Health and Wellbeing Board	19 November 2025
Report of the Director of Public Health

Progress Against Goal 6 in the Joint Local Health and Wellbeing Strategy 2022-2032

Summary

1. This paper provides the Health and Wellbeing Board (HWBB) with an update on the implementation and delivery of Goal 6 in the Joint Local Health and Wellbeing Strategy 2022-2032. It also includes information on performance monitoring.

2. The Board are asked to note the report.

Background

3. At their March 2023 meeting Health and Wellbeing Board members agreed an action plan and population health outcomes monitor to gauge delivery of the goals and priorities in the current Joint Local Health and Wellbeing Strategy. Progress reports on the action plan have been provided at HWBB meetings over the last two years.

4. At their meeting in March 2025 HWBB members agreed a revised action plan for the next two years. Progress reports on the actions within this will be presented to HWBB members over the course of the next 18 to 24 months.

5. The population health outcomes monitor agreed in 2023 remains the same and regular updates will be provided as annexes to these progress reports.

6.  At the last meeting of the HWBB updates were given on Goal 5 in the strategy. This report sets out updates on the four actions associated with Goal 6 in the current strategy ‘Reduce health inequalities in specific groups’.

7. Population Health Outcomes Monitor: this is linked to the ten big goals and is designed to provide board members with a holistic view of whether the strategy is making a difference to the health and wellbeing of York’s population, using outcome data rather than data on what health and care services are ‘doing’. Today’s updates at Annexes A & B to this report provide information on Goal 6.

Progress Updates

Goal 6: Reduce Health Inequalities in Specific Groups:

8. Updates on these actions have been provided by the Public Health Team; York CVS and the ICB.

9. Action 18: Implement a community-based intervention to reduce health inequalities focused on Children and Young People, working with the Voluntary, Community and Social Enterprise sector.

Ø In Spring 2025, a Children and Young People's (CYP) Priorities and Workplan 2025-28 for York was agreed, with priorities around Speech, Language and Communication Needs (SLCN), Integrated Care Teams, Sensory Processing and Neurodiversity. Led by the Joint Commissioning Forum, this will guide integrated commissioning in this area and will look to improve outcomes for the most vulnerable children from inequalities groups.

Ø One project, funded through Health Inequalities (CORE20PLUS5), is currently in the co-production stage following extensive engagement with Voluntary, Community and Social Enterprise (VCSE) partners across the city. It was agreed that the most effective use of this funding for Children and Young People (CYP) would be to focus on a small cohort identified through the CORE20PLUS5 framework. This approach will deliver a multi-disciplinary, holistic intervention through collaboration between providers, ensuring care is person-centred and tailored to individual needs.

Ø The service specification will be designed to encourage closer partnership working among the many VCSE organisations already supporting CYP in York. By strengthening links with statutory services, health professionals, local area coordinators, and pastoral leads, the aim is to provide integrated support for children, young people, and their families, reducing the risk of escalation to more intensive physical or mental health services.

Ø The ethos of this funding is to create a longer-term (three-year) initiative. It is anticipated that delivery will commence in early 2026. To drive this work forward, a lead VCSE delivery partner will be appointed by the end of November. This partner will oversee the process, award grant agreements to participating VCSE providers, and ensure robust evaluation and reporting throughout the life of the grant.

10. Action 19: Improving chronic disease prevention, diagnosis and outcomes in CORE20PLUS5 groups (those facing the largest health inequalities) through enhancement to the Quality and Outcomes Framework (QOF) in General Practice

Ø The Inclusion Health Register Pilot in York was a pioneering initiative aimed at improving equity in healthcare by identifying and supporting some of the most vulnerable populations. Using a data-driven approach, the pilot focused on coding patients from Inclusion Health groups within GP systems. The project achieved a 32.18% increase in coded patients, equating to an additional 2,667 individuals formally recognised across participating practices. This pilot has paved the way for our focus on chronic disease prevention, diagnosis and outcomes in CORE20PLUS5 groups.

Ø This ambition continues to be a central focus for York. Initially, this work was to be advanced through enhancements to the Quality and Outcomes Framework (QOF+) within general practice. However, following recent developments, a system-wide Inclusion Health Enhanced Service (LES) is now to be offered across the whole ICB footprint, providing a more unified and comprehensive approach.

Ø The Inclusion Health LES is designed to ensure that individuals from groups facing the most significant barriers to health are proactively identified and supported within primary care. This service introduces annual enhanced health assessments, trauma-informed care, and strengthened community partnerships, all underpinned by improved data collection and flexible, culturally competent care pathways. For York, the LES offers significant benefits. It provides a universal uplift across the system while allowing flexibility to respond to local priorities.

11. Action 20: All partners to adopt and implement the standards developed by the Poverty Truth Commission

Ø In March 2025, City of York Council adopted the standards developed by the Poverty Truth Commission (PTC) through an Executive meeting, and there has been a large amount of work on disseminating these standards through staff communications and protocols.

Ø This is now being extended to health partners, with the PTC standards embedded in the practice model for neighbourhood working which is being worked up between health and the local authority

12. Action 21: Work towards establishing a Poverty Truth Commission for Children

Ø Work has now commenced on establishing a Poverty Truth Commission for Children. Doing this requires a different approach from the adults PTC which ran between 2022 and 2024, and York CVS are leading an initial planning process which aims to produce a commission highlighting the experiences and voices of young people in the city experiencing poverty and bringing their input together with decision makers.

Consultation and Engagement

13. As a high-level document setting out the strategic vision for health and wellbeing in the city, the current Joint Local Health and Wellbeing Strategy capitalised on existing consultation and engagement work undertaken on deeper and more specific projects in the city. Co-production is a principle that has been endorsed by the HWBB and will form a key part of the delivery, implementation, and evaluation of the strategy

14. The actions in the action plan have been identified in consultation with HWBB member organisations and those leading on specific workstreams that impact the ten big goals.

15. The performance management framework has been developed by public health experts in conjunction with the Business Intelligence Team within the City of York Council.

Options

16. There are no specific options for the HWBB in relation to this report. HWBB members are asked to note the update and provide comment on the progress made.

Implications

17. It is important that the priorities in relation to the current Joint Local Health and Wellbeing Strategy are delivered. Members need to be assured that appropriate mechanisms are in place for delivery.

        Recommendations

18. Health and Wellbeing Board are asked to note and comment on the updates provided within this report and its associated annexes.

Reason: To ensure that the Health and Wellbeing Board fulfils its statutory duty to deliver on their Joint Local Health and Wellbeing Strategy 2022-2032.

Contact Details

Author:	Chief Officer Responsible for the report:
Compiled by Tracy Wallis Health and Wellbeing Partnerships Co-ordinator	Peter Roderick Director of Public Health
	Report Approved	Date
Specialist Implications Officer(s) None
Wards Affected:			All	ü
For further information please contact the author of the report

Annexes:

Annex A: HWBB Scorecard (for Goal 6)

Annex B: HWBB Trends (for Goal 6)