Agenda item

Purpose: The Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) to provide an overview of the key prevention and Health Inequality activities taking place in West Berkshire.

Steve GoldenSmith (Asssociate Director of Prevention and Health Inequalities, Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB)) gave an overview of the report on Health Inequalities for West Berkshire.

During the debate the following points were discussed:

·         There were four ways the NHS could reducing health inequalities:

1.    Influencing / supporting multiagency action to address the social determinants of health.

2.    The NHS as an anchor organisation – as commissioner, employer, partner and purchaser.

3.    Tackling existing inequalities in healthcare.

4.    Focus on ill health prevention and influencing healthy lifestyle behaviours. This needed to be collaborative to encourage and embed people to manage lifestyles in a more positive way.

·         It was advised these were not In order of priority and the solution was in working in partnership to address the wider determinants of health.

·         West Berkshire data was shared which showed that there were a number of areas of concern. These included above national average rates of asthma, cancer, dementia and hypertension.   Many of these could be driven by wider determinants of health and health inequalities. It was noted that Reading and Oxford had more areas of deprivation to West Berkshire, but West Berkshire had higher rates of these health conditions. It was not known why this was as a full evaluation by the BOB ICB had not taken place yet.

·         It was explained that the NHS focus on reducing health inequalities through the Core20Plus5 approach which enabled Integrated Care Sytem’s (ICS) to target action for the most deprived 20% of the population. Key clinical areas were maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension case-finding.

·         Data was shared on the index of multiple deprivation that highlighted Eastfield House surgery, Falkland Surgery and Strawberry Hill Medical centre by in large provided most of the primary care services to these populations.

·         An overview of the data insights methods was shared which highlighted how the BOB ICB could drill down the data to enable focussed work on targeted areas of the population and for targeted clinical priorities.

·         For children, the BOB ICB had a different set of clinical areas that they focussed on to address health inequalities. These were asthma, diabetes, epilepsy, oral health and mental health. They used data insights to target cohorts with particular needs.

·         It was advised that inequalities were found in access to healthcare, peoples experience of healthcare and the outcomes of healthcare. Access to services could be influenced by a variety of factors including trust and knowledge. Experiences and outcomes of services could also vary hugely.

·         The BOB ICB were carrying out community engagement through Healthwatch to understand the challenges to access to NHS dental services and specifically for children who were neurodivergent.

·         The BOB ICB were also starting to utilise improved data to understand if there was any unwarranted variation in access, experience and outcomes of children’s mental health services. There was also some targeted work being undertaken through getting help level teams, such as Mental Health Support Teams. It was noted that there was some correlation seen between how likely referrals were to be urgent and deprivation, and how likely patients were to not attend appointments.

·         An overview of the Community Wellbeing Outreach programme was shared. They were targeting communities that did not engage well with healthcare to help them to engage in a more timely way and to participate in their own healthcare. It was advised that the appointments could take some time as not only were medical checks taken, but also there were conversations had around healthy living.

·         In West Berkshire the Community Wellness Outreach programme was funded by the BOB ICB and was provided in partnership by the public health team and Solutions4Health. Sessions were carried out in a range of community venues including community centres and employment settings. The venues were decided upon to target particular groups of people. Members requested further details of these sessions. It was advised that the outcomes and experience of this pilot had been very good and a full evaluation of this first stage of the programme was beginning.

Action: Vicky Phoenix to gather information on the sessions and locations used by Community Wellness Outreach Project and to share this with Members.

·         The model was particularly helpful in having conversations with people around lifestyles and prevention which could have life changing impacts and a decreased likelihood in people needing services in the future.

·         Data was shared on the vaccination rates in West Berkshire for adults and children. There was variation between ethnic background and covid vaccination uptake which required further education. In children’s vaccinations there was also variation around ethnic background and deprivation with vaccination rates. It was advised that a great deal of work was being done to encourage, communicate and educate people to access vaccinations. This included working with community leaders, providing services in local areas and making the hours for vaccinations more flexible. There were also national communications around this issue as this was not just in the BOB area. There were some areas of good practice across the UK, however this did not bring levels to where they wanted them to be.

·         The role of health visitors in educating parents around childhood vaccinations was highlighted. It was advised that there was a trial for health visitors to provide flu vaccinations.

·         The role of pharmacies in vaccination provision was also highlighted.

RESOLVED that the report be noted.