Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

ICS Priority 2: Support our communities and places to be healthy and sustainable

ICB Strategic Priority: Increase the numbers of citizens taking steps to improve their wellbeing

ICB Challenge:    

  • Growing numbers of frail and older people, and people with multiple conditions.
  • Health inequalities are most stark in Harlow, Stevenage, Watford, Welwyn Hatfield, and Broxbourne.
  • Those in the most deprived areas die 3-4 years earlier and spend up to 18 years longer in a state of poor health than those in the least deprived areas.
  • On average, rough sleepers die 30 years earlier than the general population.
  • Unpaid carers provide critical support for people with health and social care needs. The support provided by carers is often physically and emotionally demanding, with consequences for carers’ own health and wellbeing.

Expected outcomes:    
We will work with our communities to improve our residents’ health and wellbeing by reducing health inequalities and taking action on the wider determinants of health including housing, employment and the environment

Governance Groups    

  • ICS Health Inequalities Strategic Board and the Health Creation Strategy Group    
  • ICS Prevention Board

What our residents say:
Our ICS commissioned online focus group sessions in early November 2022, to hear from stakeholders who work with or represent seldom heard communities. Each group brought together representatives who work closely with specific groups including BAME; Children and Young People; People Living in Poverty; and a General Inclusion Group. This qualitative work brought these issues to light:

“Those people from deprived backgrounds on low-income jobs who are not able to afford appointments [as they are] working very long hours, very scared to take time of work, in terms of not getting time off work or would lose money to get appointments by GPs.”

“We need to be aware of the physical barriers like public transport and the cost of getting to these locations for these appointments”

“The built environment has a huge influence on people's health in the long term, can we get a better built environment? Can we do better in terms of our housing stock? Can we do better in terms of, I mean, with the financial crisis coming along? How are we helping our residents in terms of economic support, jobs and so forth?”

“We do a lot of work with families with children who are under five in one of, if not, the most deprived neighbourhoods in Hertfordshire and you know what we're seeing there is, we're trying to kind of marry together, health and well-being education and learning and development of skills and your kind of trying to work against a centralised kind of mechanisms and it does make it quite challenging. So one thing is whilst looking at priorities, it's also about looking at the place’s priorities alongside those overarching ones and being able to be a little bit more flexible.”

The doctors don't live in the communities where the people live and they don't understand that you're having a choice between paying for the bus to go to the food bank or pay for the bus to go to see the doctor, and then you get a snotty note saying why didn't you turn up your appointment?”

Year 1 priority actions

  1. Increase access to self-help via primary care (additional roles, particularly social prescribing)
  2. Start engagement on our ICS Green Plan
  3. Undertake actions in relation to digital and planned care to support self-care and reduce demand / improve efficiency in outpatients.
  4. Increased work on suicide prevention (for Veterans in particular).
  5. Better identification of and support for carers (via VCFSE).

For further details about key deliverables across the next five years, please refer to pages 32 - 35 of the PDF.

Hertfordshire and West Essex Joint Forward Plan 2023 - 2028

Download the full plan