First and foremost, the WMCA committed to holding the Mayor’s WM BAME roundtable meetings every 6 months to monitor steps taken by WMCA and wider regional partners in relation to the Health of the Region commitments to action.
The Mayor is convening regular Health of the Region Roundtables and has also brought together an independent Core Group to drive further action forward from WMCA and Health & Wellbeing Partners and utilise the role of the forum.
The WMCA committed to carrying out rigorous equalities impact assessments of all of its directorates and wider agencies.
An organisational wide EqIA was conducted in late 2020 to identify equality impact in relation to Covid-19 and embedding equalities within key deliverables and directorate objectives. This was across WMCA portfolios of Productivity and Skills, Transport, Housing, Public Service Reform, Wellbeing and Inclusive Communities. The EqIA is being revisited as part of the Corporate Objectives 2021-24 development process and work is underway to enhance the process using the PHE Health Equity Assessment Tool.
The new multi-agency Midlands System Transformation Recovery (STaR) Board (as it was then) committed to carrying out an evaluation of regional NHS programmes through a Black Lives Matter and post-COVID lens.
NHSEI’s Regional Oversight of Inequalities Board will aim to use the national Core20PLUS5 improvement approach to reducing health inequalities to approach regional NHS programmes and their evaluations which includes ethnic minority communities and will be draw on the findings of the recent NHS Race & Health Observatory Review to triangulate this with regional policy.
PHE West Midlands (as it was then) committed to developing a BAME and Disparities workplan to ensure improving health outcomes for BAME communities is a cross-cutting consideration across priorities of health and wellbeing programmes; and undertake analysis to determine the extent of inequalities and impacts of COVID-19 on black and minority ethnic communities.
The Office of Health Improvement and Disparities Midlands (OHID) has since developed the West Midlands Disparity Report 2022 has been developed, which is being used to underpin the development of a workplan.
The Black Country and West Birmingham CCG Equality & Diversity Leads’ Group across the BCWB STP (as it was then) committed to ensuring a consistent and unbiased approach in supporting BAME colleagues and delivering BRAP training for all STP board members. The Health Inequalities and Prevention Board also aimed to improve their collection and use of ethnicity data, and work to understand and address inequalities between different ethnicity groups.
Building on previous relationships, the Black Country Integrated Care System (ICS) now has in place a strong network of EDI leads from the majority of providers. Their Education & Leadership #BLM Group continues to review and build consistent approaches in delivering NHSEI EDI priorities. To bolster this work, the system also has representation on NHSEI Regional EDI Board, which will further support the work of the BCWB People Board as well as the Health Inequalities and Prevention Board.
Royal Wolverhampton NHS Trust committed to making progress on the Workforce Race Equality Standards (WRES) and to stay on track to meet the 2028 target for leadership diversity.
The Royal Wolverhampton NHS Trust was the first Trust within the Black Country Integrated Care System to achieve the Race Code Charter Mark – a framework for achieving race diversity at Board and senior levels – and it is making year on year progress against their WRES metrics for workforce diversity and representation.
Birmingham and Solihull STP (as it was then) committed to: routinely producing data to support restoration and recovery broken down by sub-analyses of socio-economic factors, including ethnicity and levels of deprivation; delivering various initiatives to support people with diabetes, including a marketing plan developed with our BAME diabetes patient champions and provider (Weight Watchers); and implementing the NHSEI perinatal mental health support for BAME women.
Birmingham and Solihull Integrated Care System (BSol ICS) has now developed a system analysis by key protected characteristics to inform decision-making.
Virtual diabetes education sessions have been held to raise awareness, which have included sessions to non-white communities to help reduce health inequalities at venues such as the Saltley Well-Being Centre, Soho Community Hall and Saheli Hub.
The ICS’ community perinatal mental health (PNMH) service is now delivering an increased access action plan for women from different ethnic minorities.
Solihull Metropolitan Borough Council (SMBC) committed to working to adopt the Health Equity Assessment Tool (HEAT) as part of their ‘health in all policies’ / integrated equity assessments work across the Council.
SMBC has embedded the adoption of the HEAT into its Health Inequalities Strategy and a cross-organisational strategy implementation group is now advocating for HEAT assessments for the Council and other partners. In the short-term, SMBC is focused on HEAT training, identifying key projects for application and ‘learning by doing’, with a longer-term goal to embed the tool into wider corporate processes.
Dudley Group NHS Foundation Trust committed to launching a health and wellbeing strategy for staff, supported by their BAME inclusion network, which provides a 12 month calendar of culturally appropriate health and wellbeing initiatives to support staff from a physical and mental wellbeing perspective.
The Trust’s ethnic minority staff network actively promoted Covid-19 vaccine uptake and raised awareness around mental health and conditions that have a greater impact on people from ethnic minority communities.
Aston University committed to developing ‘Inclusive Aston’, which includes working towards a Race Equality Charter award
Aston University has been committed to improving the representation, progression and success of minority ethnic staff and students within higher education. Through joining the Race Equality Charter, the University has been working through its framework to systematically identify and self-reflect on institutional and cultural barriers standing in the way of Black, Asian and Minority Ethnic staff and students. In response, the University has been developing initiatives and solutions for action. They are working towards obtaining their Bronze Race Equality Charter award.
West Midlands Police committed to working to look more like the people they serve and set a target of recruiting 1,000 BAME officers over three years.
Various initiatives have been taking place to increase the diversity of the Force and are already starting to see an increase in representation. Initiatives includes data driven decision making, targeted advertising, intensive qualification support and maximising internal support
The Walsall Together Partnership committed to meeting the Workforce Race Equality Standard and seeking to hear ethnic minority views through engagement with partners such as Walsall for All and Healthwatch
Walsall Healthcare Trust (WHT) is hosting the employment of the central team as well as a significant proportion of the workforce for services in scope. WHT has achieved the Race Code Charter and is committed to continual learning from national guidance and best practice. WT engagement approach includes strong links to a Walsall Ethnic Minority Communities group, established by an individual in WT partner organisation Black Country Healthcare NHS Trust. Healthwatch continue to represent all views at the Partnership Board and across several governance fora.
Healthwatch WM committed to conducting targeted work to gather views and experiences of patients and the public, especially from underrepresented groups.
Healthwatch Birmingham and Solihull published a report outlining the Health Inequalities faced by the Somali Community in Birmingham
The West Midlands Fire Service (WMFS) committed to continuing to take positive actions and make the service more representative of the communities it serves.
Positive Action is now at the heart of WMFS’s strategy to increase underrepresented groups in their organisation through a two-staged approach of promoting and nurturing to attract and retain females and candidates from ethnic minority groups.
The WMCA committed to working with partners to become a Marmot City-Region and develop a 3-year action plan for change.
The WMCA is currently learning from Greater Manchester and Coventry City approaches and exploring how this might be taken forward in the region.
The WMCA committed to incorporating a ‘Health In All Policies’ (HIAP) approach into its Inclusive Growth Framework.
Work to develop the WMCA approach to HIAP is underway through a ‘test, learn, evolve’ model, linking wellbeing and prevention priorities to the WMCA Inclusive Growth Framework.
The multi-agency Midlands System Transformation Recovery (STaR) Board working with PHE WM (as both bodies were named then) committed to establishing a Health Inequalities Working Group which would support Integrated Care Systems to plan and be held accountable for addressing health inequalities within the populations they serve; and to provide standards, guidance and tools to ensure health inequalities are considered in the design and evaluation of new NHS services.
NHSEI Midlands, working with PHE Midlands (now DHSC’s Office for Health Improvement & Disparities, Midlands), established a ‘Regional Health Inequalities and Prevention Oversight Group’ and established 3 work streams: the Health inequalities Forum bringing together all system leads on a regular basis to share progress and knowledge; a ‘Prevention’ workstream that is taking forward work on the NHS’ contribution to tobacco, alcohol and obesity control; and, more recently, an ‘Anchor Institutions’ group.
ICSs have been supported to produce their Health Inequalities Plans aligned to NHS priorities, address issues in their local area and take account of their role as ‘anchor’ institutions. The Board has published Health Inequalities Toolkits (Phases 1 & 2), which provide standards, guidance and tools to ensure health inequalities are considered in the design and evaluation of new NHS services.
Birmingham and Solihull STP (as it was then) committed to implementing their system leadership programme for 500 leaders who would receive bespoke learning on meeting the needs of vulnerable citizens and tackling key inequalities, as well as supporting vulnerable people shielding through local lockdowns, with additional support delivered through partner organisations.
BSol ICS’s People Board developed a system-wide ‘Time to Lead’ programme for system leaders to access an intervention that supports the healing process for those health and social care workers affected by the demands on services during the pandemic. The programme was developed in partnership with system leaders and key stakeholders including members of the ICS Equality, Diversity and Inclusion staff network and the Black, Asian and Minority Ethnic staff network. It has been based on ‘light touch teaching’ and ‘high touch experience’.
The WM Police and Crime Commissioner (PCC) committed to continuing to work with partners to identify additional opportunities for intervention and prevention in reducing the harm caused by drugs, gangs and violence. For example, the ‘New Chance’ programme provides a whole system approach to keep low level female offenders out of the criminal justice system.
The PCC are continuing to work with partners to take forward action on intervention and prevention in reducing harm caused by drugs, gangs and violence for example, violence prevention through youth works, drugs strategy and prioritising those at risk.
The Directors of Public Health share the ambition to reduce health inequalities and address the wider determinants of health. In particular, they are committed to working with partners and the WMCA to address these disparities through inclusive growth, leadership and coordination.
Directors of Public Health continue to share the ambition to reduce health inequalities and address the wider determinants of health. They have been working with the WMCA on a range of areas of such as leadership and coordination.
Black Country and West Birmingham CCG (as it was then) Health Inequalities and Prevention Board, which had a sub-group that steers the ‘Wider Determinants of Healthy Life Expectancy’ (WHoLE) programme, committed to undertaking their second phase – to design, appraise, implement and evaluate interventions.
Black Country ICS has since reported on its first phase of the WHoLE programme, publishing an independent overview of local experience and international evidence and bespoke high-level analysis on its website, to generate debate and decision around collaborative whole system action in improving population health and wellbeing in the Black Country and West Birmingham.
The West Midlands Fire Service (WMFS) committed to focusing on tackling the wider determinants of health during their ‘Safe and Well’ visits as they are also the underlying causes of fire risk.
A strategic priority for WMFS is to reduce health inequalities through a co-ordinated suite of activities that reduce health inequalities across the life course and also reduce the risk and vulnerability to fire and other emergencies while creating more resilient communities. This encompasses many different areas of work including: enhancing the ways that they deliver their prevention activities; training and development; changing the way they use data and digital capacities to improve their systems; and building partnerships and collaborations.
The Dudley Group NHS Foundation Trust committed to working with partners including the Local Authority and Dudley College to explore how they can ensure more employment opportunities for local people, in particular those who have found it hard to get employment in the past
The Trust has been working with partners to ensure employment opportunities for local people. As of January 2022, this included providing 27 young people with placements as part of the Kickstart programme, signing up to the Care Covenant and recruiting care leavers to a cohort of care worker roles.
University Hospitals Birmingham committed to working with CLES and Pioneer Housing on a project to retrain hospitality workers to work within UHB hospitals.
Birmingham & Solihull ICS ‘I CAN’ programme underway with developed pathway in operation focusing on recruitment into Trusts. Within the first 4 weeks, 251 jobseekers completed the application form, were sifted and received individual calls. A ‘Heat Map’ has been developed to identify areas requiring engagement, based upon recent unemployment data, and those areas that we have already engaged with. Applicants have either been redirected to other agencies, placed in roles with Trusts or are in training.
Sandwell and West Birmingham NHS Trust are committed to deploying a minimum of 2% of its future annual budget with local suppliers and to paying all staff at or above the ‘living wage’.
Sandwell and West Birmingham NHS Trust remain committed to paying all staff at or above the ‘living wage’.
The Walsall Together partnership committed to ensuring Housing, the Community and Voluntary sector is represented on the Partnership alongside health and other statutory partners, and that its plans are informed by evidence of the holistic needs of the population.
Walsall Housing Group (whg), One Walsall (council for CVS) and Walsall Community Associations are full, equal partners and Walsall Together Board members, using an Alliance Agreement governance model. ‘Resilient Communities’ is the operating model of health, care and aims to build capacity and capability within population and communities. Priorities are based on JSNA, Joint Health & Wellbeing Strategy and citizen voice. Currently undertaking deep dive into loneliness and social isolation. A 2022/23 priority is to develop an integrated data and intelligence function that combines quantitative service-based information with outcomes data and qualitative feedback from citizens.
The WMCA committed to training and supporting healthcare professionals to refer disabled citizens to physical activity as part of its IncludeMe initiative.
Discussions are taking place with NHS Improvement team on how we can develop further opportunities to create greater connections between health and activity. WMCA are working through logistics with Activity Alliance on the development of an e-learning package to provide confidence to refer to physical activity.
The WMCA committed to amplifying its Thrive into Work programme to a further 450 people living with poor mental and physical health, focusing on those out of work and those at risk of leaving employment due to their health condition.
WMCA has amplified its Individual Placement and Support (IPS) service, ‘Thrive into Work’, which now has specialist pathways supporting people with a health condition who also have: a neurodevelopmental condition; at risk of losing their home; or are coming to the end of treatment under a CSTR, Pre-Arrest (DIVERT), Arrest Referral Services, Liaison Diversion/MHTR. From November 2020 to July 2022, a total of 2,566 people have been supported through the programme.
The WMCA committed to continuing to advocate for the utilisation of transport hubs as digital screening centres and for ‘pop up’ heart / CV checks, breast screening, sexual health etc.
WMCA continues to support the system, for example by working with University Hospital Birmingham NHS Trust on an evidence-based approach to locate the diagnostic hubs in areas most accessed by people that are underserved.
The Midlands System Transformation Recovery (STaR) Board (as it was then) committed to ensuring that the differential experience of access and delivery of services would be an intrinsic part of service design and evaluation.
The Midlands Inequalities Board have been taking forward this work with DHSC Office for Health Improvement and Disparities (OHID) to support ICSs in applying the Health Equity Assessment Tool (HEAT) to their service design and evaluation. This is to address health inequalities systematically within a programme of work or service and identify what action can be taken to reduce health inequalities as well as promote equality and inclusion. Support has included commissioning the Commissioning Support Unit to deliver “train the trainer” training in ICSs to ensure that differential experience of access and delivery of services is a sustainable and intrinsic part of service design and evaluation.
Having carried out a West Midlands-wide needs assessment, with stakeholder consultation, and a rapid evidence review of how public health interventions are interpreted, Public Health England WM planned to use their review to inform regional and local commissioning of language and interpreting services.
PHE West Midlands’ review informed commissioning of an interpreting service for the Health Protection function in the West Midlands and the resource was used to update the national Migrant Health Guide language interpreting and translation page, to inform local asylum support arrangements and to add value to local outbreak management planning during the pandemic response. Currently, the review is being used to inform wider work around culturally sensitive and appropriate responses in service provision, for example alcohol support.
Black Country and West Birmingham CCG (as it was then) committed to developing an Academy to provide population health management capacity to the system via projects that aimed to widen access to health and care including early diagnosis of cancer in vulnerable groups.
Development of the Academy is progressing and initial work is focused on developing the Academy’s infrastructure: on leadership, culture, data infrastructure and networks of staff with PHM expertise; on generating actionable intelligence to understand overall population need, tools to understand needs of specific population segments, and opportunity analysis; on designing effective interventions supported by evidence, design thinking, engagement, evaluation and accountability; and on focussing on the four pillars of population health.
Birmingham and Solihull STP (as it was then) committed to developing population health management within Primary Care Networks (PCNs) and ensure its primary care estate is under one digital domain by March 2021 promoting digitally enabled care for staff to work together in virtual multidisciplinary teams.
BSol ICS has since developed a population health management strategy – a 3-year programme to ensure all Primary Care sites are part of a single digital domain, and are now working to migrate the domain to be fully cloud based.
The Dudley Group NHS Foundation Trust committed to working with colleagues in Dudley to explore how to collectively make a difference to cancer outcomes, with a particular focus on parts of the Borough where outcomes are poorer. This would ensure that screening services provided by the Trust would be delivered in a way which encourages uptake from more vulnerable people and that cancer services would be culturally sensitive and more person centred.
The Trust has been working with the local Council for Voluntary Service to identify barriers to accessing services and developing actions to tackle what can be done quickly whilst committing to conducting deeper conversations in the future.
Aston University committed to exploring the development of a Health Hub at Aston that would be open to the local community.
Aston University have since undertaken a series of listening events with communities as part of this development.
The Walsall Together partnership committed to understanding the inequitable take up of health and care services and working through the Partnership and wider community networks to address key causes.
The overarching strategic aim of the WT partnership is to work together to reduce inequalities, focussing on the wider determinants of health. WT recognise the need to better understand the needs of their population from this perspective. WT have leadership in this area from colleagues within the ICS and Public Health, and are looking to develop an integrated data and intelligence function for the partnership that will enable them to prioritise and make decisions based on information about inequality. WT already work well with housing and third sector colleagues to understand inequalities in access and have taken action to address these for a small number of initiatives – and are now committed to expanding their capability and action in this area.
The West Midlands Fire Service (WMFS), as a key part of their ‘Safe and Well’ visits, committed to referring people on to other partner agencies to gain access to services that can tackle wider health and care issues.
WMFS have been proactive in their prevention approach through their Safe and Well visits. For example, referrals to smoking cessation services during Safe & Well visits have resulted in people quitting and being less likely to have a fire.
WMCA committed to developing its Include Me WM programme to engage disabled people and people with long term health conditions to be physically active.
The Citizens Network and IncludeMe Panel aim to address disabled people and those with long term health conditions being at the heart of the conversation by connecting existing groups and individuals together to share their voice, which is used to support change at a policy level. The Network connector has been building up relationships and the panel has been recruited.
WMCA committed to working other Commonwealth Games Delivery Partners to develop a long-lasting physical activity and wellbeing legacy for the region.
WMCA has worked with Commonwealth Games (CWG) Delivery Partners to develop a physical activity and wellbeing legacy for the region using CWG as catalyst to change the regional low levels of inactivity. For example, the Commonwealth Active Communities programme has been supporting inactive people to become more active and is focused on collaboration, co-design and co-production with communities and concentrates on where biggest changes can be made. Alongside physical activity, CWG continue to be used to accelerate awareness and understanding of mental health and wellbeing issues by focusing on three areas: Games-time wellbeing, workplace wellbeing and supporting mental health in construction.
WMCA’s Young Combined Authority Board committed to encouraging and challenging the West Midlands Combined Authority and its partners to listen to the voices of citizens when shaping policies which will affect their lives.
The YCA Board welcomed the Health of the Region Report and presented a statement of support when it was brought to the WMCA Board in November. They have continued to emphasise the need and advocate for a fairer and more inclusive recovery in the West Midlands, and the role of youth voice in realising this. They continue to work with the WMCA on shaping regional policy.
PHE West Midlands (as it was then) committed to working with national colleagues and NHS Midlands advocating for community centred and asset-based approaches, providing resources, tools and products to enable ‘people-powered health’ including support and leadership for the Regional Social Prescribing Network, promoting the role of the NHS as an anchor institution, maximising opportunities through volunteering (including PHE staff role modelling this) and landing social marketing campaigns.
The Office for Health Improvement & Disparities (OHID) Midlands are taking forward this function of PHE WM. OHID have been continuing to learn and share from community centred and asset-based approaches, for example through the (national) evaluation of Community Champions. Work has been undertaken to re-set relationships with the Regional Social Prescribing Network alongside NHS Midlands discussions around personalisation. OHID are working on supporting the scaling of anchor institutions and are in discussion with NHS Midlands to enable more integrated approaches in this space. National to regional joint work around social marketing campaigns and behaviour change is currently being reviewed to maximise on OHID’s calendar of events and promote more joint approaches with NHS Midlands.
Birmingham and Solihull STP (as it was then) committed to supporting behaviour change for staff and community leaders through various wellbeing initiatives including a targeted campaign on flu vaccination with a focus on the most vulnerable and those disproportionately affected by COVID-19.
As of February 2022, there were over 60 sites offering access to 1st, 2nd and booster doses of COVID-19 vaccinations across (what is now) the ICS patch to local citizens and all staff groups. There is a local strategy focussing on historically underserved communities to understand and support those in low uptake areas. A new joint partner strategy to improve the uptake in childhood vaccinations across Birmingham and Solihull is in development.
The West Midlands Fire Service (WMFS) committed to continuing to use firefighting as a means of tackling wider health and wellbeing issues for young people through their Fire Cadets programme, which utilises their schools education and their work at Safeside to tackle wide range of safety, health and wellbeing issues that underpin long-term risk of fire.
Remote contact by instructors was maintained throughout Covid to support the health and wellbeing of the young people involved in the Fire Cadets programme which has now restarted. School education and Safeside face to face work was paused with new remote delivery packages in place during the pandemic and has now become part of a blended approach. New Virtual Reality programmes have been developed in the last year as part of the Service’s wider digital approach.
Aston University committed to in partnership with Aston Villa Foundation to go into local schools to deliver workshops about eye health, conduct eye screening and eye tests for those that need it, and working with children and parents on childhood eating habits.
Aston University have been working in partnership with Aston Villa Foundation has engaged with around 4500 individuals in various capacities to help raise awareness around the importance of eye health as of December 2021. They have been involved with a raft of research on eating habits such as a qualitative study in partnership with Birmingham City Council on family food purchasing in East Birmingham.
Coventry University committed to creating a number of fully funded PhD studentship opportunities focused on themes related to COVID-19 and the post-pandemic future.
Coventry University has launched a suite of 50 fully-funded PhD studentships designed to deliver research-led solutions to the challenges posed by COVID-19. In response, Coventry University has invested £3.4 million of its Quality Related (QR) funds from Research England into recruiting the next generation of researchers.
Having re-established the Police Cadets programme to support young people and reduce inequalities, the PCC and West Midlands Police committed to rolling out units in our most diverse and challenging areas, focusing on young people who need the most support.
The Police and Crime Commissioner has since committed to increase the size of the West Midlands Police Cadets programme by 50% (an extra 750 young people) with measures for success in place.
