Agenda item

Health Inequalities Update

To outline progress on drafting a Health Inequalities Strategy and Action Plan 2021-24.


Board to also receive an update on the Birmingham and Solihull Integrated Care System Inequalities Work Programme.


Health Inequalities Strategy Update


Ruth Tennant updated on the progress of drafting a Health Inequalities Strategy and Action Plan, highlighting the following points:

·  As a Health and Wellbeing Board, there had been a significant amount of work to help develop a multi-agency approach to tackling health inequalities.

·  As the ICS develops, there would be an emphasis upon ensuring a strong system-wide response towards health inequalities. There was a need to ensure the local and ICS approach complemented one another.

·  There would also be a focus upon community engagement, especially the learning from the strong community links established as part of the Covid-19 response.


Rob Davies also updated on the development of the Health Inequalities Strategy, explaining the following:

·  A three step programme had been followed consisting of – understanding where we were now, establishing where Solihull wanted to be (including a collective understanding leading to priority setting), as well as planning how they would get there (via a shared action plan).

·  They were currently at step 3, with 3 main life-course priorities, as well as 3 enabling strategies, as identified in the report.

·  It was explained how the development of the Strategy had taken into account the White Paper and introduction of the ICS, as well as the learning from the Covid-19 response.

·  The development of the Strategy had also taken into consideration the recently published national paper, the ‘Build Back Fairer: The Covid-19 Marmot Review.’ It was emphasised how this paper focused upon early years and integrating health and economic outcomes – this clearly linked with the wider Health and Wellbeing Strategy, as well as the Inclusive Growth orientated Council Plan.

·   In regards to next steps, more engagement with key partners was planned to shape the priorities further, as well as ensure clear linkages with the health system overall, especially the ICS.


Members raised the following questions and observations:

·  Andy Cave explained how a key element of reducing inequalities was on-going engagement and inclusion. He stressed the importance of co-production and ensuring this was a golden trend throughout all the priorities identified within the draft Strategy.

·  Rob Davies emphasised this was recognised – he explained that, as part of the last priority, regarding facilitating strong, inclusive and resilient communities, there would be a focus on building upon the strong community links established as part of the Covid-19 response.

·  James Voller noted how the report made reference to a VCSE strategic assessment, to understand the community based assets across the Borough. He emphasised that any community asset mapping needed to be linked with plans to ensure these assets were sustainable. James Voller also queried how this Strategy would be connected with health inequalities work being undertaken elsewhere – for instance the local LeDer (Learning Disabilities Mortality Review) steering group, which had focused upon the inequalities faced by people with learning disabilities.

·  Ruth Tennant explained it was recognised a system-wide approach to addressing health inequalities was required, whilst also ensuring focus upon clear, deliverable actions.

·  Anne Hastings highlighted how the report made reference to reviewing and refreshing the Locality arrangements for the East, North and South of the Borough – she expressed concern that the voluntary sector wasn’t always linked in with this work.

·  Fiona Hughes explained that, in regards to the locality agenda, re-setting work had been undertaken, to take into account the community, voluntary and locality responses to the pandemic. A Thriving Communities Management Board had been established, which was overseeing the work of localities – a key area of focus would be further engagement of the voluntary and community sector. It was noted further updates on this could be reported at future Board meetings.

·  Councillor Meeson explained how he welcomed the focus on early years proposed within the Strategy. He requested for the Strategy to clearly take into account how early years were strongly linked with parenting – he stressed how help for parents during this period often made a crucial difference.

·  Councillor Sexton also explained how she was pleased to see the emphasis upon early years – she expressed concern at a potential gap in regards to school leavers, who were particularly impacted by the effects of Covid-19. Councillor Sexton also raised the issue of co-production and queried how this would differ from standard consultation processes – she also questioned the plans to engage with ‘hard-to-reach’ groups. Councillor Grinsell emphasised how, as part of the Council’s Inclusive Growth agenda and the Economic Recovery Plan, there was targeted support for young people who were ‘Not in Employment, Education or Training.’



The Health and Wellbeing Board noted the progress on developing the Strategy and Action Plan.


ICS Inequalities Work Programme


Richard Kirby, Chief Executive of the Birmingham Community Healthcare NHS Foundation Trust updated on the above work programme, highlighting the following points:

  • They were focusing on the role of the ICS in contributing towards the reduction of health inequalities, whilst recognising and linking with the work being undertaken elsewhere.
  • It was critical to clearly link this work programme with the two Health and Wellbeing Boards, in Birmingham and Solihull, in particular links with these Boards’ JSNAs and key strategies.
  • Going forward the ICS Inequalities work programme would report to the two Health and Wellbeing Boards, as well as the ICS Partnership Board.
  • A focus of this work programme was ensuring the NHS organisations were effective partners to Local Government and other key agencies. Many of these organisations already had a strong track record of working with the LA’s, such as the Mental Health Foundation Trust.
  • It was recognised how inequalities were affected by unequal access to and treatment within the NHS. They were also caused by much deeper inequalities in society, including access to housing and employment. As a consequence, there was a focus upon closer collaboration between NHS organisations and Local Government.
  • A further key area for the ICS was enhancing the digital offer, in a way that supported inclusion and didn’t exacerbate existing inequalities.
  • At an early stage of this work programme, they were looking to build a model of local engagement with communities, which could be adopted by the Primary Care Networks.
  • A further proposed area of work was ensuring clear links with the Covid-19 response, including engaging with the delivery of the vaccine programme and recovery work, particularly for deprived and vulnerable groups.


Members raised the following queries and observations:

  • Andy Cave explained how he welcomed the engagement work proposed around PCNs. He detailed how, locally, Healthwatch had developed a set of quality standards for involving and using local experience to help reduce inequalities – he confirmed he would be happy to engage with Richard Kirby on this further.
  • Jenny Wood highlighted how the update on the ICS Inequalities Work Programme requested the Boards views on the 9 proposed areas for work. It was explained how there would be certain pieces of inequalities work being delivered locally, whilst other pieces of work would be delivered at a BSol or cross-regional level. It was suggested that Solihull Together could be the appropriate forum locally to support oversight and co-ordination of this on a day-to-day basis.



The Health and Wellbeing Board

(i)  Endorsed the approach to health inequalities within the work of the ICS, as set out in this report.

(ii)  Agreed that Solihull Together is the appropriate forum locally to support oversight and co-ordination of the ICS Inequalities Work Programme on a day-to-day basis.


Supporting documents: