Health improvement

The health improvement section includes information about:

  • alcohol
  • excess weight
  • family centre two-year checks
  • infant feeding
  • physical activity
  • school readiness
  • sleep
  • smoking
  • under-18 conceptions
  • unintentional and deliberate injuries in children (aged 0 to 4)

Alcohol

Why this is important

Alcohol plays a significant role in our social lives and in our economy: it provides employment, generates tax revenue and stimulates the night-time economy.

Although the majority of people who drink do so moderately, alcohol consumption has doubled over the past 40 years. As a result, alcohol is the leading risk factor for deaths among men and women aged 15 to 49 years in the UK (PHE, 2018) and there are more than one million alcohol-related hospital admissions every year. The harm from alcohol goes far beyond individual health affecting families, friends and communities; it contributes to violent crime, domestic abuse and absence from work.

The impact of alcohol harm falls disproportionately on the more vulnerable people in society. Those in the lowest socioeconomic groups are more likely to be admitted to hospital or die from an alcohol-related condition compared to those in higher socioeconomic groups, so action that supports local work to prevent or reduce alcohol-related harm can also help reduce health inequality.

However, it is important that we do not neglect our efforts to those in the higher socioeconomic status groups. A study released by the Office for National Statistics (ONS) has found that the most regular drinkers are those in professional jobs, with 69.5% of professionals reported having drunk in the last week compared with 51.2% of people in routine or manual occupations. Although the relationship between alcohol consumption and socioeconomic status is complex there is a need to dismantle the stereotype around those who are problem drinkers.

The Barnsley picture and how we compare

  • Just over a quarter (25.8%) of adults (18+) in Barnsley report drinking over the recommended 14 units of alcohol each week; similar to the England rate of 25.7%.
  • The proportion of dependent drinkers in 2016/17 in Barnsley (1.80%) was significantly higher than the national rate of 1.35%.
  • Barnsley’s 2017/18 rate for hospital admissions for alcohol-related conditions (793 per 100,000 population) is significantly higher than the England rate of 632 per 100,000.
  • The 2017/18 rate of 793 per 100,000 equates to 1,906 hospital admissions of Barnsley residents for conditions that were related to alcohol (1,133 males and 773 females).
  • Out of 16 comparator authorities, Barnsley has the fifth highest rate for alcohol-related hospital admissions.
  • In terms of younger people, Barnsley’s 2015/16 to 2017/18 rate for hospital admissions in the under 18’s for alcohol-specific conditions for:
    • Males (27.5 per 100,000) is similar to the England rate of 26.4 per 100,000.
    • Females (58.5 per 100,000) is significantly higher than the England rate of 39.6 per 100,000.
  • Under 18 admission rates for males have declined in recent years, and the current rate of 27.5 per 100,000 is the lowest since 2006/07 – 2008/09. However, for females, rates have fluctuated, with an increase from 45.7 per 100,000 in 2011/12 to 2013/14 to 58.5 in 2015/16 to 2017/18.
  • In terms of alcohol-related mortality, although Barnsley’s 2017 rate of 53.5 per 100,000 is similar to the England rate of 46.2. Rates have fluctuated, and are now at their second highest since 2008.
  • Barnsley’s 2016/18 under 75 mortality rate from alcoholic liver disease (12.3 per 100,000) is significantly higher than the England rate of 8.9 per 100,000, and is the highest since 2004/06.
  • Almost half (47.4%) of Barnsley alcohol users in treatment in 2017 left successfully (free of alcohol dependence) and did not re-present for treatment within 6 months. This is significantly better than the England rate of 38.9% and a significant improvement from the 2010 rate of 17.0%.

Data from:

What we're doing and the assets or services we have

Alcohol is one of three priorities in the refreshed Public Health Strategy along with food and emotional resilience.

To ensure we have a good understanding of alcohol demographics, alcohol related harm, alcohol treatment and what our partners are already doing in this area, Barnsley Council Public Health team decided to complete the alcohol CLeaR (Challenge, Leadership, Results) assessment tool.

The alcohol CLeaR self-assessment tool has been produced by Public Health England (PHE) to support an evidence-based response to preventing and reducing alcohol-related harm at a local level and builds on experience and successes from the tobacco control CLeaR model.

CLeaR helps place-based alcohol partnerships to assess local arrangements and delivery plans providing assurance that resources are being invested in a range of services and interventions that meet local need and which, the evidence indicates, support the most positive outcomes.

The CLeaR self and peer-assessment have been completed in Barnsley and 40 areas of improvement have been identified.

Our Alcohol plan

Based on results from the CLeaR assessments, an alcohol plan has been developed that sets out seven priorities and suggested outcomes for addressing alcohol related harm in Barnsley.

  • night time economy
  • availability
  • affordability
  • acceptability
  • children and young people
  • partnership approach
  • alcohol treatment

A high level detailed alcohol action plan has also been developed to ensure we are working towards each priority area and our progress is measured.

In addition to the work already mentioned, Barnsley Council’s Public Health team have formed an Alcohol Alliance. The overarching purpose of the Barnsley Alcohol Alliance is to develop a system wide approach to address the availability, affordability and acceptability of alcohol in Barnsley. This Alliance brings together a wide range of partners with the aim of working together to implement, manage and evaluate the alcohol plan, alcohol improvement plan and a range of alcohol related targets. The Barnsley Alcohol Alliance will provide a shared voice, leadership and a joint opportunity for all its members in a way that allows us to do more together than could be achieved by acting in isolation.

An area that we have been working on over the last two years related to alcohol, and also assisting with cross council priorities, is that of the night time economy (NTE). This work is continuing and is focused on:

  • an award winning Best Bar None scheme in the town centre. The majority of town centre bars and clubs are now signed up to the scheme and due to a new BBN category of ‘Best Dining Experience’ some restaurants have now also been accredited with the award.
  • a night life marshal service that ensures that the taxi queues are well managed and vulnerable people due to intoxication are kept safe.
  • Security Industry Accreditation training events for all NTE staff, which may include: door staff, licensees, marshals and street pastors and bar staff.
  • an 'ask for Angela' scheme that all BBN venues are signed up to.

Opportunities for improvement or future development

Improvements to the availability, affordability and acceptability of alcohol in Barnsley, in addition to the other three priorities of the alcohol plan will be made by keeping track of the Alcohol Action Plan and support from the Alcohol Alliance.

A collaborative approach to understanding the local data via an in-depth analysis will also be initiated. The exceptionally high rates of alcohol-specific hospital admission episodes for females under the age of 18 have been highlighted as a particular focus area to investigate. Consequently, we are working closely with Barnsley District General Hospital to complete a retrospective case review. Through completion of this, we will acquire a greater understanding of the circumstances of individual cases, identifying the journey that patients go through prior, during and following an alcohol-specific hospital admission. With this knowledge, we will be better equipped to generate effective targeted intervention and reduce the aforementioned admission rates across the borough.

We are working towards submitting an application for Purple Flag. The Purple Flag standard is an accreditation process similar to the Green Flag award for parks and the Blue Flag for beaches. It allows members of the public to quickly identify town and city centres that offer an entertaining, diverse, safe and enjoyable night time economy. We will also strengthen the Alcohol Alliance by ensuring the right people are in attendance and build good working relationships with those involved in the Alcohol Action Plan. We will continue with our communications approach around alcohol related harm and link with our partners so as a borough, we are sending out consistent evidence-based messages.



Excess weight

Why this is important

Healthy eating helps us to maintain a healthy weight and reduces our risk of type 2 diabetes, high blood pressure, high cholesterol and the  risk of developing cardiovascular disease and some cancers such as breast, bowel and pancreatic cancer.Healthy eating also has many other benefits. When we eat well we sleep better, we have more energy and better concentration levels.

Overweight and obese children are becoming bigger at an earlier age and are staying obese into adulthood. It is estimated that obesity is responsible for more than 30,000 deaths each year. On average, obesity deprives an individual of an extra 9 years of life, preventing many individuals from reaching retirement age. Cancer Research UK has predicted that in the future, obesity could overtake tobacco smoking as the biggest cause of preventable death. Obesity increases the risk of developing a range of diseases. Obese people are:

  • at increased risk of certain cancers, including being 3 times more likely to develop colon cancer
  • more than 2.5 times more likely to develop high blood pressure - a risk factor for heart disease
  • 5 times more likely to develop type 2 diabetes

The economic cost for obesity is worryingly high and is having an impact on economic development and the NHS. The overall cost of obesity to wider society is estimated at £27 billion. The UK-wide NHS costs attributable to overweight and obesity are projected to reach £9.7 billion by 2050, with wider costs to society estimated to reach £49.9 billion per year.

Local Barnsley rates of adult excess weight (overweight and obese combined) are 69.7% which is significantly higher the national average of 62% (PHE, 2107/18).

Source: Public Health England

The Barnsley picture and how we compare

Adults:

  • Latest data (2017/18) indicates that more than two-thirds (69.7%) of Barnsley adults are overweight or obese; a significantly higher proportion than the national average (62.0%).
  • Out of 16 similar local authorities, Barnsley’s rate was the fifth highest.
  • Rates have declined over recent years, and the 2017/18 rate of 69.7% is the lowest since 2015/16.
  • 12% of Barnsley mothers giving birth at Barnsley hospital in 2017/18 were classified as obese at the time of booking.

Children:

4-5 year olds:

  • More than one in five (21.3%) of Barnsley’s 4-5 year old population were overweight or obese in 2018/19; similar to the England rate of 22.6%.
  • Out of 16 similar local authorities, Barnsley’s 2018/19 rate was the lowest.
  • Excess weight in 4-5 year olds in Barnsley has fluctuated in recent years (from a high of 23.6% in 2015/16).
  • At ward level, excess weight rates range from 14.2% in Darfield ward to 30.4% in Worsbrough (three years aggregated data (2015/16-2017/18).

10-11 year olds:

  • More than one in three (34.9%) of Barnsley’s 10-11 year olds were overweight or obese in 2018/19; similar to the England rate of 34.3%.
  • Out of 16 similar local authorities, Barnsley’s 2017/18 rate was the third lowest.
  • Excess weight in 10-11 year olds in Barnsley has fluctuated in recent years (from a high of 35.6% in 2006/07).
  • At ward level, rates range from 25.5% in Penistone East ward to 38.3% in Dearne North (three years aggregated data (2015/16-2017/18).

Data from:

What we're doing and the assets or services we have

  • Barnsley Clinical Commissioning Group (CCG) commissions the tier 3 weight management service for children and adults.

  • Development and promotion of a ‘pilot’ Wellbeing Service, which incorporates two elements – Grants to local area teams to promote mental and physical wellbeing, as well as a Wellbeing Support Programme (GP referral) delivered by Barnsley Premier Leisure, a scheme offering 1:1 & group support for individuals wanting to change behaviour, improve levels of activity, diet, nutrition and wellbeing.

  • The 0-19 Public Health Nursing Service support overweight and obese children and families as identified through the National Childhood Measurement Programme.

  • The Local Plan was adopted in Spring 2019. Through our planning processes, we are limiting the growth of additional hot food takeaways across the borough.  Planning applications will consider the childhood obesity rates when reviewing applications.  Applicants are now asked to complete a health needs assessment, and rules have been introduced about the number of hot food takeaways on one front to prevent over concentration in areas.

Opportunities for improvement or future development

The Barnsley Food Plan 2018-21

The food plan will require partnership delivery which will address issues around healthy weight, but it is not limited to that alone. The plan is about changing the food environment and culture within Barnsley, as well as improving access to quality food and improving health and wellbeing outcomes. Our approach will focus on developments to the policies and structures which we live, work, shop, eat and learn within. Barnsley’s food plan has been developed in response to priorities in the 2018 refreshed public health strategy and will help to influence the social, cultural and environmental conditions around us. The plan will prioritise local supply chain, the reduction of sugar, education, public sector catering, the consumer food environment and food access.

The plan aims to achieve a number of outcomes specifically relates to its priorities.

  • Supply chain: We will celebrate the food journey from production to waste.

  • Consumer environment: Food will play a key role in strengthening our local economy and connections with our businesses and communities.

  • Sugar: We will reduce the amount and frequency consumed by our children and young people.

  • Education: Residents and employees will have an improved understanding of the importance of a healthy balanced diet.
  • Public sector catering: We will be exemplar and serve quality products.

  • Access: Each person will have access to food that is nutritious, affordable, diverse and that benefits their health and wellbeing.

Resources and supporting documents



Family centre two-year checks

Why this is important

The two-year progress check is the first statutory assessment point in the Early Years Foundation Stage.

Analysis of the borough wide data enables services to plan and work together, in order to address areas of learning where attainment is low. The analysis derived from the borough’s two-year progress checks is shared widely and is used to inform family centre delivery of services, for example outreach priorities for stay and play/parent and child groups. The data is also shared with primary schools to support effective transition and to enable schools to better meet children’s needs from the outset, ultimately improving outcomes at the end of the Foundation Stage (second statutory assessment point).

The data has been used when working on government initiatives as part of the social mobility agenda. The main focus for this work has direct links to the two year data for the borough and has a focus on improving communication and language.

The Barnsley picture and how we compare

  • Within Barnsley, rates for two year olds achieving typical or above typical development range from 43.5% in the health and self care aspect to 70.6% in the moving and handling aspect.
  • Girls perform better than boys for every aspect within the personal, social and emotional development area, the physical development area and the communication and language area.
  • Non-funded two year olds perform better than funded for all aspects within each area (personal, social and emotional development, physical development and communication and language).

Resources and supporting documents



Infant feeding

Why this is important

On average there are around 3,000 births each year in Barnsley. Most women are aged between 20 to 34 years when they give birth.

Maternal behaviours such as smoking, breastfeeding and maternal weight have an impact on the health and wellbeing of both the mother and baby. Breast feeding saves lives, protecting the health of babies and mothers immediately and over time. It reduces the risk of sudden infant death (SID) and babies who are breastfed are less likely to develop infections. Longer term benefits of breast milk include a reduced risk of becoming obese, developing diabetes, high blood pressure and high cholesterol levels. For mothers there is a decreased risk of breast and ovarian cancers and hip fractures in later life. It also supports the mother-baby relationship and the mental health of both baby and mother.

In Barnsley just over half of women start breastfeeding their baby; this falls to around a third of women breastfeeding when their baby is 6 to 8 weeks old. As well as health benefits to mother and baby, increased breastfeeding rates contribute to reducing health inequalities through improved outcomes. Financially, high rates of breastfeeding not only result in savings to family budgets, but also to reduced service costs associated with dealing with health problems which occur more frequently when babies are not breast fed.

Whilst breastfeeding is the best option for babies, and the Infant Feeding Team work to support mothers to breastfeed, we also work to ensure that all babies receive high standards of care and the best possible chance to thrive regardless of feeding type.

The Barnsley picture and how we compare

  • Just over half (55.6%) of mothers in Barnsley in 2016/17 gave their babies breast milk in the first 48 hours after delivery. This is significantly lower than the England rate of 74.5%.
  • Out of 16 comparator authorities, Barnsley’s rate is the sixth lowest.
  • Breastfeeding initiation rates in Barnsley have fallen in recent years (from a high of 64.0% in 2014/15).
  • There are large variations in the proportion of mothers in Barnsley who initiate breastfeeding, with rates ranging from 40.2% in St Helens ward to 74.7% in Penistone East ward (2015/16 - 2017/18 data).
  • Around a third of mothers in Barnsley (32.9% - provisional data for Quarter 1, 2019/20) continue to breastfeed their babies at 6-8 weeks after birth.

What we're doing and the assets or services we have

Barnsley Maternity Services (provided by Barnsley District General Hospital Trust), Public Health Nursing Services (provided by Barnsley Council) and Infant Feeding Support (provided by Barnsley Council) work together to provide integrated breastfeeding support. To ensure women and their partners/supporters are fully informed and empowered to initiate and continue breastfeeding for as long as they choose and are able to access timely and appropriate support when problems arise.

Breastfeeding peer support groups are held across the borough. These are for mums experiencing difficulties with breastfeeding or needing support with breastfeeding. Details are listed on the infant feeding website.

Our Director of Public Health, Julia Burrows, is a Baby Friendly Initiative Guardian. This role has the responsibility of promoting, protecting and supporting the Baby Friendly standards, including compliance with the International Code of Marketing of Breastmilk Substitutes.

We have strong multi-agency working across all partners and to support this we have in place a multi-agency Maternal and Infant Nutritional Feeding Steering group chaired by our Head of Public Health (Children and Young People).

Barnsley Hospital and Barnsley Council’s 0-19 Service, family centres and infant feeding staff have been Baby Friendly Initiative UK (BFI) accredited since 2013 and will be re-accredited in December 2019. Implementing the BFI standards provides effective professional support to mothers and their families (PHE recommendation).

We comply with International Code of Marketing Breastmilk Substitutes by restricting the advertising of formula milks and baby foods.

There are borough wide infant feeding policies, pathways and guidelines in place.

The 0-19 Infant Feeding service includes both paid and voluntary staff who provide mother to mother peer breast feeding support via ante natal discussions on infant feeding, telephone triage and one to one contact at breastfeeding groups in each local community or via home visits. Our breastfeeding peer support training is provided in local communities to improve community capacity.

We have in place a free breast pump loan scheme, with premature, ill babies and mothers given priority. We continue to work closely with Barnsley Hospital’s maternity and neonatal unit.

We provide support for mothers with multiples and breastfeeding management challenges.

Our Breastfeeding Welcome Here Scheme is in place to ensure all families should be able to breastfeed their babies in public places without fear of harassment or discrimination. The Equality Act 2010 has specifically clarified that it is unlawful for a business to discriminate against a woman because she is breastfeeding a child.

We have a communications and digital offer with websites with links to family centres, maternity websites and a Facebook page. This supports wider initiatives and opportunities such as use of family centres, Having a Baby Programme, Stop Smoking Service, libraries and food banks.

We promote local, national and world-wide events such as breastfeeding weeks and other initiatives.

Healthy Start

Healthy Start is a government welfare food scheme. Healthy Start supports young and low income pregnant women and families with children under the age of four years in the UK by providing monetary vouchers, vitamins, nutritional and breastfeeding information.

We provide a free, two months, supply of vitamins for all pregnant women at their first appointment, for infants who are breastfed and when infants reach eight to twelve months of age.

Pregnant women who are not-eligible for the Healthy Start scheme can be purchase vitamins at a reduced rate from the family centres.

Opportunities for improvement or future development

Antenatal workshops

A joint antenatal workshop between maternity services and the Infant Feeding Service is taking place as a pilot. The aim is to support mothers to get breastfeeding off to a good start by providing information on breastfeeding at the antenatal stage for pregnant women and their partners.

Specialist services

We are keen to develop and improve services for breastfeeding mothers with more specialist challenges.

Return to work and study

We are working to provide improved support to employers to implement policies, practices and environments that support mothers to breastfeed during study and work.

Volunteers

We are eager to support and improve the uptake of infant feeding volunteers across the borough.

Incentives schemes

We are considering the opportunities which an incentive scheme may bring in an effort to improve breastfeeding rates. This is based on the outcomes of The Nourishing Start for Health (NOSH) study which showed an increase in breastfeeding in the areas where it was offered.

Resources needed for future development

Funding opportunities need to be sought to deliver our suggestions for future improvements and developments.

Resources and supporting documents



Physical activity

Why this is important

Physical activity includes any form of movement which raises the heart rate and has a positive impact on mental and physical wellbeing. It can include daily living tasks such as house work and gardening, transport such as cycling, walking and scooting, as well as more organised activities such as using the gym, park run or playing team sport.

The benefits of being physically active are well established. Regular participation in physical activity can reduce the risk of many chronic conditions including coronary heart disease (CHD), type 2 diabetes, cancer, stroke, obesity, mental health illness and musculoskeletal conditions. Physical activity helps by strengthen the heart, lungs and bones, improving our mood and reducing anxiety.

Being active can have a hugely positive impact on individual’s health. Deprived communities generally have a lower life expectancy and a lower healthy life expectancy. By increasing physical activity levels, we can reduce these health inequalities enabling more people to enjoy good health for longer. Importantly physical activity improves our quality of life through immediate and long term benefits.

The Barnsley picture and how we compare

Physically active:

  • Latest data (2018/19) indicates that almost two-thirds (64.3%) of Barnsley adults are physically active (doing at least 150 minutes physical activity per week). This is similar to the England rate of 67.2%.

  • Out of 16 similar local authorities, Barnsley’s rate is the joint seventh highest.

  • The 2018/19 rate is the highest since 2015/16, when it was 59.7%.

  • In 2018/19, 46.1% of Barnsley children and young people (aged 5-16) were physically active (undertaking an average of at least 60 minutes of physical activity per day). This is an increase from the 2017/18 rate of 36.9%.

  • Out of 16 local authorities, Barnsley’s rate is the sixth highest.

Physically inactive:

  • Latest data (2018/19) indicates that less than a quarter (24.2%) of Barnsley adults are physically inactive (doing less than 30 minutes physical activity per week). This is similar to the national rate of 21.4%.
  • Out of 16 similar local authorities, Barnsley’s rate is the fifth lowest.
  • The 2018/19 rate is the lowest since 2015/16.

Walking

  • The proportion of adults in Barnsley that walk (continuously for over 10 minutes) at least five times a week (29.6%) is lower than regional and national rates of 31.0% and 32.4%. However, the 2017/18 rate of 29.6% is higher than the 2015/16 rate of 26.8%.
  • One out of five adults (20.5%) in Barnsley walks for leisure at least five times a week; higher than the regional and national rates of 16.1% and 15.9%, and an increase from the 2015/16 rate of 15.5%.
  •  A third of adults (33.5%) in Barnsley walk for travel at least once a week; lower than the regional and national rates of 39.2% and 42.2%. However, the rate is higher than it was in 2016/17 (28.1%).

Cycling

  • The proportion of adults in Barnsley that cycle (for any duration) at least once a week (8.1%) is lower than regional and national rates of 10.1% and 11.5%. However, the 2017/18 rate of 8.1% is significantly higher than the 2015/16 rate of 4.0%.
  • 7.0% of adults in Barnsley cycle for leisure at least once a week, similar to the regional and national rates of 7.2% and 7.7%, and an increase from the 2015/16 rate of 3.7%.
  • 2.2% of adults in Barnsley cycle for travel at least once a week; lower than the regional and national rates of 4.6% and 6.1%. However, the rate is higher than it was in 2015/16 (1.9%).

What we're doing and the assets or services we have

Active in Barnsley – Physical Activity Strategic Plan (2018 to 2021)

The Physical Activity Strategic Plan sets out the priorities for getting Barnsley more physically active and will inform the Public Health Strategy 2018-21. Ensuring that all Barnsley residents have the opportunity to benefit from being more physically active. To achieve the vision of a

“healthy and proud Barnsley where active living is part of everyday life for everyone”

we have identified 5 priorities:

  • Active Schools and Colleges
  • Active Workplaces
  • Active Spaces
  • Active Communities
  • Professional and Volunteer Networks

To experience the many benefits of a physically active population, the Active in Barnsley partnership recognise the need to work collaboratively to create a borough that is designed around healthy, happy and active living for all.

An implementation plan and a communications plan will be created by August 2019 that will drive the work of the Active in Barnsley partnership forward.

Active Travel Strategy (2019 to 2024)

The Barnsley Active Travel Strategy is designed to build upon Barnsley Metropolitan Borough Council’s (BMBC) vision of promoting walking and cycling and encouraging active travel in Barnsley. The vision for active travel is set out in the Barnsley Active Travel Strategy and includes the following:

“Creating a borough where active travel is a preferred choice, supported by a connected network of high quality, safe and inviting cycle routes and footpaths for all people to use”

Delivering this vision will lead to more people walking and cycling and contribute to the following outcomes:

  • Improved health and reduced health inequalities by introducing active travel into everyday life;
  • Increased economic growth and productivity leading to higher living standards;
  • Reduced congestion on the highway network by providing better travel choices;
  • Improved Air Quality;
  • Safer Active Travel Routes.

These outcomes will be realised by delivering the following actions:

  • Integrate active travel into the planning process
    The Barnsley Active Travel Strategy will ensure active travel is prioritised in future planning processes. In addition, it will encourage active travel to be better integrated with other types of transport, e.g. walking to the bus stop or cycling to the train station.

  • Provide and maintain active travel routes
    Barnsley needs purpose fit active travel routes that people want to use. Barnsley’s existing walking and cycling routes have been developed over time as resources have allowed. They are not always continuous or direct, and may not serve important areas of interest, which means that some people who would like to actively travel are unable to do so. It is important that these routes are well maintained and designed to be as inclusive as possible.

  • Support active travel in the community
    There is a need to encourage and promote active travel in our community. People need the skills, confidence, correct information and most importantly the motivation to make active travel a preferred choice. Initiatives to support this change include pedestrian and cycle training, road safety campaigns, projects to encourage active travel to schools and employment and promotion and advertisement of available routes.

    An implementation plan will be created by August 2019.

  • GP exercise referral scheme
    This is delivered by Barnsley Premier Leisure (BPL) and is defined as the Health Referral Scheme where GPs can refer or patients can self-refer if they fit the eligibility criteria. This is one of the elements of a wider offer to support increased physical activity and weight management. This service has been developed by BPL to complement and add value to their physical activity offer. There is a small charge for the service to make it more sustainable.

Commissioned services supporting target groups

Wellbeing Service

The Barnsley Wellbeing Service has two strands;

  • BPL wellbeing support programme
  • Area Wellbeing Grants
Wellbeing Support Programme

Barnsley Premier Leisure (BPL) will deliver one element of the new Wellbeing Service that offers specialist support to people (one to one or group) who are motivated to change their lifestyle by becoming more active, connected, learning, giving and taking notice (Five Ways to Wellbeing Framework).

The service is GP referral only and offers will provide an eight to 12 weeks Wellbeing Support Programme to address mental wellbeing, physical activity and diet/nutrition. This offers an extension to the existing health referral programme to include diet and weight management support for people who require additional help to make sustainable lifestyle change. It is also important to ensure that this support is aligned with existing local provision/groups working closely within local area teams/ward alliances to ensure integration and sustainability within the community to ensure people are empowered and enable to help themselves in future.

Wellbeing Grants

Area Teams have also been allocated wellbeing grants to offer/extend/add value to community-based services/groups/initiatives, targeting those who cannot or do not engage with services to improve their mental and physical health and wellbeing. These funds have been allocated based on Index of Multiple Deprivation (IMD) and the number of Lower Super Output Areas (LSOAs) in each locality to ensure funding was fairly distributed to the most disadvantage areas. The grants support the outcomes of the Five Ways to Wellbeing; Be Active, Connect, Give, Take notice, Keep learning.

To date, most of the grants have now been allocated – with some area teams offering a second round. A range of the grants have been offered to support physical activity, but the themes are broad ranging.

Live Well Barnsley, area councils and physical activity

Live Well Barnsley is a directory of services for the whole of Barnsley, offering an overview of activities, groups, one-off events, services and peer support across a range of different issues and areas. The website was contracted out, but has now been brought in-house to BMBC and is in the process of being re-built to enable easier navigation and regular maintenance to ensure the content is up to date.

This does encompass some of the information and services commissioned by Area Councils, and creates opportunities for other commissioned services to signpost customers to local services and support available in their area.

Commissioned Activation Programmes

Working with local partners and with Sport England, Barnsley is currently delivering two targeted projects:

  • Active Dearne
    This is funded through the Tackling Inactivity Economic Disadvantage (TIED) fund and is an exciting programme to support adults and families on low working incomes across the Dearne Valley to become more active. For Barnsley this is specifically the Goldthorpe and Thurnscoe communities in the first year (2019) with the addition of Bolton Upon Dearne in the second year (2020).
  • Families Fund
    This is funded by the Sport England Families Fund over three years (2019-2021) and provides physical activities opportunities to families who have been identified as requiring support. The programme is delivered by Barnsley Council’s 0-19 team and is gradually being rolled out across all family centres in the borough.

NHS Get Fit First Programme

The NHS Health and Wellbeing programme aims to make sure that people are in the best possible health, and are able to recover better, following a routine, non-urgent operation.

This is for people who have a body mass index (BMI) of 30 or over or who are a smoker. People on the programme will be encouraged to attend a weight management service or a stop smoking service. Support is provided to lose weight or quit smoking, to improve health, reduce risks and to become healthy before and stay healthy after their operation.

Places to play, enjoy and be active

Barnsley is working hard to ensure that our parks, open spaces, playing facilities, leisure centres, golf courses and off road cycling and walking network is promoted and maintained to a level that encourages people to utilise these spaces for formal, informal and recreational use. These include:

  • Parks
  • Playgrounds
  • Golf Courses
  • Leisure Centres operated Barnsley Premier Leisure
  • Trans Pennine Trail & National Cycling Network
  • Country Parks

Opportunities for improvement or future development

We will be building on whole system planning for implementing our Active in Barnsley partnership to enable local people to move more. This will involve working with a wider range of stakeholders including planners and developers, public transport operators, health care organisations, the leisure industry, community and voluntary sector and residents.

We want to further engage businesses and organisations to improve opportunities for staff wellbeing, particularly to moving more and travelling more actively.

We will be working with local healthcare organisations to ensure physical activity is consistently included within primary and secondary care consultations and patient pathways.

Resources and supporting documents



School readiness

Why this is important

School readiness starts at birth with the support of parents and caregivers, when young children acquire the social and emotional skills, knowledge and attitudes necessary for success in school and life.

Ages 4 to 5

Between the ages of four and five, children should:

  • Be prepared to be separated from their parent or main carer.
  • Be able to clearly demonstrate their ability to listen and follow age appropriate instructions.
  • Show an interest in a variety of subjects, paying attention to the subject or activity they are taking part in.
  • Have a range of vocabulary and language to be able to express their needs, feelings, thoughts or ideas.
  • Be able to identify themselves by name, age, and state factors in their life e.g., name family members.
  • Be able to interact in an age appropriate way with another child or adult.
  • Be able to interact, share and play, taking responsibility for their actions and understanding repercussions for their actions.
  • Be able to focus on and also show interest in the work they are undertaking.
  • Be able to observe, notice, discuss and ask questions about their environment and experiences.
  • Be able to engage with books and have some understanding of words and language.
  • Respond to boundary setting.
  • Be able to vocalise their needs such as toileting, thirst, hunger, illness etc.
  • Be able to engage in age appropriate fine motor skills and the ability to care for themselves in dressing, toileting and eating and drinking.

Age 5

School readiness at age five is important because it has a strong impact on future educational attainment and life chances. Children who don’t achieve a good level of development aged five years struggle with social skills, reading, maths and physical skills, which impacts on outcomes and in childhood and later life including: educational outcomes, crime and health. Children from poorer backgrounds are more at risk of poorer development and the evidence shows that differences by social background emerge early in life.

The return on investment is greater than many other economic development options:

  • For every £1 spent on early years education, £7 has to be spent to have the same impact in adolescence.
  • The benefits associated with the introduction of the literacy hour in the UK outstrip the costs by a ratio of between 27:1 and 70:1.
  • Targeted parenting programmes to prevent conduct disorders pay back £8 over six years for every £1 invested with savings to the NHS, education and criminal justice system.

The School Readiness outcome indicator is defined as “children who have reached a good level of development at the end of the Early Years Foundation Stage (EYFS) as a percentage of all eligible children in Barnsley.

Children are defined as having reached a good level of development if they achieve at least the expected level in the early learning goals in the prime areas of learning (personal, social and emotional development; physical development; and communication and language) and the early learning goals in the specific areas of mathematics and literacy.”

The Barnsley picture and how we compare

  • In 2017/18, 70% of five year olds in Barnsley achieved a good level of development at the end of Reception; similar to the England rate of 71.5%.

  • When compared to similar local authorities, Barnsley’s rate was ranked 6th out of 11 (where 1 is the best).

  • Rates have been increasing over recent years, and the 2017/18 rate is significantly higher than it was in 2012/13.

  • 4% of children had the Ages and Stages Questionnaire (ASQ-3) completed as part of their 2-2 ½ integrated review (2017/18).

Data from:

PHE Child and Maternal Health Profile

What we're doing and the assets or services we have

0-19 Team

The 0-19 Public Health Nursing Service delivers the Healthy Child Programme across Barnsley and getting ready for school is one of the six high impact areas of the programme. The service is mandated to provide five health reviews – antenatal health promoting visit, new baby visit, 6-8 week assessment, 9-12 month review and 2-2 ½ review which is undertaken jointly with early years settings personnel.

For children who are in a childcare setting, termly contact with the child’s key worker assesses school readiness. For children who are not in a childcare setting, a targeted assessment is undertaken in line with the service’s school readiness care pathway. Where a need is identified, children are put on the relevant care pathway, such as, toileting, behaviour, development delay.

Family Centres

Educational programmes and projects

Family Centres deliver the antenatal education programme called having a baby. The programme was developed as a multi-agency approach in partnership with Barnsley family centres and health professionals to support families to adapt to parenthood. This is delivered by staff from children’s centres, midwives, the infant feeding team and health visitors, the Having a Baby programme helps make significant improvements to people’s lives, giving Barnsley babies the best possible start in life and supporting parents with practical information and advice.

The Dearne Family Centres have recently launched a project called Little Talkers, targeting children aged 12-18 months for phase 1 of the initiative. Staff will work with parents in the home to support speech and language by delivering activities and reading stories to support parents’ understanding of different ways to engage with their child it the home. Resource packs will also be used with the family. Staff re-visit the family after six months to see if progress has been made and if the intervention has made a difference.

Toddler groups

The Family Centres also run baby and toddler groups to support parents with activities and share the benefits of play and interaction. The groups have a planned learning intention which have primary focuses on Personal Social and Emotional Development (PSED) and Communication to support parents to learn the benefits of play and interaction with their child. 

Day care

A number of the Family Centres have day-care on site with fully qualified staff who work with children to prepare them for school. A plan is put in place for individual children’s needs with regards to starting school and stages of development. Staff regularly meet with parents and provide them with additional activities and next steps so they can be supported to get their children ready for school at home.

Nurseries

Nurseries also include activities that aim to get children ready for school including

  • Role play areas with school uniform; pictures and logos of the schools children will be attending.
  • Reflective and going home books for parents to take home.
  • Pictures of the classrooms children will be moving into to support familiarisation.
  • Letters and sounds group times, story time and numeracy activities.
  • Talking to the children about school routines.
  • Mark making activities and looking at letters in the child’s name, fine motor activities getting fingers ready for writing for example: Dough Disco and Finger Gym.
  • Literacy rich environments, reading areas and music sessions.
  • Activities to support self-care skills for example putting their own coat on, toileting, handwashing, being independent at snack time, putting shoes on and taking them off.

Family Centres also liaise with schools/other professionals and invite teachers into the settings to observe children, with extended visits if required for children with Special Educational Needs (SEN) with a key person at the new school. Transition reports are also compiled for children. These are detailed developmental records which show where each child is in the prime and specific areas of learning.

Parenting sessions

Family Centres Outreach deliver parenting sessions on toileting to the wider community. Potty Parties are held once a term to support children to be independent in toileting by providing information for parents as well as resources such as a potty, stickers and sticker charts. This support is also delivered in Private, Voluntary and Independent (PVI) settings where requested. A number of Family Centres also support parents by offering dummy exchanges to help children to lose their dummies to promote speech and language and develop confidence and self-esteem.

Family Centres also host and deliver a number of different parenting programmes including; Sleep Success from two years old, Solihull from pre-birth upwards and Webster Stratton from three years upwards.

Early help interventions

Early Help interventions are delivered where Family Centre workers can complete home visits and signpost parents to groups and additional services. Family Support Workers can provide more intensive support with a group of professionals around them. This can involve work around boundaries and routines which in turn can help parents to prepare their child for school.

Opportunities for improvement or future development

  • Strengthen the integrated review at two to two and a half years of age to include health, parent and early years setting.
  • Potential to develop a School Readiness strategy.
  • Develop more robust structures to support transitions to include all relevant professionals.
  • Develop better information sharing, if consent given e.g., safeguarding information, any Early Help in place.
  • Provide more support to PVI childcare provisions regarding skill and knowledge when assessing children’s developmental stages / transitions.
  • Potential to work with primary care to ensure that children who aren’t in a setting are identified as ready for school.
  • More work with schools to prioritise transitions with feeder settings, especially for children with SEN.
  • Potential for a summer campaign over the six week holidays, for example: School Readiness Roadshow across communities to reach all children in the borough.
  • Develop more ‘school readiness’ information for parents and other professionals i.e., what school readiness means and what their child should be able to do by the time they attend school.

Resources and supporting documents



Sleep

Why this is important

Sleep is an essential component of health and its timing, duration and quality are critical determinants of health. Sleep may play an important role in metabolic regulation, emotion regulation, performance, memory consolidation, brain recuperation processes, and learning. Due to the importance of these functions, sleep should be viewed as being as critical to health as diet and physical activity.

Insufficient sleep has major health consequences in adults, adolescents, and young children. Strong evidence exists that among adults insufficient sleep has a significant effect on numerous health conditions, including chronic disease development and incidence. Evidence also shows that children who experience short sleep duration are more likely to become obese than those who do not.

Insufficient sleep, unlike other health risk factors such as smoking, excessive alcohol consumption, obesity, and physical inactivity, has historically received much less attention in the public health and clinical settings. Insufficient sleep is an important public health risk factor that would benefit from further investigation.

The Royal Society for Public Health (RSPH) has warned that the UK public is under-sleeping by an average of almost an hour every night, which amounts to losing an entire night’s sleep over the course of a week.

RSPH polling has also shown that the public feel getting enough sleep is the second most important activity for optimising their health and wellbeing, ahead of health behaviours such as eating five fruit and vegetables a day, undertaking enough physical activity, and sticking to recommended alcohol guidelines. Indeed, sleep was ranked second only behind not smoking.

Insufficient sleep is costly for employers and society; not only does it lead to higher levels of absenteeism, but also increases presenteeism. A recent RAND Europe report investigated the link between insufficient sleep and workplace productivity, quantifying the economic costs. Insufficient sleep was found to cost the UK economy approximately £38 billion per year.

What we're doing and the assets or services we have

One of the key themes highlighted in the last Director of Public Health Annual Report, ‘A Day in the Life Of’, was sleep. This was due to the significant number of Barnsley residents revealing their feelings of tiredness during the day and how lack of sleep was affecting their day to day lives. As a result of this response, the report made a number of recommendations to raise the awareness of the importance of sleep.

Similarly, a recent Workplace Health Needs Assessment (2018) for businesses in Barnsley included a number of questions for employees in relation to sleep. The findings suggest a high proportion of employees who completed the workplace health survey have problems associated with their sleep and would like information or help to access sleep promotion activities at work.

With regard to guidance and support networks available in Barnsley, the focus is predominantly on young children and parents. Many parents can seek advice from health care professionals about sleeping and safety, particularly if they have concerns. Health visitors, midwives and general practice nurses are well placed to provide advice. The healthy child programme includes sleep guidance as part of the ‘pregnancy and first five years of life’. Discussions with parents about safe sleeping are part of maternity care, both antenatal and post-natal, as is support offered by health visitors. South West Yorkshire Partnership (Mental Health Access Team) offer a sleep workshop for adults experiencing issues with sleep.

Children with ongoing sleep difficulties would get referred to Sheffield’s Children Hospital as Barnsley does not commission a sleep service.

In order to improve better health in Barnsley, a more proactive approach is required to promote good sleep hygiene and minimise the impact of sleep loss for Barnsley residents. The multi-dimensional nature of sleep and the wide-reaching implications it has would require addressing all of these issues across a number of organisations.

However, there are measures that the council’s Public Health Service has taken to have an impact at a population level. The main focus of this has been to raise awareness among the general public, local businesses or organisations and managers and Barnsley Council staff.

In order to raise awareness among the general public, the first round of social media campaigns started in October 2018, predominantly featuring in the week leading up the change from British Summer Time to Greenwich Mean Time.

The messages during this campaign included:

  • introducing a ‘slumber number’ as guideline hours of sleep each day, to provide guidance for the public on roughly how much sleep they should be aiming to have
  • Sleep hygiene infographics (social media), to share sleep hygiene habits and practices, which describe the ideal conditions for a good quality sleep eg avoiding caffeine or eating a heavy meal at night etc.

Sleep hygiene messages used in the October campaign have been used in addition to other related messages on national sleep days throughout 2019:

• World Sleep Day (15 March 2019)
• Stop Snoring Week (22 to 26 April 2019)
• National Sleep Awareness Week (10 to 16 March 2019)
• National Sleep-In Day (30 October 2018)
• Clock change days (March and October 2019)

The general public, local businesses, organisations, managers and employees have been supported by providing them with a Barnsley Sleep Toolkit. Barnsley Council Public Health has produced a ‘Sleep and Recovery Toolkit’, which offers insight and advice on sleep loss. This tool kit has been adapted from a Public Health England document and shortened to make an easy read and follow document. The toolkit provides practical information and guidance on how businesses and managers can create an environment where employees understand the importance of sleep and recovery. The toolkit also gives valuable advice and sleep hygiene tips to employees and the general public and assists them to make healthier choices at work and at home.

Opportunities for improvement or future development

To work in educational settings promoting a local public health sleep campaign

Schools and colleges can have a positive impact by giving key messages on sleep hygiene and supporting students who may have issues. This would be in the institutions interest from a health and educational perspective.

Sleep to be covered in secondary school curriculum

Sleep education is included as part of personal health social and economic education within the curriculum to provide adolescents with knowledge as to the importance of sleep for health and wellbeing. To ensure schools have access to resources and lesson plans based on the available evidence.

Sleep hygiene in colleges

There is currently lack of understanding of how poor sleep is affecting students’ health, engagement and attainment in colleges. It is recommended that we work with Barnsley’s colleges to understand if this is an issue, and if so, work collaboratively on evidence based sleep hygiene interventions.

Resources and supporting documents



Smoking

Why this is important

Smoking prevalence in Barnsley is reducing, but at 17.4% Barnsley still has one of the highest rates in the country.

Half of all smokers will die as a result of their addiction. It is the leading cause of preventable disease and death in England and has been identified as the single biggest cause of inequality in death rates between deprived and affluent areas. Smoking causes and exacerbates long term health conditions. Smoking is the biggest cause of cancer in the UK, being linked to 16 different types of cancer and is responsible for 7 out of 10 cases of lung cancer.

Not only is there a substantial health impact to the population, smoking costs the economy and health system significantly. In Barnsley alone, it is estimated that smoking cost the local economy a total of £63.5 million in 2018, which includes costs such as those associated with lost productivity, social care and smoking related house fires. Smoking costs the NHS in Barnsley approximately £11.7 million each year (ASH 2018).

Our vision is to create a smoke-free generation in Barnsley where smoking prevalence is less than 5% and children and young people can grow up in a place free from tobacco, where smoking is unusual.

The Barnsley picture and how we compare

  • Around 1 in 5 adults in Barnsley are smokers (17.4%), according to the national annual population survey (2018). This is significantly higher than the England rate of 14.4%.
  • Out of 16 comparator authorities, Barnsley has the fifth highest rate.
  • Smoking prevalence in Barnsley has fallen in recent years (from 24.4% in 2012).
  • Approximately 19% of deaths (in those aged 35 and over) in Barnsley are due to smoking.
  • In 2017/18, there were almost 4,000 hospital admissions of Barnsley residents for diseases that were totally or partly due to smoking.
  • There are large variations in smoking prevalence, with rates in Barnsley GP practices ranging from 9.1% in Penistone to 35.1% in Central Barnsley (2017/18 QOF data PHE National General Practice Profiles).
  • Smoking prevalence varies between different occupational groups. In Barnsley, in 2017, 14.5% of residents in managerial and professional occupations were smokers, compared with 27.5% in routine and manual occupations.
  • The proportion of smokers in Barnsley who successfully quit at 4 weeks (CO validated) (2,301 per 100,000 smokers aged 16+) is significantly better than the national rate of 1,305 per 100,000. Barnsley’s rate of 2,301 represents 799 smokers who successfully quit at 4 weeks in 2018/19.
  • 16.0% of mothers in Barnsley smoke during pregnancy; significantly higher than the national rate of 10.6%, although there has been a downward trend since 2013/14 when the rate was 23.0%.

What we're doing and the assets or services we have

Stop smoking service

A local free stop smoking service is available to all smokers who live or work in Barnsley at a variety of locations across the borough. The service provides a range of free nicotine replacement therapy and expert behavioural support, either face to face, over the phone or online.

Smoking in pregnancy

All pregnant smokers in Barnsley are seen by a trained Stop Smoking Specialist Midwife and given one to one support to help them quit in order to protect both mother and baby. This service is delivered by the maternity team at Barnsley Hospital making smoking support a routine part of antenatal care.

Make smoking invisible

A range of voluntary smoke free areas have been successfully rolled out across the borough, primarily to help make smoking invisible to children and young people in order to reduce the number of them taking up the habit. So far in our journey to make smoking invisible, after public consultation, we have implemented smoke free play parks, smoke free town centre zones (PALs Square) smoke free markets and smoke free primary schools. Next stages in the programme, dependent on public consultation may include smoke free high streets (starting with Hoyland), smoke free town centre, Glassworks and Library @ the Lightbox, smoke free secondary schools and smoke free Barnsley College.

Tobacco Control Alliance

Barnsley’s Tobacco Control Alliance contributes to the improvement of the health, environmental and economic status of people living and working in the borough through coordinated, effective and sustained action against tobacco by organisations and individuals working in partnership. The Tobacco Control Alliance is well attended by key partners from across the borough The Alliance is Chaired by the Deputy Leader of the Council.

QUIT programme at Barnsley Hospital

QUIT is a supportive programme to help patients, staff and visitors to quit smoking. Patients who smoke will be identified, offered brief advice, nicotine replacement therapy and referred to the on-site stop smoking service. Barnsley Hospital is a fully smoke free site.

Tobacco enforcement

Barnsley Council has a full time officer dedicated to tobacco enforcement. The role includes ensuring shops are adhering to all the tobacco laws and smoke free legislation such as plain packaging, keeping cigarettes behind shutters, underage sales and also investigating illegal tobacco sales, including both illicit and counterfeit.

Opportunities for improvement or future development

  • Expansion of make smoking invisible into other areas, dependent on public consultation, in order to help reduce the uptake of smoking.
  • Focused work with colleges and secondary schools in Barnsley to support young people to quit smoking and help prevent the uptake of smoking in the first place.
  • Working with the stop smoking service to provide innovative and creative ways to reach those most at risk and hardest to reach, ensuring an equitable service which, targets those most in need.

We have achieved significant improvements in our smoking prevalence rates in recent years and we must continue to keep this momentum going by driving forward this agenda and keeping it a priority area for the health and social care system.

Resources and supporting documents



Under-18 conceptions

Why this is important

Barnsley is an area where teenage pregnancy has declined less rapidly than elsewhere. In 2019, Barnsley remains one of the areas with the highest rates for females under the age of 18 conceiving in the country, the highest area in the South Yorkshire region, and of statistical neighbours the third highest area.

Crucially, there are large inequalities within Barnsley with rates varying enormously between certain wards of the borough. Teenage pregnancy is a cause and consequence of educational, health and social inequality for young people and their children.

Young people who become pregnant are significantly more likely to have:

  • faced more challenges and experienced deprivation
  • had care experience
  • be from a family with history of teenage pregnancy
  • been out of education, employment and training
  • experience of living with a learning disability
  • lower employment rates by the age of 30
  • life long experience of poverty

It is important to acknowledge that not all young families experience significant adversity or poor health and educational outcomes and young people can be fantastic parents. Some families require nothing more than universal service input, however others may need additional support to reach their full potential.

There is a graded relationship between teenage pregnancy and adverse childhood experiences with the more adverse childhood experiences (ACE) a child has experienced, the more likely they are to become teenage parents.

Babies born to teenage parents are more likely to be:

  • still born
  • suffer infant mortality
  • of a low birth weight
  • not breastfed
  • living in poverty

Young families are more likely to experience:

  • emotional health and wellbeing issues (including post-natal depression)
  • smoking throughout pregnancy and after pregnancy
  • substance misuse
  • repeat pregnancies
  • domestic abuse
  • a child death or injury that leads to a serious case review
  • children being removed

National evidence suggests that work to raise aspiration of young people, keep young people in school for as long as possible, relationships and sexual health education and access to youth friendly contraceptive and sexual health services, are effective in reducing under 18 conceptions.

The Barnsley picture and how we compare

  • Barnsley’s 2017 rate for under 18 conceptions is 29.1 per 1,000. This is significantly higher than the regional and national rates of 20.6 and 17.8 respectively.
  • Although Barnsley's 2017 rate is the highest of the four South Yorkshire authorities, when compared to statistical neighbours, it has dropped from being the highest in 2016 to the third highest.
  • The rate of 29.1 represents 109 conceptions to under 18's during 2017, a reduction from 129 in 2016, and the lowest number since 1998.
  • Barnsley’s under 18 conception rate has halved since 1998.
  • Less than half (45.0%) of under 18 conceptions in Barnsley in 2017 led to abortion; lower than the national rate of 52.0%.

Data from:

What we're doing and the assets or services we have

Barnsley’s Teenage Pregnancy Partnership is a multi-agency partnership of professionals across the borough including: public health, sexual health services, maternity services, targeted youth support, family centres, colleges and area council managers.

The group oversees the local teenage pregnancy strategy and works to an action plan that is based around national evidence and local priorities.

Particular strengths for the partnership over the past 12 months include:

  • Young people being able to access support from the teenage pregnancy midwife up until the age of 21 and continuity of care from maternity services.
  • A pathway between sexual health and maternity services that provides outreach to young people at antenatal and postnatal stage to arrange access to appropriate contraception and sexual health screening.
  • Every secondary school in Barnsley engaging in the public health commissioned offer of relationships and sex education.
  • A large number of pharmacies in the borough now offer free emergency contraception to young people under the age of 25.

Opportunities for improvement or future development

The focus of the teenage pregnancy partnership has now been widened to include not only prevention but support for young people who do become parents. This work is still in its infancy however a particular focus will involve:

  • an extended offer for young families from the 0-19 Public Health Nursing Service.
  • promoting links between maternity and early help services to break down barriers young people may have to accessing support.
  • a piece of consultation work involving young families.
  • linking in with regional colleagues to set a local agenda for teenage pregnancy.

It is acknowledged that teenage pregnancy is a complex issue that does not have a silver bullet, however it is hoped that work taking place in the borough now will benefit children and young people in the future.

Resources and supporting documents



Unintentional and deliberate injuries in children (aged 0 to 4)

Why this is important

Unintentional injuries for the under-fives tend to happen in and around the home. They are linked to a number of factors including:

  • child development
  • the physical environment in the home
  • the knowledge and behaviour of parents and other carers (including literacy)
  • overcrowding or homelessness
  • the availability of safety equipment
  • new consumer products in the home

The majority of unintentional injuries are preventable. Reducing injuries has clear benefits for children and their families. Childhood injuries, especially severe injuries, can have long-term health, educational, social and occupational consequences. These include physical disability, long-lasting psychological impact, cognitive or social impairment, lower educational achievement and poorer employment prospects. The personal costs of an injury can be devastating. For example, a toddler’s severe bathwater scald may require years of painful skin grafts and disfigurement and a fall at home can result in permanent brain damage. In addition, injuries also have a negative effect on the psychological health and wellbeing of those caring for children.

While the cost of a severe injury in childhood such as a severe head injury or bath water scald can be considerable, because less severe injuries occur much more frequently, these also incur substantial costs for a local health economy. Recent research shows that the average NHS short-term cost of a hospital admission of 2 days or more for a burn, poisoning or fall in the under-fives (the three most common causes of hospital admissions in this age group) ranges from £2,500 to £3,000, the NHS cost of an admission for a day or less from £700 to £1,000 and for an emergency department attendance without admission from £100 to £180.These do not include costs for NHS or social care for longer term follow-up of more severely injured children, and will therefore underestimate the true costs of these injuries.

Parents also face substantial costs when their children are injured: the short term cost to parents (such as childcare and travel) for children admitted for 2 or more days ranges from £100 to £400; for those admitted for a day or less from £40 to £200 and for those attending emergency departments without admission from £20 to £70.

Unintentional injuries disproportionately affect children living in socioeconomic disadvantage and deaths from injuries in childhood have the steepest social gradient of any cause of death in childhood. Reducing inequalities in child injury should therefore be a priority, in addition to reducing injury rates overall.

Resource

Reducing unintentional injuries in and around the home among children under five years

The Barnsley picture and how we compare

  • Barnsley’s 2018/19 rate of 98.4 per 10,000 for hospital admissions caused by unintentional and deliberate injuries in children (aged 0-4 years) is significantly better than the national rate of 123.1 per 10,000.
  • Out of 16 comparator authorities, Barnsley’s rate is the fourth lowest.
  • Admission rates have fallen in recent years (from 143.3 in 2010/11).

Data from:

Figure 1: The main causes of emergency hospital admissions for under-fives following unintentional injuries in and around the home in 2014/15-2016/17 (rate per 100,000 resident population of children aged 0 to 4 years)

The main causes of emergency hospital admissions for under-fives following unintentional injuries in and around the home in 2014/15-2016/17 (rate per 100,000 resident population of children aged 0 to 4 years)

Source: Hospital Episode Statistics, NHS Digital

What we're doing and the assets or services we have

Effective local action to reduce unintentional injuries in children requires health visitors, school nurses, local authority children’s services such as early help teams, early years settings and voluntary organisations to work together to lead and support local delivery of accident prevention interventions.

Resources from the Child Accident Prevention Trust are displayed in Family Centres and leaflets can be provided to families where they are needed.

CAPT resources are also used during Child Safety Week to deliver local activities and events and promote safety messages in a fun and engaging way. Social media campaigns are also run during Child Safety Week and throughout the year from Family Centre Area pages and Family Services Directory Facebook pages.

The antenatal “Having a Baby” programme delivered jointly by Family Centre staff, midwives and health visitors covers child safety as does the parenting programme “Now I am Here” for parents of young children.

The Parent Held Record (Red Book) given to all mothers of all new babies contains accident and safety advice regarding accidental poisoning, burns and scalds, drowning, suffocation and falls.

The Public Health Nursing Service (PHNS) (0-19) provides a universal service to all families and developmentally specific safety advice is incorporated into universal child health contacts through the Health Visitors and is detailed in the Standard of Practice. The PHNS deliver the 4-5-6 model, whereby The Early Years High Impact Area 5 sets out the key contribution of health visitors to manage minor illness and reduce accidents to improve outcomes for all children.

All A&E notifications are now received electronically onto Systmone and are screened by PHNS staff. Where attendance is for accidental injuries (and where appropriate) this is followed up by the service.

Multi agency training is available for all staff around “Don’t shake the baby” and includes information on safe sleep.

The PHNS has a strong social media presence, particularly on Facebook and both the PHNS and the Infant Feeding Team regularly post safety advice and recommendations, including, but not limited to, posts on strangulation (from head bands, dummy clips, cot bumpers etc.), car seat safety, choking hazards (from button batteries, foods), burns and scalds (from hair appliances, baths, hot drinks etc.).

Opportunities for improvement or future development

There is an opportunity to shape work locally National Institute for Health and Care Excellence (NICE) guidance PH29 and PH30 (2010), alongside PHE’s “Preventing unintentional injuries guide”, offer a framework for shaping the work locally particularly for vulnerable families.