Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

ICS Priority 3: Support our residents to maintain healthy lifestyles

ICB Strategic Priority: Increase healthy life expectancy, and reduce inequality

ICB Clinical Priority: Reduced premature mortality rate for CVD.

ICB Challenge:

  • Falling life expectancy through conditions including heart disease and obesity
  • The number of adults who are overweight was similar to that of England in 2020/21, and still notably high at 62%, with wide variation between districts.
  • Around 1 in 5 adults across our geography are physically inactive, which means around 20% of the adult population are at increased risk of a range of health conditions and diseases which are preventable through increased physical activity.
  • Smoking prevalence in adults is similar or better than the England average for all our districts; however, there is some variation between the areas with the lowest rates (St Albans at 5.4%) and the highest (Harlow at 18.9%).
  • Whilst the majority of our system are better than the national average for smoking rates in early pregnancy and at delivery, in West Herts 1 in 10 women and in Hertfordshire as a whole 1 in 15 women are smokers.
  • Variation in alcohol-related mortality within deprived areas experience higher rates.

Expected outcomes:
We will support people to be physically active, eat healthily and maintain a healthy weight, and we will provide support and advice to prevent tobacco, alcohol and substance misuse.

Governance Groups:
ICS Prevention Strategic Group

Essex Public Health targets: Year 3

  • Increased uptake of smoking cessation services
  • Reduced smoking rates
  • Increased levels of physical activity
  • Improved diet
  • Reduced alcohol consumption
  • Reduced levels of high cholesterol
  • Increased uptake of mental wellbeing and community resilience support.

Year 4+

  • Fewer exacerbations of conditions / admissions related to smoking
  • Reduced levels of high blood pressure
  • Reduced levels of obesity
  • Improved blood glucose control
  • Reduced prevalence of type 2 diabetes
  • Reduced alcohol-related admissions
  • Improved self-reported wellbeing score

What our residents say:
A survey into Joint Forward Plan priorities, carried out in 2023 by the ICB and thematically analysed by Healthwatch Hertfordshire heard from 1,124 respondents, predominantly aged 50+. It identified the following findings:

  • 10% (41) of respondents suggested that the NHS could focus more on prevention to help improve the health of the population, but particularly those in the most need. Of this 10%, some respondents felt that the NHS could work more closely with other services, including councils, Public Health and the voluntary sector to improve health outcomes.
  • Respondents suggested that prevention could focus on providing more education and practical support about how to live a healthy lifestyle.
  • There was considerable support for more preventative interventions and early diagnosis through health checks.


  • GPs need awareness, education and training to signpost to support services, particularly for gambling addiction.
  • Addiction awareness in schools and for parents – educate about soft socialisation to gambling and alcohol within families. Schools/colleges/universities should teach about gambling related harms as well as for drugs and alcohol.
  • Drug addiction support organisations to increase the number of dual diagnosis workers to support people living with a mental health condition alongside their drug addiction.

Year 1 priority actions

  1. Prevention – work to include obesity reduction in various pathways, weight management services, tobacco dependency national programme.
  2. Clinical – focus on the following areas to support a reduction in CVD mortality:
  • AF (detection and annual reviews)
  • Hypertension (case finding and effective treatment)
  • Lipid management

For further details about key deliverables across the next five years, please refer to pages 39 - 45 of the PDF.

Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

Download the full plan