Director of Public Health Annual Report 2022: Preventing heart disease and stroke in Buckinghamshire

We need a renewed focus on preventing cardiovascular disease in Buckinghamshire. This needs to address the key social, economic and environmental risk factors for cardiovascular disease, alongside the behavioural and clinical risk factors to keep our residents healthy and narrow inequalities. Tackling the key risk factors will also improve health in a variety of other ways, including reducing the risk of cancer, diabetes, dementia, musculoskeletal problems and poor mental health, and produce many other societal and economic benefits, making Buckinghamshire an even better place to live.

To tackle cardiovascular disease and reduce inequalities in illness and premature death in Buckinghamshire we need a multilevel approach that addresses risks at the individual, community and Buckinghamshire-wide level that will impact over the short, medium and long term.

We need to work together with partners and communities across Buckinghamshire to:

1. Act on the broader determinants of health, such as income, debt, good quality employment, high quality education and healthy environments to level up outcomes across Buckinghamshire. Tackling these issues is an essential component of reducing inequalities in health.
2. Support a systematic large-scale improvement in behavioural risk factors by:

Ensuring the physical, social, commercial and economic environments in which people live, work and learn support healthy behaviours.

Increasing the understanding and the skills required to design effective behaviour change interventions across Buckinghamshire Council, the NHS and partners, including rolling out the behaviour change Making Every Contact Count programme. This enables people to have ‘healthy conversations’ to support behaviour change in their day-to-day interactions.

Working with communities to understand what would support them to reduce their risk of cardiovascular disease and co-design and evaluate appropriate approaches.

Supporting NHS trusts to implement the NHS Long Term Plan smoking cessation support requirements as smoking is the single biggest modifiable driver of health inequalities.

Working together with partners and communities to develop a whole system approach to healthy eating and physical activity to combat the rise in unhealthy weight and obesity.

Working together to tackle smoking via the Tobacco Control Action Plan.

Working together to address harmful alcohol misuse through development of our new drug and alcohol strategy.

3. Increase detection and management of modifiable risk factors in people at higher risk of cardiovascular disease, including those living in more deprived areas, ethnic groups at higher risk of cardiovascular disease and those with mental illness by:

Increasing capacity in primary care in more deprived areas to undertake NHS health checks and detect and manage clinical risk factors, such as high blood pressure and diabetes, and refer to appropriate interventions, such as smoking cessation.

Working with people from ethnic minority groups to design effective, culturally competent approaches to increase detection of risk factors and management of risk factors.

Working with NHS and local authority partners to develop and implement the whole system plan to tackle inequalities in cardiovascular disease.

4. Improve data collection and monitoring to track progress.

Improve data collection in primary and secondary care to enable monitoring of outcomes by ethnicity and areas of deprivation and improve the quality, accuracy and completeness of ethnic monitoring data.

Undertake equity audits to determine access to and uptake of prevention and treatment initiatives of cardiovascular disease by different groups.