Let's Talk Crawley

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The Crawley Story

Introduction

Creating a healthier population requires working together with communities, and health and care professionals to address the issues that are influencing poor health outcomes.

We know that people’s health is influenced by many factors, such as where you are born, grow up, live, work, and age. The COVID-19 pandemic brought into focus the health inequalities for the population of Crawley, which is one of the most culturally diverse communities in West Sussex.

The West Sussex Health and Care Partnership agreed Crawley as an area of priority in the West Sussex Health and Care Plan. The Crawley Programme was launched in 2021 to explore what health challenges there may be for people in and around the town and the impact of these on the population of Crawley.

To make real changes for the people of Crawley, we want to work with them to help to craft the local solutions that create healthier and connected communities.

The Crawley Programme is about building partnerships, gathering insights, engaging with the local population, and taking advantage of all opportunities help Crawley residents to stay well for longer.

This requires a step-change in emphasis and approaches across the public, private, and voluntary, community and social enterprise (VCSE) sectors as part of a ‘whole systems approach’ to the health of local populations.

The start of the Crawley journey

The Crawley Programme has been far reaching and here we describe phase one of the work, what we have learned and what have been identified as a priorities to start establishing Crawley as a healthier place to live, work, and age.

What did we do?

The Crawley Programme took a wholly local approach to looking at the needs of the population of Crawley. From January 2022 to April 2022, we:

  • Undertook a study to know what health and care services are available and being delivered in Crawley.
  • Engaged from the outset with people and communities to understand what barriers they have faced, and what is a priority to them to help support their health and wellbeing. This was through our ‘Let’s Talk Crawley’ engagement plan.
  • Engaged with communities who had been identified in our Equality and Health Inequality Impact Assessment (EHIA) as experiencing health inequalities.
  • Engaged with our health and care professionals to gain their views and local insight into how services in Crawley are delivered and accessed; and
  • Undertook the start of a Crawley estates baseline review.

What did we learn?

We discovered a real need to ensure health and care services are rooted in the community; that we are not providing ‘more of the same’ services, and that people have the opportunity to craft the local solutions to help create healthier outcomes for themselves and their families.

We learned that Crawley:

  • Is one of the most affected areas economically because of COVID-19 due to the reliance on Gatwick Airport. This is evidence of how place impacts people, and the significant impact it has on people’s mental and physical health.
  • Has some of the most deprived neighbourhoods in England and is in the highest 20% of deprivation in England.
  • Lifestyle and behaviours have a significant impact on their health outcomes including obesity, physical activity, alcohol admissions, smoking prevalence, and sexual health.
  • Has an ageing population with multiple long-term conditions, including cancer, depression, diabetes, asthma, atrial fibrillation (AF) and cardiovascular disease (CVD).
  • Residents,’ as an average, have a higher population percentage of people living with mental health disorders than the England average.
  • Perinatal mental health activity has increased in complexity of what people are needing.
  • Residents’ life expectancy is 5.8 years lower for men and 6.0 years lower for women in the most deprived areas, compared to the least deprived areas in Crawley.
  • Residents tend to access health services later when they are unwell, and therefore have more complex health needs and outcomes as a result.
  • Residents feel they have the services they want and need, but the main barrier is accessing them. This is across all services, hospital, community, GP, and mental health.
  • Residents struggle with transport. Physically getting to health and care appointments is a challenge when reliant on public transport, family, friends, and carers. This has an impact on testing, screening, and other diagnostics to help manage and identify health issues.

To address these challenges, we need to consider how we are supporting Crawley residents to stay well, live healthier lives and prevent more people from becoming acutely unwell in the first place.

Understanding the community and areas of focus

The Pandemic has shone a stark light on inequalities in health and healthcare in Crawley. To ensure we understand and can target Crawley’s health inequalities we have developed a Crawley CORE20PLUS5, which defines our most deprived areas (CORE20), six groups identified as experiencing poor health access and outcomes in Crawley (PLUS), and our clinical priorities.

  • The ‘Core20’ is the focus on the 20% most deprived communities - Crawley has some of the most deprived neighbourhoods in England (two Lower Level Super Output Areas (LSOAs) in the highest 20% of deprivation national, both in Broadfield
  • The ‘PLUS’ is the population groups experiencing poor health access and outcomes. In Crawley these are ethnic minority communities; low skilled workers, homeless, Armed Forces, Asylum Seekers and Refugees, residents not registered with a GP.
  • The ‘5’ is the part that sets out clinical areas of focus. Nationally there are five, in Crawley our clinical priorities are:
    1. Maternity: enhancing the pre and postnatal care for pregnant women
    2. Mental Health: enhancing access to mental health services and support
    3. Long Term Conditions: focusing on people living with long term conditions, which will support them to manage their condition(s) well. Our priority conditions are: hypertension, asthma, diabetes, Stage 1 cancer, Atrial Fibrillation and Cardiovascular Disease.

What’s next?

We now enter the exciting second phase, which will focus on developing priority services areas for Crawley. We will be continuing the conversation with the population of Crawley and asking them to help craft the local solutions to priority areas listed below.

Understanding the Crawley need and responding to that need will take time. However, together, with our partners we know we can make a positive difference for the people of Crawley. The first priorities are:


  1. Improving access to services in Crawley

We heard that the health services available to the people of Crawley are what the population need and want. However, what came through loud and clear was an issue in accessing services.

In September we are going to continue engaging with Crawley communities to understand in more depth what the barriers are that they are facing. And together create a proposal, to start to break those barriers down.

It is so important that we enable Crawley residents to be able to access the right services, at the right time and place for them. For them to feel confident in navigating healthcare services to meet their needs in any language or accessibility.

We are also in the final stages of launching a new translation service to facilitate better communication with those who first language is not English.

  1. Improving Access to Maternity Services

Maternity care in the UK is sadly, not equally safe for everyone who get pregnant and gives birth, with ethnicity, deprivation, country of birth, spoken language, medical history, and age all influencing your risk of having worse outcomes for you or your baby. The Crawley insights have highlighted our Black, Asian, and Mixed ethnicities, people living in poverty or deprivation, and under 20 years old, or over 40 years old who are pregnant and give birth all have a greater risk of worse outcomes. For some people who have two or more of these characteristics carry an even higher risk. We also discovered that need for perinatal mental health services (services delivered during pregnancy, labour, delivery, and the days and weeks after having a baby) has increased significantly with more complex cases.

Crawley residents told us they were concerned about accessing maternity services; that they didn’t find it easy to know where to go or who to talk to, especially when English wasn’t their first language. Travelling was also raised as a challenge to people when accessing maternity and antenatal services.

To ensure maternity services for Crawley meet the needs of the local population we will co-design what is needed in Crawley with local people. The places in Crawley we are looking at first are the two most deprived areas, which also has a higher Black, Asian, and Mixed Ethnic population. The Crawley maternity plan will include a change in midwifery care, where a named midwife, who works as part of a small team of midwives is with the pregnant person all the way through their pregnancy, birth, and after. The aim is to safely deliver as much maternity care locally as we can and look to provide as many of the key services you may use or need in fewer locations aiming to reduce the need to travel within and outside Crawley.

3.
Frailty and Long-Term Condition Management

Crawley has an ageing population with many living with long-term or multiple health conditions. The need for local health services to help manage their conditions will continue to grow.

What came through when talking to people was the multi-generational concern for their ageing relatives and making sure they can get the health care they need to live healthier, longer independent lives.

A national approach to Anticipatory Care Planning (ACP) is being rolled out as a programme in 2022/23. It’s all about talking about what matters most for you and making plans for your future care. We will build upon our experience in Crawley as we plan to roll out this programme.

  1. Increasing access to diagnostics in Crawley

Many people in Crawley are living with physical or health needs, and they require diagnostics (diagnostics are scans, tests, and screening) to help identify health issues which need to be managed or treated and help them to live independent healthy lives.

Crawley residents told us it can be a challenge if they need to travel further afield for their diagnostics, which can often lead to people missing appointments or being delayed due to location and being reliant on family, friends, and carers to take them.

In 22/23 we aim to develop a Community Diagnostics Centre at Crawley Hospital which will increase the number of diagnostics which we can undertake at this site; meaning more Crawley residents will be able to be referred to and receive their diagnostics at Crawley Hospital, providing quicker access and identification of health issues, bringing these services closer to home.

A pilot mobile unit is also being considered to specifically address health inequalities, enabling all our residents to have equal opportunity to access the diagnostics they need.

  1. Improving Mental Health Services in Crawley

A considerable number of people in Crawley are living with mental health conditions. We have also seen many more people needing mental health care at crisis point.

People have told us it is challenging to access mental health services, when in crisis or when managing a long-term condition, and that people’s go-to for help is the Urgent Treatment Centre (UTC), in Crawley Hospital.

As part of the community transformation of mental health services for adults and older adults, Crawley will be one of the first locations in Sussex to refocus its services, to ensure that GPs, Trusts, and Voluntary sector provide straightforward and timely access to patients when they need help and support.

  1. Improving primary care in Crawley

The population of Crawley is set to increase significantly by 2043. With a growing population we know that community infrastructure is vital, especially when it comes to health services.

From what people have told us accessing GPs and primary care services is a challenge, and the fear is as the population grows the pressure on services will increase even further.

In 2022/23, we will continue to work with general practice, partner organisations, and patients to develop and implement changes to how services are planned and delivered. We will build upon the Fuller stocktake report, - Next Steps for Integrating Primary Care. For any change in primary care to work, it’s clear we need to be developing services at a neighbourhood level and helping people stay healthy.

NHS Sussex is committed to putting place first, to working differently and providing the population of Crawley with services that support their health and wellbeing

You can get involved with the Crawley Programme by contacting us via email at sxicb.publicinvolvement@nhs.net

The Crawley Story

Introduction

Creating a healthier population requires working together with communities, and health and care professionals to address the issues that are influencing poor health outcomes.

We know that people’s health is influenced by many factors, such as where you are born, grow up, live, work, and age. The COVID-19 pandemic brought into focus the health inequalities for the population of Crawley, which is one of the most culturally diverse communities in West Sussex.

The West Sussex Health and Care Partnership agreed Crawley as an area of priority in the West Sussex Health and Care Plan. The Crawley Programme was launched in 2021 to explore what health challenges there may be for people in and around the town and the impact of these on the population of Crawley.

To make real changes for the people of Crawley, we want to work with them to help to craft the local solutions that create healthier and connected communities.

The Crawley Programme is about building partnerships, gathering insights, engaging with the local population, and taking advantage of all opportunities help Crawley residents to stay well for longer.

This requires a step-change in emphasis and approaches across the public, private, and voluntary, community and social enterprise (VCSE) sectors as part of a ‘whole systems approach’ to the health of local populations.

The start of the Crawley journey

The Crawley Programme has been far reaching and here we describe phase one of the work, what we have learned and what have been identified as a priorities to start establishing Crawley as a healthier place to live, work, and age.

What did we do?

The Crawley Programme took a wholly local approach to looking at the needs of the population of Crawley. From January 2022 to April 2022, we:

  • Undertook a study to know what health and care services are available and being delivered in Crawley.
  • Engaged from the outset with people and communities to understand what barriers they have faced, and what is a priority to them to help support their health and wellbeing. This was through our ‘Let’s Talk Crawley’ engagement plan.
  • Engaged with communities who had been identified in our Equality and Health Inequality Impact Assessment (EHIA) as experiencing health inequalities.
  • Engaged with our health and care professionals to gain their views and local insight into how services in Crawley are delivered and accessed; and
  • Undertook the start of a Crawley estates baseline review.

What did we learn?

We discovered a real need to ensure health and care services are rooted in the community; that we are not providing ‘more of the same’ services, and that people have the opportunity to craft the local solutions to help create healthier outcomes for themselves and their families.

We learned that Crawley:

  • Is one of the most affected areas economically because of COVID-19 due to the reliance on Gatwick Airport. This is evidence of how place impacts people, and the significant impact it has on people’s mental and physical health.
  • Has some of the most deprived neighbourhoods in England and is in the highest 20% of deprivation in England.
  • Lifestyle and behaviours have a significant impact on their health outcomes including obesity, physical activity, alcohol admissions, smoking prevalence, and sexual health.
  • Has an ageing population with multiple long-term conditions, including cancer, depression, diabetes, asthma, atrial fibrillation (AF) and cardiovascular disease (CVD).
  • Residents,’ as an average, have a higher population percentage of people living with mental health disorders than the England average.
  • Perinatal mental health activity has increased in complexity of what people are needing.
  • Residents’ life expectancy is 5.8 years lower for men and 6.0 years lower for women in the most deprived areas, compared to the least deprived areas in Crawley.
  • Residents tend to access health services later when they are unwell, and therefore have more complex health needs and outcomes as a result.
  • Residents feel they have the services they want and need, but the main barrier is accessing them. This is across all services, hospital, community, GP, and mental health.
  • Residents struggle with transport. Physically getting to health and care appointments is a challenge when reliant on public transport, family, friends, and carers. This has an impact on testing, screening, and other diagnostics to help manage and identify health issues.

To address these challenges, we need to consider how we are supporting Crawley residents to stay well, live healthier lives and prevent more people from becoming acutely unwell in the first place.

Understanding the community and areas of focus

The Pandemic has shone a stark light on inequalities in health and healthcare in Crawley. To ensure we understand and can target Crawley’s health inequalities we have developed a Crawley CORE20PLUS5, which defines our most deprived areas (CORE20), six groups identified as experiencing poor health access and outcomes in Crawley (PLUS), and our clinical priorities.

  • The ‘Core20’ is the focus on the 20% most deprived communities - Crawley has some of the most deprived neighbourhoods in England (two Lower Level Super Output Areas (LSOAs) in the highest 20% of deprivation national, both in Broadfield
  • The ‘PLUS’ is the population groups experiencing poor health access and outcomes. In Crawley these are ethnic minority communities; low skilled workers, homeless, Armed Forces, Asylum Seekers and Refugees, residents not registered with a GP.
  • The ‘5’ is the part that sets out clinical areas of focus. Nationally there are five, in Crawley our clinical priorities are:
    1. Maternity: enhancing the pre and postnatal care for pregnant women
    2. Mental Health: enhancing access to mental health services and support
    3. Long Term Conditions: focusing on people living with long term conditions, which will support them to manage their condition(s) well. Our priority conditions are: hypertension, asthma, diabetes, Stage 1 cancer, Atrial Fibrillation and Cardiovascular Disease.

What’s next?

We now enter the exciting second phase, which will focus on developing priority services areas for Crawley. We will be continuing the conversation with the population of Crawley and asking them to help craft the local solutions to priority areas listed below.

Understanding the Crawley need and responding to that need will take time. However, together, with our partners we know we can make a positive difference for the people of Crawley. The first priorities are:


  1. Improving access to services in Crawley

We heard that the health services available to the people of Crawley are what the population need and want. However, what came through loud and clear was an issue in accessing services.

In September we are going to continue engaging with Crawley communities to understand in more depth what the barriers are that they are facing. And together create a proposal, to start to break those barriers down.

It is so important that we enable Crawley residents to be able to access the right services, at the right time and place for them. For them to feel confident in navigating healthcare services to meet their needs in any language or accessibility.

We are also in the final stages of launching a new translation service to facilitate better communication with those who first language is not English.

  1. Improving Access to Maternity Services

Maternity care in the UK is sadly, not equally safe for everyone who get pregnant and gives birth, with ethnicity, deprivation, country of birth, spoken language, medical history, and age all influencing your risk of having worse outcomes for you or your baby. The Crawley insights have highlighted our Black, Asian, and Mixed ethnicities, people living in poverty or deprivation, and under 20 years old, or over 40 years old who are pregnant and give birth all have a greater risk of worse outcomes. For some people who have two or more of these characteristics carry an even higher risk. We also discovered that need for perinatal mental health services (services delivered during pregnancy, labour, delivery, and the days and weeks after having a baby) has increased significantly with more complex cases.

Crawley residents told us they were concerned about accessing maternity services; that they didn’t find it easy to know where to go or who to talk to, especially when English wasn’t their first language. Travelling was also raised as a challenge to people when accessing maternity and antenatal services.

To ensure maternity services for Crawley meet the needs of the local population we will co-design what is needed in Crawley with local people. The places in Crawley we are looking at first are the two most deprived areas, which also has a higher Black, Asian, and Mixed Ethnic population. The Crawley maternity plan will include a change in midwifery care, where a named midwife, who works as part of a small team of midwives is with the pregnant person all the way through their pregnancy, birth, and after. The aim is to safely deliver as much maternity care locally as we can and look to provide as many of the key services you may use or need in fewer locations aiming to reduce the need to travel within and outside Crawley.

3.
Frailty and Long-Term Condition Management

Crawley has an ageing population with many living with long-term or multiple health conditions. The need for local health services to help manage their conditions will continue to grow.

What came through when talking to people was the multi-generational concern for their ageing relatives and making sure they can get the health care they need to live healthier, longer independent lives.

A national approach to Anticipatory Care Planning (ACP) is being rolled out as a programme in 2022/23. It’s all about talking about what matters most for you and making plans for your future care. We will build upon our experience in Crawley as we plan to roll out this programme.

  1. Increasing access to diagnostics in Crawley

Many people in Crawley are living with physical or health needs, and they require diagnostics (diagnostics are scans, tests, and screening) to help identify health issues which need to be managed or treated and help them to live independent healthy lives.

Crawley residents told us it can be a challenge if they need to travel further afield for their diagnostics, which can often lead to people missing appointments or being delayed due to location and being reliant on family, friends, and carers to take them.

In 22/23 we aim to develop a Community Diagnostics Centre at Crawley Hospital which will increase the number of diagnostics which we can undertake at this site; meaning more Crawley residents will be able to be referred to and receive their diagnostics at Crawley Hospital, providing quicker access and identification of health issues, bringing these services closer to home.

A pilot mobile unit is also being considered to specifically address health inequalities, enabling all our residents to have equal opportunity to access the diagnostics they need.

  1. Improving Mental Health Services in Crawley

A considerable number of people in Crawley are living with mental health conditions. We have also seen many more people needing mental health care at crisis point.

People have told us it is challenging to access mental health services, when in crisis or when managing a long-term condition, and that people’s go-to for help is the Urgent Treatment Centre (UTC), in Crawley Hospital.

As part of the community transformation of mental health services for adults and older adults, Crawley will be one of the first locations in Sussex to refocus its services, to ensure that GPs, Trusts, and Voluntary sector provide straightforward and timely access to patients when they need help and support.

  1. Improving primary care in Crawley

The population of Crawley is set to increase significantly by 2043. With a growing population we know that community infrastructure is vital, especially when it comes to health services.

From what people have told us accessing GPs and primary care services is a challenge, and the fear is as the population grows the pressure on services will increase even further.

In 2022/23, we will continue to work with general practice, partner organisations, and patients to develop and implement changes to how services are planned and delivered. We will build upon the Fuller stocktake report, - Next Steps for Integrating Primary Care. For any change in primary care to work, it’s clear we need to be developing services at a neighbourhood level and helping people stay healthy.

NHS Sussex is committed to putting place first, to working differently and providing the population of Crawley with services that support their health and wellbeing

You can get involved with the Crawley Programme by contacting us via email at sxicb.publicinvolvement@nhs.net

Page last updated: 06 Jan 2023, 01:08 PM