CLAHRC YH Public Health & Inequalities Theme 4 th Meeting of the Public Health and Inequalities Advisory Group Tuesday 9th June 2015, 10 to 1pm (with a buffet lunch provided from 12 to 1pm) Venue: Board Room, Sir Frederick Mappin Building, Mappin Street, Sheffield, S1 3JD Present: Mark Gamsu (Chair for Kate Pickett)

Catherine Homer

Jo Cooke

Sarah Salway

Liddy Goyder (Theme Lead)

Diane Bell (for Alison Patey)

Susan Hampshaw

Emma Howard Drake (for Giles Ratcliffe)

Janet Harris

Ian Copley

Lynne Carter

Ellie Holding (for Clare Relton)

In attendance: Apologies: Alison Patey; Andrew Furber; Andrew O’Shaughnessy; Angela Tod; Annette Haywood, Clare Relton; Charlotte Orton; Emma White; Jo Abbott; Louise Brewins; Judith Hurcombe; Julia Burrows; Kate Pickett; Liz Such; Tom Sanders

NOTES 1. Welcomes and introductions Thank you to Mark Gamsu for chairing this meeting. The group welcomed Emma Howard Drake who represented Giles Ratcliffe from North Lincolnshire Council. 2. Matters arising from 5th March Advisory Group meeting  The matters arising from the last Advisory Group meeting are addressed under the agenda items below.  Actions to share reports and contact details will be checked outside the meeting. Post meeting note: actions have been completed. 3. NIHR Mobilisation Fellowships. Janet Harris and Lynne Carter Janet Harris and Lynne Carter presented their NIHR Mobilisation Fellowships to the group (summary of projects previously circulated with meeting agenda). Janet Harris: Knowledge brokering in Sheffield: Commissioning Community organisations to address the health and wellbeing agenda. Knowledge brokering may be a useful approach to foster exchange of information and facilitate evidence informed decision making on the contribution of community programmes to integrated health and wellbeing programmes. Research indicates, however, that linkages promoting knowledge exchange can be constrained where there are formal contractual arrangements and competition for scarce resources. Collaboration can also be affected by ‘fault lines’ that arise when trying to combine research evidence with technical and prudential knowledge – the wisdom and experience which are represented by community organisations in the design and implantation of their services (Ward et

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al, 2014). Valuing different types of knowledge can bridge this gap, but very little research has been done where examining the utility of knowledge brokering is in synthesizing knowledge across health, wellbeing and community development sectors. This three-year Fellowship will be spent working with the Sheffield City Council, the CCG and community organisations to look at how interactions can be used to share knowledge and co-create an evidence base for commissioning community services which takes into account knowledge from community organisations, patients, the public, providers and local authorities. The outcome of the fellowship is to provide an evidence base for community organisations in Sheffield, to show what works in terms of knowledge exchange and to encourage questioning between workers and commissioners. The challenge of this was discussed. The process of getting a true dialogue between workers and commissioners takes time and doesn’t necessarily fit within the commissioning cycle. Lynne Carter: Mobilising knowledge about ethnic inequalities to improve access, experience and outcomes for Black and Minority Ethnic users of NHS services. Research evidence and other types of information show that healthcare access, service experience and health outcomes vary between ethnic groups. Currently this knowledge is rarely used to improve services. This fellowship builds on the Evidence & Ethnicity in Commissioning (EEiC) project led by Sarah Salway which explored the obstacles and enablers related to commissioning health services that better meet the needs of minority ethnic populations and thereby reduce inequalities. The fellowship will test a package of knowledge mobilisation (KM) tools which aim to support NHS commissioning staff make effective use of knowledge about these ethic health inequalities. Lynne Carter will be doing action research working as part of teams involved in NHS commissioning and gathering of data from these case studies about how well the KM tools work; whether they encourage greater demand for knowledge on ethnic diversity and inequality and whether they increase the confidence of staff involved in commissioning to use this knowledge. The group broke into pairs to discuss times when they had worked to put knowledge into practice, looking at one model of knowledge mobilisation. There was discussion around the importance of CLAHRC projects using knowledge-into-action models rather than focusing on publications. The barriers to knowledge are particularly important when focusing on sensitive issues such as ethnicity. The intended outcome of the fellowship is a set of tools and a community of people committed to using them.

4. Work package updates: Identifying and fulfilling priority evidence needs for Local Authorities (CH) CLAHRC YH themes were showcased at a networking event for colleagues across Yorkshire and Humber. The networking event aimed to:  Develop joint working opportunities between CLAHRC YH and LA’s, describe current work and expertise in CLAHRC YH  Plan support to address evidence gaps for LA’s  Access and work with academics to develop research proposals. 40 delegates attended the event representing 10 out of the 15 local authorities, with additional delegates from Public Health England, NHS England and the LGA.

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Presentations provided an overview of the core aims and objectives of CLAHRC YH and a summary of findings from a survey of Y&H Public Health structures and Health and Wellbeing Board priorities. Presentations were given from CLAHRC YH themes to share current research projects and potential areas for future collaboration with local authorities. The showcase event was the first in a series of CLAHRC YH workshops for local authorities and NHS partners. All presentations can be downloaded here: https://sites.google.com/a/nihr.ac.uk/clahrcyh/ourthemes/public-health-and-inequalities/theme-activity/2-4-generating-evidence-for-local-authorities Developments following the event:   

We are looking to formalise a role for LA reps working with CLAHRC – likely to be termed a LARK (Local Authority Research linK). VPH and CH will visit contacts from each LA to develop CLAHRC and LA partnerships Working with Management of Frailty Theme to run a workshop on implementing the frailty index Re-run the PH and LA survey to get an annual snap shot of changes in PH structure and priorities

The group discussed whether using the word ‘research’ engages LAs or deters them. It is important to frame research in a way that LAs identify with. Tailoring interventions to address ethnic inequalities (Sarah Salway) Liz Such has been very productive in developing this programme and a range of new bids, projects, and dissemination outputs since the last update were reported: 1. Bid for Sheffield CCG RCF funds for a study on innovation in improving access to primary healthcare for new migrant groups. 2. Paper on community researchers accepted subject to minor amendments for the new BMC journal Research Involvement and Engagement (Salway, Chowbey, Such and Fergusen) 3. First meeting of the Health Equity and Inclusion group in PH - several members of the PH and I theme will be contributing to the development of this with outcomes tied in with the CLAHRC 4. Abstract accepted on the review of pathways to poor health among the Roma for BSA MedSoc in Sept 2015. 5. Established contact with three community-level organisations in the region that deliver physical activity/exercise programmes to marginalised groups to add to the body of work on-going in this area. 6. The video has been finalised for the consanguinity work. To be evaluated. It was noted that this was particularly impressive given the part-time nature of Liz’s post. Mark Gamsu acknowledged the great level of detail involved in this work and suggested the possibility of dedicating more time for individual projects and workstreams within the Theme programme at future meetings. It was agreed that as well as presentations from other themes it would be worth dedicating more time at future meetings for presentation and discussion of these. Post meeting

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note: Over lunch there was further discussion of local authority representation at the Advisory Group and it was suggested, amongst other issues we might encourage attendance from some local authority and practitioner colleagues by flagging up in advance projects/topics that would be presented/discussed. Extending and targeting “Making Every Contact Count” interventions in the community (Annette Haywood) The project has ScHARR ethics approval and Cohort 1 (Review/Reassessment Team) will receive their training on the 22nd June. Donna Turner (MECC researcher, seconded from Sheffield Council) has been meeting with managers and talking to the teams at their team meetings and getting all the information ready to go out to staff. The programme is being reviewed with the leads for smoking, nutrition, alcohol and intelligence. A regional event was held on 20th April, which enabled the team to gather and share information about MECC across the region. The hope is we can learn from the Sheffield example of MECC, and discuss how it compares with other people’s experiences. One aim of the evaluation is to explore whether MECC will have a positive impact to the health and wellbeing of staff. This is an area of concern for councils and other organisations. Concerns were raised that the way the programme is introduced was crucial and there was a risk if it was seen as managerially imposed and not as a positive or voluntary initiative. If staff are mandated to attend training outside their job role they may fail to engage. Past evaluations of MECC staff reported difficulties with exploring sensitive issues. To evaluate MECC within a CLAHRC framework it is important to examine what we mean by MECC and how organisations motivate people. Expansion of the Yorkshire Health Study (Annette Haywood/Ellie Holding for Clare Relton) Longitudinal data from around 5000 people who completed the 2nd wave surveys is now available. The full dataset will be available towards the end of 2015 (around 11000 responses). We have been busy developing our publicity materials and identifying new pilot sites since the last management meeting. We are now working with a range of NHS, LA, sports and micro health organisations across Y&H. Pilots were launched at Rotherham and Doncaster councils using a variety of methods including video and emails. The University of Sheffield has sent an email to their Juice staff and Barnsley Health Trainers are recruiting across the service. Workshops have been run in partnership with Young Healthwatch and Chilypep (Children’s and Young People’s Empowerment Project) to engage young people and BME populations. Pilots with North Lincolnshire Council, Leeds City Council and Barnsley Hospital begin in the next few weeks. We are trying to engage with as many councils, universities and hospitals in the Y&H region in time for the ‘hard launch’ on the 9th-15th November 2015. During this week the study will be publicised through local TV, radio and newspapers. Pilots will run within our partner organisations and there is some discussion about organising local events around health and wellbeing. The target is 100,000 new signups by January 2016. Liddy suggested using some time at a future meeting to discuss the hard launch in more detail. ACTION: If you would like pilot the YHS in your organisation, please contact Annette or Ellie. Healthy Weight projects (PB) A day long Healthy Weight Stakeholder Event will take place on Thursday the 25th of June where we find out about some of the cutting edge research being undertaken by doctoral students and other researchers who are working in the area of weight and obesity across Yorkshire and Humber

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After hearing from them in the morning, we will use the remaining time to identify future opportunities for collaborative research and implementation work which delegates might want to take forward. This would take the form of identifying research questions, funding opportunities, potential collaborators and ways of taking these pieces of work forward. We are keen to involve as many colleagues around the region as possible, and this does not require a specialist knowledge of research methods, so please do come along. There will also be time for networking and sharing ideas with others from the region. The meeting takes place on Thursday 25th June, from 9 30 to 3 30 in room A225 of the Alfred Denny Building at the University of Sheffield. Grid reference E3 111 on the campus map http://www.sheffield.ac.uk/polopoly_fs/1.356816!/file/campus-map-az.gif 5. White Rose Studentships – update (KP) The White Rose student network is meeting Thursday 11th June. ACTION: KP will give an update from the meeting at the next PHI Advisory Group 6. Funding opportunities (Standing item) Potential in working in partnership with School for PH Research with funding for evaluations provided by Public Health England. If AG members have an idea for potential interventions, contact Annette, Liddy or Sarah Salway to discuss whether appropriate for this programme. 7. Local Authority/PHE updates PHE: Diane Bell - PHE are experiencing significant restructuring and change while working closely with LA’s on health and wellbeing priorities. Due to a government push on adult and child obesity, future work is expected in this area. Doncaster: Susan Hampshaw – Rupert Suckling appointed as DPH. The council are reviewing their performance, policy and research services to build more research capacity. Rotherham: Catherine Homer - Rotherham also has a new DPH, Terri Roach. It’s implementing a new operational plan where public health is sat under adult services, becoming a directorate of its own. New strategic directors will be in post from next March. 8. Any other business NHS projects: 2 projects funded by NHS England. One is looking at the evaluation needs assessment of Better Care Fund partnerships and how expertise in CLAHRC can support them, the other at the knowledge interaction cycle and actionable tools, focussing on NIHR outputs e.g. training packs and patient decision aids. The projects will provide key outputs for NHS England. There is a regional PH conference on the 5th of November organised by Y&H DPHs and Carol Massey from PHE. The event is likely to be held in Sheffield at the Edge, Endcliffe Village, hosting around 200 delegates. The aim is to encourage networking and sharing practice across the region. The deadline for abstracts for workshops and presentation is mid-August and a call will be circulated shortly. Date of next meeting: Tuesday 8th September 2015, Pemberton Room, Second Floor, School of Health and Related Research (ScHARR), 10am to 1pm

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Date and Time of future meetings Tuesday 8th December 2015 – 10am to 1pm

Venue Faculty Board Room, Mappin Street, Sheffield

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Notes ADVISORY GROUP 9th June 2015 FINAL.pdf

evidence informed decision making on the contribution of community programmes to integrated. health and ... represented by community organisations in the design and implantation of their services (Ward et. Page 1 of 6 ... done where examining the utility of knowledge brokering is in synthesizing knowledge across health,.

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