Agenda item

To receive an update on the feedback from the Inequality Workshop as well as the Alliance Programme. – Please note that a report for this item will be published as a later agenda supplement.

The Board received an update from Elizabeth Disney (Wiltshire Locality Chief Operating Officer) and Lucy Townsend (Corporate Director of People, Wiltshire Council).

Alliance Work Programme Update and Inequality Workshop Feedback

The update covered the following matters:

• A timeline was provided outlining the development of the Wiltshire Alliance.
• An update was provided on the agreed priorities of the Alliance for 2021/2022, with progress reviews provided of each project.
• An update was provided on a recent Alliance Development Day which took place on 17 March, which had a theme of focusing on inequality within the Wiltshire Alliance (ICA).
• Attention was drawn to the agenda pack, which featured feedback from the Health and Wellbeing Board workshop, which had a focus on inequalities.

Comments were received in relation to the use of existing data to predict future trends, to which it was clarified that such approaches currently take place with predictive modelling in operational health and social care services as well as with a longer-term lens of population health management. Demographic growth was cited as a way of predicting demand change, with it noted that other layers of data can be added such as cost of living to provide further depth of analysis.

In addition, it was questioned where within the work there was an emphasis on children and young people, to which it was clarified that though the slides focused more on adult services there is a requirement to look at children. Furthermore, it was noted that when looking at population health management, the lens of children and mental health could be used.

Another layer for analysis was discussed as being the cost-of-living crisis and how might this increase demand for services. Through understanding what the demand might be like, there would be the opportunity to change how health care services are offered through the ICS. It was also acknowledged that in order to provide more layers of data, organisations need to be brought together in order to understand local populations.

BSW Inequalities Strategy 2021 – 2025

The update covered the following matters:

·       Context was provided in regard to the Inequalities Strategy, with the aim to provide a framework for system activity to reduce health inequalities.

·       A summary of the strategy was provided, which included a three-phase approach.

·       The NHS Core20Plus5 approach was outlined to the Board, which was designed to support Integrated Care Systems to drive targeted action in health inequalities improvement.

·       Implementation of the BSW Inequalities Strategy was outlined, with the three phases equating to short-, medium- and long-term visions.

Comments were received in relation to how Core20plus5 could have an important impact on healthcare inequality and how it had been produced on data to identify where the biggest difference could be made, with areas not in isolation to others, such as the cost-of-living crisis and mental health in the pandemic. Kate Blackburn also noted that there is hope of Wiltshire Public Health to be a national pilot area, with a programme of training taking place through the BSW academy, predominantly for analysts.

It was also noted that the Health and Wellbeing Board needs to demonstrate that it is thinking about the BSW Inequalities Strategy and that with winter on the horizon, that a shift is taking place into Phase 2 of the approach, with Core20plus5 in mind.

The example of Trowbridge was drawn upon, with Dr Gareth Bryant drawing upon previous projects that took place in the late 1990s, that looked into inequalities. It was stated that though Wiltshire is affluent, it has hidden and small pockets of serve deprivation; with Trowbridge being in the bottom quintile having experienced the same problems for a length of time. It was recognised therefore that the Health and Wellbeing Board has to be brave with investment and be a trusting environment, with the best solutions likely to come from local sources and communities. It was also highlighted that there is a microlevel between the individual and the choices that they make, therefore there is importance in recognising that though the Board is some distance from that, an environment can be set to facilitate partnership work and to enable teams to come together. Cllr Laura Mayes also noted that the Wiltshire Council Business Plan is looking to work in communities to listen to their strengths in order to build on them, as a core driver to improve social mobility.

Decision – The Wiltshire Health and Wellbeing Board accepted the following recommended proposals:

i) That the Board notes the progress made in reflecting the feedback from the workshop and the ongoing work programme of the Wiltshire Alliance.