Presentation by Ben Anderson, Director of Public Health, and Rebecca Woolley, Public Health Specialist
Minutes:
Consideration was given to a presentation by Director of Public Health Ben Anderson and Public Health Specialist Rebecca Wooley in respect of progress in prevention and health inequalities. The presentation covered five priorities, including strengthening understanding of health inequalities, developing healthy lifestyles, supporting prevention and early diagnosis of chronic conditions, promoting equity of care, and harnessing partners roles as anchor institutions.
Priority 1, Strengthen our understanding of Health inequalities, involved three areas of activity: improving the understanding of health inequalities in Rotherham, ensuring that partners have access to bespoke data products, and ensuring that data around health inequalities informs commissioning, decision-making and service-delivery.
There were three key areas of progress relating to Priority 1: development of an interactive health inequalities tool, research around the impacts of the COVID-19 pandemic, and delivery of MECC and JSNA training. Next steps were to explore opportunities to rollout training around health inequalities, picking up on the findings from the SY Health Inequalities Event; profiling each of the inclusion groups outlined within the strategy; exploring opportunities to build primary care data into this programme of work, including the development of PCN profiles; and considering asset-based community development and understanding of communities as part of the approach to tackling health inequalities.
Priority 2, Develop healthy lifestyles - prevention pathway, involved action to
reduce the prevalence of smoking in Rotherham and narrow the gap between our most and least deprived communities; increase the proportion of people in Rotherham who are a healthy weight; reduce alcohol-related harm for people in Rotherham; and support older people in Rotherham to retain their independence and age well.
Key areas of progress had been achieved, including an umbrella prevention brand was in development to support with upstream prevention messaging and campaigns; RotherHive was being expanded to incorporate sections on healthy eating, physical activity and smoking; a local tobacco control action plan and e-cigarette policy had been agreed by the Health and Wellbeing Board in January; work to embed the compassionate approach to weight had started, including training and development and changes to commissioning and service delivery; the OHID approved drug and alcohol grant funding project plans had been agreed; and an action plan had been developed from appreciative enquiry approach to address broader physical activity aims with stakeholders.
Next steps regarding these workstreams were noted, including work to launch and utilise the prevention brand to engage with local people around their health and wellbeing; to continue to develop the RotherHive resources to support with signposting and local people finding local advice and support; and to map the support available to help with the modifiable risk factors associated with poor health in Rotherham, with a focus on identifying inequities and variation across Rotherham.
Priority 3, Support the prevention and early diagnosis of chronic conditions, comprised several key aims, including reducing the health burden of cardiovascular disease in Rotherham, improving the management of diabetes, reducing the health burden of chronic respiratory disease in Rotherham, increasing the proportion of cancer diagnoses made at stage 1 or stage 2, and ensuring people get support with their mental health at the earliest possible stage.
Key areas of progress included significant analytical work undertaken through the Place Development Programme, relaunch of the NHS Health Checks programme, rollout of the lung health checks programme, delivery of the Community Transformation Programme within mental health, and an audit underway to baseline Rotherham’s position against the NHSE Prevention High Impact interventions and the Core20Plus5 clinical areas.
Next steps in respect of Priority 3 were to build the findings of the audit work into the Prevention and Health Inequalities Strategy and Action Plan, establish a PHM Operational Group to take forward the learning from the Place Development Programme, and drive work around personalisation, for example, producing physical activity videos targeted towards people with chronic pain, frailty etc.
Priority 4 - Tackle Clinical Variation and promote equity of access to care, comprised several aims, including narrowing the gap in maternity outcomes for ethnic minority women and women from deprived communities; reducing premature mortality for people with learning disabilities, autistic people and those with severe mental illnesses; improving access to social prescribing for ethnic minority communities; and mitigating against digital exclusion.
Key areas of progress noted included the continuity of care model within maternity having been launched within TRFT in December 2022, which linked with the Core20Plus5 clinical areas; work underway to deliver commitments around improving the health of people with learning disabilities, including improving uptake of enhanced health checks, improving access to health promotion and cancer screening programs and rolling out the Oliver McGowan training for all NHS and social care staff; and a Digital Exclusion Strategy developed for Rotherham with relevant links to the Prevention and Health Inequalities Group. Next steps for Priority 4 included engagement with primary care around clinical variation.
Priority 5 - Harness Partners roles as anchor institutions, comprised several aims, including improving the health and wellbeing of our workforce across the place partnership, employing people from deprived communities and inclusion groups in Rotherham; increasing our local spend to support Rotherham’s economy; reducing our environmental impact.
Key areas of progress were noted, including Self-assessments undertaken undertaken by all Place partners using the JRF framework, workshops with key stakeholders having used findings from these assessments to identify priority actions, and an anchor action plan had been drafted for submission for Place Board approval in April. Subject to approval at Place Board, the next step was delivery of the action plan which included actions around analysing recruitment and retention practices from an equalities perspective, baselining local spend within procurement and social value, using our estates differently to foster health and wellbeing, joint action to deliver on net zero commitments, and embedding consideration of health inequalities within decision-making.
Several points of feedback from the Health Inequalities Event were noted:
• Significant energy and support across South Yorkshire
• Need to focus on workforce development and staff understanding the context/challenge around health inequalities
• Usefulness of the ‘intervention decay model’
• Work in the ‘seams’ – particularly between community-based interventions and service-based interventions
• Linked to the above, importance of community engagement, targeting the communities of public health interest
In discussion, the following points were raised:
- The large scale of the work was felt to be noteworthy.
- The importance of partners working on this together to make a real impact was emphasised.
- Changes to management approaches can lead to inequality in outcomes because of differences in motivation to seek care.
- Patients least likely to seek care often are the most in need of care; consideration will be needed around how this leads to differences of resource, funding and practical changes.
- There was an opportunity to shift how early young people are experiencing chronic conditions.
- Metrics currently emphasise flow and moving people through services, rather than health.
- Slides from the ICP would be shared regarding school readiness and the 0-5 age group.
Resolved:-
1) That the update be noted.
2) That the Board endorse the next steps that have been outlined, which will inform the action plan.