Advance equality and reduce health inequality

During 2018/19 meeting the needs of the local population remain a priority for the CCG and our colleagues in health, social care, voluntary groups and the local communities, and a flavour of our work is referred to on this webpage in the delivery of work plans to advance equality and reduce health inequalities; Health and Wellbeing Board key achievements, undertaking Equality Impact Assessments to support our commissioning plans much more. 

Before ways that we moved forward to advance equality and reduce health inequalities are highlighted you can access local population data by clicking on the links below

You will find the latest Camden JSNAs on diabetes, cancer, frailty and falls, CKD, COPD and alcohol which highlight inequalities among gender and ethnic groups and recommendations to be taken forward on these areas. These reports can be found on the publicly available Camden Open data website by clicking here

You can also find the latest JSNAs for smoking, children, young people mental health and older people by clicking here

You can also access the latest analysis and briefings on health inequalities in Camden by clicking on the following links: 

  • Overview of health inequalities around Long Term Conditions (LTCs) across gender and ethnicity by clicking here:
  • Overview of the mortality gap between men and women to address inequality in life expectancy by clicking here

Delivery of local projects to meet the needs of local population groups

 Advance Equality 

Camden Lesbian Gay Bisexual & Transgender community (LGBT) residents
  • Camden CCG has launched the Rainbow Lanyard in collaboration with our partner CCGs in North Central London (Barnet, Islington, Haringey and Enfield). The Rainbow Lanyard is regarded as an open and visible commitment to building LGBT equality within work and making us a LGBT inclusive organisation. We believe it is important for us to be explicit about our commitment to advancing LGBT equality and send a clear message to our staff, Governing Body members and any organisations that we commission services from that prejudice and discrimination towards LGBT staff is unacceptable. 
Accessible Information Standard (improving access in General Practice for learning disability and visibly impaired residents in Camden)
  • Camden residents who are deaf or visually impaired or have learning disabilities told Healthwatch Camden that they face particular difficulties if GPs do not meet their communication support needs.
  • From the feedback given Healthwatch realised that that majority of Camden’s GP practices were not meeting the Accessible Information Standard (N=32)
  • Healthwatch with thesupportoftheCCG visited all 32 general practices
    • Key achievements
      • All patients now get the chance to register using a format they prefer (Easy Read or Large Print).
      • The practices are taking action to ask all patients if they have a communication support need and recording patient preferences somewhere that can be seen easily every time by all staff (poster and screen).
      • All general practices meet the Care Quality Commission Compliance check list.
      • Camden is now the only CCG area in the country where almost every GP practice is meeting the basic requirements of the AIS.
      • Healthwatch Camden have been recognised nationally by Healthwatch England for the work that they have done (a special note of thanks has to be given to Anna Wright at Healthwatch Camden). 
Deaf awareness training sessions for General Practice and CCG staff
  • To promote deaf awareness the Communications and Engagement Team at Camden CCG hosted 12 training sessions led by Asif Iqbal, MBE BA (Hon), Rehabilitation Officer for Deaf and Hard of Hearing People, London Borough of Camden. Training workshops were held at the CCG and in local general practices with a mixture of clinical and non-clinical staff attending. To date over 100 people have attended the training.
  • The aim of the training was to enable participants to have a greater understanding of deafness and the issues involved with communication and access to information.
  • Learning outcomes: build confidence to talk to deaf people directly; gain a basic understanding of deafness and acceptable terminology; ability to use basic everyday signs and clear lip-reading skills; to be aware of technology and services available to meet deaf and hard of hearing client’s needs; and know how to work with a BSL Interpreter.
  • A special note of thanks has to be given to Asif Iqbal for his support in helping the CCG. 

To reduce health inequalities 

Bangladeshi Community
  • Establishment of a strategic partnership between Council, CCG and members of the Bangladeshi community to identify priority areas and co-design and deliver solutions to improve health and wellbeing among Camden’s Bangladeshi community.
  • Development of an action plan based on extensive community engagement, with strong political, senior management and community leadership to drive change. Priority areas in the action plan include improving primary care accessibility, building community resilience and facilitating engagement with initiatives to support healthy weight and healthy lifestyles among the Bangladeshi community. 
Healthy Weight Healthy Lives & Lifestyle services (Somerstown ward)
  • The Community Action Group in Somerstown (one of the most deprived Wards in London) identify and inform the activities which take place in the ward.  The group reflects the local population of Somerstown and was formed through engagement with Black and Ethnic Minority (BME) and local groups to ensure it represents all those living in the Somerstown & St Pancras area.
  • Community engagement activities in Somerstown as a part of the development of the people’s fruit and vegetable market (Camden Can Innovation Funds), have focused on gaining views from all local people including those from BME.
  • We have worked with local school children from BME groups in Somerstown to develop ideas to promote the people’s fruit and vegetable market.
  • We have developed further community engagement activities through the mosque (Somerstown Islamic Cultural and Education Centre) and the Bengali community. 
Cultural Advocacy Project
  • The project is commissioned by the joint commissioning team (Camden CCG and Camden Council) and is run by Mind. The project has two key interventions - community and inpatient support. The community aspect is to develop ground up community approaches to identify and engage with target BME communities and develop community awareness around mental health. The second element aims to support new and repeated users of inpatient and crisis services where specific BME interventions are seen as likely to be beneficial to their recovery. 
Resilience Network in Camden
  • The Network is formed of a partnership of voluntary and community sector organisations, Camden and Islington Foundation Trust, Tavistock and Portman, commissioners and residents. The key aim of the Resilience Network is to provide a network of services that support people in their community to achieve the key resilience outcomes. These are to ensure that people are better able to address and manage mental health need themselves, can access the right support at the right time and take part in the community life. The Network builds on people’s strengths and enables people to follow their interests on their own terms. Everything the Network offers will promote and champion inclusion and make it easier for people with mental health needs to take an active role in their communities. 
Cervical cancer (transformation funding projects)
  • We are working in partnership with Camden Council and Cancer Research UK to improve uptake of cervical cancer screening in Asian women. They are awarding small grants to voluntary and community sector organisations to support targeted work with Asian women to increase cervical screening uptake. Camden Council are also procuring a mixed-channel social marketing and community engagement programme focusing on cervical cancer, targeting young and BME women (with a focus on the Asian community in Camden), in partnership with other North Central London boroughs and CCGs.  This population awareness programme will be delivered across the 5 NCL boroughs in Feb-March 2019, timed to align with a national PHE-led campaign.  Both projects will seek to address the knowledge and psychosocial barriers preventing these women from taking up their offer of cervical cancer screening in order to increase screening uptake.   
Smoking
  • The local stop smoking service offer was redesigned and commissioned following resident engagement with priority groups, including BME groups. In the first one and a half years of the contract the new service, Breathe, has been developing strong partnerships with local communities to encourage smokers to self-refer into the service: this includes work in Somerstown, with local mosques, a Ramadan campaign and engaging with local businesses. 

Health and Wellbeing Board

In partnership with representatives from the Council, public health, Healthwatch Camden, representatives from the voluntary sector, hospitals (acute, community & mental health) and community representatives we have worked to address the key drivers identified in Camden’s JSNA: 

Health and Wellbeing Strategy: 

Key achievements - Overall aim to increase life expectancy and reduce health inequality. 

Five priorities:

  1. 1001 days and best start in life.
  2. Healthy weight/healthy lives.
  3. Reducing alcohol related harm.
  4. Mental health and well-being.
  5. Resilient families programme (CSF scrutiny and Children’s Trust Partnership Board). 

Achievements: First 1001 days/best start in life

 School readiness

71.4% of children achieved a good level of development at the end of their reception year.   

Children being kept safe from harm

70% of referrals received by Children’s Centre family support were for families with children under 2 years old (i.e. the first 1001 days) (17/18) 

Dental decay

30% of 5 year olds in Camden had current or past experience of tooth decay in 2017. This figure has risen from 24% since the last survey conducted in 2015, but is lower than the 36% recorded in 2012 (survey numbers are small, and should be interpreted with caution). Since the introduction of the fluoride varnish programme in Camden in 2015/16 there have been 17,103 fluoride varnish applications among primary school aged children. 

MMR vaccination

There remains a significant challenge around MMR vaccination uptake in Camden:- 

74% of eligible children in Camden had received one dose of the MMR vaccine by age 2 (Q1, 18/19) 

69% of eligible children in Camden had received two doses of the MMR vaccine by age 5 (Q1 18/19) 

Reduced poverty through maximising family income

£701,892 secured by the Early Years Welfare Rights Team for families in 17/18 

Perinatal mental health

A perinatal mental health (mild to moderate) pathway has now been established and is being accessed/used locally. 

Achievements: Healthy weight, healthy lives 
Healthy weight programmes for individuals and families 
  • Over 1,000 Camden adults completed a structured weight management and physical activity programme in 2017-18, of which more than a third lost 3% of their starting weight and 97% increased their physical activity.  73% of those completing a programme lived in the most deprived areas of Camden and 59% came from BME groups. 

Families for Life Programme -189 families were supported by this programme in 2017-18, with more than half increasing fruit and vegetable intake whilst also decreasing consumption of foods high in fat and sugar. 

Healthy Living Service - 236 children were seen in 2017-18 and over 80% lost weight or saw their weight plateau. 

Camden Can: Key achievements
  • 51 organisations have signed the Camden Pledge, pledging to make healthy food and drink more affordable and accessible, and to encourage and enable physical
  • 21 organisations/community venues have joined the Breastfeeding Friendly Scheme which uses window stickers to provide safe, comfortable spaces for women to feed their babies.
  • The Camden Can Innovation Fund has given local groups/organisations funding to  find innovative ways of tackling obesity in  Camden e.g. people’s fruit and veg stall in  Chalton Street, an interactive game for  young people with learning disabilities. 
Achievements: Reducing alcohol related harm 
An increased focus on alcohol awareness
  • An alcohol awareness campaign (Glass Half Full) ran in 2018. This was aimed at increasing and higher risk drinkers who were middle aged or older. An evaluation report is currently in progress. 
Strengthened partnership work around prevention
  • Local providers have been expanding their IBA training offer and exploring with partners how best to support staff (for example: workers in care homes) 
  • MECC training is now offered to service users and peer mentors 
Establishment of a cross-council working group focused on improving outcomes for the street population
  • The group meets regularly and has overseen the procurement of Routes Off the Street. This model will deliver assertive interventions in a street setting and structured support and onward referral for vulnerable adults referred to the specialist hub (inc. primary care services). 
Effective treatment to support a reduction in hospital admissions for some of the most vulnerable drinkers
  • Data suggests that the service has saved healthcare £216k in one year. The CCG and public health is currently working together to agree future funding 

Achievements: Mental health and wellbeing 

Increased access to perinatal mental health support
  • Launch of Camden Blossoms in 2017/18 – peer support for pregnant women and their family's, and new mums and dads
  • Launch of (and additional phase 2 funding awarded to) the North London Partners Perinatal Mental Health Service in 2017/18, for women with severe mental illness 

Supporting people with mental illness into employment

  • Learning from employment pilots let to the development of the Camden Work and wellbeing service, launched in October 2017. 
Dementia
  • Development and embedding of a local Dementia Action
  • At scale delivery of dementia friends 
Improving the physical health of people with serious mental illness
  • Established an Integrated Practice Unit (IPU) for psychosis and chronic conditions, led by Camden and Islington Foundation Trust, in partnership with primary care and physical healthcare providers 
Preventing suicide
  • Established a multi-agency suicide prevention plan and steering
  • Introduced training for front-line staff working in areas of high-risk such as debt advice and
  • Developing post-suicide support for families and others affected by suicide, including a simple signposting leaflet delivered in partnership with the police, and options for a local prevention 
Achievements:
  • 301 women accessed Camden Blossoms.
  • 120 parents-to-be/new parents received mental health promotion through the Baby Steps educational
  • 56 people with mental health problems into employment.
  • 3,750 people trained as Dementia Friends.
  • The lowest rate for 5 years, lower than London and England. 

Key achievements one year on from the launch of the Supporting People Connecting People Communities plan: 

  • Strong progress in innovating with the strengths based ‘3 conversations’ approach (to inform a new adult social care practice model).
  • Aligning neighbourhood social care teams with GP neighbourhoods as a step towards more integrated neighbourhood
  • Implementing a review of the MH s75 agreement resulting in improvements to mental health social
  • Transformation of the assistive technology offer and pathways Greenwood: a new Centre for Independent Living opening soon
  • Work has started on a 10‐15 year accommodation needs analysis to inform an ASC accommodation commissioning
  • Articulating a refreshed vision for extra care.
  • Continuing with maximising opportunities for engagement and co-production. 

Equality Impact Assessments (EIAs)

EIAs are of critical importance to the public sector and Camden CCG as it helps guides us in ensuring that our commissioning decisions and plans identify and address existing or potential inequalities before the decisions or plans are implemented. 

Since the 1 April 2018 Camden CCG has initiated 15 Equality Impact Assessments. 

Equality Delivery System (EDS2)

Local Stakeholders were invited to grade the CCG for meeting Goal 1: (Better Healthcare Outcomes for all) and Goal 2: (Improved Patient Access and Experience) under EDS2. 

The CCG was graded as achieving the standards required for Goals 1 and 2. 

The community representatives graded the following 3 services under EDS2:

  • End of Life.
  • Primary care: Services for adults with learning disabilities.
  • Mental Health: Minding the gap. 

Representatives from the following organisations and groups assisted us by grading our work, Camden Patient and Public Engagements Group, Voluntary Action Camden, Camden Carers Service, Parents Advisory Board and the Mental Health Service User Group. 

Follow this link to download the grading outcomes report. 

Please contact Martin Emery, Communications and Engagement Team if you have any questions (email: martin.emery@nhs.net / Tel: 0203 688 1755).