Inclusion health addresses the health and social needs of socially excluded individuals who face multiple overlapping risk factors such as poverty, violence, and complex trauma. These factors often lead to barriers in accessing healthcare, resulting in poor health outcomes and health inequalities, including a lower average age of death. Common barriers include low engagement with services, difficulties accessing services due to transport or technology, challenges in understanding the healthcare system, stigma, negative past experiences, and language barriers. Inclusion health groups encompass people experiencing homelessness, people experiencing substance dependence, vulnerable migrants and refugees, Gypsy, Roma, and Traveller communities, individuals in contact with the justice system, victims of modern slavery, sex workers, LGBTQIA+ members, and other marginalised groups.
This needs assessment has reviewed both quantitative data and qualitative insights regarding the status of inclusion health groups in the East Riding. It incorporates feedback from professionals on their work with inclusion health groups and the challenges they face. The evidence was gathered through several methods, semi-structured interviews with professionals across East Riding to obtain in-depth views on current practices, challenges, and successes, a co-production initiative with HEY Smile Foundation, where we created a system map of health and VCSE services in Bridlington, identifying strengths, gaps, and areas for improvement; a consultation event with Public Health, HEY Smile Foundation, and local voluntary and community groups in Bridlington to gather local perspectives on inclusion health needs; and online surveys distributed to both professionals and the VCSE sector to collect broad feedback on inclusion health services. The semi-structured interviews also aimed to strengthen relationships with professionals, using their knowledge to guide our approach to working with those facing inclusion health challenges.
The needs assessment is an iterative process and following its initial publication, a phase of consultation and relationship building with people with lived experience will be undertaken. These insights will help to develop an action plan around the recommendations in order to accurately understand and comprehensively address unmet needs.
Recommendations within the document include:
- Deliver services flexibly
- Options such online video appointments, evening and weekend options, ability to reschedule and Did Not Attend policies can help to overcome barriers to accessing services
- Increase shared learning, shared best practice, and adaptability
- Learn from the parts of the system which are working well in terms of engaging with inclusion health groups and improving health outcomes.
- Develop the workforce and improve awareness of inclusion health
- Health care professionals and those working with inclusion health groups should be trained to recognise and address inclusion health needs, including cultural competency and education around the wider determinants of health.
- Targeted awareness campaigns, training programmes should be implemented, with leadership championing these initiatives
- Increase collaboration and partnership working across the conditions of living
- Holistic approaches to health using multidisciplinary teams and sharing expertise across the system should be implemented where possible.
- Support and develop VCSE networks linked with inclusion health groups
- Increase awareness and understanding across the VCSE sector of the nature of inclusion health and the importance of inclusion health work. Continue to support with the development of training and education for VCSE networks.
- Improve collaboration between VCSE groups, local authority, and local health and care providers, increasing VCSE representation in multidisciplinary meetings and strategic- level influence.
- Support capacity-building across the VCSE, commissioning into the VCSE where there are existing trusting relationships where possible.
- Recommendations for specific inclusion health groups
- Are available on page 3 onwards of the document.
The East Riding Inclusion Health Needs Assessment document can be viewed and downloaded below.