Agenda item

Staying Focussed on the Wider Determinants of Health

To consider a report which reiterates the importance of the Board’s responsibilities around poverty and the wider determinants by including an update and information about existing work to tackle poverty and improve health. The report acknowledges that Anti-Poverty work programmes are indirectly supporting most priorities in the Leeds Health and Wellbeing Strategy and asks the Board to provide strategic direction to the health and care system to ensure a maintained focus on the wider determinants of health.


The Board considered the report of the Director of Public Health presented to prompt discussion and give direction to achieve continued focus on the wider determinants of health.


The report referenced Leeds’ Anti-Poverty work programmes which indirectly supported most priorities within the Leeds Health and Wellbeing Strategy, the strongest links being with Priority 5 ( a strong economy with quality local jobs) and Priority 10 (Promote mental health and physical health equally). The report referenced existing work to tackle poverty and improve health. A copy of the report entitled ‘Supporting Communities and tackling poverty update’ considered by LCC Executive Board on 21st September 2016 was attached as appendix 1.


Dave Roberts, LCC Financial Inclusion Team, and Myrte Elbers, LCC Public Health, presented the report and identified the continuing link between poverty and health - financial worries continued to exacerbate mental health issues and the Public Health Team had a commitment to support the Money Advice Centre and enhance current provision.


Partners commented that the effects of poverty were reflected in the increased demand for their services. Discussions focussed on the following:

Key Workers

·  Leeds Community Healthcare staff had reported that, as they visited people at home to deliver services it would be useful to have access to a “4 Numbers you need” or “one portal” approach – in order to pass on information about clients in need to relevant organisations. HWB discussed this initiative, recognising the value of key workers being able to signpost and link into follow-on services

·  Where a community health worker identified a client in need, they could pass details to their local ward Councillor who was publically accountable and could assume responsibility for engagement with and support for that individual

·  A new portal for Mental Health advice had recently been launched


Funding and Resources

·  A comment was noted that certain areas of the city disproportionately required services, particularly primary care. Debt was a common theme impacting on health which could be dealt with through the developing social prescribing approach

·  Frank discussions would be needed with communities to understand the funding that is available to ensure the areas of real need are properly resourced. The agreement of all parties is required to divert funding from one area to another

·  Recognition that some communities have the capacity and ability to deliver for themselves and others don’t


Service Links

·  The value of workshop type meetings where service providers can develop a much better awareness of each other’s provision – such as a recent LCC Community Committee focussing on vulnerability.

·  The links to the previous agenda item on commissioning for better outcomes. The Board noted the new Community Hub way of working was being rolled out across the city with various services based under one roof to allow better access to services and closer working between services. A comment that more health providers based in the Hubs would be welcomed was noted.


Economic activity and opportunity:

·  LTHT provision of apprenticeships was highlighted as a means of targeting the most disadvantaged localities in order to provide better quality opportunities.

·  The role of the developing “Innovation District” was recognised, seeking to bring economic benefits to the area.

·  Additionally, the HWB features some of Leeds’ largest employers who could consider the opportunity to take on apprentices and staff from Leeds most deprived communities when recruiting to the health and care workforce Information on the number of staff from Leeds postcodes was requested.


The whole family approach

·  One in five Leeds' children live in poverty. The LCC Early Years Team included Leeds Community Health officers and focussed on the child and the whole family’s wellbeing.

·  Supporting parents back to work would lift families out of poverty.


The role of Non-Medical and Social Prescribing Solutions

·  Discussions focused on crisis/preventing crisis before it happened and HWB noted a suggestion for HWB to support work on the theme of ‘relationships’ – identified as a key issue

·  Figures on the impact of social prescribing were requested – have savings been made and can the savings be re-invested into services?

·  The over-medicalisation of people presenting with issues when health services may not be appropriate


In conclusion, the Board recognised the links between the work focussing on the wider determinants of health and the Annual Report from the Director of Public Health; and also identified the need for the Leeds and the West Yorkshire STPs to retain the same focus


a)  To note the contents of Appendix 1 – the supporting communities and tackling poverty update to Executive Board - and information on initiatives being undertaken around poverty to improve health and reduce inequalities.

b)  In response to the questions put to the Board in the reports’ recommendations relating to how the Board can support ongoing work and the links between the issues; the Board

(i)  Noted the comments made during the discussions

(ii)  Agreed to include the matters raised during todays’ discussions, particularly around workforce, into the Work Plan for the 20th February 2017 meeting


Supporting documents: