In the midst of the first peak of the COVID pandemic, I was appointed as Clinical Lead for Health Inequalities for the Nottingham City ICP. This role was not created in response to the health inequalities highlighted by the pandemic, but because the inequalities in health outcomes in Nottingham City have long been recognised. The pandemic has sadly made worse and more visible what were already very real differences in health and wellbeing between the diverse communities within the City.
I have been a GP in Sneinton/ St Anns for over 30 years. There I have seen at first hand the struggles local people have with low income, poor housing, unemployment, barriers to access care, difficulties when English is not fluent, and low education attainment levels. I have also seen the incredible strength, resilience, flexibility, support and community spirit of our citizens and voluntary and statutory services. I am both pleased and excited to be involved in the City ICP where services and citizens can come together to address some of our most pressing problems that affect health and wellbeing.
Most inequalities in health outcomes experienced by our citizens (such as the wide differences in life expectancy and years lived in good health) are related to what are called the wider determinants of health i.e. income, employment, housing, environmental factors like pollution and access to green spaces. So, it is vital these areas are addressed by our ICP.
Working together, across agencies, improvements can be made to improve other drivers of health inequalities. Things like barriers to accessing care, and promotion of healthier habits like reducing smoking, having a healthy diet, taking exercise and looking after your mental well-being all make a difference. By increasing the knowledge and cultural awareness of our health and social care workforce we will improve citizens experiences and create easier access to services.
Since my appointment to post I have been linking with various forums related to vulnerable groups who experience the poorest health outcomes in our society. So far, I am directly involved in work related to homelessness, those experiencing severe and multiple disadvantage, migrants (including asylum seekers and refugees), carers, people with long term mental health conditions and those with a learning disability. There has been some really great work in relation to issues for these vulnerable groups which it has been a privilege to witness and be a part of.
One project I would like to highlight here is the work with rough sleepers during the ‘Everyone In’ government initiative. The requirement to provide all those who were homeless with accommodation during the initial weeks of the lockdown was met in Nottingham with an amazing collaborative effort. Collectively we were able to provide the very best wrap-around services, from health, social care, housing, voluntary agencies, and community groups. As a result, many, previously unengaged, homeless people were supported to get help with mental ill health, substance misuse or other issues and were enabled to move into permanent accommodation. This work has been recognised nationally as a particularly effective collaborative response. The project did not ended there as the multi-agency group has continue to apply the lessons learned from this project by developing ongoing collaborative wrap-around support to those who are still, or newly homeless.
Further to the work with vulnerable groups I am also supporting the current ICP programmes relating to care leavers, health inequalities experienced in BAME communities, reducing smoking, and improving flu vaccination uptake. I hope to share more detail of this great work happening across Nottingham in future blogs.
If you would like to know more about health inequalities in Nottingham please contact me.