Agenda item

Representatives of the Tees Valley CCG will be in attendance to provide information on Health Inequalities from the Health Service perspective.

The Chair welcomed representatives of the Tees Valley Clinical Commissioning Group (TVCCG) to the meeting and invited them to present information regarding health inequalities from a health service perspective. Members were advised that the presentation was intended to complement the briefing note issued with the meeting papers.

 

Members were informed that for any approach to health inequalities to be successful collaboration was essential.

 

Health inequalities across the Tees Valley tended to be worse than the English average especially around higher obesity levels, poorer GCSE results and higher rates of smoking.

 

In order to address such inequalities the NHS had a mandate to tackle five focus areas; restore NHS services inclusively; mitigate against digital exclusion; ensure datasets were complete and timely; preventative programmes that engaged most at risk groups and strengthening leadership.  All work in this regard had to be of a collaborative nature meaning working closely with system partners.

 

In terms of service restoration there was a need to improve business intelligence and data capture. Doing this would, hopefully, lead to improved service delivery. There was also a requirement to restore services at a place level, especially services that were stopped due to the Covid-19 pandemic such as diagnostic spirometry.  

 

Another action to reduce health inequalities was to mitigate digital exclusion, especially through the lens of health inequalities. This included supporting systems to implement digital pathways where these supported access.  

 

In terms of improved datasets; there were plans to improve the coding and recording of all activity across Primary Care and the development of performance dashboards.

 

The fourth action, to accelerate preventative programmes that actively engaged at-risk groups, included analysis of the effectiveness of the Covid-19 vaccination programme and increasing the number of social prescribers, care co-ordinators as well as health and well-being coaches.

 

There was also a requirement for Primary Care Networks to tackle neighbourhood inequalities. Actions to achieve this included working collaboratively with PCNs and Local Authorities.

 

Members were advised that a great deal of detail sat behind the top level actions presented. The TVCCG advised the Panel they were grateful to the Council’s Public Health Team for their contribution to this work.

 

A Member commented that health inequalities were unfair as well as avoidable and queried what financial resources were available to assist with this. It was clarified that there was a limited amount of resources which needed to be directed carefully. Members were advised that specific financial information would be available from the Finance Director of the TVCCG.

 

A Member commented that the information about health inequalities presented to the Panel did not seem to have improved from previous years and that collaborative working had not always been effective. The Member queried how confident the TVCCG was in achieving its aims. It was confirmed that success depended on a collaborative approach but every effort would be made to achieve the actions identified to Members.

 

A Member commented that financial investment was not the only solution to the problem of health inequalities. A significant element of improving the situation was cultural shift, notably individuals wanting to change their lifestyles. It was confirmed that this formed part of the solution but structural change remained pivotal to any possible solutions.

 

A Member raised the issue of a recent publication from the Office of National Statistics entitled “Avoidable mortality in Great Britain” which identified that Middlesbrough had the highest female preventable mortality rate. The Member queried what factors contributed to this and what actions could be taken to address this. It was clarified that the details of the report needed to be considered before updates could be brought back to future meetings.

 

The Director of Commissioning, Strategy and Delivery (Primary & Community Care) commented that it was important for the Health Scrutiny Panel to have an overview of health inequalities. It was also commented that relevant organisations had an element of their funding allocated for tackling health inequalities and that collaborative working should not be underestimated. The TVCCG advised they would be happy to come back to a future meeting of the Panel to deliver a joint presentation on this issue.

 

The Chair queried if the relatively new initiative of social prescribing was working. Work had been conducted between PCNs with some Care Coordinator roles being created. PCNs had been asked to collate relevant performance data on social prescribing and this was currently being analysed. 

 

A Member queried if there was a specific timeline for the actions identified to be achieved. It was clarified that many of the actions were either continuations or had been carried over from previous years, and as such had a long term aim.

 

The Chair thanked the TVCCG for their presentation.

 

ORDERED that:

 

1.     Further financial information to be brought back to a future meeting of Health Scrutiny;

2.     That regular updates about mortality rates identified in the ONS report “Avoidable mortality in Great Britain” be brought back to future Health Scrutiny Panel meetings;

3.     That the information presented be noted.