Southern Health and Social Care Trust

EXECUTIVE
SUMMARY
BACKGROUND
The Craigavon Health Improvement Programme (the Programme) has
sought to address the health inequalities that exist in the 3 designated
Neighbourhood Renewal (NR) areas in Craigavon of Brownlow, Lurgan and
Portadown North West through a series of targeted interventions. Managed
by the Promoting Wellbeing Team from within the Southern Health and Social
Care Trust in the Craigavon and Banbridge locality. The work commenced in
April 2011 and is due for completion in March 2016.
The Programme has been funded by Department of Social Development
under the Neighbourhood Renewal Programme, a cross government
strategy aimed at tackling disadvantage and deprivation by working with
and through local communities. The NR Strategy has sought to close the
gap in the quality of life between the most deprived neighbourhoods
and the rest of society through the better co-ordination of public services and
the creation of safer environments.
The Craigavon NR area has a combined population at the 2011 Census
of 20,281 individuals, with Brownlow having seen the most dramatic increase
in its population, particularly amongst those over 65 years where an increase
of 60% has been observed. Whilst past interventions have had a positive
impact, the situation in the NR areas continues to be worse than for the
Southern Health and Social Care Trust area as a whole, including:

General Health - individuals were more than 3 times as likely to describe their health
as bad or very bad and to have a longstanding illness
Mortality Rate - a 29% higher rate for premature and avoidable death with a 20%
higher rate in deaths to under 75s
Suicide Rate - a 59% higher rate for suicide
Mental Health - a 25% higher prevalence of mood and anxiety disorders
Obesity - adult obesity in the Southern Health and Social Care Trust is the highest in
NI at 28%, with childhood obesity 1.5 times higher in the most deprived areas than for
the Southern Health and Social Care Trust area as a whole
Alcohol and Smoking - hospital admissions for alcohol were twice as high with
smoking prevalence three times more likely

The Programme has responded to the strategy outlined in People and

Place and delivered in the context of Making Life Better, the 10 year
Public Health Strategy for NI that seeks to reduce health inequalities by
greater partnership working whilst recognising the important role that
community and voluntary sector organisations have to play in the provision
of health services. To enable this to happen, the Strategy recognises the
importance of adopting a clear community development approach for health
and social care programmes and the need for community capacity and social
capital to be developed and utilised effectively.

Programme delivery has achieved the

following key quantitative outputs:
Establishment of the
Verve Healthy Living
Centre (HLC) Network

Development of
a Health Trainer
Network

Delivery of
Healthy
Lifestyle Programmes

Establishment
of the Verve
Healthy Living
Centre (HLC)
Network
Ten community organisations
came together to form the
Verve Network

Community Intercultural
Programme (was Craigavon)
Drumcree Community Trust
Drumellan Community
Association
Edgarstown Community
Centre (the Place Initiative)
North Lurgan Community
Association
Northern Pharmacies
Taghnevan Community
Development Association
Shankill (Lurgan)
Community Projects Ltd
(Mount Zion House)
Shankill Parish Caring
Association (The Jethro Centre)
Drumgor Detached Youth
Worker Project including
Fit Zone.

Four of these organisations

are based in the Lurgan NR
area, with three each from
Brownlow NR and Portadown
NW NR areas. The HLC
network was set up in 2013
and branded as Verve
promoting healthy
communities. The overall aim
of Verve has been to promote
healthy communities and
act as a conduit to allow the
Southern Health and Social
Care Trust to reach those
most in need. Interventions
have sought to recognise and
complement existing services
in the NR areas, promoting
communities as welcoming,
accessible and safe for all.

EXECUTIVE SUMMARY

Development of a Health Trainer Network

Applying learning based on research into programmes within similar
communities on the mainland UK the Southern Health and Social Care
Trust decided to pilot the Health Trainer model. This Model is based on the
recognition that the skills, know how and social networks that exist within
communities can be a powerful force for promoting and protecting health.
In this project ten individuals from the local community were
identified to be trained to work as Health Trainers. They completed a City
and Guilds Level 3 Certificate and were the first in Northern Ireland to gain
this qualification. The role of the Health Trainer is to empower individuals
with the skills to make healthier choices through an educational and
behaviour change approach. Their role involves signposting to specialist
services and providing one to one motivational support. In addition to
the Health Trainer qualification the Health Trainers have completed a
range of other courses that have allowed them to deliver healthy lifestyle
programmes that help individuals, groups and communities adopt and
sustain healthy behaviours.

Delivery of Healthy Lifestyle Programmes

The number of individuals that have participated in the Programme on at
least one occasion is 13,498. Individual programmes delivered have included:
8,307 individuals paticipating in Physical Activity Programmes, of which
5,954 were involved in weekly exercise programmes such as yoga,
Pilates, swimming, Zumba, body combat and armchair aerobics
431 individuals on Mental Health and Emotional Wellbeing Programmes
397 individuals on Smoking Cessation Programmes
336 individuals on Cancer Awareness Programmes
818 homes/individuals reached with Accident Prevention Training
and Support
20 participants on Sexual Health Programmes
394 older people were supported to tackle social isolation
27 families supported (12 x Mellow Parenting Programme and 15 x Portadown
Fathers Forum) on Family Support and Early Intervention Programmes

in addition, other
support provided
included

1,705 individuals attended

community health events
1,031 individuals received health
checks or body composition analysis
271 individuals attending specialist
training courses
115 individuals receiving one-toone interactions with health trainers
to change a health aspect of their life
style and put in place an action plan

Referrals from the

Programme to other
services included
497 individuals referred to their GP
as a result of high blood pressure
on screening
56 accessing specialist smoking
cessation service
13 referrals to the Trust stop

smoking service
70 accessing Heart Start
Emergency Life Support
42 drop-in health checks
Referrals to the programme have come
from a range of sources
The FUSE Newsletter produced
3-4 times per year and distributed
to 10,000 households and
organisations in Craigavon NR area
Social media - Facebook page
facebook.com/vervecraigavon
A promotional film produced
youtube/W3SKG1I0VBY

Benefits of the Programme

Service Delivery - an opportunity to deliver health programmes in a more joined up way across the NR areas
Good Practice - the opportunity to successfully replicate a model of good practice as seen in mainland UK
Increased Organisational Profile and Usage - increased number of local residents making use of the services available
Increased Capacity - to deliver services directly without the need to bring in external support. Training provided
has increased community capacity and contributed to an increase in the numbers of individuals willing to act as
volunteers at each Centre
Skills Development - staff, Health Trainers and volunteers are better skilled to be able to deliver a range of courses
Career Development - training has improved the career prospects of the Health Trainers, whether in their
current role or in a similar job role in another organisation
Economies of Scale - Organisations involved in the Verve Healthy Living Centres have been able to share resources,
covering a wider geographical area resulting in improved working relationships and collaboration
Hard to Reach - anecdotal evidence suggests some individuals have been reached and engaged with for the first time.
Build Relationship with the Southern Health and Social Care Trust - relationships between the Southern Health and
Social Care Trust and local communities have improved, with increased joint working and greater communication
Cross-Community Working - with the focus on delivering the Programme as best they can, there has been little
mention of religious or sectarian concerns. Health Trainers have been willing to work in communities outside of their
own area and provide support irrespective of the individuals religious or political background
Accessing Funding - involvement with the Verve Network and the skills developed has increased the opportunity to
access additional funding for future sustainability
Addressing Health Issues - the softer approach has worked well in encouraging more individuals to seek help and to
begin to address the health issues they have

EXECUTIVE SUMMARY

health issues in participants

Health issues that were prevalent in Programme participants have included:
A lack of confidence and low self-esteem
Overweight or Obese with a poor diet, with the resultant dental and oral

health issues
High Blood Pressure, Hypertension and Diabetes
Smoking and related health conditions
Physical aches and pains (especially backs and knees) brought about by weight
issues and a lack of exercise
Emotional issues such as stress, anxiety and depression
Poor mental health associated with socio-economic environment in which they live

impact of the programme

The change in participants physical and mental health before and after the support can be illustrated by the table below
drawn from evaluation forms completed:

health condition

physical

mental

before

after

before

after

3%

2%

16%

1%

14%

40%

11%

36%

5%

35%

54%

37%

48%

6%

34%

11%

47%

very poor
poor
fair
good
excellent

Changes in the physical health of participants have included becoming more active; improved fitness; fewer aches and
pains; reduced weight; reduced blood pressure; toned and stronger; sleeping better; and improved energy levels.
Changes in the mental health of participants have included beating/coping with stress; greater peace of mind; feel better
as a person; feel good factor; reduced depression; increased self-confidence and self-esteem.
Improvements in the general health and wellbeing of participants have included feeling less socially isolated and reduced
loneliness; improved interpersonal skills including communication; increased motivation levels; improved balance in their
life with an increased opportunity to relax; happier appearance and generally more positive; improved appearance and
hygiene; and changes to habits including reduced eating, drug and alcohol intake.
The impact on clients health can be illustrated by the following case studies.
Before joining a fitness class through the Verve Programme,
I did not engage in much activity outside of the home. The
Programme has changed my life. I have more energy, I enjoy
myself, my self esteem is very high, Im keeping myself fit
and Ive made lots of friends. I am really grateful for
being a part of this wonderful programme. If it stops
I dont know what Im going to afterwards.
Thank you for everything.

Through working with Faye (the Health

Trainer) I have learnt how small changes work
better for me than big ones. I have learnt different
ways to get my 5 fruit and vegetables each day.
I am more active in general and have been able to go on
long bike rides. I have lost weight (20 pounds), I no longer
have as much back pain and feel so much better.

The Health Trainer helped me achieve this (fitness and

weight loss) through the weekly weigh-ins and discussions
about food and lifestyle. She provided me with tips to help
address areas of difficulty that had prevented
weight loss in the past.
I have achieved my goal of weight loss and
as a result my confidence is also increased.

Christina (Health Trainer) was fantastic.

Her realistic and brilliant ideas were just what
I needed and she gave me the push to encourage
me and my family. The children now help out at dinner
time and we make it fun and simple. Christina and I
worked on things like meal choices and menu planning,
keeping it simple. The best thing is that my two children also
have a healthy approach to eating. I personally have achieved a
happy home at dinner time.

EXECUTIVE SUMMARY

Recommendations from the Evaluation

Based on the findings of the evaluation, the following recommendations are put forward.

Funding for Programme Delivery

Core funding should be sought to support the Verve Network and Health Trainer activities. This would include support for
both Health Trainer salaries and programme costs.
The Armagh, Banbridge and Craigavon District Council should be consulted to establish if funding through community
planning may also be available from 2016.

Programme Management

The future governance of the Verve Network needs to be clarified, with the ongoing role of the Southern Health and
Social Care Trust to be established.
The need for a Coordinator to oversee the work and provide strategic direction to the Network has been identified as
critical to its success; therefore securing this post is vital going forward.
Establishing the Network as a social enterprise should be considered.

Programme Delivery

An annual programme of Network wide health activities should be agreed.

Courses should continue to be tailored to the needs of the group and be flexible to be delivered at a time when most
suitable to the circumstances of participants.
A voluntary payment structure for all courses should be drawn up and agreed by the Network members.
Recruitment should focus on hard to reach individuals and not simply deliver to groups that have already been formed
at Verve Centres.
Pathways of support for individuals should be identified through which progress can be made to address complex or
multiple health issues and be backed up with one-to-one support from a Health Trainer.
Extending the delivery beyond the NR areas to include Craigavon or the new Armagh, Banbridge & Craigavon District
Council area should be considered.

Verve Network and Health Trainers

Individual Health Trainers should be encouraged to collaborate more, with the potential to form teams of trainers to
address issues over a wider area.
Consideration should be given to individual Health Trainers becoming specialists on specific issues, for example as a
mental health specialist Health Trainer.
A Health Trainer Continuous Professional Development plan should be established annually and include all training to be
received by Health Trainers.
Succession planning for Health Trainers should be considered, including the usage of the community health champion
approach and the provision of training to new Health Trainers identified.
Supervision support should be established for Health Trainers to protect their mental health and help deal with the issues
they are encountering.

Links to Primary and Acute Care Services

There is the need to establish better links between the Verve Network and Primary/Acute Care providers in the Southern
Health and Social Care Trust area, potentially through the implementation of Family Support Hubs in these areas.
Care pathways should be established, with the Health Trainer acting as the link, to provide effective cross referrals and
an exchange of information.
Social prescribing should be encouraged as an alternative to prescribed medications.

Prepared by
Supported by the Northern Ireland Executive
through the Department for Social Development