Tackling Causes and Consequences of Health Inequalities

Dr James Matheson Dr James Matheson graduated from St George’s, University of London in 2009. He trained in Lancashire and Cumbria before moving to work with Hope Citadel Healthcare, a Community Interest Company which provides primary care in areas of concentrated disadvantage. He has worked overseas and has published in the area of humanitarian disaster response, teaching around this subject at St George’s, and holds the Diploma in the Medical Care of Catastrophes. Dr Matheson is passionate about addressing causes and consequences of health inequalities, working as a General Practitioner and teaching and training the next generation of GPs to guard the health of our patients. He is a visiting senior lecturer at Manchester Metropolitan University and, through the Shared Health Foundation, teaches on a number of courses from undergraduate to postgraduate level on subjects around deprivation medicine, health inequalities and the social determinants of health. Dr John Patterson Dr John Patterson is Medical Director of Hope Citadel Healthcare, a Social Enterprise working within the NHS, running practices and walk-in centres in hard-pressed neighbourhoods around Greater Manchester. They currently run nine practices serving a population of 31,000. Dr Patterson is lead for Focused Care, which supports the most vulnerable and needy households. Dr Patterson also works within Oldham CCG. His role initially concentrated on Quality, Innovation, Productivity and Prevention (QIPP) and Medicines Optimisation. Building on previous great work and working with an exceptional team, the CCG has seen a reversal of the largest per capita prescribing spend in the country as well as significant improvement in the quality of prescribing. From 2018 he has taken over the role of Chief Clinical Officer When not at work he is busy getting in trouble with his wife by re-enacting famous Irish Rugby victories with their four willing children. Dr Laura Neilson Laura Neilson works in Greater Manchester trying to reduce health inequalities. She set up Hope Citadel Healthcare 10 years ago when she was a medical student. Hope Citadel provides GP services in areas of deprivation, currently holding 3 CQC outstanding awards and running 9 practices. Laura also runs the Shared Health Foundation, an organisation funded through philanthropic donations. Shared Health Foundation pilots innovative approaches to reduce harm from health inequalities and currently delivers work for; young people who are self-harming, families living in temporary accommodation, health literacy for parents of under 5’s and a advocacy for young carers. Together with the great team she works with developed Focused Care, a project based in 50 GP practices in Greater Manchester which makes invisible patients visible, unpicks the story behind the story an allows our hard-pressed households to thrive. Laura also works in A&E as a regular doctor! She won the HSJ ‘Rising Star’ Award in 2016 for her "inspirational style" and teaches on health inequalities. She has three boys and is therefore somewhat of an expert by experience in Minecraft and Harry Potter.

Contents

Foreword by Michael Marmot

Introduction

Part One: Setting the Scene








An Insight from the Frontline



An Introduction to Health Inequalities



A Multi-level Approach to Treating Social Risks to Health for Health Providers



A Tale of Two Cities – Hull and York.


Part Two: Knowledge and Skills




Our Patients and the Benefit System



Fuel Poverty and Cold-Related Ill Health



Child Safeguarding and Social Care



Domestic Violence and Abuse



Substance Use: Our Patients, Drugs and Alcohol



Addressing Smoking Cessation in Areas of Deprivation



Safer Prescribing: The Threat and Challenge of Caring for People with Chronic Pain



Persistent Physical Symptoms



Social Prescribing: Connecting People for Health and Wellbeing



Why do People not Engage with Healthcare?



Managing Difficult Conversations



Motivational Interviewing



Person-Centred Care



Trauma-Informed Care



Building Resilience Through Self-Care



Medical Advocacy: The Duty of Physicians as Advocates
Part Three: Populations and Groups




Child Health



Tackling Health Inequalities in Adolescence



Understanding and Responding to Complexity in Young People



Addressing the Health and Wellbeing of Young Carers



Women’s Health and Health Inequality



Men’s Health



Ageing Unequally



Improving health and healthcare experiences of Black, Asian and Minority Ethnic (BAME) communities?



Engaging with the Health Issues of Gypsies and Travellers



The Health and Wellbeing of Asylum Seekers and New Refugees



Homeless Healthcare



Veterans’ Health



Working with People in Contact with the Criminal Justice System and in Secure Environments



Mental Health and Primary Care Management of Complex Psychiatric Conditions
Part Four: Successful Models of Learning and Practice




A GP Curriculum for Health Equity



Examples of Innovative Service Models across the UK



Widening Participation in Medical Education