NHS England’s Innovation for Healthcare Inequalities Programme (InHIP) aims to address local healthcare inequalities experienced by deprived and other under-served populations.
The programme is a unique collaboration between the Accelerated Access Collaborative (AAC), NHS England’s National Healthcare Inequalities Improvement Programme and the Health Innovation Network and delivered in partnership with integrated care systems (ICSs).
Two project teams (comprising of clinical and non-clinical expertise) from ICSs in the West of England have worked together with local communities to identify, address and minimise healthcare inequalities to improve access to the latest health technologies and medicines.
InHIP projects are focused on a clinical area of priority which closely aligns with the national Core20PLUS5 approach to reducing healthcare inequalities: in the West of England this is cardiovascular disease (CVD).
What’s happened in the West of England?
Working with Pier Health Group: Family Health Prevention Programme to Optimise Cholesterol Management for Core20PLUS communities
The Weston, Worle & Villages Locality (in Bristol, North Somerset and South Gloucestershire (BNSSG) ICS) has some of the most deprived areas in England. Men who live in the more deprived areas are likely to die 7.5 years earlier than their counterparts from less deprived areas. For women this equates to 6.7 years. Overall, people living in those areas are not only, on average, more likely to die earlier, but also have 10 fewer years of good health than those living elsewhere in the region. CVD Prevent states 21.7% of patients (with diagnosed CVD in the catchment of the Pier Health Group Primary Care Network (PCN)) are treated to target: 78.3% of patients are therefore not optimised.
This project aimed to reduce the cardiovascular risk of patients in two GP surgeries in the most deprived communities within the PCN through the use of a community health and wellbeing worker approach and lipids optimisation. Patients who have raised cholesterol but were not on optimal medication, including inclisiran and bempedoic acid in line with NICE guidance, were identified and reviewed to optimise their treatment and reduce their cholesterol levels.
The innovative community health and wellbeing worker approach sees the role as the ‘eyes and ears’ of primary care within the community. Based on the Brazilian Family Health Strategy, and trialled by Westminster City Council in England, they are lay members of the community who are trained, paid and integrated into the GP practice that proactively and regularly:
- visit local households to build trust and relationships,
- promote prevention opportunities,
- provide chronic disease support,
- connect to local services and
- act as a point of contact.
In Brazil this led to a 34% reduction of cardiovascular mortality, reduced inequity, increased breastfeeding, vaccination and cancer screening rates.
The project was a collaboration between Health Innovation West of England, BNSSG Integrated Care System, the Weston Worle & Villages Locality Partnership, Pier Health Group, North Somerset Council’s Public Health team and Voluntary, Community and Social Enterprise partners.
Working with Kingswood Medical Group: Optimising Cholesterol Management for Core20PLUS communities
Bath and North East Somerset, Swindon and Wiltshire (BSW) ICS has several areas in the most deprived 10% of the country, particularly in Swindon. Men who live in the more deprived
areas of Swindon are likely to die 5.7 years earlier than their counterparts from less deprived areas. For women this equates to 7 years. CVD Prevent states 21.65% of patients (with
diagnosed CVD in BSW) are treated to target; therefore, 78.35% are not optimised.
A lack of robust data has prevented the BSW CVD team from correctly prioritising those communities where greatest support is required.
The project, which worked with Kingswood Medical Group in Swindon, aimed to improve local intelligence to create greater understanding and engagement in health prevention.
- Phase 1: Create a CVD data dashboard demonstrating local data enabling greater understanding of patient and population needs and treatment gaps
- Phase 2: With the identified patient groups from Phase 1, co-design and deliver services to increase engagement and adherence in all treatment and lifestyle options which reduce risk of CVD and improve lipid optimisation using NICE-approved innovations
- Phase 3: Evaluation and dissemination of findings to the patient population and wider stakeholders.
What support did Health Innovation West of England provide?
We provided advice on innovation, community engagement, healthcare inequalities improvement and sought opportunities to highlight potential gaps in available innovations to inform future developments. We delivered project management and coordination to the two projects detailed above and offered opportunities to take part in a programme of educational webinars and community of practice meetings to share learning across systems.
Update on our InHIP projects
The evaluation of these InHIP projects has now been completed, revealing a range of valuable learnings around targeting CVD related health inequalities in deprived areas of BNSSG and BSW. Our evaluations will form part of NHS England’s national evaluation of the InHIP projects. This will support a wider understanding of reducing health inequalities across England and help inform future health inequalities work.
NHS England and the Accelerated Access Collaborative have developed the InHIP Development Toolkit. This toolkit can be access through signing up to the FutureNHS Collaboration Platform and is intended for anyone who is:
- Designing a project to reduce healthcare inequalities within their local area
- Developing an innovation to reduce healthcare inequalities
- Working on a change programme that needs to understand its impact on different communities
- Considering how the work they do, or the innovation they are developing, impacts populations that face healthcare inequalities.
Find out more
Please visit here for case studies relating to InHIP wave one work undertaken across other ICSs.
For more information, please contact healthinnowest.transformation@nhs.net.
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