Appendix 1

 

A National Contract on Cancer	People can:	Local Players and Communities can:	Government and National Players can:
Social & Economic	Take opportunities to better their lives and their families' lives through education, training and employment Participate in social networks and provide social support to others to reduce stress, and to give them help to give up smoking	Tackle social exclusion in the community to make it easier for people to make healthy decisions Work with deprived communities and with businesses to ensure a more varied and affordable choice of food (including fruit and vegetables)	Increase the tax on cigarettes by 5 per cent in real terms each year End advertising and promotion of cigarettes Prohibit sale of cigarettes to youngsters and ensure enforcement Seek to ensure cheaper supplies of fruit and vegetables Tackle joblessness, social exclusion, low educational standards and other factors which make it harder to live a healthier life
Environmental	Protect others from secondhand smoke and children from sunburn	Through local employers, make smoke-free environments the norm, with adequate separate provision for smokers and availability of smoke extractors where possible Tackle radon in the home (e.g. through direct advice from local authorities to affected householders)	Encourage employers and others to provide a smoke-free environment for non-smokers Encourage local action to tackle radon in the home and to eliminate risk factors in the workplace (e.g. enforcing regulations on asbestos and encouraging provision of non-smoking areas) and the environment (e.g. air pollutants) Continue to press for international action to restore the ozone layer

 

A National Contract on Cancer	People can:	Local Players and Communities can:	Government and National Players can:
Personal behaviour	Stop smoking, increase consumption of fruit, vegetables, and dietary fibre each day, avoid high consumption of red and processed meat, keep physically active, maintain a healthy body weight that does not increase during adult life Cover up in the sun Practise safer sex Follow Sensible Drinking advice	Encourage the development of healthy workplaces and healthy schools Target health information on groups and areas where people are most at risk	Develop healthy living centres Fund health education campaigns to provide reliable and objective information on the health risks of smoking, poor diet and too much sun Encourage research into ways to modify high risk behaviours (e.g. low consumption of fruit and vegetables)
Services	Attend cancer screenings when invited (i.e. for breast and cervical screening in women) Seek advice promptly if they notice danger signs Participate in managing their own illness and treatment	Provide effective help in stopping smoking to people who want to stop especially for disadvantaged groups Work with voluntary organisations to provide clear and consistent messages about early detection and uptake of screening Ensure that vulnerable groups have equitable access to screening services Ensure rapid specialist treatment for cancers when they are diagnosed	Encourage doctors, dentists, nurses and other health professionals to give advice on prevention Ensure smokers have access to high-quality smoking cessation services, particularly in health action zones Ensure that healthy schools work with pupils and parents to improve health Maintain effective, appropriate and high quality existing cancer screening programmes and consider possible extensions of these Ensure all patients with suspected cancer are seen by a specialist within 2 weeks of urgent referral by a GP Ensure equal access to high quality treatment and care, through implementation of the expert report on the organisation and management of NHS cancer services

 

A National Contract on Coronary Heart Disease and Stroke	People can:	Local Players and Communities can:	Government and National Players can:
Social & Economic	Take opportunities to better their lives and their families' lives, through education, training and employment Cycle or walk to work	Tackle social exclusion in the community which makes it harder to have a healthier lifestyle Provide incentives to employees to cycle or walk to work, or leave their cars at home	Continue to make smoking cost more through taxation Tackle joblessness, social exclusion, low educational standards and other factors which make it harder to live a healthier life
Environmental	Protect others from secondhand smoke	Through local employers and others, provide a smoke-free environment for non-smokers Through employers and staff, work in partnership to reduce stress at work Implement the Integrated Transport Policy - A New Deal for Transport: Better for Everyone - including a national cycling strategy and measures to make walking more attractive Provide safe cycling and walking routes	Encourage employers and others to provide a smoke-free environment for non-smokers

 

A National Contract on Coronary Heart Disease and Stroke	People can:	Local Players and Communities can:	Government and National Players can:
Personal behaviour	Stop smoking or cut down, watch what they eat and take regular physical activity Manage their blood pressure if they are at risk of or suffering from circulatory disease	Encourage the development of healthy schools and healthy workplaces Target information about a healthy life on groups and areas where people are most at risk Enforce the ban on illegal sale of cigarettes to underage smokers	Control advertising and promotion of cigarettes Develop healthy living centres Ensure access to and availability of a wide range of foods for a healthy diet Provide sound information on the health risks of smoking, poor diet and lack of physical activity
Services	Learn how to recognise a heart attack and what to do, including resuscitation skills Have their blood pressure checked regularly Take medicine as it is prescribed	Provide help to people who want to stop smoking Reduce waiting times for coronary artery surgery and angioplasty Aim to reduce the incidence of second strokes Improve access to a variety of affordable food in deprived areas Support those suffering from coronary heart disease and stroke, and their carers Provide facilities for physical activity and reliable transport to help people get to them Identify those at high risk of coronary heart disease and stroke and provide high quality services Implement the National Service Frameworks	Encourage doctors and nurses and other health professionals to give advice on healthier living, and deliver effective and efficient services Develop National Service Frameworks and work towards their implementation

 

A National Contract on Coronary Heart Disease and Stroke	People can:	Local Players and Communities can:	Government and National Players can:
Personal behaviour	Stop smoking or cut down, watch what they eat and take regular physical activity Manage their blood pressure if they are at risk of or suffering from circulatory disease	Encourage the development of healthy schools and healthy workplaces Target information about a healthy life on groups and areas where people are most at risk Enforce the ban on illegal sale of cigarettes to underage smokers	Control advertising and promotion of cigarettes Develop healthy living centres Ensure access to and availability of a wide range of foods for a healthy diet Provide sound information on the health risks of smoking, poor diet and lack of physical activity
Services	Learn how to recognise a heart attack and what to do, including resuscitation skills Have their blood pressure checked regularly Take medicine as it is prescribed	Provide help to people who want to stop smoking Reduce waiting times for coronary artery surgery and angioplasty Aim to reduce the incidence of second strokes Improve access to a variety of affordable food in deprived areas Support those suffering from coronary heart disease and stroke, and their carers Provide facilities for physical activity and reliable transport to help people get to them Identify those at high risk of coronary heart disease and stroke and provide high quality services Implement the National Service Frameworks	Encourage doctors and nurses and other health professionals to give advice on healthier living, and deliver effective and efficient services Develop National Service Frameworks and work towards their implementation

 

A National Contract on Accidents	People can:	Local Players and Communities can:	Government and National Players can:
Social & Economic	Take opportunities to improve their education, training and employment	Monitor care homes for older people Promote safety practices at work Tackle social exclusion (New Deal, urban regeneration) Work within health improvement programmes on local partnership to improve local accident prevention initiatives, e.g. better identification of highest risks/priorities/targets Promote safety measures to community groups Raise public awareness of risks	Develop New Deal for Communities Remove obstacles to partnership Promote parental education (Sure Start) Improve provision of consistent monitoring data Co-ordinate Government strategy on accident prevention
Environmental	Install, check and maintain smoke alarms Maintain household appliances to reduce accidents in the home Wear seatbelts on car journeys Drive safely and within speed limits Ensure that they play an effective role in workplace safety procedures	Install smoke alarms in local and health authority properties Encourage private sector safety checks on appliances Develop traffic calming and other measures for local safety schemes as part of local transport plans Give greater priority to walking and cycling in local transport plans Adopt school travel and green transport plans Promote/maintain home safety checks for older people Develop safe play areas Maintain highways, pavements and playgrounds Identify/safeguard potentially hazardous sites (rivers, railways, dumps etc) Undertake community safety audits/risk assessment Ensure well-developed emergency planning	Ensure safety standards in new buildings Continue work on improving product standards Monitor standards for sports facilities and equipment Monitor water safety co-ordination at national level Promote Design for Safety Monitor vehicle safety standards Support for pilot schemes and voluntary bodies (e.g. Child Safety Week) Implement EC regulations on accident prevention Develop road safety strategy

 

A National Contract on Accidents	People can:	Local Players and Communities can:	Government and National Players can:
Personal behaviour	Avoid drinking and driving Ensure that cyclists, especially children and young people, wear cycle helmets Undertake effective training to improve road safety skills Ensure that children and young people take up cycle / pedestrian training Take up physically active lifestyles (to improve bone density and prevent osteoporotic fractures) Ensure a healthy diet (with sufficient calcium and vitamin D intake for bone health)	Conduct local campaigns (LEAs) on accidental injury prevention Ensure more effective enforcement - fire, police, trading standards Put measures in place on prevention (e.g. stairgates, car seats) and rehabilitation (e.g. aids for older people) Ensure effective provision/loans of safety equipment to target groups Develop private sector promoting safety culture for occupational road use Promote swimming training	Provide education / publicity on drink-drive Provide education/publicity on speed management Promote accident prevention through schools programmes (Healthy Schools Award) Promote Safer Routes to School Set up Youth Networks, playgroup associations Target health action zones/education action zones/SRB/New Deal for Communities
Services	Have regular eye tests Learn basic resuscitation/emergency skills	Provide pedestrian training for children Continue reviews of medication, eyesight in older people (over 75 check) Promote safety awareness, with risk assessment of fallers, on discharge from hospital Promote local initiatives on physical activity in older people Promote cycle proficiency schemes Promote family support - accident awareness, parenting skills Take part in Healthy Schools programmes Provide local alcohol services Ensure integrated service provision	Develop and implement National Service Framework for Older People

 

A National Contract for Mental health	People can:	Local Players and Communities can:	Government and National Players can:
Social & Economic	Take opportunities to improve their education, training and employment Develop parenting skills Support friends at times of stress - be a good listener Participate in support and self-help groups Work to understand the needs of people with mental illness	Tackle inequity and social exclusion Work within health improvement programmes to develop local mental health initiatives on prevention, better identification and treatment, including help for at-risk groups such as recently bereaved, lone parents, unemployed people, refugees Develop job and volunteeering opportunities for people with mental illness Develop strategies to support the needs of mentally ill people from black and minority ethnic groups Encourage positive local media reporting to reduce stigma surrounding mental illness	Consider the mental health impact when developing policy on employment, education, social welfare, child abuse, children in care and leaving care, refugees and substance misuse Develop New Deal for Communities Tackle joblessness, and social exclusion Improve provision of mental health systems and collection of information Tackle alcohol and drug misuse Ensure responsible media reporting of suicide and homicides
Environmental	Improve workload management Support colleagues Visit elderly friends and family who are isolated Encourage children to read Encourage children to adopt a healthy diet and take physical activity Be alert to bullying at school Be alert to glue sniffing and substance misuse in schools Engage in regular parent- teacher dialogue Ensure children have safe access to public open space	Develop effective housing strategies which meet the needs of local communities Reduce stress in the workplace Develop local initiatives to reduce crime and violence and improve community safety Develop school programmes for mental health promotion including coping strategies, social supports and anti-bullying strategies, substance misuse detection and treatment Develop local programmes to tackle dyslexia in schools Encourage use of open spaces for leisure and social events	Continue to invest in housing, supported housing, to reduce discrimination and stigmatisation and reduce homelessness Encourage employers to develop workplace health policies which address mental health Reduce isolation through equitable transport policies Promote healthy schools and include mental as well as physical health education Promote healthy prisons and address mental illness in prisoners

 

A National Contract for Mental health	People can:	Local Players and Communities can:	Government and National Players can:
Personal behaviour	Use opportunities for relaxation and physical exercise and try to avoid using alcohol/smoking to reduce stress Increase understanding of what good mental health is Contribute to the creation of happy and healthy work and school environments	Support people with severe mental illness and ensure their access to other mainstream services for physical health as well as the mental health care they need	Increase public awareness and understanding of mental health and mental illness Reduce access to means of suicide Develop healthy living centres
Services	Contribute information to service planners and get involved Contact services quickly when difficulties start Increase knowledge about self-help	Develop range of comprehensive and culturally sensitive mental health services in accordance with Modernising Mental Health Services Implement the National Service Framework for Mental Health Provide advice and practical help on financial, housing, day care, and work problems	Develop the National Service Framework for Mental Health Provide incentives to emphasise good mental health care Audit all suicides and learn the lessons for prevention (the Confidential Inquiry into Suicide and Homicide)

We welcome your comments on this site. Prepared 5 July 1999