Agenda item
Health inequalities update
To update the Board on the ongoing work on health inequalities being undertaken in Brent.
Minutes:
Dr Melanie Smith (Director of Public Health, Brent Council) introduced a report updating the Board on the setup and progress of the health inequalities programme following the report presented to the Board in June 2020, which detailed the disproportionate impact of COVID-19 on BAME communities in Brent. She highlighted that the impact of COVID-19 was not equal and the infection was more serious, with higher mortality rates, for certain groups such as older people, men, and those in deprived communities, but even after allowing for age and deprivation those of Black and Asian heritage had worse outcomes. It was agreed at the last meeting that work should be done together to address health inequalities in Brent, focusing in particular on Church End and Alperton - areas which were highlighted as particularly affected during the first wave of the virus with a significant distressing number of deaths. Dr Melanie Smith highlighted the following key points in relation to the health inequalities report:
- A governance structure had been established with a Steering Group and a Reference Group and a wide range of partners across the Council, NHS and Healthwatch, as outlined in the report. The NHS had approved the business case for the new model of Primary Care that had been proposed with staff being appointed to drive it forward at pace.
- There were short, medium and long term actions that would be taken to address health inequalities. Immediate actions would be aimed at reducing exposure to COVID-19 and susceptibility to severe infection while improving access to healthcare, in collaboration with the community. This would be a Borough wide approach with targeted interventions on those particularly affected areas of Church End and Alperton. As well as this work would include increasing uptake of preventative services, such as flu vaccinations and cancer screenings which had been impacted by COVID-19, and improving the control of long-term conditions such as diabetes and hypertension which were more prevalent in BAME communities.
- Four Community Champions had been recruited from 2 well attended community meetings with Church End and Alperton residents. These would help the Council understand the needs of Brent communities and how those communities experienced COVID-19 to help develop messaging. Communities had fed back that COVID-19 messaging during the first wave of the virus had been confusing and not culturally competent so the project was looking to address this with the Community Champions and Health Educators, with more culturally competent messages now created. There were regular events scheduled with the Community Champions and wider community groups to help with the action plan. There was the opportunity for more volunteers to become Community Champions, with the Council looking to increase their reach into communities and looking for younger volunteers in particular. The Council were very grateful to those who had came forward but could not say they were necessarily representative of all the diverse communities in the Borough so the door was still open for more people to volunteer. There was also the opportunity for appointments to paid positions – Community Health Educators – with a focus on health education and promotion within the community.
- Targeted enforcement activity had taken place working with the community to help people understand the new restrictions and provide practical support for businesses.
- The CCG had secured funding for a Primary Care and Mental Health project which would be a joint piece of work between the Council, CCG and local trusts taking responsive and holistic Primary Care into the community rather than residents accessing services in traditional ways.
- The area of digital inclusion needed to be addressed particularly with the move to many services online during the first wave of the virus.
- A North West London NHS volunteering piece of work led by Helpforce was underway, which sought to improve low-level mental health outcomes such as depression and anxiety. The Council were at an early stage of understanding how the project would interface with existing volunteers schemes and a workshop was due shortly to introduce the work to local VSC organisations.
- Longer term plans would come from working with the community and Champions where the more entrenched structural determinants of health inequalities would be addressed.
The Chair thanked Dr Melanie Smith for providing the update and invited comments from the Board, with the following issues raised:
In relation to COVID-19 and the disproportionate impact on BAME communities in Brent, the Board queried what the statistics showed. Dr Melanie Smith advised that the most robust information on the disproportionate impact of COVID-19 on Black and South Asian communities came from looking at the national statistics for England and Wales, which showed once one allowed for the fact that BAME communities tended to be younger and lived in more deprived communities there was still a doubling of mortalities in Black communities and one and a half times mortality for those of South Asian heritage. The most recent testing data showed that the uptake of testing in Brent was reflective of the diversity of the local population. Carolyn Downs (Chief Executive, Brent Council) added that the registered deaths in Brent from COVID-19 were disproportionate in relation to the Asian community compared to the percentage of the population.
Dr MC Patel (Chair, Brent CCG) advised that Brent’s flu vaccination campaign had launched very well and was doing better at the time of the meeting than at the same stage a year ago, with Brent being one of the top London Boroughs for numbers vaccinated.
The new model of Primary Care being piloted aimed to break down the silos between different pathways of the NHS and wrap care around the resident, bringing different professionals into the team to deliver care to the individual. Dr MC Patel advised that this was the first time a model of care looked to establish holistic care putting the patient at the centre of care and reducing the barriers between different services. The traditional system where a resident would need to go to a GP and get a referral would no longer be used so that no matter where a resident accessed healthcare they would be referred to the correct place without having to go back to their GP. The model aimed for a patient to remain in the system once they had accessed it so that they could return whenever they needed advice throughout their lifetime. Outreach to those in the community who traditionally did not access healthcare would take place.
Board members noted that the Council’s new procurement
strategy had just been released looking at how suppliers could help
Brent communities which could be added to the schedule of works
going forward.
RESOLVED:
i) To agree the recommendations set out in the report.
ii) To receive a report at the next Health and Wellbeing Board providing an update on the progress of the health inequalities work.
Supporting documents: