Click on the tabs below to reveal the shortlisted NHS teams and projects per category.

Innovation and Improvement in Reducing Healthcare Inequalities Award

Organisation : Advancing Quality Alliance and Salford City Council 

Project Title : Using asset-based community development to increase uptake of COVID-19 vaccine in Salford

Synopsis :

Working in partnership, Salford City Council Public Health, Salford’s five primary care networks, Aqua, and local community organisations, collected and used community insight to rapidly design and deliver drop-in COVID-19 and flu vaccination clinics, targeted to communities with high levels of vaccine hesitancy.

This project evidenced:

  • An increase in COVID-19 and flu vaccination in targeted communities.
  • Easily replicable new ways of working through co-design and delivery with targeted communities, which led to providing warm, welcoming drop-in services offering a range of health and care screening, vaccination, and welfare advice.
  • Strengthened partnership working between primary care, public health, and local communities

Organisation : City and Hackney PBP, NHS North East London, Hackney CVS, ELFT, London Borough of Hackney and Corporation of City of London

Project Title : Peer Led Tree of Life in Schools for African and Caribbean Heritage Young People

Synopsis :

Our project focused on addressing inequalities experienced by African and Caribbean Heritage (ACH) students in accessing the right mental health support at the right time.

Our partnership between the NHS, schools and VCSEs, adapted the Tree of Life model and pioneered its use in schools as an ACH peer led and ACH focused approach embedded in the whole school system. Developed in Zimbabwe, the Tree of Life allows culture to be reframed as a strength.

The high voluntary access rates and enthusiasm from students and the improvements in mental wellbeing demonstrate the value of providing peer led culturally attuned support.

Organisation : Coventry & Warwickshire Partnership Trust

Project Title : Midlands Op Courage

Synopsis :

Midlands OpCourage is a mental health service providing specialist care for British Armed Forces’ veterans and their families.

It is a highly responsive service tuned into military culture and aligns with the CORE20PLUS5 approach of the NHS in targeting those veterans facing severe and complex mental health needs and co-morbid issues such as addiction.

Midlands OpCourage is a collaborative programme built up from local partnerships between statutory, mental health and veteran specific services.

Organisation : Hertsmere Borough Council

Project Title : Hertsmere Cancer Screening Project

Synopsis :

The Hertsmere Cancer Screening Project is identifying patients who have not responded to cancer screening invites and those with increased risk of cancer and taking away the barriers to booking patients often experience by proactively contacting them to arrange the appointments during a phone call.

The project has also launched a Hertsmere against cancer campaign to raise awareness of risks, symptoms and screening services.

Organisation : Improvement Academy

Project Title : Yorkshire Community Health Checks

Synopsis :

The Connected Bradford Community Health Checks is a co-produced initiative to provide at risk communities cardiovascular health checks in community settings.

The health checks additionally facilitate connections to primary care services and supported lifestyle interventions to address risk factors for cardiovascular disease (CVD). Interventions include risk-lowering medications, such as statins, and social prescribing to address the wider determinants of cardiovascular health.

The project developed from clinical evidence at Bradford Royal Infirmary regarding the increased mortality observed from specific sub-populations in parallel with conversations with community members that highlighted experience of poor outcomes from CVD.

Organisation : Medway Public Health, Kent and Medway ICB, OHID, Kent Community Health FT, EK360 and BHF

Project Title : Kent and Medway Hypertension Heroes

Synopsis :

A multiagency collaboration between voluntary and statutory bodies including Kent and Medway ICB, developed a personalised approach to improving hypertension awareness, detection and management.

Working with community volunteers, complimenting initiatives in primary care and community pharmacies, EK360 lead co-design and co-delivery with community groups to reach populations who may be at risk, but unaware of having hypertension and/or not accessing services or support to help identify and manage their blood pressure. Trained volunteers engage their communities to overcome barriers to self-management, take their own blood pressure readings and manage risks through lifestyle change; self-monitoring; treatment and accessing primary care support.

Organisation : Midlands & Lancashire CSU, NHS England and Specialist Pharmacy Services

Project Title : Learning Disabilities and or Autism: Developing a Community of Practice

Synopsis :

This national project upskilled, motivated, and inspired primary care network pharmacists to undertake structured medication reviews in people with a learning disability to help reduce inequalities. Pharmacists are well-placed to deliver holistic lifestyle and medicines expertise to help these patients get the most from their medicines and live a fulfilling life.

Strongly co-produced by a range of stakeholders, the project identified pharmacists’ learning and development needs; scoped and delivered a model of support; collected data to demonstrate success; and made recommendations for uptake across the system. Participant and user feedback was positive, and the model is available for wider implementation.

Organisation : Modality Partnership Hull

Project Title : Modality Partnership Hull: A PCN approach to core 20 plus 5

Synopsis :

Core20plus5 offers a unified approach to population health management for organisations of any size within the NHS. Our PCN approach examined how we could implement and tailor national approaches to the benefit of our local population and patient needs. Using data, local intelligence, and feedback we have designed quality improvement initiatives that will benefit the patient populations who need our support the most. We focus on comprehensive models of care that offer continuity, coordination and proactive engagement, drawing on best practice to improve quality of care. Each service is designed to improve access, experience and outcomes for its target patients.

Organisation : University College London Hospitals FT

Project Title : RESPOND: an Integrated Asylum-seeker and Refugee Health Service

Synopsis :

RESPOND is an integrated, co-designed health system providing services for asylum-seekers and refugees (ASR).

Our Outreach Assessment Service has seen more than 1400 asylum-seekers in initial accommodation centres in North Central London (NCL), exploring physical, mental, sexual, dental and social health needs (aligned to CORE20PLUS5), using a holistic care-planning framework to promote service access.

A specialist multidisciplinary team (MDT) facilitates partnership-working, and a comprehensive patient-held health plan is created for service-users. RESPOND addresses health inequality in a vulnerable population, and has demonstrated improved access to health services, identification of health needs and patient / stakeholder experience. 

Reducing Healthcare Inequalities for Children and Young People Award

Organisation : Barts Health Trust

Project Title : Equity in care for children with Retinoblastoma and a paradigm shift in its detection

Synopsis :

Retinoblastoma is an uncommon children’s eye cancer (incidence of 1 in 13000). We found equal outcomes for children with retinoblastoma irrespective of socio-economic status or ethnicity in the UK in the only study to assess for health inequalities.

The signs include a white reflex from the eye or an absent ‘red reflex’. We found a disproportionate number of children from non-white communities who are seen urgently with an absent ‘red reflex’ yet are found to be normal. We advocate decolonisation of the term to ‘fundal reflex’ in order to avoid increased anxiety in these communities and reduce NHS costs.

Organisation : Central and North West London FT 

Project Title : North West London Young Adult Mental Health and Wellbeing Partnership

Synopsis :

To develop and implement a new North West London mental health model of care for young adults aged 16 to 25 years. The new Young Adult Partnership is designed to:

  • Improve equality of access to early intervention,
  • Address inequalities and better identify unmet need,
  • Improve access and quality of mental health provision,
  • Engagement and navigation of services

Organisation : Fullscope, Cantab PCN, Cam Medical PCN and Cambridgeshire South Care Partnership

Project Title : Single Session Thinking: Supporting Children and Young People’s Mental Health

Synopsis :

The Fullscope GP pilot ran from June 2021 until June 2022. It gave GPs in two Primary Care Networks, rapid access to a single session intervention (by phone/ video link) for children and young people presenting with mild/moderate mental health or wellbeing issues. 

We aimed to tackle inequalities in service provision and outcomes by co-designing and testing a Single Session Thinking approach. 

Following a comprehensive write up of the project (included in supporting evidence), we have been using the learning from both the intervention and project delivery, to scale up the pilot and embed in a new pathway.

Organisation : Leeds GP Federation

Project Title : Leeds Community Ambulatory Paediatric Service (CAPS)

Synopsis :

Winter months are associated with growth in respiratory illnesses, particularly in children and young people. This in turn increases demand for clinical care across the health system including General Practice, Urgent Care services, Community Care and Emergency Departments.

The Leeds Community Ambulatory Paediatric Service (CAPS) was developed to help manage paediatric presentations, specifically children with acute respiratory symptoms. CAPS provides same day appointments for children and young people with respiratory infections to help relieve the pressure on primary and secondary care and to improve care for children and young people in one of the five clinical areas of focus.

Organisation : Mid and South Essex Hospitals Trust

Project Title : Reducing inequalities in paediatric Sickle-Cell care provision across Mid & South Essex

Synopsis :

Mid and South Essex NHS Foundation Trust’s Children’s department has developed a specialised Sickle-Cell service at Basildon University Hospital to ensure optimised and equitable care for Sickle Cell patients. The Trust provided training to all staff about Sickle Cell to improve identified inequalities resulting from a lack of understanding of the disease. Haemoglobinopathy-trained consultants led local patient engagement to shape the service.

With transcranial doppler scans now offered locally, patients and their families no longer need to travel to London for their care and recruitment of specialist roles mean patients can now contact staff 12 hours a day for advice.

Organisation : Midlands Partnership University FT

Project Title : Improving Lives for Young People in Staffordshire and Stoke-on-Trent

Synopsis :

Young people involved with Criminal Justice services have multiple health and social inequalities; 43% have emotional health needs, 25% have a learning disability, 30% of boys and 44% of girls are looked after children. 

1 in 3 are neurodivergent, over 60% have speech and communication challenges, 86% of boys and 82% of girls have been excluded from school. 

The Children’s Health and Justice Team (CH&JT) is a small team improving the lives of our children and young people through comprehensive, holistic assessment and intervention, striving to address the underlying health inequalities of CYP in partnership with agencies. 

Organisation : Reach and Unite Outreach Empowerment CIC

Project Title : A place for every child

Synopsis :

RUOE is a proactive and reliable service that caters to young individuals at risk of marginalisation. Research shows that loneliness and assimilation can lead to mental health problems, which are the leading causes of youth suicide. To prevent such occurrences, we promote inclusivity, cultivate healthy friendships, and enhance confidence, ultimately establishing a secure and encouraging atmosphere.

RUOE helps remove the barriers that enable children and families to thrive. We work in Wolverhampton, which has 10% of most deprived UK regions and has higher than average proportions of young people living in poverty/with SEND.

Organisation : South Thames Cancer Teenage & Young Adult Operational Delivery Network 

Project Title : Fertility preservation for teenage & young adults with cancer

Synopsis :

Collaboration between multiple stakeholders including clinicians, the charitable sector and young people themselves to reduce inequalities in care in terms of pathways for fertility preservation for teenage & young adults (TYA) (16-24 year olds) with cancer at both a local level (development of a single pathway across the South Thames region as part of a quality improvement project & delivery of education) and nationally (development of proposal presenting a case for either specialised commissioning or consistency in funding at local level).

Organisation : South West Provider Collaborative and Lead Provider Devon Partnership Trust

Project Title : Transforming access to, and experiences of, specialised mental health care for children and young people in the South West.

Synopsis :

Following a comprehensive needs and gap analysis of our specialised CAMHS provision in the South West, our Provider Collaborative co-created a whole care pathway redesign to meet the complex needs of the region’s children and young people. Our intentions were to:

  • Ensure equitable access to services and consistent high-quality care and treatment in region
  • Robustly review our bed usage and consider future need across the entire CAMHS pathway
  • Provide integrated services, developed on the basis of need
  • Reduce lengths of stay, reinvest clinical efficiencies into appropriate community services, and enable further admission avoidance and alternatives, including step up/down options