On Tuesday 24 October 2023, more than 200 people from across NW London gathered in St Pauls, Hammersmith for the first health equity summit for the area. One year on from the launch of the region’s inequality strategy, it was a chance to reflect on what had been achieved and discuss the challenges ahead.
Urgency and accountability
Acknowledge the urgency of addressing health inequalities, which have been increased by the COVID-19 pandemic and the cost-of-living crisis. There is a need for accountability to make progress across the system.
Embedding health equity
Health equity should be included and considered in everything we do.
Community engagement and working together
Working with communities and involving affected individuals and organisations in decision-making is important to achieving health equity. We need to work closer with the voluntary, community and social enterprise sector (VCSE) and be service user led.
Working to address wider factors that shape health
Recognising and addressing the wider areas which affect health such as the cost of living, housing, and environmental factors, to achieve better health outcomes for all.
Transparency and further inclusion needed with the local community. Shift towards making decisions from community led engagement. A theme running throughout the sessions was the need to take a more coordinated approach, not purely focusing on race and deprivation but considering how these factors connect with other factors such as disability.
Recognising the urgency
The speakers and participants acknowledged that health inequalities have been a long-standing issue, but the COVID-19 pandemic and the cost-of-living crisis have increased these disparities, making it more urgent to address them.
Commitment to change
If we are going to truly reduce inequalities, we need to do things differently. There was an emphasis on being accountable for progress in addressing health inequalities.
Encouragement for transformative programmes
The speakers and audience expressed hope and motivation for transformative programmes that can bring meaningful change. It was noted that representation matters and involving our communities in the decision-making process is crucial.
Building trust takes time
The process of working together in healthcare requires time and effort. In the Hammersmith and Fulham building trust project discussed, it took 18 months of preparation and residents played a leading role in building trust between the community and healthcare providers.
Listening to the community should be an ongoing process. Continuous engagement is essential for building and maintaining trust.
Care providers should not assume what communities want. It's important to engage with the community, listen to their needs, and work together for solutions based on their input.
Barriers to access
Barriers to healthcare access such as; language and representation in services and providers were highlighted as important issues to address. The use of translators for sessions, raising awareness about complaint processes and language translation in general practice were mentioned as ways to overcome this challenge.
The wider factors that shape health breakout sessions showed lots of good work going on across the system, but also the gaps in leadership around key areas like housing and health, and cost of living.
There was representation from the voluntary and community sector organisations on how they are working to address the wider factors, but many concerns were raised about how this work is resourced and sustained over time.
Cost of living
Long-term and predictable crisis
The cost-of-living crisis was described as a long-term and predictable issue rather than a sudden crisis. It has significant and ongoing impacts on people's lives and well-being.
Health issues presented
The session discussed examples of health issues people have due to the cost-of-living crisis, including behavioural problems in children, lack of nutritious food and chronic fatigue. Employment and financial struggles were also mentioned as contributing factors to health problems.
Need for long-term work
Addressing the cost-of-living crisis and its effects on health equity requires a long-term strategy. This strategy should involve neighbourhood partnerships with the right resources and community-based approaches to support those in need.
Role of voluntary and community sector organisations
Organisations like Citizens Advice and Family Friends play a crucial role in supporting individuals. The session emphasised the importance of helping those in more vulnerable financial situations. There were suggestions to invest more in grassroots initiatives and consider providing cash transfers to individuals in need to mitigate the impact of the crisis.
Housing and Health
Understanding housing process
One of the key takeaways was the importance of understanding the housing process and providing support for people in both social and private housing. This includes addressing the challenges and barriers that individuals face in obtaining and maintaining safe and stable housing.
Strong local leadership
Developing strong leadership with a focus on housing is essential. This involves coordinating efforts at a local level to make sure that housing-related issues are effectively addressed within the community.
The session acknowledged the difficulties and challenges faced by both residents and health and care staff when dealing with housing-related issues. A sense of "hopelessness" often arises due to a lack of understanding of housing processes, which underscores the need for education and support in this area.
Working with local authorities
Working closely with local authorities and key stakeholders is crucial in developing strategies to create healthier cities.
Every contact counts
Healthcare providers should make every patient contact count by addressing environmental factors that affect health. This includes providing information and resources related to preventative care and information on ways to reduce exposure to air pollution.
Focusing on the most affected
We need to ensure work on healthier environments is focussed on the groups whose health is most impacted and who have least access to green space, live in the most polluted areas or live in unsuitable housing.
Business sector involvement
Engage the business sector who have an important role to play in reducing air pollution, and creating healthier environments.
Let’s talk about race
Transparent and inclusive discussions
There is a need for transparent and inclusive discussions when making local decisions regarding the delivery of health services to Black, Asian, and Minority Ethnic (BAME) communities. Involving these communities in decision-making is essential for addressing structural racism.
Community led delivery
To address structural racism, there needs to be a significant move in the healthcare system to allow community led delivery of health and well-being services, especially in areas with high inequality and a significant number of BAME communities.
Shifting from quantitative data
Moving from relying on data as a critical indicator of performance. There needs to be a commitment to including community-led participatory research and insights to identify community needs and to propose evidence-based solutions for improving access, experience, and the quality of care for BAME communities.
Equity and fairness
The session highlighted the importance of understanding the links between equity and fairness. This perspective draws parallels between the term "equity" as it relates to financial value and its application to health equity. It emphasises the need to ensure that health equity initiatives are not only focused on equal distribution but also on fairness and justice in healthcare access and outcomes.
Challenges with baseline data
The session discussed the challenges of determining a baseline for health equity initiatives. It was noted that reliable data may not always be available to identify existing health inequalities, making it difficult to assess where the healthcare system is starting from. Overcoming this challenge requires creative approaches to gathering relevant data and understanding the current state of health inequalities.
Population health insights
Designing services based on service user’s needs
The most important aspect of the process discussed is working with users to understand their needs, not only in terms of data but also in terms of the technology. User-centred design is critical for effective data use.
Looking at all the data
The discussion emphasised the need to move away from using data in everything we do and to pull data together to create meaningful impact. This includes using data from various sources to gain a better understanding of health and well-being, particularly in areas with greater inequalities.
Engaging voluntary, community and social sector services
There is recognition that not all data is available, especially from voluntary, community, and social sector (VCSE) services, who may not have the resources to provide this information. This data gap needs to be addressed to have a better understanding of population health and the effectiveness of interventions.
Data should reflect the approach of working together with neighbourhood teams and should be linked across datasets to make it relevant for people. Qualitative data from public engagement is also important, as it helps in understanding what people are saying and informs changes.
The summit closed with the presentation of the first North West London Health Equity Awards. These awards celebrate people from across NW London who are doing their bit in understanding, and tackling, the barriers that create inequalities and can prevent fair access to health care.
We were delighted at the phenomenal response, not just the 85 nominations, but the passion and kindness within the nominations. There are alot of people working and volunteering across NW London to make life better for others, as well as the eagerness of people across the system to nominate others.
- Cleo Chalk, from Healthwatch
- Cllr Ketan Sheth from Brent (Chair of the North West London Joint Health Overview and scrutiny committee)
- Dr Talac Mahmud, Hounslow GP - HIYOS
- Jennifer Roye, NHS NW London Chief Nurse
- Rory Hegarty, ICS Director of Communications and Involvement
Anthony Sembatya and Nathan Christie-Plummer – West London NHS Trust
“Anthony Sembatya and Nathan Christie-Plummer from West London NHS Trust for their work developing a rapid recruitment pathway for refugees and asylum seekers to find employment and volunteering opportunities and access pastoral care in the NHS across NW London.”
Basch Helps CiC
“Basch Helps support new parents with their Angel Box and mental health support through their parent support services and health & wellbeing hub.”
Brent Health Matters
“Brent Health Matters received five separate nominations reflecting the important role they play in the borough. Their nominations are for a number of their projects including TB screening, access to mental health and tackling inequalities in the Brazilian communities.”
Central Mosque of Brent Volunteer Team
“The Central Mosque of Brent Volunteer Team were nominated for their ongoing work to improve access to health and facilitate health education in the local community including vaccine hesitancy and diabetic eye screening.”
Cheryl Chin – Feltham and Bedfont PCN
“Cheryl Chin was nominated for her dedication as a health inequalities champion for Feltham and Bedfont PCN. Amongst her many successes, Cheryl’s work in leading her team to proactive work with individuals where English was not their first language and had specific health factors led to 34% undergoing full NHS health checks. Through specific project work she has lead her team and supported asylum seekers, healthy eating seminars for the Asian community and worked to connect patients with sight loss to key services."
Dr Etheldreda Kong
Below: Rose on behalf of Dr Ethie Kong
“Dr Ethie Kong - Ethie was nominated for all her work supporting homeless and gypsy communities, work with people with dementia and mental health as well as her work supporting the Chinese community and working to increase GP registration. Her award was collected by Practice Manager Rose Denis-Girard.”
Dr Layan Allawi
“Dr Layan Allawi, Darzi Fellow who was nominated for her work with sickle cell patients including working with patients to improve their inpatient experience. Dr Allawi has started a new placement outside London but the work she did is continuing to make a difference to patients and is being carried on by the team at London North West.”
Hammersmith and Fulham Homeless Health Partnership (Dominic Lenaghan, Anne McBrearty, Beryl Cross, Oz Gencalp, Jabeen Ayub)
Hammersmith and Fulham Homeless Health Partnership were nominated for their work in delivering accessible healthcare to people experiencing homelessness in H&F. Building on their partnership work to bring vaccines to this vulnerable community during covid, along with more health interventions post pandemic, the team have now established a weekly nurse led clinic with local health partners, to provide a hub for clients to come along to get their healthcare needs met in one place.
Hammersmith, Fulham, Ealing and Hounslow MIND
“Hammersmith, Fulham, Ealing and Hounslow MIND have been nominated for their work to connect the South Asian community to more mental health service. Working in partnership with the community they have seen not only an increase in people sharing their views and helping to shape services but seeing an increase in engagement in mental health services from the community.”
Pharmacy Department at London North West University Healthcare NHS Trust
"The Pharmacy Department at London North West University Healthcare NHS Trust , together with Patient Advocate & Expert Patient (Mr Sam Barnett- Cormack) + Expert Researcher from Leeds University (Dr Claire Easthall) co-developed a new training programme on patient centred conversations for the pharmacy workforce to support better medicines related care.”
Team of Westbourne Community/ Maternity Champions
“The team of Westbourne Community/ Maternity Champions were nominated for their work in partnership with local people to make Westbourne a better and healthier place to live. This has included a cost of living campaign, drop in sessions for new patients, a community café and chair-based exercise sessions with the local sheltered accommodation.”
- Anjie Chhapia
- Bedfont Primary Care Network
- Being Empowered to Compete
- Brody Sutcliffe & Bethany Ross
- Celware Hmaidatou
- Community Perinatal Support Programme team
- Georgi Lopez
- Great Chapel Street Medical Centre
- Jodie Rojas- Agudelo and Gabriela Ramos
- Little Park Surgery (Renata Zarzycka, Dr Mark Remedios, Dr Rajkanwal Sibia, Dr Gurcharan Salotera, Dr Janet Bolaji, Dr Selena Stellman, Dr Selina Bowry)
- Mark Remedios
- Mental Health Partnership Programme
- Mosaic's trained Community-Based Health and Well-being Advocates
- Nexus Project led by Dr Lindsay Dewa
- Nta Glover
- Sharon Tomlin
- TransPlus @ 56 Dean Street (Tom Rew, Shannon Mina, Charles Hendry, Tristan Brown, Rebecca Hayton, Richard Cameron, Julie Ross, Marcelo Mirra, John Golden, Lucy Turner, Frances Lander, Jaymie Huckridge, Phil Kelly, Karen Gurney, Skye Davies, Matthew Williams, Rebecca Tallon De Havilland, Shradha Billawa, Callum Crouch, Rhi-Kemp Davies, Lori Lynn, Stewart Neil, Hannah Ward)
- West London tri-borough Perinatal Mental Health Service (Wala Salman, Tatinder Sahota, Althea Rowe, Fatima Abbas, Akvinder Bola-Emerson, Jodie Wells, Jamila Carey)
- Westminster Community Champions programme led by Lesley Derry
- Yusuf l Yusuf and Nazrine Ibrahim
- Abdi Ali (Health Improvement Facilitator)
- Aimee Allen and Clare Turvey
- Arben Rrukaj
- ARC-Hounslow Drug and Alcohol Team
- Blossom Antenatal (Siobhan Siddy, Clare Castell, Anne Anderton, Olivia Van Dyk, Brid McConigley)
- Brent Integrated Care partnership
- Brent Primary Care Team
- Caroline Evans
- Cath Lab in WMUH
- Childhood Immunisations Pilot Team Westminster
- Clare Turvey CWHFT HIV Community
- DIYA South Asian Group (Mind in Harrow)
- Dr Sadia Khan, Mark Edmunds and Sadie Myhill
- Dr Scott Rice and Kay Sandhu
- Ealing Infant Feeding Team (Beverley Beckford, Andrea Gunpot, T'Andra Narayan, Harvinder Rudki, Jesal Kawa , Carlota Orichi Eburi)
- Ealing Public Health team - led by Anna Bryden (Director of Public Health)
- Emma Kennedy
- For Diabetes support –(Bipin Dattani, Ruchi Wadhwa, Arvinda Patel, Heather Thomas, Jasuben Patel, Ruth Samuels, Zoe Kampta, David Kampta, Bachoobhai Mehta, Jay Parekh, Prafulaben Dave, Ketan Jasapara, Anju Parekh, Maryam Zoghi, Roopali Kapadia, Shirley Wardell, Rolland Vaughan, Zhijun Wang, Rashmibhai Shah, Jayantibhai Khagram, Carole Michealides, Liz Piggot)
- Fulham Good Neighbours team (Ruth George, Stephen Fay, Jac Davies, Barney Valentine, Rubab Butt, Grace Fabean, Olivera Milosevic, Jamie Hilton and Simon Maskell)
- Haemotology Team – (Adowa Asante, Vinay Shah, Merlene Jordan, Dorota Cwik, Silvia Sadeghian, Andrea Walker, Kunal Vekaria, Teresa Aquillina, Shobnah Parek, David Warunge, Sultana Dharsee)
- Harrow Care (Anjie Chhapia, Sukhi Singh, Anil Patel, Shaila, Nisha, Ranjan)
- Jackie Rosenburg
- Josephina Becci
- Kalwant Sahota
- Kings Pharmacy, Stanmore
- Ladan Egeh
- Marsha Sorrell-Smith, Chelsea Community Champions Project Manager
- Maryam Shah
- Mental Health Partnership Programme
- Mental health partnership programme
- Nicolas Skoric
- North Kensington Team members Krishna Sarda, Radhika Howarth, Meena Nathan
- North West London Skills Academy
- Nushrat Kassam
- One Westminster social prescribers (Delphine Bernede, Alexandra Hernandez, Grace Thomas, Shelley Reynolds)
- Perinatal Diversity and Inclusion Team – West London
- Roundwood ward Central Middlesex hospital
- Roundwood ward, St. Marks Hospital- Central Middlesex Hospital (3 nominations)
- Solace Centre team led by Mirna Scholey and Catherine Bingham
- Sree Roy and Nandine Maktadir
- The Alcohol Care Team (ChelWest, LB Hounslow and CNWL)
- The DAWN team
- The Rough Sleepers and Mental Health Programme (RAMHP) Team at West London NHS Trust
- Valdev Chaggar
- Yahya Khan
- Zoch Nwaosu
- Key actions from the event are being taken forward by the Health Equity team – for more about the programme and key contacts, click here.
- The Health Equity team has launched a health inequalities academy to provide training and support to individuals across the system. You can find details of upcoming training here
We are keen to get your feedback about the event and suggestions about future events and have created a survey to capture this. The survey should take less than 5 mins to complete.