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Developing Nottingham’s LAA Jeanelle de Gruchy and Chris Nield Health Equality, Nottingham City PCT. Objectives of session. LAA indicator issues LAA partnership working issues Effective indicators. SMART Indicators.
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Developing Nottingham’s LAA Jeanelle de Gruchy and Chris Nield Health Equality, Nottingham City PCT
Objectives of session • LAA indicator issues • LAA partnership working issues • Effective indicators
SMART Indicators • Specific – mental health (support to people known to mental health services) • Measurable – mental health (DSH) • Achievable – prevalence (smoking, physical activity, alcohol) • Relevant – physical activity cf. statins • Timed – 1996/97 or 2005? 6 monthly or at the end of 3 years?
Measurement • Outcome vs process (quitters v. prevalence) • Definitions (obesity, PA) • Baselines – expense and time measuring (PA) • Perverse incentives (mental health employment; CHD – statins v. PA) • Time-scale – needing to show results in 3 years (easier to argue for older people CHD cf. young people and obesity) • Inequalities – overall numbers vs. targetted
LAAs in partnership • Accountability – it’s a political process • Consultation with partner organisations • Conflicting guidance – GOEM, City Council, SHA, ODPM guidance document (eg what is a ‘stretch’) • Lead organisation control (driven by performance management) • Some lack of understanding of NHS organisation drivers / performance management / limited focus on public health (and limited capacity!) • Understanding of health / health outcomes • Valuing professional/technical expertise • Is 0.5 of a fruit ‘unambitious’?
Negotiating indicators • Time scale to negotiate • Community consultation • Iterative process, but difficult to ensure all kept on board with the process • Blocks and cross-cutting issues • Alcohol – crime or medical…? • Infant mortality (technical expertise) • Prioritisation / nos. of indicators allowed • Lobbying by interest groups (avoidable injury; supporting young parents)
Effective indicators • A health priority (national / local target) • Evidence base • Build on reality of local situation • Be creative – the reality is it needs to be measured • balance between routinely available info – but may need to survey. • Particularly NB as we develop our stretch targets