Choosing Health? (white paper)

Front Cover submitted by WHIG Administrator — last modified 2005-10-04 16:29

Front cover to the "Choosing Health?" white paper.

Executive Summary submitted by WHIG Administrator — last modified 2005-10-04 16:29

Summary of the white paper.

Foreword & contents submitted by WHIG Administrator — last modified 2005-10-04 16:29

Contents of the "Choosing Health?" white paper.

Chapter 1: The time for action on health and health inequalities submitted by WHIG Administrator — last modified 2005-10-04 16:29

Health in England has improved dramatically over the last century. New challenges have emerged and need to be tackled now if progress is to be maintained. Unfair inequalities in health have persisted and remain a key challenge. Traditional methods of improving health are becoming outdated and new approaches and new action are needed to secure progress. Consultation with the public has enabled the development of a new approach to public health, based on the reality of people’s lives and the choices they make about their own health. People’s lifestyle decisions are personal ones and they do not want Government to take responsibility away from them. People do want credible information and advice on lifestyle choices that impact on health and personalised support to follow through choices that they want to make but find difficult. There is support for Government to act in areas where one person’s choice can affect another person’s health. Society has a duty to take additional steps to protect children and young people’s health.

Chapter 2: Health in the consumer society submitted by WHIG Administrator — last modified 2005-10-04 16:29

The choices people make as consumers – what we eat and drink, and how we use services and facilities – impact on health. People get information on health from many different sources including friends and family, product labelling, the media, and national campaigns. A modern strategy for health will include action to stimulate both demand for healthier options – through information that people trust – as well as increase availability of those options, so that people can make the choices they want to. Action to address inequalities in health needs to focus particularly on getting information across to people in different groups and securing better access to healthier choices for people in disadvantaged groups or areas. Where demand for healthier choices is increasing – for example following the national campaigns on 5 A DAY and on salt – industry is already responding. The Government has a role in taking the lead on issues where strong national and public concern about health indicates the need to do more. This includes coordinated action with industry to increase awareness of the benefits and supply of healthy options – in particular supporting opportunities for exercise and a healthy diet – and action to reduce demand for less healthy foods, tobacco and alcohol, particularly among children and young people.

Chapter 3: Children and young people - starting on the right path submitted by WHIG Administrator — last modified 2005-10-04 16:29

This chapter sets out action to support children and young people, as well as their parents, families, carers and staff in the public and voluntary sectors. It aims to support development of a healthy framework for life. There will be new sources of information guidance and practical support for parents, children and young people – particularly those who are disadvantaged in early years – provided in ways that are designed to meet their individual needs and be accessible to everyone. Services will be coordinated to meet needs and increasingly will be brought together in one location as part of an integrated service delivery through children’s trust arrangements. The components of good health will be a core part of children’s experience in schools through a coordinated ‘whole school’ approach to health – in lessons, sport, provision of food, personal advice and support, and travel arrangements. There will be new initiatives to promote physical activity and sport inside and outside school. We will strengthen measures to protect children and young people and help them understand and manage risk and develop responsible patterns of behaviour.

Chapter 4: Local communities leading for health submitted by WHIG Administrator — last modified 2005-10-04 16:29

The environment we live in, our social networks, our sense of security, socioeconomic circumstances, facilities and resources in our local neighbourhood can affect individual health. There are unacceptable differences in people’s experience of health between different areas and between different groups of people within the same area. Action by local authorities working with local communities, businesses and voluntary groups to tackle local health issues makes a difference to the opportunities for both adults and children to choose healthier lifestyles. This chapter sets out action to maximise the positive impact of the local community setting with measures that include: local authorities providing local leadership to bring concerted and integrated local action on health; investment and new initiatives in disadvantaged and deprived communities; and promoting partnership between the public and voluntary sectors with business to develop national and local champions for health and extend opportunities for people to take up healthy lifestyles in local communities. Smoking is a major cause of illhealth. Balancing the rights of people who choose to smoke against the interests of the majority who object to being exposed to secondhand smoke at work and in public places was one of the most controversial issues in the consultation. This is an area where campaigns and public demand for change have not done enough to achieve national targets to reduce prevalence in smoking. We therefore intend to shift the balance significantly in favour of smokefree environments. By 2006, all government departments and the NHS will (subject to limited exceptions) be smokefree. We will consult on detailed proposals for regulation with legislation where necessary so that by the end of 2008, all enclosed public places and workplaces will be smokefree except those specifically exempted.

Chapter 5: Health as a way of life submitted by WHIG Administrator — last modified 2005-10-04 16:29

The consultation made it clear that people are ambitious for their health and the health of their families, but often found it difficult to turn good intentions into sustained action. People wanted support both in making the right decisions for their own health and help to carry them out in practice. This chapter sets out new proposals to provide that support. First, anyone who wants help to make healthier choices and stick to them will have the opportunity to be supported by a new kind of personal health resource, NHS health trainers. In keeping with a shift in public health approaches from ’advice from on high to support from next door’, health trainers will be drawn from local communities, understanding the daytoday concerns and experiences of the people they are supporting on health. They will be accredited by the NHS to have skills appropriate for helping members of their community to achieve the changes that they want to make. In touch with the realities of the lives of the people they work with and with a shared stake in improving the health of the communities that they live in, health trainers will be friendly, approachable, understanding and supportive. Offering practical advice and good connections into the services and support available locally, they will become an essential commonsense resource in the community to help out on health choices. A guide for those who want help, not an instructor for those who do not, they will provide valuable support for people to make informed lifestyle choices. Different neighbourhoods will need different types of health trainers and in developing good practice we will learn from seeing which models work best for different communities and individuals. By starting in the most deprived communities we will learn how best to ensure that health trainers reach the most deprived groups. Second, everyone who wants to will have the opportunity, starting in the areas of the country with the biggest health challenges, to use a personal health kit to develop their own personal health plan, based on who they are, what they want and what their circumstances are. This tool will help people to identify their own priorities for health, the changes that they feel ready to make, to receive online guidance about what will make the most impact to their lives and receive tailored advice on how to go about making changes and sticking to them.

Chapter 6: A health-promoting NHS submitted by WHIG Administrator — last modified 2005-10-04 16:29

This chapter sets out how the NHS, as it tackles waiting for treatment successfully, will increasingly become a health improvement and prevention service, supporting individuals in the healthy informed choices that they make. It includes measures to: help local health services to plan and deliver effective action to tackle inequalities and improve health; make the most of the millions of encounters that the NHS has with people every week; ensure that all NHS staff have training and support to embed health improvement in their daytoday work with patients; address the needs of people at particular risk; and ensure that health improvement and prevention services – such as sexual health services, NHS Stop Smoking Services, obesity services and alcohol services – benefit fully from the same drive for modernisation and improvement that exists across the rest of the NHS.

Chapter 7: Work and Health submitted by WHIG Administrator — last modified 2005-10-04 16:29

For people in employment, work is a key part of life. The environment we work in influences our health choices and can be a force for improving health – both for individuals and the communities they are part of. Work offers selfesteem, companionship, structure and status as well as income. This chapter sets out the action that employers, employees, Government and others can take to extend healthy choices by: reducing barriers to work to improve health and reduce inequalities through employment; improving working conditions to reduce the causes of ill health related to work; and promoting the work environment as a source of better health. It also sets out what the NHS will do to become a model employer in supporting and promoting the health of its 1.3 million staff.

Chapter 8: Making it happen - national and local delivery submitted by WHIG Administrator — last modified 2005-10-04 16:29

This chapter sets out the key actions by which national government should be judged: regulation; resourcing delivery; joining up action; aligning planning and performance assessment; building partnerships and inviting engagement. It also summarises how action will be ensured locally, particularly through local government and the NHS. Annex B has a more detailed description of those delivery mechanisms and how they will be used. The Annex also outlines how we will get sufficient workforce capacity and capability to deliver.

Annex A: Choosing Health? consultation submitted by WHIG Administrator — last modified 2005-10-04 16:29

In preparation for this White Paper, the Department of Health (DH) launched the Choosing Health? consultation on 3 March 2004. This ran until 28 June 2004. In parallel with the Choosing Health? consultation, the DH also carried out two separate consultations on physical activity and diet through the Choosing Activity and Choosing a Better Diet consultations respectively.

Annex B: Making it happen submitted by WHIG Administrator — last modified 2005-10-04 16:29

This annex sets out how we will ensure that there is a strong system to deliver everywhere the commitments we make in this White Paper, and how can we build on the popular support for action to create irreversible momentum for change. To do this we propose actions in three broad areas: Evidence and Information; Workforce Capacity and Capability; Systems for Local Delivery