Drive to reduce health inequalities is HEATing up

The Health Equity Assessment Tool (HEAT) is supporting public health and NHS professionals in Cheshire and Merseyside to address health inequalities and improve programmes and services in a fairer, more equitable way.

HEAT is a framework that allows professionals to systematically review their programme of work or service to ensure that it is as inclusive as possible and actively promotes the reduction of health inequalities.

Using HEAT provides a number of benefits. The clear and straightforward format means that any professional in the health and care system can use the tool in their programmes and services. The tool is also designed to provide meaningful and concrete actions to tackle inequalities and can be adapted for use across a range of different work programmes and services. HEAT also helps to fulfil legal duties relating to inequalities and equitable access for users.

It was originally designed by Public Health England and is now led by the Office for Health Improvement and Disparities (OHID).

Speaking about the tool, Andrew Furber, Regional Director for OHID in the North West, said:

“We are delighted to support our public, private and third sector colleagues with this tool that will ultimately help us meet our shared goal of reducing health inequalities and creating a fairer, healthier society.

“We are delighted to support our public, private and third sector colleagues with this tool that will ultimately help us meet our shared goal of reducing health inequalities and creating a fairer, healthier society.

“HEAT has been carefully developed over many years to ensure that it is robust and as user-friendly as possible, and we’re dedicated to constantly learning and making improvements as we continue our journey of tackling health disparities. I would encourage anyone who is running a programme or service to embed this tool into their work, they’ll be surprised at just how easy it is!”

The development of this tool is set against the backdrop of an increasing awareness and understanding of inequalities in the country and how this relates to health.

In Cheshire and Merseyside, inequalities within the subregion’s nine local authority areas have resulted in many people living in poverty and deprivation, which negatively impacts health.

Because of this, life expectancy is lower for men and women, many areas are below average levels of healthy life expectancy, the COVID-19 mortality rate is higher than average, levels of fuel poverty have been higher than average since 2016 and areas also struggle with increasing levels of alcohol and drug misuse.

Earlier this year, the Collaborative, alongside Cheshire and Merseyside’s Population Health Board, welcomed the publication of All Together Fairer, the subregion’s report and strategy into health inequalities from Professor Sir Michael Marmot and his team at the Institute of Health Equity.

The report detailed the variety of inequalities in the subregion and set out measurable actions for each area, as well as the subregion as a whole, to create a fairer, equitable society.

Working together under the umbrella of All Together Fairer, public, private and third sector organisations in Cheshire and Merseyside are now collaborating as one system to implement the recommendations within the report and do everything in their power to build a fairer, healthier subregion.

Ian Ashworth, Director of Public Health for Cheshire West and Chester and Lead Director for All Together Fairer, said:

“I am delighted that in Cheshire and Merseyside, we are becoming ever-more connected with our strategic intelligence and are making use of resources like HEAT that really make a difference.

“If we want to reduce inequalities and improve health, we must be at the forefront of innovation and always thinking one step ahead, which is why I’m so glad that our talented colleagues at OHID are supporting our subregion with this tool.”

HEAT in Practice: Innovation Agency’s use of HEAT to support diversity pledges

The Innovation Agency runs a number of innovative programmes and projects across the North West Coast, including Cheshire and Merseyside, acting as one of 15 Academic Health Science Networks (AHSNs) in the country.

The organisation reviewed its Equality, Diversity and Inclusion agenda, supported by The AHSN Network, and pledged to undertake health equity assessments across all its programmes of work, using HEAT, by March 2022.

Following a period of training and adopting the tool, HEAT was embedded into a variety of projects and the Innovation Agency quickly experienced many positive outcomes and benefits. This included the identification of a more inequalities and patient-focused approach to COPD and asthma discharge and care bundles, the development of a subregional respiratory website for patients, carers and clinicians, and a stronger emphasis on inequalities when working with the North West Coast paediatrics health and social care network on Paediatric Early Warning Scores (PEWS).

Thanks to HEAT, the Innovation Agency has also delivered unconscious bias training to all staff members and has shared the tool with clinical specialities who are rewriting their policies to also include protected characteristics that were previously not in the policy.

Dr Phil Jennings, Chief Executive of the Innovation Agency, said:

“We know that some of our communities in the North West Coast suffer from more chronic health conditions and some of the lowest life expectancy rates in the country; and we are committed to reducing inequities by working with our system partners and targeting those areas with the worst health outcomes.”

“We have signed up to an AHSN Network series of equality, diversity and inclusion pledges and as part of our work to deliver these pledges I am delighted that we are delivering health equity assessments across our programmes of work and focusing on areas of greatest need, so that improvements and innovations in care are available to all parts of the population.”

To read the Innovation Agency’s diversity and inclusion pledges, please visit:

To find out more about HEAT, please visit:

OHID, in partnership with Health Education England, is offering free training on how to use HEAT. To find out more, please contact