A report outlining the Herefordshire Inequalities Strategy for 2023-2026.

Alan Dawson provided an overview of the Herefordshire Inequalities Strategy 2023-2026. The strategy was developed by a sub-group of the One Herefordshire Partnership and has engaged with a number of partners including, in particular, the clinician and practitioner forum and the One Herefordshire Partnership, itself. The principal points included:

1. The strategy attempts to link the national approach to reducing health inequalities to the local proposed approach.
2. The national approach, ‘Core20PLUS5’, contains three main elements:
   1. ‘Core20’ deals with the 20% most deprived wards in each area in England. Herefordshire has 9 in that category.
   2. ‘PLUS’ are the areas that are specific to the local population and there are three groups that are focused upon in the strategy. First are those who are not registered with a general practice. Second, those who fall within the most rurally dispersed of the population, which is another area that particularly affects Herefordshire. Finally, the strategy focuses on the Gypsy Roma and traveller community.
   3. ‘5’ relates to the five nationally mandated clinical areas that are focused upon regarding health inequalities:

                                               i.     Maternity

                                              ii.     Mental health

                                             iii.     Respiratory

                                            iv.     Cancer

                                              v.     Hypertension

3. The strategy aims to create a framework that can address health inequalities in the county.
4. There are three over-arching objectives that the strategy seeks to confront:
   1. 1. Digital and health literacy:

                                               i.     There is a lack of digital and health literacy in which accessibility to services has become increasingly digitalised.

                                              ii.     A key aim of the strategy is to help staff to improve their digital and health literacy so that they can assist patients and the public and in turn, reduce inequalities.

                                               i.     This objective seeks to ensure that staff understand what is meant by health inequalities, how they approach them, and ultimately reduce health inequalities amongst the workforce.

                                               i.     There is already a lot of work being done in the county, a lot of which is reflected in the plan at the end of the strategy.

                                              ii.     The work of the Community Partnership, led by Herefordshire Healthwatch, who have looked at the factors driving health inequalities and consider what can be done by partners in the statutory and voluntary sectors, respectively, together around that.

                                             iii.     The work of primary care networks of general practice, community staff, and social care workers is also important to understand the needs of their population, in addition to dealing with those needs in defined areas and in defined ways.

5. The plan at the end of the strategy is not exhaustive but covers the main strategic elements of the approach and highlights the approach being taken to meet the three over-arching objectives, stated above.

David Mehaffey asked if there could be direct reference to the Integrated Care Strategy in the context of the health and wellbeing strategy.

The Chair asked how and when an evaluation of the three over-arching objectives would be delivered to the board in the future.

Alan Dawson confirmed that he would bring back a report to the board and suggested an update of every six months.

The Managing Director of Wye Valley NHS Trust suggested an annual update to reflect the long-term nature of the work.

Christine Price suggested that a more coordinated approach between the agencies involved in the strategy should be followed in order to improve engagement and subsequently implement the strategy’s priorities.

Alan Dawson agreed with the suggested recommendation and noted that the strategy is at a new phase.

The Director of Public Health noted that the work of the Inequalities Strategy can cover many different areas including housing and the economy, for example, and that consideration is needed to ensure that resourcing is available to implement the actions recommended in the report.

In addition to the report’s recommendation, the board agreed that an annual report would be brought back and that a more coordinated approach between the agencies involved in the strategy should be followed in order to improve engagement and subsequently implement the strategy’s priorities.

The recommendations were proposed, seconded, and approved unanimously.

Resolved:

a)    That the Board considers and comments on the Inequalities Strategy.

b)    That a more coordinated approach between the agencies involved in the strategy should be followed in order to improve engagement and subsequently implement the strategy’s priorities.

Action(s):

1. That a report be brought back to the Health and Wellbeing Board annually to evaluate how and when the strategy’s three-overarching objectives would be delivered.