Despite being in Herefordshire, one of the most rural counties in England, the district of South Wye contains an urban area that represents the other side of life in the country.
The population stands at around 16,000. Unemployment is not high, but wages and education levels are low. In terms of health, there are long-standing statistics around mortality: the standardised mortality rate exceeds the Herefordshire average by 13 per cent, rising to 19 per cent for males. Male psychiatric admissions are twice the county average and rates of teenage pregnancy almost three times that of the county as a whole.
The high rate of psychiatric admissions reflects problems with drug use, low self-esteem and depression.
One area of South Wye falls within the 20 per cent most deprived in England, with another four areas falling within the most deprived 25 per cent. Many issues are compounded by the fact that the area, made up largely of five housing estates, is divided by two trunk roads. This makes transport difficult and locals feel they live on their estate, rather than in South Wye.
Nonetheless, local people were at the heart of the work in the South Wye healthy living community (HLC), which won the healthy communities category in the 2006 Sustainable Communities Awards.
The HLC was a community development trust whose programme of work was determined by a series of 'planning for real' events held with the people of South Wye. Its steering group consisted of two local residents from each of the five local estates, a GP and representatives from the council, local primary care trust and two local voluntary organisations, one of which is an umbrella group for all local health and social care non-statutory groups, the other a local development agency.
The HLC benefited hugely from network opportunities offered by structures set up in the South Wye regeneration partnership.
Local partners included Herefordshire county council's social care and housing and sports development divisions, an emerging children's trust and the health development and public arms of the PCT. Not-for-profit enterprises such as the Herefordshire Money Box credit union and private sector retailers and caterers, such as the canteens on a local industrial estate, also came on board.
The work took place under the banner of the South Wye Regeneration Partnership, which secured£4.3m from the government single regeneration budget in 1999. Overall£13m over seven years was earmarked for the area.
Work was split into the main areas of exercise, healthy eating, schools, information and advice and local services. Some projects were one-off initiatives, while others ran for several years and still others are ongoing. They ranged from purchasing an exercise bike for the gym in a family centre, t'ai chi lessons and hire of a local swimming pool, to providing healthy food at youth club discos and a trip to a fruit farm for a pre-school group.
Fitness for purpose
Of the 40 projects carried out, a handful can be considered particularly important.
Residents said they wanted help to get fit but that there was a lack of facilities. There was a leisure centre but many people said the gym was not for them, so instead a fitness worker started a number of classes, including walking groups, pre-school classes, buggy workouts and classes in sheltered housing. This work is ongoing. We also wanted to raise the profile of healthy eating and could combine messages with ongoing work around increasing exercise.
Some funding for the five-a-day scheme enabled us to employ a part-time food community worker to run cook-and-eat sessions and improve access to fruit and vegetables.
Other projects included the Hot Wok shows in sheltered housing schemes and at community events, on healthy cooking with a wok, and producing food for community events from an allotment tended by volunteers. These sessions are still run occasionally by volunteers.
One disappointment was an attempt to do more work in reducing the social isolation of people with mental health problems. A community survey showed that they wanted to do something about preventing mental ill health that would be run by local people and avoid labelling service users.
Many local people with mental health problems attended a day centre run by the charity Mind, and we aimed to provide something more locally.
A drop-in centre (Ch@t) was set up in a cafe in a local shopping area. We employed a support worker but after the funding for this role ceased, it proved challenging to run.
Volunteers, often vulnerable themselves, struggled to run the centre. There were issues around users of the service feeling labelled and it closed last month. We did not have the right formula for success this time but the centre ran for three years, demonstrating the need for such a service.
Although challenging, provision of a similar service is something we would like to work on and continue to provide in an adapted model in the future, as many people found sanctuary there and were helped to move on to living better lives.
In 2005, five years of HLC was celebrated with a 'Walk this Wye' day that included a fitness class, walk to the allotments, visit to Ch@t and lunch with 60 partners, the majority of them local residents.
Although funding for HLC ended in March, the health inequalities work will continue to be built on by the PCT and other local partners.
During the life of the HLC, it attracted more than£350,000 additional funding into the area and over 60 residents became involved in community work, with many accessing training and some going on to paid employment as a result. It is estimated that we worked with about 14 per cent of the population.
In future we would like to work on the fact that primary care services are scattered; there is only one GP practice in the area, with most people registered with GPs in the city. A drop-in nurse-led centre is one option, although we have already started to have health visitors hold clinics at a children's centre. We want any service to build on provision that is already present and continue to develop the good community networks that the HLC helped to develop.
Penny Harding is health improvement manager at Herefordshire PCT, winner of the healthy communities category in the Sustainable Communities Awards 2006. She was previously healthy living community co-ordinator.
The Sustainable Communities Awards 2007, run by HSJ and its sister publication Local Government Chronicle, are launched this week. The 2007 awards include a new category recognising work on identifying the worst health inequalities and interventions created through multi-agency partnerships that help those affected. For details and entry forms for the 2007 awards, visit www.sca2007.com. For details on the 2006 award winners, visit www.sca2007.com