The Oneplace website encourages joint working and flags up good provider performance. Moya Sarner reports
The Oneplace website shows how local services are performing in relation to a range of providers across the country. Assessments of provision for health, the environment, housing, crime, education, and vulnerable people, and how they work together, can all be accessed here.
Improvements include better commissioning arrangements, pooled resources and targeted spending
To improve collaboration the site not only pulls together information from all the main public service inspectorates, including the Care Quality Commission, but also evaluates how well organisations work in partnership.
Results are measured by government indicators and local priorities, and based on the comprehensive area assessment. Problems are marked by red flags; green flags highlight exceptional performance or innovation.
Care Quality Commission chief executive Cynthia Bower says: “Poor health can be the result of a number of issues often to do with poverty, inequality, the economic circumstances in which people find themselves. But in some areas local partnerships have made really excellent progress in tackling some key health problems.”
She highlighted the example of Hackney in London, which in 2005 had “some of the worst rates of infant mortality in the country”. It has been awarded a green flag for reducing this “by a very significant level”, thanks to the local strategic partnership involving local health services, the voluntary sector, and City University London (see box). Selected initiatives from the reducing infant mortality programme now have long term funding.
According to Oneplace, 83 infant deaths were recorded in 2005: significantly above the national average. There were 24 deaths in 2009, recorded in line with the rest of the country. Improvements cited include better commissioning arrangements, pooled resources and targeted spending by local partners, and effective community engagements.
Red flags have drawn attention to failures too.
“In other areas we haven’t seen such a concerted effort to tackle health inequalities”, Ms Bower said. “The worst one was in Lancashire, where people have some of the poorest health in the country. We can see a very stark example: Burnley residents are almost 50 per cent more likely than the national average to die of heart disease or stroke before the age of 75. That’s a huge issue and has a dramatic impact on individuals and families within that community.”
According to Oneplace, over the past 15 years the gap in life expectancy for men between the “healthiest” and “unhealthiest” districts increased from 3.4 years to 5.6 years.
NHS East Lancashire public health director Ellis Friedman says the primary care trust is working hard to improve the situation, along with a range of partner agencies, through its health inequalities strategy Saving a Million Years of Life.
Of Oneplace Dr Ellis says: “It is increasingly important that we work together across the different sectors to find more cost effective measures to improve quality for patients. I’m sure this sort of thing will be helpful. The general principle of making information about good performance available is beneficial. I’m sure it will be one of the things we will be looking at routinely.”
For Ms Bower, the route to improvement lies through collaboration. “We want to see better joint working in these areas, between the NHS, the local council, and a range of partners to tackle this, including factors such as unemployment, poor housing, and other stress factors that can have an impact on health,” she says.
“PCTs more than ever before have developed strategic partnerships and have been focusing on joint working, and there’s lots more evidence of pooled budgets and joint commissioning than we’ve seen before.
“What you will be able to see from Oneplace is really excellent examples of very innovative partnerships.”
Case study: Hackney
Hackney’s infant mortality programme is based on a clear vision: to increase the number of women booking their hospital care before 12 weeks of pregnancy, increasing the level of antenatal care provided, reducing the number of mothers presenting late to maternity services and putting their baby at risk, and increasing the support available to vulnerable women in community settings where they feel more comfortable.
Successful initiatives include:
- Translation support, received by more than 600 women taking part in the programme in 2008. Bilingual maternity support workers collaborated with community midwives to increase access to services. This has resulted in improved antenatal booking rates within 12 weeks of women finding they are pregnant.
- Bump buddies: in a project run by regeneration agency Shoreditch Trust, nearly 50 black and minority ethnic women have been trained and have supported more than 200 pregnant women.
- Birth buddies: at the Homerton hospital, nearly 50 birth buddies have helped more than 330 women by acting as birth partners.
Oneplace says: “This service is so popular there is a waiting list to volunteer for the scheme. Maternity services are seen as more responsive and accessible.”