Agenda item

Steven Senior, Public Health Consultant to provide an update. Report and presentation attached.

Steven Senior, Consultant in Public Health gave a presentation on the inequalities in Primary Care in Bury. A detailed report and PowerPoint slides were included in the agenda pack.

The focus of the presentation was on Coronary Heart Disease (CHD) which is a major cause of illness and death in Bury and can be reduced by good quality primary care. Intervention decay describes how the number of people who could benefit from a healthcare treatment gets eroded by gaps and barriers that stop people accessing care. The importance of linking intervention decay to service resourcing, structures, processes, and outcomes was explained. More deprived populations experience higher rates of CHD deaths. Most parts of Bury are above the England average for CHD deaths.

In response to a member’s question around using innovative ways to ensure that patients with cardiovascular disease are accessing services, it was explained that the data shows where to look but not necessarily what to do with it. Suggestions were made to help patient access services. It was suggested that the Neighbourhood Teams and Community Champions could help with patients accessing services. It was suggested that connections are to be made with services who connect with the community more often.

Kath Wynne Jones gave examples of work taking place within neighbourhoods, INT leads have neighbourhood plans which have different indicators depending on the need of that area, the leads are working with Community Hub Managers. The indicators are for health and care. There has been work done with the VCFA around using volunteers to help with community engagement.

A member suggested that health services in areas of deprivation struggle to recruit staff and therefore cannot deliver everything that they would like to due to staff shortages.

Members discussed issues around deprivation getting worse due to the cost of living rise, it was explained that work is being done within communities and integrated neighbourhood teams around health inequalities.

Implementation decay and co-production work is being addressed at the next Partnership Meeting. There is ongoing work around how to engage different people in the community to get their voices shared. The Partnership Meeting has a wide range of stakeholders involved.

It was agreed:

1.     Cardiovascular disease is the initial focus for work to address health inequalities through primary care.

2.     Further analysis should be done to look at equity in other aspects of primary care for people with coronary heart disease.

3.     Bury CCG should support PCNs to analyse inequalities in health and care (starting with cardiovascular disease) within practice and PCN populations with the aim of identifying aspects of care that vary according to patient characteristics such as deprivation and ethnicity and to identify clustering of aspects of care that might help identify those patients who are potentially missing out on the most effective interventions.

4.     Data on skill mix across practices is collected to allow a fuller assessment of equity of distribution of the clinical workforce relative to deprivation and health need and support PCNs’ workforce strategies.

5.     Council and CCG speak to counterparts at the Greater Manchester level and propose analysis to understand the relationship between general practice workforce supply and composition and key outcomes.

6.     Bury CCG and Council and GP Federation to support the Primary Care Networks to develop their health inequalities plans drawing on the frameworks outlined in this paper.

7.     The Health and Wellbeing Board to be updated on progress against these recommendations in September 2022.