What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?​

The difference in healthy life expectancy is as much as 12 years across socio-economic divides in North Wales. Our challenge is our ambition: a need to address the risks associated with a status quo leading to citizens of North Wales losing healthy years of life and living longer with more complex but unmet needs due to the inequalities that exist.

As a Health Board, we are only part of the story in reversing health inequalities: the wider determinants of health are drivers of how healthy people are, and inequalities in these factors are a fundamental cause of health inequalities. This brought a challenge and opportunity to us: how can we work across the system to build collective, inclusive action?

We set out to create a programme which could serve as a blue-print for primary care, as advocates for population health in their community to shift the status quo.

What does your project aim to achieve?

Our transformation programme brought together principles of whole systems convening, cultivating communities of practice, social learning, change management, improvement methodology and behaviour change. We wanted to inspire others and build on people’s entrepreneurial spirit to deliver a more adaptive, innovative response to address health inequality.

The resulting outputs from work to date culminated in teams designing outlines of local initiatives contributing to a shared goal of collective action to address health inequalities in their community. We aimed to encourage participants to be creative and feel inspired to ‘do different’.

Early results indicate synergies created added immense value to participants: 90% of participants found the opportunity in support of their professional development, helped build new connections, inspired them to make a difference in their area of work and had increased their knowledge on health inequalities.

Our aims is to now boost the culture, capabilities and structures needed for embedding the blue-print.

How will the project be delivered?

The programme approach to create pace and momentum is underpinned by industry best practice MSP®. The infrastructure describes a 12-month programme including 5 elements as a catalyst for change.

Our benefits profile describes the capabilities, outcomes and benefits that can be achieved.

With our aim to boost the culture, capabilities and structures needed for embedding the blueprint the intention is to:

• Embed the programme within primary care to support the ambitions of multi-agency working as part of Accelerated Cluster Development
• Explore the inclusion of a Health Inequality Truth Commission within the approach to consider different means of citizen involvement
• Shape and develop the community of practice including connection with the Academy for Health Equity & Prevention
• Work in collaboration with Future Generations Office, 2025 Movement, Strategic Programme for Primary Care and the Wider Determinants of Health Unit to enhance and develop the blueprint

How is your project going to share learning?

The potential for shared learning is significant: during 2023, the inverse care law programme brought together 156 people across 3 primary care innovator clusters including 28 community and voluntary organisations allowing us to share learning.

We envisage to share this via:

• Set-up of a Q SIG for the programme, inviting membership and expertise from others including members from the Community of Practice Leadership programme
• Host a sharing session for our #BetterByBetsi community, a 517 strong team of improvement champions
• Capture value and impact via a case study for publication
• Share learning with key alliances such as the Future Generations Office, 2025 Movement, North Wales Insight Partnership, Strategic Programme for Primary Care, All Wales Wider Determinants of Health Community of Interest and the All Wales Strategic Programme for Primary Care
• Share learning via Bevan Fellows involved with the programme