Agenda item

The Director of Public Health submits a report to update the commission on the Prevention and Health Inequalities Steering group.

The Director of Public Health submitted a report to update the Commission on the Prevention and Health Inequalities Steering group which was established in June 2024. The following was noted:

·       The Leicester City Prevention and Health Inequalities Steering Group was a strategic group that provides direction and alignment on prevention priorities to address health inequalities in Leicester.

·       A strategic group had been established which reported to the Leicester Health and Wellbeing Board and operated as a formal subgroup of the Board.

·       In June 2024, the Director of Public Health established a new initiative in Leicester to address health inequalities with urgency and focus.

·       It was explained that a wide range of stakeholders had been involved in selecting 5 priority topics. The group had considered the contributors to health inequalities and reviewed supporting evidence.

·       The group decided on the following five priorities for the next 18 months:

­   Hypertension (High Blood Pressure) case finding

­   Healthy weight (neighbourhood focus)

­   HPV (Human Papillomavirus) vaccine uptake

­   Social isolation in people with severe mental illness

­   Bowel cancer screening uptake

·       The approach had been designed using an incident management model, similar to the measles response, and this methodology was now being applied to the prevention of long term conditions, tackling health inequalities and improving outcomes for local communities.

·       Hypertension had been identified as a priority, with work including the use of a roving health unit and encouraging follow up activity.

·       Targeted work on healthy weight had also been undertaken.

·       A focus on HPV had included engagement with secondary schools in the city, with HPV vaccinations delivered via the roving unit.

·       Social isolation amongst people with severe mental health needs had been identified, particularly noting that there was currently no clear pathway for homeless people. A bowel cancer pathway for this cohort was due to be launched in the spring.

·       Data analysis was being reviewed and refined, with a final version expected in March.

·       It was noted that the programme would continue to meet quarterly and would identify priorities for the next 18 months.

In discussions with Members, the following was noted:

·       Members requested further detail in March on early indications, ongoing priorities and what investment was being made, and sought clarification on whether the current priority strands would continue beyond the initial phase. It was advised that data analysis was being finalised and would provide greater clarity on impact and next steps, and that the programme would continue to review priorities over the next 18 months in line with emerging evidence and need.

·       It was commented that the evaluation approach was thorough and innovative, drawing on outbreak management principles and applying them to long term conditions. In response, it was explained that the programme was intentionally data and intelligence driven, starting with an understanding of the contributors to inequalities and impacts on life expectancy, before identifying evidence based interventions. The approach focused on proactively reaching communities and delivering practical short and medium term actions, although it was acknowledged that some areas, such as social isolation, may require longer term programmes to demonstrate measurable impact.

·       Members noted the significant interest in the programme and queried how data was being used more widely. It was reported that discussions were taking place across the Midlands on how data analysis could be applied differently, including at neighbourhood level to allow for more detailed breakdowns by area, with inequalities remaining central to the work.

·       A suggestion was made that suicide prevention and public health emergencies be added as priorities, alongside concerns raised about access to mental health services and the difficulty of navigating support, particularly in relation to suicide rates. It was explained that a wide range of topics had been proposed by stakeholders and had been considered through an agreed assessment process, and that any additional topics would need to be reviewed through that same process to ensure consistency and fairness.

·       While welcoming the focus on long term conditions, members emphasised that wider determinants of health also needed to be recognised, including social isolation, limited community interaction, poor bus services and access to transport, all of which contributed to inequalities.