe deprivation is evident in most
of the districts across the North West. Action for Sustainability (2000)
Based on the data retrieved from the
Concentrations of SOAs showing
IMD, we explored seven indicators to
deprivation in the most deprived
elicit population demographic The challenge faced by the NWDA
decile are found in the urban areas in
particular to the North West. These (2000) was to ensure that partnership
and around Liverpool and
were drug misuse and treatment, working was effective and sustainable
Manchester”.
alcohol related hospital stays, for the NW region to develop. To
smoking related mortality, obese achieve this they assert that:
adults, life expectancy and older
1.4 The North West Health
people supported at home.
Context
“Mainstreaming sustainable
In their report, ‘Action for development principles at policy and
Sustainability’ (NWDA 2000) the strategy level, together with robust
North West Development Agency set application of these principles at
a series of long term goals for the programme and project delivery level
North West Region (see table 2). In are vital to the sustainability of the
doing so, the NWDA recognise the North West. Policy-makers and
importance of and need for practitioners must continue to work
partnership working across agencies together to push the boundaries of
to secure the long terms goals. understanding to ensure that the
relevance of sustainability to all
North West activity is clearly
identified and progressed” (pg 9)
6Urban Regeneration: Making a Difference
In terms of Healthy Communities, the 1.5 North West Indicators of Cancers
NWDA’s aim was to ensure that Deprivation in Health and Well-
Cancer incidence in the NW is
“Healthy communities where people being
amongst the highest in England.
enjoy life, work and leisure and take
There are a number of major areas Shack et al (2007) highlight the
care of themselves and others” were
that serve as health indictors which extent of cancer in the NW and assert
supported. The NWDA also draws on
are linked to the current that the region has some of the
the Health Survey of England (DH
Governments priority areas for highest incidents of Cancer in
2006) and uses the predicted
improvements in the nation’s health. England and Wales. Using statistical
outcomes for obesity, life expectancy
modelling, Shack et al were able to
and social deprivation to illustrate the
Statistics from the British Heart predict the population estimates of
need for sustained action. Similarly,
Foundation Health promotion Unit the NW up 2020. Alarmingly, cancer
the Health Profile of England (DH
(2005) suggest that: rates are set to rise. A particular
2006) provides statistics on a large
concern is lung cancer rates which
range of ‘public health’ and socio- “Death rates from Coronary Heart
are currently the more commonly
economic indicators. Disease (CHD) are highest in
diagnosed cancer in the NW
Scotland and the North of England,
The Local Health Profile (LHP) accounting for 20% of all new cases.
lowest in the South of England, and
indicators from the Health Profiles of These rates are expected to rise along
intermediate in Wales and Northern
England define each deprivation with breast, colorectal and
Ireland”.
indicator. In the case of life oesophageal cancers.
expectancy, (indicator 18) the LHP Although there has been a steady
measure this from birth and on decrease in the number of deaths
average, people are more likely to live from CHD in the North West, current Mental Health
two years longer in the south than statistics indicate that 220 per
Additional facts were obtained about
the North West. Interestingly, and 100,000 people in the NW dies from
the mental health problems in the
akin to the NR funding evident in CHD in 2002. (BHF 2006). The LHP
North West. Patients with severe and
local areas, the IMD identified that: definition of obese adults is based on
enduring mental health problems,
“synthetic estimate of the percentage
“the Merseyside districts of Liverpool, aged 16 and over (2004/05) were
of adults who are obese”. Salford’s
Sefton, Wirral, Knowsley and St analysed. The North West and
Public Health Annual Report
Helens, and Manchester and some London in particular have a
(2004/05) outlines obesity as one of
of the areas around including significantly higher number of
the main concerns for its population
Wigan, Rochdale, Bolton, Salford registered patients. The NW has the
and stresses the link between
and Oldham stand out as containing highest number of people misusing
lifestyle, obesity and heart disease.
large concentrations of SOAs with drugs and alcohol. In addition the
high levels of deprivation.” Whilst obesity levels are considered to NW also has the greatest number of
be average in the North West, figures patients with a severe and enduring
on smoking reveal that the region has mental illness registered with a GP.
More recently, Rasuloi et al’s (2007)
above average levels of smoking Other indicators such as numbers of
small area analysis of the inequalities
which are directly attributable to people admitted to in-patient care,
in health expectancies indicate that
mortality rates (ONS 2006). LHP those with depression and anxiety,
those people living in the North West
definition of deaths from smoking and standardised mortality rates for
region of England face greater life
(indicator 19) is the “average annual suicide and injury are the highest in
expectancy inequalities compared
death due to smoking-related causes England (However, given this data,
with people living in all other areas of
(aged 35 and over) expressed as a according to other figures in this
England.
number and directly standardised rate report, the North West do not
per 100,000 pop of all ages”. The prescribe as much anti-psychotic
Health Profile of England (DH 2006) medication as London, NE and
statistics states that smoking deaths Humber regions). Similar to other
are higher in the North of England regions, use of ECT has reduced since
and London. In relation to the North 1998. The Local Health Profile (LHP
West, there are an average number indicator 27) defines drug misuse and
of smoking related deaths in the treatment as being:
North West.
7Urban Regeneration: Making a Difference
“the number of resident persons aged Older People Education
15 – 44 in contact with drug
The LHP figures for older people One of the NWDA aims is to ensure
treatment services per 100,000
supported at home (indicator 7) were that the North West is supported to
resident population”
based on those aged 65 and over develop:
However, current figures are not who were being helped to live at
“a culture of lifelong learning that
available. The North West figures home per 100,000 of the population.
allows people to fulfil their duties
indicate that those currently in The North West picture highlights an
and potential in a global society by
contact with drug treatments are around average number of older
acquiring new skills, knowledge and
significantly above average. Data in people being supported at home,
understanding (pg 36)”.
the health profile clearly indicates a which places a great strain on the
significant ‘north south’ divide in community in terms of the carers They state that skill levels are not
relation to drug misuse and needed, home support services and consistent across the region making
treatment. the economic and employment education an urgent priority. To
stability of the community. Salford address this, the NWDA are currently
Alcohol abuse was measured by the
has similar economic activity working in partnership with the
Health Profile (DH 2006) by the
measures with its neighbour and Learning & Skills Council, to address
number of hospital admissions.
England generally. the skills and employment needs of
Alcohol consumption in the North
the region.
West is amongst the highest in
England. Alcohol abuse therefore
Social Factors
presents a real concern for the North
1.6 Evidence of Neighbourhood
West region. The LHP definition of Social equality is an aspect of working
Renewal in the North West
alcohol related hospital stays which the NWDA report highlights.
(indicator 26) are: As they suggest: A number of programmes have been
established to support regeneration
“directly standardised rate for persons “Social equity that respects, welcomes
initiatives in the North West. These
who were admitted a least once for and celebrates diversity and allows
include New Deal for Communities
alcohol related condition. The all communities and generations a
which are partnerships aimed at
indicator measures the rate of representative voice (pg 24).”
tackling employment, crime,
hospital admissions that are
A strategy has been developed which education, health and housing.
attributable directly to alcohol”
embraces equality issues relating to Complementary programmes are also
The DH health profile indicators have gender, race and ethnicity, disability, running under the guise of
correlated areas of deprivation figures sexual orientation, age diversity and Neighbourhood managements and
with alcohol related figures to religion. To support this activity, the Neighbourhood Wardens. Both of
suggest a link between deprivation NWDA set up a North West Equality these programmes work with the
and alcohol consumption. Health and Diversity Leadership Group local community to improve services
Profile data suggests that Blackpool, (NWEDLG) which will help to make and enhance the link between local
Burnley, Manchester, Liverpool and recommendations on policy and services and the neighbourhood.
Barrow have the highest correlation practice for the NW region. Neighbourhood wardens in particular
between deprivation and alcohol are responsible for increasing the
attributable mortality. visibility of semi-officials within the
community. Partnership working in
these communities involves
partnerships between a number of
private, voluntary, business sectors
with professional bodies and local
authorities. In this way, the main
focus of the partnership is seen as an
empowering approach which places
the community at the centre of
decision making. Within the North
West, 17 areas have received funding
8Urban Regeneration: Making a Difference
from the Neighbourhood Renewal Table 3 Key messages for LSPs 1.7 Summary
Unit to support Regeneration Activity for those in strategic
Evidence from the Office of National
(see Warne & Howarth 2009. leadership roles
statistics and others has provided
Take a strategic view of data for insight into those areas which are
There is evidence of good practice
performance improvement, most deprived. A large number of
from the North West which indicates
identifying future requirements for these areas are located within the
sharing of data between the
data access and quality to underpin North West region Sustainable
partnerships involved in NR. Examples
strategic decision-making, service communities have indeed been
of this can be found in the ODPMs
improvement, tracking of supported through the NRF. The
review of data sharing in the NW.
neighbourhood change, robust range of initiative in place assures
Lessons learned from this report
performance management and that this work is longitudinal and
illustrates some of the complexities
public accountability based on the communities needs.
involved, and also examples of where
partners have shared NR data fort he Help create the conditions for more The national picture reveals a number
benefit of the community (ODPM effective data sharing: argue the of concerns faced by health and
2005). In particular, the ODPM report case for more joined-up approaches social care agencies. Against this
outlines examples the trust built to performance management and backdrop, local trusts have adapted
between partners through “clearly the use of evidence; foster a ‘can policies to support their own health
articulated common goals”, which do’ approach; and promote local and well-being activity. Some of these
culminated with “mutual advantages good practice in data sharing and have a direct relationship with urban
to the participating organisations and analysis regeneration (UR) and suggest a
fair sharing of contributions, risks and sustained programme to improve
Appreciate the high level issues
rewards (pg 7)”. Key messages for local health and well-being. The way
relating to data sharing and data
LSP’s which arose out of this report in which local initiatives have moved
protection – including powers under
suggest a range of ways in which towards these goals is variable and
administrative law relating to public
partnerships can better share data to are in keeping with the local
bodies and the scope for lawful
enhance NR performance and population demands. As such, this
sharing under the DPA. Consider
management (see table 3). report has selected Salford as a focus
adopting a high level data sharing
to determine the extent of UR and
A number of initiatives have been protocol
how this has informed local policy
employed to promote good practice
OPDM (2005 p.9) and impacted on the local
between UR partnerships. Of these,
community.
the Standards/Competences for Public
Health Practice Post Consultation
Draft October (2003) suggest a range
of performance indicators to support
he sustained growth and
development of partnership working
in UR. In particular, the unit “Work in
partnership with communities to
improve their health and wellbeing”
includes four elements with covering
performance criteria with which
partnerships can assess their work
and progress.
9Urban Regeneration: Making a Difference
1.8 Focus on Salford
Salford is situated within the
boundaries of Greater Manchester.
Currently, 220,000 people reside in
Salford. Coronary Heart Disease
(CHD), Cancer and Mental Health are
the major health problems faced by
Salford’s population.
Table 4 Population of Salford (Census 2001)
Data from (www.salford.gov.uk/council/corporate/e-government/ieg/ieg2/ieg2organisation/ieg2-egov-
accesschannels.htm
Box 1: Deprivation and Poverty in 20%. Further to this: For income have rates between 100 - 150
Salford ( 2000 Local Index of deprivation, 8 wards were in the and only 2 wards fall below
Deprivation worst 7% nationally and a total national average of 100”
of 15 were in the worst 20%For
“Salford today has a population of http://www.salford.gov.uk/council/
child poverty, 7 wards were in
approximately 224,300. corporate/e-
the worst 7% nationally and 12
Deprivation and poverty in the government/ieg/ieg2/ieg2organisa
wards were in the worst 20%For
city are still major causes for tion/ieg2-egov-
a series of health indicators, 13
concern. The 2000 Local Index of accesschannels.htm
wards were in the worst 7%
Deprivation placed the city as the
nationally and 19 wards were in
28th most deprived authority in
the worst 20% .In the 1998
England and Wales. Of the 20
Standard Mortality Rates, 3
wards in Salford, the index
wards have a SMR rates over
revealed that 8 wards were in
200, 6 wards have SMR rates
the worst 7% nationally and a
between 150 - 199, 9 wards
total of 15 were in the worst
10Urban Regeneration: Making a Difference
Salford has experienced intense 1.9 Regeneration Activity in Coronary Heart Disease
deprivation for many years and Salford
In the North West, current statistics
therefore falls into one of the key
A diverse range of data illustrates the indicate that 220 per 100,000 people
areas described in the Deprivation
health and social care problems faced in the NW died from CHD in 2002.
indices. The Salford profile reveals a
by Salford. On a par with the North (BHF 2006). In particular, CHD is one
poor picture of the health and
West, Salford’s population reflect the of the major problems faced by
well-being of the population. Of all
need to address health and social care Salford. Deprivation, smoking and
the Health Profile (DH 2006) 26
inequalities through intensive and coronary heart disease have a high
indicators, Salford’s only above
sustained public health and correlation. Public Health therefore, is
average result was in relation to road
regeneration programmes. The three a key player in any regeneration
injuries.
major areas of mental health, activity. This means not only
Death rates from smoking are higher coronary heart disease and cancer are addressing the health needs of the
in Salford than the NW and England perhaps the most prominent health population, but managing the
average. Possibly as a result, deaths issues. However, as the indices of community in terms of its health and
from stroke and heart disease in deprivation demonstrate, there is also well-being, access to sports, areas of
Salford are also greater that the NW a pressing need to deal with the activity, healthy lifestyle choices and
and England figures. Mental health is socio-economic problems. There are a re-educating the community into a
a serious problem for Salford with number of approaches within Salford more sensible and safe life.
benefit claims for mental health which is aimed at addressing the Healthy@Heart is one such initiative
greater than the NW and England. populations’ needs in terms of Urban designed to improve the health of the
Teenage pregnancy is also higher than Regeneration activity. community through a programme of
the NW and England. There are activities. Delivered by qualified
However, it is difficult to divide public
however no significant differences instructors, the programme is aimed
health and regeneration agendas. The
than the England average, however at people with heart conditions or
symbiotic relationship between the
Salford does have a low rate of road who have high risk factors of CHD.
populations needs and services means
injuries and deaths but significantly There are now 15 Healthy@Heart
that they cannot be easily separated.
worse public health figures in the classes which provide access. In
Integrated working at all levels within
community, children & healthy starts, addition, Salford’s Health
a range of organisations is now a
lifestyles, life expectancy and health Improvement Team has developed
priority. On the whole, Salford Local
in the community. health walks to combat CHD and
Authority, PCT and other agencies
obesity. This has been achieved in
have achieved much in addressing the
partnership with Salford Community
needs of Salford. A few examples of
Leisure and was signalled as a success
such innovative working are
story in Salford Public Health Annual
presented below. This is certainly not
Report (2004/05).
exhaustive list and perhaps does not
do justice to the work, commitment
and partnership working that is
Mental Health
currently ongoing. Such is the fluidity
of the work, that it is difficult to Mental health issues are a significant
ascertain a truly up-to-date picture of problem for individuals living in
regeneration activity in Salford. This Salford. With the greatest percentage
next section presents a snap shot of of adults registered with GP’s for
evidence located through websites, severe mental health issues, Salford
public health reports and local PCT and the local mental health trust
evaluations. (Bolton, Salford & Trafford MHT see
box 2) have worked collaboratively to
address the populations needs. Close
partnership working has resulted in a
number of initiatives and integrated
work to help support those people
with enduring chronic mental ill-
health.
11Urban Regeneration: Making a Difference
Cancer activities to help older people in the
Box 2 community. This includes a social
Cancer incidence in the NW is
Bolton, Salford & Trafford inclusion group in Irlam and
amongst the highest in England.
Mental Health Trust Cadishead. This programme supports
Salford in particular has suffered from
older people to leave their homes and
Bolton, Salford and Trafford Mental higher than average cancer death
attend a number of support groups.
Health NHS Trust provides integrated rates. According to Salford Public
Through these groups, new
mental health and social care services, Health Report (pg 30) cancer death
friendships have been made and
to the 700,000 people living in the rates exceed NW figures by 16% and
older people report they feel more
Bolton, Salford and Trafford local nationally by 31%. Their aim now is
confident to leave their home.
authority boundaries and a range of reduce cancer death rates for under
specialist and secure mental health 75 years old by a minimum of 20%
services across Greater Manchester, by the year 2010. The Public Health
Social
the North West and beyond. District Annual Report notes that good
services are provided in partnership progress is being made. Examples of According the Salford PCT Public
with the relevant local authorities good practice are evidenced through Health Report (2004/05) a high
through Section 31 partnership a recent joint appointment between priority is given over to “improving
agreements. We directly employ over the PCT and City Council for a health outcomes for health and emotional
3,600 staff from different professions and well-being manager and officer. well-being”. Interestingly, the report
and disciplines with 400 staff Working together, a range of chooses to use ‘emotional’ wellbeing
seconded from partner organisations. initiatives designed around smoking to perhaps signify the prevalence of
As a teaching Trust, there is a vibrant cessation have been developed. City mental health and social deprivation
programme of research and wide advice and support is now issues. As noted in the ‘improving
development, teaching and training. available for those wishing to stop health and well-being outcome 1’,
smoking. This initiative works con- includes the development and
Bolton, Salford & Trafford Mental
jointly with the five a day initiative to introduction of a new ‘health and
Health Trust (now Greater
support local residents develop a social care directorate – so named
Manchesterester West Mental Health
healthier lifestyle. under the umbrella of community
Trust) www.bst.mht.nhs.uk
health and social care’. Akin to other
trusts in England, the directorate
Older people encompasses cultural and leisure
Examples of partnership working are
services. The report asserts that this
clearly evident in Salford PCT’s Public Under the Improving health and well-
work is strengthened by a
Health Directorate Report. This being 1.2 (a) of the Public Health
commitment or ‘pledge’ to local area
includes section 31 partnership Report, the older population needs
agreements. Partnership working with
agreements with the Mental Health have been addressed. Partnership
the community is also evident
Trust (MHT) to support and manage working within neighbourhoods is
through the development of a
integrated health and social care particularly evident through the wide
number of health and social care
services. In addition close working ranging of integrated working
community initiatives. This has been
with the Police helps to monitor and between the PCT, hospital trust,
propelled through LIFT and SHIFT
evaluate mental health assessment Mental Health Trust, Police, Housing,
funds which have enabled a range of
issues. Partnership working in this the voluntary sector and all other
health and community services to
respect also extends to a ‘Joint council services. This is also evidenced
thrive.
Diversionary panel’ set up between in the LAA, partnership board
the MHT and Police to secure working, and neighbourhood
integrated working for mentally ill working and at all levels of the
offenders. directorate. There are very good,
constructive working relationships
and increasing numbers of joint
appointments with the PCT. Good
examples included in the Public
health Annual Report (Salford PCT
2004/05) which outlines a range of
12Urban Regeneration: Making a Difference
1.10 Salford’s Neighbourhood In relation to health and well being,
Renewal Context one of the key themes includes a Table 4: Healthy City Forum
healthy city. This theme is closely Objectives
Given the need of Salford population
aligned to the national priorities set
and the development of partnership (taken from the Partners IN Salford
out in the NHS Plan and is designed
working across a range of agencies, it website) www.partnersinsalford.org
to improve the health and well being
is not surprising that Salford was
by reducing inequalities through a The Healthy City Forum will develop
awarded Neighbourhood Renewal
‘modern health service’ “designed and implement a Health Inequalities
Fund’s. Initially, a Community Plan
around the populations needs”. Strategy detailing expectations from
was developed, through which seven
Priority is also afforded to community partners, monitoring their
key priority areas (themes) emerged.
involvement through partnership achievements and co-ordinating a
In response to the community plan
working which promotes an inclusive strategic approach to evaluation by:
and to facilitate partnership
city where citizens feel valued. For the
arrangements for the seven themes, a (i) Bringing together the health
purpose of this scoping exercise, the
Salford Strategic Partnership was set improvement, promotion of well
health theme was the main focus
up. The Partnership includes people being and NHS modernisation
which includes three key priorities;
from the community, voluntary, agendas, where partnership
tobacco control, building healthy
private, public and faith sectors who working adds value, into a
communities through empowering
work together to promote equality. coherent programme;
the local community and improving
There are 26 partners who meet
health through healthy food and (ii) Identifying strategies where
twice a year to discuss issues, review
physical exercise. partners working together will
progress and set plans. Additionally,
improve health by reducing
to facilitate the themes, Seven The SDP for addressing the Healthy
inequalities more than working in
Strategic Delivery Partnerships (SDPs) City was the Healthy City Forum (see
isolation;
were established by ‘Partners IN table 4). The aims of the forum are
Salford’. Each of the SDPs are linked to: (iii) Ensuring action is taken by the
to the seven themes and are other 6 strategic delivery groups
The Healthy City Forum will achieve
responsible for leading on priorities of the partnership to improve
the pledge of Salford City Council and
set out in the Community Plan. health by reducing inequalities;
the Community Plan to improve the
Aptly named Partners IN Salford, the health, well being and social care of (iv) Report to Partners IN Salford on
plan aims to ensure collaborative the people in Salford; and the Primary the progress of the Healthy City
working to sustain regeneration: Care Trust corporate objective of Programme and from the
promoting long-term well being in Partnership to the sub-groups;
“Partners IN Salford’s vision for the
partnership with other agencies (v) To promote an understanding in
city focuses on overall prosperity,
improved health, better educational Three key targets were developed to agencies and communities in
and cultural opportunities, valuing take this forward. The plan stipulates Salford of the determinants of
children and young people, and that Healthy lifestyles should be health, Salford health assets and
maintaining a clean and well- promoted and health inequalities local health inequalities;
managed environment. However, the tackled. Secondly, the Forum aims to (vi) To influence investment for health
vision goes further. It stresses a work in partnership to promote and by ensuring investments in local
commitment to social inclusion and improve the health of the community. services are targeted at those that
to reducing exclusion among Finally, service redesign was included have the most contribution to
neighbourhoods and communities. to increase access in order to meet make in improving health and by
No one in Salford should be demand. reviewing existing financial
disadvantaged because of where allocations and the influx of new
they live. Partners IN Salford is funds to assess the impact on
committed to reducing the health and inequalities;
inequalities gap between Salford and
the rest of England.” (Salford
Community Plan pg 1).
13Urban Regeneration: Making a Difference
This partnership has empowered the Healthy Living Centre’s
(vii) To take the lead in the Local community through ensuring that
In addition to the NDC activities
Strategic Partnership for the they play a pivotal role in the design
through CHAP, two new Health &
implementation of the health and management of health services in
Social Care Centres have been built
section of the Community Plan the community. (See table 5 for
using NHS Local Improvement Finance
and Neighbourhood Renewal examples of activities taken from their
Trust (LIFT) funds. These centers will
Strategy and ensure health action website).
be managed through CHAP with
is integral to the community
support from the NDC. A number of
strategy.
partners are involved in the Healthy
Table 5: Examples of
Living Centre’s including the NDC,
Regeneration Activities in
PCT, LIFT, CHAP, Salford City Council
Two areas in particular were singled Charlestown & Lower Kersal
and a local pharmacy.
out under the New deal for www.partnersinsalford.org
Communities Partnership (NDC) to
The team is working in partnership
receive help through partnership
with Salford Primary Care Trust on the Summary
working. The two areas Charlestown
governance of the two planned
and Lower Kersal are located in the Currently, a great deal of
Health and Social Care Centres (also
centre of Salford. One of the key Regeneration activity is evident within
known as LIFT Centres) at St.
priorities for the NDC was to improve Salford. The seven key priority areas
Sebastian’s and St. Aidan’s
the health of the community by were developed in response to the
Charlestown Centre Update community’s needs, demonstrating
• The provision of new and improved
awareness of the need to include and
health care facilities The centre in Charlestown began in
empower local people. The healthy
September 2004, and it opened in
• The redesign of existing services city theme has supported a range of
October 2005. It is now home to a
through greater integration activities in partnership with the NDC,
Doctors’ Surgery, Pharmacy,
between primary and secondary NDF and the community. This
complementary therapies, services for
staff, as well as extended roles and partnership working is typical within
carers and people with long term
new ways of working Salford and illustrates the extent of
conditions, and a range of other
the progress made to date. It is hard
• Community ownership of the new services identified by local people.
to ascertain whether any of these
developments
Lower Kersal Centre Update partnerships have been evaluated or
These aims are realised through indeed how this has been achieved.
The centre next to St Aidan’s Church
partnership working under NDC However, the projects located
on Littleton Road officially opened in
Health Improvement scheme that through the websites clearly outline a
January 2007. The centre houses 3
have developed a number of projects commitment to partnership for the
doctors, a pharmacy and a number of
to improve the health and well being benefit of the community.
other health services. The centre is
of the community. Two of the largest
available to the whole community but As the PCT Public Health Annual
projects in Charlestown & Lower
has an extra focus on health services Report states, Salford is making good
Kersal include the Community Health
for the area’s children and young progress. Exemplary practice through
Action Partnership (CHAP) and the
people. partnership working with the New
use of LIFT funds to develop health
Deal Initiate, CHAP and other
and social care centres. In particular
partners have resulted in a positive
CHAP (Community Health Action
impact on Salford’s communities. The
Partnership) is made up of local
PCT in particular aims to continue this
residents who help direct the work of
good work and learn from these
the NDC Health Task Group.
activities. The report recommends
that examples such as Sure Start and
New Deal should be rolled out across
the city. In addition and to help
smooth this process, the PCT aims to
continue its work with local residents
14Urban Regeneration: Making a Difference
to secure a reduction in health and
social inequalities. Finally, the report
also asserts that LSP’s have a crucial
role to play in the continued
development and support of healthy
communities.
The three key areas in relation to
health have witnessed innovative
programmes to support the
community in preventing ill-health. A
natural consequence of this is the
impact on the well-being of the
community. Health and social equality
are inextricably linked, any positive
effects from UR on the health or the
social equality of Salford population
will have a reciprocal effect.
15Urban Regeneration: Making a Difference
1.11 References Report of the Public Health Director 1.12 Websites:
(Salford) on Cancer to the Trust
Department of Health (1999) Saving Bolton, Salford & Trafford Mental
Board. Salford PCT.
Lives Our Healthier Nation. The Health Trust
Stationary Office. London Salford PCT Public Health Annual http://www.bstmht.nhs.uk/default.asp
Report (2004/05) The Changing Face x (accessed 1st August 2007).
Department of Health (1998) Our
of Public Health in Salford. Salford
Healthier Nation. A Contract For British Heart Foundation Statistics
PCT.
Health. The Stationary Office. London Database
Shack L, Khan S, Moran T (2007)
Department of Health (2006) Health www.heartstats.org
Cancer Incidence Projections, North
Profile of England. Working in
West, 1982-2020. North West Cancer Community Health Action Partnership
Partnership across Government with
Intelligence Service. NHS. (CHAP) http://www.chalk-
People, their Communities, Local
ndc.info/index/doing/ndc-
Government, Voluntary Agencies and Skills for Health (2003)
health/chap.htm (accessed 1st August
business. HMSO. Standards/Competencies for Public
2007)
Healthy Team Practice. Post
National Statistics (2007)
Consultation Draft. Community Health Profiles
Amendment: Changing Regional
http://www.communityhealthprofiles.i
Economies: North West. ONS London The Office of the Deputy Prime
nfo/ (accessed 1st August 2007)
minister (2004) Creating Sustainable
North West Development Agency
Communities. The English Indices of Neighbourhood Renewal Unit
(2000) Action for Sustainability. The
Deprivation (revised) HMSO. ODPM http://www.neighbourhood.gov.uk/
Programme for Integrating
Publications. (accessed 1st August 2007)
Sustainable Development across the
North West. NWDA Wigan. Wanless D (2002) Securing Our New Deal for Communities accessed
Future Health: Taking a Long-Term through the NRU site at
Office for National Statistics (ONS)
View. HM Treasury. http://www.neighbourhood.gov.uk/
mortality data and mid year
population estimates, analysed by the Warne T & Howarth M ( 2009 ) North West Public Health Observatory
Association of Public Health Explicating the role of partnerships in Health and Lifestyle Trends in England
Observatories Community Health changing the health and well-being assessment tool
Profile Project. Web link of local communities in urban http://www.nwph.net/lifestyles/
http://www.apho.org.uk/apho/net/vie regeneration areas: Development of (accessed 1st August 2007)
wResource.aspx?id=2909) the Warwarth Conceptual Framework
North West Development Agency
for Partnership Evaluation, Volume 1,
Partners IN Salford (2006) Community Regional Intelligence Unit
Salford Centre for Nursing and
Plan for Salford. Making the Vision http://www.nwriu.co.uk/aboutus/230
Midwifery Research, University of
Real. Salford County Council 7.aspx
Salford
www.salford.gov.uk/council/corporate
Salford County Council
/e-
www.salford.gov.uk/council/corporate
government/ieg/ieg2/ieg2organisation
/e-
/ieg2-egov-accesschannels.htm
government/ieg/ieg2/ieg2organisation
Petersen S,, Peto V, Scarborough P, /ieg2-egov-accesschannels.htm
and Rayner M (2005). CHD Statistics.
British Heart Foundation Health
Promotion Research Group.
Department of Public Health,
University of Oxford
Rasulo D, Bajekal R, Yar M (2007)
Inequalities in Health Expectancies in
England and Wales: Small Area
Analysis from the 2001 Census.
Health Statistics Quarterly. 34-45.
ONS.
16Urban Regeneration: Making a Difference
17Urban Regeneration: Making a Difference
Chapter 2 A Profile of Neighbourhood
Renewal Activity Focused on Promoting
Health and Well-being in the North
East Region
Glenda Cook, Pam Dawson and 2.2 Aims of the Scoping Exercise government's cross-sector
Denise Elliot regeneration programmes, including
The aims of this scoping exercise are
New Deal for Communities,
2.1 Introduction first to provide an overview of the
Neighbourhood Management,
North East in terms of its location,
The North East of England is a Neighbourhood Wardens.
aspects of deprivation and health and
geographically, demographically,
well-being needs. Secondly, describe The ensuing wave of community
economically and culturally diverse
the partnerships / forums that have development programmes followed
region. Deterioration in economic
been set up to promote regeneration by the Neighbourhood renewal
growth throughout the 1990’s
across the North East and improve initiative resulted in an array of
contributed to high levels of
health and well-being across the different, often disparate websites,
deprivation and economic inactivity.
region. policies and papers. Each of these
Whilst economic inactivity has fallen
contained various data with one
in recent years this is still higher than
common denominator, that of
other regions and is particularly
2.3 Search strategy satisfying the needs of the
concentrated in the over 50’s age
community health and well being. For
group where ill health is more Uncovering relevant evidence about
example, the Index of Multiple
prevalent than other parts of the regeneration and the partnerships
Deprivation, developed by the Office
country. In keeping with government that exist in the North East region
of the Deputy Prime Minister (2004)
policy the region has been subject to was not a straightforward activity.
details seven Domains of deprivation
wide ranging programs of The process of searching and locating
which include income deprivation,
regeneration to bring about economic evidence through internet searches
employment deprivation, health
growth, to combat social deprivation involved negotiating all the
deprivation and disability, education,
and address inequalities in health. complexities of identifying relevant
skills and training deprivation, barriers
Regeneration partnerships emerged terms that are used by search engines
to housing and services, living
during the 1990’s, which drew and understanding the environment
environment deprivation and crime.
together organisations from all in which regeneration activity takes
These domains represent the
sectors to help promote best practice, place. This is an activity that
Governments beliefs about the key
share experiences and act as a transcends the boundaries of
regeneration areas which have been
catalyst for change. In the context of economics, health, social care,
targeted through a far-reaching range
health and well-being the public housing, transport, education, policy,
of initiatives and illustrate the extent
health agenda has now moved service planning and delivery. Terms
of problems faced by communities
toward a community ‘hands on’ that are understood within one sector
and urban regeneration programmes.
approach predicated on partnership are not necessarily used by other
working between the NHS, local sectors. Added to this the same term The North East has some of the most
authorities, independent and may have several meanings across rural areas in England and yet is also
voluntary agencies. This agenda sectors. witness to much extensive
emphasises working with the regeneration in some of the most
During the initial internet searches it
community to address the health and deprived areas of the UK. A range of
became clear that different phases of
well-being needs of the population National statistical databases have
regional and community development
and development of targeted locally- been used to source health and social
followed the government agenda of
based services. care data about the health and well-
the day. In recognition of these
being of the North East.
problems it was agreed by the project
steering group to focus the scoping Initially, little evidence was located
activity around the Neighbourhood simply using terms such as urban
renewal initiative. This is a regeneration or neighbourhood
government strategy to regenerate renewal. However, two sites were
England’s most deprived localities by located which provided relevant
improving services to narrow the gap information about the progress and
between deprived areas and the rest processes of Regeneration. The
of the country. The Neighbourhood Neighbourhood Renewal Data Site
Renewal Unit runs a number of the (NRD) provides access to databases on
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