Throughout this assignment I aim to carry out a health need assessment on the borough of Brent. In this health needs assessment I will identify and discuss two key factors that influence the health and well-being of the local population of Brent. I will also discuss government policy that addresses the key factors and how the government have decided to better the community with these policies. I have chosen to look into ethnicity and overcrowding as my 2 key factors and discuss how these affect the health of the population of Brent.
I will also investigate whether there is a correlation between ethnicity and overcrowding in the likelihood of contracting tuberculosis. While discussing these I will include how this policy or legislation helps to promote the health and well-being in Brent. I will then describe the role of the nurse, other health care professionals and other agencies in promoting health to address the identified health needs of the population of Brent and discuss the importance of effective inter-professional and inter-agency working in promoting health and well-being of this population.
It will conclude by summarising the main issues addressed within the content. I decided to do my health needs assessment on Brent. The NHS defines a health needs assessment as a “systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities”. The reason I choose Brent is because I am on clinical practice in Northwick Park so I was interested to research the area. I also carried out my health assessment in Brent as I live close by to the borough and it is interesting to see what affects the community of Brent.
Brent is located in North West London. It borders Barnet to the north-east, Camden to the east and Ealing, Hammersmith & Fulham, and Kensington & Chelsea to the south, and Westminster to the southeast and Harrow to the north-west. There are 21 wards in Brent as you can see from this image. Brent is a borough with very distinguishing characteristics. Brent council (2010) It has one of the highest levels of migration in London with the second highest number of adults entering the country and applying for a ational insurance number last year. It is one of the most culturally diverse areas in the UK where 71% the population of Brent come from a different ethnic group than white British. The biggest ethnic group in Brent is black and black minority groups. There are predominately more females than males residing in Brent. The health of the population off Brent is very mixed as the life expectancy is over the London average but the rates of new cases of stroke, heart disease and tuberculosis are a lot worse than the London average.
There is also an 8year difference in the life expectancy for men who live in the least deprived areas over the men who live in the most deprived areas. The north of the borough is generally wealthier, and the south more disadvantaged. In June 2009 the Office of National statistics (ONS) estimated the population of Brent at 255,500. ONS (2009) the population is relatively young with 43% under the age of 30yrs old. As Brent is a very multicultural and diverse borough I have chosen to look into ethnicity and how this has an affect on health.
There is evidence to prove that different ethnic groups are more prone to develop different diseases for example black African are more susceptible to sickle cell disease. The Office of National statistics (ONS) uses the phrase ethnic minority to refer to people who are not white. Although Redfern. S et al(1999) defines ethnicity as a mixture of “race and culture”. She also states that “almost anything can be used to create ethnic divisions, though, after skin colour, religion and language are the most common factors”. So my understanding of ethnicity is a group of people with the same common factor.
In Brent BME are the largest ethnic group at over half the population. Large-scale surveys like the Health Survey for England show that BME groups are more likely to report ill-health, and that ill-health among BME people starts at a younger age than in the White British. There is more variation in the rates of some diseases by ethnicity than by other socio-economic factors . However, patterns of ethnic variation in health are extremely diverse, and inter-link with many overlapping factors. The relative poverty of BME groups is probably the most important.
There are many new policy initiatives to improve the use of health services by BME groups, as well as tackling broader socioeconomic inequalities between ethnic groups. You can see how diverse Brent’s population is from this graph. From this image you can see that the BME group is the highest compared to white British. The reason I choose this is because the rate of Tuberculosis has risen in Brent as the population had become more multicultural and diverse. As groups have emigrated into Brent from countries that have a high rate of tuberculosis they bring it with them and become highly susceptible to it.
According to London Archives (2010) in 2009, there were 299 new cases of TB in Brent. 89% of these cases were among Black, Asian, and Minority Ethnic (BME) groups. The second key factor I identified in Brent is overcrowding. Overcrowding is a factor of poor housing and “It costs the NHS in England an estimated ? 600m per year to treat the health impacts of poor housing” (CIEH 2011). Stewart. J(2001) describes overcrowding as to many people in one “dwelling” or household. Also Oakes. J et al (2006) defines overcrowding as “being above a specific threshold for example two or more people per room”.
Overcrowding can affect health in numerous amounts of ways. Households that are overcrowded usually have “few economic resources”(Oakes. J et al(2006)). According to Ealing PCT (2004) over half of households in London are severely overcrowded. Overcrowding is most severe amongst London’s Bangladeshi and African households. 53% of Bangladeshi households, 46% of black African households and 39% of mixed white and black African households in London are living in overcrowded housing of all tenures. This is shown clearly in this graph from Bloomer.
E(2011) where overcrowding is lowest in white British houses and highest in Bangladeshi households. There have been difficulties of researching the links between overcrowding and health. In spite of this there is some evidence of the dangers overcrowding can pose to the health of children and adults. 23,00 children in Brent live in overcrowded living conditions — one of the major contributory environmental conditions linked to increased risk of TB statistic from Ealing PCT. The most renowned and strongly recognized link is that with tuberculosis.
Tuberculosis is an airborne disease. It is carried on mucous droplets suspended in the air”. If a person who is infected with tuberculosis coughs, sings or even breaths there can be a release of mucous droplets. If a family is living in overcrowded conditions and a member of the household had tuberculosis it is highly probable that another member of the household will contract it from them as it is highly contagious. This graph shows the cases of Tuberculosis rising in London and England since 1981 up to 2001. In 1981 tuberculosis was high but began to decline until 1985 where it began rising again.
It hit an all time high in 2001 as you can see from the graph. The cases of Tuberculosis have risen in Brent again since this information was taken. Also apparent in this graph is the number of overcrowded houses in London compared to England. The numbers of overcrowded households declined in both London and the rest of England until 1991 where the number of overcrowded households in London began to increase again and the number of households in the rest of England continued to decrease. Health promotion is a very important factor in helping people stay well and healthy.
According to the NHS health promotion is a “term that has been applied to a wide range of approaches to improving health of people, communities and populations. But whatever the particular focus of health promotion work, health promotion needs to be grounded in firm principles and philosophy”. There are many roles in nursing. Gott. M et al(1990) The nurse cares for the patient, carries out procedures ordered by the doctor and, in collaboration with the doctor and other team members, assesses the patient and treats his or her problems.
The nurse coordinates the work of others involved in caring for the patient, including the patient’s family, who may do a lot of the caring for the patient. The nurse also protects the patient, working to prevent infection and ensure a safe, healthy environment in the hospital. Teaching is a major role of the nurse in restoring health, promoting health and preventing illness. When a person is ill, the nurse shows things that the patient can do to help with their own recovery. Whenever the nurse works with a patient, the nurse uses the opportunity to teach that person about self-care.
Nurses teach both patients and their families about proper diet and nutrition, cleanliness and hygiene, exercise, sleep and rest and all the other aspects of a healthy life. This is why a nurse plays a vital role in promoting health as they promote wellness in patients who are healthy or ill. When promoting health the nurse is a role model of health promoting lifestyles. As a caregiver a nurse makes sure that health promotion and prevention services are readily available for all members of the community including the less advantaged.
Nurses work together with doctors, physiotherapists, occupational therapists and many more healthcare professionals to promote health in the area. In Brent there is a health and wellbeing strategy 2008- 2018. They state that the “aim of this national policy framework is to develop a greater emphasis on preventative health care services, promoting healthier life styles, greater independence and choice for service users”. The vision of this policy is to “improve health and well-being of all Brent residents with a particular focus on venerable communities”.
They will try to reduce health inequalities, increase social inclusion and secure longer and healthier lives for Brent residents. In this policy they want to redirect resources form interventions into preventive activities and improve community wellbeing. They aim to take 5 steps which are called “work streams” towards bettering the health and wellbeing of Brent. The first concentrates on ensuring assessable services. This will include primary care services and adult social care services. The second is to support individuals to lead healthier lifestyles.
This will be done by promoting health in areas such as smoking, diet, alcohol intake and physical exercise as Brent has a high level of adult and child obesity. The third focuses on improving the economic, social and environmental factors which promote good health and well being. Brent will improve this for the more deprived population by focusing on priority areas such as employment and housing. Brent has also come up with initiatives to increase the supply of affordable housing within Brent which will help families who live in temporary accommodation move into more permanent and settled homes.
Also within this work stream they plan to reduce crime rates and fear of crime across the borough. The fourth work stream aims to improve prevention, management and outcomes for priority health conditions in Brent. As there as prevalent conditions within the more disadvantaged groups such as the ethnic minority groups in Brent such as diabetes and tuberculosis. As I have discussed earlier Brent has one of the highest rates of tuberculosis in London. This issue will be tackled by opening high quality TB services to all, increase identification of new cases through primary care along with other settings and to raise TB awareness.
The last work stream they want to have improved by 2018 is outcomes for children and young people and their families. This includes education on substance misuse, sexual health and emotional well being at an earlier stage to prevent the problems from developing, to strengthen mental health services and therapies for children with disabilities. A big effort will be made to reduce obesity and increase physical activity to improve health and wellbeing of children and young people. Brent Housing partnership (BHP) (2011) has come up with a new strategy to deal with housing and overcrowding.
They have decided to supply lofts and extensions to families who are experiencing overcrowding. There are many residents in Brent who are waiting to move residence as where they are already is inadequate to the size they need for their family. However there are not enough households to meet the large demands and the wait to move would be too long. They have applied for funding from the Greater London Authority to implement this programme to ease overcrowding. In 2010 BHP completed 58 lofts and extensions to households in Brent.
So far they have been allocated funding for 11 households that will benefit from the Loft and extension programme. Families that qualify for this are on the overcrowded or severely overcrowded list. This will help relieve stress on the families who qualify and in turn improve their health. Effective inter-professional and inter-agency working in promoting health and well being are becoming integral to healthcare in the UK. Sargeant. J (2008) It is anticipated that this approach can maximise professional resources and optimize patient care. Graham.
D et al(2010) describes inter-professional care as “complex interactions between two or more members of different professional disciplines”. The purpose of this is to develop goals which are achieved through agreed procedures and care plans. For inter-professional care to work all members of the team need to pull together and make a joint decision based on shared viewpoints. (Payne,2000: Hardy 2001). The advantages of this is that tasks do not need to be repeated by each practitioner and completed once for the whole team and it help meet the health needs of the patient more efficiently.
Anyone involved in the care of the patient including the patient themselves have a role to play in the team. Effective inter-professional care is important as it benefits the patient and helps the healthcare practitioner feel more confident. Interagency work is also teamwork but it is teamwork that is done across different sectors for example social care and healthcare practitioners working together to get the best possible result for the patient. Brent has a protocol for inter agency information sharing (2005) this is a information sharing agreement.
It says that effective information sharing and information governance are a key part of the work of all public sector organisations. It is therefore important that partner agencies in Brent commit to a method that helps remove potential barriers to information sharing between public sector organisations. The parties involved in the protocol are Brent council, Brent fire brigade, Brent police, Brent teaching primary care trust (TPCT), Central and North West London mental health trust and North West London hospitals NHS trust. This protocol focuses on people using associated services commission by the partner agencies to share information.
The parties involved implemented this protocol by agreeing that all staff within each organisation adhere to the principles set out in the protocol. By putting in place methods that meet the standards and procedures outlined in the protocol and by providing training and awareness of key principles of information sharing. This essay has discussed the borough of Brent and ethnicity and overcrowding within the borough of Brent. In this essay I have discussed how multicultural Brent is and how many different ethnicities there are in Brent.
I have looked into how ethnicity has an effect on the health and wellbeing of the local population and gone more in detail into a link between ethnicity and Tuberculosis. Also I researched overcrowding in Brent and discussed its link with Tuberculosis. The evidence states that different ethnic groups are susceptible to different diseases and that it is predominantly the Bangladeshi community that live in overcrowded conditions. I discussed two policies that help with housing in the area and also the health and well being in Brent.
I described the role of the nurse and other healthcare professionals in promoting health and how important health promotion is. I also discussed effective inter-professional and inter- agency working in promoting health and well being. Brent is making a large effort to eliminate health inequalities and better services for all. By 2018 it aims to be a more attractive borough to live with more temporary homes for people and eliminate overcrowding. Overall Tuberculosis is quite high in Brent but the government have put in place policies and procedures to bring this down.