Agenda item

The Health and Wellbeing Board is RECOMMENDED to:

1.    NOTE the progress made in embedding the Marmot approach, using the 8 Marmot principles as a framework for understanding inequalities, and strengthening system-wide action on health inequalities in Oxfordshire.

2.    NOTE the next phase of delivery, focused on converting insight and deep-dive recommendations into agreed actions, clear ownership and measurable outcomes.

3.    AGREE that Marmot related equity measures should be embedded within the refreshed Health and Wellbeing Strategy outcomes framework to strengthen oversight and accountability.

Kate Holburn (Deputy Director of Public Health) and Jessica Allen (Deputy Director- Institute of Health Equity) presented the Marmot update. Members were reminded that Oxfordshire had formally adopted the Marmot Place approach as a framework for addressing health inequalities and improving population wellbeing through action on the wider determinants of health. The Deputy Director explained that the Marmot approach recognised that health outcomes were influenced by a broad range of social, economic and environmental factors, including housing, education, employment, income, transport, community resilience and access to services. Accordingly, the programme required a coordinated, whole-system response involving organisations across the public, voluntary and community sectors. 

The Deputy Director of Public Health explained that significant progress had been made since Oxfordshire adopted the Marmot Place framework. Work had focused on embedding Marmot principles across existing programmes and partnerships, whilst also strengthening the evidence base relating to health inequalities within the county. Although Oxfordshire was often perceived as a relatively affluent county, county-wide averages masked significant inequalities experienced by particular communities and neighbourhoods. A central ambition of the programme was therefore to improve understanding of these inequalities and ensure that policy and service delivery were informed by a more comprehensive appreciation of residents’ lived experiences.

Members were informed that extensive engagement activity had been undertaken with communities across Oxfordshire. Over 700 residents had participated in engagement exercises designed to capture lived experience and improve understanding of the issues that mattered most to local communities. This engagement had included both urban and rural communities and had sought to reach residents who were often underrepresented in traditional consultation processes. The findings had highlighted a range of recurring themes, including concerns regarding access to services, cost-of-living pressures, housing quality, transport connectivity, social isolation and employment opportunities.

One of the most significant findings from the engagement programme had been the variation in experiences across different parts of Oxfordshire. Whilst some challenges were common across the county, it was apparent that communities experienced these issues in different ways depending upon local circumstances. Rural communities frequently highlighted concerns relating to transport, access to services and social isolation, whilst urban communities often raised issues associated with housing affordability, deprivation and the pressures associated with rapidly growing populations. The Marmot Place programme therefore sought to ensure that action was tailored to local circumstances rather than relying upon a single county-wide approach. 

The Board heard that considerable work had also taken place to align the Marmot Place programme with other major strategic initiatives across the county. The Deputy Director of Public Health explained that Marmot principles were increasingly influencing the development of the Health and Wellbeing Strategy, the Better Care Fund, neighbourhood health planning work and broader partnership activity. Particular emphasis was being placed on prevention, early intervention and reducing inequalities, ensuring that these themes became embedded within the design and delivery of services.

Barbara Shaw welcomed the emphasis on lived experience and emphasised the importance of ensuring that engagement became an ongoing feature of the programme, and that communities remained actively involved in shaping priorities and influencing action. 

The Board RESOLVED to:

1.    NOTE the progress made in embedding the Marmot approach, using the 8 Marmot principles as a framework for understanding inequalities, and strengthening system-wide action on health inequalities in Oxfordshire.

2.    NOTE the next phase of delivery, focused on converting insight and deep-dive recommendations into agreed actions, clear ownership and measurable outcomes.

3.    AGREE that Marmot related equity measures should be embedded within the refreshed Health and Wellbeing Strategy outcomes framework to strengthen oversight and accountability.