Obesity in among the biggest health problems in Doncaster today - and yet we are seeing more fast food joints open in the town.
That is among the concerns raised in the third part of our Free Press round table on health, along with concerns that out communities need to be rebuilt to provide better support.
We put a group of experts together at Primary Care Doncaster's base at Devonshire House, on South Parade.
Our panel was Doncaster MP Rosie Winterton; Primary Care Doncaster chief executive Laura Sherburn; Doncaster Healthwatch chief executive Andrew Goodall; Doncaster Council public health consultant Dr Victor Joseph; Doncaster Patient Participation Group members Barbara Bell and Geoffrey Johnson; Secondary care doctor member of Doncaster NHS Clinical Commissioning Group Dr Emyr Jones; Doncaster Royal Infirmary medical director Sewa Singh, and Rotherham Doncaster and South Humber Healthcare Trust care group, Jo McDonough.
What is the biggest health problem we are seeing in Doncaster?
Victor Joseph: We have one of the highest rates of people of excess weight in our population and smoking is another big one. These are lifestyle issues but they translate as one of the biggest issues causing cancer heart disease, diabetes, so it is a really big health problem. That's why we need to embed prevention in what we do. As all partners we can look at this. As the first tier of prevention we should look to see that everyone is registered at a GP or dentist dentist. We take that for granted, but there are people who are not . Social isolation for people is a big issue, financial difficulties people are facing. In tier two, in the health system we need to take advantage of making every contact count. That's an initiative that's started in Yorkshire and the Humber. It's having conversations with staff, perhaps receptionists, nurses, doctors, asking things like whether or not they take part in physical activity. We're making a good start in Doncaster. There are specific things that can be done based on a specialist area. We've got a place plan, we've got areas of opportunity. We can all do something about these issues.
Andrew Goodall: It's an opportunity to engage more people in conversations about health. The more people talk and the more people listen and the more they can inform others and influence local services. In solutions it is about working together across communities rather than trying to do everything ourselves. We can do it collectively and come up with innovative ideas
Emyr Jones: There are two things that strike me as being important to Doncaster. The first one it the social infrastructure. I think as a community we're social deprived in relation to many other parts of the country with worklessness and educational attainment, and all these things could do with improving. I think we need to invest in improving the whole of Doncaster society. The other one is lifestyle, like obesity and smoking and I think the lifestyle choices that people are making are not always the healthiest choices. We need to be trying to encourage and educate and provide the necessary infrastructure to make the right lifestyle choices. It's always a difficult one. Doncaster is growing, there's a lot of investment coming in here. There are new entertainments arriving, and there are new developments out on Doncaster Carr at the moment. They are nearly all fast food joints. Ok it's nice to attract business, its nice that people should relax, its nice that people should have leisure time, but nearly everyone one of the new developments at Doncaster Carr is a fast food joint. I'm not sure that that's healthy. I think that we ought to be trying to invest in other developments.
Jo McDonough: We have seen a significant rise in demand for all types of mental health service for all ages from access to talking therapies, which people can access via the talking shop in the town centre through to some of our more specialist services. There are over 4,000 families in Doncaster living with someone with dementia and we're looking at how we can try to support those families better in terms of health and social care, not just around the diagnosis, how can people live at home and well, as long as possible with dementia and I think these are some of the things that we're seeing where prevention work would have an impact. We're also seeing the outcomes of that social deprivation, worklessness and unhealthy lifestyles coming through in terms of mental health and the support we have to provide people to cope with the challenges that life throws up.
Geoffrey Johnson: We haven't discussed carers, and I'm thinking of the health of carers because I feel that the NHS, GP practices, DWP, health and social care, business, employers voluntary organisations, and the PPG network. all need to work together to communicate together. We've got to identify young carers in schools, and we need to reach out to the borough to get out the message of what is the definition of a carer . When we recently had a carers day at my local GP practice, people did not know if they're a carer as they can be a family member, a relative, helping a friend or a neighbour. I was a carer who was in employment, and had to give up my job to look after my father. I think employers need to understand more a carer's role but we need employment rights for carers to run along the existing employment rights, for example the right to flexible working and the right to time off for family and dependents , the possibility of a career break. I worked in the civil service. I think its important for the borough that we go our to employers to highlight what its like to be a carer, what the definition of a carer is, and to discuss with the employer how to keep the person in employment.
JM: I agree and if you look at the health organisations and the council, we are significant employers in Doncaster and we should be supporting our own staff to be we'll but also for those who are carers to give them that flexibility as its a significant impact on people's lives.
RW: I think you have to go back to people working together, you have to have evidence based . One of the things I found most worrying was when the Government abolished things like primary care trusts and strategic health bodies who spent a lot of time analysing exactly what was happening in an area. Every area will be different. Doncaster, as an ex-coal mining town, had different health problems than somewhere in the countryside. because of people working down the mines and you've got to accept that places will have different issues, but you need the analysis to be done, and not with guess work but based on experience of GPs, public health, people like health watch and the hospitals and so on.
VJ: We have a joint strategic health assessment for the area, so we've got a measure for the whole area which is based on hard data.
RW: What comes out of that to you as the number one problem?
VJ: We still have heart disease, cancer, respiratory problems, such as COPD, They are some of the big problems in Doncaster.
JM: Together, we have a place plan that says there are three things that we need to work together on. One is around increasing workforce, increasing quality, and managing scarce resource. All the information from all the partners has identified these key areas and we going to do that together. One is around accessing urgent care, so some of this will be linked to that. One is around starting well, that's how everyone is working with children and babies in the first thousands days of their lives as that is where we can see some real impact, the next is working with vulnerable adolescents, and supporting them. There's one around learning disabilities and supporting people to be leading the most fulfilled lives, and one around intermediate care, helping older people stay out of hospital. The last one is complex lives, about supporting homeless people. I think that's one of the real successes across health and social care in the last year that we've come together to form that one plan and all the organisations here have signed up to that.
Sewa Singh: The biggest problem for me is about deprivation because if you look at a lot of the problems we deal within health care they were caused by deprivation. We've lost the community spirit in Doncaster which I think existed 20 years ago where we supported each other when health problems came out and I think our lifestyles that we choose to live are related too. So when I talk about deprivation I talk about it in two parts. I talk about financial deprivation, as if we could eradicate poverty in Doncaster it would make a big difference. I think there is social deprivation as well. We need to put our communities back together again.