HEALTH INEQUALITIES REGIONAL APPROACH Prepared by Yorkshire and the Humber NHS Date 16 th May 2008 Paul Johnstone Regional Director of Public Health NHS/DH Yorkshire and the Humber

Y&H has some of the worst health inequalities of any region - both between and within the region 7/14 PCTs are Spearhead areas Non spearhead areas have significant inequalities Target – to reduce inequalities in health by 10% by 2010 as measured by infant mortality and life expectancy at birth

All Age All Cause Mortality rates per 100,000 people ( ), at a Middle Super Output Area level: Y&H

New SHA in 2006 placed tackling health inequalities and meeting the 2010 targets as a top priority Built on existing strategy by previous RPHG, SHAs Govt Office, Regional Assembly, RDA Twin track approach - NHS action - Supporting LSP/negotiating LAAs priorities

Track 1 - NHS Used National Support Team visits and methodology Each PCT identified local priorities and NHS action needed supported by APHO and PHO tools (web link) SHA Chief Executive asked that all PCT CEx have a health inequalities objective. - Ensured agenda was mainstreamed in NHS - Most focused on smoking, statins. - But some significant differences Each set a target which is measurable, industrialising intervention (1-2) which will make a difference in AAACM and narrow the health gap meeting 2010 targets.

Track 2 - LAA Regional PH team (based in GO and SHA) work as one whole system. Governance – Engine Room Enabled 3rd and 4th round LAAs to be drawing from same health inequalities information

National health inequalities 2010 PSA life expectancy target*: progress at Spearhead PCT Department of Health 2010 PSA inequalities update (Dec 2007) YHPHO Forecast MalesFemalesMalesFemales HullOff-Track BarnsleyOff-Track On-Track RotherhamOff-Track On-Track NE LincolnshireOff-Track DoncasterOff-TrackOn-TrackOff-TrackOn-Track BradfordOff-Track WakefieldOff-Track Near-Track Y&H SpearheadsOff-Track *10% narrowing of life expectancy relative gap between Spearhead areas and England from baseline and target

Components of an effective regional system Regional vision - SHA and CEx for NHS actions - Local Govt and GO- one of 4 objectives - Regional Assembly and RDA- one of 8 objectives information – - Needs assessment -central role of PHO and intelligence leads network - Performance information especially AAACM Core SHA business - performance, workforce, clinical, PCT reviews Core GO business - PH team part of wider cross GO negotiating teams Governance- Engine room Method- for NHS NSTs and emerging JSNAs Sharing best practice - Fdor CEs - For other partners New DsPH network

Is it making a difference Inequalities now mainstreamed in SHA business Clinical engagement through DARZI More focused on industrialising- clear evidence of this happening Beginning to see improvement in the data Use of social marketing and QOF

Local Action – Prostate Cancer Social norms - role model Linked to community events – Fireman’s Fete Effective placement stories Developed partnerships; now on back of buses Link with Services - Men’s Health MOTs at local drop-in

BEER MATS