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Written Statement - Improving men’s health in Wales

Mark Drakeford, Minister for Health and Social Services

Following the announcement in December 2015 that Wales will introduce a new human papillomavirus (HPV) vaccination programme for men who have sex with men (MSM), this written statement highlights other areas of work in Wales specifically to support men adopt a healthy lifestyle and improve their health.

Supporting healthy lifestyle choices

Smoking rates among men are higher than among women and men are less likely to access the free support available to help them quit. Public Health Wales has commissioned insight research into barriers to accessing NHS services to help quitting, which will help to shape Stop Smoking Wales’ work in the future.

Smoking is markedly higher in the prison population – 80% compared to 20% – which in Wales is male only. We are working towards smoke-free prisons in Wales; prisoners will be offered support and advice to help them quit smoking and the opportunity to attend a stop smoking programme through the prison healthcare support programme.

Men are more likely to misuse alcohol than women, with almost half of men saying they drink above the recommended guidelines and a third reporting that they binge drink.

On 8 January, the UK Chief Medical Officers issued revised guidelines for alcohol consumption which included a reduction for men to 14 units a week – a single guideline for men and women. My officials are working with Public Health Wales to communicate the revised alcohol guidelines. The Welsh Government is also consulting on an approach to tackle risky drinking behaviours as part of the Substance Misuse Delivery Plan 2016-18.

The workplace is an effective setting to improve the health of working age adults and to target men’s health – the employment rate for men is currently about 74%. The Welsh Government’s work and health programme, Healthy Working Wales supports employers to target men’s health issues in the workplace through the Corporate Health Standard and Small Workplace Health Award. Currently, 3,000 organisations in Wales, employing 455,719 people have been involved in Healthy Working Wales programmes. This represents almost a third of the working population in Wales.

Preventative healthcare measures

Population screening programmes help to identify the presence of previously-undiagnosed disease in people who are not suffering any signs or symptoms. A one-off ultrasound screening test for men aged 65 in Wales was launched in May 2013, looking for the swelling of the aorta, which could lead to a split or rupture – an abdominal aortic aneurysm (AAA). There is a high risk of dying from a ruptured AAA and finding the aneurysm early gives men the best chance of treatment and survival.

Between May 2013 and March 2014, more than 15,000 men attended for their first scan. Of these, 194 aneurysms were detected by the screening programme and as a result of this 17 men were placed on surveillance and five had life-saving surgery. The overall uptake rate for men invited for screening during 2014-15 was 74.7%, which is a very promising start for a new national population screening programme. To date, around 2,000 men have taken advantage of the offer. A coaster and poster campaign has been planned in association with the Welsh Rugby Union to tie in with the Six Nations – all 320 Welsh rugby clubs will be sent coasters and posters about the AAA screening programme.

Bowel cancer is the third most common cancer in Wales and kills around 1,000 people each year. The bowel screening programme, which is available to men and women aged 60 to 74, aims to reduce the number of people dying from bowel cancer in Wales by 15% by 2020. Take-up is lower in men than in women. A number of interventions, targeted at men, have been or are being tried and evaluated – examples include collaborative work with Cancer Research UK; sending out gloves and kits to help collect samples and the trial use of introductory letters before issuing bowel screening kits. Since September 2015, all men have received a pre-invitation letter about two weeks before they get their test kit. Based on evidence from a pilot, people who received a pre-invitation letter were more likely to respond to screening, especially men.  

The Welsh Government has published a suite of major health delivery plans, including for cancer, heart and liver disease. These are comprehensive, all-Wales and all-population plans. However as men in general have higher risk and prevalence for some diseases, work is being taken forward by individual delivery plan implementation groups which will help to alleviate the impact on men’s health at a population level.

We know lung cancer is more common in men and has particularly poor outcomes. The cancer implementation group is taking forward a lung cancer initiative to help people recognise symptoms earlier, receive treatment at an earlier stage, increase lung surgery rates and improve the overall care pathway in order to improve patient outcomes.

Separately, my officials have worked with the Wales Cancer Intelligence and Surveillance Unit to produce a detailed analysis of lung cancer in Wales to highlight a range of issues including gender differences. Providing this information at primary care cluster levels has assisted local teams to more effectively engage communities in the development of local priorities.

Men in Blaenau Gwent have some of the lowest life expectancy levels in England and Wales according to official statistics. Aneurin Bevan University Health Board’s Living Well Living Longer programme was the first of its kind in Wales and started in Blaenau Gwent to identify those at the greatest risk of developing cardiovascular disease and invite them for a short health check at venues throughout the county.

The Welsh Government has provided Aneurin Bevan University Health Board with funding in 2014-15 and 2015-16 to improve primary and community care to support the delivery of the programme. As part of the programme, blood pressure, pulse and cholesterol checks will be carried out to assess individuals’ risk of developing cardiovascular disease over the next 10 years. Once the results have been assessed, a plan of action is agreed with the patient and they identify their priorities with health professionals to reduce their risk of cardiovascular disease.

Mental health and wellbeing

Mental health is a priority area for this government, – more than £600m is being invested this year in mental health services in Wales.

One in four adults experience mental health problems or illness at some point during their lifetime. Suicide is a particular concern and men are three times more likely to take their own lives compared to women; men aged 30 to 49 are at the greatest risk. The Welsh Government’s new five-year strategy Talk to Me 2 is deliberately targeted at those people who are particularly vulnerable to suicide and self harm and to care providers who will respond to their needs. It aims to promote, co-ordinate and support plans and programmes to reduce suicide and prevent self harm at national, regional and local levels.

We need to help create a society where mental health problems are not hidden and this is why the Welsh Government funded a further phase of the Time to Change Wales campaign, which will continue to raise awareness, break down myths and stereotypes and challenge mental health stigma and discrimination across Wales. The Time to Change Wales Wear the Same Shirt campaign with Sport Wales uses football to help dispel myths and get communities playing and talking.

Together for Mental Health is the Welsh Government’s 10-year strategy for improving mental health and wellbeing in Wales and improving the care and treatment of people using mental health services, their carers and their families. We are currently consulting on priority areas and actions for 2016-19.