Health Needs Assessment - Professional Issues in Health

Health Needs Assessment - Professional Issues in Health

In this essay I will be conducting a health needs assessment, to do this I will be looking at two key factors in my local community, to understand what a health need assessment is it will be easier to define this; The National Health Service of Evidence in February 2011 explained that Health needs assessment is a systematic method for reviewing the health issues facing a population, leading to agreed priorities and reduce allocation that will improve health and reduce inequalities.

My two chosen factors disturbing my area of Hayes Middlesex are Crime and Housing. The reasons for choosing these factors are as Hayes is a high crime challenged area as there are many different views, religions, and ethnicities within Hayes, and a lower amount of police and community workers within the borough of Hillingdon, and not enough housing for the amount of people that want to live here, and the results that will be shown are interesting to others as of the different statistical data compared to other areas around London. The essay is about reviewing factors of different health statistics in my local area, I will begin looking at the main data such as population the statistical genders, and the geographical features of Hayes Middlesex. After discussing any aspects of Hayes Middlesex I will begin discussing my two chosen factors for health and wellbeing in Hayes, and what the link is between the two and how these factors can affect the health and wellbeing in my community. I will then go on to discuss the role of a nurse and inter professional working within the community and how policies surround my fortitudes of health, once complete I will recap my essay in points with an explanatory conclusion, then completing my essay.

As explained I will be looking at the statistics for Hayes Middlesex, geographically Hayes Middlesex is located in the borough of Hillingdon, located in West London, in the South East of England, Hillingdon is a higher population density than the UK average of 2.4 persons per hectare, and according to the office for national statistics 2001 Hayes has a population density of 243,006 this statistical figures make up of 134,100 females and 128,400 males within the Hillingdon borough, the ethnic majority are; White British; 184,400, Black Ethnicity; 2,800, Indian Ethnicity; 25,600, Pakistani;4,900, with a total of 25,700 making up different ethnic groups, including mixed ethnicities and white British, showing that White British have greater population than ethnic groups.

There are many health services available in the Hillingdon Borough, and according to the office for national statistics there are 9,976 people out of 117,045 within the Hillingdon borough of whom works in a health service, and social work. Within the Hillingdon borough there are 142 GP Services, 138 NHS Dentists, 65 Pharmacies, 26 Opticians, and 16 Health clinics ranging from sexual health, to diabetes, childcare, pregnancy and smoking clinics (NHS Choices, November 2010). Hillingdon Hospital is the boroughs Main Hospital, and provides everything needed for general and serious health care, Hillingdon is the only acute hospital in Hillingdon and a busy Accident and Emergency, inpatients, day surgery, and outpatient clinics. The trust also provides some services at the Mount Vernon Hospital, in co-operation with both the West Hertfordshire Hospitals NHS Trust and East & North Hertfordshire NHS Trust (The Hillingdon Hospital NHS 2011), it also includes respite care and a maternity wards, including 24 hour visitation rights to family members whom is within the respite care. Within the Hillingdon borough it is said that173, 354 people are in good health, 51,767 people are in fairly good health, and 17, 885 people are in not good health, these statistics show that out of the population of the Hillingdon borough the majority of persons are in good health in comparison to the population of the Hillingdon borough who has bad ill health. (Office for National Statistics 2011).
The table on the left shows the average life expectancy at birth for males and females in the Hillingdon Borough (2007-2009) with the comparison to the life expectancy in England. This table shows that females have a higher life expectancy at birth within the Hillingdon borough of the age of 83.7 years to males, of 78.6 years giving an age separation of almost 6 years. (National Office for Statistics, Life Expectancy at Birth, Hillingdon Borough, 2007-2009). The table shows the average life expectancy for males and females in England and the Hillingdon borough it shows that males in females within the borough have an overall higher life expectancy then other males and females in the England Area, this may occur because of environmental issues occurring around parts of England in comparison to the environmental issues occurring in the Hillingdon borough. The infant mortality rate in Hillingdon is 4.5 (under the age of 1 year, 2006-2008) which is lower than the rate in England, but according to the national office for statistics the long term illnesses and other illnesses are lower within the Hillingdon borough than in England, this includes illnesses such as; Diabetes, Mental Illness, an Heart Disease.
Now the general geographical information that I have given is complete, I will now move on to my chosen factors within the Hillingdon borough. My first chosen Factor is Crime. Crime is something that effects London, and England overall, but statistics show that crime rates in Hillingdon has risen in the last 4 years, according to the Hillingdon Partners Community Strategy Policies 2009-2011, they tell us ‘While the ranking of 340 for Hillingdon, is below average nationally (as could probably have been expected), the ranking is also below the average ranking (310) for all CDRPs covered by the Greater London area. The City of London CDRP (ranked number 373) has the highest crime figures in the Greater London area. The Richmond upon Thames CDRP (ranked number 158) has the lowest crime figures in the Greater London area’. Looking at statistics for the crime rate in the Hillingdon borough, the most regular crime is violence against a person statistics showing 5, 866 people, the least occurring crime is wounding or other act endangering life showing rates of 314 people. Other common crimes in the Hillingdon borough are criminal damage including arson (3, 232), Theft from a motor vehicle (3, 001) and Burglary and Robbery (2, 321). These statistics are from the Office for National Statistics Recorded Crimes 2008-2010.

The table shown on the left are different statistical tables in London, and the Yellow surrounded area is showing the crime rates in Hillingdon the table shows although Hillingdon is not one of the highest crime areas it is in the area of 4,208-5, 643 people in Hillingdon taking part, or being a victim of crime offences between April 2009 – March 2010. The local Police are attempting to change any rising crimes and make the borough a much safer place for everyone living in the borough. The Neighbourhood Watch of the Hillingdon Borough explains; ‘Hillingdon Neighbourhood Watch (HNW) is a voluntary organisation, run by volunteers. Schemes are community-based projects run by residents, with the support and service of the police and HNW. Neighbourhood Watch schemes raise awareness of crime prevention issues and promotes looking out for your neighbours. The borough has more than 400 neighbourhood watch schemes.

The main aim of a neighbourhood watch scheme is to create a partnership between the local community, the police and the local authority. The schemes are a great way of building community relations and working together with the police to reduce crime, fear of crime and improve the quality of life in your area. They can target crime problems and take action to prevent them. In consultation with the local police they can find out from local people what crimes most concern and affect them and focus on those specific problems’.

To start looking at my second key factor; Housing I will be looking at the link between housing and how it affects health in the area. The Black Report sited specific importance on housing as a problem towards health and saw a decrease in housing a key issue for health. Having poor housing has been compared to other health issues that are similar to each other including smoking and alcohol consumption. Thinking about poor housing and who it affects, it can have a strong effect on the ill health or ‘venerable’ such as people with major disabilities, the elderly or children, and having poor housing can have a long term effect on the families and the venerable if they stay in the housing for a long period of time. Many people worry about children within a poor housing situation as it can have an effect on their growth and development, the Social Care Institute for Excellence explains; ‘Environmental housing conditions can affect the health and well-being of children. The concern is the immediate physical structure or environment rather than other elements of the accommodation, such as the neighbourhood or the appropriateness of the housing for disabled children. Therefore, although it is acknowledged that temporary accommodation and housing tenure also raise issues which can affect the health and well-being of children, considering only the impact of non-decent or substandard living conditions such as dampness and overcrowding, regardless of the status of the tenants. Poor housing conditions can have an impact on the health and well-being of parents too, and therefore affect their ability to parent, but this briefing considers the direct impact of the housing environment on the health of children only. The contribution of environment to household accidents is also not covered by this briefing’.

As there is many shortage for housing in the Hillingdon borough people with a lower income have no choice but to live in a poorer housing environment and can be the only available housing for them the office for national statistics show that only 2, 540 people in the Hillingdon borough own their own home, most of the houses in the Hillingdon borough are rented or council properties, this shows that there are too many housing around Hillingdon that can have a poor effect on a person’s health, and as people have no choice to live there, they cannot improve their health and their health can only get worse. The care and repair for poor housing shows that the main reasons for ill health in people in poor accommodation or housing is manly damp and/or mould growth, cold homes, or condensation, the main ill effects it could have on a healthy person are; Asthma, Bronchitis, Respiratory problems, and mental health issues. In the borough of Hillingdon there are 3, 657 people have mental health issues because of housing (national office for statistics).
Most homes in Hillingdon are overcrowded with a residency of 96, 462 people in Hillingdon a major 32, 119 houses are overcrowded with up to 1.5 persons per room. The main concern for poor health in overcrowded homes is mental health issues, the reasons for this can be caused because of recurring stress, and upset, constantly stressed about a person’s health and wellbeing, and financial problems not only effecting a person mentally but physically and emotionally. According to the social care institute, a recent report found that more than one million children in England are currently in "damp, cold, infested" housing. More than one million houses in England are considered "unfit to live in". However, there is currently no widely accepted definition of what constitutes sub-standard, inadequate or non-decent housing, although a recent Government policy document described decent homes as "homes that are warm and weather-proof with reasonably modern facilities". According to a survey based on the 2001 census, "more than half a million families in Britain live in officially overcrowded housing", which is measured by whether a household "has fewer bedrooms than implied by the [bedroom] standard", as described in the Household Survey for England. These statistics are important because a person's physical environment can have an impact on their health and well-being. This is especially the case for young children, who can spend 90% of their time in the home. Other groups of children are also particularly vulnerable to environmental conditions within the home. This table shows the barriers to housing services in the Hillingdon borough it shows the high levels of poor housing and the effectiveness towards the people living in the houses in the Hillingdon Borough and the barriers towards housing and services.

Within nursing and other health professions, health promotion is widely accepted, and according to the World Health Organisation a definition of health promotion stands as; ‘Health promotion is the process of enabling people to increase control over and to improve their health’. There are many means and ways to promote health in the NHS so when it comes to promoting health and stopping poor housing, the NHS enables information for people of all ages to understand, specializing information health promotions so we can help others to improve their health. The department of health have stated that more money has been invested to help people with poor housing and will contribute to a range of solutions to prevent unnecessary admissions into hospital (2008-2010), this means that any person suffering from health problems or long term illnesses that are joint with poor housing will be aided in improving their environment to improve their health. This document is intended at any person working within the NHS; Nurses, Doctors, GP’s, etc. This also shows Inter-Professional and Multi-Disciplinary working within the community showing a wide contribution from the NHS in helping to promote health and share information in poor housing situations.

The nurse’s role when it comes to promoting health in poor housing is mainly educational, and partially medical, this means that the nurse helps in providing information to the people that live in poor housing, they give options in how to help themselves and others to prevent an increase in ill health or any mental, physical or emotional illnesses. The office for national statistics shows that people who live in households with one or more person with ill health because of poor housing is almost half of England, and poor housing causes stress and mental health issues, the nurse then will give support and information to the patient and show them any groups that give more support to them and can meet people in their situation under the NHS, for example NHS Choices can offer information to people who are involved in poor housing, showing videos of other experiences and offers any information to people who want it (NHS Choices 2010). The nurse also gives any medication to people who are seriously suffering from any illnesses due to poor housing, they also provide any medical support that a person can do for themselves, including ways to relieve stress at home such as, deep breathing, having a break, and getting support from family, and friends. Lastly the nurse can also help the patient by giving advice to help their family from staying at home to prevent longer lasting ill health, such as respiratory problems, especially in children, including diet and exercise. The government have now put together lots of health promotion policies directed at people who have any health issues or long term illnesses, for example the government have made a 5-A-Day promotion leaflets for people suffering from long term illnesses, an example of this is shown in the British Medical Association (September 2007).
We now must look at why collaboration of professionals is important. The collaboration between inter-professionals is important as it is carried out every day, and throughout a nurses working life. Inter professional working involves professionals collaborating to work together more effectively to improve the quality of patient care. It allows for flexible and coordinated services and a skilled and responsive workforce. Collaborative and inter professional working can be seen as a key element in improving health service delivery. Joint understanding and collaboration develops effective multidisciplinary teams. This allows professionals to work across the boundaries of traditionally defined roles, and enables effective role replacement. This provides rural healthcare professionals with the vital support of skilled employees, for example nurse practitioners, midwives and pharmacists. This is particularly helpful in smaller areas where healthcare professionals often have to provide a broader range of services than those in larger example of non inter professional working would be the case of ‘Baby P’ because of the miss communication between all health workers and doctors the case of baby p failed, causing the child to pass away. BBC News states ‘Baby Peter's "horrifying death" was down to the incompetence of almost every member of staff who came into contact with him’. Baby Peter passed away due to serious child abuse, causing serious injuries such as, broken spine, broken ribs, numerous cuts, bruises, and aspirations and more. As stated baby Peter’s death was because of miss communication and all professional’s involved that did not communicate with each other. The professionals that was meant to be involved inter professionally with each other were; Baby Peters GP, the Social Services, and hospital staff, if the communication between all professionals was organized and all worked together, then the case of Baby Peter would be a completely different story, instead of investigating his death and past child abuse, the child would still be alive and would be investigating recent child abuse, but because of failed communication the case of Baby Peter failed.

This is an example of miss communication of professionals. Inter communication is when all medical professions needed to come together to take care of the patient, making sure their health is a key issue, and come together so the patient is overall healthy.

In conclusion this essay demonstrates an overall health needs assessment; this has been done by looking at two key factors around my local community and understanding what a health need assessment is. Then I described what my two chosen factors were and gave reasons for choosing them, giving any statistics in my chosen area that are to do with any effectiveness of health and any geographical information based around the chosen area, and how inter professional working can be involved in some health affecting problems, after discussing my two chosen aspects I moved on to then talking about the role of the nurse and inter professional working within the community giving an example of a miss communication in inter professional working within health, and the consequences it received and what could change if the inter professional working was communicated fairly.

References NHS Evidence – commissioning Formerly a Specialist Library of the National Library for Health a=7&b=276759&c=UB3+1SU&d=13&e=13&g=337639&i=1001x1003x1004&m=0&r=0&s=1300828173750&enc=1&dsFamilyId=1815
office for national statistics, Neighbourhood Statistics, Hillingdon Borough London Borough of Hillingdon (2004) Strategic Environmental Assessment Scoping Report – unpublished report, London Nhs Choices, Doctors Services In Hillingdon 12 November 2010 The Hillingdon hospital NHS trust 2011
Office for national statistics 2011 Neighbourhood Hillingdon, Result Tables.
Life expectancy at birth 2007 – 2009, Lead Tables, Office for national statistics 1997-2011 London Borough of Hillingdon
the Office for National Statistics Recorded Crimes 2008-2010. Home Office; Office for National Statistics;... Violence Against the Person (Count, Offences, Apr09-Mar10) Neighbourhood Watch in The Hillingdon Borough, Changed Being Made, People Taking Part, September 2010

The black report, Professor Peter Townsend, Emeritus Professor Of Social Policy, University Of Bristol Socialist Health Association 7 November, 2010 SCIE research briefing 19: What is the impact of environmental housing conditions on the health and well-being of children Published December 2009 Social Care Institute for excellence Care and repair for poor housing in England 2007-2011 Definition of Health Promotion World health organisation, definition of wellness 2010

Department of Health Extra Care Housing Fund Bidding Guidance 2007 – 2008

NHS Choice 2010, Mental Health, & Poor Housing

NHS Choices, Relieving Stress, LIvewell 2010

Enabling people with long term conditions to self manage their health: a resource for GPs 11 September 2007, 26 October 2010 Baby Peter 'was failed by all agencies' By Katherine Sellgren
BBC News education reporter