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CCG Series: Lewisham CCG on reducing inequalities

CCG Series: Lewisham CCG on reducing inequalities


So two months into CCG establishment and what are we really doing to make inroads into the weight of health inequality? 

Lewisham is a centre of inequality being both one of the most deprived and one of the most diverse boroughs in London and having particularly high incidence of mental health, sexual health and HIV as well as the expected high levels of obesity in both adult and children and alcohol related problems. 

None of this will surprise but what can CCGs do to make improvements in these areas that previous years of well-meaning NHS interventions have failed to do?

The potential is in the power of co-operation. Co-operation between health and local authorities, co-operation between health and GPs and co-operation and understanding of the local population and local voluntary sector organisations. For years each of these groups has been in ignorance of each other’s plans and aspirations have worked in isolation and so made little if any change in health outcomes.

Clinical commissioning with its engagement of member practices, the emphasis on stakeholder involvement and really engaging with the public not to mention the central forum of the Health and Wellbeing Board all have the potential to change this.

In Lewisham the concerns expressed at joint commissioning (council and health) from the council about childhood immunisation rates prompted the CCG to make this its first target. Working with Public Health to provide comparative data to practices, sharing the situation and supporting peer review with back up from the Health Visitors for the hard to reach produced a 10% hike in coverage rates in just 6 months. 

In other areas we have aligned contract levers: CQUINNS in secondary care and QP indicators and Local Enhanced services in primary care to target areas of greatest concern. This has seen improvements in smoking cessation; fall in admissions for COPD and significant improvements in diabetes outcomes. We have also appointed GP leads in strategic areas such as obesity, mental health, alcohol and diabetes to promote improvements and encourage greater partnership understanding .

The Health and Wellbeing Board has been united in identifying priority areas for improvement and as far as possible encouraging participants to use their individual resources to promote these aims. Health and Local authority are also hosting joint engagement events and using these both to promote health priorities and listen to the concerns of the population. 

So significant improvements have already been made but the potential for more is there provided we maintain current levels of engagement and enthusiasm.



If your CCG has something to share, don't hesitate to contact Lalah-Simone Springer ( for more information. 


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