The Innovation Agency, the AHSN for the North West Coast, committed to undertake health equity assessments on all work programmes by March 2022.
These assessments would seek to identify where and how their improvement and innovation programmes might impact health equality. From these insights, they would take action to mitigate these impacts for particular groups and communities.
To tackle this objective, the Innovation Agency needed a practical framework that could be systematically applied to programmes or projects to identify and support local action. A Health Equity Working Group was set up, involving members across the organisation. They decided on Public Health England’s Health Equity Assessment Tool (HEAT).
HEAT is a tool consisting of a series of questions and prompts. Each is designed to help systematically assess health inequalities in programmes and identify what can be done to contribute to creating more equality.
HEAT is recommended as it provides an easy-to-follow template, one that the Innovation Agency could tailor to individual work programmes. Its prompts also speak to multiple dimensions of health inequalities.
Further information on Public Health England’s Health Equity Assessment Tool (HEAT) can be found on the gov.uk website.
The process needed to be tested, so the Patient Safety and Care Improvement (PSCI) team piloted a retrospective project assessment with the HEAT tool.
After establishing its effectiveness, the Innovation Agency coordinated PHE-run training sessions for its staff. They also created a working group to design a process for equity assessments across the organisation. This group was also charged with developing guidelines to help the Innovation Agency incorporate health equity assessments into the innovation pipeline when working directly with SMEs.
The Innovation Agency segmented the programme into four stages:
- A training session to help colleagues identify appropriate health inequalities data and support the initiation of the HEAT process.
- A refinement of HEAT with assistance from an internal panel to create a collaborative document that includes reflective feedback from colleagues with diverse experiences and backgrounds.
- A further refinement of HEAT with assistance from a North West Coast (NWC) community panel to provide reflective feedback on whether the process is equitable for NWC communities.
- An assurance framework to capture HEAT insights, sharing learnings amongst staff and ensuring best practice methodology. This includes measuring success and identifying barriers to implementing HEAT in practice.
The HEAT process identified specific health equity actions, and the Innovation Agency are starting to shape the work programme as follows:
- Tailoring care bundles to patients’ individual needs
- Improved accessibility options on a respiratory website aimed at patients, carers and clinicians
- Joining patient and carer forums to understand common issues and challenges
- Engaging with patients and carers to gather feedback and use this to improve processes.
The Innovation Agency is now applying the HEAT process to its broader portfolio of programmes. The health equity process will be integrated into standardised project management processes in order to ensure sustainability.
- They found HEAT can be used alongside other techniques in a variety of ways, so it’s essential to establish a process.
- It was important for executive and senior management to provide support. Without it, staff can struggle to prepare and deliver a draft HEAT and, in particular, balance it with their current work capacity.
- HEAT can be integrated more easily into some AHSN innovation programmes due to the outcome measures. For example, the Innovation Agency were able to integrate it very effectively with patient safety-related projects. However, they needed to adapt it across different organisational departments and workstreams.
- They can enable work programmes to align with the current national focus on health inequalities by integrating health equity assessments to align with and reference Core20Plus5, the NHS England and NHS Improvement 2021/22 health inequalities initiative.
- It was essential to establish a community panel to represent groups most at risk of suffering health inequalities and to improve accessibility to these communities by working with them in their own community settings.
Access more learning case studies – Diversity and Innovation Progress and Learning Report 2022.