Healthcare delivery
their lifetime. There is a huge gap in the healthy life expectancy at birth linked to deprivation. Data from 2017-2019 state that people living in the least deprived areas could expect to live almost two decades longer in good health than those in the most deprived areas. People in the most deprived areas spend around one third of their lives in poor health. Long-term health conditions are known to be the cause of a reduced quality of life, and this disproportionally affects people in lower socio- economic groups. Deprivation also increases the likelihood of having more than one long-term condition at the same time. It is also a fact that, on average, people in the most deprived fifth of the population develop multiple long-term conditions at least ten years earlier than those in the least deprived fifth.
Prevalence of mental ill-health Evidence and data for the prevalence of mental ill-health are difficult, patchy and inconsistent. Recognition, reporting and diagnosis varies between groups but, not surprisingly, the demand for mental health services is higher in more deprived communities. Data also shows that suicide rates among the most deprived groups were consistently around double the rates among the least deprived. There is also data to suggest that inequalities
in various types of mental ill-health exist across a range of protected characteristics including sexual orientation, disability, sex and ethnicity. Asylum seekers and refugees are also at increased risk of experiencing depression, post- traumatic stress and other anxiety disorders.6 COVID-19 has had an unequal impact
on different population groups and has exacerbated existing health inequalities in England. Mental ill-health reportedly has severely affected children and young people with lockdowns and home education being particularly impactful, with lasting outcomes. Children and young people were away from
school, from their friends and leisure activities and from full time education for six months in the first lockdown followed by two shorter ones. The effect particularly on exam results and on subsequent educational opportunities have been severe, and are frequently mentioned in media reports.7
NHS England has set up an
approach to child health inequalities, which not only include mental ill health but a series of long -term clinical conditions such as epilepsy and asthma. The approach is titled ‘Core20PLUS5’ and includes targets that aim to improve health outcomes and access to care for children with asthma, diabetes and epilepsy, as well as those with oral health and mental health needs. The new government has also announced
a ministerial taskforce to work on the child poverty strategy. There will be a set of new targets for ICBs and for the NHS, which will be important for reducing the human cost of suffering.
West Yorkshire ambitions from the ICB This author felt compelled to review the local situation and came across a document, which has nearly run its time but still is indicative of aspects of the efforts to health and care which they aimed to improve over a five-year period.
They suggest that the ambitions are devised to tackle some of the long-term trends which are causing ill-health and unhappiness across West Yorkshire. The place-based team covers a wide range of different communities, such as Bradford, rural west Yorkshire, the cities of Leeds and Wakefield and the town of Harrogate. They specifically mention that the partnership in the ICB expect to deliver on national targets, on people’s experience of care such as accident and emergency, cancer, mental health and operation wait times.
The five-year plan for West Yorkshire and Harrogate Health and Care Partnership Ambitions, which they have been working to deliver, include: l As a successful partnership we expect to deliver on national targets, on people’s experience of care, such as accident and emergency, cancer, mental health and operation wait times.
l We will increase the years of life that people live in good health in West Yorkshire and Harrogate compared to the rest of England.
l We will reduce the gap in life expectancy by 5% (six months of life for men and five months of life for women) between
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