Change that leads to better lives

Addressing health inequalities in Essex - Implementing the Health Equality Framework (HEF)

We have been working with Essex on the development of their health equalities strategy, including the implementation of the HEF.


In early January people with learning disabilities and families came together with practitioners, managers and commissioners from health and social care to talk about the HEF and how to make it happen in Essex. It is still early days, but practitioners and managers agreed that the framework encourages joint working between health and social care staff, a broader understanding of the individual’s circumstance and how that impacts on overall health and wellbeing.

Rosemary Leak, Integrated Learning Disabilities Health Commissioner in Essex, shares the impact HEF has had on their services.

“Having instigated the HEF through our specialist healthcare providers, we have been really pleased with the way that it has helped shape the work they do and the initial outcomes it has delivered for them as practitioners and the people they work with.

One service has incorporated the HEF into their Initial Community Assessment Tool and are routinely gaining a broader perspective of an individual’s life and situation, whilst avoiding any duplication of effort in the assessment process.

We have also heard about some of the basic improvements it can lead to for individuals. There are people who now have a hospital passport or Health Action Plan, have been for dementia screening, or whose staff are able to identify when they are in pain. Without the HEF this might not have happened, or happened at the start of teams’ interventions.

It is also good for the staff to see that the work they do has a measurable impact in someone’s life, and that this information will eventually be used by commissioners to plan at a strategic level for this group of people.”

The ability to bring data together, and thus inform commissioning, Health and Wellbeing Boards and Joint Strategic Needs Assessments is yet to be explored in Essex, but there is huge potential as data from the HEF is easily aggregated.

Of course there are still problems with implementation, not least how the HEF relates to current IT systems, but the positives outweighed the negatives and crucially people with learning disabilities and families support its implementation. They are keen to explore how it can help reduce health inequalities for people with learning disabilities, and get a better picture of what is happening in Essex.

The authors of the HEF have updated it, based on learning from implementation, with step by step guidance to support practitioners and managers. Called the HEF+, it is available to download here, along with lots of other relevant resources.

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