Evidence Base. There is strong evidence to support the use of EHCs to support women with pregnancy choices, reducing teenage pregnancy across Barnsley. 1.3
Evidence Base. 1.7.1. With the production of a Revised LDP, there will be a corresponding need to update or renew a number of studies/documents contained within the current LDP evidence base, which underpins the plan. In line with previous AMRs, all contextual, policy and legislative changes that have occurred since the adoption of the LDP will also need to be given due consideration, as part of the evidence base updates. The list below illustrates those evidence base documents that are likely to be required, as part of the LDP full revisions process: • Population Data and Housing Forecasts • Local Housing Market Assessment (LHMA) • Gypsy and Traveller Accommodation Needs Assessment • Urban Capacity Study • Settlement Boundary Review • Sustainable Settlement Hierarchy • Employment Land Review • Retail Study Update • Green Infrastructure Assessment • Assessment of Environmental Constraints • Public Open Space Assessment • Renewable Energy Assessment • Transport Assessment • Landscape
Evidence Base. The Department of Health proposed the NHS Health Check programme, based on the evidence and cost benefit presented in the Impact Assessment2 document. Modelling work3 undertaken by the Department of Health (DH) found that offering an NHS Health Check to people between the ages of 40 and 74 and recalling them every five years was both clinically and cost effective. Cardiovascular Disease, which includes heart disease, stroke, diabetes and kidney disease are the biggest causes of death in the UK. The national Health Checks programme could on average: • Prevent 1,600 heart attacks and strokes • Prevent at least 650 premature deaths • Identify over 4,000 new cases of diabetes each year. • Detect at least 20,000 cases of diabetes or kidney disease earlier, allowing individuals to be better managed to improve their quality of life. NICE guidance is available for some of the components of the health check and on interventions in associated referral pathways following the health check e.g. physical activity and smoking cessation. Public Health England has produced a briefing outlining the evidence base supporting the mandated NHS Health Check programme4.
Evidence Base. The service will apply and/or support evidence-based practice and will be informed by national and local drivers for change for example: • Current DoH policy and guidelines, delivery of national key targets & NSF & NICE guidelines • CQC registration requirements • Gold Standards Framework and Liverpool Care Pathway for people at the end of life • Essence of Care • Infection Control Standards e.g. hand hygiene audits • Locality commissioning plans and locally agreed care pathways • The Devon Joint Strategic Plan and subsidiary action and operational plans • The integration of health and social care delivery in Devon through the continuing development of localities and clusters The commissioning specification is supported by the joint Health and Wellbeing Strategy 2013–16.
Evidence Base. There is strong evidence to support the use of EHCs to support women with pregnancy choices. Pharmacists must have the appropriate competency and have completed the self-declaration in order to deliver the EHC under the PGD. The must be familiar with and follow NICE, BASH and FSRH guidance relating to contraception and Sexual Health. BASH Home Page NICE Guidance on EHCs FSRH home page The service will be underpinned by the following A quality Standard for contraceptive services (FSRH, 2014) PH51 Contraceptive services with a focus on young people up to the age of 25 (NICE, 2014) A Framework for sexual Health Improvement in England (DH, 2013) Clinical governance in Sexual Health (DH, 2013) Service Standards for Sexual and Reproductive Healthcare (FSRH 2013) British HIV Association Standards of Care for People Living with HIV (BHIVA 2013) Clinical Guidance – Emergency Contraception (FSRH 2011) UK National Guideline on Safer Sex Advice (BASHH & BHIVA 2012) National Chlamydia Screening Programme Standards (6th Edition 2012) Recommended Standards for Sexual Health Services (MEDFASH 2005) NICE guidelines on prescribing. UKMEC Clinical Guidance for delivery of EHC by the FSRH MHRA Guidance 1.3 General Overview Spectrum Community Health CIC has been awarded the contract to deliver an Integrated Sexual Health Service for Barnsley until April 2019. Spectrum is integrating the GUM and CASH elements of the service and is putting greater focus on prevention of STIs and unintended conceptions. To bring this into practice we are managing and leading a service transformation which requires a change in the model for sexual health provision in Barnsley. Spectrum is delivering an integrated sexual health service with an increase in both the capacity for, and the impact of, the prevention element of the service. Spectrum is investing in dual training of clinical staff to deliver integrated holistic sexual health services in multiple locations .Spectrum uses various methods to increase access to sexual health services for targeted high risk groups. Spectrum is investing in a programme of education and support in schools and other non-school settings, incorporating innovative delivery methods. The service model will promote pro-active outreach work and deliver a one-stop-shop model offering choice to reach all target groups. Spectrums 3 criteria for delivering the Pharmacies EHC element of the service; The service offer will be high quality, integrating contraception needs with...
Evidence Base. MODERATE For any species, there is a balance between the energy expended in acquiring food, the energy provided by that food and its subsequent expenditure to maintain body processes, such as thermoregulation, growth, and reproduction (Xxxxxx et al. 2022). Harbour Porpoises, which are also known as the aquatic shrew, have a large body surface to volume ratio and thus, individuals need to consume relatively large amounts of food to sustain their high metabolic rate. This leads to the need for ultra‐high foraging rates and ultra-high capture rates of high energy density prey (Wisniewska et al 2016, 2018). Harbour Porpoises in the Greater North Sea have shown a preference for energy rich sandeels, based on habitat modelling, and dietary, telemetry and fisheries survey data (Xxxxxx et al. 2016, Xxxxxxx et al. 2019). They have re-distributed within the region from northern to southern waters, leaving areas that were previously rich in sandeels to waters where their diet can be dominated by lower quality prey such as leaner gobies and gadoids (Leopold 2015). As noted previously, incidences of starvation in Harbour Porpoises have increased within the Greater North Sea in recent years. Stranded porpoises that were found to die from starvation in Dutch waters had fewer prey remains in their stomachs, and these prey were, on average, of lower quality (Leopold 2015), which may have been easier to catch for porpoises in poor health (XXxxxxxxxx et al. 2021). Maternal nutritional status in the region has been found to significantly affect foetal size, whereas globally it was reported that pregnancy rates were best explained by the energy density of prey eaten – though the global assessment did not fully consider health status of porpoises as such data were not available, and sampling biases between studies existed, e.g. bycaught vs. stranded animals (IJsseldijk et al. 2021). Evidence gaps: Research is required to strengthen evidence regarding the contemporary feeding ecology of Harbour Porpoise, through continued collection of stomach contents and tissue samples for fatty acid/stable isotope analysis, in addition to a regular review of changes in key prey species distribution and abundance. Continued ongoing evaluation of the impacts of fishing activities on Harbour Porpoise through inclusion of those species in ecosystem models, and an evaluation of their functional role in the ecosystem, are also required. Investigations need to be undertaken into how activities may c...
Evidence Base. WEAK There is no direct evidence of the impact of habitat destruction on Harbour Porpoise although there is for other species (Xxxxx, 2017). However, there is understanding of the general impact activities cause to habitat integrity (Harwood, 2001), which can be used to make some judgements on how activities may indirectly affect Harbour Porpoise. Evidence gaps: Research has not yet been prioritised towards assessing the impacts of destruction of habitat on the Harbour Porpoise, and thus research into establishing the level of risk of habitat change (deterioration) regarding the species is required. Further work considering how Harbour Porpoises use their habitat, e.g. feeding, reproduction, etc., is required to inform how activities may impact these behaviours, and will enable management discussion. While impacts of noise exposure from offshore renewable energy developments have been considered within the Greater North Sea, including displacement of individuals during construction phases (see Vallego et al. 2017 and references therein), the alternation to habitats on a largescale from future planned renewable energy developments and impacts on the species has not been addressed. Some positive effects may be observed for Harbour Porpoises such as increased food availability due to reduced fishing, artificial reef effects, and the absence of vessels. However, to fully evaluate, an ecosystem approach to assessing any impacts of habitat degradation from such activities needs to be undertaken (Galparsoro et al. 2022).
Evidence Base. The plan will be based on evidence. This will draw from sources of information and data that already exist and will also involve undertaking or commissioning new research where information is currently absent or out of date. The early stage of the LDP revision, the Pre-Deposit Participation stage is very much about ensuring that the relevant and necessary information and research exists or is being collected. This information then moulds how the LDP develops, from options at the early stages to detailed policies and proposals at the later stages. The LPA recognises the importance of looking at the housing issues at the earliest opportunity in order that all the necessary information is available for early dialogue and that all options available are thoroughly explored. The Ceredigion Local Housing Market Assessment was carried out in 2016. This assessment provides an up to date understanding of the dynamics of the housing market within Ceredigion, including identifying any effects that areas outside of the County (particularly the adjoining Counties) may have on the housing markets that operate within the County. The Authority will review the population and household projections and the impact of changes, both for the current and the replacement Plan. In 2017 a Strategic Viability Assessment was carried out to help conclude on whether evidenced based targets can deliver the required Affordable Housing in Ceredigion; consider the current Plan allocations and the extent to which these might need re-consideration on possible viability grounds; ensure that the analysis (and hence conclusions) reflect the latest policy implications and to take on board the justifiable concerns of the local development industry. In addition, Joint Housing Land Availability Studies (JHLAS) are undertaken annually and includes reports on the contribution of small sites to the housing supply and the LPA monitors outstanding consents and extant sites. All of this information will assist in looking at the housing issues (including supply, demand and need) that are likely to arise within the County during the plan period. The LPA has previously completed an Urban Land Capacity Survey as part of the LDP preparation process. This assessed the potential contribution of small, unallocated sites to the overall supply of housing and employment land throughout the County. The LPA is currently reviewing the need for additional employment land within the County through the Employment Land Revi...
Evidence Base. The National Carers Strategy 2008: Carers at the heart of 21st-century families and communities • Recognised, valued and supported: next steps for the Carers Strategy: Nov 2010 • The Operating Framework for the NHS in England 2011/12 • The NHS Outcomes Framework 2011/12 1.3 General Overview It is estimated that there are currently around 70,446 carers in Leeds, of these, 14,369 provided 50 hours or more of unpaid care per week; 7,631 provided between 20 and 49 hours of unpaid work per week and 48,446 provided up to 20 hours of unpaid care per week. These carers contribution to the health & social care economy is valued at just over £1 billion per year (Leeds University report, Valuing Carers – calculating the value of unpaid care, 2007). One of the commitments for NHS Leeds in the carers strategy is to work in partnership with GPs, NHS partners and Leeds carers Centre to identify and support carers appropriately. In October/November 2010 NHS Leeds carried out a survey of carers views on short breaks/respite provision to find out their opinions of existing provision and how their needs could potentially be better met in the future. The result of the survey carried shows considerable interest in the proposal to offer a community based short breaks ‘sitting’ service in the cared for person’s home, to support the cared for person while the carer goes out, and/or to take the cared for person out thereby allowing the carer to have a break from caring while remaining at home. Of the 150 responses received, 50% of carers of adults and 82% of carers of children expressed an interest in being able to access a short break of up to 4 hours. NHS Leeds has made £100K available for short breaks on a recurring annual basis for three years from April 2011. The recent Spending Review has also made available additional funding in PCT baselines to support the provision of breaks for carers with the guidance that PCTs should pool budgets with local authorities to provide carers’ breaks, as far as possible, via direct payments or personal health budgets for 2011/2012. 1.4
Evidence Base. The baseline information upon which policies are to be developed will be continually reviewed and updated to ensure it is representative of the latest situation within the County. The LDP will address wider reaching issues than the current Unitary Development Plan (UDP) and an extensive evidence base will therefore need to be developed early in the process to reflect this.