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Equality, diversity and reducing health inequality

NHS Hammersmith and Fulham CCG is committed to embedding equality and inclusion in everything that we do, but more specifically:

  • How we commission services on behalf of our residents 
  • How we recruit and support the development of our staff
  • How we proactively engage and support all our residents particularly given the diversity of our population and service users

Our work on embedding equality into the commissioning of health services is underpinned by engagement with our stakeholders. We believe that engagement with and drawing on the expertise of residents, patients, services providers and third sector organisations, is critical in shaping services that are of high quality, value for money and reflect the needs of our diverse populations.

The involvement and active participation of stakeholders helps us to meet our public equality duties by:

  • Identifying at an early stage in the design and development of services, whether the service is free of unlawful discrimination or impacts adversely on any group of service users at any of stage of development
  • Advancing equality by ensuring that services are accessible to all who need the service
  • Fostering good relations by drawing people from different communities to work together collaboratively with commissioners - and the wider health and social care workforce - to identify solutions to local health challenges.

As a public sector body, Hammersmitth and Fulham CCG is required to publish its equality objectives and we have adopted the Equality Delivery System Framework to identify our equality objectives. The EDS2 is a toolkit which helps us drive up equality performance and embed it into mainstream business. 

Using the EDS2 as a framework, we engaged with a range of community groups face to face in 2017-18 to determine our 2019-22 equality objectives. We analysed the demographic groups we had engaged with before, mapped this against information from our local JSNA and based on this were able to undertake targeted, tailored outreach with a range of groups to inform our equality objectives, including: people with physical disabilities, people with learning disabilities, older people’s groups, Mosaic LGBT Youth Centre clients, homeless people, BAME groups (including Somali women and clients of the Iranian Association), and former offenders and their families.

Read our draft local equality objectives – pending Governing Body approval – for 2019-22. For a brief summary of the context, you can read the cover sheet for the equality objectives. You can also read the draft NW London equality objectives (also pending Governing Body approval).

You can see the engagement and equalities presentation we have used to ensure that commissioning staff have basic training in these areas here. The basic level of training has been supplemented with more specialist equalities and reducing health inequalities training delivered by the Consultation Institute for those members of staff most directly involved in engagement and equalities work.

Other steps we have taken to ensure that our public involvement work ties in with EDS2, include: setting up a NW London Equality Steering Group which comprises both engagement and equality leads, and plays a role in ensuring EHIA screening informs engagement and setting up local processes for ensuring we engage better around equalities. 

Accessible documents

Should you require any information in other languages or other formats, such as Easy read, large font or Braille, please contact: hafccg.engagement@nhs.net / 0203 350 4303.

Here are some documents we have already created in accessible formats:

The borough of Hammersmith and Fulham

Hammersmith and Fulham is a small, but densely populated and vibrant borough with a large proportion of young working age residents and a low proportion of residents aged 65 and over and the fifth lowest number of children of any London Borough. It has high levels of migration in and out the borough, and ethnic and cultural diversity. Rich and poor live side by side, creating inequalities within small geographical areas.

The annual Joint Strategic Needs Assessment (JSNA) is carried out by the local Public Health Department in partnership working between the local authority, the London Borough of Hammersmith and Fulham, the NHS, and community representatives. It is founded on a strong evidence base of need.

It provides a comprehensive local picture of health and wellbeing needs and how they may develop in the future, focused on the needs of the population as a whole, not individuals.

The JSNA has identified the main aspects of chronic disease that have major impacts on population health and wellbeing in Hammersmith and Fulham. These challenges include:

  • Whilst life expectancy for men in Hammersmith and Fulham is lower than London and England it is consistently higher for women.
  • Those living in areas of high density social housing in areas such as College Park and Old Oak, Hammersmith Broadway, Wormholt and White City are around twice as likely to report bad/very bad health compared to those in areas with low density, across all ages.
  • Causes of early death are cancer, followed by cardiovascular disease.  
  • A significant number of people die from lung disease.
  • Accidents and injuries are most common among younger residents and comprise a large proportion of total avoidable deaths.

The JSNA also highlights a number of other areas of concern in Hammersmith and Fulham:

  • A third of children under 16 (29%) live in poverty according to official definitions, which is higher than London.
  • Prevalence of obesity remains high for children in the borough, with nearly a third of children of school age either overweight or obese, around 6,000 to 7,000 children.
  • 28% of local 5 year old school children suffer from decayed, missing or filled teeth.
  • Hammersmith and Fulham had the 8th highest population with severe and enduring mental illness known to GPs in the country in 2012/13 (2,452 people).

You can find out more about the local borough and the partnership working planned to promote equality and address health inequalities in the Joint Health and Well-being Strategy 2016-21.

Demographic monitoring

We collect the demographics of the local residents with whom we engage via our equality monitoring form. We edited the form based on feedback from protected groups and equality experts in 2018. We are then able to ensure that our engagement is representative and that we are addressing any gaps in our engagement.