Joint Forward Plan Appendix 4

Appendix 4: National Five Priority Areas for Tackling Health Inequalities

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Priority 1: Restoring NHS services inclusively

• We will continue to ensure at trust level, we have disaggregated waiting lists by deprivation and ethnicity to identify and address differences between groups
• Continue to invest Health Inequality Improvement funding to undertake EHIIAs of all ICB major programmes. Key priority areas for these EHIAs so far have been for elective care recovery, maternity, SMI, COPD, cancer, and hypertension. These live documents will inform co-produced action planning to tackle inequalities
• Continue to develop “waiting well” initiatives e.g., WSFT is developing a waiting well pathway for long waiters prioritising people in the 40% most deprived groups and roll this out across the ICS
• Develop plans for proactive case finding using detailed public health information linked to PHM intelligence. Our focus is likely to be on maternity, SMI, chronic respiratory disease, early cancer detection and hypertension. This is being done through our three Alliances which include all system partners including the VCSE
• Our Community Ambition programme has invested funding from NHS Charities Together in projects led by grassroots ethnic minority organisations to co-produce solutions addressing inequalities. This includes understanding community health needs, developing culturally competent maternity and mental health services and promoting healthy lifestyles. This work has enabled a more diverse range of voices to be heard across our system and as such we will evaluate the outputs of these projects and look to fund those worthwhile on an ongoing basis. The Bangladeshi Women’s Association of Essex is completing a unique health needs assessment of its community as one of these projects. Their report was published in September 2022 and shared locally and regionally to help us tackle health inequalities in South Asian communities
• Continue our Core20Plus5 Community Connectors programme and ensure it is led by the Connectors themselves and where they say their communities’ highest needs and priorities lie, which will include the ‘plus five’ areas but also any other significant issues that emerge in relation to access to services. Recent examples include improving awareness for black women about staying well in pregnancy and enabling reliable free transport for people living in deprivation to support their access to hospital services
• We will further explore improving accessibility to health and care services for people from marginalised groups as well as those with additional language and sensory needs by March 2025 supported by those with lived experience
• Ensure we include a focus upon health inequalities and how they can be tackled in all strategic plans we develop

Priority 2: Mitigating against digital exclusion

• We will ensure people are not excluded from accessing care if they do not have access to, or cannot use, digital means of communication
• We will ensure that we support people to become digitally included. This includes signposting to, and investing in support from local schemes, organisations, and initiatives
• We will ensure that digital will be the right tool and used when appropriate or useful
• We will ensure that digital information is made available in formats that people can engage with, and understand it, if they have specific communication needs (large font, multiple languages etc)
• We will ensure our online services are easy to navigate, consistent across services and kept up to date
• We will ensure family and carers of those in need are supported in being able to access digital care
• We will ensure help is available for those unable to access or utilise digital services
• An Equality and Equity Project / Produce Lifecycle Toolkit has been developed and is being implemented into core practice. This methodology will be applied to the design and implementation of all new digital channels, capabilities, and services for the public as well as the adoption of best local practice across existing digital channels
• Increase digital access and digital literacy for the most disadvantaged or vulnerable groups. A system-wide Digital Care Delivery Board has been formed to coordinate the range of digital options, remote care, virtual consultations, remote monitoring, virtual wards, and care tech initiatives. Both Suffolk and Essex County Councils are also working to improve broadband access
• SNEE has developed a Digital Equality and Equity assessment model. This will be merged with the health EIIA to produce a comprehensive toolkit that providers can use to measure themselves against. All new digital services will be designed in line with the equality and equity model and existing services are being refined to meet public expectations

Priority 3: Ensuring datasets are complete and timely

• Ensure the ICB continues to collect, refine, and analyse ethnicity data from a range of national datasets covering secondary care, mental health, and community service
• Regularly review the quality and accuracy of ethnicity and other data recording across our services
• Ensure the Health Inequalities Improvement Dashboard is fully utilised in our programmes of work and will be utilised by the ICB Prevention and Inequalities Committee in its work
• Build on our existing PHM programme and development of our SNEE wide Intelligence Function to ensure we have a stronger focus on health inequalities in all our datasets to better inform decision making

Priority 4: Accelerating preventative programmes that proactively engage those at greatest risk of poor health outcomes (including CORE20PLUS5 approach)

• Please see section five and in particular the sections on: mental health, diabetes, respiratory, CVD and stroke of the JFP for specific preventative priorities

Priority 5: Strengthening leadership and accountability

• Continue to ensure the ICB and its partners have named Senior Responsible Owners for tackling health inequalities. The ICB SRO is Dr Ed Garratt
• Ensure all ICB programmes have a focus upon health inequalities and the tackling these features in their work
• Establish the Health Inequalities and Prevention Committee (HIPC) chaired by the Suffolk Director of Public Health to provide a focal point and strategic leadership on reducing health inequalities and embedding prevention across the ICB
• Continue to commit greater levels of funding to tackling identified health inequalities across SNEE
• Continue to support the ICP in raising the profile of health inequalities