Why Suffolk could be the healthiest place to live in the UK
PUBLISHED: 15:29 31 October 2016
Suffolk is taking a preventative approach to helping people to stay healthy for longer. Nick Cottam explores the county's healthcare strategy
If you want to live a long time then stay in Suffolk. Life expectancy in the county is among the longest in the UK, second only to the London Borough of Kensington and Chelsea, according to one study, and consistently in the top five to 10 counties. The flip side is that Suffolk folk living longer means more pressure on healthcare resources, from GP surgeries and social care to admission to hospital, and ultimately finding the right care home.
Suffolk, like so many other parts of the country, struggles to look after its ageing population. According to the county’s 2015 Public Health Report, a significant 40% of publicly funded social care spending is for those aged 65 and over. The same age group accounts for 48% of all admissions to hospital, and it is the elderly who bear the brunt of such diseases as dementia and heart disease.
Not surprisingly, the report adopts the theme of prevention. It’s a county-wide approach that can be applied to all age groups, from the one in five children who are overweight or obese, to the 40 to 74 age range who are entitled to an NHS Health Check, which can act as an early warning system problems such as high blood pressure, Type 2 diabetes and obesity.
“Ipswich has one of the highest rates of obesity on the UK,” says Dr Chris Rufford, who works with Suffolk GP practices trying to encourage patients to eat better and exercise more. “Ironically, people living in a city like London tend to exercise more, but in smaller towns like Ipswich they just don’t. It’s a case of rolling out of bed, into the car and drive to work.”
The big question is can the NHS really refocus on prevention? Dr Rufford thinks so, although it requires a whole network of other agencies to play their part. One example is a new service called OneLife Suffolk, which offers a first stop alternative to GP surgeries and is designed to address issues such as obesity, smoking and weight loss. Anyone in Suffolk can call and sign up for one of the services available.
At the apex of preventative healthcare, Suffolk has a Health and Wellbeing Board, which has the broad aim of helping people and communities stay healthier throughout the age range. The board’s priorities refer to “seeing increased healthy life expectancy”, the aim being to help people live for longer without requiring either medical or social care.
With this in mind the Health and Wellbeing Board has been promoting a year of cycling, a Suffolk Walking Strategy and a campaign to combat loneliness.
“The more social contacts people have, generally the healthier they are,” says Dr Mark Shenton, chairman and clinical lead of the Ipswich and East Suffolk Clinical Commissioning Group (CCG), the body responsible for buying medical services on our behalf. “There are things I can’t deal with by just telling people to take a pill. Take a bowls group. It’s not the bowls that make people healthier. It’s people getting together to play bowls.
“We know that there’s a strong link between health and education. If you don’t smoke at 19 the chances of you becoming a smoker are almost zero. If anxiety disorders aren’t tackled at a very young age they can have a very negative impact on a person’s life opportunity as an adult.” A key challenge for Suffolk GPs is to reach out to pockets of deprivation across the county. Parts of Ipswich and Lowestoft, for example, have areas of multiple deprivation among the worst in the UK. Getting the preventative healthcare message across is critical, notes Dr Shenton.
“It’s no longer ‘doctor knows best and this is what’s going to happen’. One of our roles as GPs is to engage patients in some of the CCG decision making involved in their care. A person suffering from osteo arthritis of the hip, for example, may need a hip replacement, but the alternative could be physiotherapy and pain management. The important thing is to involve the patient in discussing the options.” This can work well until options narrow.
“The problems facing rural Suffolk are a growing population of the frail and elderly suffering from multiple morbidity. Patients come to me, often again and again, with problems related to their basic needs of food, shelter, warmth and companionship,” says Dr Matt Piccaver, a GP at Glemsford. The upshot, he and other GPs maintain, is a GP recruitment problem that can’t be solved in the short term, even with the extra money the Government is making available to primary care.
Dr Shenton agrees. “It’s difficult because you’re not going to recruit more GPs in months. Many see the bright lights of London and other big cities, and Suffolk can’t match that. What we can do is create portfolios for young GPs which keep them interested and allow them to specialise.” Dr Shenton is able to split the week between his CCG role and general practice in Stowmarket.
The challenge for GPs and public health agencies is to adapt and channel scarce resources to where they are most needed. This applies to both physical and mental health, a key component of the preventative agenda.
“As GPs we have to ask ourselves how we can reduce demand,” says Dr Shenton. “At our practice we have a gym and personal trainers. We’re also using technology developed by McLaren to help people change their lifestyle and provide feedback on how they are performing physically.”
Dr John Hague, the mental health lead for the Ipswich and East Suffolk CCG notes the importance of new talking treatments which provide people with better access to information and allow them to share experiences.
“Mental health problems are universal and we’re going to be individually lucky to escape them in our lifetime. We have to think in terms of how to manage the brain better to deal with things like stress, anxiety and bereavement. “ Suffolk, he says is pretty average when it comes to mental health problems, although old age and rural isolation can make people particularly vulnerable. Young people in Suffolk can get advice on health issues via a website called The Source, while Dr Hague also applauds sites such as Action for Happiness and the Wellbeing Board’s Ready to Change, which enables people with mental health issues to self refer.
Whichever aspect of healthcare, from early life to old age, the underlying message is one of education and engagement. Help people help themselves and they have a better chance living to a ripe old age, and enjoying the experience.