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Health Improvement Plan

Lancashire Teaching Hospitals has set up a Health Improvement Plan, which is a comprehensive strategy aimed at reducing health inequalities across our region. The plan is a testament to the organisation’s unwavering commitment to fostering a healthier, fairer society where everyone can thrive.

Aims of our Health Improvement Plan

Through our Health Improvement Plan, we aim to:

  • Work with local partners to address the social determinants of health that can result in people experiencing health inequalities and influence health outcomes e.g. education, employment, housing and community support. 

  • Create a supportive network that promotes health and wellbeing at every stage of life.

  • Offer a roadmap for creating a healthier, more equitable society in Lancashire and South Cumbria. 

  • Ensure that we engage with our residents, listen to their needs, and adapt our strategies to ensure that we are making a meaningful impact.

What are health inequalities?

Social determinants of health Health inequalities are systematic differences in health that affect various groups of people. Health inequalities are a persistent challenge, deeply rooted in the social, economic, and environmental conditions in which people are born, grow, live, work, and age. These disparities are not only unjust but also preventable. The Trust’s mission is to address these inequalities head-on, ensuring that every individual, regardless of their background or circumstances, can lead a healthy and fulfilling life.

Marmot Review (2010) 

The Marmot Review (2010) was a strategic review of health inequalities that has provided us with a clear roadmap for improvements. These recommendations lie at the heart of our Health Improvement Plan. 

At Lancashire Teaching Hospitals, we are dedicated to transforming into a ‘health improvement organisation’ that not only treats illness but also actively promotes health and wellbeing. 

Why is it important that we take action to reduce health inequalities?

Across the Lancashire and South Cumbria region there are high levels of deprivation and persistent poverty in coastal areas, rural communities as well as in its towns and cities, all of which contribute to unfair and wide inequalities in health and poor health. 

We are committed to working collaboratively with our partners and the community to tackle the root causes of health inequalities and have aligned our work to that of the Lancashire and South Cumbria Integrated Care Partnership Strategy 2023–2028 and the life course approach of Starting well, Living well, Working well, Ageing well and Dying well. By focusing collectively on prevention, education, and creating supportive environments, we aim to ensure that everyone has the opportunity to lead a healthy life. 

Health Inequalities in Lancashire and South Cumbria 

The Lancashire and South Cumbria region has a population of 1.7m people. Within that, Lancashire Teaching Hospitals is a specialist provider serving people from across the whole of Lancashire and South Cumbria and it is important that we consider the extent of the health inequalities across our region, as well as the local Central Lancashire footprint.

Local statistics for Lancashire and South Cumbria highlight the extent of health inequalities in our region. We face a number of challenges in Lancashire and South Cumbria which have a direct impact on people’s health and wellbeing. We have communities across our region that face some of the greatest disadvantages seen anywhere in the country and the health inequalities across different parts of our geography are stark.

  • 31% of our population live within the 20% most disadvantaged communities in the UK. This varies significantly across Lancashire and South Cumbria (LSC). In Blackpool, 70% of the population live within the 20% most deprived areas, whereas other areas of LSC experience less deprivation.  
  • Up to 25% of children and 20% of over 65s are living in poverty.
  • 13% of people live in fuel poverty and are unable to afford to heat their homes, which is higher than the national average of 10.6%.
  • 17% of people in Pennine Lancashire are part of a minority ethnic group.
  • Approximately 40% of ill health in Lancashire and South Cumbria is caused by smoking, not taking enough exercise, being overweight and taking illegal drugs.
  • Only around one fifth of adults are meeting the recommended levels of physical activity.
  • Across Lancashire and South Cumbria, there are high levels of people living with mental health conditions including depression.
  • There are high levels of people living with other long term health conditions including cardiovascular disease, heart failure, hypertension, asthma and dementia.
  • Within the local population, there are high rates of alcohol, smoking, and respiratory related admissions, obesity and digestive related conditions, and late cancer diagnosis.
  • Home ownership, employment rates, and levels of education vary enormously across the region.
  • Quality and availability of housing differs significantly across different parts of Lancashire and South Cumbria.
  • Crime, antisocial behaviour, and poor experiences of community safety are greater in the most disadvantaged neighbourhoods.

Source: Lancashire and South Cumbria ICB 

Access to services, experience of care, and health outcomes are worse for those people living in the most disadvantaged communities. And there are significant differences in the number of years people can expect to live a healthy life across our area.

We know many people in Lancashire and South Cumbria could be living longer, healthier, happier lives than they currently do, and we know we must do everything we can to address these inequalities. 

Life expectancy across Lancashire and South Cumbria Life expectancy for males in Lancashire and South Cumbria

Life expectancy in Lancashire and South Cumbria is lower than the national average – by almost a decade in some areas. There is also a large variation in the number of years people can expect to live a healthy life. Babies born in this area today have a healthy life expectancy that is lower than the expected state pension age of 68. In some areas, healthy life expectancy is as low as 46.5 years, although this varies significantly across our communities.

Diseases that contribute to the gap in life expectancy between the most and least deprived areas are circulatory disease, cancer, respiratory conditions. Around 21,000 people across Lancashire and South Cumbria who are currently registered with a GP practice have 5 or more long-term health conditions, and a disproportionate number of these are from the areas of greatest disadvantage. 

Across the region, there are significant variations in life expectancy as a result of health inequalities and we must collectively take action to ensure fair, equitable health services are available to everyone across the region. 

Health and Lifestyle Factors Affecting Health Inequalities Health and Lifestyle Factors Affecting Health Inequalities in Lancashire and South Cumbria

Health behaviours, such as diet and exercise, can improve or damage the health of individuals. These are determined by the choices available in the places where people live, learn, work and play. Behaviours such as stopping smoking, moderation of alcohol intake, healthy eating, physical activity, sexual practices and disease screening can reduce the risks of developing serious illnesses such as cancer, heart disease and type 2 diabetes. When compared to the England average most health risk factors are higher in Central Lancashire. 

Our Health Improvement Plan aims to take action to reduce the impact of some of these health and lifestyle factors. You can find out more about the actions we intend to take to tackle health inequalities in our Health Improvement Plan.

Core20PLUS5 Framework - Targeting the most deprived communities 

Core20PLUS5 is an NHS framework to inform action on reducing healthcare inequalities at a national and system level based on the theory of social determinants of health. The approach defines a target population – the ‘Core20’ most deprived 20% of the population, ‘PLUS’ population groups that are at increased risk within our area and identifies ‘5’ focus clinical areas requiring accelerated improvement and drives action in healthcare inequality improvement. The Core20PLUS5 framework forms the basis of our clinical interventions for adults.

Our Health Improvement Plan has two key areas aimed at both adults and children. You can view the priorities identified for both groups below. 

Core20PLUS5 - Adults 

Our work with adults will focus on several clinical areas of health inequalities including: 

  • Maternity
  • Severe Mental Illness (SMI)
  • Chronic Respiratory Disease
  • Early cancer diagnosis
  • Hypertension
  • Smoking cessation. 
Core20Plus5 Adults

Core20PLUS5 - Children 

Our work with children and their families will focus on several clinical areas of health inequalities including:

  • Asthma
  • Diabetes
  • Epilepsy
  • Oral Health
  • Mental health.

Core20Plus5 Children

You can read more about the work we are doing in each of these areas of focus to tackle health inequalities in our Health Improvement Plan.

Partnership Working - Working with our local partners to tackle health inequalities 

Successfully reducing health inequalities requires us to work in partnership with stakeholders in and outside of health. Across partner organisations there is a shared ambition, but also individual responsibility where each organisation can help to connect either data, intelligence or programmes of work that have the same aims. 

The LSC place-based health inequalities strategy is developed in partnership between the Lancashire and South Cumbria Integrated Care Board (ICB) and Lancashire County Council (LCC) through the Health and Wellbeing Boards. There is a Health and Wellbeing Board for Chorley and for Preston.

Voluntary, Community, Faith and Social Enterprise Partners (VCFSE) 

There are approximately 50 VCFSE partners actively working with us across Central Lancashire and work is ongoing to engage with more partners. We are working with partners to support families in key areas including carers, bereavement, community support, health promotion, and support. 

Working jointly together under the Lancashire and South Cumbria Integrated Care Partnership Strategy, we have a joint vision for a safer, fairer and healthier Lancashire. There are 3 priorities that have been identified including:

  • Best start in life - Achieving the very best start in life for our children, young people and families.
  • Happier minds - Reducing the chances of heart disease, stroke, diabetes, dementia and cancer. 
  • Healthy Hearts - Improving wellbeing and reducing addiction, self-harm and loneliness. 

Population Health Approach - Improving health outcomes across our population

Lancashire and South Cumbria ICB have developed a population health model to provide a structured, consistent and effective approach across Lancashire and South Cumbria. Population health management aims to improve health outcomes and reduce inequalities across an entire population. The diagram below explains the ways in which a population health approach is being implemented across Lancashire and South Cumbria to reduce health inequalities.

Population Health Approach edit 

How will we deliver our Health Improvement Plan?

Effective delivery of our work around health inequalities will rely on 3 key principles that will be threaded throughout our Health Improvement Plan to ensure our organisation can embed, sustain, change and grow our understanding in reducing health inequalities.

Key principles

  • To give everyone a ‘health equity attitude’ - Through better awareness, understanding and visibility we can then act to improve access, experience and outcomes for our patients. 
  • To actively engage with local communities to improve services for their needs - Engaging our local communities and co-producing improvement must be at the centre of this work. We need to genuinely listen to understand with an appreciation that our communities are best placed to co-produce the solutions to the problems that we seek to solve.
  • To take a population health approach to improvement work - This approach will be effective in enacting sustainable change that makes an impact to the group most in need.

How will we achieve this?

  • Health inequalities education - a new approach to health equity education.
  • Health inequality data visibility - mandated collection, sharing and use of data to understand inequalities.
  • Active health promotion - for patients, families and colleagues.
  • Connection – Understand our role as an anchor institution and the Social Values Framework.
  • Lived Experience - Learning from the experience of people on whom a social or combination of issues has had a direct impact on the person.
  • Co-production - A way of working together underpinned by principles that support inclusion, equity, shared decision and ownership for what is produced and the impact of has at all levels, especially strategically.
  • Structure - Following the 6-step approach for population health intervention.
  • Data led - Using data to drive areas that require improvement.
  • Focussed - Targeted population specific solutions, not generalised solutions that may not be effective.

You can read more about the key health improvement projects we are undertaking with local communities to tackle health inequalities across Lancashire and South Cumbria in our Health Improvement Plan.

Our role as an anchor institution 

According to the Health Foundation, anchor institutions are large organisations that have a significant role to play in their local community. The size, scale and reach of the NHS means that it influences the health and wellbeing of local communities simply by being there. 

The Health Foundation's ‘Building Healthier Communities - The Role of the NHS as an Anchor Institution’ report identifies five ways in which NHS organisations act as anchor institutions:

  • Employment
  • Procurement and Commissioning 
  • Use of capital and NHS estates
  • Environmental sustainability
  • Partnership Work with place-based partners. 

The Health Foundation argues that the NHS must use its actions and considerable influence to have a positive impact on the health and wellbeing of the communities it serves by placing social value at the heart of its daily operations. That is why our role as an anchor institution is at the heart of the actions we are taking to tackle health inequalities in Lancashire and South Cumbria. 

Social Value Strategy Social Value Strategy

The importance of social value

Social value is a ‘catch-all’ term used to describe the difference we can make to the communities we provide services to. Social value matters because it is the right thing to do. 

Social value encompasses all activity across our organisation. It goes beyond the financial bottom line; it includes employment, training and education, commissioning or procurement, investment and service delivery. It also includes how we go about doing our work, such as the ethical approaches we consider, the community engagement we undertake through to the collaboration we have with partners and wider stakeholders. 

The purpose of social value is to deliver an impact within the community. This can be through reducing health inequalities, increasing the diversity of our workforce, retaining and attracting talent and skills to the area, improving the health and wellbeing of our communities and colleagues, through to increasing economic prosperity in the region and improving the environment.

You can find more information about all the great work that is being done with local communities in our Social Value Strategy Framework. 

Where you can find support 

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Get in touch

Chorley and South Ribble Hospital

Preston Road

Chorley

PR7 1PP

01257 261222

Royal Preston Hospital

Sharoe Green Lane

Fulwood

Preston

PR2 9HT

01772 716565

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