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Explicating the role of partnerships in changing the health and well-being of local communities: a profile of neighbourhood renewal activity focused on promoting health and well-being in Salford and the north west region and the north east of England. Volume 2: 2009 Howarth, ML, Warne, T, Cook, G, Dawson, P and Elliott, D Title Explicating the role of partnerships in changing the health and well-being of local communities: a profile of neighbourhood renewal activity focused on promoting health and well-being in Salford and the north west region and the north east of England. Volume 2: 2009 Authors Howarth, ML, Warne, T, Cook, G, Dawson, P and Elliott, D Type Article URL This version is available at: Published Date 2009

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  • Explica tin g t h e role of p a r t n e r s hips in c h a n gin g t h e h e al t h a n d w ell-b ein g of local

    co m m u ni tie s: a p rofile of n eig h bo u r hood r e n e w al a c tivity

    focus e d on p ro moting h e al t h a n d w ell-b ein g in S alfor d a n d t h e

    no r t h w e s t r e gion a n d t h e no r t h e a s t of E n gla n d. Volu m e 2: 2 0 0 9

    Ho w a r t h , ML, Warn e, T, Cook, G, Daw so n, P a n d Ellio t t , D

    Tit l e Explica ting t h e role of p a r t n e r s hips in c h a n gin g t h e h e al th a n d w ell-b ein g of local co m m u ni tie s: a p rofile of n eig h bou r hood r e n e w al a c tivity focus e d on p ro moting h e al t h a n d w ell-b ein g in S alfo rd a n d t h e no r t h w e s t r e gion a n d t h e no r t h e a s t of E n gla n d. Volum e 2: 2 0 0 9

    Aut h or s H ow a r t h , ML, Warn e, T, Cook, G, Da wso n, P a n d Elliot t , D

    Typ e Article

    U RL This ve r sion is available a t : h t t p://usir.s alfor d. p rin t/15 7 2 9/

    P u bl i s h e d D a t e 2 0 0 9

  • U SIR is a digi t al collec tion of t h e r e s e a r c h ou t p u t of t h e U nive r si ty of S alford. Whe r e copyrigh t p e r mi t s, full t ex t m a t e ri al h eld in t h e r e posi to ry is m a d e fre ely availabl e online a n d c a n b e r e a d , dow nloa d e d a n d copied for no n-co m m e rcial p riva t e s t u dy o r r e s e a r c h p u r pos e s . Ple a s e c h e ck t h e m a n u sc rip t for a ny fu r t h e r copyrig h t r e s t ric tions.

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    mailto:[email protected]

  • Explicating the role of partnerships inchanging the health and well-being of local communities: A profile of Neighbourhood Renewal Activity Focused on PromotingHealth and Well-being in Salford and the North West Region and theNorth East of England

    URBANregenerationm a k i n g a d i f f e r e n c e

    Volume 2: 2009 Authors: Michelle Howarth & Tony Warne: Salford Centre for Nursing, Midwifey and Collaborative Research

    University of SalfordGlenda Cook, Pam Dawson and Denise Elliott: School of Health,Community and Education Studies, Northumbria University

  • Urban Regeneration: Making a Difference


    Project Context

    Chapter 1 A profile of Neighbourhood Renewal Activity Focused on

    Promoting Health and Well-being in Salford and the North

    West Region

    1.1 Introduction

    1.2 Aims of the Scoping Exercise

    1.3 The Extent of Deprivation in the UK

    1.4 The North West Health Context.

    1.5 North West Indicators of Deprivation in Health and Well-being

    1.6 Evidence of Neighbourhood Renewal in the North West.

    1.7 Summary

    1.8 Focus on Salford.

    1.9 Regeneration Activity in Salford

    1.10 Salford’s Neighbourhood Renewal Context.

    1.11 References

    1.12 Websites

    Chapter 2 A Profile of Neighbourhood Renewal Activity Focused on

    Promoting Health and Well-being in the North East Region

    2.1 Introduction

    2.2. Aims of the Scoping Exercise

    2.3 Search strategy

    2.4 The North East and its population

    2.5 The Extent of Deprivation in the North East

    2.6 The Health Context of the North East

    2.7 Long-term health and well-being goals for the North East

    2.8 Regeneration partnerships in the North East

    2.9 Summary

    2.10 References

    2.11 Web sites

    Chapter 3 Profile Summary of North West and North East England

    Neighbourhood Renewal Activity: promoting health and


    2.1 Introduction





























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    Urban Regeneration: Making a Difference

    The Project Context


    This scoping and mapping report isone of three outputs from a project:Explicating the role of partnerships inchanging the health and well-beingof local communities , one of anumber of projects in a larger HigherEducation Funding Council StrategicDevelopment Fund project ( HEFCE )entitled: Urban Regeneration: Makinga Difference. This was a collaborativeventure between ManchesterMetropolitan University, NorthumbriaUniversity, University of Salford andUniversity of Central Lancashire.Bradford University was an affiliatedpartner.

    This overarching project had twoaims:

    • To address key urban regenerationchallenges in the North of Englandthrough inter-disciplinarycollaboration between the partneruniversities and practitionerorganisations, particularly in thepublic and voluntary sectors, and toenhance their collective impact onsociety

    • To build a long term strategicalliance between core universitypartners while developing adistinctive form of knowledgetransfer (KT), which is both teachingand research-driven, in order tomeet the needs of organisationsand professionals in business andthe community

    Four thematic areas were identified,which reflect important issues in theregeneration of the North of Englandand map on to the breadth anddepth of expertise amongst theuniversity partners and an existingfirm base of collaboration withexternal organisations.

    One university led on each theme,but every university will contribute toeach theme. The themes were: Crime,Community Cohesion, Health andwell-being and Enterprise.( )

    Health and Well-Being Theme

    The North of England has some ofthe worst health profiles in the UK,with startling inequalities in thehealth experience of differentpopulation groups as defined bygeographical and social group.Relative proportions of deaths fromcancer, heart disease and stroke inparticular, have been rising in recentyears. Rates of long-standing physicaland mental health are also highcompared with other parts of thecountry.

    These patterns are manifestations ofthe degree of well-being in thecommunity, which is affected by awide range of factors, includinghousing, poverty, transport,employment etc, covering the wholespectrum of regeneration issues.Availability for work is a naturalconsequence of health and well-being, with some parts of the Northhaving amongst the highest figures ofworklessness in the UK.

    Whilst the public sector is themainstream provider of support,through the National Health Serviceand local authorities, the non-statutory sector plays a vitalcomplementary role and is critical tosustaining the welfare of some of themost vulnerable communities andsections of the population. Thisincludes charities and not-for-profitorganisations such as housingassociations. It is a diverse andfragmented sector with an ability tobe highly responsive to new ideas.

    Effective cross-sector working isfundamental to the challenge ofmeeting the needs of vulnerablepopulations and working towards theinclusion of marginalised groups.Universities have a key role to play inthis process, yet this form ofknowledge transfer is only in itsinfancy, with huge potential fordevelopment.

    The NHS and local authorities areheavily dependent on the highereducation sector as a source ofprofessionally qualified people and asa resource for further professionaldevelopment and research andevaluation. This is complemented bypractical, action-research in a numberof HEIs, which is focused on theneeds of communities of practice.

    The Health theme identified 4important areas which link health toregeneration:

    • Health, employment and well-being, including the social andeconomic dimensions ofregeneration;

    • Ageing and disability, including thehealth and social care dimensionsof regeneration;

    • Enabling environments, includingthe physical and culturaldimensions of regeneration;

    • Public health and primary care,including health inequalities.

    In addition, a core focus across all ofthe projects will be on increasing theskill and knowledge level of thoseworking in health and well-beingregeneration. From (

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    Urban Regeneration: Making a Difference

    The Project: Explicating the roleof partnerships in changing thehealth and well-being of localcommunities

    It is clear that concepts of partnershipand collaboration underpin thesuccessful implementation of urbanregeneration initiatives. What is lessclear is how partnership workingimpacts upon the health and well-being aspects of urbanregeneration. Evaluations ofoutcomes are limited, and littlecomprehensive information isavailable as to the extent of any suchactivities across the North West andNorth East regions. This projectsought to examine the issues inrelation to these and to develop aframework for supporting the analysisof effective partnership working.

    Key aims of the project

    There were four main aims of theproject:

    1. A scoping and mapping exercise todevelop a profile of communityhealth and well-being needs andassociated neighbourhood renewalactivity in Salford and thenorthwest, and in Newcastle andthe northeast

    2. A review of the literature anddevelopment of a conceptualframework for partnershipevaluation

    3. Evaluation of the framework inaction through a series of casestudies of partnership working indesignated urban regenerationareas

    4.Determine the key factors ineffective partnership working


    The project was in itself a recognitionof the need for partnership workingbetween Universities in order tomaximise the value of sharedknowledge and experience inaddressing a common aim. It was alsoan opportunity to engage with localcommunities in urban regenerationareas to identify their needs andexperiences in relation to their healthand well-being and also determine away in which effective partnershipworking could be assured.

  • 4

    Chapter 1 A profile of NeighbourhoodRenewal Activity Focused on PromotingHealth and Well-being in Salford and theNorth West Region

    Urban Regeneration: Making a Difference

    Michelle Howarth and TonyWarne

    1.1 Introduction

    Changes in policy following theimplementation of the White papersSaving Lives (DH 1999) and OurHealthier Nation (DH 1998) usheredin new ways of raising public healthawareness and improving the healthand well being of communities.Coupled with the later WanlessReport (DH 2002) which argued thatthe health of the nation needed toimprove through sustainable action atboth national and local levels, it is notsurprising that local regenerationinitiatives concerning health and well-being have been placed at thevanguard of community and publichealth development. The focus ofpublic health has now moved towarda community ‘hands on’ approachpredicated on partnership workingbetween the NHS, local authoritiesand independent agencies. Thus, theemphasis of regeneration is to workcollegially with the community ratherthan imposing some ideologicallydriven nationally set objectives inproviding innovative ways ofaddressing the health and well-beingneeds of the population.

    1.2 Aims of the Scoping Exercise

    The aim of this scoping exercise is todescribe the North West in terms ofits location, aspects of deprivationand health and well-being needs.Critically, the different partnershiparrangements arising from theplethora of agencies involved, makesearching for sources of evidenceproblematic. The ensuing wave ofcommunity development programmesfollowed by the Neighbourhoodrenewal initiative resulted in an arrayof different, often disparate websites,policies and papers.

    Each of these contained various datawith one common denominator, thatof satisfying the needs of thecommunity health and well being. Forexample, the Index of MultipleDeprivation, developed by the Officeof the Deputy Prime Minister (2004)details seven Domains of deprivationwhich include income deprivation,employment deprivation, healthdeprivation and disability, education,skills and training deprivation,barriers to housing and services,living environment deprivation andcrime. These domains represent theGovernments beliefs about the keyregeneration areas which have beentargeted through a far-reaching rangeof initiatives and illustrate the extentof problems faced by communitiesand urban regeneration programmes.

    The North West has some of the mostrural areas in England and yet is alsowitness to much extensiveregeneration in some of the mostdeprived areas of the UK. A range ofNational statistical databases havebeen used to source health and socialcare data about the health and well-being of the North West (seetable 1). The National Office forstatistics, Cancer sites and the BritishHeart Foundation has provided someof the figures about the state of theNorth West. Collectively, these factspresent a sobering picture of theNorth West, most notably around theNeighbourhood Renewal (NR) areasalready funded. It is not surprisingtherefore that much energy has beengiven over to the regeneration ofthese areas. Indeed, some of thefigures from the National Indices ofDeprivation (2004) reveal a consistentmessage about the extent ofdeprivation and health inequalities inthe 17 areas identified in the NorthWest.

    Initially, a modest amount of evidencewas located simply using terms suchas urban regeneration orneighbourhood renewal. However,two sites were located whichprovided relevant information aboutthe progress and processes ofRegeneration. The NeighbourhoodRenewal Data Site (NRD) providedaccess to databases on the extent ofregeneration monitoring, prioritysetting and performancemanagement at a neighbourhoodlevel. A full range of information wasavailable which detailed datasets andinformation about neighbourhoodrenewal issues. These sites do nothowever, provide any insight into theactual partnership working beingundertaken to achieve the outcomes.The NRD site was designed to helplocal partnerships target and monitorlocal programmes and ispredominantly used by thosepreparing the Local Area Agreements,Local Strategic Partnership (LSP)coordinators and those who work ata neighbourhood level. Other siteswhich provide information on thedevelopment of regeneration includethe British Urban RegenerationAssociation. The association wasofficially formed in 1990 to “providea forum for the exchange of ideas,experience and information for theemerging regeneration sector”.

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    Urban Regeneration: Making a Difference

    The Neighbourhood Renewal Unit(NRU) was also accessed as a mainsearch site because of its responsibilityfor overseeing the neighbourhoodrenewal strategy. It is part of theDepartment for Communities andLocal Government (DCLG) and workswith government offices andneighbourhood renewal teams, tomonitor and support local strategicpartnerships.

    Through the NRU and governmentfunding a wide range of initiativeswere established to ascertain localneeds and to pilot new ways to fightdeprivation in the poorest and mostdeprived communities. TheNeighbourhood Renewal Unit sitewas therefore used as the maingateway to much of the informationcontained in this report about localregeneration initiatives. The sitedetails the extent of activity for all 17sites across the North West.

    Bolton, Salford & Trafford Mental Health Trust (accessed 1st August2007).

    British Heart Foundation Statistics Database

    Cancer Research UK

    Community Health Action Partnership (CHAP) 1st August 2007)

    Community Health Profiles (accessed 1st August 2007)

    Department of Health

    Neighbourhood Renewal Unit (accessed 1st August 2007)

    New Deal for Communities accessed through the NRU site at

    North West Public Health Observatory Health andLifestyle Trends in England assessment tool (accessed 1st August 2007)

    North West Development Agency Regional IntelligenceUnit

    NW Public Health Information Portal

    NW Public Health Observatory

    Salford County Council

    Salford PCT

    The 2001 National Census

    The World Health Organisation

    Table 1. Web Sites Searched

  • 6

    Urban Regeneration: Making a Difference

    1.3 The Extent of Deprivation inthe UK

    In 2000, the Office of the DeputyPrime Minister (ODPM) commissionedthe Social Disadvantage ResearchCentre (SDRC) at the Department ofSocial Policy and Social Research atthe University of Oxford to updatethe Indices of Deprivation 2000 (ID2000) for England. The 2004 reportbuilds on previous work undertakenin 2002 and “rehearses theconceptualisation underpinning themodel of multiple deprivation usedand outlines the indicators anddomains that go to make up the ID2004”. Each domain indices isconsidered in the geographicalcontexts of the UK. This was helpfulin identifying the regions worstaffected by deprivation particularly inrelation to the North West.

    Based on the data retrieved from theIMD, we explored seven indicators toelicit population demographicparticular to the North West. Thesewere drug misuse and treatment,alcohol related hospital stays,smoking related mortality, obeseadults, life expectancy and olderpeople supported at home.

    Similar concerns about life expectancyin the North West were alsohighlighted in the NWDA Action forSustainability Report which remarksthat the “average life expectancy formen and women in the regioncontinues to be below that ofEngland and Wales and the NorthWest shares the worst life expectancyof the regions… further the NorthEast. Manchester has the lowest malelife expectancy at birth of any localauthority in England (pg 48)”.

    In relation to health deprivation, theIMD (2004) defined healthdeprivation as being “unexpecteddeaths or levels of ill health”. TheNorth West had the largestpercentage of most deprived SuperOutput Area’s (SOP’s) in England(more than any other region):“Severe deprivation is evident in mostof the districts across the North West.Concentrations of SOAs showingdeprivation in the most depriveddecile are found in the urban areas inand around Liverpool andManchester”.

    1.4 The North West HealthContext

    In their report, ‘Action forSustainability’ (NWDA 2000) theNorth West Development Agency seta series of long term goals for theNorth West Region (see table 2). Indoing so, the NWDA recognise theimportance of and need forpartnership working across agenciesto secure the long terms goals.

    Table 2: Long-term goals forthe North West

    A healthy, safe and socially responsibleregion where all people have access tonecessities and are enabled to improvetheir quality of life

    A distinctive, clean and tree richregion which safeguards its wildlife,habitats and landscapes and acts tolimit the local impacts of climatechange

    A region that uses its resources wisely,makes full use of renewablealternatives, produces minimal wasteand conserves its historic environment

    A thriving, prosperous and attractiveregion of high employment with thenecessary infrastructure to support itand which uses land efficiently

    Action for Sustainability (2000)

    The challenge faced by the NWDA(2000) was to ensure that partnershipworking was effective and sustainablefor the NW region to develop. Toachieve this they assert that:

    “Mainstreaming sustainabledevelopment principles at policy andstrategy level, together with robustapplication of these principles atprogramme and project delivery levelare vital to the sustainability of theNorth West. Policy-makers andpractitioners must continue to worktogether to push the boundaries ofunderstanding to ensure that therelevance of sustainability to allNorth West activity is clearlyidentified and progressed” (pg 9)

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    Urban Regeneration: Making a Difference

    In terms of Healthy Communities, theNWDA’s aim was to ensure that“Healthy communities where peopleenjoy life, work and leisure and takecare of themselves and others” weresupported. The NWDA also draws onthe Health Survey of England (DH2006) and uses the predictedoutcomes for obesity, life expectancyand social deprivation to illustrate theneed for sustained action. Similarly,the Health Profile of England (DH2006) provides statistics on a largerange of ‘public health’ and socio-economic indicators.

    The Local Health Profile (LHP)indicators from the Health Profiles ofEngland define each deprivationindicator. In the case of lifeexpectancy, (indicator 18) the LHPmeasure this from birth and onaverage, people are more likely to livetwo years longer in the south thanthe North West. Interestingly, andakin to the NR funding evident inlocal areas, the IMD identified that:

    “the Merseyside districts of Liverpool,Sefton, Wirral, Knowsley and StHelens, and Manchester and someof the areas around includingWigan, Rochdale, Bolton, Salfordand Oldham stand out as containinglarge concentrations of SOAs withhigh levels of deprivation.”

    More recently, Rasuloi et al’s (2007)small area analysis of the inequalitiesin health expectancies indicate thatthose people living in the North Westregion of England face greater lifeexpectancy inequalities comparedwith people living in all other areas ofEngland.

    1.5 North West Indicators ofDeprivation in Health and Well-being

    There are a number of major areasthat serve as health indictors whichare linked to the currentGovernments priority areas forimprovements in the nation’s health.

    Statistics from the British HeartFoundation Health promotion Unit(2005) suggest that:

    “Death rates from Coronary HeartDisease (CHD) are highest inScotland and the North of England,lowest in the South of England, andintermediate in Wales and NorthernIreland”.

    Although there has been a steadydecrease in the number of deathsfrom CHD in the North West, currentstatistics indicate that 220 per100,000 people in the NW dies fromCHD in 2002. (BHF 2006). The LHPdefinition of obese adults is based on“synthetic estimate of the percentageof adults who are obese”. Salford’sPublic Health Annual Report(2004/05) outlines obesity as one ofthe main concerns for its populationand stresses the link betweenlifestyle, obesity and heart disease.

    Whilst obesity levels are considered tobe average in the North West, figureson smoking reveal that the region hasabove average levels of smokingwhich are directly attributable tomortality rates (ONS 2006). LHPdefinition of deaths from smoking(indicator 19) is the “average annualdeath due to smoking-related causes(aged 35 and over) expressed as anumber and directly standardised rateper 100,000 pop of all ages”. TheHealth Profile of England (DH 2006)statistics states that smoking deathsare higher in the North of Englandand London. In relation to the NorthWest, there are an average numberof smoking related deaths in theNorth West.


    Cancer incidence in the NW isamongst the highest in England.Shack et al (2007) highlight theextent of cancer in the NW and assertthat the region has some of thehighest incidents of Cancer inEngland and Wales. Using statisticalmodelling, Shack et al were able topredict the population estimates ofthe NW up 2020. Alarmingly, cancerrates are set to rise. A particularconcern is lung cancer rates whichare currently the more commonlydiagnosed cancer in the NWaccounting for 20% of all new cases.These rates are expected to rise alongwith breast, colorectal andoesophageal cancers.

    Mental Health

    Additional facts were obtained aboutthe mental health problems in theNorth West. Patients with severe andenduring mental health problems,aged 16 and over (2004/05) wereanalysed. The North West andLondon in particular have asignificantly higher number ofregistered patients. The NW has thehighest number of people misusingdrugs and alcohol. In addition theNW also has the greatest number ofpatients with a severe and enduringmental illness registered with a GP.Other indicators such as numbers ofpeople admitted to in-patient care,those with depression and anxiety,and standardised mortality rates forsuicide and injury are the highest inEngland (However, given this data,according to other figures in thisreport, the North West do notprescribe as much anti-psychoticmedication as London, NE andHumber regions). Similar to otherregions, use of ECT has reduced since1998. The Local Health Profile (LHPindicator 27) defines drug misuse andtreatment as being:

  • Urban Regeneration: Making a Difference

    “the number of resident persons aged15 – 44 in contact with drugtreatment services per 100,000resident population”

    However, current figures are notavailable. The North West figuresindicate that those currently incontact with drug treatments aresignificantly above average. Data inthe health profile clearly indicates asignificant ‘north south’ divide inrelation to drug misuse andtreatment.

    Alcohol abuse was measured by theHealth Profile (DH 2006) by thenumber of hospital admissions.Alcohol consumption in the NorthWest is amongst the highest inEngland. Alcohol abuse thereforepresents a real concern for the NorthWest region. The LHP definition ofalcohol related hospital stays(indicator 26) are:

    “directly standardised rate for personswho were admitted a least once foralcohol related condition. Theindicator measures the rate ofhospital admissions that areattributable directly to alcohol”

    The DH health profile indicators havecorrelated areas of deprivation figureswith alcohol related figures tosuggest a link between deprivationand alcohol consumption. HealthProfile data suggests that Blackpool,Burnley, Manchester, Liverpool andBarrow have the highest correlationbetween deprivation and alcoholattributable mortality.

    Older People

    The LHP figures for older peoplesupported at home (indicator 7) werebased on those aged 65 and overwho were being helped to live athome per 100,000 of the population.The North West picture highlights anaround average number of olderpeople being supported at home,which places a great strain on thecommunity in terms of the carersneeded, home support services andthe economic and employmentstability of the community. Salfordhas similar economic activitymeasures with its neighbour andEngland generally.

    Social Factors

    Social equality is an aspect of workingwhich the NWDA report highlights.As they suggest:

    “Social equity that respects, welcomesand celebrates diversity and allowsall communities and generations arepresentative voice (pg 24).”

    A strategy has been developed whichembraces equality issues relating togender, race and ethnicity, disability,sexual orientation, age diversity andreligion. To support this activity, theNWDA set up a North West Equalityand Diversity Leadership Group(NWEDLG) which will help to makerecommendations on policy andpractice for the NW region.


    One of the NWDA aims is to ensurethat the North West is supported todevelop:

    “a culture of lifelong learning thatallows people to fulfil their dutiesand potential in a global society byacquiring new skills, knowledge andunderstanding (pg 36)”.

    They state that skill levels are notconsistent across the region makingeducation an urgent priority. Toaddress this, the NWDA are currentlyworking in partnership with theLearning & Skills Council, to addressthe skills and employment needs ofthe region.

    1.6 Evidence of NeighbourhoodRenewal in the North West

    A number of programmes have beenestablished to support regenerationinitiatives in the North West. Theseinclude New Deal for Communitieswhich are partnerships aimed attackling employment, crime,education, health and housing.Complementary programmes are alsorunning under the guise ofNeighbourhood managements andNeighbourhood Wardens. Both ofthese programmes work with thelocal community to improve servicesand enhance the link between localservices and the neighbourhood.Neighbourhood wardens in particularare responsible for increasing thevisibility of semi-officials within thecommunity. Partnership working inthese communities involvespartnerships between a number ofprivate, voluntary, business sectorswith professional bodies and localauthorities. In this way, the mainfocus of the partnership is seen as anempowering approach which placesthe community at the centre ofdecision making. Within the NorthWest, 17 areas have received funding


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    Urban Regeneration: Making a Difference

    from the Neighbourhood RenewalUnit to support Regeneration Activity(see Warne & Howarth 2009.

    There is evidence of good practicefrom the North West which indicatessharing of data between thepartnerships involved in NR. Examplesof this can be found in the ODPMsreview of data sharing in the NW.Lessons learned from this reportillustrates some of the complexitiesinvolved, and also examples of wherepartners have shared NR data fort hebenefit of the community (ODPM2005). In particular, the ODPM reportoutlines examples the trust builtbetween partners through “clearlyarticulated common goals”, whichculminated with “mutual advantagesto the participating organisations andfair sharing of contributions, risks andrewards (pg 7)”. Key messages forLSP’s which arose out of this reportsuggest a range of ways in whichpartnerships can better share data toenhance NR performance andmanagement (see table 3).

    A number of initiatives have beenemployed to promote good practicebetween UR partnerships. Of these,the Standards/Competences for PublicHealth Practice Post ConsultationDraft October (2003) suggest a rangeof performance indicators to supporthe sustained growth anddevelopment of partnership workingin UR. In particular, the unit “Work inpartnership with communities toimprove their health and wellbeing”includes four elements with coveringperformance criteria with whichpartnerships can assess their workand progress.

    Table 3 Key messages for LSPsfor those in strategicleadership roles

    Take a strategic view of data forperformance improvement,identifying future requirements fordata access and quality to underpinstrategic decision-making, serviceimprovement, tracking ofneighbourhood change, robustperformance management andpublic accountability

    Help create the conditions for moreeffective data sharing: argue thecase for more joined-up approachesto performance management andthe use of evidence; foster a ‘cando’ approach; and promote localgood practice in data sharing andanalysis

    Appreciate the high level issuesrelating to data sharing and dataprotection – including powers underadministrative law relating to publicbodies and the scope for lawfulsharing under the DPA. Consideradopting a high level data sharingprotocol

    OPDM (2005 p.9)

    1.7 Summary

    Evidence from the Office of Nationalstatistics and others has providedinsight into those areas which aremost deprived. A large number ofthese areas are located within theNorth West region Sustainablecommunities have indeed beensupported through the NRF. Therange of initiative in place assuresthat this work is longitudinal andbased on the communities needs.

    The national picture reveals a numberof concerns faced by health andsocial care agencies. Against thisbackdrop, local trusts have adaptedpolicies to support their own healthand well-being activity. Some of thesehave a direct relationship with urbanregeneration (UR) and suggest asustained programme to improvelocal health and well-being. The wayin which local initiatives have movedtowards these goals is variable andare in keeping with the localpopulation demands. As such, thisreport has selected Salford as a focusto determine the extent of UR andhow this has informed local policyand impacted on the localcommunity.

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    Urban Regeneration: Making a Difference

    1.8 Focus on Salford

    Salford is situated within theboundaries of Greater Manchester.Currently, 220,000 people reside inSalford. Coronary Heart Disease(CHD), Cancer and Mental Health arethe major health problems faced bySalford’s population.

    Table 4 Population of Salford (Census 2001)Data from (

    Box 1: Deprivation and Poverty inSalford ( 2000 Local Index ofDeprivation

    “Salford today has a population ofapproximately 224,300.Deprivation and poverty in thecity are still major causes forconcern. The 2000 Local Index ofDeprivation placed the city as the28th most deprived authority inEngland and Wales. Of the 20wards in Salford, the indexrevealed that 8 wards were inthe worst 7% nationally and atotal of 15 were in the worst

    20%. Further to this: For incomedeprivation, 8 wards were in theworst 7% nationally and a totalof 15 were in the worst 20%Forchild poverty, 7 wards were inthe worst 7% nationally and 12wards were in the worst 20%Fora series of health indicators, 13wards were in the worst 7%nationally and 19 wards were inthe worst 20% .In the 1998Standard Mortality Rates, 3wards have a SMR rates over200, 6 wards have SMR ratesbetween 150 - 199, 9 wards

    have rates between 100 - 150and only 2 wards fall belownational average of 100”

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    Urban Regeneration: Making a Difference

    Salford has experienced intensedeprivation for many years andtherefore falls into one of the keyareas described in the Deprivationindices. The Salford profile reveals apoor picture of the health and well-being of the population. Of allthe Health Profile (DH 2006) 26indicators, Salford’s only aboveaverage result was in relation to roadinjuries.

    Death rates from smoking are higherin Salford than the NW and Englandaverage. Possibly as a result, deathsfrom stroke and heart disease inSalford are also greater that the NWand England figures. Mental health isa serious problem for Salford withbenefit claims for mental healthgreater than the NW and England.Teenage pregnancy is also higher thanthe NW and England. There arehowever no significant differencesthan the England average, howeverSalford does have a low rate of roadinjuries and deaths but significantlyworse public health figures in thecommunity, children & healthy starts,lifestyles, life expectancy and healthin the community.

    1.9 Regeneration Activity inSalford

    A diverse range of data illustrates thehealth and social care problems facedby Salford. On a par with the NorthWest, Salford’s population reflect theneed to address health and social careinequalities through intensive andsustained public health andregeneration programmes. The threemajor areas of mental health,coronary heart disease and cancer areperhaps the most prominent healthissues. However, as the indices ofdeprivation demonstrate, there is alsoa pressing need to deal with thesocio-economic problems. There are anumber of approaches within Salfordwhich is aimed at addressing thepopulations’ needs in terms of UrbanRegeneration activity.

    However, it is difficult to divide publichealth and regeneration agendas. Thesymbiotic relationship between thepopulations needs and services meansthat they cannot be easily separated.Integrated working at all levels withina range of organisations is now apriority. On the whole, Salford LocalAuthority, PCT and other agencieshave achieved much in addressing theneeds of Salford. A few examples ofsuch innovative working arepresented below. This is certainly notexhaustive list and perhaps does notdo justice to the work, commitmentand partnership working that iscurrently ongoing. Such is the fluidityof the work, that it is difficult toascertain a truly up-to-date picture ofregeneration activity in Salford. Thisnext section presents a snap shot ofevidence located through websites,public health reports and localevaluations.

    Coronary Heart Disease

    In the North West, current statisticsindicate that 220 per 100,000 peoplein the NW died from CHD in 2002.(BHF 2006). In particular, CHD is oneof the major problems faced bySalford. Deprivation, smoking andcoronary heart disease have a highcorrelation. Public Health therefore, isa key player in any regenerationactivity. This means not onlyaddressing the health needs of thepopulation, but managing thecommunity in terms of its health andwell-being, access to sports, areas ofactivity, healthy lifestyle choices andre-educating the community into amore sensible and safe [email protected] is one such initiativedesigned to improve the health of thecommunity through a programme ofactivities. Delivered by qualifiedinstructors, the programme is aimedat people with heart conditions orwho have high risk factors of CHD.There are now 15 [email protected] which provide access. Inaddition, Salford’s HealthImprovement Team has developedhealth walks to combat CHD andobesity. This has been achieved inpartnership with Salford CommunityLeisure and was signalled as a successstory in Salford Public Health AnnualReport (2004/05).

    Mental Health

    Mental health issues are a significantproblem for individuals living inSalford. With the greatest percentageof adults registered with GP’s forsevere mental health issues, SalfordPCT and the local mental health trust(Bolton, Salford & Trafford MHT seebox 2) have worked collaboratively toaddress the populations needs. Closepartnership working has resulted in anumber of initiatives and integratedwork to help support those peoplewith enduring chronic mental ill-health.

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    Urban Regeneration: Making a Difference

    Box 2Bolton, Salford & TraffordMental Health Trust

    Bolton, Salford and Trafford MentalHealth NHS Trust provides integratedmental health and social care services,to the 700,000 people living in theBolton, Salford and Trafford localauthority boundaries and a range ofspecialist and secure mental healthservices across Greater Manchester,the North West and beyond. Districtservices are provided in partnershipwith the relevant local authoritiesthrough Section 31 partnershipagreements. We directly employ over3,600 staff from different professionsand disciplines with 400 staffseconded from partner organisations.As a teaching Trust, there is a vibrantprogramme of research anddevelopment, teaching and training.

    Bolton, Salford & Trafford MentalHealth Trust (now GreaterManchesterester West Mental HealthTrust)

    Examples of partnership working areclearly evident in Salford PCT’s PublicHealth Directorate Report. Thisincludes section 31 partnershipagreements with the Mental HealthTrust (MHT) to support and manageintegrated health and social careservices. In addition close workingwith the Police helps to monitor andevaluate mental health assessmentissues. Partnership working in thisrespect also extends to a ‘JointDiversionary panel’ set up betweenthe MHT and Police to secureintegrated working for mentally illoffenders.


    Cancer incidence in the NW isamongst the highest in England.Salford in particular has suffered fromhigher than average cancer deathrates. According to Salford PublicHealth Report (pg 30) cancer deathrates exceed NW figures by 16% andnationally by 31%. Their aim now isreduce cancer death rates for under75 years old by a minimum of 20%by the year 2010. The Public HealthAnnual Report notes that goodprogress is being made. Examples ofgood practice are evidenced througha recent joint appointment betweenthe PCT and City Council for a healthand well-being manager and officer.Working together, a range ofinitiatives designed around smokingcessation have been developed. Citywide advice and support is nowavailable for those wishing to stopsmoking. This initiative works con-jointly with the five a day initiative tosupport local residents develop ahealthier lifestyle.

    Older people

    Under the Improving health and well-being 1.2 (a) of the Public HealthReport, the older population needshave been addressed. Partnershipworking within neighbourhoods isparticularly evident through the wideranging of integrated workingbetween the PCT, hospital trust,Mental Health Trust, Police, Housing,the voluntary sector and all othercouncil services. This is also evidencedin the LAA, partnership boardworking, and neighbourhoodworking and at all levels of thedirectorate. There are very good,constructive working relationshipsand increasing numbers of jointappointments with the PCT. Goodexamples included in the Publichealth Annual Report (Salford PCT2004/05) which outlines a range of

    activities to help older people in thecommunity. This includes a socialinclusion group in Irlam andCadishead. This programme supportsolder people to leave their homes andattend a number of support groups.Through these groups, newfriendships have been made andolder people report they feel moreconfident to leave their home.


    According the Salford PCT PublicHealth Report (2004/05) a highpriority is given over to “improvingoutcomes for health and emotionalwell-being”. Interestingly, the reportchooses to use ‘emotional’ wellbeingto perhaps signify the prevalence ofmental health and social deprivationissues. As noted in the ‘improvinghealth and well-being outcome 1’,includes the development andintroduction of a new ‘health andsocial care directorate – so namedunder the umbrella of communityhealth and social care’. Akin to othertrusts in England, the directorateencompasses cultural and leisureservices. The report asserts that thiswork is strengthened by acommitment or ‘pledge’ to local areaagreements. Partnership working withthe community is also evidentthrough the development of anumber of health and social carecommunity initiatives. This has beenpropelled through LIFT and SHIFTfunds which have enabled a range ofhealth and community services tothrive.

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    Urban Regeneration: Making a Difference

    1.10 Salford’s NeighbourhoodRenewal Context

    Given the need of Salford populationand the development of partnershipworking across a range of agencies, itis not surprising that Salford wasawarded Neighbourhood RenewalFund’s. Initially, a Community Planwas developed, through which sevenkey priority areas (themes) emerged.In response to the community planand to facilitate partnershiparrangements for the seven themes, aSalford Strategic Partnership was setup. The Partnership includes peoplefrom the community, voluntary,private, public and faith sectors whowork together to promote equality.There are 26 partners who meettwice a year to discuss issues, reviewprogress and set plans. Additionally,to facilitate the themes, SevenStrategic Delivery Partnerships (SDPs)were established by ‘Partners INSalford’. Each of the SDPs are linkedto the seven themes and areresponsible for leading on prioritiesset out in the Community Plan.

    Aptly named Partners IN Salford, theplan aims to ensure collaborativeworking to sustain regeneration:

    “Partners IN Salford’s vision for thecity focuses on overall prosperity,improved health, better educationaland cultural opportunities, valuingchildren and young people, andmaintaining a clean and well-managed environment. However, thevision goes further. It stresses acommitment to social inclusion andto reducing exclusion amongneighbourhoods and communities.No one in Salford should bedisadvantaged because of wherethey live. Partners IN Salford iscommitted to reducing theinequalities gap between Salford andthe rest of England.” (SalfordCommunity Plan pg 1).

    In relation to health and well being,one of the key themes includes ahealthy city. This theme is closelyaligned to the national priorities setout in the NHS Plan and is designedto improve the health and well beingby reducing inequalities through a‘modern health service’ “designedaround the populations needs”.Priority is also afforded to communityinvolvement through partnershipworking which promotes an inclusivecity where citizens feel valued. For thepurpose of this scoping exercise, thehealth theme was the main focuswhich includes three key priorities;tobacco control, building healthycommunities through empoweringthe local community and improvinghealth through healthy food andphysical exercise.

    The SDP for addressing the HealthyCity was the Healthy City Forum (seetable 4). The aims of the forum areto:

    The Healthy City Forum will achievethe pledge of Salford City Council andthe Community Plan to improve thehealth, well being and social care ofthe people in Salford; and the PrimaryCare Trust corporate objective ofpromoting long-term well being inpartnership with other agencies

    Three key targets were developed totake this forward. The plan stipulatesthat Healthy lifestyles should bepromoted and health inequalitiestackled. Secondly, the Forum aims towork in partnership to promote andimprove the health of the community.Finally, service redesign was includedto increase access in order to meetdemand.

    Table 4: Healthy City ForumObjectives

    (taken from the Partners IN Salfordwebsite)

    The Healthy City Forum will developand implement a Health InequalitiesStrategy detailing expectations frompartners, monitoring theirachievements and co-ordinating astrategic approach to evaluation by:

    (i) Bringing together the healthimprovement, promotion of wellbeing and NHS modernisationagendas, where partnershipworking adds value, into acoherent programme;

    (ii) Identifying strategies wherepartners working together willimprove health by reducinginequalities more than working inisolation;

    (iii) Ensuring action is taken by theother 6 strategic delivery groupsof the partnership to improvehealth by reducing inequalities;

    (iv) Report to Partners IN Salford onthe progress of the Healthy CityProgramme and from thePartnership to the sub-groups;

    (v) To promote an understanding inagencies and communities inSalford of the determinants ofhealth, Salford health assets andlocal health inequalities;

    (vi) To influence investment for healthby ensuring investments in localservices are targeted at those thathave the most contribution tomake in improving health and byreviewing existing financialallocations and the influx of newfunds to assess the impact onhealth and inequalities;

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    Urban Regeneration: Making a Difference

    (vii) To take the lead in the LocalStrategic Partnership for theimplementation of the healthsection of the Community Planand Neighbourhood RenewalStrategy and ensure health actionis integral to the communitystrategy.

    Two areas in particular were singledout under the New deal forCommunities Partnership (NDC) toreceive help through partnershipworking. The two areas Charlestownand Lower Kersal are located in thecentre of Salford. One of the keypriorities for the NDC was to improvethe health of the community by

    • The provision of new and improvedhealth care facilities

    • The redesign of existing servicesthrough greater integrationbetween primary and secondarystaff, as well as extended roles andnew ways of working

    • Community ownership of the newdevelopments

    These aims are realised throughpartnership working under NDCHealth Improvement scheme thathave developed a number of projectsto improve the health and well beingof the community. Two of the largestprojects in Charlestown & LowerKersal include the Community HealthAction Partnership (CHAP) and theuse of LIFT funds to develop healthand social care centres. In particularCHAP (Community Health ActionPartnership) is made up of localresidents who help direct the work ofthe NDC Health Task Group.

    This partnership has empowered thecommunity through ensuring thatthey play a pivotal role in the designand management of health services inthe community. (See table 5 forexamples of activities taken from theirwebsite).

    Table 5: Examples ofRegeneration Activities inCharlestown & Lower

    The team is working in partnershipwith Salford Primary Care Trust on thegovernance of the two plannedHealth and Social Care Centres (alsoknown as LIFT Centres) at St.Sebastian’s and St. Aidan’s

    Charlestown Centre Update

    The centre in Charlestown began inSeptember 2004, and it opened inOctober 2005. It is now home to aDoctors’ Surgery, Pharmacy,complementary therapies, services forcarers and people with long termconditions, and a range of otherservices identified by local people.

    Lower Kersal Centre Update

    The centre next to St Aidan’s Churchon Littleton Road officially opened inJanuary 2007. The centre houses 3doctors, a pharmacy and a number ofother health services. The centre isavailable to the whole community buthas an extra focus on health servicesfor the area’s children and youngpeople.

    Healthy Living Centre’s

    In addition to the NDC activitiesthrough CHAP, two new Health &Social Care Centres have been builtusing NHS Local Improvement FinanceTrust (LIFT) funds. These centers willbe managed through CHAP withsupport from the NDC. A number ofpartners are involved in the HealthyLiving Centre’s including the NDC,PCT, LIFT, CHAP, Salford City Counciland a local pharmacy.


    Currently, a great deal ofRegeneration activity is evident withinSalford. The seven key priority areaswere developed in response to thecommunity’s needs, demonstratingawareness of the need to include andempower local people. The healthycity theme has supported a range ofactivities in partnership with the NDC,NDF and the community. Thispartnership working is typical withinSalford and illustrates the extent ofthe progress made to date. It is hardto ascertain whether any of thesepartnerships have been evaluated orindeed how this has been achieved.However, the projects locatedthrough the websites clearly outline acommitment to partnership for thebenefit of the community.

    As the PCT Public Health AnnualReport states, Salford is making goodprogress. Exemplary practice throughpartnership working with the NewDeal Initiate, CHAP and otherpartners have resulted in a positiveimpact on Salford’s communities. ThePCT in particular aims to continue thisgood work and learn from theseactivities. The report recommendsthat examples such as Sure Start andNew Deal should be rolled out acrossthe city. In addition and to helpsmooth this process, the PCT aims tocontinue its work with local residents

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    Urban Regeneration: Making a Difference

    to secure a reduction in health andsocial inequalities. Finally, the reportalso asserts that LSP’s have a crucialrole to play in the continueddevelopment and support of healthycommunities.

    The three key areas in relation tohealth have witnessed innovativeprogrammes to support thecommunity in preventing ill-health. Anatural consequence of this is theimpact on the well-being of thecommunity. Health and social equalityare inextricably linked, any positiveeffects from UR on the health or thesocial equality of Salford populationwill have a reciprocal effect.

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    Urban Regeneration: Making a Difference

    1.11 References

    Department of Health (1999) SavingLives Our Healthier Nation. TheStationary Office. London

    Department of Health (1998) OurHealthier Nation. A Contract ForHealth. The Stationary Office. London

    Department of Health (2006) HealthProfile of England. Working inPartnership across Government withPeople, their Communities, LocalGovernment, Voluntary Agencies andbusiness. HMSO.

    National Statistics (2007)Amendment: Changing RegionalEconomies: North West. ONS London

    North West Development Agency(2000) Action for Sustainability. TheProgramme for IntegratingSustainable Development across theNorth West. NWDA Wigan.

    Office for National Statistics (ONS)mortality data and mid yearpopulation estimates, analysed by theAssociation of Public HealthObservatories Community HealthProfile Project. Web link

    Partners IN Salford (2006) CommunityPlan for Salford. Making the VisionReal. Salford County

    Petersen S,, Peto V, Scarborough P,and Rayner M (2005). CHD Statistics.British Heart Foundation HealthPromotion Research Group.Department of Public Health,University of Oxford

    Rasulo D, Bajekal R, Yar M (2007)Inequalities in Health Expectancies inEngland and Wales: Small AreaAnalysis from the 2001 Census.Health Statistics Quarterly. 34-45.ONS.

    Report of the Public Health Director(Salford) on Cancer to the TrustBoard. Salford PCT.

    Salford PCT Public Health AnnualReport (2004/05) The Changing Faceof Public Health in Salford. SalfordPCT.

    Shack L, Khan S, Moran T (2007)Cancer Incidence Projections, NorthWest, 1982-2020. North West CancerIntelligence Service. NHS.

    Skills for Health (2003)Standards/Competencies for PublicHealthy Team Practice. PostConsultation Draft.

    The Office of the Deputy Primeminister (2004) Creating SustainableCommunities. The English Indices ofDeprivation (revised) HMSO. ODPMPublications.

    Wanless D (2002) Securing OurFuture Health: Taking a Long-TermView. HM Treasury.

    Warne T & Howarth M ( 2009 )Explicating the role of partnerships inchanging the health and well-beingof local communities in urbanregeneration areas: Development ofthe Warwarth Conceptual Frameworkfor Partnership Evaluation, Volume 1,Salford Centre for Nursing andMidwifery Research, University ofSalford

    1.12 Websites:

    Bolton, Salford & Trafford MentalHealth Trust (accessed 1st August 2007).

    British Heart Foundation StatisticsDatabase

    Community Health Action Partnership(CHAP) (accessed 1st August2007)

    Community Health Profiles (accessed 1st August 2007)

    Neighbourhood Renewal Unit 1st August 2007)

    New Deal for Communities accessedthrough the NRU site at

    North West Public Health ObservatoryHealth and Lifestyle Trends in Englandassessment tool 1st August 2007)

    North West Development AgencyRegional Intelligence Unit

    Salford County

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    Urban Regeneration: Making a Difference

  • 18

    Urban Regeneration: Making a Difference

    Glenda Cook, Pam Dawson andDenise Elliot

    2.1 Introduction

    The North East of England is ageographically, demographically,economically and culturally diverseregion. Deterioration in economicgrowth throughout the 1990’scontributed to high levels ofdeprivation and economic inactivity.Whilst economic inactivity has fallenin recent years this is still higher thanother regions and is particularlyconcentrated in the over 50’s agegroup where ill health is moreprevalent than other parts of thecountry. In keeping with governmentpolicy the region has been subject towide ranging programs ofregeneration to bring about economicgrowth, to combat social deprivationand address inequalities in health.Regeneration partnerships emergedduring the 1990’s, which drewtogether organisations from allsectors to help promote best practice,share experiences and act as acatalyst for change. In the context ofhealth and well-being the publichealth agenda has now movedtoward a community ‘hands on’approach predicated on partnershipworking between the NHS, localauthorities, independent andvoluntary agencies. This agendaemphasises working with thecommunity to address the health andwell-being needs of the populationand development of targeted locally-based services.

    2.2 Aims of the Scoping Exercise

    The aims of this scoping exercise arefirst to provide an overview of theNorth East in terms of its location,aspects of deprivation and health andwell-being needs. Secondly, describethe partnerships / forums that havebeen set up to promote regenerationacross the North East and improvehealth and well-being across theregion.

    2.3 Search strategy

    Uncovering relevant evidence aboutregeneration and the partnershipsthat exist in the North East regionwas not a straightforward activity.The process of searching and locatingevidence through internet searchesinvolved negotiating all thecomplexities of identifying relevantterms that are used by search enginesand understanding the environmentin which regeneration activity takesplace. This is an activity thattranscends the boundaries ofeconomics, health, social care,housing, transport, education, policy,service planning and delivery. Termsthat are understood within one sectorare not necessarily used by othersectors. Added to this the same termmay have several meanings acrosssectors.

    During the initial internet searches itbecame clear that different phases ofregional and community developmentfollowed the government agenda ofthe day. In recognition of theseproblems it was agreed by the projectsteering group to focus the scopingactivity around the Neighbourhoodrenewal initiative. This is agovernment strategy to regenerateEngland’s most deprived localities byimproving services to narrow the gapbetween deprived areas and the restof the country. The NeighbourhoodRenewal Unit runs a number of the

    government's cross-sectorregeneration programmes, includingNew Deal for Communities,Neighbourhood Management,Neighbourhood Wardens.

    The ensuing wave of communitydevelopment programmes followedby the Neighbourhood renewalinitiative resulted in an array ofdifferent, often disparate websites,policies and papers. Each of thesecontained various data with onecommon denominator, that ofsatisfying the needs of thecommunity health and well being. Forexample, the Index of MultipleDeprivation, developed by the Officeof the Deputy Prime Minister (2004)details seven Domains of deprivationwhich include income deprivation,employment deprivation, healthdeprivation and disability, education,skills and training deprivation, barriersto housing and services, livingenvironment deprivation and crime.These domains represent theGovernments beliefs about the keyregeneration areas which have beentargeted through a far-reaching rangeof initiatives and illustrate the extentof problems faced by communitiesand urban regeneration programmes.

    The North East has some of the mostrural areas in England and yet is alsowitness to much extensiveregeneration in some of the mostdeprived areas of the UK. A range ofNational statistical databases havebeen used to source health and socialcare data about the health and well-being of the North East.

    Initially, little evidence was locatedsimply using terms such as urbanregeneration or neighbourhoodrenewal. However, two sites werelocated which provided relevantinformation about the progress andprocesses of Regeneration. TheNeighbourhood Renewal Data Site(NRD) provides access to databases on

    Chapter 2 A Profile of NeighbourhoodRenewal Activity Focused on PromotingHealth and Well-being in the North East Region

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    Urban Regeneration: Making a Difference

    the extent of regenerationmonitoring, priority setting andperformance management at aneighbourhood level. A full range ofinformation is available which detailsdatasets and information aboutneighbourhood renewal issues.

    The Neighbourhood Renewal Unit

    (NRU) was also accessed as a mainsearch site because of itsresponsibility for overseeing theneighbourhood renewal strategy. It ispart of the Department forCommunities and Local Government(DCLG) and works with governmentoffices· neighbourhood renewalteams, to monitor and support localstrategic partnerships. Through theNRU and government funding a widerange of initiatives were establishedto ascertain local needs and to pilotnew ways to fight deprivation in thepoorest and most deprivedcommunities.

    The Neighbourhood Renewal Unit sitewas therefore used as the maingateway to much of the informationcontained in this report about localregeneration initiatives. The sitedetails the extent of activity for all 14sites across the North East.

    One NorthEast:

    British urban regeneration association:

    Communities and Local

    North East regional Information Partnership:

    The Northern Way:

    The growth strategy:

    Spatial strategy:

    EastRSS Renewal pathfinder:

    Neighbourhood renewal Unit:

    Government Office for the North East

    Table 1. Web Sites Searched

  • 2.4 The North East and itspopulation

    The North East is the smallest Englishregion outside of London. The regionextends from the Scottish border toYorkshire and from the Pennine Hillsto the North Sea. Situated on theeastern seaboard of the UK facingEurope. It is geographically diversewith large rural areas with smallpopulations, and concentrations ofpeople in the industrial heartland ofTyneside, Wearside and Teeside and indensely populated cities of Newcastle,Sunderland and Middlesborough. Tothe north of the region isNorthumberland, which is the mostrural county in England with 157people per square mile. In 2006 theNorth East regional gross value added(GVA - a measure of the size of theeconomy) was £38.8 billion,indicating that the region has thesmallest economy of all the Englishregions. Economic growth worsenedthroughout the 1990’s, resulting inmore concentrations of deprivation inthe North East than other Englishregions. In recognition of the pooreconomic performance of the regionthere was an emphasis on ‘closingthe gap’ in the targets set out in the2006 Regional Economic Strategy(RES), “Leading the Way”, with thekey economic target in the RES being“to increase the region’s level of GVAper head from 80% of the nationalrate in 2006 to 90% in 2016”.

    Recent indices suggest that growthhas improved steadily and growthbetween 2005 and 2006 was thehighest of all the UK countries orregions. This economic growth hashad a positive impact on the regionand there are some indications thatthe North East is a region wherepeople experience a high quality oflife, however within the region thereare localities that suffer from acutedeprivation.

    Manufacturing, business services andthe public sector are the dominantsectors within the North East’seconomy. Manufacturing accounts fora bigger proportion of the North Easteconomy than nationally (19% in2004 in comparison to 14%).Business services accounted for 23%regionally and 33% nationally; andpublic sector activity accounted for29% of activity regionally and justover 24% nationally (NERIP, 2008).

    The rate of employment is lower thanthe national average with the gapnarrowing in recent years. Thenumber of working age people inemployment in 2007 (including self-employed) was 71%, which isapproximately three percentagepoints lower than the UK average.There is an intra-regional disparity inemployment rates in the North East,with Middlesborough, Hartlepool andSouth Tyneside below 67% and atthe other end of the scale,Darlington, Derwentside and DurhamCity in excess of 76%. The North Easthas the second highest proportion ofworkless households of the UKregions.

    The North East is one of the fewregions where the population is notgrowing. It is home to just over 2.5million people (5.1% of the totalpopulation of England). There isrelatively low proportion of peoplefrom black and minority ethnicgroups (2.4%, NRIP, 2008), with themajority of those being from Asianbackground; whilst the size of thepopulation remains relatively static,change in the population is expecteddue to migration to and from theregion (influx of females 28-34 yearsand children, men 28-34 yearsmoving out of the region;62-70 yearsmen and women are moving into theregion).

    Reported projections up to 2020indicate that the region is ageing;these projections indicate that therewill be a decline in under 15’s; aninitial increase in 16-64 year olds until2010, followed by a decline in thispopulation group; and a steadyincrease in 65-79 group; over 80’s willsee a large increase over this periodof time. An increase in the olderpopulation is more marked in thefemale population than it is in males.Demographic change suggests thatthe North East is likely to experiencethe impact of economicallysupporting an increasing proportionof the population outside of theworkforce.

    2.5 The Extent of Deprivation inthe North East

    In 2000, the Office of the DeputyPrime Minister (ODPM) commissionedthe Social Disadvantage ResearchCentre (SDRC) at the Department ofSocial Policy and Social Research atthe University of Oxford to updatethe Indices of Deprivation 2000 (ID2000) for England. The 2004 reportbuilds on previous work undertakenin 2002 and “rehearses theconceptualisation underpinning themodel of multiple deprivation usedand outlines the indicators anddomains that go to make up the ID2004”. The actual Index used SuperOutput Area Lower Layers to providean opportunity to identify and targetareas where small pockets ofdeprivation exist. However, theupdated version (IMD 2004) usesSuper Output Area (SOA) levelmeasures of multiple deprivation andcontains seven SOA level DomainIndices. In addition, each domainindices is considered in thegeographical contexts of the UK.According to the Department forCommunities and Local Government(2007) report England’s most deprived


    Urban Regeneration: Making a Difference

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    Urban Regeneration: Making a Difference

    20% of LSOA’s have the majority orall of the following characteristics:

    • Just over a third of people areincome deprived (35.4%)

    • One in five women aged 18-59 andmen 18-64 (20.3%) areemployment deprived

    • Just under half of children 48.8%live in families that are incomedeprived

    • 37.5% of older people are incomedeprived

    In relation to the most deprived 20%of LSOA’s on the IMD (2007) theNorth East had the largest percentage(34.2%), followed by the North West(31.8%). Further examination of theindices of multiple deprivation (whichinclude income deprivation,employment deprivation, healthdeprivation and disability, education,skills and training deprivation, barriersto housing and services, livingenvironment deprivation and crime)indicate that there are localities withinthe region that suffer from acutedeprivation. In keeping with the focusof this scoping exercise healthdeprivation, defined as “unexpecteddeaths or levels of ill health” (IMD2007) was examined by exploring lifeexpectancy, death from cancer andcoronary disease, smoking relatedmortality, teenage conception rates.

    2.6 The Health Context of theNorth East

    Life expectancy in the North East islower than the national average.There is also a variation in outcomeswithin the Region. For example thereis a 12 year variation in lifeexpectancy between the highest andlowest districts (NESHA, 2008).Women have a slightly higher lifeexpectancy than men with the gapbeing slightly above the national

    average (the difference between menand women in the North East is 4.4years and 4.4 years nationally).Selective health indices arehighlighted below to illustrate thatpeople living in the North East aredisadvantaged with respect to theirhealth.

    The standardised mortality rate ofdeath from all forms of cancer inpersons less than 75 years is higher inthe North East than any other Englishregion. Whilst the rate has decreasedin recent years, there are around 130deaths per 100,000 people per year(15 percentage points above the ratefor England as a whole).

    The standarised rates for deaths fromcoronary heart disease in personsunder 75 is higher in the North Eastthan in any other region in Englandwith the exception of the North West.In 2005 the annual rate in the regionwas 59 death per 100,000 people,which is 23% above the rate forEngland. Incidence rates are muchhigher for males at approximatelythree the rate for females.

    These statistics reflect higher levels ofillness and disease prevalent in theregion. Other factors affecting healthand well-being also portray a dismalpicture of the regions health andwell-being. The General HouseholdSurvey (2005) indicates that there arehigher rates of smoking within theregion: 29% of the population aresmokers compared to 24% nationally.The region has, and has had for sometime, the highest conception rateamongst teenage females: in 2003there were 49.6 conceptions per100,000 almost 20% above thenational rate of 41.3% in Englandand Wales.

    A recent consultation by NESHA(2008) concerning the health of theNorth East region reached theconclusion that the “North East had

    the worst health in England” (p.16),and “in comparison to the rest ofEngland the North East has thegreatest economic deprivation, highunemployment, the largest proportionof deprived areas and a highprevalence of smoking. Each of thesefactors is a significant determinant ofhealth. Taken together they largelyexplain why the reion has the highestdeath rates in England, highest levelsof illness, the highest reportedsickness levels, the highest rate ofcancer, highest levels teenagepregnancy” (p.18).

    2.7 Long-term health and well-being goals for the North East

    A 21st century strategy for the healthand well being of the North East hasnow been published, followingwidespread consultation. It sets out a vision for the North East to have the best and fairest health and well-being, and to be recognised forits outstanding and sustainablequality of life (NHS Public HealthNorth East 2008). The strategy setsout 10 key themes:

    • Economy, culture and environment

    • Mental health, happiness and well-being

    • Tobacco

    • Obesity, diet and physical activity

    • Alcohol

    • Prevention, fair and early treatment

    • Early life

    • Mature and working life

    • Later life

    • A good death

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    Urban Regeneration: Making a Difference

    Regional advisory groups, withmembership across sectors, willsupport the implementation of thestrategy, which aims to make thehealth of the North East the best ofany in the country over the next 25years. Social marketing and publichealth research are seen as key planksof activity to enable improvements tobe made in population health andwell-being and a total of seven cross-cutting approaches to change at aregional level are to be implemented:

    • Governance

    • Lobbying activity

    • Research and development, analysis

    • Policies and planning

    • Service redesign & funding

    • Performance management ofservices

    • Advertising and social marketing

    The strategy sets out a long termaspiration and inspiration for a NorthEast, which will have an environmentconducive to maximising andsustaining health and well-being, witha safe drinking culture and reducedsmoking prevalence. Increased levelsof physical activity will beencouraged, to promote individualsto have a weight and body massindex within safe limits. There will bea clear focus on valuing andimproving individual mental healthand happiness, and the North Eastwill have the best preventativeservices delivered fairly. The strategyprovides a vision for the region tobecome the safest place to be bornand experience early life; to achievethe best possible work and lifebalance; to grow old in a healthy,happy way; and, at the end of life, tobe supported to approach a gooddeath, free from pain, with dignity, ina place of one’s choosing.

    2.8 Regeneration partnerships inthe North East

    A plethora of partnerships havedeveloped in recent years with thecommon aim of addressing thedeprivation that exists within theregion. Collectively these partnershipshave created regional and supra-regional strategies that transcendeconomy, business, health,environment and culture. Some of theissues relating to deprivation areexperienced across the North ofEngland. In the 1990’s there existed a£30billion output gap between theNorth of England and the average forthe country England. Thedisadvantage that resulted from thiscould not be tackled by one regionalone therefore the ‘The NorthernWay,’ a collaboration between thethree Northern Regional DevelopmentAgencies - Yorkshire Forward,NorthWest Regional DevelopmentAgency and One NorthEast - wasforged. This partnership developed a20 year strategy to transform theeconomy of the North of England.The City Regions of the North Eastand North West shared commonground, they are home to 90% of theNorth’s population and generatemore than 90% of the area’seconomic activity between them. Thecities have become the engines forthe Northern Way as it works inconjunction with a range of 'bottomup' and 'top down' regenerationinitiatives, including the RegionalStrategies, such as the growthstrategy and the spatial strategyNeighbourhood Renewal Strategiesand the Local Strategic PartnershipPlans.

    Within the region partnerships havedeveloped to provide a strategicdirection to promote growth andprosperity. One NorthEast, forexample, is the Regional DevelopmentAgency (RDA) within North East

    England. It was established in April1999 to help the people of the NorthEast to create and sustain jobs,prosperity and as a consequenceexperience higher quality of life. OneNorthEast’s mission is to 'Totransform the region throughsustainable economic development.'In contrast Government Office for theNorth East (GONE) addresses localneeds through streamlined, strategicnetworks that aim to deliver,influence and develop governmentprogrammes to meet the specificneeds in the region and draw downresources from central government.

    The work of national regenerationagencies that have a focused remitare also evident in the region. Thelegacy of an industrial and miningpast has contributed to significantdeprivation in some communities inthe North East. Regenerationinitiatives, such as coalfieldregeneration and tourismdevelopment are seeking to createnew employment, homes, leisurefacilities and public space. In theseareas English Partnerships issupporting the development ofaffordable housing and increasing thequality and quantity of private-sectorinvestment in housing. This andinitiatives, such as bridgingNewcastleGateshead, one of ninehousing market renewal pathfindersare facilitating the physical and socialregeneration of the poor standard ofhousing in the most deprived areas inthe region. This has been a concertedeffort across agencies to increase theproportion of dwellings that meet thedecent home standards and raise theNorth East from the lowest of allregions (in 2003 just over 23% ofhomes met decent home standards incontrast to the national average of31% NRIP, 2008).

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    Urban Regeneration: Making a Difference

    In total 86 local authorities havereceived Neighbourhood renewalfunding, with 14 based in the NorthEast. This funding addressesdeprivation issues through co-ordinated strategic and holisticneighbourhood renewal andcommunity planning. This is astrategy that is intended to respondto local circumstances rather thandirecting everything from centralgovernment. The NeighbourhoodRenewal Unit runs a number of thegovernment's cross-sectorregeneration programmes, includingNew Deal for Communities thattackles poor job prospects, high levelsof crime, educational under-achievement, poor health, problemswith housing and the physicalenvironment NeighbourhoodManagement that works with localagencies to improve and link theirservices at a local neighbourhoodlevel; and Neighbourhood wardensthat provide a highly visible,uniformed, semi-official presence inresidential and public areas, towncentres and high-crime areas. Thefollowing table provides evidence ofNeighbourhood Renewal in the NorthEast. (See Ttable 1).

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    Urban Regeneration: Making a Difference

    Local authority




    Web site

    Evidence located

    Using Neighbourhood Renewal funding Durham CountyCouncil, working in partnership with Derwentside DistrictCouncil, has created a network of CommunityInformation Points in community venues across targetwards. The Derwentside Partnership enables localauthorities, public sector agencies, the voluntary andcommunity sector (VCS) sectors, and the business sectorto work together to regenerate Derwentside.

    Has a ‘Healthier Place’ strategy that aims to work withpartners to improve the health of the population andreduce health inequalities.

    The Community Strategy and the Local DevelopmentFramework (LDF) are the key documents through whichthe 'Vision for a Sustainable Derwentside' is to berealised at the local level.

    Easington is the 4th most deprived ward in England,using the Indices of Multiple Deprivation.Neighbourhood Renewal Funding has been allocated tosupport a variety of Service Improvements in Easingtonthrough the East Durham Local Strategic Partnership.

    The East Durham Local Strategic Partnerships includesEasington. A key theme of the LSP and LAA is healthand older people.

    Easington has a regeneration vision for 2021. Much ofthe regeneration projects are aimed at providing newopportunities for employment to replace the thousandsof jobs lost due to the closure of the mining industry.Some projects address housing issues, however, noprojects were found concerning health.

    The Stockton Renaissance Partnership Board developedthe Community Strategy which focuses on six areas - theenvironment; community safety; health; regeneration;education and lifelong learning; and arts and culture.

    Regeneration initiatives for housing, town centerdevelopment, neighbourhood management, Pathfinderiniatives are identifiable.

    Under the Neighborhood Renewal fund projects aresupported to address health inequalities in neighborhoodRenewal areas e.g. addictive behavior service, alcoholcounseling service and healthy lifestyles.

    Table 2 - Neighbourhood Renewal in the North East

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    Urban Regeneration: Making a Difference

    Local authority



    Wear Valley

    Web site

    Evidence located

    City of Sunderland Local Strategic Partnership hasidentified Improving health and social care as 1 of 8priorities, and within this theme the priorities aresupporting families, working with communities whoexperience ill health, improving quality of services andaddressing the problems contributing to long termproblems such as poverty, poor housing andunemployment.

    Regeneration projects within Sunderland include Port ofSunderland, Hendon Beach, Sunderland Central Stationand Hendon East end initiatives. No specified healthprojects.

    Wansbeck has 10 of its 16 wards amongst the 20%most deprived wards in England. 7 wards are in theworst 10% - one of the contributory factors being thelegacy of the coalfield past that resulted in low income,lack of employment and social deprivation. Hence themain purpose of the Community Plan (developed by theLocal Strategic Partnership – the Wansbeck Initiative) isto improve the economic, social and environmental well-being of the District.

    Wansbeck and Blyth Valley are both designatedSpearhead areas that have agreed to take a collaborativeapproach as a means of tackling health inequalities inSouth East Northumberland through LAA agreements.

    Wear Valley Local Strategic Partnership’s (LSP)Community Plan has specific priorities relating to:Population, Health Inequalities, Lifelong Learning,Community Safety, Economy, Environment and Housing.Health is 1 of 7 thematic groups.

    A number of health related regeneration projects areidentified including: Healthy Living – WWH; HealthyLiving - Ageing Well; Tackling Substance Misuse; Boysand Young Mens Sexual Health Worker;

    Ageing Well; Specialist Smoking Cessation Advisor.

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    Urban Regeneration: Making a Difference

    2.9 Summary

    Evidence from the Office of Nationalstatistics and others has providedinsight into those areas which aremost deprived. A large number ofthese areas are located within theNorth East region. Sustainablecommunities have indeed beensupported through the NRF. Therange of initiative in place assuresthat this work is longitudinal andbased on the communities needs.

    The national picture reveals a numberof concerns faced by health andsocial care agencies. Against thisbackdrop, local trusts have adaptedpolicies to support their own healthand well-being activity and the regionhas produced its own public healthstrategy and vision to reduce healthand well-being inequalities and makethe North East a better place to live.Some of these have a directrelationship with urban regenerationand suggest a sustained programmeto improve local health and well-being. The way in which localinitiatives have moved towards thesegoals is variable and is in keepingwith the local population demands.

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    Urban Regeneration: Making a Difference

    2.10 References

    Department for communities andlocal government (2007) The EnglishIndices of deprivation 2007.Department for communities andlocal government

    NERIP (2006) Demographic change.Report of the North East RegionalPartnership Executive Team

    NERIP (2008) The state of the region2008. Report of the North EastRegional Partnership Executive Team

    North East Strategic Health Authority(2008) Our vision, our future, ourNorth East. NESHA

    The Office of the Deputy Primeminister (2004) Creating SustainableCommunities. The English Indices ofDeprivation (revised) HMSO. ODPMPublications.

    2.11 Web sites

    North East Regional InformationPartnership

    Communities and Neighbourhoods

    ‘Regenerating the English Coalfields

    English Partnerships -The NationalRegeneration Agency

    Moving Forward : The Northern Way

    The growth strategy:

    Spatial strategy:

    One North East

    Government Office for the North East

    Bridging Newcastle Gateshead

    ‘Regenerating the English Coalfields -Interim evaluation of CoalfieldsRegeneration Programmes: ResearchSummary’

    Tourism NorthEast

  • Chapter 3 Profile Summary of NorthWest and North East EnglandNeighbourhood Renewal Activity: promoting health and well-being

    Michelle Howarth and Glenda Cook

    2.1 Introduction

    The degree to which partnerships arevisible within urban regenerationareas has been recorded in a range offormats including websites, publicdocuments, research reports andconference proceedings. Mediarepresentation has been variable andwork to consolidate the vast amountof evidence about the extent ofpartnership working is rare. Thusthere was a need to determine theextent of regeneration and thecontext in which this was beingundertaken. To address this, twoscoping exercises were conducted toexplicate the evidence base forregeneration activity using acontextual programme of work thatsought to describe the geographicallocations and use of epidemiologicaldata to better understand the healthand social care needs of the NorthWest and North East of England.

    The overarching aim of the twoscoping exercises was to provide anillustration of the regeneration activitythat has taken place in the North Eastand North West of England. Bothscoping exercises described thegeographical locations in whichregeneration partnerships occurred. Indoing so, the reports detail theextensive search strategies that weredeveloped to capture contemporarydata about such activity. Each chapterdescribes the health populations’needs alongside an account of theregeneration partnerships. Thecontext in which the partnershipswere shaped provides greaterclarification of the work undertakenand the drivers and barriers toregeneration partnerships working inan urban setting.

    The health problems faced in theNorth East and North West ofEngland are similar and reflect theneed to focus partnership work inareas such as coronary heart disease,mental health and older peoplesservice provision. This report providesa backdrop against which readers aremade cognisant about the deprivationin these areas and the partnershipworking that was designed to tacklethe areas most deprived. CoronaryHeart Disease, Mental health andaging provide predictors of the healthand social needs of the populationand signal the way in which servicesand partnerships should be prioritisedin the future.

    The report is divided into twochapters. Chapter 1 describes theextent of deprivation in the NorthWest and details the search strategy,health of the population andneighbourhood renewal activitywithin the area. A focus on Salfordhas been provided to contextualisethe key regeneration issues within theNorth West. Chapter two describesthe regeneration activity that hasbeen developed to address thepopulations health needs in the NorthEast. The extent of deprivation isdiscussed coupled with a descriptionof the health context of the NorthEast. The long term health needs ofthe North East are discussed withinthe context of regenerationpartnerships and provide a snap shotof the ways in which regenerationhas been managed throughpartnership processes.

    The North West Picture

    The scoping exercise helped todecipher the ways in which the NorthWest managed regenerationprogrammes through partnershipworking within some of the mostdeprived areas of the UK. Data werelocated through a range of Nationalstatistical databases which were usedto source information about thehealth and well-being needs of theNorth West. The data specificallyexplored the contexts of older people,cancers, mental health, heart diseaseand other indicators of deprivation. Inrelation to older people the exercisefound that around average number ofolder people being supported athome. However, the incidence Cancerincidence in the NW is amongst thehighest in England. The NW has thehighest number of people misusingdrugs and alcohol. In addition theNW also has the greatest number ofpatients with a severe and enduringmental illness registered with a GP. Inaddition social factors such aseducation , employment and housingwere included in the scoping exerciseto help set the scene for theregeneration activity taking place.

    In tackling these issues, a number ofprogrammes were established tosupport regeneration initiatives in theNorth West. This included New Dealfor Communities partnerships aimedat tackling employment, crime,education, health and housing.Complementary programmes werealso used such as Neighbourhoodmanagements and NeighbourhoodWardens. A healthy picture emergedin relation to Salford, Regenerationactivity is evident within Salford.


    Urban Regeneration: