September 2017 PHE Bulletin, Public Health England's regular update, provides news and information for all those concerned with protecting and improving the public's health. Visit our website for more information. PHE annual conference Our annual conference in mid September brought together over 1500 people from every conceivable profession, discipline and organisation, playing their part in protecting and improving the health of the people to share and learn from each other. The three themes were addressing inequalities, promoting world-leading science and the economics of prevention. Highlights from the conference can be seen here. New drive to prevent heart attacks and strokes The NHS, working with Public health England (PHE), has announced a new drive to prevent heart attacks and strokes saving thousands of lives by taking a more integrated approach to cardiovascular care. New PHE analysis suggests that there is now an opportunity to prevent more than 9,000 heart attacks and at least 14,000 strokes over the next three years with better detection and management of high blood pressure, high cholesterol and atrial fibrillation. PHE and NHS England have written to all 44 STPs, drawing attention to this prevention opportunity, and sharing with them the data for their local area. The majority of STPs have identified prevention of cardiovascular disease as a priority and can drive improvement in two ways. Firstly, through partnerships that support widespread implementation of initiatives such as healthy workforce schemes, active transport plans, the Active 10 app, and smoking cessation programmes. Secondly, they have the ability to roll out the NHS Right Care CVD Prevention Programme across a much wider area and support the implementation of the NHS Health Check programme. PHE Action plan for cardiovascular disease prevention published PHE's Action plan for cardiovascular disease prevention, 2017 to 2018 has been launched on World Heart Day (29 Sept). With cardiovascular disease (CVD) causing 26% of all deaths and costing the UK healthcare system over £8 billion a year, we know more can be done to prevent many thousands of avoidable deaths and ill health. As well as highlighting some of our programmes and resources, the plan includes some of our CVD initiatives planned for 2017 /18. This includes important work looking at a new return on investment tool, air pollution, sugar reduction and the NHS Health Check programmes. The plan is aimed at those involved in the commissioning and provision of services for CVD and its prevention such as clinicians, local authorities, service commissioners, public health specialists, the third sector and PHE staff. Heart Age Test relaunch PHE has relaunched its Heart Age Test as part of the One You brand, which supports adults in making simple changes towards a longer, happier life. The online test is for anyone aged 30+ and provides an estimation of their Heart Age based on basic physical and lifestyle-related information - having a heart age older than your actual age means you are at a higher risk of having a heart attack or stroke. In total, 1.3 million people have taken the test so far.
PHE publishes interim report updating on progress of its sugar reduction and wider food reformulation programme The programme aims to reduce the amount of sugar children consume from everyday food by 20% by 2020, with a 5% reduction in the first year. The report covers the period April to September and updates on PHE's actions since the last combined technical and progress report was published in March. The report also sets out the next steps for the programme up to March 2018. There is no assessment of whether industry is progressing towards the 20% reduction target; this will be covered in the next, more detailed report which will be published in March 2018. The report is available here. Please contact sugarreduction@phe.gov.uk with any queries.
New liver disease atlas published PHE has published the 2nd Atlas of Variation in Risk Factors and Healthcare for Liver Disease in England. The Atlas is made up of 39 indicators relating to liver disease, 19 of which show trend data over time. It shows the degree of variation across the country, a national figure for comparison and commentary providing options for action and a list of evidence based resources for local health systems to improve. This is a valuable resource for local health systems, so do please share it widely. Stoptober 2017 campaign launched Our Stoptober 2017 campaign has launched, encouraging smokers to quit smoking for 28 days as they are then 5 times more likely to quit for good. Smoking prevalence is at an all-time low, down to 15.5% of the adult population. But there are still nearly 7 million people smoking regularly and it remains the biggest cause of preventable early death. Along with local Stop Smoking Services, local authorities and the NHS, Stoptober is being supported by a number of commercial partners and employers. To help you support Stoptober we have a range of resources you can download or order for free, including posters, conversation starters, digital assets and more. Alcohol drugs and tobacco commissioning resources published The Alcohol, drugs and tobacco commissioning support pack (previously Joint Strategic Needs Assessment (JSNA) support packs) will help local authorities to develop joint strategic needs assessment and local joint health and wellbeing strategies which effectively address public health issues relating to alcohol, drug and tobacco use. The pack covers four topics: 1. Planning alcohol harm prevention, treatment and recovery in adults; 2. Planning drugs prevention, treatment and recovery in adults; 3. Planning comprehensive interventions for young people; 4. Planning comprehensive local tobacco control interventions. For each of these topics, there are two documents: i. A set of good practice principles and indicators to help local areas assess need and plan and commission effective services and interventions; ii. Bespoke data for each local area to help them commission effective services and interventions. Local areas are sent their bespoke data packs directly by PHE centre teams, but copies of these will be available from ndtms.net (login required) from November 2017. Associated tools and documents: PHE has produced two tools for commissioners to support them in commissioning alcohol and drug services: a commissioning tool to help commissioners estimate spend and cost-effectiveness, and a social return on investment tool which estimates benefits from investing in alcohol and drug services. Both these tools are available by logging into ndtms.net and come with supporting guidance. A new set of estimates for opiate and crack users in England has been published, for the year 2014-15. The national report is available on the Liverpool John Moores University website. There is also an accompanying set of data for each local authority, which is available on the PHE alcohol and drugs legacy site. Queries should be sent to evidenceapplicationteam@phe.gov.uk. The Health Economics Evidence Resource (HEER): robust data on economic evidence for public health interventions This Excel based tool allows users to understand the key cost-effectiveness and return on investment evidence on activities in the public health grant. Each piece of evidence is summarised across over 20 criteria to provide details on exactly how the results were created and to highlight the inputs and assumptions used in the original studies. This will allow users to understand the relevance and applicability of the evidence to their local setting. It brings together recent economic evidence from the literature, which is commonly used and has been quality assured by the PHE Health Economics team, into a live database. It will be reviewed annually to include up-to-date economic evidence for public health interventions, including those in relation to the wider determinants of health. The HEER is relevant for local authorities, clinical commissioning groups, charities, academics and anyone else interested in public health. Reducing Health Inequalities: System, Scale and Sustainability launched PHE's Health Equity Unit has launched "Reducing Health Inequalities: System, Scale and Sustainability". Published in response to demand from across the public health system, the guidance is an update of the Health Inequalities National Support Team (HINST) background document "Systematically reducing health inequalities". The guidance provides broad scope for application, taking you through different levels of intervention on health inequalities. It explores risk, impact of interventions over time and across the life course, emphasising the importance of acting at scale to reach large sections of the population and have real effect. Childhood Vaccination Coverage Statistics, England, 2016-17 published Published by NHS Digital, the information in this bulletin on immunisation statistics in England comes from PHE. The 2016-17 report is accompanied by a new interactive data dashboard which has been developed in collaboration with PHE. In 2016-17, four out of the six routine vaccinations at 1 and 2 years showed small decreases in coverage compared to 2015-16. This includes coverage for the Measles Mumps and Rubella (MMR) vaccine as measured at 2 years which decreased in 2016-17 for the third year in a row. Coverage for this vaccine is now at 91.6 per cent, slightly lower than in 2015-16 (91.9 per cent). In 2016-17, 93.4 per cent of children reaching their first birthday were reported to have completed their primary DTaP/IPV/Hib course (three doses). This compares with 94.7 per cent in 2012-13. National coverage figures reported for the MMR 1st dose as measured at 5 years show coverage at the WHO recommended target level of 95 per cent for the first time. National coverage figures reported for the Diphtheria, Tetanus, Pertussis and Polio (DTaP/IPV) booster as measured at 5 years show a decrease in 2016-17 for the fourth year in a row. Eliminating hepatitis C as a major public health threat – finding the undiagnosed Hepatitis C (HCV) is a bloodborne virus that is often asymptomatic, and symptoms may not appear until the liver is severely damaged many years later. As a consequence, many individuals with long-lasting infection remain undiagnosed and fail to access new fast and effective treatments, and can present late with end-stage liver disease and cancer. Our new poster campaign invites people to take a quick 6-item online quiz to find out whether they might have been exposed to the hepatitis C virus and should seek a test. Posters (Product code: HEPCQUIZ001) can be ordered online or by calling the health and social care orderline (0300 123 1003). Latest National Child Measurement Programme trends report published PHE has published the latest National Child Measurement Programme (NCMP) trends report that shows changes in children's BMI between 2006/07 and 2015/16. The NCMP takes annual height and weight measurements from over a million children in Reception (age 4-5 years) and Year 6 (age 10-11 years) in state maintained primary schools in England. This new report shows that obesity is stabilising in Reception girls and there is a downward trend in obesity in Reception boys. In Year 6 however, there is a significant upward trend in obesity among both boys and girls. For the first time, the report also maps the trend of childhood obesity across local authority areas. Child and adult diet patterns and trends: Slide set presentations PHE Risk Factors Intelligence has produced the Child diet patterns and trends: presentation and the Adult diet patterns and trends: presentation (Sept 2017). These PowerPoint slides present key data and information on the patterns and trends in child and adult diet in clear, easy to understand charts and graphics. The slides and accompanying notes can be downloaded and used freely with acknowledgement to Public Health England. They are a useful tool for practitioners and policy makers working on diet and obesity at local, regional and national level. A review of new psychoactive substances in secure mental health: summary document PHE has reviewed the latest clinical evidence, and surveyed low, medium, high secure, and Child and Adolescent Mental Health Units in England on the current issues they were experiencing with new psychoactive substances (NPS). The survey found that current NPS use was relatively low (1.1%), however the reported prevalence of use by patients prior to admission was significantly higher. It also highlighted a number of issues experienced by units including violence, trading and exploitation and impacts on staff. The results provide a strong case for continued public health action focussed on patients with mental health conditions who are using, or have used NPS. Read the full report here.
Opportunities for pharmacy teams - report A new report published by PHE, Pharmacy: a way forward, sets out opportunities for how pharmacy teams in the primary and community sectors can play an even bigger part in helping the public better look after their health. The report has been produced to take stock of the opportunities within the sector, and prompt local areas and pharmacies to review the way in which they currently contribute to health improvement, and where they could use their knowledge and expertise to make a difference. Now available: Quick and easy access to evidence for local authority public health teams Over 1300 full text journals purchased by PHE and the NHS national core content collection of journals are now quickly and easily accessible to you in just one search, through provision of the new dedicated Discovery service. The bespoke discovery service enables you to access a range of quality public health research evidence using a single search box, without the need to go to multiple publisher websites or platforms. You will be able to find the evidence you need to inform your professional decision-making. Use this link to register for a free online introductory training session, to be held: 12 October, 14:00–15:00. Don't worry if you can't make this date, you will be able to view a recording at your own convenience. Need some help? Email: libraries@phe.gov.uk or Telephone: (020) 368 20600.
Another important step on Allied Health Professional education public health journey A PHE-led new guidance document has been published to make clear what good practice looks like for public health in pre-registration Allied Health Professional education. The Guidance: Public Health Content within the Pre-Registration Curricula for Allied Health Professions helps shape individual professions curricula and supports universities to review and develop their courses. The guidance includes 12 recommendations covering content, approach to inclusion of public health content and skills development and recommended resources. The hope is that the guidance will be useful to professional bodies as they review their curriculum and to universities who are updating their courses. Local government and improving mental wellbeing Local government has a unique role to play in improving mental health and by making improvements in this area, we improve health overall. This is an extremely topical issue and Duncan Selbie was recently interviewed on local government's role in mental health improvement and economic imperative for the Municipal Journal, which you can read fully here. How are we working together to tackle cardiovascular disease? Public health in a hurricane zone New psychoactive substances in secure mental health settings: the growing case for public health action Realising the potential of community assets to improve our health and wellbeing Understanding health threats in the places we live and work Health Matters - Your questions on cervical screening Fentanyl: What's being done to mitigate future problems Routes to Diagnosis – making the most of cancer diagnosis data Clearing up confusion caused by flip-flopping diet news Closing the health gap and reducing inequalities Promoting the impact of science on our health The National Poisons Information Service - what it is and does Making the economic case for prevention Supporting local action on health inequalities NICE says more than a million people should be offered lifestyle tips as a way to avoid type 2 diabetes Healthcare professionals, from GPs to community nurses and pharmacists, should refer people with elevated blood sugars to exercise classes and nutrition courses, NICE has said in updated guidance. NICE has identified 1.7 million people as having the highest risk of developing type 2 diabetes. This is based upon them having a fasting glucose between 6.5-6.9mmol/l. NICE says people with very high fasting glucose (between 6.5-6.9mmol/l) should be given priority when allocating places on intensive lifestyle change programmes. Lifestyle change programmes, such as the 'Healthier You: NHS Diabetes Prevention Programme' developed by NHS England and Public Health England (PHE) aim to help people to change their diet and increase their physical activity. NICE publishes draft guidance on smoking cessation interventions and services NICE has published draft guidance on smoking cessation interventions and services, which is now out for consultation until 1 November. Upcoming: Teleconference invitation to Health Matters on 'Preventing ill health from alcohol and tobacco' The next edition of Health Matters, 'Preventing ill health from alcohol and tobacco', will be launched via teleconference on Wednesday 4 October 2017, 12.15pm–1.00pm. The TC will make the case for trusts implementing the identification, treatment and referral pathways set out in the national CQUIN 'Preventing ill health from risky behaviours – alcohol and tobacco'. The session will be of particular value to NHS professionals, mental health and community trusts, acute trusts, CCGs and local authorities. Please dial in 5-10 minutes prior to the start time, using the following alternative numbers and the conference code: Local call rate: 0330 336 9105, National free phone – United Kingdom: 0800 358 6377 and Conference code: 1225902. RSVP: Please register for the teleconference here. You will then receive supporting materials on 4 October, prior to the call. | 
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