Big Blue Bus - healthy living centre

Category:         Scheme best addressing Health Inequalities

Name:               Teresa Cresswell

Job Title:           Manager - Chesterfield Sure Start Healthy Living Centre

Organisation:    Chesterfield PCT

Email:                teresa.cresswell@chesterfieldpct.nhs.uk

Telephone:        01246 283030

Key team:          Janice Hunt – Health Lead, Darren Mann – Driver Outreach Worker, Dave Cantril, Gary Oakley, 3 X Cooks, Heather Miles - Youth Worker, Liz  Jackson– General Nurse Sexual Health, Crèche Workers X 3,

Title:                 Big blue bus – healthy living centre

Chesterfield PCT has 8 wards with higher levels of deprivation and poor health. We actively involved local people and professionals in different communities by using qualitative research methods supported by hard data led us to consider the most effective way of targeting isolated pockets of deprivation.   The research identified a wide range of unmet public health and social care needs including poor health due to lack of understanding, knowledge and poverty, limited access to services for young people, the need to improve nutrition and cooking skills, support for parents, and activities for children under 4.     It was acknowledged that traditional health and social care approaches were not meeting the needs and we needed to look at more flexible and innovative way to deliver a holistic public health approach.  We set out to improve access and deliver more flexible services at the point of need.

We developed a 40’ double-decked bus, specifically designed to deliver health promotion, and social care related services.  The facility provides – Confidential room for health promotion screening, counselling, fully equipped cookery demonstration kitchen, toilet and baby change, crèche that converts to a youth provision in the evenings, lounge area, video, computer linked by wireless LAN enabling access to the web, and service users quickly gaining information.  

Objectives  –

• A regular facility taking services to disadvantaged communities targeting families on a low income; young people; older people, isolated minority groups.

The provision of:

• Health promotion lifestyle screening to reduce the incidence of CHD, Stroke and Cancers
• Early learning and play
• Cooking and nutrition classes to improve diet and weight control
• Benefits and housing advice to tackle inequalities
• Parenting support
• Young People’s services – health, sexual health, youth provision, to raise self-esteem, promotes positive lifestyle choices.

We sought the views of over 600 people, both professional and community members of all age ranges.  (Evidence available)  There was a steering development group from a variety of agencies.  We set out to deliver a complex range of services, staffed by different agencies. The bus was launched in January 2003. 

We have had one year’s experience of developing and delivering services.  In one year we have seen:

• Adults for health checks 186
• Ongoing Health Support   94
• Children Using the Crèche 144
• Parents attending parenting courses 26
• Sexual Health Advice 384
• Young people using the service 768
• Adults 1,333

The challenges were  - How could we deliver a high quality complex range of services equitably to each community, and how could we afford this?

We explored the availability of premises in each community, and looked at community need, quickly recognising that a full time provision in each community would be underused, and not cost-effective.  Our collective experience suggested that mobile provisions were often of poor quality.  We widely researched existing provision nationally, learning from the experience of other established mobile services.  

We could not afford the capital, or provide all of the revenue for additional staffing and bus revenue costs.  We joined forces with Sure Start, who sought additional funding from Single Regeneration Budget, whilst the PCT sought  £1m revenue costs from the New Opportunities Fund.  Sure Start contributed £600k over 5 years.  This was matched funded in kind by the PCT and partner agencies.

Benefits:

• Partnership with Sure Start cut management costs.
• Enabled Sure Start to roll out services to a wider community
• Increased the potential for partnership working
• More Agencies have asked to deliver services via the bus
• Facilitated a wider range of agencies seeing health in its broadest sense
• Highlighted public health issues
• Local Communities wanting to use the bus to promote their community
• Very good attendance a take up on Public Health Awareness Days – e.g. Stop Smoking
• Through users we are identifying new health needs so we can inform PCT of health trends

Next Steps:

• Evaluate all service provision and change as appropriate
• Put on one more evening for youth provision so we are running 5 evenings
• Look at age segregation for young people so we can undertake more age related work.