The Scottish Allied Health Professions Public Health Strategic Framework Implementation Plan 2022 to 2027 sets out the ambitions for AHPs, their partners including NHS Boards to progress, support and enable AHP's to improve public health in the population, to reduce health inequalities and encourage self-management and self care through prevention and early intervention.
In April 2023 I was successful in my application to receive funding from NES AHP Careers Fellowship programme to focus on Health Inequalities. I am one of 19 AHP's and AHP Healthcare Support Workers to receive funding of up to 2 days a week to focus on personal development and delivering a project within the workplace. Funding allows dedicated time to focus and understand our caseload of those with a diagnosis of Diabetes, Peripheral Arterial Disease (PAD), by gathering important data about the social determinants, economic and environmental factors which impact on individual's health and wellbeing. The other aspect of the project focuses on developing our Team, delivering a One Year Action Plan to lead and support transformative change for our service and contribution to tackling health inequalities for individuals and communities in Dumfries and Galloway.
One Year Action Plan Themes
Health Inequalities are the unfair and avoidable differences in people's health across social groups and between different population groups. To tackle health inequalities requires action that addresses three fundamental drivers of social inequality, power, income and wealth. These drivers affect the distribution of wider environmental influences on health, such as availability of good quality housing, work, education and learning opportunities, as well as access to services.
When we talk about health inequalities, it is useful to be clear on which measures are unequally distributed and between which people. The only way to really evaluate if your service is providing inclusive and equitable care is to understand the community you're working with, both on a local level, and in terms of the clinical population. How do you know if you are seeing who you should expect to be seeing within your service?
To focus and understand the more complex part of the Podiatry caseload, for individuals with a diagnosis of diabetes and PAD is vitally important for service planning and delivery of care. Diabetes costs NHS Scotland around £1 billion pound each year, of which approximately 80% (£800 million) is spent treating potential avoidable complications. Furthermore, around 12 per cent of the total inpatient budget in Scotland goes on treating diabetes and its complications. It is important that individuals engage with diabetes services, glucose monitoring, have access to person centred education, support resources, online learning, with pathways to enable and empower self-management, to help reduce these complications.
Peripheral arterial disease (PAD) is a common problem which affects 9% of the population. PAD is closely associated with age and with the prevalence of diabetes, brings a high risk of death and disability, particularly leg amputation, and is a strong marker of more extensive arterial disease. Around 1–2 % of people with PAD will undergo amputation within 5 years, making PAD one of the biggest causes of lower-limb amputation in the UK. PAD can be largely treated through medication and lifestyle changes to help reduced the risk of developing coronary heart disease, stroke and loss of limb.
Therefore it is important that we ensure we are working with people to prevent the onset or progression of disease and preventing inappropriate use of health services should be seen as a way to manage growing demand in a more sustainable way.
Lesley Brown is Team Lead East/Professional Advisor Podiatry Services for Dumfries and Galloway Health and Social Care Partnership
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