Proactive Population Health Management and Health Inequalities (PPHMI) Programme

Covid-19 shone a stark light on inequalities within our populations, highlighting underlying disparities in health outcomes, especially between people from different ethnic and socioeconomic groups.

On 01 July 2022, North West London became a statutory partnership and the bodies of organisations with the eight boroughs are determined to tackle health inequalities and address the variations in health outcomes amongst our population.

We know that people in our communities in NW London are dying earlier than they should, with a range of factors including poverty, poor-quality housing, low-paid or unstable jobs impacting people’s physical and mental health

The Population Health Management and Health Inequalities (PPHMI) programme focuses on the building blocks of health to improve people’s health outcomes and reduce the differences in healthy life expectancy.

It is fundamental to the delivery of the ICS’s four key purposes of improving population health, reducing inequalities, improving value for money and building social and economic growth, and inequalities is a golden thread that weaves throughout the work of the system

The Proactive Population Health Management and Health Inequalities (PPHMI) programme is not a commissioning programme, but rather supports other programmes, boroughs and trusts to take action, arranged around three agreed pillars:


We deliver change using the co-produced ‘Focus-on’ methodology.


Our workstreams (click here for further details)

• Reducing Health inequalities – Our health inequalities workstream identifies and addresses inequalities in access, experience and outcomes through working with partners using the Core20Plus5 framework for both adults and young people

• Addressing structural racism – Our structural racism approach in North West London is driven through the Race Equality Steering Group, highlighting and addressing the issues that different ethnicities face, including hearing from our communities and staff groups and facilitating change

• Population Health Inequalities – Our population health management approach in North West London is delivered through the Focus-on methodology and the population health management workstream builds capacity and capability across the system to successfully implement this approach and reduce inequalities

• Healthy living – Our healthy living workstream works with partners, particularly public health colleagues, to maximise the opportunities to increase healthy behaviours in our communities, including better targeting and signposting, filling gaps in service provision and improving staff skills in making every contact count

• Third sector and Volunteering – Our third sector and volunteering workstream supports the third sector to be effective partners within the ICS and develops volunteering across our communities, promoting the role volunteering plays in the health and wellbeing of both volunteers and those receiving support

• Anchor Development and Digital Inclusion – Our Anchor Institution workstream works in partnership across the ICS to reduce health inequalities and improve wider determinants of health within our three anchor pillars: (1) Employment (2) Procurement and Social Value (3) Sustainability. Our Digital Inclusion work increases digital skills within our communities through digital skills training to access and navigate health technology and improve health outcomes

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