ADPH Minding the Gap News Brief @mindingthegapyh @ProfKEPickett #HealthInequalities #Publichealth @annettehaywood

Welcome to the One Hundred and Thirteenth edition of the ADPH Minding the Gap News Brief, the Yorkshire and Humber Health inequalities Programme.

Great North Run 2018

This year the Association for the Study of Obesity (ASO) have offered a place in the Great North Run. The wider issues related to Obesity are not well understood and why one person becomes obese opposed to another really does need investigation. The race takes place on the 9th of September and this year. It will be a challenge as I have to confess that the old bones are creaking even more than last year, however, I will not be beaten by something as insignificant as 13.1 miles of hideous pain and torture.

The ASO is the UK’s foremost charitable organisation dedicated to the understanding, prevention and treatment of obesity and aims to develop an understanding of obesity through the pursuit of excellence in research and education, the facilitation of contact between individuals and organisations, and the promotion of action to prevent and treat obesity.

I would really appreciate your support for ASO, both moral and financial; your support will help to get me through the bad times and the charity will benefit as well.

Donations can be made here

Health Impact, and Economic Value of Meeting Housing Quality Standards

It is well established that the UK is in a housing crisis, not just in terms of a shortage of homes and sky-high prices, but in terms of the poor state of existing homes. Four in ten British homes don’t meet the basic criteria to secure occupants’ well-being, according to a recent survey.

This research looked into individual measures to improve housing and their effects on the people living in them. The research also looked into costly hospital admissions for this study, but in the long term their reduction is likely to be only the tip of the iceberg in terms of saving NHS money and resources. There may also be an impact on GPs, outpatients and social care in the community. The report recommends that housing quality standards should be updated to include improvements to remove damp as a matter of primary health importance.


This Could Cost Lives: A Frontline View on the Funding of Supported Housing

Around 30,000 people severely affected by mental illness live in some form of supported housing. They often offer a lifeline for many people with mental illness, helping them get out of hospital and get their lives back on track. For mental health supported housing to fulfil its potential, it must have a firm financial footing, but this has been in doubt since 2015 as the Government has made a series of proposals to cap or limit money spent on this vital service.

The report highlights that it was the overwhelming view of the service managers and staff that the Government’s reforms will make mental health supported housing harder to access for the people whose lives it is designed to transform. The fact that 84% believed that their service could be threatened by these proposed reforms is a stark illustration of their potential harm. If enacted, thousands of vulnerable people could go without the support they need, and there would be enormous additional costs for the NHS. Yet the impact of these proposals should not be considered in pounds and pence alone. Mental health supported housing prevents people from being sent far away from their loved ones to places they don’t know.


The 100-Year Life: The Role of Housing, Planning and Design

The population of the UK is ageing, and homes that meet the needs of our ageing population will be increasingly in demand. While many people will stay healthy and fit for much of their later years, the likelihood of having one or more long-term condition,  physical or mental, that make day-to-day life at home more difficult does increase with age.

This paper outlines its conclusions under four key areas: integrating services; making finance more flexible; creating age-friendly communities – including homes and the built environment; and engaging with older people in designing new products from kitchens and bathrooms to transport. But, more broadly the paper suggests that If we are to be successful in creating homes and places which meets both fast rising demand, and the diverse and individual needs of older people, our thinking needs to be much broader. We need to consider how we help people afford better housing and plan their finances; how we develop long-term special plans and a workforce with the right skills; and how we use existing policy levers, such as expansion of personal budgets, to best effect.


The Social Determinants of Young People’s Health: Identifying the Key Issues and Assessing How Young People are Doing in the 2010s

This paper provides an overview of evidence on the social determinants of young people’s health. Drawing on a model of social determinants that includes money and resources, living conditions, family factors, peers and social groups, education and work and worklessness,. The research asked (a) what is known about the most important social determinants of health in the 12-24 age group and (b) what proportions of today’s young people experience the kinds of social disadvantage we know are associated with poorer health outcomes?

The research found that there are links between adolescent disadvantage and certain adolescent health outcomes and that young people in situations of disadvantage have poorer health outcomes and that this needs to be tackled. In addition, the paper suggests that it is clear that there are links between experiences as a young person and adult outcomes, and between childhood health difficulties and adult health difficulties. By measures known to be associated with later health, the report demonstrates that significant proportions of today’s young people aged 12-24 are experiencing disadvantage that is likely to be associated with poorer long term health outcomes.


That Age Old Question

Ageism is the most commonly experienced form of prejudice and discrimination, both in the UK and across Europe. Other forms of discrimination, such as racism and sexism, are rightly regarded as unacceptable, yet ageist assumptions and attitudes often go unchallenged. Negative stereotypes of older people as lonely, vulnerable, in poor mental and physical health, and an economic burden are sadly all too familiar.

This report reveals that ageist views are held across generations, and that an ageing society is viewed by many as a challenge rather than an opportunity. Tackling this issue will require a multifaceted approach and that’s why we have made a number of recommendations for tackling ageism aimed at a range of stakeholders, including national and local government, employers, the media, and the voluntary and community sectors.


Statistics on Smoking – England , 2018

This report presents a range of information on smoking which is drawn together from a variety of sources. The report aims to present a broad picture of health issues relating to smoking in England and covers topics such as smoking prevalence, habits, behaviours and attitudes among adults and school children, smoking-related ill health and mortality and smoking-related costs.



Childhood Obesity: A Plan for Action: Chapter 2

Childhood obesity is one of the biggest health problems this country faces. Nearly a quarter of children in England are obese or overweight by the time they start primary school aged five, and this rises to one third by the time they leave aged 11. Our childhood obesity rates mean that the UK is now ranked among the worst in Western Europe.

The burden of childhood obesity is being felt the hardest in more deprived areas with children growing up in low income households more than twice as likely to be obese than those in higher income households. Children from black and minority ethnic families are also more likely than children from white families to be overweight or obese and this inequality gap is increasing. We want to address these disparities to ensure that all children, regardless of background, have the best start in life.

The national ambition is to halve childhood obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030. Doing so will bring multiple physical health benefits and we aim to reverse the emergence of Type 2 diabetes in children.

Action Plan

Childhood Obesity: Government’s Plan Targets Energy Drinks and Junk Food Advertising

According to the BMJ, the commitments outlined in chapter 2 of the government’s childhood obesity plan are welcome, and represent a significant improvement on those in the first plan. The ambition “to halve childhood obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030” are positive goals but further steps will be needed if they are to be achieved.

The article suggests that the government has still not created a long-term child healthy eating strategy that is matched to the scale of the problem. There are still significant areas that have not been addressed and there appears to be a lack of urgency. Strong, robust and bold actions are needed now.


Dying On The Streets: The Case for Moving Quickly to End Rough Sleeping

Last year in England, more than 4,700 people slept rough on any one night, and a far larger number experienced rough sleeping during the course of the year. The number of people sleeping rough has risen by 169% since 2010, when the Government introduced the current method of counting. As the number of people sleeping rough has risen, so too has the number of people dying on the streets. The only area with consistent data on this is London, where 158 people who were sleeping rough died between 2010 and 2017.2 That is an average of one death every fortnight. More than half of those who died had a mental health support need recorded.

However, the report suggests that here is nothing inevitable about the rising number of people dying on the streets. With improved support and new interventions we can prevent the tragedy of future deaths and ensure people sleeping rough get the help they desperately need. The failings in the system which is supposed to get people off the streets are clear – overstretched outreach and support services, inadequate provision of emergency accommodation, and a failure to take safeguarding responsibility for the lives of some of society’s most vulnerable people. Urgent action is needed to change all of this.


The Power of Place: Health and Wellbeing Boards in 2017

This is the fourth report in a longitudinal review of health and wellbeing boards (HWBs). According to the report, the most important trend from this research is the decision by a significant number of boards to reassert a focus on the wider determinants of health and exercise a place leadership role. They are acting as the anchors of place in a sea of Sustainability and Transformation Partnerships (STPs), integration and new models of care.

The HWBs which have adopted this route see themselves as developing a wider and longer term place perspective that provides a strategic framework for more immediate and more narrowly focused activity. It helps the board to avoid the trap of “tick box sign off” of work that has been led elsewhere. And it gives the board ownership of the overall direction of travel of the local health and care system.


Don’t Eat the Chalk

Chris Gibbons is the Health Economics and Research Officer for Sheffield City Council. His blog re-examines and questions health investment, commissioning and decision making.

I know my recommendation to read will have no influence, but just take a look and make your own mind up!


Author Talks

Professors Richard Wilkinson and Kate Pickett are available to give talks about The Inner Level and inequality to interested audiences in the UK and across the world. They are particularly keen to spread the word to as many people as possible and so will prioritise larger audiences, ideally of 100 people or more.

They do not charge speaker fees but do ask that standard class travel costs (and accommodation costs if needed) are covered. They also invite donations to be made to The Equality Trust which we will be happy to discuss with you. Richard and Kate are based in York and the time and distance involved in travel to an event are factors to be considered when making the donation.

Ideally, they would prefer to do events during the working week but weekend bookings are possible and, again, are a factor to be considered when making the donation.

If you wish to book a talk, please email us and we will get in touch with you as soon as possible to make arrangements. Thank you for your support in the fight against inequality. It is not inevitable. We can build a better world where all can flourish.

The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Wellbeing 

(Richard Wilkinson, Kate Pickett)

Why is the incidence of mental illness in the UK twice that in Germany? Why are Americans three times more likely than the Dutch to develop gambling problems? Why is child well-being so much worse in New Zealand than Japan? As this ground-breaking study demonstrates the answer to all these hinges on inequality.

In The Spirit Level Richard Wilkinson and Kate Pickett put inequality at the centre of public debate by showing conclusively that less-equal societies fare worse than more equal ones across everything from education to life expectancy. The Inner Level now explains how inequality affects us individually, how it alters how we think, feel and behave. It sets out the overwhelming evidence that material inequalities have powerful psychological effects: when the gap between rich and poor increases, so does the tendency to define and value ourselves and others in terms of superiority and inferiority. A deep well of data and analysis is drawn upon to empirically show, for example, that low social status is associated with elevated levels of stress, and how rates of anxiety and depression are intimately related to the inequality which makes that status paramount.

Wilkinson and Pickett describe how these responses to hierarchies evolved, and why the impacts of inequality on us are so severe. In doing so, they challenge the conception that humans are innately competitive and self-interested. They undermine, too, the idea that inequality is the product of ‘natural’ differences in individual ability. This book sheds new light on many of the most urgent problems facing societies today, but it is not just an index of our ills. It demonstrates that societies based on fundamental equalities, sharing and reciprocity generate much higher levels of well-being, and lays out the path towards them.

Read more here

‘The Micawber Principle’ – Debt, Poverty, Employment, Benefits and Health

Link to presentations and workshops can be found here

Evaluation Report

Healthy cities: how to achieve a healthy population in an urban environment…

Venue:              Horizon Leeds, 2 Brewery Wharf, Kendell Street, Leeds, LS101JR

Date:                Tuesday, 17 July 2018

Time:                9:00 – 17:00

About this event

According to the World Health Organisation (WHO) now is the first time in human history that most of the world’s population lives in cities rather than in rural settings.

This event will explore how local authorities, NHS and third sector organisations are responding to this challenge and working together to improve health and wellbeing in urban areas.

Be inspired by international examples and learn how towns and cities across England are:

•taking different approaches to devolution

•integrating health and care services

•tackling health inequalities

•empowering citizens to act regarding their health

•promoting healthy lifestyles for residents

•tackling childhood obesity

•using data to improve population health.

Cost £240 – £538.80         To register click here

For more information about this event, please visit, email or 020 7307 2409.

Between Science and Policy: Interpreting and Practicing Knowledge Exchange in the UK Academia

Venue:             MED.L2.5, Medical School, Framlington Place, Newcastle University

Date:                Thursday 19th July 2018,

Time:               1.00pm – 2.00pm

This presentation will discuss preliminary results of my PhD research exploring two knowledge exchange-oriented organisations located at the UK universities.  Building on theories from STS and policy studies and using insights from organisation studies, the project explores ways in which cultural and institutional changes initiated by the new funding paradigms (e.g. moves towards knowledge translation and impact) have led to a reconfiguration of the relationship between science and policy.

The findings provide insights into the ways institutional change has occurred in academia, by employing the concept of institutional logics (Thornton, Lounsbury, & Ocasio, 2012). The multiplicity of factors leading to the introduction of changing research funding paradigms has resulted in the development of a new institutional logic guiding contemporary academic practices and understandings – the logic of impact. This new logic has emerged to co-exist and compete with the existing and historically developed logic of excellence. The logic of excellence, based on traditional values of science, views science as intellectually driven and underpinned by the freedom of inquiry of academics. By contrast, the new logic is problem-driven and assumes high levels of engagement with research users for the purpose of solving problems.

To understand this new institutional context of hybridity between two logics on a micro level, as well as its impact on knowledge exchange between science and policy and practice, the presentation will explore three areas: 1.) academic knowledge practices, 2.) framings of science and knowledge exchange and 3.) perceived boundaries between science and policy and practice. The overall argument put forward in this presentation is one of the symbiotic relationship between politics and evidence as two contradictory but co-dependent modes of governing.

“Preconception to Pension: Obesity through the Life Course”

 Venue:             Newcastle University, Newcastle upon Tyne

Date:                6-7th of September 2018

Programme Features: obesity and age-related disease; bariatric surgery and life stages; food insecurity and obesity, molecular aspects of obesity and reproduction and intergeneration

For more information click here 

Unsustainable Pressure? The Future of Health & Social Care

Venue:              Hayes Conference Centre, Derbyshire
Date:                11th & 12th October 2018

The conference includes Key Note Speakers:

Glen Garrod, ADASS President
Aileen Murphie, National Audit Office
Lyn Romeo, Chief Social Worker for Adults

Learn from practice. The Conference shares over 20 operational and strategic workshop sessions.

This not just another “conference”. It is the best training at the best price. Learn from colleagues who are doing the job and from cutting edge experts. Probably the best event of its kind and now in its 26th year, this is your conference and is organised and run by Commissioners for Commissioners and all those that have an interest in Health & Adult Social Care.

Price: only £175 plus VAT Early Bird (public sector)

According to the organisers the price includes, Fantastic presentations, overnight en-suite accommodation and all meals, a money back guarantee, the opportunity to network with commissioners and free taxi from Derby station (if travelling by train) and return after the event.

Bookings can be made Here

For a paper booking form contact or for further questions or queries call 07598450728 or 01926741811

For full details of the Minding the Gap data protection Transparency Notice statement please click here

If you have any queries around submitting an article for the Minding the Gap News brief please contact

Ian Copley, Project Co-ordinator, Minding the Gap  E-mail:

‘Over the Garden Fence’ Performed by @HayloTheatre ‏hosted by @JaneMckeown1 @sheffielduni ‏ #dementia Dementia friendly initiative @ShefSNM

You are invited to attend a Performance of
‘Over the Garden Fence’- Performed by Haylo Theatre

Be prepared to laugh but also to shed a tear (bring your tissues!) for this inspiring, thought provoking and emotional insight into living with dementia.

On: Tuesday 24th July 2018
At: Firth Hall at the University of Sheffield, Firth Court

Arrive at 10.45am for the Performance running from 11am – 12 midday

This performance forms part of the School of Nursing and Midwifery Dementia Friendly Initiative.

If you intend to come please let Jane McKeown know at: or 0114 2222071


Vacancy ~ @yqsrdotorg Senior Research Fellow ~ significant research project to develop & test an innovation in #patientsafety

The Yorkshire Quality and Safety Research group is seeking to appoint an enthusiastic, highly organised and motivated researcher, for two years in the first instance, to take a leading role in the conduct and management of a significant research project to develop and test an innovation in patient safety.

This exciting three-year research project, funded by the Medical Research Council, aims to develop and test a new portable, sensor-based naso-gastric (NG) tube placement device (NG-Sure) to enhance patient safety.

Specifically, the successful candidate will co-ordinate four of the five project workpackages which will include two hospital-based clinical studies (WPs 1 and 2) as well as taking a lead on the user-centred design workpackage with healthcare professionals, patients and carers (WP3), and the ‘first-in-man’ study (WP4). The successful candidate will also work closely with the project subcontractors who will be responsible for the technical development of the device (WPs 1-3), technical project management and governance, and economic evaluation (WP5).

We are therefore seeking a researcher with experience of both qualitative and quantitative methods to contribute to the project overall.

Following this, the successful candidate will be involved with others in the research team to develop funding applications to support research that may be needed beyond the lifetime of the project and support the work of the research group.

Medipex NHS Innovation Awards & Showcase closing date 11/07 @Medipex ‏@CATCHshef

“Medipex NHS Innovation Awards & Showcase

We are delighted to announce the launch of our 2018 NHS Innovation Awards. This event seeks to identify and celebrate the innovative ideas and people which drive our NHS. It is an opportunity to showcase outstanding projects and initiatives and to provide support to those with real value and potential to improve lives.

We are delighted to welcome our partner in delivering this event for 2018, Inter-Medi Group (IMG).

This year we are accepting entries into the following categories. If you wish to enter an innovation which you feel falls outside the scope please get in touch with the Medipex team for advice.

  • Medical Devices & Diagnostics

Innovations relating to the development of a new medical device, technology, piece of equipment or diagnostic tool.

  • Service Improvement – Primary Care
  • Service Improvement – Secondary Care

Innovations which have potential to improve the quality, efficiency and productivity of services across the NHS.

  • Mental Health

Innovations relating to improvements in mental health care. In particular, improving access to services and outcomes for vulnerable service users.

  • Self-Management

Innovations related to improving the self-management of long term conditions. For example; promotion of a healthy lifestyle, increasing access & understanding of key disease indicators, educational materials, improving remote access for patients.

Enter by Wednesday 11th July 2018.”

For more details please see:

Workshop:‘The Positive Deviance Approach: Learning from exceptional performers to improve the quality and safety of care.’ @RuthMBaxter @yqsrdotorg #CLAHRC @ClahrcP

‘The Positive Deviance Approach: Learning from exceptional performers to improve the quality and safety of care.’

Positive deviance is a new approach to improving the quality and safety of patient care which focuses on identifying and learning from those who demonstrate exceptional performance on outcomes of interest. We have expertise in positive deviance and through the workshop we will share our learning and help teams to explore how this approach could be implemented in individual teams. A flyer with details of the workshop is attached.

YQSR flyer


Target audience for the workshop

It is designed for anyone interested in using an asset-based approach to generate improvement (e.g. academics, clinicians) or those who are tasked with making improvements to the quality/safety of care (e.g. quality improvement or audit teams). It’s important that delegates have access to routinely collected data that can be used to measure performance and thus identify those performing exceptionally well (“positive deviants”).

The Positive Deviance Approach: Learning from exceptional performers to improve the quality and safety of care


Any queries please contact

Briefing on Domestic Abuse and Coercive Control for Health and Social Care Workers @ShefSNM ‏@parveenazamali

Sheffield University Interpersonal Violence Research Group is pleased to invite you 

Briefing on Domestic Abuse and Coercive Control for Health and Social Care Workers’ 

10th July 2018 10.00 – 14.00

Barbarhouse Annex, 3a Clarkhouse Road Sheffield S10 2LA

Domestic violence and abuse (DVA) is a major public health and social problem that affects people in every community, culture and country. It can take the form of physical aggression, sexual coercion, psychological abuse and controlling behaviours. Global estimates indicate that about 1 in 3 (35%) women worldwide have experienced some form of DVA in their lifetime. DVA is associated with severe physical and psychological consequences, and victims/survivors need help and support from appropriate professionals and services.

Health and social care professionals, such as medical practitioners, nurses and midwives, social workers, working in any health and social care settings can play a crucial role in identification, prevention and management of DVA. They need to be able to be to provide person centred, sensitive and empathetic care to all their cleints and especially those experiencing DVA. However, DVA victims often report that health and social care professionals blame them for abuse, do not show concern, and do not address the abuse even when DVA is obvious. Evidence also suggests thatr health and social care professionals are often unprepared to deal with DVA victims due to various barriers such as lack of time, lack of training, lack of confidence, knowledge and awareness about DVA and its impact. Considering this the aim of this interactive session is to help participants (medical professionals, nurses, primary care nurses, midiwives, health visitors, domestic violence pracitioners, social workers) understand the complexities of DVA and to help them explore ways to appropriately support those who be experiencing DVA.

It will specifically help participants to:

  • Explore what is DVA and identify its various forms.
  • Describe the impact or effects of DVA on victims and their families.
  • Discuss the complexity of possible presentations of DVA across a range of clinical environments.
  • Understand the factors that may impact on the victim’s ability to disclose DVA and how these may be addressed.
  • Identify the possible actions health professionals can take that may occur as a result of a disclosure of DVA.
  • Understand local pathways to support

Who should attend:

  • Health care professionals
  • Social workers
  • Academics and researchers
  • Health and social care students
  • Anyone interested in the topic

Refreshments will be provided.

Please follow the link for registration and further information here.

Newsletter ~ @HSRN_UK #HSRUK2018

Health Services Research UK news: June 2018

Just a few days to go until the Health Services Research UK 2018 Conference on 4 and 5 July. You can still register last minute here. The NHS turns 70 on the second day of Conference, a timely opportunity to celebrate one of the nation’s most loved institutions (look out for lightning talks on NHS70 across the programme).

Be sure to set aside 15 minutes this week to plan your own path through conference. What abstract themes and workshops grab your attention? This year’s conference includes a wider look at research links across Europe (don’t miss the newsflash on collaboration with the EU after Brexit). Plus, for the first time we have invited abstracts on global health services research, embedded in themes including patient voice, workforce, methods, innovation and quality. We’ll also hear about new opportunities through the NIHR to support health systems research in low and middle-income countries.

Don’t forget to book your place at the conference dinner on Wednesday evening, and take some time out to relax. You’ll find our HSRUK stand in the exhibition hall, at Thursday’s lunchtime AGM and otherwise zipping around. Come and say hello! We’re looking forward to seeing you there.

Kym Lang
Director, HSRUK

What’s new

BRACE: a new rapid evaluations collaboration
The Birmingham, RAND and Cambridge Evaluation (BRACE) Centre is one of the two rapid evaluation centres funded by the NIHR to conduct rapid evaluations of promising new services and innovations in healthcare.

HSRUK Conference
4-5 July 2018
Nottingham Conference Centre


The 11th Health Services Research UK (HSRUK) Conference returns to Nottingham! Presenting the leading edge of health services research in an engaging, multidisciplinary programme. Don’t miss out on our fascinating plenaries, 80 verbal presentations and workshops, our conference dinner, and HSRUK’s annual general meeting. Book now! 
Winter Pressures in the NHS

A recent policy roundtable led by HSRUK and the Health Foundation brought together senior NHS leaders, researchers and specialists to present research and discuss how the NHS can respond to winter pressures and emergency care. You can find a list of resources about the topic in our website.


New HSR call from Arthritis Research UK

Arthritis Research UK is inviting researchers to apply for two new funding calls ‘Stacking the odds towards a cure’. Also see ‘Pushing frontiers in health research’, which will seek to help people live better with arthritis today.

International Perspectives on Evaluation of PPI in Research

The call for abstracts is now open for the International Perspectives on Evaluation of PPI in Research Conference, to take place in Newcastle upon Tyne on 15-16 November 2018. The conference will provide an international platform to critically explore and reflect on the issue of evaluation of patient and public involvement in research.

NIHR funding opportunities
The NIHR has published new funding opportunities to develop individual programmes. This call includes grants for evaluating the Digital111, applied health research, and promotion of mental health among others. Please visit our opportunities page for more details.


Staff wellbeing – why patients should care

A study of routine data showed that NHS organisations with higher levels of staff satisfaction had better patient outcomes. This included reported levels of patient satisfaction – and even some relationship between staff wellbeing and rates of patient deaths.

Find out more about what NHS organisations can do in this blog by Tara Lamont, NHS Deputy Director at the NIHR Dissemination Centre and HSRUK Board member.
Consultation: Priorities in European health research
Many health system challenges are not unique to the UK. TO-REACH is asking for your view on important policy issues that could benefit from cross-European research, to help inform the European Commission’s preparations for a new (Ninth) Framework. Share your views!


Healthcare transitions – a complex journey –
This month’s issue of the CLAHRC Partnership Programme newsletter shows different approaches that the NIHR CLAHRCs are taking in their regions to address complexities in healthcare transitions.


Vacancies at ICNARC
The Intensive Care National Audit & Research Centre (ICNARC) is looking for a statistician to join its dynamic team, and two individuals to join its Board of Management. Find more details in our Jobs section.