Guidance

NCHI: written and visual examples of local practice

Published 15 September 2015

Context to the NCHI

Reducing health inequalities is central to Public Health England’s (PHE’s) work. However, it’s not always easy to describe what they are. We often get tangled up in technical language.

The National Conversation on Health Inequalities (NCHI) builds on a strong tradition of engaging with communities in England.

Evidence, facts, and figures are vital for creating effective policies to reduce health inequalities. But understanding what communities want is just as important for making effective services.

NCHI is aimed at developing a common language and understanding around health inequalities and, with local partners, encouraging and empowering local communities to act on them.

We launched the programme with a toolkit outlining 7 principles for local conversation on health inequalities, and held an event for our stakeholders in June 2014.

Following on from that, we commissioned Taylor Nelson Sofres, British Market Research Bureau (TNS-BMRB) to develop a series of practical written examples of local practice and photo-stories. They cover:

• housing
• employment
• education
• communities

These stories describe people’s lived experiences of health inequalities and how support in some of these important areas can make a huge difference to their health, wellbeing and social situation.

These examples highlight the interrelationships between health and other policy areas and promote the importance of holistic services and policy making.

Audiences and ways to use examples of local practice

The examples can help:

• professionals at a local level (for example clinical commissioning groups, police, fire and rescue service, clinical commissioning groups, providers of local services)
• local government and councillors
• voluntary sector organisations
• members of the public and communities

Professionals can use these stories in:

• running public engagement or consultations with local communities
• advising local councillors, politicians and leaders to take action
• contacting other partners, like service providers who could collaborate in addressing health inequalities with illustrative examples
• speaking to varied audiences: the stories are a practical tool, showing the impact of local practice and the ‘art of the possible’ in order to promote local conversations and practical action

Members of the public and communities can use stories to:

• illustrate the nature of health inequalities and enhance understanding for individual and in group settings to enable self-advocacy
• inspire action among groups that may have an interest in reducing inequalities: peer-support networks, public and patient involvement groups, community groups that bring people together to learn about health inequalities and ways to improve health and wellbeing
• provide examples of best practice in addressing health inequalities and improving health and wellbeing outcomes at a local level

Approach

Working with local partners, this programme aims to develop a common language around the issue, establish a better understanding of how the public recognise health inequalities, identify potential opportunities for innovative communication and action, and empower local communities to act.

Building on the toolkit for local dialogue, PHE commissioned TNS BMRB to develop a range of multimedia video stories to illustrate the impact that local services can have on an individual’s life and wellbeing. The project focuses on 4 social domains: employment, housing, education and community. These examples of local services demonstrate how support, which addresses employment, housing, education, and community need, can also have wider outcomes health and wellbeing.

A range of organisations were identified by PHE as having projects that were examples of best practice. They were invited to submit a written or visual case study to illustrate how their service can help impact on people’s health and wellbeing. A short list of 8 examples was then selected, all of which illustrated good practice and delivered support with measurable impacts.

The team visited the selected organisations to meet both service users and staff, observe the training and support provided to users and gain an understanding of the issues experienced.

A second research visit was then made to conduct a more in depth information gathering on each project. This involved structured interviews with individuals in some services to illustrate complex issues faced by service users. Project and strategic staff were also interviewed to explore how project work, community action and partnership working addressed the issues and benefitted individual and local communities.

PHE and TNS-BMRB then selected 4 local examples to develop multi-media photo stories. It was important to identify an individual story of how a service had helped to address housing, employment, education and community issues, and the resulting effect this service had on people’s lives. All participants who took part in a full visual story received £80 as a thank you for their time.

TNS-BMRB worked closely with organisations to identify those individuals who were in a position to participate and understood the purpose of the research. All participants agreed to take part before taking part in interviews and photo shoots. The nature of their consent and use of their data was discussed in detail: they learned how the photo stories would be used and shared with the public. The participants had the right to withdraw at any time in the interview process or after the interview. All participants were given the opportunity to view their photo story (video), and were asked to provide final confirmation that they agreed the content and dissemination of the film.

Citing the examples of local practice

The examples of local practice may be cited, respectively, as follows:

Public Health England. 2015. National Conversation on Health Inequalities. Written and visual example of local practice. London: PHE

Individual case studies may be cited as follows:

• Public Health England. 2015. National Conversation on Health Inequalities. Education example of local practice. London: PHE
• Public Health England. 2015. National Conversation on Health Inequalities. Employment example of local practice. London: PHE
• Public Health England. 2015. National Conversation on Health Inequalities. Community example of local practice. London: PHE
• Public Health England. 2015. National Conversation on Health Inequalities. Housing example of local practice. London: PHE

For queries relating to this document and the NCHI, please contact the programme lead: Lina Toleikyte (Health Equity Unit, PHE).