Partnership responds to important public health report

Posted on: 3 June 2020

Local health and care staff on home visitWest Yorkshire and Harrogate Health and Care Partnership (also known as an integrated care system) welcomes the report findings published by Public Health England on Tuesday 2 June regarding the disparities in the risk and outcomes of COVID-19. It provides further evidence, should we need it, that the impact of COVID-19 has replicated existing health inequalities we know exist across West Yorkshire and Harrogate communities.  It is a useful contribution to the evidence base and our work already well underway.

As highlighted in the report the largest inequality identified was by age, with those aged 80 or older 70 times more likely to die if they have been diagnosed with Covid-19 than those aged 40 or under. The risk of dying is higher in males than females, higher for those living in more deprived areas than those in the least deprived, and higher for ethnic minority groups than for white people.

The review found that the death rates due to COVID-19 were higher for those from certain BAME groups. Particularly those from Bangladeshi backgrounds who were discovered to be twice at risk of death when comparing them to non BAME counterparts.

Across West Yorkshire and Harrogate our cultural vibrancy is borne from cities, towns, villages and strong diverse communities with even stronger identities we proudly represent.

As a result the healthy life expectancy of people living in some areas is below the national average, and the inequalities between communities are significant. Working together with our communities is what motivates our local health and care partners to work as one partnership together, putting the needs of people first. We take this very seriously.

We are working as a Partnership to understand the indirect impacts of COVID-19 on population health and how this disproportionately impacts on specific groups of people and further widens health inequalities.  For example: the impact of school closures on low income families or young carers; the impact of lockdown on those at risk of domestic abuse and the differential impact of the pandemic on health seeking behaviours.

BAME staff network presented to our Partnership Board in March 2020As a Partnership we have big ambitions to reduce inequalities for groups of people that experience some of the largest gaps in life expectancy. These include reducing the gaps in life for people living in the most deprived decile and people living with mental health conditions, learning disabilities and/ or autism.

Working with universities, Healthwatch and public health teams and others, we are creating a greater understanding of the variation in health outcomes across the area and also people’s differing experiences of the pandemic.

We have developed targeted approaches to reducing inequalities in the reset and stabilisation phase over the coming months, whilst ensuring we learn from groups that have been disproportionately affected to rebuild a fairer society that supports good health for all.

With much to do we are hopeful that we will achieve better wellbeing for everyone by working with community partnerships, whilst recognising the relationship between healthiness and ethnicity is complex and ultimately a life and death situation for many who are at an increased risk of contracting coronavirus and sadly dying.

Only by bringing organisations together with the information available to us can we make a difference to those hardest hit, including Black, Asian and minority ethnic communities and those living in poverty, people with mental health concerns, learning disabilities and carers (or all). We are working with local and national intelligence leads to better understand the impact COVID-19 has had on specific groups of people, with a key focus on BAME communities and people living in the most deprived areas.              

A £450,000 Health Inequalities Fund targeted towards improving outcomes for groups of people disproportionately affected by the impacts of COVID-19 has been launched. This is a partnership approach with the voluntary and community sector. This is the latest tranche of funding we are making available to voluntary and community organisations through our Partnership. It comes at a time when their work can help support people who were already subject to significant inequality, that COVID-19 will risk making worse.

Through the work of the West Yorkshire and Harrogate Health Inequalities Network, and links with our six local places (Bradford district and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield), vulnerable groups of people have been identified who are likely to be disproportionately affected by the indirect impacts of COVID-19. We are working to understand how we can mitigate against these impacts in the immediate and longer term. This includes working with the West Yorkshire Violence Reduction Unit, to identify emerging priorities and those groups of people most at risk, for example through domestic abuse.

BAME staff working at system levelOur focus now is to provide system level insight into how we can prioritise prevention in the reset and stabilisation phase of the pandemic. Identifying which approaches have the greatest impact on longer term population health and identifying who these should be targeted towards to reduce inequalities. This will include support for people with long term health conditions who are shielding; early diagnosis and treatment of cardiac and respiratory disease; and improving uptake of diabetes care; screening and immunisation programmes.

The disproportionate deaths of BAME health and care staff during the COVID-19 pandemic also brings this agenda into sharp focus. A key part of achieving this is ensuring that this is everyone’s business and our West Yorkshire and Harrogate BAME network has been working hard to support the Partnership’s response as well as the response within their own organisations. This involves a number of key areas:

  • Leadership development
  • Communication
  • Health and wellbeing resources for staff
  • Involvement in shaping and contributing to research
  • Involvement in decision making
  • A consistent approach to supporting our staff with risk assessments.

Keeping colleagues safe and well is a priority to us. As part of our Partnership response, and following advice from the BAME Network, the West Yorkshire and Harrogate Association of Acute Trusts (hospitals working together) and the Mental Health, Learning Disability and Autism Collaborative have worked together with HR colleagues to develop a consistent approach to risk assessment in the workplace. This has helped to give staff that work across organisations and are able to flex to meet local workforce need, the assurance and support they may seek. It also reflects that we take seriously the ‘putting in place risk assessments for people who are in high-risk occupations’ set out by the Health Secretary, Matt Hancock on 2 June 2020. 

'Can You Hear Me?' podcastA series of West Yorkshire and Harrogate podcasts called ‘Can you hear me?’ has recently launched, giving a voice to the diverse talent working to improve health and care for people in West Yorkshire and Harrogate. The first episode (launched on 14 May 2020) focused on the impact of COVID-19 on our Black Asian and minority ethic population (both staff and the wider public). You can find out more about the work of the BAME network here.

It is helpful to note that further work is needed, which is not reflected in the report, and the Partnership will continue to pursue further, for example the health inequalities in other groups of people such as Gypsy Roma and Travellers and the impact on people living with mental health conditions, learning disabilities and/or autism. We would also be interested in the indirect impacts of COVID-19 and how these are related to the underlying causes of poor health including people’s social networks, living conditions, financial and job security. Building on local intelligence, it would also be interesting to see the significant inequalities within regions and towns in subsequent report reviews.

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