Salford Health Bus Plan 2013/14
The Salford Health Bus
1) Introduction
The Salford Health Bus is only a small part of a much wider and comprehensive programme of Health Improvement Service work around Screening, Campaigns and Brief Intervention work. This area of work constitutes only part of the activity of the Health Improvement Service, who also provide Community Development services and Health Improvement Behaviour Change programmes in communities. This is because there extensive evidence to suggest that improving population health can only come about by using multiple methods of service delivery, a single method is unlikely to bring about significant changes in behaviour. The factors that impact upon the health of a community or individual are multi-factorial and extensive and are extensively linked to socio-economic factors as well as education, housing, employment and culture. Therefore the Salford City Council’s Health Improvement Service employ a broad range of methods or techniques including health promotion campaigning, brief advice, education and the development of confidence, skills and knowledge, alongside the development of strong community networks and self-help.
The programme of geographical locations for the Salford Health Bus are based upon health inequalities data provided by Public Health, the target population groups identified by public health data in the Service Specification, and the likelihood in engaging with the target populations in any given geographical location. Map 1 below highlights the deprivation indices across Salford. The darker coloured areas (amber, red and burgundy) clearly identify the areas and geographical communities that the Health Improvement Service would seek to target in order to bring about the largest health gain to those who are likely to have the poorest health. There is a vast evidence base that links poverty and poor health status, and the importance of investing resource in these communities in order to reduce the disparity in health status between the poorest and most affluent communities.
The table below describes the population groups that the Health improvement Service have been commissioned to target in order to address a range of health issues
Programme area / Description of priority group / Priority Areas /Alcohol / Adults with high levels of alcohol intake / Kersal, Broughton, Irwell Riverside, Ordsall and Langworthy
Cancer / Screening at risk groups:
Breast cancer - women aged 50 to 70
Cervical cancer – women aged 55 to 64
Bowel cancer - Men and women aged 60 to 74
General cancer awareness - 50+ C2DE Salford population (
(refers to BCOC & HCC) / Langworthy, Broughton and Barton/Eccles.
Children and families health – oral health / Work required with Oral Health team
Parents with children not registered with a dentist / Prioritise by level of deprivation/ poor dental health
Children and families – infant feeding / Families with children aged 0 to 12 months / Prioritise by level of deprivation
Children and families – unintentional injuries / Families with children aged 0 to 18 years / Prioritise by level of deprivation
Children and families – sleep safe / Families with children – aged 0 to 1 year / Prioritise by level of deprivation
Healthy weight / Adults, previously sedentary, body mass index 25 to 30
Parents with children aged 4-16years who are accessing Family Weight Management Services / Prioritise by level of deprivation
Flu vaccination / Adults and ‘at risk’ groups
Sexual health / Young people, aged 14 to 18 yrs. / Hot spot areas – Ordsall, Langworthy, Little Hulton, Irwell Riverside, Pendleton, Swinton North
Mental Wellbeing (MW) / Vulnerable and at risk groups, for example low-income single mothers, recently bereaved elderly people, people with chronic physical illness, and newly arrived communities;
people with mild to moderate depression and anxiety;
people with long-term and enduring mental health problems; and
frequent attenders in primary care. / Prioritise by level of deprivation
Older people / Older people aged 65yrs and over
Living alone
A combination of co-morbidities
Sedentary / poor mobility
Socially isolated
Early signs / low level dementia / Prioritise by level of deprivation
Mental wellbeing / Vulnerable and at risk groups, for example:
low-income single mothers, recently bereaved elderly people, people with chronic physical illness, and newly arrived communities;
people with mild to moderate depression and anxiety;
people with long-term and enduring mental health problems; and frequent attenders with mental health problems in primary care. / Prioritise by level of deprivation
Parenting / Parents with children aged 0 to 18 / Priority areas to be confirmed – Eejay via Joe Garaway
Primary immunization – Jewish Community / Children 0 to 16 yrs / Prioritise OJ neighbourhoods
Tobacco / Adults
Routine and manual workers
Areas of high prevalence (25% and above) / Prioritise by level of deprivation and smoking prevalence
Workplace / Need to make the distinction between workplaces with lower paid / routine and manual worker type roles / wages and workplaces with higher skill level / high pay. / To be agreed with Fiona Reynolds/ Alistair Fisher
2) Evidence of Effectiveness
International Evidence
There is some compelling international evidence to suggest the effectiveness of using mobile facilities in order to target specific populations or ‘hard to reach’ population groups, who may be less likely to access conventional health services. For example, Abdullah et al (2008) found that a mobile service was particularly effective in engaging with elderly populations and hard to reach groups for smoking cessation. A cost-effectiveness study by Oriol et al (2009) concluded that a health bus serving a disenfranchised community in Boston, USA, had the potential to secure a return on investment of $36 to every $1 invested in the programme. Hill et al’s (2012) study assessed the cost effectiveness of using a mobile bus for disease screening and a range of disease prevention activities amongst low income groups with the aim of reducing health costs and health disparities in Boston. The findings were positive in that this approach enabled them to engage with the target groups as well as enabling the identification of disease signs and symptoms that were previously undetected in up to 60% of the service users. Following on from, this Song et al (2013) conducted a large-scale study which found that the earlier identification of disease signs and symptoms from the mobile health bus had resulted in a 32% reduction in the relative risk of myocardinal infarction and a 44.6 reduction risk of stroke. This resulted in a cost saving in associated health care of $3 to every $1 invested in the health bus programme.
Local Evidence
The Health Improvement service have delivered a number of Greater Manchester commissioned services from a mobile bus over the previous two years, including smoking cessation services and cancer awareness. An evaluation of these services has been undertaken by an external agency. The evaluation included quantitative data analysis and qualitative service user feedback. The service was found to have a positive impact on smoking habits for most respondents, as well as in raising awareness of the signs and symptoms of cancer which can lead to earlier diagnosis. The key findings from the evaluation are as follows:
• Over half of Phase 2 respondents said they had quit smoking following their use of the bus service, and almost 40% decreasing the amount they smoke. This is compared with just less than a third having quit within Phase one, and a further 40% reducing the amount they smoke
• In terms of respondent’s perception of how helpful the bus service has been in their attempts to quit smoking, a large proportion of the sample rated this either ‘Very’ or ‘Fairly’ helpful across both Phase 1 and Phase 2 of the research.
• Almost everyone, 98% of respondents in Phase 1 and Phase 2, stated that they would recommend the bus to others. This positive word-of-mouth recommendation is the best form of customer satisfaction.
• Overall, the fact that across both Phase 1 and 2, many respondents had not previously accessed an NHS Stop smoking service (Phase 2: 68.5%; Phase 1: 73.5%), indicates that this approach is targeting a new market sector, namely those who may not otherwise access such services to help in their attempt to quit smoking.
3) Service Implementation
· The following table sets out the proposed timetable for the use of the Health Bus during 2013/4.
· In the spirit of cooperative working Salford Royal Foundation Trust and the Health Improvement Service of the City Council have agreed joint use of the bus for Salford health promotion campaigns.
· The bus has recently been rebranded as a Health Improvement Service and Salford Royal Foundation Trust (SRFT) vehicle, a images showing the new branding is attached at the end of the document.
· The bus is stored by Arriva at their garage in Wythenshawe when not in use.
· There are costs incurred in using the bus for the driver and fuel, which are met through dedicated health promotion budgets.
Programme / Overview / Timescale / Programme Detail / Expected OutcomesMen’s Health / To provide an awareness raising and mini MOT programme to coincide with Men’s Health Week / June 10-16
1 week / The bus will visit 10 different sites across Salford offering health MOTs and brief interventions on mental health; smoking; alcohol; men’s cancers; and other health lifestyle issues. Sites include workplaces, supermarkets and Salford University Mosque.
Referrals will be made to other agencies as appropriate including primary care; stop smoking; alcohol; health trainers; and Big Life Being Well programme; as well as to health improvement service projects. In addition, the workplace health advisors will try to encourage workplaces to implement programmes for their staff.
Information on other topics such as welfare rights and debt advice will also be available.
It had been planned to include Media City Piazza as one of the venues but this will now be incorporated into a men’s health event to be held there in July.
The elected Mayor is hoping to visit the bus on Wednesday when it will be at the Civic Centre. / Sue to complete
Child Safety / Awareness raising on unintentional injuries, tooth healthy, healthy eating using the bus and delivering sessions in primary schools / June 24- 12 July
June 24-30 child safety week
3 weeks / The bus will be used for a period of three weeks to promote child safety campaigns in partnership with other SCC teams/campaigns for example unintentional injuries and sleep safe. We will also work with Smoke Free Homes staff as well as promoting HIS programmes of work for families with children aged 0-11.
The bus will visit 4 primary schools in each neighbourhood and, in addition to the brief interventions for parents, sessions will be held for the children on healthy eating, hand hygiene and tooth brushing. The full list of participating schools will be available 10th June.
Workplaces / To provide an awareness raising and mini MOT programme / September
2 weeks / Following consultation with HR managers in local companies, a programme of visits will take place across businesses in Salford offering health MOTs and brief interventions.. Also information will be collected on the current health status and concerns of each workforce to inform further workplace sessions. It is hoped that this campaign will encourage local businesses to sign up to the Good Work Good Health Charter. It is planned to concentrate on manual and unskilled workers for this campaign where possible.
Stoptober / To promote smoking cessation and smoke free homes / September/October
1 week / Stoptober is a national campaign launched in 2012 backed by Cancer Research UK and the British Heart Foundation, and was the first 28-day quit attempt of its kind to encourage the nation’s 8 million smokers to give up. There is a website www. smokefree.nhs.uk/stoptober, an app, a facebook page and a support pack. The Public Health Commissioners have already been asked by Tobacco Free Futures (and PH England) to complete a questionnaire setting out their intentions for promoting the 2013 campaign. The intention is to use the bus for this purpose on industrial sites across Salford as well as at the “A Taste of Salford” event.
The Health Improvement Service will work alongside Smoke Free Homes on this campaign.
Fresher’s week / To deliver brief interventions on a range of lifestyle issues including sexual health, alcohol, smoking and healthy eating in the University, colleges and academies / October
1 week / The bus will be placed on each of the further education and Academy campuses in Salford for one day to deliver a range of brief interventions on lifestyle topics including alcohol, sexual health, smoking and healthy eating.
Older People / To raise awareness on a number of relevant issues such as home safety, dementia support, flu vaccination, keeping warm in winter / October
1 week / This is planned to be a campaign targeted on sites with a high older people footfall to cover a range of relevant topics. There will be a emphasis on the importance of flu vaccination as this campaign is timed to coincide with the beginning of the local flu vaccination campaign. HIS will work with other agencies and other council teams to promote relevant services. It is also planned to use this work to promote dementia awareness and the range of support available within Salford. HIS will work with relevant third sector organisations in this campaign.
New Year New You / To promote smoking cessation and any lifestyle change groups in neighbourhood programmes / January
1 week / The bus will be used across all neighbourhoods to take advantage of New Year resolutions to make lifestyle changes. For this reason the main areas to be covered will be smoking, alcohol, weight management and physical activity. HIS will promote its programmes of work to encourage behaviour change in these areas.