Collaborating for Health Equity in Scotland
North Ayrshire Council · 1 October 2024
Back to Cabinet — 1 October 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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NORTH AYRSHIRE COUNCIL 1 October 2024 Cabinet Title: Collaborating for Health Equity in Scotland Purpose: To provide initial information on our bid to become a participant in the Collaborating for Health Equity in Scotland (CHES) programme and next steps. Recommendation: It is recommended that Cabinet notes the update and endorses the bid to participate in the programme. 1. Executive Summary 1.1 Public Health Scotland (PHS) and the University College London Institute of Health Equity (IHE) have partnered in the CHES to strengthen and accelerate the action underway to improve Scotland's health, increase wellbeing and reduce health inequities. 1.2 CHES will partner with three places in Scotland. We submitted an expression of interest (EOI) on Friday 20th September 2024. The EOI was developed jointly with partners, including across all relevant service areas, the CPP and IJB. 1.3 The EOI highlights that NAC experiences consistently poor outcomes across all key indicators, the strategic alignment between the ‘Marmot principles’ and the ambition in our own Council Plan, our commitment to partnership working, and our corporate culture of learning and continuous improvement. It also highlights that we have recently been successful in securing funding from the Scottish Government to participate in the Fairer Futures Partnership (the next phase of the Child Poverty Pathfinders). 2. Background 2.1 PHS and the IHE, directed by Professor Sir Michael Marmot, have partnered in the CHES to strengthen and accelerate the action underway to improve Scotland's health, increase wellbeing and reduce health inequities. 2.2 The aim of CHES is to answer two fundamental questions: i. What are the most impactful areas for intervention in Scotland to make meaningful progress in closing inequities in healthy life expectancy? ii. How can national and local organisations work more effectively to close the gap between policy intent and impact in these areas? 2.3 In order to answer these questions, CHES will:
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i. Develop analyses which will provide new insights into the most effective ways to take action in Scotland through the Marmot 8 framework. ii. Show, through practical work with three places in Scotland, how local areas and partnership actions can strengthen action on health equity and improve wellbeing. iii. Develop recommendations for national and local organisations and sectors to strengthen delivery to reduce inequities in health and wellbeing. iv. Provide a catalyst for enhanced action in Scotland and renewed and strengthened partnerships for health equity. 2.4 CHES will partner with three places in Scotland. Alongside that, there will be collaborations with healthcare systems, other public services, businesses, the third sector including community groups and voluntary and faith sector, communities and academia. Expression of interest 2.5 An expression of interest (EOI) was submitted on Friday 20th September 2024, ahead of the deadline of 23rd September 2024. The EOI was developed jointly with partners, including across all relevant service areas, the CPP and IJB. As required, the EOI was signed off by the NAC Chief Executive and on behalf of the NHS A&A Chief Executive Officer. The Council Leader provided a supportive quote. 2.5 The EOI highlights that NAC experiences consistently poor outcomes across all key indicators (see table below). Indicator NAC Scotland Rank ( / 32) Life expectancy of males 74.58 76.54 28 Life expectancy of females 79.47 80.72 26 Healthy life expectancy of males 56.51 60.39 28 Healthy life expectancy of females 52.07 61.07 32 2.6 This health inequity impacts across other key outcomes for our communities. For example, NAC also has the third highest rate of economic inactivity across Scotland (29.9% against a national average of 22.9%) and the second highest rate of long-term limiting illness across Scotland (41%). 2.7 There is a strong alignment between ambitions within our Council Plan and the eight Marmot principles: • Give every child the best start in life. • Enable all children, young people and adults to maximise their capabilities and control their lives. • Create fair employment and good work for all. • Pursue environmental sustainability and health equity together. • Ensure a healthy standard of living for all. • Strengthen the role and impact of ill-health prevention. • Tackle discrimination, racism and their outcomes. • Create and develop healthy and sustainable places and communities.
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2.8 Data shows that there is a complex interaction between the area’s health, social and economic inequities. In addition, we know the importance of adopting a place-based approach and are striving to better understand inequity within the area, with significant differences in outcomes between localities. 2.9 We believe that participation in the programme can help us to understand this dynamic in greater detail, including in relation to intersectionalities, and will enable us to design and target interventions that can successfully reduce these inequities. We will also need to consider intertemporal dynamics, particularly in relation to how we: • maintain a focus on transformation of long-term and intergenerational inequity through prevention and early-intervention, while • simultaneously supporting those households whose needs are the most acute today. 2.10 The EOI proceeds to highlight the council’s commitment to partnership working and collaboration, our culture of learning and continuous improvement, the synergies between this programme and our participation in other national programmes, and the resource and capacity which would be deployed to the programme. 2.11 With regards to complementary national programmes, it is particularly worth highlighting that we have recently been successful in our bid to participate in the Scottish Government’s Fairer Futures Partnership (FFP) (the next phase of the Child Poverty Pathfinder). This funding will support three full-time posts for 18 months to help provide greater coherence across a number of relevant workstreams, including moving towards a ‘no wrong door’ approach and the development of a ‘single shared assessment’ to enable better use of data. 2.12 In terms of resource and capacity, Sam Anson will be responsible for this work in his capacity as lead for our Strategic Priority of Wellbeing. Additional capacity will be provided through all relevant service areas as part of a cross-sectoral project team approach that: i) recognises that health inequity is the responsibility of all of us – i.e. it is impacted by our services while also impacting upon our operating context, and ii) helps to embed the informal matrix-management approach to delivery as embodied by our strategic priorities Next steps / timeline 2.13 CHES will do an initial review of an area’s fit with programme aims and notify all who have submitted if they have been shortlisted by Friday 3rd October. Shortlisted participants will be invited to meet with them between Monday 14th October and Friday 25th October. They will then decide the three places identified as most meeting the criteria, notifying them by Monday 4 November. Cabinet members will be kept informed of progress throughout this process. 3. Proposals 3.1 It is proposed that Cabinet notes the update and endorses the bid to participate in the programme 4. Implications/Socio-economic Duty Financial
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4.1 None. Human Resources 4.2 Staff from across all relevant service areas will be involved in this work as part of a cross-sectoral project team. By way of demonstrating our whole-system approach to this agenda, that is likely to include each of Education, Communities, Place, Economy and HSCP. Legal 4.3 None Equality/Socio-economic 4.4 The primary purpose of the programme is to strengthen and accelerate the action underway to improve Scotland's health, increase wellbeing and reduce health inequities. Health inequity arises when there are unfair and avoidable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically, or by other dimensions (e.g. sex, gender, ethnicity, disability, or sexual orientation). Climate Change and Carbon 4.5 None Key Priorities 4.6 The proposal supports the North Ayrshire Council Plan Strategic Priority of Wellbeing. Community Wealth Building 4.7 Addressing health equity – including a focus across the full suite of eight Marmot principes – is integral to our CWB ambitions of adopting an inclusive and people- centred approach to developing our local economy and ensure fair distribution of wealth and opportunities for our communities 5. Consultation 5.1 Discussions have taken place with key partners (including through the CPP) and other council services. Sam Anson Executive Director (Education) For further information please contact Sam Anson, Executive Director (Education), on samanson@north-ayrshire.gov.uk. Background Papers 0