Agenda item

To receive a presentation from Jill Harland and Robert Taggert, Northumbria Healthcare NHS Foundation Trust, updating Members on the Trust’s work on inequalities.

Members received presentations from Jill Harland and Robert Taggert, Northumbria Healthcare NHS Foundation Trust, updating Members on the Trust’s work on inequalities.  Presentations filed with signed minutes.

Jill Harland highlighted the following key points:-

•       It was important to recognise that approximately 80% of health inequalities and the influence surrounding them was outside the NHS and was about the wider determinants of health.  However, the NHS still had a key role to play.

•       The Health Inequalities Programme Board had been set up post Covid and it had strategic oversight on what the Trust was doing.  Its objectives were how to understand health inequalities and quantify and embed that understanding into the Trust’s routine reporting.

•       Everything would be brought together under one umbrella and raise the profile of health inequalities, bring partners together and to work with a collective lens.

•       The Board met monthly and considered the different priorities, what was known about them, where the inequalities were, what could be improved and what was needed to make changes.

•       Priority areas had been identified along with the actions that needed to be taken.  Priorities included:-

•       Health while waiting – to look at quality of a patient’s life while waiting for treatment

•       Staff Health Needs Assessment – to look at what the health inequalities were for staff.  Two ‘deep dives’ relating to musculoskeletal health and financial wellbeing in salary bands 1 to 3.

•       Local Health Index – joint working with public health colleagues to look at local data for a more granular understanding of place.  There was now an experimental version of the local health index to look at three domains; healthy people, healthy lives and healthy places to make comparison with the national average.  A proposal had been submitted to NHS England and it was hoped that it would be able to be opened up and used at an ICS level.

•       Lung Cancer Case Finding Pilot – Over 55s with COPD and living in more deprived areas were at higher risk of developing lung cancer.  A pilot scheme had resulted in a higher than international average detection rate.  Pilot scheme based on Valens PCN.

•       Tobacco Dependency Treatment Service – patients were offered Nicotine Replacement Therapy within two hours of admission.  Connection with patients was maintained for a time after discharge.

•       Best Start in Life – smoking cessation services to promote healthier pregnancies.

•       The Community Promise – initiatives by the Trust to promote staff and wellbeing.

•       Colposcopy – addressing health inequalities in attendance.  Non-attendance at appointments was highest in gynaecology and colposcopy and in younger women and in more deprived areas.  Reasons were mainly due to transport issues, anxiety, and health literacy.  Interventions had resulted in an improvement in attendance rates.

•       A Quality Improvement Approach had been developed – Planning Pilot, Evaluate and Disseminate

•       Three areas of focus for year 2 were:-

•       Developing the capacity and capability for a population health laboratory approach – health inequalities metrics in routine reporting

•       Embed and integrate approaches to tackle health inequalities across the Trust’s work.

•       Complete initial pilot projects, adopt good practice and disseminate widely – new projects.

Robert Taggert highlighted key points relating to the Interactive Public Health Dashboard:-

•       The aim was to create a more interactive format for the dashboard.  Metrics would be updated in real time, easy to use and navigate and be informative.

•       Five dashboards were currently in development looking through an inequalities lens with the Cancer SOF metrics dashboard being close to completion.  Self harm and RTT SOF metrics dashboards were ready for review and the dashboards for A&E waiting times and fuel poverty and respiratory A&E visits were in progress.

•       Cancer SOF Metrics Dashboard had three caveats:–

•       First treatment for new tumour or metastatic tumour only

•       62 day wait clock starts at time of first appointment to time of first treatment

•       Appointment and treatment both with the Trust only

•       Information available on the dashboard was shown along with the levels of information available interactively.  Further information was available on average waiting times by rurality, IMD quintile, referral type and cancer site.  Waiting times were greater for those in more deprived areas compared to the more affluent.

•       Other possible future SOF dashboards included access rates for mental health and safe high quality care looking at C.Diff and gram negative infection rates.

The following comments were made:-

•       Only patients whose treatment was totally within the Trust would be included.  There was no control over waiting times for other Trusts.

•       The dashboards started with facts and figures but there would be a focus on speaking to patients about their experience.

•       It was acknowledged that there may be pockets of health inequalities within more affluent areas, and it was important to ensure that they were not missed.

•       The Trust was looking at inequalities from a patient perspective whereas the Health & Wellbeing Board was looking from a residents’ perspective, however, these were the same people.  It was hoped that there would be much closer alignment with datasets.

•       A link up should be considered between Adult Social Care and Public Health Consultants and a connection with CNTW regarding mental health would be useful.

RESOLVED that the presentations be received.