The attached presentation covers three items listed as a, b, and c below.

Several officers introduced the presentation that had been circulated with the agenda. The Board were made aware that the Public Health Consultant NHS GM was present to take the Board through the Greater Manchester Integrated Care Partnership programme of Fairer Health for All, the Public Health Consultant MFT to speak on Manchester Foundation Trust’s approach to Tackling Health Inequalities, and the Director of Public Health to go through the local Council approach. The Board were informed that the presentation was slightly different to the one that had been circulated.

The Public Health Consultant NHS GM began talking through the Fairer Health for All section. The presentation provided a summary of the programme and Board were told about the process gone through to structure the programmes approach. The Public Health Consultant NHS GM provided the principles of the programme and gave an in-depth description of what they were, what they meant, and what they were to achieve. The Board were then shown a slide on the social model for health and the Public Health Consultant NHS GM outlined what this was and what this would mean for people in Trafford.

The Public Health Consultant NHS GM then moved onto an overview of the strategy’s missions which showed the six strategies that all linked into the programme. Towards the end of the presentation the Public Health Consultant shared with the Board the achievements that are hoped would come from these missions. This included ensuring children and young people having a good start in life and helping people, families and communities to feel more confident in managing their own health, as well as several more.

Finally, the Board was made aware of the tools that would be utilised in order to deliver the programme. These were the Health and Care Intelligence Hub and the Fairer Health for All Academy, which aimed to look at the utilisation of data and intelligence and learning and developing skills.

The presentation continued led by the Public Health Consultant MFT around the Manchester Foundation Trust’s programme at tackling health inequalities and opened with the drivers behind health inequalities. These were listed as socioeconomic factors, physical environment, health behaviours, and health care.

The Public Health Consultant MFT described the framework in place for tackling health inequalities which broke down the work into three elements, and were developed at an MFT away day in February 2023.

Following this, the Public Health Consultant MFT went through the key themes in the Health Inequalities Plan.

The first was around embedding equity into services. This utiliesed data, intelligence, technology and communications to make sure the information was accurate and shared in a way that the target audience could understand it.

The Second of these key themes was integrating care around communities. The Public Health Consultant MFT informed the Board that this was about taking a local approach, having focused resident engagement and co-design.

The Public Health Consultant MFT shared that the third theme was around looking at the wider determinant / root causes behind health inequalities, with MFT operating as an “Anchor Organisation”.

The final theme looked at staff health and wellbeing. The Public Health Consultant MFT provided further detail to each of the four themes and informed the Board of the actions taken so far and what the next steps were going to be to make sure they formed further achievements.

The Director of Public Health presented the final section of the presentation which looked at how the programmes would be delivered in Trafford and how the Council was working o address health inequalities. The Director of Public Health spoke about the investment that had gone into prevention and how it had a great rate of return so far.

The Board were made aware of what the process to addressing health inequalities should look like.  The Director of Public Health stressed the importance of looking at evidence and utilising a data driven approach. It was also said of the importance of mapping the work done to reduce health inequalities to ensure a reduction in the duplication of work and to keep track of what was being completed. The Board were then informed of the formation of the Fairer Health for Trafford Partnership, its aim of reducing health inequalities in Trafford and how this involved a tactical forum that coordinates health inequality action across Trafford. The Board were ensured that this partnership would work alongside the two previously mentioned pieces of work from MFT and Greater Manchester Integrated Care.

The Director of Public Health proceeded to go through the strengths of establishing the Fairer Health for Trafford Partnership. These were the following;

• A partnership that supports a need led, system-based approach to mitigating health inequalities.
• A set of measurable, shared, system-based health inequality objectives that can be understood across the system by residents and professionals.
•  Potential to reduce duplication and improve effective use of resources.
• An annual progress report built on quarterly performance monitoring that is shared with Trafford Health and Wellbeing Board and Trafford Locality Board, so we know what we are doing, why, and if we are collectively making a difference to the lives of our residents.

Finally, the Director of Public Health went through the commitment they were hoping for from partners of the Health and Wellbeing Board, and the next steps to the programme.

Following the presentation, the Chair welcomed the programme and the move towards the approach to reducing health inequalities. The Board were asked if they had any questions or additions.

Councillor Brophy spoke about her roles as being frontline worker for the NHS, a frontline Councillor in her ward, and a frontline carer for her family. Councillor Brophy spoke about how she was not convinced that, despite being impressed by the work on reaching out to people on the frontline, it was not filtering through to the frontline. She felt that the link between services providing physical health and mental health support is poor, due to differences of organisations and the often-complete mismatches in approach. Councillor Brophy added further that there were inequalities in the services delivered in different elements of the Manchester Foundation Trust.

The Public Health Consultant MFT responded that a review had been done of the work which recognised that there was a large difference in quality of service in the organisation. He stated that this was a legacy issue of there being elements taken from different areas of the trust. However, he reassured the Councillor that work was now ongoing to have consistency.

The Director of Public Health responded on the issue of mental health. She mentioned the first meeting of the All Age Mental Health group the week prior, which brought together the system around mental health, and acknowledged that significant challenges around some of the inequalities did exist. The Board were also informed of a Public Health Mental Health Lead role that now existed, which the Director of Public Health hoped would look at how they address the actual experiences of patients. 

Councillor Eckersley asked several questions. The first asked what constituted specialist dementia care and how can someone say they are a specialist dementia care provider. He also asked about the increased number of GP appointment done during Covid, and whether there were any plans to utilise that style of appointment more moving forward to reduce inequalities. Councillor Eckersley also asked if there were any plans to use pharmacies to reduce the burden on GPS. He finally asked about AI and if there were any plans to utilise this.

The Public Health Consultant MFT mentioned the My MFT app which operated as a patient portal. This was being used for questionnaires which could allow patients to input some information prior to the appointment.  He mentioned that they were looking at utilising it for triage so information could be sought whilst a patient is on the waiting list, but they were conscious that not everyone has access to the app and wanted to make sure that everyone still gets the same quality of service.

The Public Health Consultant MFT also responded on some of the elements where they were looking to utilise AI. One of these was to use it to predict who might not be able to attend an appointment  based on demographic factors and appointment history, and the helping them to target some prevention work. 

The Public Health Programme Manager stated that there was a real drive nationally and locally for community pharmacy, to take pressure off of other areas of the health system.

The Public Health Consultant NHS GM responded that with regard to AI, that the Intelligence Hub had a data warehouse, where primary care, pharmacy, and secondary care records were linked, which created a massive possibility of data usage.

The Associate Medical Director spoke to the Board about the digital progress that had been made with GP’s following covid and how the digital system did offer improved access to GP’s. However, he warned that there was a need to ensure that those who do not have access to the equipment to access their GP remotely were still getting the support.

The Corporate Director for Adults and Wellbeing responded on the Councillor’s question around specialist dementia care. He said that there were several factors that constitute whether a unit can become one of these. This included the staffing model, the training of staff, and the physical environment of the care home. However, the Corporate Director responded that one of the most fundamental requirements is a co-designed offer, incorporating several provisions.

The Chief Executive of Trafford Leisure asked about cross collaboration between Council’s. She mentioned that there were many areas in the borough where one side of the street was in Trafford, and the other in Manchester. The Chief Executive of Trafford Leisure felt that Council’s should work together on where the inequalities are and not just what boundary it falls within. She also commented that if you can make changes to the individual, that can lead to change on a wider scale.

The Director of Public Health responded with regards to neighbourhoods, that the Council had identified them and were focused on addressing inequalities, with the location being key to the work.

The Managing Director for Trafford LCO closed by providing three positive cases of projects that have been done in Trafford to address health inequalities.

The Chair thanked all the officers for the input and moved the recommendations which were approved.

RESOLVED: That the presentation be noted at the recommendations be approved.