This week’s leadership message comes from Robin Tuddenham and Dr James Thomas

We want everyone living in West Yorkshire and Harrogate to live a long and healthy life. Most of what keeps us healthy and well is a wider set of factors than traditional health and care services. For example the place where we live, whether we feel isolated or alone, the food we eat, if we have someone to love, whether we have a job and access to green spaces. They are all critical to whether we live a good life. What we know is that to improve our population's health we need to tackle the inequalities than exist, the lived experience for some of our citizens which can act as a barrier to living a larger life.

Our programme aims to challenge traditional ways of working so we see the whole needs of people, and understand better what causes or exacerbates ill-health and what keeps people well now and in the long term. It is not an ‘add on’ or afterthought; we are ambitious and determined to reshape the way we deliver health and care across our partnership.

It’s a stark fact that women in our most deprived communities live around eight years less and men live around 10 years less than those in our least deprived areas. The statistics are both worrying and challenging - there is a lot to consider. People living in areas with the most disadvantages are also more likely to have a long term illness or disability and to have been diagnosed with stroke or lung cancer than others. They are also more likely to be living with risk factors for disease such as higher smoking rates and levels of childhood obesity.

In West Yorkshire and Harrogate the leading cause of death is cancer which accounts for just over a quarter of deaths as a whole. This is followed by heart disease and stroke, which account for a quarter of deaths. The most obvious question is what are we going to do about and how will we know our collective action has made a real, positive difference to people’s lives?

Critical to any difference we can genuinely make is the way we work with colleagues in our six local places (Bradford district and Craven; Calderdale, Harrogate, Kirklees, Leeds and Wakefield). The role of voluntary and community organisations is also vital. From the very smallest volunteer-led community group, to the largest not-for-profit organisation, they often have established high levels of trust with people who may have faced multiple barriers when accessing statutory services. They have a strong empathy and knowledge of the people and diverse communities they serve. They are often rooted in that community or work in ways that empower people to bring about their own lasting change. Working with them as equal partners is paramount.

If we want to break down unjust difference in life opportunities we need to reduce the gaps in health we know exists, for example nationally over 600 people a day quit their jobs to care for a loved one; in West Yorkshire and Harrogate there is a gap of between 6.2% (Craven) and 14.5% (Wakefield) in the employment rates for those people living with a long term health condition and overall employment. In 2014 it was estimated that close to 5,000 people aged over 65 living alone in Calderdale felt lonely or trapped in their own home. This is where working at a West Yorkshire and Harrogate level really matters because we can share the work of other programmes, such as the Cancer Alliance, and share and spread good practice already taking place at pace.

We also know that people living in more deprived and more urban areas have less access to green space to exercise safely and have higher proportions of fast food outlets both of which impact on levels of obesity. People in living in poorer communities and also those in routine and manual occupations are more likely to smoke than the rest of the population; people living with learning disabilities and/or mental health conditions are more likely to die prematurely. Working with the health and care champions (people with lived experience), enables us to look at the barriers they face but most importantly take collective action to improve.

Working as a Partnership, and importantly together, with communities gives us the opportunity to help create the conditions for people to be healthy, to reduce the things that contribute towards poor health and wellbeing, and do more to promote the things that keep us well.

We have a strong relationship with the West Yorkshire Combined Authority who is working through the Leeds City Region Local Enterprise Partnership to develop the Local Industrial Strategy. This is a long-term, evidence-based plan to strengthen local economic growth, reduce health inequalities and improve skills, productivity and the earning power of people and the region as a whole. For example, we can make a big difference by working together on healthy work places that support and encourage healthy behaviours – for us all.

Whilst on the theme of employment the main causes of long term sickness, are musculoskeletal problems and mental ill health – understandably these impact on the years spent in good health.

We have a higher rate of people not in work than the rest of the country and for those in work, 25% of the jobs in our region pay below the living wage. One in three people in our workforce have a long term health condition that can sometimes affect their ability to work, or reduce their ability to work full time or for as many years as they would like before retirement. Working with the employers in West Yorkshire and Harrogate we can help them to understand the role they play in promoting good health and contributing towards the local economy, providing healthy workplaces that promote physical activity, active travel and good mental health. As a Partnership we can work much better together to reduce inequalities by improving equal access to employment for people living with long term physical and mental health conditions and people from poorer socio economic backgrounds, as well as those with learning disabilities.

Together, we can work to reduce the number of people catching infections. By making sure people are diagnosed early and treated appropriately, we will also reduce the number of antibiotics prescribed where they are not needed. By sharing good practice and tapping into national expertise from Public Health England, we can drive lasting change.

We can improve population health at the same time as making climate friendly choices – such as improving walkways, promoting active travel to offset reliance on cars or investing in local food growing. People who live in our poorest neighbourhoods also have the fewest opportunities to benefit from outdoor play or recreation. We know that well maintained and spaces, such as small parks, community gardens or urban trails encourage physical activity.

We aspire to become a global leader in responding to climate emergency through reducing carbon through our buildings, our supply chains, how we travel and how we use digital technologies; as well as through rethinking and developing climate friendly products and practices throughout our health and care system. Key to this is encouraging people to use public transport to reduce carbon emissions and working with the Combined Authority and transport providers to improve air quality through clean transport, more green space and making active travel easier – all areas we know are important to them too.

As a Partnership we aim to add to the sum of our places. Tackling these determinants at scale and sharing the great practices that are taking place across our places is key to our Partnership’s success.

These are definitely ‘wicked issues’ and only as a partnership between health, local authorities and our citizens can we start to make a difference for our communities and those people that are at risk. You will see from our draft Five Year Strategy the importance our partnership places on these issues, and our commitment to working together on them.

We need to be bold, brave and compassionate; we need to be international trailblazers where others follow but most importantly we need to do this now if we want to ensure we are improving the wellbeing of people now and in the future in West Yorkshire and Harrogate.

Have a good weekend,
Robin and James