Agenda item

To discuss how the Health and Wellbeing Board can support health inequalities in terms of what the Board expects to do/achieve, how the Board will know it is on track and be clear on what success looks like.

Dr Julie Higgins, Joint Chief Officer Blackburn with Darwen/East Lancashire Clinical Commissioning Group (CCG) and Integrated Care System (ICS) Lead for Health Inequalities provided the Board with an overview of the national and regional requirements, along with key actions the Integrated Care System (ICS) is proposing to take to reduce health inequalities.  The report also seeks to provide the Health and Wellbeing Board with an opportunity to offer views in relation to the actions and consider how best the Integrated Care System (ICS) and Health and Wellbeing Board could work jointly to take forward work on this critical issue.

Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council, reminded the Board, in terms of health inequalities, a few key markers that the Health and Wellbeing Board are held accountable for:

i)  Average life expectancy at birth (males 78.5 years and females 82.3 years)

ii)  Average healthy life expectancy at birth (males 60.4 years and females 64.6 years)

Therefore, on average currently, there are approximately 20 years of ill-health and disability in both males and females and there are parts of Lancashire where the healthy life expectancy is just above 50 years of age.  This is incredibly important as a marker, not just from a health and care perspective, also for a wider society perspective and this has been seen during the COVID pandemic.  The role of the Health and Wellbeing Board is a unique one in being able to bring partners who can influence a range of sectors across the life course, education to work and health and care service.  There is a long way to go, however this is the first step in, and the role of the Board in addressing these inequalities is even more significant when coming out of the current pandemic.

Dr Julie Higgins, reported that the COVID experience has been really difficult and this is due to health inequalities, however through the pandemic, it has moved it further up the agenda of the NHS.  A proposition has been accepted by the Integrated Care System (ICS) Board to set up a Health Inequalities Commission. 

Detailed further in the presentation were:

·  Tackling health inequalities – making sense of the asks

·  Summary of health inequalities required actions

·  Feedback from NHSEI (NHS England and NHS Improvement) on Lancashire and South Cumbria Integrated Care System (ICS) action on health inequalities (phase 3 planning)

·  COVID-19 Horizons

·  Addressing health inequalities through COVID-19 Horizons

·  Embedding action and assurance on health inequalities at every layer and through every strategy

·  Key actions for the Integrated Care System (ICS)

The Integrated Care System (ICS) has agreed to undertake key actions over the short and medium term to embed a focus on addressing health inequalities throughout everything it does.  The actions, summarised below, are set out in the enclosed Appendix A.

·  In the short term, all organisations/systems will assure themselves they are undertaking the requirements of the Phase 3 guidance and North West Community Risk Reduction Framework and look to identify areas for improvement or where support is required.

·  Support the continued development of population health management across the system, underpinned by a Community Call to Action approach to mobilise community assets.

·  Utilise a Maturity Matrix baseline assessment to understand.

·  Begin the development of a health inequalities action plan that embeds a focus on addressing inequalities throughout all processes and strategies.

·  Begin work with local government and Voluntary, Community, Faith and Social Enterprise (VCFSE) Sector partners to scope and develop a health inequalities commission for Lancashire.

Undertaking these actions will ensure a response to the NHS national and regional requirements to respond to health inequalities and also ensure this becomes a key area of focus for service changes moving forward.

Following the presentation, it was noted that this area of work is around community development and how it is mobilises what is currently being done and engage with the community connectors, to move this area of work forward.

Resolved:  That the Health and Wellbeing Board:

  i)  Noted the proposed approach by the Lancashire and South Cumbria Integrated Care System to develop a cohesive and robust plan for mobilising health and care organisations to address health inequalities in Lancashire and South Cumbria.

  ii)  Considered and provided feedback on how best this work can align with the work of the Health and Wellbeing Board.

  iii)  Supported, in principle, the commitment to develop a health inequalities commission for Lancashire and South Cumbria, to be undertaken jointly with local authorities in the area.

  iv)  Noted that Dr Sakthi Karunanithi, Director of Public Health, Lancashire County Council would be the lead officer for the Health and Wellbeing Board to work with Dr Julie Higgins, Joint Chief Officer Blackburn with Darwen/East Lancashire Clinical Commissioning Group (CCG) and Integrated Care System (ICS) Lead for Health Inequalities in consolidating and developing the plan into an action plan.