HEALTH INEQUALITIES REGIONAL APPROACH
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Transcript of HEALTH INEQUALITIES REGIONAL APPROACH
HEALTH INEQUALITIES
REGIONAL APPROACH
Prepared by Yorkshire and the Humber NHSDate 16th May 2008
Paul Johnstone
Regional Director of Public Health
NHS/DH Yorkshire and the Humber
• Y&H has some of the worst health inequalities of any region - both between and within the region
• 7/14 PCTs are Spearhead areas
• Non spearhead areas have significant inequalities
• Target – to reduce inequalities in health by 10% by 2010 as measured by infant mortality and life expectancy at birth
All Age All Cause Mortality rates per 100,000 people (2002-2006), at a Middle Super Output Area level: Y&H
• New SHA in 2006 placed tackling health inequalities and meeting the 2010 targets as a top priority
• Built on existing strategy by previous RPHG, SHAs Govt Office, Regional Assembly, RDA
• Twin track approach
- NHS action
- Supporting LSP/negotiating LAAs priorities
Track 1 - NHS
• Used National Support Team visits and methodology
• Each PCT identified local priorities and NHS action needed supported by APHO and PHO tools (web link)
• SHA Chief Executive asked that all PCT CEx have a health inequalities objective.
- Ensured agenda was mainstreamed in NHS
- Most focused on smoking, statins.
- But some significant differences
• Each set a target which is measurable, industrialising intervention (1-2) which will make a difference in AAACM and narrow the health gap meeting 2010 targets.
Track 2 - LAA
• Regional PH team (based in GO and SHA) work as one whole system.
• Governance – Engine Room
• Enabled 3rd and 4th round LAAs to be drawing from same health inequalities information
National health inequalities 2010 PSA life expectancy target*: progress at 2004-06
Spearhead PCT
Department of Health 2010 PSA inequalities update (Dec 2007) YHPHO Forecast
Males Females Males Females
Hull Off-Track Off-Track Off-Track Off-Track
Barnsley Off-Track Off-Track Off-Track On-Track
Rotherham Off-Track Off-Track Off-Track On-Track
NE Lincolnshire Off-Track Off-Track Off-Track Off-Track
Doncaster Off-Track On-Track Off-Track On-Track
Bradford Off-Track Off-Track Off-Track Off-Track
Wakefield Off-Track Off-Track Off-Track Near-Track
Y&H Spearheads Off-Track Off-Track Off-Track Off-Track
*10% narrowing of life expectancy relative gap between Spearhead areas and England from 1995-97 baseline and 2009-11 target
Components of an effective regional system
• Regional vision - SHA and CEx for NHS actions - Local Govt and GO- one of 4 objectives - Regional Assembly and RDA- one of 8 objectives• information – - Needs assessment -central role of PHO and intelligence leads network - Performance information especially AAACM• Core SHA business - performance, workforce, clinical, PCT reviews• Core GO business - PH team part of wider cross GO negotiating teams• Governance- Engine room• Method- for NHS NSTs and emerging JSNAs• Sharing best practice - Fdor CEs - For other partners• New DsPH network
Is it making a difference
• Inequalities now mainstreamed in SHA business
• Clinical engagement through DARZI
• More focused on industrialising- clear evidence of this happening
• Beginning to see improvement in the data
• Use of social marketing and QOF
Local Action – Prostate Cancer
• Social norms - role model• Linked to community events –
Fireman’s Fete• Effective placement stories• Developed partnerships; now on
back of buses• Link with Services - Men’s Health
MOTs at local drop-in
BEER MATS