National Conversation on Health Inequalities: examples of local practice
Reducing health inequalities: a toolkit and guidance for starting local conversations
The National Conversation on Health Inequalities (NCHI) is a Public Health England programme about reducing differences in health.
The aim is for local authorities to start talking about health inequalities in their communities.
The NCHI want to together to create a clear, consistent language for describing the causes of health inequalities. By discussing what causes these issues, they can local partners work with communities to plan solutions for change.
National Conversation on Health Inequalities: examples of local practice
NCHI: written and visual examples of local practice
NCHI aims to develop a common language and understanding around health inequalities and, with local partners, encourage and empower local communities to act on them.
The programme launched in 2014 with a toolkit outlining 7 principles for local conversation on health inequalities.
Public Health England (PHE) have since commissioned TNS-BMRB (Taylor Nelson Sofres, British Market Research Bureau) to develop a series of practical written examples of local practice along with video/photo-stories covering:
National Conversation on Health Inequalities: Video photo stories
This document presents video photo stories that demonstrate how support can help reduce health inequalities.
NCHI commissioned Taylor Nelson Sofres British Market Research Bureau (TNS-BMRB) to produce a series of case studies, including video photo stories.
- people’s experiences of health inequalities
- how support can make a huge difference to social situations and health and wellbeing
National Conversation on Health Inequalities: the Bromford Deal
This example sets out the work done by the National Conversation on Health Inequalities (NCHI) in supporting tenants into employment.
Saida is a 35 year old parent of 2 teenage children living in a deprived area of the West Midlands. While raising her family she studied at college gaining a diploma in Supporting Teaching and Learning in School, and worked in various administrative support jobs.
Things were looking positive for Saida until her circumstances changed quite abruptly. Sadia had just just started a job as a receptionist and was still in her probation period when she became ill.
She had to have surgery and after the operation she wasn’t able to work for several months. It wasn’t a good impression [to make] and she had to resign.
Having to deal with the surgery and becoming unemployed, Sadia had a death in the family a close member her uncle, then within weeks her aunty also passed.
Once Sadia was fit to return to work, Saida applied for Job Seekers Allowance (JSA) but struggled to find employment. A lack of success in finding work, coupled with unrelated family issues, led to deterioration in her health and wellbeing.
Sadia wanted to work . But there was a problem, first her health conditions then her family issues and then the death in her family, facing all these issues and problems Sadia applied for jobs and wasn’t receiving any response.
It was very stressfull for Sadia, worrying about the kids, bills, finances, paying rent, everything.
Sadia was diagnosed with depression and referred for counselling.
National Conversation on Health Inequalities: Your Activity
This example sets out the work done by the National Conversation on Health Inequalities (NCHI) levelling the playing field in youth sport.
David, a former student at The Carlton Academy, said:
When I first get there on the first lesson and the kids are told; oh you’re doing frisbee today, they always moan, they always say; ‘oh frisbee, it’s just throwing it’, but there’s actually many different things you can do it … it’s beneficial when you actually learn it. It has actually allowed me to participate in sport.
The same old games
According to the DfE (2013) National Curriculum in England: physical education programmes of study – key stages 3 and 4:
“A high quality physical education curriculum inspires all pupils to succeed and excel in competitive sport and other physically demanding activities.”
Not all students have participated in sport outside of school environments. They can enter school feeling at a disadvantage, which can translate as ‘I am not good at sports’.
Research shows that young people become less engaged in activity between ages 14 and 16, which affects their confidence and competence in being physically active as adults. Jonathon, a former student, said:
“I came out of primary school hating sport and then in Year 9 (secondary school) I played rugby for the first time and absolutely loved it. So, I have a theory there is a sport for everyone, no matter what you say, there is a sport for you.”
National Conversation on Health Inequalities: Reach Out project
This example sets out the work done by the National Conversation on Health Inequalities (NCHI) using community outreach for better health.
Kerri and Lisa, 2 sisters in their 20s, were living on their own after their parents passed away. Having lost both their parents within a short space of time, the sisters were struggling to cope and had become extremely depressed; both felt unable to leave the house.
Lisa suffered from multiple health conditions including diabetes and a rare skin condition that often left her unable to get up or care for herself. She had developed acute agoraphobia.
These conditions had gone untreated for at least 18 months. Lisa was consistently refused home visits from her local GP surgery. She could see no way out of their situation and had become suicidal. A Tendring Reach Out Officer said:
“She was very very poorly with diabetes, and she also had another disease – a skin condition which really did disable her, she couldn’t go out, couldn’t move certain days, couldn’t wash herself…she couldn’t even go to the front door. A doctor hadn’t seen her for about a year and a half.”
“With the diabetes situation she was so unwell that she’d asked for a home visit but they’d said ‘no, in your age group, you can come and see us’. She had depression. Her sister had to go out and get the shopping for them.”
National Conversation on Health Inequalities: Healthy Homes Programme
This example sets out the work done by the National Conversation on Health Inequalities (NCHI) improving homes for better health.
Ann, 62, and her husband Steve, 65, were both ill and finding it difficult to manage at home. Steve had Huntington’s Disease, a degenerative brain disorder and Ann was caring for him.
However, when Ann suffered 2 strokes she needed hospital treatment and there was no one to help Steve. A social worker suggested that Ann arranged respite care for Steve, so that Ann could take a break.
Respite care is short-term accommodation outside the home, where a loved one can be looked after. This provides temporary relief to those caring for family members.
Ann found this very difficult to organise because of her own poor health and negative experiences of respite care for Steve in the past.
“I couldn’t deal with this because of the state I was in…I had 2 mild strokes, so I was in and out of hospital and worried about who was going to look after Steve. I didn’t want to put him back into respite because I had a really bad experience before…I didn’t think he had been cared for properly, and all I wanted to do was to take him home.”
At the time, Steve was confined to the living room at home where he had a hospital bed and a commode because he could not use the stairs safely.
“Because of his condition, the stairs were no good for him and it was clear we needed to live somewhere more accessible. He ended up falling down the stairs and splitting his head open. When he was released from hospital he had 2 care workers getting him up, washing him, getting him dressed, feeding him and returning him to bed. I would have done it.”