Primary Care Trust (PCT) is one of the organizations functioning under NHS. The main objectives of PCT is to find the various reasons behind the health issues existing in Greenwich and to plan and conduct programs to improve the health condition of the people of the Greenwich. One of the major reasons of the health problems in Greenwich is socio-economic inequalities. Smoking, sedentary lifestyle, prevalence of infectious disease and conditions like obesity, hypertension, Diabetes are the few determinants of health among the people of Greenwich. Poor diet, teenage pregnancies are few factors which influence the health of young citizens and leads to increased mortality. Increase in the population and presence of diverse ethnic groups in Greenwich also account for health issues. Overcoming all the risk factors of the health remains the main challenge of PCT. Thus, motive of the PCT is to organize various educational camps along with local organizations and help in improving the health of the people. PCT also plans to approach various ethnic groups such as Irish people and counsel them and provide the required help to improve their health. Also, planning of the urban areas of the state to provide all the resources and the health facilities to the needy people is on the agenda of the PCT.
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Today most of the death and illness cases in UK are due to tobacco consumption and alcoholic intake. It was stated that more than 107,000 people are dying with smoking related diseases a year (Cancer research UK, 2010). The other major disease is diabetes, it is stated that one out of twenty people are suffering from this disease in UK (Diabetes UK, 2010). Pollution is the source to get Cardio Vascular Diseases. It IS analysed that 40% of the deaths in UK are due to illness caused by air pollution (Department of Health UK, 2006).
In order to control all the risk factors causing illness to the public, UK government has introduced health caring services by establishing National Health Services to the public. Greenwich Teaching Primary Care Trust (PCT) is one of the caring trusts look after public health. It is an integral part of the National Health Service (NHS) which was established in 2001. PCT is responsible for planning, securing and improving health and health services and reducing health inequalities across Greenwich. The PCT provides primary and community health services, mental health care, walk-in-centres, patient transport (including accident and emergencies), NHS direct, population screening (e.g. breast screening), pharmacies, dentists and opticians for people within its jurisdiction. The PCT engage in commissioning (i.e. plans and purchases) services from other health service providers – such as specialist hospitals where people go for treatments that is not available within the borough.
The commissioning involves services from voluntary or non-governmental organisations, private healthcare institutions and the NHS trusts for all public health issues affecting environment, health and well-being of the citizens. It is also responsible for merging of health and social care so that the two systems can work together for patients and have health protection responsibilities for ensuring the protection of the public’s health. The PCT also ensure that decision making about local services are diligently initiated by those best placed to make them and also ensure that the local people are involved in any decision making.
PUBLIC HEALTH ROLE AND RESPONSIBILITIES OF GREENWICH TEACHING PCT
Establishing some health data information centres such as ‘Service Hub’ and other practice based commissions on public awareness about health.
To Provide Supporting lifestyle choices by restricting some areas to avoid passive illnesses. Ex: smoking, alcohol etc.
Promoting mental health and well-being by supporting the poverty
Effective and efficient healthcare delivery
Child healthcare is maintained by providing Immunisation vaccines.
For complete borough healthy wellbeing, Greenwich PCT is collaborated with some government organisations such as Greenwich council, Environmental Agencies, Health professionals, General public and other relevant stakeholders and other resources.
Building of community hospitals, Modern Healthcare systems and improving access to healthcare services
To reduce crimes, disorders, misuse of drugs, alcohol taking, it has engaged in planning and strategic policies in conjunction with local authorities according to Crime and Disorder act 1998 and also considering the prisoners health according to NHS Act 2006(Greenwich NHS, UK)
Greenwich PCT provided an emergence planning system for three main incidents
The Civil Contingencies Act is responsible to handle and deal the emergencies
Recently in the year 2009 Greenwich PCT, introduced two main key functions to optimise and improve the health inequalities in the public.
Greenwich community Health Services deals with services provider part to optimise the health and wellbeing of public and to reduce the inequalities.
NHS Greenwich deals with commissioning part by providing care and support to the public.
Both the services are aimed to provide community health services.
IDENTIFICATING THE CHELLENGES FACING THE ORGANISATION IN THE TERMS OF PROTECTING AND IMPROVING HEALTH OF THE POPULATION
·Pollution: Pollution is one of the main reasons for various diseases. Cutting down of pollution can be done by counselling and educating people about the pollution free environment.
Disabilities by Accidents: Rash driving, drinking and driving and not following the traffic rules are the main causes of accident. These accidents lead to disabilities which is also causes mental illness. Proper guidance and following traffic rules is needed to avoid accidents.
Increased prevalence of smoking, obesity and poor mental well-being: Prevalence of smoking is high in the people who are unemployed and in socio-economically deprived people. Similarly obesity rate is increasing constantly.
Increase in population and changes in health pattern and diseases: Population increase has its role to play in various diseases like cancer, heart attacks. Control in population is required to have a healthy society.
Wider determinants of health: Prevalence of various infectious diseases such as TB, Hepatitis B and C influences the well being of people. Also existence of HIV is rising every year which has to be kept under a check.
Socio-economic deprivation: A Socio-economic difference is one of the important reasons for health inequalities. Education and employment to these people is one of the challenges. Providing proper shelter during winter is essential to avoid death.
Planning: Health of the people is also dependent on the planning of the city. Good building design along with good modes of transportation and sufficient greenery can improve the health. Also availability of the food at affordable prices and providing employment can also improve the health.
Population diversity with regard to ethnicity: In Greenwich the main ethnic groups existing are the Black Africans and Irish people. Also, Asians are seen. The diversity in population also has role to play in health as the culture and habits is different among each ethnic group.
Limited resources and Lifestyle and attitude to health and healthcare services.
COMMENT ON THE STRATEGIES USE TO OVERCOME THERE CHALLENGES. DEMONSTRATE THE AWARENESS OF THE DETERMINANTS OF HEALTH
By reforming and improving the quality of health promotion towards the community and primary healthcare services. And upholding friendly health services which support mental health promotional activities and provision of its facilities within the borough.
Prevention and early detection and management of risk factors and diseases through optimum reassessments and improved clinical methods of diagnosing and treating infections and diseases.
Working with the council to encourage access to healthy and affordable food, increase physical activity, stopping smoking, reduce obesity and promote mental well-being and housing support for even development of a secured, safe and friendly neighbourhoods and community at large. This will aid people to have healthy choices, objectives and reliable information access to health and advice to preventive health services in the community.
Joint working with the council and other partners to ensure health improvement, development and stability into the future of young generations in order to motivate and empower the environment actively and positively through the promotion of health and urban planning.
Targeting the marginalised groups at the greatest risk of poor health outcomes and networking with these groups to initiate strategic approaches and implementation processes that will be fruitful, with particular focus on the Black African and Irish populations in the borough who have poor outcomes across the major causes of mortality and morbidity.
Projecting into the future and determining changes in the population and obesity trends between 10-15 years, which may, however lead to health risks such as cancers, diabetes and cardiovascular heart diseases (CHD) which are the chief causes of premature deaths. (Physical activities and healthy foods).
Another public health issues encountered by the PCT is the strategic tackling of health inequalities within the borough owing to the socio-economic and demographic deprivation which is the main causes of death, communicable diseases (such as Tuberculosis, Human Immunodeficiency Virus and Hepatitis), disability, teenage pregnancy and fuel poverty.
LINKS TO WIDER DETERMINANTS OF HEALTH
The major risk factors for the principal causes of mortality and morbidity in the Greenwich Teaching PCT are outline and discuss below:
Smoking: Smoking is highly prevalent among the people and has been one of the important cause of heart attack, lung cancer and bowel cancer and also the reason for obesity. Thus, it is one of the deadly habits which are found to affect the health and it is very important to educate people about the detrimental effects of smoking.
Sedentary lifestyle: Due to the inadequate physical activity a number of health complications are seen. The most common diseases seen because of the lifestyle is Coronary Heart Disease (CHD), Obesity and mental illness. People living in the deprived areas of borough and adults aged above 55years of age are found to have minimum or no physical activity.
Poor diet: People in the various deprived areas of the Greenwich do not get the 5 portions of the fruits and vegetables compared to other parts of the country. Also increased consumption of the red meat has been shown to be one of the risk factors of bowel cancer.
High cholesterol: Increased levels of Low Density Lipid (LDL) leads to Coronary Heart Disease (CHD). Increased physical activity can help in reducing the LDL levels and in preventing the CHD.
Obesity: There is a constant increase in the number of obesity cases every year. Obesity leads to a CHD, colorectal cancer and post menstrual breast cancer.
Hypertension: Among the various ethnic groups, Indian and Irish men and Black Caribbean women are more likely to have the hypertension and it can lead to CHD, heart attack and stroke.
Diabetes: Diabetes is prevalent in certain ethnic groups and this itself is a risk factor for a number of other risk factors. Diabetes can be seen along with hypertension, obesity and it can also be inherited from the family members.
Mental ill-health: Lack of vision towards life, proper interpersonal relationship and good work life balance leads to mental illness. Apart from these reasons, poor diet and smoking habits lead to mental illness and proper counselling and guiding the people can help in overcoming this issue
Alcohol: Prevalence of alcoholism is very less in case of various ethnic groups such as Pakistanis, Bangladeshis and ethnic minority groups. Alcoholism can lead to a number of cardiac diseases and also is a risk factor in case of cancer.
Poor social and economic condition: Most of the risk factors such as poor diet and sedentary lifestyle are prevalent in people who are in poor socio-economic status. Improving their status and educating can help in change the existing situation.
To conclude PCT is constantly surveying the prevalence of various health conditions and also finding the cause of diseases and mortality in Greenwich. The main hurdles faced are socio-economic inequalities, smoking, teenage pregnancy, infectious disease, cancers, obesity etc. PCT has been planning and conducting various educational programmes to overcome these issues by collaborating with the local organisations. Further planning and organisational collaboration will be required to provide the citizens of Greenwich to lead a healthy and happy life.
Cancer research UK. (Jul 2010). Smoking Statistics [Online]. July 2010. Available from: http://info.cancerresearchuk.org/cancerstats/types/lung/smoking/
Diabetes UK. (2010). Report on Diabetes [Online]. March 2010. Available from: http://www.diabetes.org.uk/Documents/Reports/Diabetes_in_the_UK_2010.pdf
Department of Health UK. (2006). Report on cardio vascular diseases [Online]. Feb 2006. Available from: http://www.advisorybodies.doh.gov.uk/comeap/statementsreports/CardioDisease.pdf
Greenwich Teaching Primary Care Trust (2009). Public Health Report [Online]. May 2009. Available from: http://www.greenwich.nhs.uk/documents/1178.pdf
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