This report updates the Health and Wellbeing Board on the progress made towards reducing health inequalities in Herefordshire using the CORE20+5 model.

The Consultant in Public Health introduced the report and delivered the presentation 'Health Inequalities' (HI), including slides on: what are health inequalities?; life expectancy [additional slide]; health inequalities across Herefordshire; our main strategies to tackle HI; Core20+5; flow of HI work; and Primary Care Network priorities 24/25.

The Chairperson drew attention to the 'Inequalities Strategy 2023-2026' and suggested that it would be helpful to update the document, or provide an addendum, to reference significant changes that had occurred since the adoption of the strategy, for example: mention of the strategy being ‘currently out for consultation’ (para. 41); the paragraph on Fastershire (para. 47); and the living wage ‘of £8.75 an hour’ (para. 28).  The Chairperson also queried the meaning behind the different coloured tree icons in the presentation slide ‘Health inequalities across Herefordshire’.

The Executive Director of Strategy and Integration commented on: the work of the Health Inequalities, Prevention and Personalised Care Board (HIPP) which worked across the Integrated Care System (ICS) as a whole, in addition to the Herefordshire HIPP Board; and the money put into primary care through the Clinical Excellence and Investment Framework to develop health inequality plans.  In response to a question, the Consultant in Public Health acknowledged the need to explore trends in life expectancy and healthy life expectancy as more data became available; the Director of Public Health added that disability-free life expectancy was another indicator of population health.

The Consultant in Public Health provided a live demonstration of the health inequalities dashboard, enabling health and social care partners to identify inequalities, plan interventions, and evaluate impact; it was reported that development was ongoing on various datasets, including bowel cancer screening, health checks, and hypertension prevalence. 

The Chairperson noted the value of detailed analysis by practice which would enable partners to work collaboratively to address health inequalities in specific communities and local areas.

The Executive Director of Strategy and Integration commented on the next stage of development, integrating secondary care datasets.  The Consultant in Public Health confirmed the intention to add more indicators incrementally to ensure that the dashboard was accessible, easy to understand, and usable.

Other board members welcomed the dashboard and comments were made about the potential to target preventative and other resources to key cohorts, and to reduce demand on urgent and emergency healthcare pathways.

The Voluntary and Community Sector (VCS) representative said that VCS organisations and faith groups could be engaged to work with communities, particularly to spread messages about screening programmes.  The Consultant in Public Health said that the primary care networks would lead on interventions, working closely with public health, including outreach and other community initiatives. 

The board briefly discussed some of the barriers to the uptake of health checks and vaccinations.

Resolved:       That:

a)           The comprehensive and innovative programme of work which is underway to reduce health inequalities in Herefordshire be noted;

b)          The continuation of a system approach to delivery of the strategic priorities identified in the Inequalities Strategy be supported;

c)           The development of a revised action plan to incorporate the CORE20+5 approach be supported;

a)           The board requests that consideration be given to:

§    updating the Inequalities Strategy 2023-2026 document, or providing an addendum, to reference significant changes that had occurred since the adoption of the strategy,

§    the inclusion of a key to the tree icons on the presentation slide ‘Health inequalities across Herefordshire’, and

§    referencing connections to the work being undertaken across the Integrated Care System.

b)          Updates be provided at appropriate future meetings on the trends in life expectancy, healthy life expectancy, and disability-free life expectancy, as more data becomes available.