This report shares reflections, learning, and possibilities for positive change that arose from a collaborative Inclusion Health Learning Programme led by Pathway, the leading homeless and inclusion health charity, in partnership with Groundswell and supported NHS England.
Convened by Pathway Fellow Gill Taylor, the bespoke programme was rooted in both lived experience and the latest evidence. It brought together seven Integrated Care Systems in a unique learning environment (employing mixed teaching methods) with more than 20 expert speakers, including lived experience facilitators and performers, award-winning clinicians, leading researchers, and practitioners to explore scalable, system-wide strategies to shift the dial on extreme health inequalities facing socially excluded populations.
The report captures a moment of real momentum in the inclusion health field – which focuses on people who experience the most extreme forms of social exclusion, including homelessness. Coming at a critical juncture for the NHS with the imminent launch of the NHS 10-Year plan, the report issues an important call for action to improve the health of the most excluded.
Inclusion health was given its first statutory policy footing in late 2023, with the NHS England Framework for NHS Action on Inclusion Health. The framework builds on the pioneering work of clinicians and practitioners from around the country who have spent the last two decades developing and delivering specialist health services to people experiencing homelessness, addiction, those leaving prison, sex workers and vulnerable migrant communities. The framework introduced five guiding principles, for ICSs, for establishing and expanding activity that tackles the severe health inequalities and appallingly low life expectancies facing inclusion health groups.
The report describes insights from local systems on their efforts to embed the framework, and reflects on examples of promising practice and innovation in key areas. We heard from people working in systems and from expert speakers about innovative co-production with lived experience groups, bold strategic leadership, unique approaches to data and evaluation as well as developments in safeguarding, workforce development, and preventative healthcare.
Published during an intense period of change in our health system, the report also reflects how systems have navigated significant local and national challenges to achieve positive outcomes and secure inclusion health provision into the future. Nonetheless, despite strong engagement and innovation at the local level, achieving fundamental improvement for this population is hampered by systemic barriers such as fragmented data collection, short-term and siloed funding pathways, and cross-cutting policy gaps.